Cancer remains a leading cause of morbidity and mortality worldwide, and Turkey is no exception. According to the Turkish Ministry of Health, the incidence of cancer in Turkey continues to rise, with common types including lung, breast, colorectal, prostate, and stomach cancers. As cancer care involves various diagnostic, therapeutic, and supportive strategies, the need for a multidisciplinary approach has become increasingly emphasized in clinical guidelines and institutional policies.
The multidisciplinary approach in oncology treatment involves collaboration among medical oncologists, radiation oncologists, surgical oncologists, radiologists, pathologists, palliative care specialists, nutritionists, and psychosocial support professionals. This model facilitates comprehensive evaluation, personalized treatment plans, and integrated follow-ups, ultimately improving patient satisfaction and survival rates.
This paper aims to discuss the concept of multidisciplinary care in oncology, its implementation in Turkey, and the outcomes observed through selected case studies.
Multidisciplinary Oncology Care: Concept and Structure
A multidisciplinary approach in oncology ensures that each patient’s case is evaluated by a team of specialists who collaboratively design and adjust treatment strategies based on the latest clinical evidence and individual patient factors. Multidisciplinary oncology teams typically hold regular tumor board meetings where cases are discussed in detail, covering diagnostic imaging, pathology, surgical possibilities, medical treatments, and supportive care needs.
Core Components of Multidisciplinary Oncology Teams:
• Medical Oncology: Responsible for chemotherapy, immunotherapy, and targeted therapy.
• Radiation Oncology: Manages radiotherapy planning and application.
• Surgical Oncology: Conducts tumor resections and surgical interventions.
• Pathology: Provides histological diagnosis and molecular profiling.
• Radiology: Offers imaging assessments for staging and follow-up.
• Palliative Care: Ensures quality of life and symptom management.
• Nursing, Nutrition, and Psychology: Deliver supportive care services.
The integration of these disciplines creates a patient-centered care pathway that enhances treatment outcomes and patient experience.
Oncology Care in Turkey: Progress and Challenges
Turkey has made considerable advancements in oncology care infrastructure over the past two decades. State-of-the-art oncology hospitals, comprehensive cancer centers, and university hospitals increasingly adopt multidisciplinary models in line with international recommendations. However, implementation varies across regions due to disparities in resources, personnel availability, and institutional culture.
The Turkish Ministry of Health actively promotes multidisciplinary oncology councils (Onkoloji Konseyleri), which are formal, weekly meetings where newly diagnosed and complex cases are discussed by relevant specialists. While tertiary and teaching hospitals have successfully institutionalized these councils, some district hospitals still struggle due to limited staffing and logistical barriers.
Case Studies from Turkey
This section presents three anonymized case studies from Turkish oncology centers to illustrate the impact of multidisciplinary care on patient outcomes.
Case Study 1: Multidisciplinary Management of Breast Cancer
Patient Profile:
A 45-year-old female diagnosed with stage II invasive ductal carcinoma of the breast.
Multidisciplinary Team Involvement:
• Radiology confirmed the tumor’s size and axillary involvement.
• Pathology provided hormone receptor and HER2 status.
• Surgery planned a breast-conserving operation.
• Medical oncology proposed adjuvant chemotherapy and hormone therapy.
• Radiation oncology coordinated postoperative radiotherapy.
Outcome:
Through a multidisciplinary tumor board, the patient received a tailored treatment plan, including neoadjuvant chemotherapy, successful breast-conserving surgery, and adjuvant radiotherapy. Two years post-treatment, the patient remains disease-free with preserved breast aesthetics and minimal complications.
Key Takeaway:
Early multidisciplinary decision-making led to breast conservation, improved quality of life, and comprehensive care planning.
Case Study 2: Integrated Palliative Care for Advanced Lung Cancer
Patient Profile:
A 65-year-old male with stage IV non-small cell lung cancer (NSCLC) and bone metastases.
Multidisciplinary Team Involvement:
• Radiology confirmed metastases via PET-CT.
• Pathology conducted molecular profiling.
• Medical oncology initiated immunotherapy based on PD-L1 status.
• Palliative care managed pain, nutrition, and psychological support.
• Social services arranged home care support.
Outcome:
The patient’s symptom burden reduced significantly with coordinated pain management and home care services. Immunotherapy prolonged survival by 10 months beyond initial expectations. Regular multidisciplinary reviews ensured timely adjustments in care.
Key Takeaway:
Integrated palliative care in conjunction with oncologic treatment enhances both survival and quality of life in advanced-stage cases.
Case Study 3: Multimodal Approach to Rectal Cancer
Patient Profile:
A 58-year-old male with locally advanced rectal adenocarcinoma.
Multidisciplinary Team Involvement:
• Radiology staged the tumor using MRI.
• Surgery, radiology, and oncology determined neoadjuvant chemoradiotherapy.
• Surgery performed a low anterior resection after downstaging.
• Pathology confirmed tumor regression.
• Medical oncology provided adjuvant chemotherapy.
• Nutrition and psychology supported postoperative recovery.
Outcome:
Downstaging from T3N1 to T1N0 allowed for sphincter-preserving surgery. The patient recovered well with no major complications. One-year follow-up showed no recurrence.
Key Takeaway:
Preoperative multidisciplinary planning improved surgical options and postoperative quality of life.
Discussion
These cases demonstrate that multidisciplinary care improves clinical decision-making, enables tailored treatment strategies, and enhances patient outcomes in oncology. In Turkey, especially in tertiary centers, multidisciplinary tumor boards ensure the consistent application of evidence-based practices.
Benefits observed include:
• Increased survival rates.
• Better management of treatment-related side effects.
• Enhanced patient satisfaction and trust.
• Improved psychosocial and palliative care integration.
Challenges include:
• Inconsistent implementation in smaller or under-resourced hospitals.
• Scheduling difficulties for multidisciplinary meetings.
• Administrative and logistical barriers.
• Need for continuous professional education and team training.
Efforts by national health authorities to standardize multidisciplinary oncology practices through regulations and accreditation criteria have gradually improved consistency.
Conclusion
The multidisciplinary approach in oncology treatment offers undeniable benefits for patient outcomes, especially in complex, multi-systemic diseases like cancer. Turkey’s adoption of this model, particularly in tertiary hospitals, showcases how collaborative care can be successfully implemented in a middle-income country with diverse healthcare settings.
The case studies presented emphasize the importance of early, coordinated intervention across specialties, highlighting how multidisciplinary teams improve both survival and quality of life. Future efforts should focus on addressing implementation challenges in peripheral centers, expanding training programs, and strengthening national oncology networks.
