Download as PDF, PPTX
Uploaded byPlan de Calidad para el SNS
Multidisciplinary care: a perspective from diagnosis and treatment of rare cancers
The document discusses the importance of multidisciplinarity in cancer care, emphasizing the integrated cooperation of specialists for effective treatment of both common and rare cancers. It highlights the challenges and necessity of collaborative networks to improve patient outcomes and streamline treatment processes. Additionally, it articulates the need for financial support to sustain these multidisciplinary approaches in cancer care settings.
More Related Content
![Management Of Early Stage Ca Cervix [Autosaved]](https://cdn.slidesharecdn.com/ss_thumbnails/management-of-early-stage-ca-cervix-autosaved-1233338415127954-2-thumbnail.jpg?width=640&height=640&fit=bounds)
Multidisciplinary care: a perspective from diagnosis and treatment of rare cancers
- 1. Multidisciplinarity in cancer care Paolo G. Casali paolo.casali@istitutotumori.mi.it
- 4.
- 7. Algorythms clinical state y decision action n action
- 9. complexity atypical cases uncertainty pt preferences
- 10. R p<0.05
- 11. R p<0.05
- 12. Decision analysis outcome utility action outcome action
- 13. outcome U EU = (P1*U1)+(P2*U2) 1 utility = U1 P1 action outcome U 1 utility = U2 P2 action utility = U3 EU = (1*U3)
- 15.
- 16.
- 17.
- 18.
- 19. Organization TUM TUM TUM Surg Med RT
- 20. Organization TUM TUM TUM Surg Med RT
- 21.
- 23.
- 25. The good clinicaldecision… …is a patient-physician shared decision!
- 26.
- 27.
- 29. Frequent solid cancers inc. /100,000/y GI 110 Urological 84 Breast 64 Lung 56 Gynecological 28
- 30. Rare solid cancers inc. /100,000/y Head & neck 16 Melanoma 14 Sarcoma 6 CNS 6 Endocrine 4 Neuroendocrine 3 Thoracic rare 2
- 31. Rare solid cancers inc. /100,000/y Head & neck 10 Rare GI 6 Sarcoma 6 CNS 6 Endocrine 4 Neuroendocrine 3 Rare male genital 3 Rare female genital 2 Rare urological 2 Rare thoracic 2 Skin rare 1
- 32. From the referencecenter...
- 33. …to the Referencenetwork
- 34. Rare cancers… childhood
- 35. Rare cancers… hematological childhood
- 36. Rare cancers… adult solid tumors hematological childhood
- 38. Rare Tumours inEurope CHALLENGES AND SOLUTIONS 6 November 2008 - Brussels
- 40.
- 42. BZ Sondalo BL S Aviano V O TN U A B L Alzano As D G O V C C Lombardo Biel olo O A O T la Des B N B T S io G Neg VI O S V V Trevig rar M P Orbassa Ivr C I lio V no ea LO Casalpuster R D lengo C Candiolo T A PV M O R N L PC Al b Car F P pi E a R R C E M N G O E B R O A Forl ì P P O U PI L U EmpolFI A i N LI Valdar no A Citt R à di S.Severino Cast Marche ello P Città G della S.Omero G T (v.Vibrat Pieve E Pen a) R T N ne PE A Q Lancia no RO MA S.G. Rotondo C B IS L T B Olbi N Altam B a N Rioner ura A A o B Nocer R S a Inf. in Castellan S Vulture P eta Mandu T Z A ria L E CA C S C Z Trop ea M R E C T P P A Taorm ina C T A G
- 43. surgery radiation chemotherapy
- 44. “logical” patient “virtual” patient “real” patient
- 45. Who is movingin a network?
- 47. virtual sharing! pathologic diagnosis multidisciplinarystrategic decision surgery hi-tech resources rationalization!
- 48.
- 49. Teleconsulting… McAleer JJA et al. Broadcast quality teleconferencing for oncology. The Oncologist 2001; 6: 459
- 56. GIST Synovial Sarcoma Leiomyosarcoma Cellular Schwannoma
- 57.
- 58. 100 80 60 40 20 0 12 24 36 48 mos
- 59. Cost shift health system
- 62. REGIONE LOMBARDIA FARMACIE PHARMACIES ENTI EROGATORI HOSPITALS CITTADINI CITIZENS GENERAL AZIENDE HEALTH LOCAL MMG/PLS PRACTITIONERS SANITARIE LOCALI CARE UNITS HEALTH & SOCIAL ASSI ASSISTANCE
- 63. <x> name = “value” Patient discharge report Outpatient clinic visit report
- 64. Patient discharge report Outpatientclinic visit report
- 65. Patient cancer history Patientnon-cancer history Treatment program in the current phase of disease Treatment done Patient state
- 66. “ROL-doc” <x> name = “value” Patient cancer history Patient non-cancer history Treatment program in the current phase of disease Treatment done Patient state
- 67. Patient cancer history Patientnon-cancer history Treatment program in the current phase of disease Treatment done Patient state
- 68.
- 69. Disease “phase” localized metastasis terminal disease (1st CT) (2nd CT) disease
- 70. Disease phases localized metastasis terminal disease (CT 1st l) (CT 2nd l) disease
- 71. Disease phases clinical practice guidelines localized metastasis terminal disease (CT 1st l) (CT 2nd l) disease
- 72. Clinical practice guidelines Sarcoma t. molli tipico adulto G2-3 Stadiazione Metastasi Sì M. avanzata No RT No No Accetta Exeresi >5 cm Sì Sì CT + RT CT Exeresi Sì ampia > ampia conserv. fattibile Sì Accetta Resezione >5 cm Sì Sì CT radicale CT No Exeresi Sì marginale No fattibile No No Rifiuto Demolizio Sì demolizio No Demolizione ne fattibile ne No M. locoreg. Sì inoperabile Follow-up G2-3 NED
- 74.
- 75.
- 76.
- 77. In brief... Multidisciplinarity is imposed by the multimodal approach to most solid cancers Multidisciplinarity implies an integrated cooperation of specialists, not just their involvement one by one It is a challenge for cancer centers and physicians It will be more and more played within collaborative networks Rare cancers are a priority for national and cross- nation networking But networking is spreading to manage cancer care in general also at a regional level In the end, multidisciplinarity within a hospital, or a comprehensive cancer center, or a network, or a health system, needs money, which will pay off, certainly in the society perspective
- 78.