Cancer Care

The value of the MDT in oncology

February 7, 2024 Word for Word Media 0Comment

Dr Shivona Moodley explains what a multi-disciplinary team (MDT) is and how it benefits the oncology patient.

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What is a multi-disciplinary team (MDT)?

A multi-disciplinary team (MDT) is a group of healthcare professionals from various disciplines that are involved in cancer management who come together and collaborate with the intention to optimise patient care. The key aims are to improve communication, decision-making and coordination of care.

Medical and allied healthcare care professionals engage in a closed forum to discuss each patient’s case, deliberate all relevant treatment options and construct an individualised treatment plan which is then offered to the patient as the MDT treatment recommendation.

Historically, the serial model of care has been followed where the patient would present to a primary healthcare provider and be sent down the pathway by each health professional as they see fit. This model offers minimal patient input, is less efficient, lacks oversight and allows for much variation in quality of care.

MDT in oncology

Patient-centred care

Person/patient-centred care is a practice in which patients actively participate in their own medical treatment in close cooperation with their health professionals.

Patient-centred care fosters strong shared decision-making and allows for a more holistic approach which includes the family and caregivers who play an integral part of the journey.

Complexity of cancer care

In 2024, the intricacies of cancer diagnosis and management is highly complex with precision medicine at the forefront. There are multiple molecular biomarkers that allow for personalised treatment pathways based on the testing done on a patient’s tumour.

It’s important for all healthcare professionals that are involved in treating cancer patients to stay updated on the latest treatment guidelines and standards of care to ensure that patients are managed appropriately.

Benefits of a MDT

  • Improved communication, coordination and decision-making.
  • Efficacy of a team approach with shorter time from diagnosis to treatment.
  • Adherence to clinical treatment guidelines, protocols and evidence-based treatment decisions.
  • Shared decision-making empowers the patient and promotes greater appreciation of the patient’s needs and perspectives.

 Requirements for an effective MDT

  • A highly-skilled team with various specialised techniques and expertise.
  • A collaborative working culture allowing each team member to voice their opinion and contribute to the decision-making process.
  • Regular meetings and attendees.
  • Comprehensive understanding of the patients’ preferences and expectations.
  • The information presented should be complete and accurate for informed decision-making to occur.
  • Clinical governance including guidelines, protocols, outcome audits and peer review.

Barriers to establishing a MDT

  • Lack of skilled human resource and expertise.
  • Resistance on the part of providers and institutions who are unwilling to establish a collaborative team.
  • Inherent transparency challenges due to physician control, autonomy and power.
  • Financial disincentives to its implementation.

Management of patients in a MDT setting represents an evolution in cancer care from a serial model to a patient-centred approach. With the move to evidence-based medicine and personalisation of cancer treatment, it’s prudent to rely on each expert member of the team to contribute their professional opinion in sculpting an individualised treatment plan for the patient.

MDTs have been recommended in clinical guidelines and literature for many years with general overreaching support of their role and value. They have been shown to lead to more accurate staging and stage-appropriate care.

The future of the most effective MDTs will include strong advances in molecular pathology and biomarker testing, patient collaboration and clinical trial participation. These MDTs will rely on skilled human resource, good and complete clinical information, working collaboratively within an organised team and quality control in an effort to enhance patient’s experiences and improve treatment outcomes. MDTs are certainly the future of high-quality oncology care.

Dr Shivona Moodley

MEET THE EXPERT – Dr Shivona Moodley

Dr Shivona Moodley has a special interest in breast cancer, gastrointestinal cancer, gynaecological cancer, head and neck cancer and prostate cancer. Dr Moodley works at the Sandton Oncology and West Rand Oncology Centres and is part of a team of eight oncologists that consult at the DMO locations.

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