The Role of Tumor Boards and How Pathology Helps Enhance Their Purpose
By Jane Meggitt
Tumor boards provide a collaborative, multidisciplinary approach to cancer care. These boards bring together oncology, radiology and pathology specialists to aid in decision making and improve care coordination. The latter serves as a vital component of the interdisciplinary review aspect of tumor boards. Think of a tumor board as a group giving a variety of second opinions in one setting.
The Role of Tumor Boards
Tumor boards provide numerous benefits in preventing and diagnosing cancers, planning treatment and evaluating decisions. Clinicians, doctors, and pathologists work together to improve the experience of the board itself, and improve patient satisfaction. Tumor boards are also referred to as multidisciplinary cancer conferences or cancer care conferences.
Other professionals contributing to tumor boards include nurses, social workers, and genetics counselors. A smaller hospital may have a general tumor board. Larger institutions may have several tumor boards, each focusing on a different cancer type.
Not every cancer case comes before a hospital’s tumor board. The cases discussed by the tumor board generally involve less common cancers and those that are not responding well to treatment. Some of these patients may have exhausted all standard care options, and the tumor board’s decision is literally the last resort. The tumor board has expertise beyond the treating physician, and the collective effort will bring forth additional and fresh treatment ideas on patient care.
The tumor board’s goal is determining the best cancer treatment for each patient. A care plan for every individual is then devised. By working in this multidisciplinary atmosphere and receiving the perspectives of health care providers in a range of specialties, coming up with the optimum care plan for patients is a much smoother process.
Pathology and Tumor Boards
Tumor boards may consist of surgeons, medical oncologists, radiation oncologists and the specialists in particular types of cancer, such as gynecologists. Plastic surgeons contribute to discussions about reconstruction and related issues.
Pathologists play a critical role on tumor boards. They are the doctors actually diagnosing cancer based on tumor tissue samples. A review of pathology slides is an integral part of each meeting. At least one pathologist is included on any effective tumor board.
While the pathologist presents the pathologic staging at these meetings, they are increasingly providing their expertise in the use of advanced molecular testing. Molecular testing finds genetic changes that may respond to specific treatment protocols. Pathologists also interpret ancillary test results, such as immunohistochemical stains.
At a tumor board meeting, the pathologist can help guide other doctors on the most valuable tests for particular situations, as well as discuss which tests may not have much of an impact on treatment decisions or prognosis. Pathologists can also answer questions regarding quality assurance and testing methods. Because molecular testing often consists of limited tumor samples, their input can prioritize such testing.
In individual cases, the pathologist may recommend a repeat biopsy if inadequate amounts of tissue were originally obtained. They may discuss the best way to obtain such a sample, from the pathology perspective. Perhaps they will encourage additional testing on a preserved sample, unlocking which treatments may prove most effective.
The Future of Tumor Boards
Expect the role of pathologists on tumor boards to prove even more vital in the near future. Precision medicine is becoming a greater factor in treatment determination. That means pathologists will take on an even greater role when participating in these multidisciplinary teams. That also means more lives saved or extended.
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For more information about Yosemite Pathology, our work on tumor boards and how we can best serve your practice or hospital with testing and specialty services, contact us today.
Jane Meggitt’s work has appeared in dozens of publications, including USA Today, Zack’s, Financial Advisor, nj.com, The Houston Chronicle and The Nest. She is a graduate of New York University.