Building a Multidisciplinary Team for NETs

Simron Singh, MD, MPH, of Sunnybrook Odette Cancer Centre, and Jonathan R. Strosberg, MD, of Moffitt Cancer Center, describe the makeup of a multidisciplinary neuroendocrine tumor (NET) team with moderator Daniel M. Halperin, MD, of Winship Cancer Institute of Emory University. Singh lists medical oncology, surgery, nuclear medicine, gastroenterology, endocrinology, advanced practice providers, pathology, and radiology, and stresses that no single approach fits every patient. The team can work through virtual discussion, a tumor board, or a combined clinic, as long as care is coordinated. Strosberg notes that NET care is more multidisciplinary than most cancers, with surgeons debulking distant metastases, interventional radiology treating the liver, nuclear medicine delivering peptide receptor radionuclide therapy, and cardiology managing carcinoid heart disease, often coordinated by a medical oncologist. He shares a recent tumor board case in which surgeons were able to resect close to 90% of extensive liver disease that he had assumed was too widespread for debulking.