An international, multidisciplinary approach to the management of advanced colorectal cancer

The International Working Group in Colorectal Cancer conducted a survey (the Colorectal Cancer Care Pathway Review) in the summer of 1995 to examine medical, surgical and oncology nursing perceptions of patient management throughout Europe and the United States. The sample included 319 oncologists (surgical, medical and radiation) and 103 oncology nurses from a variety of centres in France, Germany, Italy, the United Kingdom and the United States. In response to issues identified in the Colorectal Cancer Care Pathway Review, a model for the optimal management of patients has been developed by the Working Group. The objectives of the Patient Management Model are: to define current best practice in advanced colorectal cancer; and to identify areas for ongoing research and clinical trials. Due to the multicultural nature of the Working Group, the model incorporates the differences in treatment that occur between countries. The Patient Management Model gives recommendations on treatment issues such as diagnosis, staging of disease, management strategy and therapy considerations including surgery, radiotherapy, chemotherapy, palliative supportive care, therapy management, auxiliary management and patient support. A multidisciplinary team approach to patient management is recommended to ensure optimal treatment and care. The multidisciplinary team should include all those involved in the treatment of tbe patient including specialists such as the oncology nurse. A summary of the recommendations of the Patient Management Model is presented here.