June 27, 2022

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Some cancer/tumor patients may require MDT consultation

Some cancer/tumor patients may require MDT consultation

Some cancer/tumor patients may require MDT consultation. Can cancer/tumor patients feel confused about the current diagnosis and treatment plan? In fact, you can choose a better diagnosis and treatment

Why does MDT need so many experts to discuss the condition? It should start from the origin of MDT.

Let me talk about a case first: a patient with rectal cancer in the field, because the mass is close to the anus, was told by the doctor that he would need to remove the anus and perform a colostomy during radical resection of rectal cancer. This made it difficult for the patient to accept, and wondered if there were other treatment options available, but this patient was lucky to make an appointment to MDT consultation.

The MDT expert team is composed of experts from the Department of Oncology, Oncology Surgery, Department of Radiotherapy, Department of Imaging, and Department of Pathology, and conducted multidisciplinary discussions on the patient’s condition. In the end, a different diagnosis and treatment plan was obtained from the original doctor. The expert team agreed that the patient could receive radiotherapy first to reduce the mass, and then undergo radical resection of rectal cancer with anal preservation. After radiotherapy and chemotherapy, the patient successfully underwent radical resection of rectal cancer and retained anus.

After reading this story, I believe that many people have a clear idea of ​​MDT consultation. There may be a question, why does MDT need so many experts to discuss the condition? It should start from the origin of MDT.

1. The history of MDT in Europe and America

In practice, the concept of MDT has a long history.

Half a century ago, American oncologists proposed the clinical diagnosis and treatment model of MDT. The initial MDT was more for teaching needs, so that young doctors could learn different expertise.

Later, with the deepening of understanding of cancer treatment methods and cancer biological characteristics and the development of communication methods such as the Internet, MDT began to be gradually used for clinical diagnosis and treatment of patients, and at the same time, it can also achieve the purpose of teaching.

Before MDT was routinely used in clinical diagnosis and treatment, there was no implementation standard for irregularities in cancer treatment.

Some cancer/tumor patients may require MDT consultation

Until 1995, Calman (Calman-Heine Report) specifically emphasized the importance of multidisciplinary teams, suggesting that all cancer departments in hospitals should arrange for oncology specialists other than surgeons to provide different opinions and service. With the participation of specialists other than non-surgeons, it is believed that a clinician with rich experience in cancer treatment should be appointed to organize and coordinate all cancer medical services in the cancer unit.

The report further recommends that other services such as physical therapy, nursing, diet, speech therapy, counseling and social services should be easy for patients to participate in.

This report promoted the development of MDT in cancer treatment. The British Ministry of Health NHS released the NHS Cancer Plan in 2000, which established the important position of MDT in cancer treatment.

 

Since then, many Western countries have also introduced the MDT model in cancer treatment, and the multidisciplinary team management of many diseases (especially cancer) has become increasingly prominent in patient management. The National Health Service of Wales (NHS Wales) pointed out that a typical MDT should include: chief clinician, team coordinator/secretary, surgeon, oncologist, radiologist, histopathologist, clinical nurse specialist and full-time palliative Treatment nurse.

2. What are the benefits of MDT consultation for cancer patients?

For cancer patients, choosing the best and most scientific treatment plan is the key element of a good treatment effect.

With the rapid development of modern medical technology, tumor treatment methods are diversified, especially for tumor patients in the middle and late stages, a single treatment method cannot achieve the desired therapeutic effect.

Multidisciplinary diagnosis and treatment-MDT

*The multi-disciplinary team (MDT) model, as the name suggests, is a clinical discussion conducted by experts from multiple disciplines for a certain case. For example, MDT is a collection of medical oncology, oncology surgery, and radiotherapy. Experts from various disciplines, including the Department of Imaging, Imaging, and Pathology, work together to formulate the best treatment plan for patients based on the opinions of each discipline.

Many studies have confirmed that the diagnosis plan discussed by MDT is more accurate and more effective than the opinion of a single department. Similarly, even if the diagnosis and treatment opinions of a single department expert are accurate in some cases, MDT consultation can guarantee the accuracy of the diagnosis and treatment plan.

In other words, MDT provides patients with an important second diagnostic opinion. In addition, through active discussions and retrospective case reviews in the meeting, experts gained valuable experience on how to combine treatments to optimize patient prognosis. Multidisciplinary team management can ensure the consistency of patient care standards, which is the main reason why many hospitals start to adopt MDT consultation.

 

For more than 20 years, many Western countries’ multidisciplinary teams (MDTs) have become an institutionalized part of pre-treatment diagnosis in the treatment and care of cancer patients, and are regarded as the gold standard for cancer treatment, even It has been stipulated by some national legislation.

 

Benefits from MDT consultation:

①Avoid a single and one-sided diagnosis and treatment plan and reduce the incidence of misdiagnosis and mistreatment;

② Increase the rationality and individualization of the treatment plan;

③ Shorten the waiting time for diagnosis or treatment of tumor patients;

④Improve the clinical efficacy and prognosis of cancer patients, reduce adverse reactions and improve the quality of life;

⑤ Avoid the burden of constant referral, transfer and repeated examinations in different departments to the patient’s family;

⑥ It saves more time and energy for patients, and reduces or eliminates patients’ anxiety.

In fact, due to some limitations of some countries’s medical system, even if it is known that MDT consultation will improve the survival and prognosis of cancer patients, there is no way to widely develop it in China. Most of the top three hospitals actually implement the MDT model.

Even so, patients and their families should understand the concept of multidisciplinary MDT, and obtain more or less different forms of multidisciplinary opinions in their daily medical treatment, according to their financial ability, medical condition, etc., to maximize the survival and benefit of patients.

 

(sourceinternet, reference only)


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