Westerly Hospital recently launched its first multidisciplinary genitourinary oncology clinic, which brings together the expertise of urologic oncology, medical oncology and radiation oncology to treat patients with genitourinary cancers.
The team at Westerly Hospital includes Dr. Joseph Renzulli, chief of urology at Lawrence + Memorial Hospital and Westerly Hospital and associate professor of urology at Yale Medicine; Dr. Sanjay Aneja, radiation oncologist at Westerly Hospital and assistant professor of therapeutic radiology at Yale Medicine; and Dr. Matthew Austin, medical oncologist at Westerly Hospital and assistant professor of clinical medicine at Yale Medicine.
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PBN: The multidisciplinary clinic brings together the expertise of medical oncology, radiation oncology and urologic oncology to treat patients with genitourinary cancers. What are some of the advantages of a multidisciplinary approach? And how does it differ from the standard of care?
DOCTORS: The advantage of a multidisciplinary clinic is the concept of real-time, personalized, collaborative care amongst experts in a particular disease. The patient and their loved ones can hear from multiple medical and surgical disciplines all in one room and understand the diagnosis, prognosis and potential treatment options for their unique diagnosis. We then provide a consensus opinion and treatment plan recommendation for that individual and coordinate that care plan for them so they do not have to worry about scheduling appointments themselves for bloodwork, imaging studies or additional physician appointments.
Typically, a patient is diagnosed with prostate cancer, bladder cancer or kidney cancer by his/her urologist. Then he or she is sent for additional imaging and testing. Next, referrals to another specialist are recommended. Perhaps two or three additional visits are required to come up with a recommendation for care. They are left wondering if the communication between the different sub-specialist they visited was by letter, a phone call or whether they communicated at all. It is fragmented compared to our individualized multidisciplinary approach. The patient satisfaction data for multidisciplinary care is well over 95%. This model has been successfully implemented and extremely well received in our Smilow Cancer Hospital Care Center at Waterford, Conn., and is considered a best practice.
PBN: How big is the team working at the clinic?
DOCTORS: Our team at the Smilow Cancer Hospital Care Center at Westerly Hospital consists of three physicians – urologist, medical oncologist, radiation oncologist. We have a superb staff supporting us, which includes an oncology nurse navigator, pharmacist and social worker. We have also recently added a specialist in cancer genetics, as many treatments are now driven by the patient’s genetic profile and this information is critical to assure other family members are aware of their risk and obtain appropriate cancer screenings.
Our team extends to include a multidisciplinary tumor board, where each patient’s case can be presented to our entire urologic oncology division for further discussion, review of data and contribution to consensus recommendations.
PBN: Which patients are referred to the multidisciplinary clinic? What steps do they go through?
DOCTORS: When a patient is diagnosed with a malignancy such as advanced or high-grade prostate cancer, invasive bladder cancer, kidney cancer or testicular cancer, they are referred to our multidisciplinary clinic. The patient’s medical records, pathology and diagnostic imaging are gathered and reviewed by our team prior to their visit. Yale School of Medicine pathologists review the tissue samples that were initially taken to provide a second opinion on the pathologic diagnosis to assure they agree with the original diagnosis. Then we invite the
patient and their loved ones to our Smilow Cancer Hospital Care Center at Westerly Hospital for a one-hour comprehensive consultation with our team.
PBN: Why is it important to include different specialties from the very beginning during the initial consultation?
DOCTORS: Involving multiple specialists from the beginning of the patient journey allows a personalized plan to be developed, which we refer to as a multimodality treatment plan.
Currently, the standard of care for cancer treatment includes combining multiple therapies to increase the success of treatment. By having all our specialists involved from the beginning of the patient’s care, we can assure they receive cutting-edge treatment with the highest treatment success rates. It also allows us to coordinate their care so that there are not time gaps in care that sometimes occur outside of the multidisciplinary model.
Lastly, our team is involved in multiple clinical trials and by approaching patients together, we can offer enrollment in clinical trials with the best clinical trial for the patient being recommended based on team consensus.
PBN: Can a multidisciplinary approach be used when treating other cancers besides genitourinary cancers?
DOCTORS: Yes. This model of cancer care has been so successful at many leading institutions, that it is available or being developed for breast cancer, thoracic cancers, head and neck cancers, and gastrointestinal malignancies throughout the region.
Claudia Chiappa is a PBN staff writer. You may contact her at Chiappa@PBN.com.
