Multidisciplinary Treatment

For rectal cancer tumours that are located near to the anus, surgical treatment may require the removal of the anus. To facilitate the removal of waste, doctors may then perform a colostomy for patients, creating an opening for a stoma in the abdomen that connects with the large intestine. The waste is then collected in an external pouch via the opening. However, this method brings a great deal of inconvenience to the patient’s daily life. With a multidisciplinary team of experts, the conditions of patients can be closely monitored. A watch-and-wait approach may then be adopted, such that a thorough evaluation could be made over the patient’s response to chemotherapy and radiotherapy, as well as the tumour’s position, before deciding whether to proceed with surgery. And should the situation not deteriorate any further, surgery may no longer be necessary.

In the past, patients as young as the age of 25 have been diagnosed with rectal cancer. For one such patient, their frequent international business travel and their keen hobby for swimming made a stoma an inadvisable solution. As MRI scans indicated the disappearance of his tumour after receiving chemotherapy and electrotherapy, doctors recommended the patient adopt a watch-and-wait approach. 10 years then passed, and there were no indications of a recurring tumour and, therefore, the patient was able to avoid such a surgery.

When treating liver cancer, not only does the size of tumour matter but also the degree of liver cirrhosis and function. As a result, the treatment methods may vary greatly according their status condition. As revealed by the latest study published in The Lancet in 2018, over the last 30 years the 5-year survival rate of liver cancer patients in China has now risen from less than 5% to the 14.1% seen between 2010-2014. With the continuous advancement in precision medicine and multidisciplinary treatments, hope has been brought to more and more liver cancer patients.

There was once a case where a Filipino liver cancer patient in his 50s, who due to the cancer having already taken over his liver and causing severe oedema in his abdomen, which had also entered the lymph nodes within his belly; plus, given his poor liver function, he was deemed unsuitable for receiving targeted therapy and was hence designated as ‘incurable’ in the Philippines. Through seeking treatment in Hong Kong, the patient was able to take advantage of tailor-made therapy plans, including the use of new types of immunotherapy medicines approved by the United States and Europe, which were then administered under Hong Kong’s Named Patient Program. His Alpha-Fetoprotein Tumour Marker has since dropped from over 2000 to approximately 1000 after the initial treatment. Within six months, his condition had stabilized, and the tumour had shrunk significantly, as was revealed by MRI scanning.

The major challenge for treating brain cancer is the very important and accurate locating of the brain tumour. Since brain function involves a complex network of nerves, there is a high risk of surgical complication and potential for damaging normal brain function, which can be greatly reduced by making as small an incision as possible. Doctors will usually perform an MRI scan prior to giving the general anaesthesia for the surgery. During the operation, ultrasound neuronavigation monitors the tumour. Some tumours may not be entirely removable through such surgery, and so for these patients living tissue will be taken from the tumour for examination later, which will then provide the basis for neurosurgeons and oncologists to better evaluate subsequent treatment options.

State-of-art surgical aids from recent years have boosted the precision of brain cancer treatments. The accuracy in the examination of brain tumour’s state has now reached 90%. However, for surgery to be carried out effectively and efficiently, the cooperation between the different specialties remains vital, which includes but is in no way limited to anaesthesiology, neurosurgery, oncology, and radiology.

Early intervention with prostate cancer may significantly increase the chance of successful treatment. The multidisciplinary treatment guidelines established jointly by the Hong Kong Society of Uro-Oncology and Hong Kong Urological Association share a similar view. It has been pointed out that should prostate cancer patients who are undergoing hormone therapy adopt chemotherapy concurrently under a multidisciplinary approach, they may have a more durable response to hormone therapy, extending survival for almost 20 months more than other treatment plans. This approach also allows better control over the tumour condition.

Nevertheless, many prostate cancer patients delay seeking medical advice. Some may feel embarrassed, while some think that their urinary problems are due to their advancing age. There was once a 70-year old patient that had already had urinary problems for a long time, and his condition only continued to get worse as time went by. Fortunately, his family members were aware of his problems and eventually persuaded him to get some treatment. After meeting with a panel of interdisciplinary experts, he was diagnosed with early-stage prostate cancer and was subsequently treated successfully by surgery. From this we can learn that a multidisciplinary treatment approach brings greater participation for the patients and their family members and helps with creating ties and consensus between the patient and their medical professionals.