At the heart of the experience of being a patient with cancer and receiving excellent cancer treatment, we have placed “patient-centered, specialized, and integrated multidisciplinary care,” which involves professionals with expertise in all of the major treatment modalities and those skilled in providing appropriate support. Also, as cancer survivors pick up the reins of their lives, a conscious and well-planned supportive framework is essential to ensure they reclaim their lives. Prevention, screening, prompt diagnosis, and rapid referral are critically important facets of every plan at a local, regional, national,and international level to improve cancer control and cancer outcomes. To place the MDT in context, we have summarized features of “best cancer practice” in Sidebar 1. 4 Multidisciplinary care will be central to that effort. 5 We have estimated that using best practice could improve overall survival to 60% and that maintaining the momentum in existing cancer research programs could further improve that toward 70% long-term survival by 2035. For example, it has been estimated that our failure to implement best practice has resulted in 50,000 to 100,000 avoidable deaths every year, even in Europe. 4 However, there remains tremendous variation globally. Improvements in the diagnosis and treatment of cancer have increased patient survival to greater than 50% in many developed countries, and the best results now approach 60% long-term survival. However, we will concentrate on multidisciplinarity in the delivery of the care of individual patients by an MDT and its importance in developing cancer care services globally. A broad range of disciplines influences cancer prevention, screening, service planning, and support for patients with cancer and survivors. The input of a wide range of professions and disciplines into cancer control, cancer research, and cancer care is a key feature of team science in the laboratory, clinic, and epidemiology. We will then focus on four areas of development and innovation that we suggest are important to the future: (1) molecular pathology and informatics, (2) clinical trials, research, and innovation, (3) patient engagement and empowerment, and (4) patient-reported outcome (PRO) measurements (PROMs). In this article, we will first summarize the current position of multidisciplinary care, the evidence for its impact, and its place within a comprehensive approach to cancer control. 1 - 3 However, there remain challenges as to how it should be delivered most efficiently, the scale of its impact, and the ways in which research and innovation, integrated into a multidisciplinary approach, can improve outcomes for patients with cancer. Multidisciplinary cancer care has an established position internationally and has been recommended by cancer organizations, governments, and learned societies as best practice since 1995. Patient-reported outcome measures will improve MDTs' insights into their patients’ problems and symptoms and can improve patient outcomes. Patient engagement and empowerment in MDTs should improve patient satisfaction and outcomes. MDTs should be research active, delivering clinical trials, and this should improve outcomes for all of their patients. Good informatics is essential to deliver the information to patients and the MDT. New point-of-care testing technologies will improve the quality and timeliness of testing. Increasing information from molecular pathology will increase the precision of their decisions, although the technologies remain expensive and may not be accessible in all countries for some time.
#JOHN MCVIE CANCER REMISSION 2017 SERIES#
MDTs will be improved by a series of ongoing innovative developments. Patients need carefully prepared information to help them share in the decision-making process. They must be well organized, efficient, and well led work with sound and timely information and communicate well within the team and with their patients. Although the literature is patchy in quality, MDTs contribute to improving cancer care and outcomes. Here, we set out the functions and approaches of MDTs and review their impact. Multidisciplinary teams (MDTs) have been recommended as a key part of best cancer care for 25 years.