Transcript: Optimization of the patient experience within the MDT
Axel Merseburger, MD, PhD
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So, we can optimize the patient experience with a multidisciplinary team and a multidisciplinary tumor board in prostate cancer. And let me highlight some points. So MDT involvement in the care of patients with a non-metastatic or metastatic hormone-sensitive prostate cancer, I think it plays a very important role in how the patients are going to be treated. Because in this MDT, we have to have this cross-collaboration to optimize the outcome and manage the disease and first define whether it's non-metastatic nmHSPC or if it's metastatic mHSPC. So, we have proven and published evidence that MDT discussion improves overall survival in mHSPC.
Also, when setting the plan, we always have colleagues and even interdisciplinary comments from nuclear medicine experts, from experts in palliative care setting. Even we invite in our MDT our study nurses and they sometimes raise their hand and say, "Hey, this might be a patient for a clinical trial." So, we have those broad therapeutic options for biochemical recurrent non-metastatic nmHSPC and also metastatic hormone-sensitive prostate cancer. So also, all the pros, this multidisciplinary discussion we have, there are possible challenges in the MDT that can be encountered. For example, inconsistencies in MDT engagement across the specialists. We have shared decision-making, which ideally includes the patients, but it's not always and everywhere. But this would be a goal to, after the MDT, to include the patient and discuss it in a shared-decision communication. Board communication, importance of an MDT is how you communicate this and also consider the patient preferences when making the decisions. And this is utmost importance. That's why I always invite the treating physicians when it's an outpatient, a clinic patient, where we don't see the patient primarily, but the referring urologist or oncologist sees the patient. I think it is very important to have this person included in the MDT in order to know the patient.
And we learn from this process. We have the situation that also this MDT can teach the team. And I think we have it once in a week and I think it's our best teaching experience with regards to urologic malignancies and especially in prostate cancer. Because we discuss the latest evidence, we always get corrected from colleagues with good ideas, evidence. And in the future, maybe including artificial intelligence, like the EAU guidelines has now released a guidelines EAU bot, like a chat bot where you can challenge the guidelines. And I think integrating, and there's also published evidence on that, artificial intelligence into the MDT might be the future, but we will see and some more research has to be done. So in summary, I think an MDT is very important. And from the German situation, it is mandatory that all the prostate cancer patients, when you work in a prostate cancer center like I do, that you have to present and discuss those patients in an MDT for raising the quality, educational purposes, and most important, to prolong the overall survival of our patients, in this case with advanced prostate cancer. So thanks a lot.
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MA-MM-16215, August 2025