Updates in the Management of CRPC - Episode 14
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Multidisciplinary treatment environments enhance the care provided to patients with advanced prostate cancer. In most situations, this treatment strategy includes input from urologists, medical oncologists, and radiation oncologists. However, despite the demonstration of improved outcomes with this approach, several hurdles face the widespread integration of these systems.
In some large metropolitan locations, where logistics can be challenging, multidisciplinary clinics are even more critical, since traveling could take several hours, suggests David I. Quinn, MD. Realistically, getting every possible specialist together in one location is impossible. In general, even if only two specialists can see each patient, better outcomes can still be achieved, Quinn believes.
The need for collaboration is increasing, as the number of therapies available to treat prostate cancer continues to grow, Quinn suggests. To address this, virtual tumor boards and telemedicine can be utilized to alleviate some of the challenges associated with multidisciplinary care. Moreover, teleconferences could help move multidisciplinary treatment approaches into even smaller community settings, Quinn believes.
The medical oncologists and urologists share the same patient rooms at some institutions in order to foster collaboration, Stephen J. Freedland, MD, notes. In some situations, formal tumor boards are generally only formed to discuss the treatment of newly diagnosed patients, rather than those with advanced disease. In addition to improving care, the multidisciplinary environment facilitates clinical trial enrollment, Freedland notes.
In some situations, physicians in community settings can participate in tumor boards at their local hospital, notes Vahan Kassabian, MD. This is particularly useful for smaller practices that cannot manage in-house systems. In most situations, whether the patient has newly diagnosed or advanced prostate cancer, input from both a radiation and medical oncologists is vital, believes David Albala, MD. Not only does multidisciplinary care elevate outcomes, it also installs confidence in patients that they are receiving a comprehensive review.
It is not necessary for all of the physicians involved in a multidisciplinary team to be located at the same clinic, notes E. David Crawford, MD. The critical component of this approach is the second opinion, whether that is achieved in person or through telemedicine. Collaboration and second opinions are particularly useful for difficult cases, Crawford adds.
Adding to this, Steven E. Finkelstein, MD, notes that simply having two specialists treating patients in the same building does not constitute multidisciplinary treatments. In order to achieve optimal outcomes, the members of the team must also communicate.