# The first appointment after a cancer diagnosis Documents, questions and the next step in Romania’s healthcare system. Choose the questions that matter now and take them to the appointment on one sheet. [Complete checklist · PDF](https://mariuscomper.uk/cancer-prima-consultatie/assets/checklist-en.pdf?v=8e7c455f81) ## What should I bring to the first appointment? Confirm the list with the centre you are visiting. Requirements may depend on the appointment and the investigations already completed. - [ ] Confirm what the centre needs: reports, medical letters, images and referrals. - [ ] Prepare copies of reports and images in the format the centre requests. - [ ] Bring a list of medicines, supplements and allergies. - [ ] For another review of the sample, ask who arranges transfer of slides or paraffin blocks. ## Questions for the appointment ### What is known and what is missing - [ ] What diagnosis is confirmed? What information is still missing? - [ ] What do the type and grade in the report mean? Has the stage been established? - [ ] Are further tests relevant to my case? What decision might they change? - [ ] When will the remaining results arrive, and who will explain them? ### The next appointment - [ ] What is the next step, and how urgent is it in my case? - [ ] Who arranges the appointment? What referral do I need, and where do I confirm? - [ ] What should I do if I cannot get an appointment within the time the doctor recommends? - [ ] Has a multidisciplinary team discussed my case? What is its recommendation? - [ ] How do I request a second opinion? Can it be covered, and what documents do I need? ### Costs and support - [ ] Is this service covered at this provider? What would I pay, and why? - [ ] If I cannot prove insured status, what diagnostic pathway is available? - [ ] Am I enrolled in the oncology programme? Is any further paperwork needed? - [ ] Who issues the sick-leave certificate, and what do I send my employer? - [ ] Can the person accompanying me request leave for the surgery or treatment? - [ ] Can I speak with a psychologist, social worker or navigator? How do I contact them? ### Treatment and contact with the team - [ ] Which options are relevant? What are their aims, benefits and risks? - [ ] Is there a relevant clinical trial we should discuss? - [ ] Which symptoms need urgent medical help, and whom do I contact between appointments? - [ ] Who is my contact person, and when are they available? ## Who arranges the next step? ### If further investigations are needed for diagnosis Romanian patient-rights law provides for direction and booking of the next consultation or investigation needed to establish a diagnosis, through a mechanism at the unit where the previous consultation took place. Ask how it works there and which documents are needed. ### For a second opinion You can seek another medical opinion. For insured people, the law provides a second consultation paid through health insurance when justified. Confirm the referral, provider and coverage; this does not promise unlimited consultations or free access to every private practice. ### For multidisciplinary discussion Ask whether specialists from different disciplines have discussed your case, what information they still need and who will explain their recommendation. Confirm the service and procedure with the centre; a hospital’s name alone does not establish them. ### The plan’s 30 days are not a guaranteed deadline Romania’s National Cancer Plan includes the objective of organising diagnosis within 30 days of first suspicion. That objective does not establish waiting times at a particular centre. Ask your team about the recommended timing for your case and what to do if an appointment is delayed. ## What do the terms in the report mean? A pathology report describes the examined sample and the pathologist’s diagnosis. Some results, including molecular tests, may arrive separately. **Type**: The kind of cancer identified in the sample. **Grade**: How abnormal the cells look under a microscope. **Stage**: How extensive the cancer is. Establishing it may require imaging and other investigations; staging systems differ between cancers. **Margins and lymph nodes**: Information that may appear when the specimen allows assessment of the edges of removed tissue or the lymph nodes examined. **Biomarkers**: Tumour characteristics measured by particular tests that may help select treatment. Relevant tests differ between cancers. Ask what is confirmed, which result is still pending and what it might change. An isolated term or value does not determine treatment on its own. ## What should I check about insurance and costs? ### If you cannot prove insured status Where cancer is suspected, reimbursement pathways cover specified diagnostic tests needed to confirm the suspicion, recommended by a family doctor or specialist, and day-hospital diagnostic services, with the required referral documents. These operate through contracted providers and the funding arrangements in the rules. Ask which service is covered at the provider you choose. ### If the diagnosis is confirmed CNAS, Romania’s national health insurance fund, states that people without income enrolled in the national oncology programme are insured and receive programme services and the basic package until recovery. Check enrolment, insured status and eligibility for the recommended treatment separately. ## What support can I ask for, including for a companion? Ask the centre about a psychologist, social worker and patient navigator. This guide does not confirm that these services are available at every provider. ### The patient’s sick leave For people insured for leave and allowances, cancer-related incapacity has special rules, including no minimum contribution-period condition. The maximum can reach one year and six months within the preceding two years, depending on disease stage. The gross rate is 100% of the statutory calculation base, not a guaranteed take-home salary. The certifying doctor and employer can clarify documents and the applicable calculation. ### Leave for the person accompanying the patient A person insured for leave and allowances who, with the consent of a cancer patient older than 18, accompanies them to surgery or specialist-prescribed treatment may receive up to 45 calendar days in a year per patient. Consent covers one person for each intervention or treatment. A specialist’s certificate is required; the allowance rate is 85% of the statutory calculation base. The 2026 one-day allowance reduction has exceptions, including national-programme patients and leave to accompany a cancer patient. Confirm the situation and certificate requirements before estimating payment. ## How can I discuss a clinical trial? The European CTIS portal lets you search by condition and country. Check participation criteria and the site’s contact details, then discuss it with your doctor. Country-level recruitment status does not confirm that a particular site is currently accepting participants or that you are eligible. Ask about the aim, risks, alternatives, visits, travel and any costs you would bear. A registry result is a starting point for a discussion. ## Sources and limits of this guide An appointment-preparation guide for Romania. Laws and official explanations establish general rights and conditions; the provider confirms its procedure and availability. NCI, the US National Cancer Institute, supplies explanations of medical terms, not an individual investigation or treatment plan. The questions and sheets support a conversation with your own care team. Sources checked: 16 October 2026. Review due by 16 January 2027. Source checking is not a clinical review of an individual case. - [Law 46/2003, arts. 4 and 11, amended by Law 27/2026](https://legislatie.just.ro/Public/DetaliiDocument/307696) - [Framework contract, HG 521/2023, arts. 77, 77¹, 92, 97¹–97²](https://legislatie.just.ro/Public/DetaliiDocument/306031) - [CNAS: national programme access, 9 January 2026](https://cnas.ro/2026/01/09/comunicat-serviciile-de-care-beneficiaza-de-la-1-ianuarie-2026-persoanele-inscrise-in-programele-nationale-de-sanatate/) - [National Cancer Plan, Law 293/2022, annex](https://legislatie.just.ro/Public/DetaliiDocument/287309) - [National Cancer Institute: pathology reports](https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/pathology-reports-fact-sheet) - [National Cancer Institute: cancer staging](https://www.cancer.gov/about-cancer/diagnosis-staging/staging) - [Emergency Ordinance 158/2005, arts. 9, 10, 13, 17 and 30¹–30³](https://legislatie.just.ro/Public/DetaliiDocument/66305) - [Law 64/2026: exceptions to the one-day allowance reduction](https://legislatie.just.ro/Public/DetaliiDocument/310545) - [EMA: searching for clinical trials in CTIS](https://euclinicaltrials.eu/search-tips-and-guidance/?lang=en)