Supportive care in oncology Learning Zone
Transcript: Role of the multidisciplinary team in supportive care
Dr Matti Aapro
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
If we look at the recommendations of most scientific societies today, they all say a multidisciplinary, multi-professional team is a must. How easy is this to organise with the small number of clinicians and nurses that are working in our centres in most countries nowadays? Not easy.
An MDT takes time. Takes time, in which your hospital director wants you to be seeing patients, because that's what brings money to your hospital, for example. Not in all countries. That's one problem. Then, the issue is how to run a MDT, where also supportive care is part of the discussion? Many hospitals are overburdened with the number of patients they have to see. So, they have to prioritise what is rightly a priority: the treatment of the cancer itself. And, there is no time for discussion about other aspects, which are very important for the patient. The ideal is to have someone who knows the patient, not from the technical perspective, like for example, the surgeon will know but from the human perspective. And, many have been able to develop this figure of the nurse navigator, who is there to help the patient understand what is happening, and can then, in another session of another MDT discuss, because supportive care, it's not only about controlling the patient's constipation that can be one of the side effects of some of the treatments we give, but also about the fact that the patient is losing some appetite. And, you don't want your patient to lose weight, because we know about all the negative potential side effects of important weight loss.
So, you need a dietician to help you there. But, then at the same time, you realise that there is a social issue for the patient because the patient can't pay for the transportation to the centre every week to be seen. So, that's another MDT in which the clinician, who is in charge of the patient should be present, if only possible. So, there's no ideal. Everyone has to do what he or she can do in his or her own centre.
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