Tutorial

Interdisciplinary Model

Cancer diagnosis and treatment requires multiple professionals and specialties, working in an interdisciplinary model. They have learned how to work together. When browsing the items below you will better understand how physicians are combining their expertise to better assist the patient.

  • Clinical oncology is a medical specialty that works with the integration of multiple professional skills. No medical professional is able to master alone all the necessary knowledge to diagnose and treat cancer. The interdisciplinary team improves the critical thinking and qualifies the results. The physician, who guides the patient in every stage of the diagnostic and treatment process, should coordinate the interdisciplinary work.

  • The interdisciplinary activity starts with a good working relationship between the clinical oncologist and the surgeon who has very specific anatomical skills and focuses great and valuable experience in their particular area of expertise, for example, neurosurgery, thoracic surgery, urology, gynecology, abdominal surgery, among many other and equally important specialties. The surgeon provides essential information for the correct assessment of local and regional extension of the tumor, contributing for a more precise tumor staging. The surgeon sets the chance for a complete tumor removal, a criterion called resectability. A proper dialogue between the clinician and the surgeon should always consider the patient’s condition in undergoing to the recommended surgery. This concept is called operability. Based on patient’s operability, other medical specialties should be necessary to evaluate and eventually reduce surgical risk.

  • After surgery, another medical professional comes into play. It is the pathologist. He carefully examines and describes the materials removed by surgery. This test is called pathological exam. After performing the macroscopic exam, the pathologist takes samples of the most significant areas of the disease. The samples are embedded in paraffin, stained with hematoxylin-eosin and subjected to microscopic sections with the aid of a device called microtome. These microscopic cuts are placed on a glass slide and examined under the light of an optic microscope, which enables the visualization of cells and tissues, allowing the tumor diagnosis. This phase of the pathologic exam is called microscopy. The microscopic diagnosis is therefore dependent on the shape of the cell clusters and based on morphologic patterns previously described for each type of cancer.

  • The name comorbidity is given to a group of other diseases that are occurring in the patient beyond cancer. Multiple medical specialties could be necessary depending on patient’s comorbidities. The involvement of multiple consulting is a medical liability act and should never be withheld. No professional, is able to master the entire medical knowledge. For example, if the patient is diabetic, a hormonal disorder linked to glucose metabolism, it is necessary to involve a specialty called endocrinology. If the patient suffers from coronary artery disease, it is advisable the participation of a cardiologist. The number of consultants is proportional to the number of comorbidities.

  • The interdisciplinary approach is not an easy task. Harmonize the relationship between complementary professionals skills is an essential medical act for successful clinical results. The attending physician shares the necessary multispecialty opinions, while constantly exercises a critical view. The attending physician exerts an integration role. He also answer questions and facilitates the patient and family communication with all other professionals involved in the case. He should be a conductor of a well-tuned orchestra.