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Interdisciplinary Teams in Cancer Care Myth of the Lone Warrior Hero 1 Team Work in Cancer Care vs Primary Care Cancer Center Sick, with a diagnosis Primary Care Well, preventive care Chronic illnesses Focus on acute treatment Focus on long term management Long term follow-up? Long term follow-up? Cancer Diagnoses Requiring Team Care Lung cancer Colorectal cancer Pancreatic cancer Breast cancer Prostate cancer Head and Neck Cancers Sarcomas Others 2 Example – Thoracic Oncology Clinic at UMass Thoracic surgery Radiation oncology Medical oncology Palliative care Clinical psychology Cancer research office Tumor board Nurse navigator Example – N.C. 66 year old presented to Rheumatology with joint pain. Clubbing identified. CXR showed R lung mass. N2 disease on bronch. Refer to Thoracic Oncology Clinic Seen by med onc, rad onc, thoracic surgery Seen by palliative care, clinical psychology Case reviewed in tumor board Plan of care provided on first visit 3 Myth of the Lone Warrior Hero Debunked – Hercules Had Help! Team Work in Cancer Care Summary Mandatory for many cancers More efficient for patients Permits comprehensive review of case Provides a variety of service But…has someone been forgotten? 4 Where Does Primary Care Come In? “Of course we’ll keep you informed” “We make sure the patient follows up with you after his treatment is over” “Most PCPs don’t want to deal with this stuff” How Should Primary Care and Cancer Care be Coordinated? Regular appointments with PCP during cancer treatment? Should PCP be primarily responsible for follow-up? How to manage communications between PCP and cancer team? 5