Ganging up on cancer
About 40 doctors, nurses and administrators grabbed paper plates filled with rigatoni, roast beef and mashed potatoes, gathered around tables in the dimly lit Phillips Hall and talked about tumors.
People came and went as pagers and appointments called them away, but Wednesday's conversation never ebbed. It was a conversation that focused on how best to treat cancer patients at Butler Memorial Hospital.
One of the four tumor boards held monthly for hospital staff, Wednesday's lunch meeting focused on four lung cancer patients. Other boards discuss other types of tumors, cancerous and noncancerous.
A tumor board brings together doctors and other specialists to discuss the medical condition and treatment options of their patients. The multi-disciplinary approach usually includes medical, surgical and radiation oncologists, or doctors who specialize in the treatment of cancer.
The tumor board meetings also can include pathologists, who study cells and tissues; pulmonologists, who are lung doctors; radiologists, who examine X-rays and other body scans; nurses; nursing students, and other medical staff members.
X-rays, CT scans, tissue slides, and a verbal account of a patient's case are presented by doctors and pathologists to others at the meeting.
Dr. Mario Kinsella of Pulmonology Associates in Respiratory Medicine in Butler presented two cases of smokers whose tumors were found during examinations for other health problems.
This led to a discussion by doctors about the value of routine chest X-rays, CT scans or other tests for patients who smoke. That prompted Kinsella to explain these tests have not been shown to catch enough early stage cancers to justify the cost of regularly testing smokers.
Dr. Sigurdur Petursson, who specializes in hematology/oncology at the Medical Center Clinic at the Benbrook Medical Center in Butler Township, said while the treatment of specific patients is usually the focus of the tumor boards, doctors do discuss matters such as insurance reimbursements and what those companies are willing to pay.
"In the end, these meetings give us an opportunity to find out if there is something new out there, to discuss all treatment options and come up with a consensus as to how to treat a patient," said Dr. Victor Onufrey, a radiation oncologist with West Penn Radiation Oncology Associates at the Benbrook Medical Center.
A study of the value of second opinions released earlier this month from the University of Michigan echoes Onufrey's statement. The study found that a team or tumor board approach to breast cancer treatment resulted in different diagnoses and treatments than those recommended by general practitioners for about 29 percent of the 149 patients in the study.In years past, Butler Memorial'stumor board discussions have resulted in new procedures, the introduction of new treatments, or the hospital buying new equipment, such as a positron emission tomography, also called PET imaging or a PET scan. PETscans help doctors locate cancers through biochemical reactions in the body. These scans also can be used in heart and brain evaluations.Brenda Andreassi, a registered nurse who is the clinical supervisor of the Medical Ambulatory Center and the hospital's Center for Pain Relief, said patients whose cases are discussed at the tumor board meetings have usually just been diagnosed."We get a chance to talk about the cases and the doctor can discuss what they have done, what they have found and ask where they should go next," Andreassi said.She pointed out the meetings also help both nurses and doctors qualify for continuing education credits or specialized certifications.Stephanie Roskovski, Butler Memorial's special assistant to the president for a healthy workplace, said the meetings have grown in attendance and in frequency because the staff has found the information and the process valuable.The boards also are being highlighted in the hospital's cancer committee's efforts to gain national accreditation as a cancer center by 2008.Dr. Melissa Thimons, a hematology/oncology doctor with the Medical Center Clinic at the Benbrook Medical Center, said the tumor board meetings help to educate doctors so they can help their patients better."It's really positive, and it results in better treatment for patients and an increase in the quality of their care," Thimons said.
