Who may take part?
The membership depends on the cancer. It commonly includes:
- surgeons;
- clinical or medical oncologists;
- radiologists who interpret scans;
- pathologists who interpret biopsies and operation specimens;
- clinical nurse specialists;
- an MDT coordinator.
Other specialists may contribute when relevant, including gastroenterologists, respiratory physicians, nuclear medicine specialists, interventional radiologists, palliative care clinicians, dietitians or therapists.
The meeting is usually organised around a particular cancer type. A person may therefore be discussed at more than one specialist MDT if the diagnosis or proposed treatment crosses different services.
What information does the MDT consider?
The team may review:
- the history and current symptoms;
- scan images rather than only the written report;
- pathology findings from a biopsy or surgery;
- stage, grade and relevant biomarkers;
- previous treatment;
- other health conditions and performance status;
- available treatment options, guidance and clinical trials.
Sometimes the main outcome is that more information is needed. The MDT may recommend another scan, a repeat or additional biopsy, review at a specialist centre, or assessment by a particular clinician before a treatment plan can be proposed.
Why can recommendations differ between similar patients?
Two people may share the same broad diagnosis but differ in the exact site, extent, biology and technical treatment options. Previous treatment, organ function, general health and personal priorities may also affect what is reasonable.
The MDT provides a way for these factors to be considered by several specialists rather than from only one clinical viewpoint. The article on why people with the same cancer may have different treatment explains those differences more fully.
Is the MDT recommendation the final decision?
It is a clinical recommendation, not a treatment imposed on the patient. The MDT cannot always know every preference or practical concern from the information presented at the meeting.
Afterwards, a clinician or specialist nurse should explain the diagnosis, the recommendation, reasonable alternatives, expected benefits and important risks. The patient can ask questions and decide whether to consent. In some situations there is one clearly preferred option; in others there may be more than one reasonable approach.
If new information emerges during that discussion, the case can be reconsidered.
What happens after the meeting?
The outcome is recorded in the medical notes. A member of the team then usually discusses it at a clinic appointment or by telephone. The next step may be another investigation, a referral to a treating specialist, a pre-treatment assessment or a conversation about options.
The timing varies. If you have not heard when or how the result will be explained, your clinical nurse specialist or hospital team is usually the most appropriate contact.
Questions to ask after an MDT
- What was the MDT's recommendation and why?
- Did the team need any more tests or specialist opinions?
- Were other reasonable options discussed?
- Which parts of my diagnosis most influenced the recommendation?
- When will I meet the clinician who would deliver the proposed treatment?
An MDT combines specialist views into a recommendation. The final treatment plan is formed when that clinical advice is discussed with the patient and their informed preferences are included.
