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16 December 2015
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''So, whose job is it?'' - Researchers call for guidelines for breast cancer care after study reveals confusing answers from doctors

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Researchers recommended the adoption of a set of guidelines for tasks and responsibilities of health professionals after a survey revealed that doctors do not agree on who gets to do what in the care of patients with breast cancer.

The study, done in collaboration by researchers at the University of the Philippines - College of Medicine and Cardinal Santos Medical Center, surveyed medical oncologists and surgeons from tertiary hospital in Metro Manila involved in Human Epidermal Growth Factor Receptor-2 (HER2) Testing, an important diagnostic exam for breast cancer.

HER-2 testing is a widely recommended diagnostic procedure for breast cancer. From patient education, to collection of specimen, and overall patient care, the procedure involved a team of health care practitioners with varying tasks and responsibilities.

The survey asked medical oncologists and surgeons about their and their colleagues’ responsibility throughout the procedure; and found varying and often different opinion on who does what in the team.

For requesting the procedure of HER-2 testing, only 69% of the medical oncologists and surgeons answered that it is the medical oncologist’s responsibility or whomever the patient saw first.

About 54% of the surveyed participants said that it was the responsibility of the surgeon and the staff in the operating room (OR) to collect the specimen.

With regard to patient education, 59% of the surveyed agreed that the responsibility is in the hands of medical oncologists or whomever sees the patient first.

With the varying answers, researchers lamented, “Though the differences are minor, these may reveal a lack of interdisciplinary awareness.”

Interdisciplinary awareness is a health professional’s knowledge on one’s own responsibility as well as responsibility of other members of the health care team with regard to the medical and therapeutic interventions done to a patient. The researchers explained that the awareness of interdisciplinary roles team is essential, not only for the well-being of the patient, but also the medical practitioners. Patients get more effective service while the medical team increase their morale and work satisfaction.

The lack of interdisciplinary awareness can only be sufficiently addressed through strong compliance to international accepted guidelines with patient care. The researchers discussed that while guidelines on HER-2 testing has been set up by the American Society of Clinical Oncology/Colelge of American Pathologists (ASCO/CAP), the Philippines currently has no central body  or authority that will implement the adoption of a similar guidelines.

Until the Philippines has find away to successfully set up guidelines for HER-2 testing, cohesive and effective medical service for Filipino breast cancer patient will remain a challenge.

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