“Having just retired from active clinical practice as a breast surgeon, I can look back at how decision making has evolved over the course of my career, from when a single doctor took the decisions, to the multidisciplinary approach we advocate today.
It was in breast cancer, with the discovery of the importance of hormonal receptors, that we rst learned that different tumours respond to different types of treatment, and also that we can often limit the surgical damage by bringing additional treatment modalities into play.
The so-called ‘collegial’ discussion of cases slowly spread to other solid tumours to become the norm. The initial core group – surgeon, radiation oncologist, and medical oncologist – was later expanded to take on board a pathologist, who was needed to de ne the precise characteristics of the disease.
Once the principle is accepted that four doctors are likely to reach better recommendations than one, you can become ve (by bringing a radiologist on board), then six (a dedicated nurse), seven (a plastic surgeon), eight (a psychologist) – and you have a multidisciplinary team. No single doctor can face the complexity of cancer by themself anymore.”
Written by: Alberto Costa
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