Introduction to Tumor Board Xinni Song MD, FRCPC Joanne Meng MD, FRCPC Ottawa Hospital Cancer Center University of Ottawa Feb 10, 2016

Introduction What is tumor board? Why is it important to have tumor board meetings? What can be discussed at tumor board meetings

What is Tumor Board? Multidisciplinary meeting of cancer specialists including, but not exclusive to Medical oncologists Radiation oncologists Surgeons Pathologists Radiologists Pharmacists Nursing staff Psychosocial support team Regular meetings to discuss issues related to patient care

Why is tumor board important? Review complex or rare cases Identify clinical issues and formulate solutions Saves time Share clinical expertise Discuss evidence-based medicine Continue medical education - scholar

What’s discussed at tumor board? Diagnosis Clinical presentation Imaging findings Pathology findings Specific clinical question Second opinions Lessons learned/clinical challenges

Tumor Board Feb 11, 2016 8:00-9:30 and 11:00-12:30 Dr. Andrea Gutauskas - Surgery Dr. Joanne Meng – Radiation oncology Dr. Xinni Song – Medical oncology

Clinical Case 42 year old woman presented to her family physician’s office with a new lump on her right breast

Questions What is the differential diagnosis of a breast lump? How to differentiate benign vs. malignant lesions? What are the risk factors for breast cancer? What types of imaging study can help this patient make a diagnosis?

Questions What are the surgical options for breast cancer? What are some of the important pathological factors used in treatment decision making? What is the role of local-regional radiation for breast cancer? What are possible systemic treatment options for breast cancer?

6 years later...... This patient presented with redness and swelling involving right breast – cancer recurrence with inflammatory features What are possible therapeutic options for her? Determination of operability Radiation Systemic therapy On clinical history, she is also having back pain and bone scan showed multiple lesions on spine consistent with metastatic breast cancer. What are possible therapeutic options for her now?

Questions?

Special Guest Tamara Levine a long-time adult educator and literacy activist. She pioneered workplace literacy and clear language initiatives across Canada with the Ontario Federation of Labour and the Canadian Labour Congress. Following breast cancer treatment and recovery, she retired from her job in labour education in 2011. She lives in Ottawa with her family where she writes, sings, walks, and swims with the loons. “But Hope Is Longer - Navigating the Country of Breast Cancer”

Questions for our guest 1) How was your cancer diagnosed? Initial presentation – symptoms Tests done 2) Tell us about the types of physicians involved in your care 3) what types of treatment did you receive? Your personal experience 4) Resources for the survivorship journey that you found helpful 5) Do you have any advice for medical students as a cancer survivor?