Abstract
Purpose: Cancer care in high-income countries (HICs) is often coordinated at multidisciplinary conferences (MDCs). However, among disparities encountered by cancer care providers in low- and middle-income countries (LMICs) is lack of access to specialized expertise. Modern communication technologies offer opportunity for remote MDCs; reports of this are limited and have described logistical barriers. We explored this concept further. Methods: We reviewed the experience of a cancer center in Lagos, Nigeria, connecting with multidisciplinary expertise in the United States (US). Multidisciplinary consultations were reviewed, and descriptive data were generated. Participating providers were surveyed. Results: Over a two-year period, 27 cases were referred for multidisciplinary consultation. Of these, 21 (78%) were referred to Roswell Park Comprehensive Cancer Center in Buffalo, NY, and 6 (22%) were referred to other US institutions. All but one (26, 97%) were referred using email, while one case was discussed via videoconference. Reasons for consultation were uncertainty about management in 10 patients (37%), need for validation of treatment plans in 14 patients (52%) and unusual clinical scenarios in 3 patients (11%). Limitations included incomplete documentation of treatment recommendations (5, 18.5%) and unavailable diagnostics (7, 26%) or therapies (3, 11%). Time to receive final recommendations ranged from 1 to 14 days, with a median of 3 days. Survey respondents (8, 100%) agreed or strongly agreed that remote MDCs added value, and that email was an effective, low-barrier method for their organization, with some drawbacks noted. Conclusion: This early experience demonstrates feasibility of remote MDCs to benefit providers and patients in LMICs. Future directions include using more sophisticated software and organization to maximize the scalability and sustainability of this concept.
Highlights
The management of cancer cases is often complex, and in many cancer types it is understood that optimal outcomes are achieved by multidisciplinary treatment—some combination of radiologic and pathologic diagnostics, surgery, radiation, systemic therapy, nursing care, rehabilitation, and psychosocial support
We performed a retrospective case study reviewing the single-institution experience of a nascent cancer center in Lagos, Nigeria, which has sought to connect with multidisciplinary expertise at cancer centers in the United States (US)
Review of practice patterns at Lakeshore Cancer Center (LCC) revealed that case volumes have been increasing, and the cancer types seen as of June 2016 were 38% breast, 12% prostate, 8% colorectal, and 6% cervical, while the remainder were a combination of other gynecological, gastrointestinal, CNS, hematologic, and renal cancers
Summary
The management of cancer cases is often complex, and in many cancer types it is understood that optimal outcomes are achieved by multidisciplinary treatment—some combination of radiologic and pathologic diagnostics, surgery, radiation, systemic therapy, nursing care, rehabilitation, and psychosocial support. The shortage of multidisciplinary oncology subspecialists is a challenge that some centers in LMICs have attempted to overcome by seeking the support of multidisciplinary expertise through the creation of international partnerships and utilization of remote communication technologies [9-12]. In our research we have found that leveraging existing communication technology—such as email—facilitates access to the needed expertise across international lines. This is a retrospective review of a single center’s experience with international remote oncology consultations
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
