The Impact Of Coordinated Multidisciplinary Cancer Service | 53460
Journal of Cancer Science & Therapy
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Introduction: Timely access to cancer treatment is expected to improve patients’ satisfaction and treatment outcome. A joint
multidisciplinary breast cancer clinic (JMDBCC) is developed at the authors' hospital in January 2011 aiming to accelerate
access to breast cancer care. Here, we assess the efficacy of this approach.
Methods: Patients were referred to relevant disciplines in different clinics on different days prior to the development of the
JMDBCC. Metric data of access to care in 2010 represent the pre-JMDBCC era while those during the subsequent 5 years
(2011-2015 inclusive) represent the post-JMDBCC era. The JMDBCC is comprised of 3 separate but closely adjacent subclinics
conducted at the same time representing the 3 main relevant clinic based disciplines, namely, breast surgery, medical
oncology and radiation oncology. A breast cancer coordinator facilitates the navigation of patients between the 3 sub-clinics.
The aim of the clinic is to provide service to new patients within 7 days at each of the following stages: acceptance to first clinic
visit (S1), first clinic visit to completion of appropriate investigations (S2) and completion of investigations to start of active
treatment (S3). Thus, the total duration from acceptance to treatment (S1-3) is aimed to be within 21 days.
Results: Five hundred and fifty (including 49 new) patients attended relevant clinics pre-JMDBCC era. Mean time metrics for
new patients were as follow: 13, 18, 21 and 46 days for S1, S2, S3 and S1-3 respectively. More patients were served each year
during the subsequent post-JMDBCC era with improvement (acceleration) in all time metrics. For example 2797 (including
158 new) patients attended the JMDBC sub-clinics in 2013 with mean time metrics for new patients as follow: 4.3, 5.4, 5 and
15.4 days for S1, S2, S3 and S1-3 respectively. Number of patients and time metrics of other years in the post-JMDBCC era will
be presented in details at the Congress.
Conclusion: A JMDBCC dramatically accelerates access to specialist multidisciplinary care. All institutions managing patients
with breast cancer are encouraged to adopt such coordinated service. The impact of an effective JMDBCC on specific disease
outcome (progression free and overall survival) should be addressed in future studies.
Jamal Zekri has received his higher medical oncology training in Weston Park Hospital (Sheffield, England). He practiced as a consultant medical oncologist at Clatterbridge Centre for Oncology (Merseyside, England) until April 2008. Currently, he is an associate professor at Al Faisal University and the head of medical oncology services at King Faisal Specialist Hospital & Research Centre (Jeddah, Saudi Arabia). He has published more than 50 papers in peer reviewed journals and presented more than 30 abstracts in international conferences.