An Insider’s Look at the Prospective Cancer Conference

Cheri Hinshelwood
Cheri Hinshelwood

Written by Cheri Hinshelwood, Communications Advisor, Sentara Healthcare

As a corporate communications professional, I am privileged to get an insider’s look at medicine in Hampton Roads. The following is a snapshot of what happened during a recent prospective cancer conference, one that guides care of current patients. A reporter was with me as we experienced first hand how some care is rendered within the Sentara Cancer Network. The reporter was gathering facts to help her better write a story about cancer care in the region.

Cancer team on your side

Cancer doctors get up pretty early in the morning, especially on Thursdays. Head and neck cancer conferences happen every Thursday on the Sentara Norfolk General Hospital and Eastern Virginia Medical Center Campus. Community partners in cancer care meet to discuss their patients’ treatment. On a recent Thursday, 26 cancer experts sit shoulder to shoulder in a conference room in Eastern Virginia Medical School’s Hofheimer Hall.

EVMS residents and doctors, medical oncologists from Virginia Oncology Associates, radiation oncologists from VOA and EVMS, head and neck surgeons, pathologists, radiologists, Sentara nurse navigators, dieticians, social workers, registrars, and community educators, along with community dentists all join in with others on the care team. They share what they know of each case based on their specialty, experience with the patient, latest studies, and advances in cancer care. Together they explore the options for each patient.

On this day, at seven o’clock the first case is summarized using no names to protect patient privacy, “57-year-old-male,” a doctor begins. Projected on a huge screen is a slide the pathologist, who is specially trained in head and neck cancer, discusses with the team. He shows images of the stained tumor samples he viewed under the microscope.  “Likely sarcoma, but it might be carcinoma,” he announces, pointing to some signs of those types of cells on screen.  After some additional discussion, he shares his final diagnosis. The radiologist continues that a CT and MRI show the sinus tumor has also invaded a nerve.

Always learning

This is a teaching case and like the others that follow, a flood of technical terms washes over those in the room. Each word has a precise meaning and very few words are needed by the clinical team to convey the exactness of the condition, potential treatments, and possible outcomes.  Notes are scribbled and treatment plans are finalized among these experts as each case progresses.

With almost no pause between cases, another case is summarized. A video launches on screen showing a 2.2 centimeter mass. “He’s got curable disease,” the surgeon says of his 38-year-old patient, “if we can get clear margins.”

Passion and compassion seep into the clinical jargon, if you listen closely. One doctor wishes out loud, “My hope for this patient would be lymphoma…” his voice trails off as he considers the youth of his patient and lymphoma as the lesser evil among the possibilities.

A case previously reviewed comes up for more discussion on this day. The surgeon leads, “What’s happening with this patient? How’s her therapy coming,” he asks. “I have her under my wing,” the radiation oncologist confirms. “She doesn’t think highly of chemo, and she’s only getting to three of five radiation treatments, despite my best efforts to encourage her,” the oncologist continues. The clinical social worker chimes in that the patient relies on a friend to get to and from treatments and adds that the friend strongly encourages treatment for this patient.

Heads nod confirming they’ve seen this before where patients may be reluctant to seek and get care. It doesn’t keep them from caring and wanting the best for their patients.