‘Tumor Boards’ Bring Many Experts to One Patient

The adage “two heads are better than one” could be rewritten when it comes to cancer care: 15 medical minds are better than one.

That’s the idea behind UNC REX Cancer Care multidisciplinary cancer conferences, in which physicians and providers from multiple specialties come together to strategize about the best treatments for the most complex cancer cases. Patients benefit from the expertise of more than a dozen experts without having to see all of them. Referring physicians benefit from knowing that several specialists are strategizing the best care for their patients.

Each “tumor board” meets once a week and focuses on a different type of cancer. There are groups for breast, thoracic, gynecologic, gastrointestinal, genitourinary and hematology/coagulation, with more likely to be added. Patient cases are presented anonymously—with only initials to identify them—and their imaging scans, test results, biopsies and tumor DNA information are shared with the group members. Together, they brainstorm problems and propose ideas for treatment. Referring physicians are invited to attend the meetings so they stay in the know about what’s happening with their patients’ cancer care.

“These conferences are unbelievably helpful, especially for the physicians who are the front line in terms of treating cancer,” says Hiren Mehta, MD, a pulmonologist who coordinates and oversees the tumor boards. “You have experts in all of these fields discussing what they do well in each case. That makes you feel reassured that these teams are helping to give the best care.”

Dr. Mehta, who attends the thoracic cancer conference weekly, says it’s common for physicians to come up with new approaches at the meetings. It might be a new way to biopsy a difficult-to-reach mass or a new type of immunotherapy being offered. Sometimes physicians know of clinical trials that might help the patient.

One or two doctors can’t know everything, so patients benefit exponentially from having more brains on their case, Jessica Padgett, RN, says.

“It’s kind of like the patient has gone for a second or third or fourth opinion, but they only have to see one doctor,” Padgett says.

A typical tumor board roster consists of at least one medical oncologist, radiation oncologist, pathologist, radiologist, surgeon, clinical researcher, patient care navigator, social worker and dietitian. Specialists such as gastroenterologists and pulmonologists attend as well. Often, more than one of each type of doctor is in attendance, Mehta says; it’s not unusual to have four or more medical oncologists on hand, for example. Even if referring physicians are unable to attend, patient care navigators, such as Padgett, are responsible for making sure they are kept apprised of developments from the board. Oncologists also copy referring physicians on their notes.

“Communication is one of the most important things in medical care,” Padgett says. “It can fix a lot of things to the benefit of the patient.”

UNC REX Cancer Care in Raleigh and UNC Cancer Care in Chapel Hill both offer tumor board conferences.

To learn more, contact:

UNC REX Cancer Care: (919) 784-6878, tumorconference@unchealth.unc.edu

UNC Cancer Care: (919) 445-1000, unccn@unc.edu