Four Tips for Optimizing Tumor Board Participation

Tumor boards are critical to the care of patients with cancer. They enable collaboration between the various specialists involved in treatment, with interventional oncologists playing a key role. We spoke with Ripal Gandhi, MD, about how interventional oncologists can make the most of this opportunity to improve patient care and develop relationships with colleagues across disciplines. Dr Gandhi practices interventional oncology at the Miami Cardiac and Vascular Institute and Miami Cancer Institute and is a Course Director for the Symposium on Clinical Interventional Oncology (CIO). He offers his tips below.

1. Consistently attend every tumor board in your area of interest.  The exciting field of interventional oncology continues to evolve and is transitioning from the innovative and early adopter phase to the more mainstream as the 4th pillar in the multidisciplinary care of cancer. With the multitude of systemic, locoregional, and surgical therapeutic options available to patients, tumor board is the optimal setting to determine the appropriate treatment strategy for a given patient.  Between various departmental meetings, clinic, procedures, and other commitments, it is certainly challenging to make time to attend another meeting.  However, being at tumor board is critical as you are the expert when it comes to locoregional therapies and can provide key input in the management of complex patients. Thus, I make attendance a priority and carve out time in my schedule.  I am fortunate to have very supportive partners with a similar mindset and we cover for each other so that we always have an active participant at relevant tumor boards. 

2. Be a knowledgeable, active participant at tumor board. To be active, you’ll need to be knowledgeable about the disease process being discussed. Most institutions have different tumor boards for different cancers. For example, our institution has a gastrointestinal tumor board, a thoracic tumor board, a breast tumor board, etc. With such a diversity of potential areas, you need to ensure you are knowledgeable about the specific disease states at hand and well versed in the relevant literature and guidelines. Be sure to review the most recent data available and know it well enough so that you can actively participate and explain the rationale for your diagnostic and treatment recommendations for a given patient.  In addition to mastering the IO literature, it is very important to develop a good understanding of therapeutic options offered by our colleagues in medical, radiation, and surgical oncology.

3. Present cases of your own. It’s important to actively participate and offer your input on others’ cases, but it’s also a best practice to present complex cases that you have seen that would benefit from multidisciplinary input. It is also beneficial to provide follow up on patients you have treated to demonstrate the efficacy of IO therapies.

4. Always advocate for the patient. The goal of tumor board is to achieve the best patient care.  The key is to develop a personalized treatment plan on the basis of treatment guidelines and individual patient clinical data.  Although IO therapies offer many benefits to patients, they are not appropriate for every patient, and it is your role to decline a procedure that is either not indicated, too risky, or unlikely to benefit the patient. It’s important to clearly explain your rationale when you believe IO may not be the way to go and perhaps another specialty may be better suited to treat the patient.  You will gain the respect of your colleagues by always advocating for the patient first.