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    Collaborative care challenges

    Multi-disciplinary teams ideal for managing advanced melanoma patients, but practical implementation hits obstacles

    A collaborative treatment approach for patients with advanced skin cancer is best achieved through the formation of multi-disciplinary teams (MDTs), according to experts. This approach provides patients with reassurance that numerous physicians have been involved with the development of the treatment plan.

    READ: Opportunities, challenges with new treatments for advanced cancer

    Clinicians including a dermatologist, medical oncologist, and surgical oncologist discussed the challenges in delivering care through the MDT approach at the 9th annual Canadian melanoma conference.

    Geographical obstacles

    Merrick Ross, M.D.When care is delivered in the community, as opposed to academic centers, there are more obstacles to developing a MDT care model, explained Merrick Ross, M.D., a surgical oncologist, chief, melanoma section and department of surgical oncology and the Charles McBride professor of surgical oncology at the University of Texas MD Anderson Cancer Center in Houston.

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    "A lot of melanoma treatment is not being delivered in academic centers," Dr. Ross says. "It is being delivered in the community, where it is more difficult to implement a multi-disciplinary approach. The offices (of various clinicians) are not necessarily located nearby, making it inconvenient (for physicians and for patients). Travelling for the patient to go see this person and that person may not be convenient."

    Indeed, community care often means that clinicians work in separate silos, and are not in frequent communication with each other about patients, but multi-disciplinary care means various specialists need to speak with each other, Dr. Ross explains.

    "This gives the patient more consistent messaging,” he says. “It is very satisfying and encouraging from the patient's point of view when various physicians are talking to each other, and there is a plan moving forward. An integrated approach to care gives patients a greater sense of security."

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