Cancer, Medical Practice, Public Health

CLUELESS! doctors are confused of each others responsibility in cancer treatment, study found

When it comes to their respective responsibilities in patient care with breast cancer, doctors may be as clueless as the next person, according to a study conducted on Metro Manila doctors.

Researchers underlined the need for multidisciplinary guidelines for patient care in breast cancer .

The study surveyed doctors from tertiary hospital in Metro Manila with regards to division of labor among health practitioners in various aspects of Human Epidermal Growth Factor Receptor-2 (HER2) Testing, an important diagnostic exam for breast cancer.

HER-2 testing is widely recommended diagnostic procedure for all primary breast cancers. From patient education, to collection of specimen, and and overall patient care, the procedure involved a team of medical practitioners with with varying tasks and responsibilities.

The study, done in collaborations between researchers at the University of the Philippines – College of Medicine and Cardinal Santos Medical Center,   revealed that more than half (54%) of the surveyed answered that surgeons and staff at the operating room are responsible for the breast tissue collection, while 23% answered it is the pathologist’s responsibility. Varying answers include staff at the operating room only (13%), medical technicians (7%), medical oncologist (1%), and  whomever was in charge of the patient (1%).

As for the primary responsibility of requesting for HER-2 testing, 69% answered the medical oncologist or whomever the patient saw first, 13% answered surgeons, 12% medical oncologist only, 4% pathologists, and 1% said it should be the patient.

With regard to patient education, 59% of the surveyed answered the responsibility is in the hands of medical oncologists or whomever sees the patient first. Other answered medical oncologists only (28%), surgeons (9%), nurses (1%), and any oncologist or practicing physician (15).

With the varying answers, researchers lamented, “Though the differences are minor, these may reveal a lack of interdisciplinary awareness.”

Researchers explained that the awareness of interdisciplinary roles played by members of the medical team is essential for the well-being of both the patient and the medical practitioners. Patients get more efficient service while the medical team increase morale and work satisfaction.

The lack of interdisciplinary awareness can only be sufficiently addressed through strong compliance to international accepted guidelines with patient care. The researchers discussed that guidelines on HER-2 testing has been set up by the American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP). However, the Philippines currently have no central body that will help with the adoption of a similar guidelines for HER-2 testing in the country. Until the Philippines has find away to successfully set up guidelines for HER-2 testing, cohesive and efficient medical service for Filipino breast cancer patient will remain a challenge.