Multidisciplinary approach vital for melanoma care


Lynn Anne Cornelius, MD

For dermatologists to have a full stake in the care of their patients with melanoma, they must go beyond what was once their sole role of diagnosis and referral to a subspecialist.

AAD_podcastLynn Anne Cornelius, MD, advocates for a multidisciplinary role, and she will lead “Melanoma Multidisciplinary Care 2014: What You Need To Know” from 1 to 3 p.m. Sunday, March 23. This session will go beyond the dermatologist’s view for how to treat melanoma to offer insights from a medical oncologist and a surgical oncologist on how they envision the dermatologist as a fellow team member.

“Historically, dermatologists would diagnose a primary melanoma. Then they would refer the patient to a surgical oncologist if the melanoma was invasive and required sentinel lymph node biopsy, or to a medical oncologist if the melanoma was advanced and showed systemic disease. We need to bring the multidisciplinary care model to the forefront, particularly with melanoma,” said Dr. Cornelius, chief of the division of dermatology and the Winfred A. and Emma R. Showman professor in dermatology at Washington University School of Medicine at Barnes Jewish Hospital, St. Louis.

Two of her colleagues from Washington University and Barnes — Gerald Linette, MD, associate professor of medicine and neurosurgery in the division of oncology, and Ryan Fields, MD, assistant professor of surgery in the division of general surgery — will join Dr. Cornelius in presenting the program.

“I felt it was imperative to include the team, so dermatologists could see and recognize how important it is for us to work in a multidisciplinary fashion to treat melanoma. We hope to present a balanced and broad view of how best to manage patients with melanoma,” said Dr. Cornelius, whose clinic emphasizes continued follow-up and involvement with patients, including those with advanced stage disease.

For those who claim a multidisciplinary approach is only easy to accomplish in an academic setting, Dr. Cornelius emphasized that any practice setting is ripe for a team approach.

“The patient doesn’t have to be seen at the same place. It’s about having ongoing communication,” she said.

Speakers will discuss recent treatment advances, including BRAF inhibitor therapy, as well as how dermatologists can use the National Comprehensive Cancer Network Guidelines, in particular in the management of resected and high-risk disease.

“Our colleagues in medical and surgical oncology know what a valued member of the team we can be in managing patients with not only stage I or II melanoma, but also more advanced melanoma, particularly in the age of new targeted therapies,” Dr. Cornelius said. “We’re an important part of maintaining the health of these patients so they can continue on their systemic therapies. Many of these therapies have cutaneous manifestations and side effects that we are the best at managing.”

Each month, her institution holds several multidisciplinary melanoma conferences, where dermatology residents see how medical and surgical oncologists often turn to dermatologists for management guidance.

“In the era of the Affordable Care Act and changes in health care, it’s imperative for us to be at the table with our colleagues, making sure that we are giving the best care to our patients and keeping them as healthy as we can while maintaining costs,” Dr. Cornelius said. “If we’re not at the table, we can be marginalized, and we can be looked as only providing outpatient medicine that doesn’t have an impact, which is not true.”

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