Tumor Board at your program

[Matte Kudesai]

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How much respect does the pathology department get at your programs during tumor board?

Are the attendings that signed the cases out present?

Do surgeons treat you like a glorified technician?

How important a role does tumor board play in conveying pertinent information about cases to surgeons?

 

[CameronFrye]

How much respect does the pathology department get at your programs during tumor board?

Are the attendings that signed the cases out present?

Do surgeons treat you like a glorified technician?

How important a role does tumor board play in conveying pertinent information about cases to surgeons?

From my limited experience (upper level residents and fellows take turns presenting tumor boards, so I've only been as an observer), it depends on the tumor board. Gyn-onc tumor board is very path-centered and is actually held in a path conference room. Thoracic tumor board is much more radiology-centric with a small amount of input from path. Neuro falls in the middle with big input from both radiology and path. Interestingly, gyn-onc fellows and neurosurgery residents will do rotations on path, so they probably have more understanding of where we're coming from.

 

[LADoc00]

Tumor boards are required by hospital credentialing (JACHO where I am).

They are either run by oncologists or the pathologists in my expression. And, I have been to tumor boards at small hospitals in the middle of nowhere wilderness that have like a staff of 1 pathologist who is near 90 and they still have a tumor board with powerpoint presentations.

 

[yaah]

They vary a ton. At most of them the pathologist is very important and respected (like sarcoma or GI or pulmonary). At the lymphoma tumor board the pathologist's (resident) job is to read the diagnosis off of the sheet, generally after the PA or hemeonc fellow who presented the clinical case has already given it away. Oftentimes precedes like this:

PA: Mr Y presented with lymphadenopathy, biopsy revealed Follicular Lymphoma grade I, bone marrow was positive 10% of marrow space.

Clinician leading tumor board (after ten minutes of radiology showing CT scans and PET scans trying to determine if the 2 mm lung nodules are new or not and where they exactly are): Pathology?

Me: Biopsy showed grade I follicular lymphoma. Bone marrow was positive, 10% of marrow space.

We don't usually show slides at that one because it would take away time from the discussion of the PET scan. Most of the other ones we do though. And usually the attendings or fellows go, residents don't have much tumor board responsibility unless they're on elective or something.

 

[l&usibari]

How much respect does the pathology department get at your programs during tumor board?

Are the attendings that signed the cases out present?

Do surgeons treat you like a glorified technician?

How important a role does tumor board play in conveying pertinent information about cases to surgeons?

At our main tumor board, the pathologists (namely, the resident who shows the slides, and the attending who may or may not speak at all) are somewhat looked down upon. The attendings may avoid coming if their case is being presented and there is potential controversy. They may come if it's straightforward and someone gives them a heads-up in advance. The surgeons treat us like colleagues, not technicians. The tumor board is extremely important in relaying pertinant information, as surprisingly often the report contains confusing or misleading information.