Skip to main content
Top
Published in: Current Anesthesiology Reports 4/2018

01-12-2018 | Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)

Organization of Multidisciplinary Cancer Care for the Surgical Patient: Role of Anesthesiologists

Authors: Elizabeth F. Rieth, Gregory W. Fischer, Anoushka M. Afonso

Published in: Current Anesthesiology Reports | Issue 4/2018

Login to get access

Abstract

Purpose of Review

The purpose of this review is to describe significant recent trends or developments regarding the role of anesthesiologists in a multidisciplinary team approach to cancer care for the surgical patient. We also discuss our own institutional multidisciplinary approach as a comprehensive cancer center with high surgical volume.

Recent Findings

Beyond the multidisciplinary team meeting concept, and local, institution-specific, or national programs, more formalized concepts and models of perioperative care have evolved. These provide a framework for robust involvement of anesthesiologists in cancer care for the surgical patient, with the goal of allowing for optimal individualized cancer outcomes.

Summary

Because of the wide-ranging nature of their perioperative expertise, anesthesiologists play an important role in multidisciplinary team cancer care for surgical patients. This role has been seen in the recent trends toward clinical models, such as the perioperative surgical home and enhanced recovery programs. Areas for future research include multidisciplinary assessment of the impact of such models on perioperative cancer outcomes through integration of data from national outcomes groups.
Literature
1.
go back to reference •• Aronson S, Westover J, Guinn N, Setji T, Wischmeyer P, Gulur P, et al. A perioperative medicine model for population health: an integrated approach for an evolving clinical science. Anesth Analg. 2018;126(2):682–90. https://doi.org/10.1213/ANE.0000000000002606Article describing a multidisciplinary integrated program to support perioperative medicine services. CrossRefPubMed •• Aronson S, Westover J, Guinn N, Setji T, Wischmeyer P, Gulur P, et al. A perioperative medicine model for population health: an integrated approach for an evolving clinical science. Anesth Analg. 2018;126(2):682–90. https://​doi.​org/​10.​1213/​ANE.​0000000000002606​Article describing a multidisciplinary integrated program to support perioperative medicine services. CrossRefPubMed
2.
go back to reference •• Ziabari Y, Wigmore T, Kasivisvanathan R. The multidisciplinary team approach for high-risk and major cancer surgery. BJA Education. 2017;17(8):255–61. https://doi.org/10.1093/bjaed/mkx003A discussion of important concepts of the multidisciplinary team approach in high risk surgery, with a focus on major cancer surgery.CrossRef •• Ziabari Y, Wigmore T, Kasivisvanathan R. The multidisciplinary team approach for high-risk and major cancer surgery. BJA Education. 2017;17(8):255–61. https://​doi.​org/​10.​1093/​bjaed/​mkx003A discussion of important concepts of the multidisciplinary team approach in high risk surgery, with a focus on major cancer surgery.CrossRef
5.
go back to reference Van Zundert AA, Wyssusek KH, Greenland KB. In reference to is multidisciplinary team care for head and neck cancer worth it? And does a multidisciplinary approach to voice and swallowing disorders improve therapy adherence and outcome? Laryngoscope. 2018. https://doi.org/10.1002/lary.27177. Van Zundert AA, Wyssusek KH, Greenland KB. In reference to is multidisciplinary team care for head and neck cancer worth it? And does a multidisciplinary approach to voice and swallowing disorders improve therapy adherence and outcome? Laryngoscope. 2018. https://​doi.​org/​10.​1002/​lary.​27177.
6.
go back to reference •• Della Rocca G, Vetrugno L, Coccia C, Pierconti F, Badagliacca R, Vizza CD, et al. Preoperative evaluation of patients undergoing lung resection surgery: defining the role of the anesthesiologist on a multidisciplinary team. J Cardiothorac Vasc Anesth. 2016;30(2):530–8. https://doi.org/10.1053/j.jvca.2015.11.018A discussion of the key items relevant to preoperative evaluation for lung resection surgery, with an emphasis on a multidisciplinary approach. CrossRefPubMed •• Della Rocca G, Vetrugno L, Coccia C, Pierconti F, Badagliacca R, Vizza CD, et al. Preoperative evaluation of patients undergoing lung resection surgery: defining the role of the anesthesiologist on a multidisciplinary team. J Cardiothorac Vasc Anesth. 2016;30(2):530–8. https://​doi.​org/​10.​1053/​j.​jvca.​2015.​11.​018A discussion of the key items relevant to preoperative evaluation for lung resection surgery, with an emphasis on a multidisciplinary approach. CrossRefPubMed
14.
go back to reference • Gustafsson U, Scott M, Schwenk W, Demartines N, Roulin D, Francis N, et al. Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS®) society recommendations. World J Surg. 2013;37(2):259–84. https://doi.org/10.1007/s00268-012-1772-0A review presenting a consensus for optimal ERAS perioperative care in colonic surgery. CrossRefPubMed • Gustafsson U, Scott M, Schwenk W, Demartines N, Roulin D, Francis N, et al. Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS®) society recommendations. World J Surg. 2013;37(2):259–84. https://​doi.​org/​10.​1007/​s00268-012-1772-0A review presenting a consensus for optimal ERAS perioperative care in colonic surgery. CrossRefPubMed
15.
go back to reference •• Feldheiser A, Aziz O, Baldini G, Cox B, Fearon K, Feldman L, et al. Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand. 2016;60(3):289–334. https://doi.org/10.1111/aas.12651A consensus paper presenting a unified protocol facilitating involvement of anesthesiologists in the implementation of ERAS programs. CrossRefPubMed •• Feldheiser A, Aziz O, Baldini G, Cox B, Fearon K, Feldman L, et al. Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand. 2016;60(3):289–334. https://​doi.​org/​10.​1111/​aas.​12651A consensus paper presenting a unified protocol facilitating involvement of anesthesiologists in the implementation of ERAS programs. CrossRefPubMed
16.
go back to reference •• Scott MJ, Miller TE. Pathophysiology of major surgery and the role of enhanced recovery pathways and the anesthesiologist to improve outcomes. Anesthesiol Clin. 2015;33(1):79–91. https://doi.org/10.1016/j.anclin.2014.11.006An overview of the pathophysiologic process of major surgery and how the perioperative management of patients within an ERP can improve postoperative recovery. CrossRefPubMed •• Scott MJ, Miller TE. Pathophysiology of major surgery and the role of enhanced recovery pathways and the anesthesiologist to improve outcomes. Anesthesiol Clin. 2015;33(1):79–91. https://​doi.​org/​10.​1016/​j.​anclin.​2014.​11.​006An overview of the pathophysiologic process of major surgery and how the perioperative management of patients within an ERP can improve postoperative recovery. CrossRefPubMed
18.
go back to reference •• Alem N, Kain Z. Evolving healthcare delivery paradigms and the optimization of ‘value’in anesthesiology. Curr Opin Anaesthesiol. 2017;30(2):223–9. https://doi.org/10.1097/aco.0000000000000430A review of the implications of the evolving healthcare landscape, including the PSH and ERAS as paradigms that exemplify the current and future value of anesthesiologists. CrossRefPubMed •• Alem N, Kain Z. Evolving healthcare delivery paradigms and the optimization of ‘value’in anesthesiology. Curr Opin Anaesthesiol. 2017;30(2):223–9. https://​doi.​org/​10.​1097/​aco.​0000000000000430​A review of the implications of the evolving healthcare landscape, including the PSH and ERAS as paradigms that exemplify the current and future value of anesthesiologists. CrossRefPubMed
20.
go back to reference • Carli F, Silver JK, Feldman LS, McKee A, Gilman S, Gillis C, et al. Surgical prehabilitation in patients with cancer: state-of-the-science and recommendations for future research from a panel of subject matter experts. Phys Med Rehabil Clin N Am. 2017;28(1):49–64A review of the literature and recommendations from a panel of experts in surgical prehabilitation for patients with cancer.CrossRefPubMed • Carli F, Silver JK, Feldman LS, McKee A, Gilman S, Gillis C, et al. Surgical prehabilitation in patients with cancer: state-of-the-science and recommendations for future research from a panel of subject matter experts. Phys Med Rehabil Clin N Am. 2017;28(1):49–64A review of the literature and recommendations from a panel of experts in surgical prehabilitation for patients with cancer.CrossRefPubMed
24.
go back to reference Scott JM, Zabor EC, Schwitzer E, Koelwyn GJ, Adams SC, Nilsen TS, et al. Efficacy of exercise therapy on cardiorespiratory fitness in patients with Cancer: a systematic review and meta-analysis. J Clin Oncol. 2017;77:5809. Scott JM, Zabor EC, Schwitzer E, Koelwyn GJ, Adams SC, Nilsen TS, et al. Efficacy of exercise therapy on cardiorespiratory fitness in patients with Cancer: a systematic review and meta-analysis. J Clin Oncol. 2017;77:5809.
26.
go back to reference West MA, Loughney L, Lythgoe D, Barben CP, Sripadam R, Kemp GJ, et al. Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study. Br J Anaesth. 2015;114(2):244–51. https://doi.org/10.1093/bja/aeu318.CrossRefPubMed West MA, Loughney L, Lythgoe D, Barben CP, Sripadam R, Kemp GJ, et al. Effect of prehabilitation on objectively measured physical fitness after neoadjuvant treatment in preoperative rectal cancer patients: a blinded interventional pilot study. Br J Anaesth. 2015;114(2):244–51. https://​doi.​org/​10.​1093/​bja/​aeu318.CrossRefPubMed
28.
31.
go back to reference •• Sekandarzad MW, van Zundert AA, Lirk PB, Doornebal CW, Hollmann MW. Perioperative anesthesia care and tumor progression. Anesth Analg. 2017;124(5):1697–708. https://doi.org/10.1213/ane.0000000000001652A review discussing the most recent up-to-date findings, focusing on the currently available “best clinical practice” regarding perioperative anesthesia care bundle factors and their effect on tumor progression. CrossRefPubMed •• Sekandarzad MW, van Zundert AA, Lirk PB, Doornebal CW, Hollmann MW. Perioperative anesthesia care and tumor progression. Anesth Analg. 2017;124(5):1697–708. https://​doi.​org/​10.​1213/​ane.​0000000000001652​A review discussing the most recent up-to-date findings, focusing on the currently available “best clinical practice” regarding perioperative anesthesia care bundle factors and their effect on tumor progression. CrossRefPubMed
34.
go back to reference •• Kim BJ, Caudle AS, Gottumukkala V, Aloia TA. The impact of postoperative complications on a timely return to intended oncologic therapy (RIOT): the role of enhanced recovery in the cancer journey. Int Anesthesiol Clin. 2016;54(4):e33–46. https://doi.org/10.1097/aia.F0000000000000113A discussion of RIOT as a novel quality metric used to measure perioperative interventions in cancer patients. CrossRefPubMed •• Kim BJ, Caudle AS, Gottumukkala V, Aloia TA. The impact of postoperative complications on a timely return to intended oncologic therapy (RIOT): the role of enhanced recovery in the cancer journey. Int Anesthesiol Clin. 2016;54(4):e33–46. https://​doi.​org/​10.​1097/​aia.​F000000000000011​3A discussion of RIOT as a novel quality metric used to measure perioperative interventions in cancer patients. CrossRefPubMed
Metadata
Title
Organization of Multidisciplinary Cancer Care for the Surgical Patient: Role of Anesthesiologists
Authors
Elizabeth F. Rieth
Gregory W. Fischer
Anoushka M. Afonso
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Anesthesiology Reports / Issue 4/2018
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-018-0291-4

Other articles of this Issue 4/2018

Current Anesthesiology Reports 4/2018 Go to the issue

Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)

The Effect of Anaesthetic and Analgesic Technique on Oncological Outcomes

Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)

New Cancer Therapies: Implications for the Perioperative Period

Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)

Transfusion Therapy: Is There a Link with Cancer Recurrence?

Patient Safety in Anesthesia (A Barbeito, Section Editor)

Safety in Anesthesia: Latin American Perspective

Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)

Cancer Tsunami: Emerging Trends, Economic Burden, and Perioperative Implications

Cancer Anesthesia (B Riedel and V Gottumukkala, Section Editors)

Propofol (TIVA) Versus Volatile-Based Anesthetics: Is There Any Oncological Benefit?