乌鸦传媒

Breast cancer is the associated with brain metastases after lung cancer in the United States. As patients with advanced breast cancer live longer, the . Survival of since the introduction of advanced surgical and radiation techniques such as stereotactic radiosurgery.

With prolonged survival in patients with metastatic breast cancer and advancement of systemic and local therapies, it becomes essential to implement an approach for treatment of brain metastases that is tailored to patients' needs and priorities. However, introducing patients to a multidisciplinary team without appropriate coordination may increase the burden on them and their caregiver, which may create a barrier to improved outcomes.

is a team-based care coordination program established at the University of Michigan Rogel Cancer Center. As described in the study in JCO Oncology Practice, the program consists of multiple specialists, including a program coordinator who facilitates clinical trial screening, referrals, navigation, and coordination of care. A total of 53 patients with breast cancer and brain metastases were enrolled.

The coordinator screened for any gaps or deficits in the patient's clinical needs, including assessment of pain, neurological function, cognition, mood, and anxiety. Appropriate referrals were made to physical medicine and rehabilitation (PM&R), neuropsychology, neuro-oncology, social work, medical oncology, radiation oncology, and neurosurgery, and clinical trials.

After the intake process, the program coordinator ensured that the requested appointments were scheduled and completed. Caregiver support was also offered. Patient-reported outcomes were collected using multiple standardized questionnaires with plans for follow-up to detect long-term improvements.

Enrollment in IMPACT the Brain also enables access to subspecialist care. A total of 47 referrals were made during the program period, including referral to specialties that tend to be underrepresented in multidisciplinary clinics such as PM&R and neuropsychology. Thirteen percent of participants had their first visit with PM&R and 36% of patients consented to clinical trials. The authors also report a of 5 days to subspecialists, compared with an average of 2 to 4 weeks wait time at their institution.

Providing multidisciplinary care to cancer patients, particularly with brain metastases, is recommended by many cancer societies including ASCO. A multi-team system such as IMPACT the Brain helps patients access and navigate subspecialty care, clinical trials, and support both for themselves and their caregivers.

This type of team-based coordination of care will help improve outcomes and alleviate the burden on patients and caregivers.

Oday Elmanaseer, MBBS, is a hematology/oncology fellow, and Ami A. Chitalia, MD, is a hematologist and medical oncologist, at Washington Cancer Institute, MedStar Washington Hospital Center, in Washington, D.C.

Read the study here and an interview about it here.