The establishment of a Tumor Board may be relevant for the development of standardized practices locally in prostate cancer treatment, including reducing the amount of time patients spend getting tested rather than being treated.
This was the view of Georgetown Public Hospital Corporation (GPHC) Urologist Dr Chris Prashad on Wednesday at a Ministry of Public Health workshop on Cancer Diagnosis and Management.
“Guyana never really had true comprehensive tumor care…. Different people have different algorithms that they follow… my proposal was to create a Tumor Board, starting at the level of the GPHC, which is arguably the largest cancer care provider in the country,” Prashad explained.
He said that whatever decisions made at the board level would have to be followed by whomever is implementing treatment, and that protocol should not be diverted from unless the Board is first consulted. The ultimate goal of this would be to create a standardized system.
Prashad made reference to cases locally where cancer patients are referred to one department but decide to seek a second opinion, and in doing so, some ultimately end up going back and forth between healthcare professionals, spending money to have basic tests done and redone, and end up not getting care.
“…And then they go back and forth, something we call the ‘Football Effect’ in Guyana. They go back and forth and eventually they come back to us and then the surgery probably will no longer be beneficial because you’ve already spent two months,” he said.
Prashad opined that one standard algorithm of care should be decided upon before surgery is initiated, and it should be adhered to for the sake of standardization.
“This comprehensive cancer care plan that is to be generated for 20 or 30 years in the future, I’m thinking it needs more input from the people on the floor who are actually facing the problems on a day-to-day basis. It’s not an entirely academic exercise,” he said.
“…It’s not like it’s an insurmountable barrier, it just took me four years to get the Tumor Board approved, it might take another year to get it working and it might take another few years to get the other things in place, but if you have a 20 year projection, it’s something that can be done,” he added.
Prashad’s comments came during a presentation by Dr Franklin Huang, an instructor of Medicine at the Harvard University and of Medical Oncology at the Dana-Farber Cancer Institute. Huang was at the time presenting on the risk factors, early detection, diagnosis and treatment of prostate cancer cases.
During a brief question and answer segment, Dr Simon Sutcliffe, of the International Cancer Control Planning Partnership, posed a question of how valuable the creation of tumor groups could be in managing patient care in Guyana.
Sutcliffe explained that a Prostate Tumor Group would allow all healthcare professionals that play a role in managing patients with prostate cancer to come together and set a standard for good practice.
By doing so, he said, it would open up the way for them to “identify and potentially exclude persons who work outside of that bandwidth of good practice such that you minimize inappropriate variation.”
Sutcliffe pointed out that the treatment guidelines he heard being referred to most on Wednesday by the healthcare professionals present at the workshop were derived through the work of Tumor Groups.
