Tumor board second opinion

A tumor board review is a collective evaluation and discussion of cancer patient cases. It involves several specialists, who represent different areas of medicine relevant to the therapy of a particular malignant disease type. The goal is to assess the situation as accurately as possible and work out the best customized treatment strategy.

Why are joint decisions better?

Combining competencies gives patients a number of benefits.

Reach beyond the individual boundaries

Cancer is a complex and very multifaceted disease.

But a single physician is not able to encompass all of these options. In order to make sure that all relevant details are taken into account, and nothing that might be decisive for the patient, gets missed, several experts need to be involved.

Collective intelligence ensures correct decisions

Today, diagnoses are based on numerous and diverse imaging, pathology, molecular genetics, and other studies. At the same time, quite a few interpretations of each individual finding might be possible. Truth, as we know, is born in an argument, or, more precisely, an unbiased consideration of different reasons and opinions leads to it. For cancer patients, the involvement of an entire pool of experts means reliable making of vital decisions.

Planning together is the way to success

It takes a lot of experience to recognize a tiny tumor early on a scan. And that's exactly what radiologists can do. On the other hand, oncologists are much more familiar with the side effects of systemic therapy, e.g., with cytostatics. Whereas it is up to molecular geneticists to decide if chemotherapy is appropriate to treat breast cancer, for example. The list of such associations could be continued. Therefore, it is always better if specialists are able to work together at the stage of therapy planning.

You can't do it alone

A surgeon does not make a decision about surgery on his or her own. Neither does a radiation therapist in regard to recommending irradiation, nor does an oncologist prescribe cancer drugs without ascertaining that another option would not be a better alternative.

Four eyes see more than two

When a cancer is difficult to classify or presents a particularly complex type, a single physician can at some point reach the limits of his or her competence. In this case, an expert team comes to the rescue. Colleague opinions help to draw the right conclusions and jointly develop the best therapy concept.

Where and when are tumor boards held?

Multidisciplinary conferences discussing cancer patient cases are common practice at multidisciplinary health care facilities. They take place regularly (usually once a week) in each oncology area. The board includes physicians specializing in the fields that may be involved in the treatment of a particular type of cancer, e.g.:

• hematologist oncologists;
• surgeons of all specialties (general, visceral and thoracic surgery, gynecology, breast care, urology, neurosurgery, heart surgery, orthopedics, dermatology, ophthalmology);
• specialists in various fields of internal medicine (e.g., gastroenterologists, endocrinologists);
• pediatricians;
• neurologists;
• radiologists;
• radiation therapists;
• pathologists.

Patient data presented for expert review include the disease course and evaluation of the patient's current condition, examination findings and information on the presence of concomitant diseases. All details are carefully studied by the board participants. The situation is considered from as many points of view as possible, an interdisciplinary discussion is held. Based on such comprehensive case analysis, as well as the individual circumstances and patient wishes, the doctors come to a joint decision on further actions in the nearest and further perspective.

What is the tumor board second opinion service about?

A team of experts from a major comprehensive health care facility or certified cancer center reviews the clinical case of a patient primarily cared for at another medical facility.

Provided that all medical records were collected and prepared very carefully, and the volume of information meets professional criteria, a remote case presentation is no different from the in-house one, either in terms of process or outcome.