Cancer conferences: Can they be improved?

PURPOSE: Cancer conferences are required for hospital cancer program approval by the American College of Surgeons. These conferences are important educational and clinical opportunities and can influence the management of patients with cancer. Nationally, they represent an enormous expenditure of time and effort by physicians, associated healthcare personnel, and tumor registrars. The educational aspects of cancer conferences have been previously reviewed. The purpose of this investigation was to evaluate the clinical aspects of cancer conferences. DESCRIPTION OF STUDY: A questionnaire, inquiring about various elements of cases presented at six consecutive cancer conferences, was sent to 93 Illinois hospitals. These elements included presentation at conference (presenter, time of presentation), clinical aspects (symptoms, history, physical examination, and laboratory tests), pathology (TNM stage and markers), therapeutic options, and quality-of-life issues. RESULTS: The person (or persons) presenting the case was most frequently the attending physician (n = 805, 52%); followed by the pathologist (n = 427, 28%); the cancer committee chairperson (n = 318, 21%); the resident (n = 138, 9%); and other members of the multidisciplinary healthcare team (n = 525, 34%), such as the nurse practitioner or radiation therapist. Of the 1547 cases reviewed, history, physical examination, and diagnostic tests were discussed in 93%, 91%, and 93% of conference presentations, respectively. However, staging by the required TNM system, tumor markers, and quality-of-life issues were discussed in only 28%, 34%, and 38% of presentations, respectively. CLINICAL IMPLICATIONS: Although clinical characteristics were adequately documented and discussed at the cancer conferences studied, other important parameters, such as TNM staging, tumor markers, and quality-of-life issues, were less often discussed. The former topic frequencies are expected, the latter unacceptable. Although cancer conferences currently enhance patient care, these findings indicate that there is potential for improvement through discussion of TNM staging, tumor markers, and quality of life.