An Indonesian family requested help after receiving several different opinions for a solid tumor case. They wanted to understand which precision oncology options were worth discussing before committing to international travel.
Clinical question
Clarifying the next treatment route after mixed opinions
The submitted file included pathology, imaging reports, prior systemic therapy notes, and family questions about local control, immunotherapy, and minimally invasive treatment. The main task was to turn scattered information into a physician-readable review file.
- Origin
- Indonesia
- Focus
- Solid tumor pathway review
- Main need
- Second-opinion preparation
Medical questions prepared for review
- Whether the pathology and immunohistochemistry reports were sufficient for further specialist evaluation.
- Whether additional molecular testing, PD-1 / PD-L1 background, or biomarker review should be considered.
- Whether local therapy, systemic therapy, biological immunotherapy, or a combined approach required discussion.
- Whether the patient needed in-person examination before any treatment-route judgment could be made.
Document preparation
Pathology package
Diagnosis, histology, immunohistochemistry, biopsy site, and report dates were organized into a single review sequence.
Imaging package
CT, MRI, PET-CT summaries and DICOM availability were checked, with attention to lesion location, tumor burden, and progression timeline.
Treatment timeline
Prior surgery, chemotherapy, radiotherapy, targeted therapy, immunotherapy, adverse reactions, and response history were mapped chronologically.
Decision questions
The family’s questions were translated into clinical prompts covering feasibility, risk, treatment order, expected hospital stay, and follow-up needs.
Pathway areas discussed
The case file was prepared around six precision oncology directions: biological immunotherapy, proton therapy, interventional oncology, NanoKnife / irreversible electroporation, iodine-125 seed brachytherapy, and cryoablation. The goal was not to recommend every technology, but to clarify which questions were clinically relevant.
Technology selection must follow diagnosis, staging, tumor location, organ function, prior treatment exposure, and physician assessment.
Coordination process
- File intake: The family submitted available reports, imaging summaries, and the main decision conflict.
- Record structuring: Novacare reorganized the file by diagnosis, staging, treatment history, and open questions.
- Question refinement: Non-clinical concerns were separated from specialist-level medical questions.
- Consultation preparation: The final brief helped the family enter physician discussion with clearer expectations.