Multidisciplinary approach to cancer

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Management of cancer involves a number of clinical disciplines. A straightforward presentation of a cancer can (and should) draw on these and other health care professionals.

With the development ofmore effective additional therapies for cancer (radiotherapy, chemotherapy), the management of cancer has become increasingly complex. No single clinician has all the skills needed to treat all cancers. This has led to the development of multidisciplinary teams that deal with certain types of cancer. Many professions allied to medicine have major roles to play in these teams (e.g. physiotherapists, stoma nurses, counsellors). The team may include individuals who are not directly involved in the treatment at presentation but have adjunctive roles at some stage in the course of the illness (e.g. palliative care). The composition of the team will vary considerably between institutions— and disease states. There must be a sufficient range of expertise to allow for informed discussion of the management policy for individual patients. The team's various roles include:

♦ To plan diagnostic and staging procedures, primary treatment approach, and any adjuvant therapy to be delivered pre- or post-operatively.

♦ To prepare patients physically and psychologically for anti-cancer therapy and subsequent follow-up.

♦ To provide information on treatment, prognosis, side-effects, and any other pertinent matters (e.g. stoma care).

♦ To efficiently plan and deliver surgery, radiotherapy, and chemotherapy as appropriate.

♦ To aid rehabilitation from the illness.

♦ To provide appropriate follow-up care.

♦ To ensure the transition from curative to palliative care is appropriately managed.

Management within such a team structure results in better outcomes for patients. Studies demonstrate survival advantages but, equally importantly, patients also have functional, psychological, cosmetic, and quality of life benefits.

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