Your Multidisciplinary Cancer Team (MDT)

This leaflet has been designed to give you information about the team responsible for your care and treatment. We hope it will answer some of the questions that you or those who care for you may have at this time. This leaflet is not meant to replace the discussion between you and your healthcare team, but aims to help you understand more about what is discussed.

We are all individuals and cope in different ways and need different lengths of time to adjust to a cancer diagnosis. You may want to discuss your worries or concerns with your Macmillan Clinical Nurse Specialist (CNS), also known as your keyworker, who can provide help and advice. If you are in hospital, you may meet the Acute Oncology Team who can also support you and will liaise with your Macmillan CNS and the wider team.

What is a multidisciplinary team and what do they do?

Following your recent diagnosis of cancer or suspected cancer, you will receive support and treatment from different clinicians who form the multidisciplinary team (MDT). The MDT includes doctors, nurses, and other professionals who will plan treatment and care that is appropriate for you.

To do this, most MDTs meet every week to discuss patients with a suspected new diagnosis of cancer at a multidisciplinary meeting (often called the MDM). Each multidisciplinary meeting has a cancer speciality (for example thyroid cancer, breast cancer). At this meeting the team also review the cases of some patients who have previously been diagnosed with cancer.

There may be a number of investigations and treatment options available to you. More than one specialist is likely to be involved in your care, so it is essential that everyone can share their expertise and understanding about your case, even though you will not personally meet all of the members of the team or come to the meeting.

Your team will discuss with you any decisions made at this meeting, either at your next appointment or while you are in hospital. They will also answer any questions you have about the benefits and risks of the treatments available to you.

Your GP will be sent a copy of the plan from the meeting, so they are aware of the discussions as well. This is usually sent electronically on the next working day.

Who is included in the MDT?

The following professionals are the key members of the MDT.

• Your Macmillan Clinical Nurse Specialist (CNS), also known as your keyworker, acts as a point of contact for you and your family throughout your treatment. They will give you help, advice, and support. They will know your case, and will help plan your assessments and investigations, as well as making sure that findings from investigations are communicated to other healthcare professionals and explained to you so that the right plan of care can be put in place.

• A cancer surgeon is a specialist in cancer surgery. They have expertise either in a specific type of cancer, or a small group of related cancers.

• Specialist doctors who have specialist knowledge of your specific type of cancer.

• A radiologist is a doctor who specialises in interpreting x-rays and scans, which can help make a diagnosis of cancer.

• A medical / clinical oncologist is a specialist in using chemotherapy and other drugs for the treatment of cancer. A clinical oncologist is a specialist in the use of radiotherapy, as well as chemotherapy.

• A cellular pathologist is a doctor who specialises in using a microscope to examine the tissue or cells removed during a procedure or operation. Cellular pathologists can detect features of cell structure which show abnormalities and can help confirm a diagnosis of cancer.

• The MDT coordinator gives administrative support and prepares information for the weekly MDT meetings. If needed, the MDT coordinator helps send and receive information from other hospitals, as well as sending the MDM plan to your GP.

There are other members of the wider MDM team that may be relevant to you and the type of cancer you have, examples include consultant nurses, dieticians, stoma nurses, palliative care, and the Acute Oncology Nursing Team, as well as cancer support workers who work closely with your CNS.

What type of treatment will I have?

Every person diagnosed with cancer is different. Decisions about what treatment is appropriate for you are based on your test results, but also how you are as an individual. We can give you leaflets about your treatment options. Please speak to your CNS for further information and copies of the relevant leaflets.

You may be offered one (or a combination) of the following treatment options:

• surgery

• chemotherapy and / or immunotherapy (anti-cancer drugs)

• radiotherapy

• supportive care and palliative care

• referral to a specialist hospital, usually in London

• “watch and wait” with regular review and observation.

Do I have to accept my treatment plan?

No. It is for you to decide. If other options are available these will be discussed with you, and we will give you time to consider them before you make your final decision. However, the proposed treatment plan will be what the MDT members think is the most appropriate treatment for you.

Where will I have my treatment?

A member of your Multidisciplinary Team will explain this to you and whether there are any options available.

How do I contact my Macmillan CNS?

We have a Cancer Care Telephone Line for you to contact your Macmillan CNS. The telephone service is available Monday to Friday 9am to 5pm, Saturday and Sunday 8am to 4pm.

The Macmillan CNS’s run phone clinics during the week, so if appropriate you will be booked on to the next available telephone clinic, which may not be the same day.

Cancer Care Line contact number: 01227 868666

What if I need spiritual and pastoral care?

Chaplains are a multi-denominational and multi-faith team working as part of the wider healthcare team. They are available for spiritual, emotional, and pastoral support or advice. Chaplains also offer spiritual and pastoral care for those of no faith, which includes giving time and compassionate attention to people to help them work through feelings of distress or anxiety.

For more information on the chaplaincy service offered by the hospitals, please ask a member of staff for a copy of the Trust’s Chaplaincy / Spiritual Care Services leaflet.

How do I make a comment about my visit?

We are committed to improving services by listening to patients, their families, and carers.

Our aim is to offer a compassionate and efficient service to all our patients and visitors. Feedback helps us to improve our services leading to positive experiences for our patients and their relatives or carers. However if you have a concern, please either:

• Speak to the person in charge of the ward or clinic, or your Macmillan CNS: this is often the best way of getting your problem sorted out. They can often do something straightaway, which avoids you becoming more anxious or distressed.

• Ask for help through PALS. If you would rather ask for help from someone else, the Patient Advice and Liaison Service (PALS), will do their best to help you. If they cannot resolve your problem, then they will be able to give you clear, friendly advice as to what your next steps should be. PALS can be contacted either by telephone on 01227 78 31 45, or email.