Multidisciplinary approach to cancer care in Rwanda: the role of tumour board meetings

Abstract

Introduction: Cancer treatment is complex and necessitates a multidisciplinary approach. Tumour Board Meetings (TBMs) provide a multidisciplinary platform for health care providers to communicate about treatment plans for patients. TBMs improve patient care, treatment outcomes and, ultimately, patient satisfaction by facilitating information exchange and regular communication among all parties involved in a patient's treatment. This study describes the current status of case conference meetings in Rwanda including their structure, process and outcomes. Methods:The study included four hospitals providing cancer care in Rwanda. Data gathered included patients' diagnosis, number of attendance and pre-TBM treatment plan, as well as changes made during TBMs, including diagnostic and management plan changes.Results: From 128 meetings that took place at the time of the study, Rwanda Military Hospital hosted 45 (35%) meetings, King Faisal Hospital had 32 (25%), Butare University Teaching Hospital (CHUB) had 32 (25%) and Kigali University Teaching Hospital (CHUK) had 19 (15%). In all hospitals, General Surgery 69 (29%) was the leading speciality in presenting cases. The top three most presented disease site were head and neck 58 (24%), gastrointestinal 28 (16%) and cervix 28 (12%). Most (85% (202/239)) presented cases sought inputs from TBMs on management plan. On average, two oncologists, two general surgeons, one pathologist and one radiologist attended each meeting. Conclusion:TBMs in Rwanda are increasingly getting recognised by clinicians. To influence the quality of cancer care provided to Rwandans, it is crucial to build on this enthusiasm and enhance TBMs conduct and efficiency.

Exploration of Clinical Ethics Consultation in Uganda: A case study of Uganda Cancer Institute

“…These approaches are similar to clinical ethics resolutions used in different settings globally. (22,23) Unlike the structured clinical ethics consultation services prevalent in developed nations, fora utilized to resolve ethical dilemmas at the UCI, while integral to their established roles, have been scrutinized for their implicit and non-ethics-focused nature. While these existing platforms serve their intended purposes, they fall short in adequately resolving complex ethical issues.…”

“…This collaborative approach mirrors practices in Rwanda, Kenya, and Botswana, where similar strategies are employed in cancer settings to address complex dilemmas within cancer wards. (23,(29)(30)(31) Intriguingly, only a minimal number of respondents in this study experienced this collaborative approach. Notably, the tumor board meetings were not primarily convened for ethical and moral case deliberations.…”