Most have heard the term multi-disciplinary cancer care, but what does this mean and how does it benefit you as a patient?
Oncology can be extremely complex with many new discoveries and improvements in current therapy being made on a daily basis. This can pose great difficulty to any specialist dealing with oncology patients as these new developments require medical personnel to be consistently keeping up to date with multiple areas in oncology that may not always be part of one’s daily practice.
Cancer patients are most often treated by many specialists from diagnosis to survivorship. Due to the large number and range of healthcare professionals treating cancer, there is great potential for poor communication and poor co-ordination among specialists. It’s of utmost importance that all these specialists communicate effectively among each other to ensure that the patient can access the best available treatment at the correct times.
Understanding multi-disciplinary cancer care
Multi-disciplinary cancer care refers to an integrated team approach to cancer treatment and involves multiple medical specialists and allied healthcare professionals who are involved in patient care.
The team works collaboratively to consider all the best available treatment options and to collectively determine the best individual plan for a patient.
The team typically comprises surgeons, oncologists, radiologists, pathologists, nuclear physicians, gynaecologists, palliative care physicians, general practitioners, cardiologists, haematologists, physiotherapists, psychologists, and any other person involved in the care of the cancer patient.
In an ideal setting, patient care is discussed by the team at diagnosis, prior to any treatment being offered to the patient, and may be re-discussed at various intervals depending on the course that an individual patient may take.
Team discussion facilitates the smooth co-ordination of treatment and allows patients to access different components of their treatment at the correct times. It’s important that the team communicates all decisions to the patient’s primary care provider.
Who puts the team together?
In many cases, surgeons are involved in initiating multi-disciplinary referral and discussion as they most often are involved in the initial diagnosis of a cancer.
The team of doctors is determined largely by the surgeon’s relationships with the doctors he/she works with, and the doctors that are involved in the multi-disciplinary team. The team should not be confined to a particular institution and should rather include interested specialists.
Patients also have the power to request the involvement of individual doctors of their choosing, and may even request that their case is discussed in a multi-disciplinary forum before starting treatment to ensure optimal cancer care.
Following this kind of discussion, it’s good to get feedback from your doctor regarding the opinions expressed by members of the team.
The benefits of multi-disciplinary cancer care
The patient benefits in being able to gain access to the best available, most up-to-date treatment plan that has been scrutinised by many specialists.
Treating doctors also benefit in getting peace of mind that they are offering their patients the best care.
Research has shown that in many cases, cancer diagnoses and treatment plans have been revised after multi-disciplinary discussion with better adherence to evidence-based guidelines. Patient satisfaction with the operation of multi-disciplinary teams is also known to be excellent.
Multi-disciplinary cancer care has been endorsed internationally and teams have been set up in most major international and local centres where cancer patients are treated.
Multi-disciplinary cancer care may be delivered in different models. In some centres the team may consult the patient simultaneously in a multi-disciplinary clinic.
In other models, cases are discussed by the team which meets on a regular basis and decisions are communicated to the patient by an individual specialist who is co-ordinating that particular case. Often these clinics tend to be tumour or organ specific.
Because of the increasing demand for these types of discussions from medical practitioners and patients, most local centres have established multi-disciplinary teams to care for cancer patients. Rural teams may also be included via video call or teleconferencing.
Multi-disciplinary cancer care is a time-consuming endeavour and requires good leadership and commitment from all specialists in the team. In most cases, specialists welcome the assistance and support of the multi-disciplinary team as it provides excellent learning opportunities and support for clinical decisions.
In an era of improved patient advocacy, it’s important that cancer patients become aware of the benefits of multi-disciplinary care for themselves, and to the greater good of oncology.
If a patient isn’t certain if their case has had the benefit of team discussion, it’s vital to raise this with one’s primary care practitioner or the treating specialist who may then enquire about the resources available in their local working environment.
MEET OUR EXPERT – Dr Ria David
Dr Ria David is a medical oncologist and specialist physician with special interests in breast-, colorectal and haematological malignancies. She works at Oncocare at the Durban and Umhlanga offices and serves on the executive committees of the Durban Breast Cancer Forum and the Cardio-Oncology Society of Southern Africa.