There are two established multidisciplinary clinics at the CRC, which opened toward the end of 2003. Professional service participation includes specialists and residents from urology, radiation oncology, medical oncology, psychology, and patient education. These health care providers, as well as research staff, ensure that all treatment options available to the patient are explained. After the patients have met with all of the specialists, the providers meet to discuss the individual cases and offer a recommendation to the patient to help him and his family to make a treatment decision. Several research studies based on the structure of this clinic have been presented at major urologic meetings (e.g., AUA, ASCO) and are reflected in recent publications. These clinics have enhanced the followup data available on patients enrolled in the database and biospecimen protocols. The implementation of this clinic has not only enhanced the research effort, but patient care as well.
Newly Diagnosed Patients with Prostate Cancer
This clinic offers services to patients who have been newly diagnosed with prostate cancer. To date, we have seen more than 1,600 patients and their families in this clinic. Ninety-eight percent of these men enroll in research projects, and most of these men continue their care at WRNMMC. In this clinic, the patients meet individually with a urologic oncologist, radiation oncologist, andrologist (sexual medicine specialist), psychologist, and patient educator to learn about the disease process, discuss their treatment options, and be counseled about short- and long-term health-related quality of life implications. The clinic includes a research segment to give the men an opportunity to enroll in the registry protocols. If patients are eligible for a clinical trial, providers in the clinic also discuss those opportunities with them as well. If patients have decided on their treatment option at the conclusion of the clinic, arrangements for their chosen treatment will be been initiated. Otherwise, a nurse clinical manager and a urologist stay in contact with the patients to ensure they make a decision in a timely fashion. The patients are also discussed in a weekly clinical meeting to ensure that all staff are aware of a patient's status. When a patient does decide on their treatment option, their decision is logged, their information dissipated to other staff, and the appropriate assistance is provided to prepare them for the procedure chosen. Subsequently, they are followed for their progress at CPDR for continuity of care.
Advanced Prostate Cancer Clinic
The second multidisciplinary clinic was designed for patients with prostate cancer who have disease progression. In collaboration with medical oncologists from the National Cancer Institute (NCI) with special interest and experience in treating prostate cancer, as well as the staff and fellows from the Medical Oncology Fellowship training program, this clinic has provided a valuable service to patients and their families. More than 1,500 patient visits have been seen by this clinic since 2003. The addition of this clinic not only provides a great service to the patient, but also provides an avenue to collect regular follow-up clinical data for the database. The clinic has also enhanced the fellowship training programs at both the NCI and WRAMC/WRNMMC medical oncology. In this clinic, patients are offered conventional treatments as well as an opportunity to participate in state-of-the-art clinical trials and other innovative therapies at both WRNMMC and NCI.