Cancer MDT

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Hi everyone.

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My name is Claire.

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I am the operations manager

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for cancer working here at Cambridge University Hospitals.

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I would like to welcome you to this film,

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which will aim to explain the purpose

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and need of a multidisciplinary team approach

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and discussion for patients suspected of cancer.

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Finding out you have symptoms

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that may require further investigation can be very daunting

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and might make you feel scared

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or worried about what's going to happen next.

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You'll be placed on what healthcare professionals

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call a pathway,

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which is designed to get you the right care

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as quickly as possible.

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This doesn't automatically mean

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you have a serious condition.

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It ensures that you are monitored closely

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and moved through the system to give you peace of mind

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or if necessary, to begin treatment promptly.

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During the film, you may hear the term MDT,

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which stands for "Multidisciplinary Team."

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MDT is a group of health and care staff

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who are members of different organisations and professions.

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They meet and work together to make recommendations

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for the responsible clinician to discuss with the patient.

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Support is available for you and your family at every step.

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Our teams are highly trained and specialised,

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and you are in safe hands here at CUH.

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No decision will be made about your care

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and treatment without you.

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If you present yourself at your GP surgery

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with symptoms suggestive of a serious condition

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or health issue indicative of cancer, your GP may refer you

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for further specialist investigations.

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This is called an urgent suspected cancer referral.

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This pathway is designed to fast-track your appointment

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with a specialist to ensure you receive a diagnosis

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as early as possible, or you may have been invited

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to take part in one of the national screening programmes

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for breast, cervical, or bowel cancer.

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If your results indicate a suspicion of cancer,

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you will again have been fast-tracked

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for further investigation to confirm or exclude cancer.

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You can also be referred for investigations

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by other specialties or department within the hospital

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or referred by your local hospital

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for a second opinion, specialist advice

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or for specialist treatment

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that is not necessarily available in your local hospital.

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Equally, a clinician can upgrade you onto a cancer pathway

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if you haven't been referred through one of these routes,

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and if they are concerned your symptoms might be serious.

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After your referral has been received at CUH,

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the specialist team may see you in clinic

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or may refer you for investigations before seeing you.

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These investigations may include blood tests,

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imaging like x-rays or scans, or biopsy.

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The results will be used

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to identify if the symptoms are an abnormality

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and if this is in fact cancerous,

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and to inform the specialist team of your condition.

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This will also help the MDT discussion

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to consider the best way of treating your cancer type

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and to determine next steps in your care.

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Although, there is no set of standard investigations

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for patients suspected of cancer,

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each specialty may request different types

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of investigations, depending on the location

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of the abnormality and the body part affected.

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There are national best-practice pathways

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that detail which tests could be carried out

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and how quickly to diagnose most forms of cancer.

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Once the results are available,

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these are collated together

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by one of our MDT coordinators,

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whose role is to ensure essential information

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is available for the MDT discussion.

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The MDT meeting will consist

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of healthcare experts including physicians, surgeons,

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oncologists, radiologists, histopathologists,

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and clinical nurse specialists known as a CNS,

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who specialise in specific cancer types.

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Other professionals like physiotherapists, dietitians,

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or occupational therapists may also be involved

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in the MDT discussion to address various aspects

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of any care required.

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Each MDT member has a different role to play

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providing diagnostic, surgical,

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medical, practical, or emotional input.

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The MDT coordinator's role at the MDT meeting

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is to facilitate and coordinate patient referrals

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through the MDT and to support the MDT chair,

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who is responsible for the management

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and running of the MDT.

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At the MDT meeting, the histopathologist,

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who is a doctor specialising in analysing biopsy samples,

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determines your exact tissue diagnosis,

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will discuss these results, if you've had one completed,

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and the radiologist will bring up any scans,

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such as x-rays, CT scans or MRI

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to present any abnormal findings.

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This will initiate a discussion between all members,

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to consider different treatment options available

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and to formulate appropriate recommendations.

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Your case will also be discussed at an MDT meeting

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at each appropriate stage of your treatment plan

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and maybe re-discussed if there are any changes

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in your diagnosis or progression.

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The MDT may also suggest any further tests

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that need to be carried out, making appropriate referrals

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to specialist services

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or which clinical trials might be suitable

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for consideration.

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The MDT recommendations will be agreed

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and finalised at the meeting,

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and the clinical team will document these

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in our patient record system, called Epic.

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Often local hospitals refer patients

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to a special MDT discussion at CUH.

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If this is the case,

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the local team will dial into the MDT meeting

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and summarise your results.

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CUH is a tertiary centre,

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meaning that regional patient cases can come to us

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to receive appropriate treatment,

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which may not necessarily be available

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in their local hospitals.

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Patients are not permitted to attend the MDT meeting,

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partly due to the number of patients discussed

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and patient confidentiality.

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However, the CNS either from CUH

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or from other hospitals,

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who may have previously met the patient,

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will act as the patient's voice at the MDT.

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Where possible, they will ensure your views

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and wishes are highlighted and considered.

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The frequency of MDT meetings varies,

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depending on cancer type.

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After an MDT meeting, you will have an opportunity

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to discuss the outcome with a member of the specialist team.

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This will often be the CNS

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or the specialist clinician,

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either at CUH or your local hospital,

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who will discuss your MDT outcome

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and recommendations in a face-to-face outpatient appointment,

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via a video appointment or telephone.

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You can then decide which option

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is the most suitable for you.

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You will then be contacted by a member of our admin team

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to schedule any appointments.

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This is likely to be via a phone call,

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and so please be aware, CUH calls will be anonymised

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and therefore the call will be from an unknown ID.

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So please ensure you keep your contact details up to date.

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If having a face-to-face outpatient appointment

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is your preferred option, you will most likely

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need to attend one of our outpatient clinics.

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For more information about attending the CUH campus,

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please see our Cancer Services pages

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of the CUH website,

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where you will also find helpful information

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and a welcome video.

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Once you have arrived at the hospital

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for your clinic appointment,

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you can check in at the reception desk or via the MyChart.

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After confirming all necessary details,

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you should remain in the waiting area.

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This is where a member of the clinical

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or the support team will call you in

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and take you to one of our clinic rooms

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for your consultation.

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You can be accompanied by a family member

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or friend if you wish, who will be able to provide support

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and help you with writing down information

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and assisting with any questions you may have.

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You may find it useful to jot down questions beforehand

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to help you remember anything important you wish to ask.

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Sometimes you may have already been admitted

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to one of our wards at CUH,

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when you're told the results of your tests

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and MDT outcome. You will still have the opportunity

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to discuss treatment options with a specialist clinician.

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At the start of your appointment,

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you will be greeted by the consultant

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and your CNS, who will introduce themselves to you.

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They will then proceed

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with discussing the recommendations reached by the MDT.

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The consultant and your CNS will make every effort

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to clarify any information

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and discuss matters important to you.

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This is to ensure you can make an informed decision

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about your treatment and care.

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You'll be encouraged to write down

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any essential information,

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however, the details and a contact telephone number

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for your CNS will be provided to you

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at your clinic appointment.

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You can contact them should you have any worries

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or need further information after your appointment.

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You may need to leave a message, but they,

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or another member of the team will get back to you

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as soon as possible.

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You may also be able to contact your clinical team

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via MyChart messaging,

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if this function is available within the clinical specialty

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caring for you. The team will respond

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to you within 10 working days.

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If there are multiple treatment options available,

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you may be given some time to consider what is best for you.

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Your CNS will contact you

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to further discuss your options if necessary,

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or will liaise with the booking team who will contact you

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to arrange a follow-up appointment to finalise your decision

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and next steps.

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At your clinic appointment,

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you may also be given a consent form to sign

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to avoid any delays with starting your treatment.

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Sometimes it may be necessary to send you for further scans

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or investigation on the day.

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Often, at the end of your appointment,

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you'll be provided with the Cancer Patient Information Pack,

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which contains practical information

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such as parking, way finding

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and services available on the CUH campus.

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You may also be assigned a cancer navigator,

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who will contact you to offer you support

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and access to services that may be important

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to you at different stages of your care.

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All decisions and detailed summary

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of your clinic appointment will be recorded

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in our patient record system

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and the summary of your treatment plan will be shared

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with you and your GP,

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who will be kept informed about your treatment and care.

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Thank you for watching.

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We hope this film has helped you to understand

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some of the most important information

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about the MDTs and your possible pathways.

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If you have any further questions,

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please contact your CNS on the telephone number

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provided to you at your consultation.

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If you however, have any non-clinical questions

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or concerns, you can contact your cancer navigator,

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the support advisors,

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or visit the Cancer Support Service Information pod

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located in Oncology Outpatients on level 2.

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Additionally, if you would like more information

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about Cancer Services at CUH,

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please visit the CUH website.