Lung cancer is the most common cause of cancer death worldwide.1 The diversity of lung cancer stages requires the utilization of multimodality cancer therapies. This is particularly characteristic of later stage disease. Yet in the US, one physician (usually the medical oncologist) assumes overall responsibility for the patient's care across the cancer trajectory. Based on the nature of the patient's disease, physician specialists are sporadically integrated into the treatment plan as dictated by patient need.
A demonstration project in Taiwan was recently reported describing and testing two models of care. One was the traditional single physician care delivery model which was compared to a multidisciplinary team model.2 It was particularly interesting that "the team" in this study was identified not solely as different physician specialists, but as a team that included nurses, social workers, case managers, nutritionists, physical therapists, and psychologists. The team met together over time to evaluate and intervene as required in patients with advanced lung cancer. When results were compared of the team approach and the sole provider model, within an overall sample of over 32,000 patients, those managed by the team approach lived significantly longer than those being cared for by a single physician provider.
Over the years, I have often stated that it was my impression that the ideal highly functional interdisciplinary team that the cancer care team should emulate is the rehabilitation team. When a patient with a spinal cord or head injury is admitted to rehab, nurses, physicians, social workers, physical and speech therapists, case managers, and pharmacists immediately convene to discuss strategies for the ideal care plan. There is a healthy respect for the expertise brought to the patient's bedside by all necessary disciplines.
When I think of the cancer team, for the most part, it is my impression that we still have much room to evolve as the team's expertise is appreciated. Much food for thought as we ponder our future.
Jemal A, Bray F, Center MM, et al. (2011). Global cancer statistics. CA: A Cancer Journal for Clinicians, Mar-Apr; 61(2):69-90.
Pan CC, Kung PT, Wang YH, et al. (2015). Effects of Multidisciplinary Team Care on the Survival of Patients with Different Stages of Non-Small Cell Lung Cancer: A National Cohort Study. PLoS ONE.
FDA Approves Onivyde for Advanced Pancreatic Cancer Marijke Vroomen Durning, RN, 10/27/2015 3 On October 22, 2015, the US Food and Drug Administration (FDA) approved Onivyde (irinotecan liposome injection, Merrimack Pharmaceuticals, Inc.), in combination with fluorouracil ...