Carey August, MD, FCAP, is director of Anatomic Pathology at Advocate Illinois Masonic Medical Center in Chicago, IL. V.O. Speights, DO, FCAP, is director of Anatomic Pathology at Scott & White Medical Center in Temple, TX.
Your doctor says to you, "We discussed your case at our tumor board, and here is your treatment recommendation." So, what exactly is a tumor board and what role does it play in your cancer care? This Q&A explains.
1. What does a tumor board do?
A tumor board is a group of doctors and other health care providers with different specialties that meets regularly at the hospital to discuss cancer cases and share knowledge. The board’s goal is to determine the best possible cancer treatment and care plan for an individual patient. Having fresh perspectives from other doctors makes it much easier to come up with that plan.
2. Who takes part in a tumor board?
Tumor board meetings can include doctors such as pathologists, surgeons, and medical and radiation oncologists. Depending on the cases being discussed, additional doctors, such as gynecologists, plastic surgeons, or urologists, may also participate. A diverse range of other health care providers, including nurse specialists and social workers, may take part as well.
A patient’s privacy is always honored. Only people who need to be involved in your care take part in the discussion.
3. Why are doctors like radiologists and pathologists there? Haven't they already provided their reports to my doctor?
Specialists such as radiologists and pathologists gather and evaluate a wide variety of information that influences your diagnosis and treatment. While medical records contain a lot of information, the specialists benefit from hearing what the attending doctors think about your condition. Attending doctors can also get the specialists’ advice and perspectives.
Here’s an example. Pathologists are the doctors responsible for making the diagnosis based on your biopsy and ensuring that the appropriate special tests are performed and reported properly. In a tumor board discussion, a pathologist might:
Recommend additional testing on your tissue sample. Modern technology enables us to refine or inform the tumor board’s decision. Typically, tissue specimens removed during a biopsy or surgery are preserved in wax, called a paraffin block. From this preserved tissue, the pathologist can often perform some additional new tests—even weeks or months later—to help predict which treatment would be effective.
Encourage your doctor to repeat a biopsy if not enough tissue was taken, and explain how, from a pathologist's point of view, the new biopsy sample should be obtained.
Share what additional blood tests, imaging scans, or other biopsies can help with making a diagnosis or planning treatment.
Help the tumor board decide what additional treatment you may or may not need after a surgery, such as radiation therapy or chemotherapy.
Suggest that you speak with a genetic counselor to determine your risk, or your family members' risk, for other cancers.
The face-to-face discussions at a tumor board help everyone on your cancer care team learn more details about your case. By working together, the team can evaluate all of the options that may improve your treatment’s effectiveness.
4. Besides providing a treatment recommendation, how else can a tumor board help me?
A tumor board can include social workers and nurse navigators who can determine the best way to implement the treatment plan designed specifically for you. For example, you may need help managing transportation or deciding how best to schedule your treatment.
The tumor board can also make sure that your doctors are aware of any clinical trials for which you may be eligible.
Having everyone in the same room, with all of their different and specialized knowledge, brings a lot of fresh perspectives and expertise to the process of deciding on a treatment plan.
5. Are all cancer cases reviewed by a tumor board?
In some hospitals, a tumor board reviews all cancer cases when treatment planning starts. In others, the tumor board focuses on cases for which a doctor seeks input from the other doctors on a patient’s team.
You have the right to be an active, informed participant in your care. It’s OK to ask your doctor if or why your case was discussed at a tumor board. Or if it wasn’t, why not? In some cases, a patient’s treatment plan is very straightforward using standard treatment guidelines, and the doctor may feel a tumor board review isn’t needed. However, you can request that one be done.
Don’t forget, you can always ask to speak to your pathologist if you have questions about your diagnosis.