At the Ambassador of Hope Gala held recently, the following question was asked of the people in attendance, "How many of you here tonight have had cancer, had a family member or close friend with cancer?" The answer did not surprise me, but it was still astounding to see 99 percent of the several hundred people in the room raise their hands. As a practicing radiation oncologist for the past 21 years and one of the attendees in the room that night who raised their hand, I have seen the look of shock, fear, loneliness and isolation when a patient hears the words "cancer," "tumor," or "malignancy."
Following the diagnosis of cancer, patients usually undergo a series of diagnostic tests possibly including radiology imaging exams, additional biopsies and lab tests. This process is all part of the term to which cancer physicians refer as "staging." From these procedures the patient and their oncology physicians learn information which will guide treatment recommendations.
Patients seeking cancer care at The Nebraska Medical Center soon realize they are not alone but have a large team of specialists working on their behalf. The medical center often uses the phrase "multidisciplinary cancer care."
At The Nebraska Medical Center, there are multiple levels of multidisciplinary cancer care. First a tumor board conference is held. At this conference, most newly diagnosed cancer patient cases are discussed. Almost every tumor conference will have multiple cancer specialists present including surgical oncologists, medical oncologists, radiation oncologists, pathologists and radiologists. Oncology nurse case workers and tumor registry staff members also participate in the meeting.
This group discusses treatment options and recommendations based on a particular patient’s cancer history, the staging of the cancer and individual factors. Frequently, the treatment may involve a combination of surgery, radiation therapy and chemotherapy. Multidisciplinary approach to care has become the best practice, and there are general oncology tumor boards held at hospitals within the region.
Patients seeking cancer care at The Nebraska Medical Center soon realize they are not alone but have a large team of specialists working on their behalf.
The Nebraska Medical Center offers the disease-specific tumor boards on a regular basis. These tumor boards will have the same members in attendance as in the general oncology tumor board with one very important difference; all the specialists have specific interest, education and experience in that particular type of cancer whether it is lung, breast, lymphoma, gastrointestinal, head and neck, neurological, sarcoma, or gynecologic cancer. I am consistently impressed to see the level of knowledge of the oncology subspecialists in the disease-specific tumor boards. Gastroenterologists, pulmonologists, endocrinologists and even dental specialists attend these meetings as the cases call for their expertise.
The medical center also offers patients disease-specific tumor clinics. These clinics are held weekly and allow the oncology specialists to work closely together and allow the patient to see several sub-specialists in one office visit. The oncologists at the medical center frequently update each other on the latest publications pertinent to a patient who is being seen. On this campus, we work together and challenge each other to determine the best possible outcome for each patient.
The National Comprehensive Cancer Network (NCCN) is an alliance of the world’s leading cancer centers, working together to develop national treatment guidelines for cancers based on the latest research. The UNMC Eppley Cancer Center with The Nebraska Medical Center as its clinical partner is one of the founding members of the NCCN. It is a unique honor to serve on their national multidisciplinary committees that develop the natural treatment guidelines for specific type of cancers. Those guidelines are updated annually and frequently more often based on newly published clinical trials or newly approved therapies by the Food and Drug Administration.