Multidisciplinary collaboration in cancer care is becoming the standard philosophy for treating cancer patients. However, due to varying opinions among specialists regarding patient care, not all specialists are working together.
For instance, according to a study published in the scientific journal of the American Society for Radiation Oncology (ASTRO), surgeons often include radiation oncologists too late in a patient’s treatment decision-making process. This is potentially leading to more mastectomies over breast-conserving therapy due to patients being uninformed of all of their treatment options.
During an interview of 318 surgeons and 160 radiation oncologists, researchers delved into the specialists’ practice patterns and attitudes toward multidisciplinary care. According to almost 30% of radiation oncologists, their biggest challenge was other providers failing to include them in the treatment decision process early enough. Correspondingly, nearly half of surgeons stated that almost none of the breast cancer patients they treated in the past year had consulted with a radiation oncologist prior to surgery.
Almost 100% of both surgeons and radiation oncologists had access to a multidisciplinary tumor board, which allows physicians from different specialties to discuss cases with one another. However, a large percentage of radiation oncologists in this study reported concern that they were involved too late in the decision-making process.
Another difficulty in true multidisciplinary care is the differing opinions among specialties regarding standard treatment. Study results showed that surgeons and radiation oncologists varied greatly on treatments for early-stage breast cancer and appropriate margin width. For this reason, the researchers believe developing institutional guidelines will help to avoid provider-based variations in care.
“If such efforts to increase multidisciplinary involvement before surgery are successful, patients may benefit from exposure to a variety of viewpoints before proceeding with definitive local therapy decisions,” Reshma Jagsi, MD, DPhil, lead author of the study and a radiation oncologist at the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, said. “This could lead to their decision-making process being more informed and more in accord with their preferences.”