What is a Multi-Disciplinary Panel (Tumor Board) Review?
Having more than one expert looking at a case may have different impact when diagnosing and treating cancer, especially for cancer patients with a rarer or more complicated case. Many hospitals and clinics have at least one cancer tumor board which helps specialists to collaborate on these specific cases and discuss potential treatment options, in different areas.
What is a Tumor Board?
It takes much thought to decide the right cancer treatment for an individual case, particularly given the number of therapies and clinical trials available today. Getting another opinion from someone else in another speciality, such as a surgical oncologist or pathologist, may help narrow down the options or open the doors to even more successful customised therapies, such as what chemotherapy medication to use.
Tumor boards have been part of cancer care for decades and are common in most hospitals. Such boards are a multidisciplinary team effort to extensively review and evaluate the medical diagnosis and treatment options available to a particular patient. Such committees will most likely be comprised of surgical, medical and radiation oncologists, along with radiology therapists and pathologists. Other disciplines, such as pain management, may also be pulled in when needed. Although the primary roles can vary between different cancer institutes, the primary objectives of tumor boards are:
Tumor Board Objectives
- Educating health care practitioners
- Assist with patient care decisions and treatment preparation
- Building greater coordination and recognition between the different specialities
Why is Tumor board required?
Research has shown that the multidisciplinary approach is the best way to provide the complicated treatment patients need for cancer; but, it is a task that needs organisational and cultural changes and must be driven by health professionals who can strengthen collaboration within their organisations.
In a traditional setup, a patient would have to bear the burden of going from one doctor to another, describing the context of the situation, care that has been provided so far, testing that has been performed etc. An already exhausted patient with cancer and their caregivers may find this exercise very challenging and lack the skills to handle the situation. However, this “one expert at a time” strategy leaves no space for formal interaction between the various experts to address the case in a systematic manner.
Therefore, a need for coordinated treatment involving numerous physicians and specialised expertise in the management of cancer treatment is critical. A multidisciplinary approach, in which contributions from the primary oncologist, surgeons, radiologists, etc. are combined to diagnose, prepare, and care, to significantly support the patient.
Within the medical fraternity, it is increasingly realised that a multidisciplinary approach to cancer treatment strengthens clinical treatment and introduces a unique standard of care for diagnosis and treatment planning. This strategy is made simpler by the tumor board.
The aim is to support the standard of care in consultation with all experts and to ensure that the patient with cancer has access to the best and most appropriate cancer treatment. Tumor boards reviews carefully all the patient images, pathology reports, etc. during their meetings, and discuss the treatment plan and diagnosis. Several case studies have shown that tumor board meetings improve care preparation and optimise treatment.
Some of the potential advantages of Tumor Board Review include
- Improved Patient care
- Staging Accuracy
- Receiving care per clinical practice and standard guidelines.
- Improved communication
- Cost-effective care
- Improved clinical and patient satisfaction
Within a multidisciplinary environment, patients certainly have plenty to benefit from their cases being reviewed by at Tumor Board. Firstly, a multi-specialist meeting at once will speed up the process. If patients are considering a second opinion on their diagnosis or treatment of cancer, it might take time to arrange appointments with various oncologists or specialists and therefore postpone treatment. With Tumour Board review, patients do not have to wait to hear more ideas and perspectives. In general, their primary practitioner will pass on the latest details and future treatment options to the patient during a tumor board meeting and eventually make a decision.
A significant advantage of these boards is the ability for patients to seek more tailored treatment plans and have higher survival odds. Specialists in different fields, such as surgical oncology or radiation oncology, may know about new treatments or clinical studies the patient may gain from, which their primary doctor may not be conscious about. Such experiences will lead to additional, improved care options for a patient.
Evidence on the effectiveness of Tumour Boards
A 2014 research in the American Society of Clinical Oncology (ASCO) Post found that participation of oncologists in tumor board review has more often than not improved patient outcomes positively. The research involved 1,600 oncologists and surveyed over 4,000 patients with advanced-stage lung cancer or colorectal cancer. Regarding the oncologists, 96% engaged in tumor boards and 54% did so every week. The findings showed greater overall survival for patients while their health care staff participated more often on boards. Patients whose medical oncologist rarely attended board meetings encountered marginally poorer survival.
Increasingly complex cancer care needs a multidisciplinary approach. An efficient tumour board depends on an automated process from gathering and planning patient data to recording treatment plans, irrespective of the meeting format. One of the key benefits of a tumour board is to ensure that the best diagnostic testing and treatment options are considered for a patient.
The international survey of members of ASCO found that doctors rely not only on tumor boards to finalise diagnosis, but also alter treatment plans based on details shared during the meeting. Survey respondents identified improvements in the form of procedure, cancer stages and pathology in cases of breast and colorectal cancer. Overall, 96% of 430 respondents said that the benefit to patients is worth the time and energy spent planning and engaging in tumor boards
Research by Foster and colleagues in 2015 also demonstrated how clinical guidelines have been affected by tumour board review. Throughout the analysis, 19 tumour board review examined 76 breast cancer cases (43 malignant cases and 33 benign diagnoses) across six sites throughout Canada. Results showed improvements in 31 patients’ treatment strategies (41 per cent), including avoidance of immediate surgery, change in method of procedure, non-invasive examination of invasive/surgical operation, and new suspected lesion identification. Much of the improvements occurred in light of new or clarified knowledge about diagnostic imaging or histopathology.
The ZenOnco.io tumour board advantage:
- ZenOnco.io is committed to upholding the best global standards and treatment guidelines.
- ZenOnco.io is closely linked with some of the leading experts in oncology. Our tumor board seeks advice from specialists around the world through video conferencing when required to access the best clinical opinions that are subject to thorough review prior to implementation.
- Our tumor board also consists of organ-site experts. (Example- Breast Cancer, Colon Cancer). This enables us to align the organ-site approach with standard guidelines.
ZenOnco.io’s tumour board members:
At ZenOnco.io, the tumour board review consists of oncology specialists such as:
- Medical oncologist typically uses chemotherapy to treat cancer or other controlled treatments such as hormone therapy and immunotherapy. The oncologist will also direct the general care of a patient and coordinate the diagnosis with other specialists. With long-term routine check-ups, a patient would most often visit their medical oncologist.
- A surgical oncologist is specially qualified to remove the tumor and surrounding infected tissue during surgery. Often, a surgical oncologist can be called upon to perform a biopsy during a diagnosis of cancer.
- Radiologists are medical doctors specialised in the diagnosis and treatment of diseases such as cancer, using imaging methods, such as x-rays, computed tomography ( CT), magnetic resonance imaging ( MRI), nuclear medicine, positron emission tomography ( PET) and ultrasound.
Fee of Tumor Board Review:
The fee of ZenOnco.io Tumor Board Review is Rs 4,000 to Rs 7,000, depending on individual consultation fee of each panel oncologist.
Today, multidisciplinary tumour boards in hospitals and health systems put together cancer experts to review patient cases and develop tailored care options. Although the size and complexity of tumour boards differ, they tend to adopt a general procedure and meeting format that can be improved by a structured, streamlined workflow from pre-meeting data collection to post-meeting decision documentation and next steps. Tumour board review at ZenOnco.io provide a variety of diagnosis and care management opportunities with the primary aim of optimising patient treatment
Your Next Step:
The best way to learn about how we can help you at ZenOnco.io is to call a Patient Care Manager (PCM) at +91 99 30 70 90 00
3. Foster, Tianne J., et al. “Effect of Multidisciplinary Case Conferences on Physician Decision Making: Breast Diagnostic Rounds.” Cureus 8.11 (2016). 4. El Saghir, Nagi S., et al. “Global Practice and Efficiency of Multidisciplinary Tumour Boards: Results of an American Society of Clinical Oncology International Survey.” Journal of Global Oncology 1.2 (2015): 57-64.