Praxia for oncology
The cancer as its own record: stage, lines of treatment, cycles given or held, toxicities, and lesions measured over time. It records what you decided and calculates no dose.
There is no oncology demo on this site yet, and that is deliberate. Every other specialty has one you can open from the demos page. This pack’s content — the diagnosis list, the regimens, the supportive-care medicines — was written without an oncologist in the room, and it is being read by one before it is shown to anybody else. It is the specialty where being wrong about a list has consequences beyond annoyance.
If you are an oncologist, that reading is the conversation we would like to have with you.
The cancer is the record, not the visit
An oncology patient’s history is not a sequence of consultations. It is one tumour with a stage, then a first line of treatment, then a second, each a series of cycles that were given, delayed or held — and a set of scans measuring whether any of it is working.
Praxia keeps that shape. The tumour is a record of its own, treatment lines hang off it, cycles hang off the line, and toxicities and assessments attach where they happened. A patient with two primaries has two of them, and nothing is merged into one timeline that reads as though it were one illness.
Lesions measured, and a sum that refuses to guess
Each assessment holds its lesions as rows — a label and a longest diameter in millimetres — and plots their sum against the assessments before it.
Beside the chart Praxia states the change as a fact: 58 to 74 mm, up 27.6%, since the previous assessment. It does not call that progression. The response category is a judgement that belongs to the report, and Praxia stores it as the radiologist’s word rather than deriving its own.
Three lesions out of four is not a sum
If one lesion on an assessment has no measurement, Praxia records no sum for it and leaves that assessment off the chart, with a line saying a lesion has no measurement. A total over three of four lesions is not comparable with the total before it, and a chart that silently compares them is worse than no chart at all.
New lesions reported, and a report that says progression, are both raised — because they were reported, not because Praxia concluded anything. A tumour marker is kept beside the measurements with its own name and value: CEA, CA 19-9, PSA, LDH.
Cycles: given, delayed, or held and why
A cycle carries its number, the date it was planned for, the date it was actually given, the doses as you wrote them, the dose level if it was reduced, and the neutrophils and platelets on the day. If it was held, it carries the reason in words.
Each of those is a thing somebody decided. Praxia does not work out a dose from a body surface area, does not apply a reduction rule to a blood count, and does not say whether a cycle should go ahead. It records that you reduced to dose level 2 and that the count on the day was what it was, so that in three months the record says what happened and who decided it.
Toxicities are recorded against the cycle they followed, with the grade you assigned.
Surveillance, after treatment ends
The years after treatment are where a private record usually thins out, and where a missed interval costs the most. Ten recalls come ready for them:
- Surveillance review
- Surveillance imaging
- Tumour markers
- Mammogram
- Colonoscopy surveillance
- Endocrine therapy review
- Echocardiogram
- Bone density
- Thyroid function
- Influenza vaccination
Performance status is recorded the same way a score is recorded anywhere else in Praxia: you assign it, Praxia stores and plots it, and the direction it calls better comes from the scale’s own definition — ECOG downwards, Karnofsky upwards.
What comes in the pack
Loaded before the first clinic, and every list yours to change afterwards. It is the largest of the ten packs, because oncology carries the most content.
- Three consultation forms — new oncology consultation, treatment review, surveillance visit
- 39 diagnoses, each with its ICD-10 code for insurance claims
- 23 medicines, including supportive care, with the strengths and frequencies you prescribe
- 12 appointment types, each with its length and its fee
- 30 tests and scans an oncology practice orders
- 10 recalls for surveillance
What it does not do
This is the specialty where the gaps matter most, so they are deliberate and they are not going to change.
- It calculates no dose. Not from weight, not from body surface area, not from a creatinine clearance. You decide; it records.
- It does not assign a response category. It sums what was measured and keeps the report’s own conclusion.
- It does not hold or proceed with a cycle. It records the decision you made and the counts you made it on.
- It is not a regimen library. Your regimens are yours, written as you write them.
Read it before anybody else does
There is no oncology demo yet, and there will not be one until an oncologist has been through the diagnosis list, the regimens and the supportive-care medicines. If you are an oncologist, that reading is the conversation we are asking for.