Cancer in Developing Countries: Facing the Challenge
Tumour Board - Best Practice in Patient Care
At the outset of the Scientific Forum, a simulated "tumour board" was presented. It provided insight into a cancer patient´s medical care management and added a human dimension to cancer´s impact on a patient´s life. A tumour board is a treatment-planning method involving a number of doctors, who are experts in different specialties. Together, they review and discuss the patient´s medical condition and treatment options. In cancer treatment, a tumour board review may include a medical oncologist and radiotherapist, who provide cancer treatment with drugs or radiation; a surgical oncologist, who provides cancer treatment with surgery; medical imaging specialists, who detects cancer using medical images; and a pathologist, who provides information derived from biopsy.
The Tumour Board (or Combined Clinic) represents the decision-making process that collectively determines the best possible treatment for a patient. In the simulation held during the Scientific Forum, the radiation oncologist led the multidisciplinary panel, comprising the medical oncologist, surgeon, radiologist, nuclear medicine physician and pathologist. Significantly, this decision-making process in oncology took the brave step of including a patient to demonstrate the benefits of a holistic patient-centered approach.
The tumor board demonstrated the benefits of assembling in a single room the combined decision-making expertise of all the relevant medical specialists. This approach is not limited to high-technology environments; rather, it is relevant for all cancer departments in the developed and developing world. The medical staff treating and caring for patients should be present in a combined clinic to make a collaborative decision on the best possible treatment for each patient given the available options.
The Tumour Board portrayed an ideal setting, in which the doctors and the patient had unhindered access to state-of-the-art technology. In the subsequent discussion period, Forum participants focused on the inequities in access to cancer care that exist between the developing and developed world. The "role-playing" enabled the participants to relate their own work to reduce human suffering and improve cancer care. The simulation and the following discussion helped to highlight the human suffering caused by the enormous shortfall in resources and capacity that severely hinder developing countries´ ability to deliver effective cancer treatment.
- Penelope Engel-Hills, Professor of Radiography, Cape Peninsula University, South Africa.
- Homer Aquino Macapinlac, Professor, Department of Nuclear Medicine, University of Texas, USA.
- Maria do Socorro Maciel, Chief of Breast Department, AC Camargo Hospital, Brazil.
- Nancy Read, Professor of Radiation Oncology, University of Western Ontario, Canada.
- Gunilla Svane, Professor of Radiology, Karolinska Institute, Sweden.
- Puay Hoon Tan, Head, Department of Pathology, Singapore General Hospital.
- Theodor Vandenberg, Associate Professor, Department of Oncology, University of Western Ontario, Canada.