Multidisciplinary teams

What is a multidisciplinary team?

A multidisciplinary team (MDT) is a group of doctors and other health professionals with expertise in a specific cancer, who together discuss and manage an individual patient’s care. They plan the treatment that’s best for you.

Who is in the team?

This depends on the type of cancer you have. Most teams will involve:

• a surgeon
• a radiologist (a specialist in x-rays and related scans)
• a histopathologist (a doctor who makes diagnosis from tissue samples)
• oncologists (doctors specialised in chemotherapy and radiotherapy)
• a palliative care doctor (a specialist in easing or relieving the symptoms cancer)
• a clinical nurse specialist.

Other health professionals may also be involved, such as a:

• physiotherapist (who helps and treats people with physical problems caused by an illness)
• occupational therapist (who helps people who have trouble moving around or doing everyday tasks such as dressing, washing or cooking)
• psychologist
• dietitian
• speech therapist.
• pharmacist

When an MDT meets, they consider all the scan and test results that you have had since your cancer diagnosis. This helps them to plan the treatment that is most effective for you, taking into account your age, general health, the cancer stage (its size and whether it has spread) and its grade (which indicates how quickly it may grow or develop).

How do the teams work?

How the team is organised will depend on where you live – there are differences between England, Scotland, Ireland and Wales, and also between regions. Some MDTs discuss patients from different hospitals, and specialists may be on teams for a number of different types of cancer.

How often a multidisciplinary team meets may also vary. This could mean that you have to wait a bit longer to get all the results of your scans and a treatment plan from your doctor. This can be frustrating and worrying – but the pooling of different types of expertise should mean the best possible decisions are made about your treatment and care.

Research that looked at how effective MDTs are in the UK found that as a result of being cared for by an MDT you’re more likely to:

• Receive accurate diagnosis and staging.
• Be offered a choice of treatments decided by a group of experts, rather than by one doctor.
• Receive better coordination and continuity of care through all stages of the cancer.
• Be treated in line with locally-agreed policies and national guidelines.
• Be offered appropriate and consistent information, as the person giving the information should be more aware of the team’s strategy for your care.
• Have your psychological and social needs considered. Communication between different team members is also better where they have a formal working relationship.

Therefore, the National Institute for Health and Clinical Excellence (NICE) and the NHS Cancer Plan recommend that the treatment of everyone with cancer should be managed by a multidisciplinary team.

If you are offered a choice about which treatment you have this can be difficult. Considering all the pros and cons| is usually the best way to make the decision. Make sure you have enough information about what the treatments involve and any side effects, and feel free to discuss the right choice with any member of the multidisciplinary team.