| Siti Hajar |
IT IS said that teamwork breeds success. Among many others, this particular mantra is repeated by organisations irrespective of their trade to achieve the best possible outcome with the country’s own health industry holding close this principle for the betterment of its varying patient demographics.
The establishment of The Brunei Cancer Centre (TBCC), regulated by the Ministry of Health, brings with it a renewed outlook in catering to the needs of cancer patients as it explores the globe, adopting international best practices and implementing these learning lessons at home as an extension of its services that has been mandated in its core values.
Apart from the acquisition of state-of-the-art technology to add to its healthcare arsenal, the people who treat patients also play a symbiotic role in TBCC’s healthcare environment and this includes the banding of a diverse group of healthcare providers who discuss, deliberate and decide the best way forward for each individual that walks through their doors.
Under the watchful eyes of TBCC’s multidisciplinary tumor board (MDT) that inherited the responsibility from the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, patient care is created through the exchange of information among participating specialists from both the centre and hospitals under the Ministry of Health who are able to share their expertise based on their own experiences, knowledge and up-to-date literature by way of ensuring that those seeking aid are given the best possible chance to survive.
“An important objective of the MDT,” explained TBCC Medical Director Dr Kenneth Kok, “is to provide a mechanism for the review of the quality of professional care provided by hospital staff members.”
Held in an informal setting, the weekly MDTs for general surgery, ear, nose and throat (ENT), gynaecology and the monthly gathering for urology is strict on confidentiality without judgment, where the contribution of individual members of staff can be discussed.
The Brunei Cancer Centre and the Rehabilitation Department of Brunei Neuroscience, Stroke and Rehabilitation Centre building
“It is this informal interaction between specialists that provides for quality assurances,” he shared, as per such practices in countries including the United States, Europe, Australia and Japan.
As it continues to develop its facilities with a new building on the way, Dr Kok shared that MDTs for head and neck, as well as breast cancer cases will be entrusted into TBCC’s hands from MDTs in RIPAS thus rounding out their MDT portfolio by the end of the year.
“The initial evaluation and treatment decisions are the most critical in the outcome for a patient diagnosed with cancer,” he said of the important role this gathering plays, adding that detection, diagnosis, management and treatment are not typically a one-person responsibility bur require the participation of surgeons, oncologists of medical and radiology specialists as well as nurses.
With a formal structure to assure that communication lines are open, each member of the team can benefit from the expertise of others among them include Memorial Sloane Kettering Cancer Centre, New York, USA, the Royal Marsden Hospital, London, UK, Krankenhaus Nordwest, Frankfurt, Germany, Maastricht Radiation Oncology, Maastricht, Holland, Chinese University of Hong Kong, SAR China and the National Cancer Centre, Singapore through knowledge and education, while at the same time contribute to the development of standardised patient management protocols as well as linkages among institutions to ensure appropriate referrals and timely consultation and optimise patient care.
With information derived from these meetings, MDT team members, he said, then formulate a management plan based on current medical guidelines where individualised cancer treatment may be achieved in the best interest of the patient where possibilities that two patients with the same type of cancer may find themselves on different pathways of cancer management.
Studies conducted in the UK and Scandinavia have shown that “through the introduction of MDT alone, patient outcome in terms of survival may improve by nearly 20 per cent,” without the added need for new drugs, surgical therapy or equipment.
Other studies, it was added, have also concluded that MDT conferences have resulted in positive patient outcomes, “particularly in terms of diagnosis and/or treatment planning and patient satisfaction,” with the added incentive that clinicians also experience better cooperation and communication.
“Patients should feel more assured that their case has been reviewed in a MDT conference by all specialists and that the management plan obtained is a consensus opinion of the specialists based on international guidelines and currently available medical evidence.”
Though there are occasions when consensus among members continues to be debated, the MDT, it was clarified, forges ahead through its platform to iron out differences to find the best possible approach.
“TBCC will make available to cancer patients in Brunei Darussalam the latest and state-of-the-art facilities for cancer treatments,” ideals of which also fall under the Ministry of Health’s three strategic priorities which include the delivery of excellence through consolidation and realignment of healthcare services.
The centre, added, Dr Kok, will include the likes of radiotherapy and up-to-date diagnostic investigations crucial to the management of cancer patients which will add to the Medical and Surgical Oncology services that are currently available in the country.
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