The road to healing
While weekly, multidisciplinary tumor boards reviewing select oncologic cases are nothing new at the Kimmel Cancer Center at Johns Hopkins, a single-site, single-day cancer clinic is quite uncommon. In its first 11 months of operation, ending in October of last year, the pancreatic cancer clinic saw 200 patients. Remarkably, the clinic’s findings—most involving cancer stage or diagnosis—were different from the patients’ outside institutions’ 24 percent of the time.
Here’s how the clinic works: Patients have lab blood work and CT scans done, then assemble for an overview of support services delivered by social workers, nutritionists, genetics counselors and others. Next, they are examined by clinicians from surgery,medical oncology and radiation oncology who prepare a one-page summary report.
At noon, the reports are distributed at a case conference to the multidisciplinary team—about 50 people in all. A surgeon, medical oncologist, radiation oncologist, pathologist and radiologist review patient information, imaging and pathology and reach a consensus on a treatment plan. Finally, the plans are discussed with each patient, and when appropriate, patients are offered access to innovative clinical trials. “We actually come to the patient with one consensus. If they saw each one of us individually, it would be very confusing,” says clinic director Joseph Herman, assistant professor of radiation oncology.
Most of the discrepancies between the clinic’s findings and those of the outside institutions, Herman says, result from reviews of pathology and CT imaging. So for example, some who believed their tumors were unresectable discovered they were actually surgical candidates. Others were found to have previously unsuspected metastases. “While that’s unfortunate,” says Herman, “we saved a lot of morbidity from unnecessary treatment like surgery, chemo or radiation.”
Herman conceived of the clinic as away to harness the expertise that exists at a high-volume pancreatic center like Johns Hopkins. “It can take patients weeks to see any one of our specialists,” he says. “Now we come to them, all on the same day.”
To discuss a case or refer a patient call +1.443.287.6499.