New Frontiers in Pancreatic Cancer Care: Multidisciplinary Approaches, the role of Pancreas Units, and their Organizational Impacts

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About this Research Topic

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Background

Pancreatic cancers have a poor prognosis for patients. The biological and treatment complexity of pancreatic cancer requires a multidisciplinary and integrated approach to the diagnosis and care of the disease, involving different highly-specialized medical professionals. Novel integrated protocols, including chemotherapy, radiation therapy, and surgery, are being developed in response to the need for new therapeutic techniques for treating pancreatic cancer.

The multidisciplinary model in pancreatic cancer care finds its full implementation in Pancreas Units, which stand as new organizational structures within which the professionals of the various disciplines are present. Such professionals contribute in an integrated way to patient care and research. Disciplines include oncology, surgery, radiology, endoscopy, gastroenterology, genetics, pathology, radiotherapy, nutrition, psycho-oncology, palliative medicine, and nursing sciences. A similar concept has been successfully applied in other oncological fields, primarily through the establishment of Breast Units worldwide, with higher survival rates and quality of life than in non-specialized facilities.

In pancreatic cancer care, multidisciplinary teams are particularly effective in the diagnosis and evaluation phases, where several steps need to be carried on in the investigation, including radiology, endoscopy, and pathology assessments. A multidisciplinary meeting appraising the diagnostic test results leads to a joint diagnosis and curative path proposal.

Pancreas Units seem to represent an effective response to pancreatic cancer patients’ clinical needs. Still, their multidisciplinary approach and the need for different professionals to join forces in a systematic way require addressing several organizational themes. Such topics include the management of teams and team dynamics, the knowledge management and knowledge translation processes and facilitators to allow the creation of a common language and the effective transfer, sharing, and creation of new knowledge. Moreover, clinical decision-making in pursuing the best care should be coupled with shared-decision making in a patient-centric perspective. Patients should be fully aware of the options, comprehend the pros and cons of the clinical paths, and be included in the decision-making process by taking into account their values, aims, and care preferences.

Pancreas Units are soon to become a reality in several countries. For example, in Italy, the Lombardy Region has recently launched its brand new program for the establishment of the first Pancreas Units in the country. More experiences should be expected also in other contexts.

The purpose of the call is to collect the recent developments and undergoing studies in pancreatic cancer care following a multidisciplinary approach, including their organizational, managerial, and healthcare implications, their impacts on surgical and oncological practice, and clinical decision-making. Interdisciplinary studies, experiments, and experiences are also welcome, including the organizational outcomes, the team and knowledge translation dynamics, the relationship with the patients and shared decision-making processes, the new frontiers in clinical and managerial education and tentative solutions.

The Research Topic welcomes manuscripts on:
- Multidisciplinary approaches to pancreatic cancer care;
- Their impact on surgeons, oncologists, radiation oncologists, nurses, scientists, other clinicians, patients, medical institutions, industry actors, and policy-makers;
- The managerial practices and organizational models to be implemented in Pancreas Units;
- The required skillset for the clinical staff and its impact on medical and managerial undergraduate, postgraduate, and life-long learning education.

Original articles, case reports, reviews, commentaries, and surgical perspectives are welcome.

Keywords: Pancreatic Cancer, Pancreatic Cancer Care, Pancreas Units, Multidisciplinary Teams, Clinical Decision-Making, Shared Decision Making, Team Dynamics, Knowledge Translation, Medical Education

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