Improving outcomes in lung cancer: the value of the multidisciplinary health care team

Abstract

Lung cancer is a major worldwide health burden, with high disease-related morbidity and mortality. Unlike other major cancers, there has been little improvement in lung cancer outcomes over the past few decades, and survival remains disturbingly low. Multidisciplinary care is the cornerstone of lung cancer treatment in the developed world, despite a relative lack of evidence that this model of care improves outcomes. In this article, the available literature concerning the impact of multidisciplinary care on key measures of lung cancer outcomes is reviewed. This includes the limited observational data supporting improved survival with multidisciplinary care. The impact of multidisciplinary care on other benchmark measures of quality lung cancer treatment is also examined, including staging accuracy, access to diagnostic investigations, improvements in clinical decision making, better utilization of radiotherapy and palliative care services, and improved quality of life for patients. Health service research suggests that multidisciplinary care improves care coordination, leading to a better patient experience, and reduces variation in care, a problem in lung cancer management that has been identified worldwide. Furthermore, evidence suggests that the multidisciplinary model of care overcomes barriers to treatment, promotes standardized treatment through adherence to guidelines, and allows audit of clinical services and for these reasons is more likely to provide quality care for lung cancer patients. While there is strengthening evidence suggesting that the multidisciplinary model of care contributes to improvements in lung cancer outcomes, more quality studies are needed.

Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature

“…The literature describing MDT working in cancer care is diverse and increasing in scope and volume with an increasing number of systematic 1 – 3 , 8 and other reviews. 4 The field is growing, as many disciplines alongside traditional health care effectiveness reviewing methodology are becoming involved in understanding MDT working, including psychology, improvement science, organizational science, and others. The diversity of the evidence base in itself presents a challenge to health care professionals, patients and their advocates, as well as those involved in health care organization, who want to improve the care of patients with cancer.…”

Survival of Patients with Small-Cell Lung Cancer Treated at Tertiary Hospitals in the East of Thailand, 2007-2016: A Retrospective Study

“…Moreover, CCH, with three radiation machines and four radiation oncologists, had to service 1900 new cases in 2018. Therefore, to ensure patient care quality and outcomes in the East of Thailand, we need more radiation oncologists, radiation machines, multidisciplinary care teams and meetings, leading to better outcomes in lung cancer patients, in terms of adequate and accurate staging and appropriate treatment modalities [29].…”

New Frontiers for Molecular Pathology

“…Thus, it is advisable that a pathologist should be a member of a multidisciplinary team (MDT). A MDT guarantees relevant treatment options and an individual treatment plan for each patient, which is an obligatory form of personalized medicine (29).…”