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I'm really excited to be joined here with Doctor Andy Lati and we're gonna be talking about advanced prostate cancer in the context of multidisciplinary teams. Um Doctor Lati, thank you so much for, for joining us and I'm really looking forward to this discussion. Yeah, happy to have the opportunity to speak with you all today. Uh So at the start of these sessions, we like to uh put everything that we're doing in the context of a patient. And what what we've done is we've written a little er patient vignette which will help to frame the conversation we're about to have so that we are always bringing it back to the context of a patient. And the little vignette is, is this John, a 68 year old retired engineer was diagnosed with advanced prostate cancer after after experiencing persistent lower back pain and fatigue upon receiving his diagnosis at a community hospital. John and his family were understandably overwhelmed by the complexity of the treatment options and the daunting path ahead. So recognizing the necessity of a comprehensive approach, John's primary oncologist referred him to a multidisciplinary team at a larger specialized cancer treatment center. It was MDT comprised experts including oncologists, radiologists, pathologists, urologists, palliative care specialists. And the team faced several challenges, complex treatment decisions, resource limitations at the Community Hospital and enuring John's quality of life throughout the process. So as we, as we delve into this discussion about the MDT, we want to keep the patient who faces that type of scenario at the front of our minds because that's the most important thing that uh that we're all dealing with. So uh in saying that doctor Li, we're really um excited to kind of chat to you about um your experience and your approach in this area. I wanted to ask, can you elaborate on um the relationship with patients? Can you elaborate on how this translates into fostering effective collaboration within a multidisciplinary team for advanced prostate cancer, particularly when there are complex treatment decisions to be made. So, uh yeah, I'm, I'm very happy that you framed the discussion um as such, you know, patients really are at the center of what we do as healthcare providers and approaching problems and you know, formulating um strategies, we really need to be mindful of the fact that that, that, you know, the patient is at the center. So when I meet with patients, I think the biggest approach and the most important um the function I serve is to be an educator and be an advocate and as you said, cancer in general, um prostate cancer probably even more. So, um we really need to leverage the expertise and the specialization of various people, whether it be surgeons, radiation, doctors, medical oncologists and oncologists, a sound communication and um coordination of these services is, is is very important to um excellent patient care. So first and foremost, II inform patients as to my role amongst the greater multi disciplinary team as a medical oncologist, I also informed them that I will serve as their um care coordinator and as their center point of contact to help guide them amongst the services and the teams that they need to gain access to a lot of what I do has to do. Um revolves around providing education and comfort and a realization that that patients have a partner in um what, you know, the care and the journey that they're about to embark upon and um you know, serving as a compassionate and um you know, willing a willing aid in that process is what I pride myself in. And um how would I approach my, my patients? Really interesting and, and, and, and it is all about that patient and, and collaboration amongst amongst a team, you kind of touched on the strength of some um some different health care settings. II wonder whether you might be able to chat about how tertiary or quaternary level centers best collaborate with community hospitals to begin to optimize the treatment plans for patients with advanced prostate cancer, especially considering resource limitations and all of the, all of the challenges. Yeah, it, it's a, it's a very challenging um topic. So, uh you know, I have the, you know, the, the benefit of practicing at a tertiary center. And um my expertise is in prostate cancer and that's the field in which I II deal with day in and day out. And I have the luxury of being able to, you know, dedicate my time, my effort and my educational and and research endeavors into that one focused area. I am in awe of community oncologists and community subspecialists understanding their responsibilities and their focus is more broad and diverse. And the challenge in that capacity is to be an expert as much as one can be in multiple things. And that's a very big ask and a and a very um tall order that uh it is is is asked upon those working in the community. Similarly, um access to specialized uh treatments may be more limited, which is understandable, understanding the facts. Um Community centers are responsible for such a wide array of disease types and scenarios. So, orchestrating a si a situation through which uh a patient can benefit from the expertise and the focus of a tertiary center while being able to receive care um through i in through the um execution of a local team and the convenience that that provides is really the best of both worlds. So, you know, at our center, we pride ourselves in our ability to engage and interact with our community liaisons. Um And that's a, a first and foremost, a recognition of the skill sets and the benefits um uh provided at each center. So, m my approach is to again provide um you know, expert counseling and guidance for, for um folks that are working within the community and, and allowing for an, an, an understanding of the resources they have and the comfort level through which they're able to execute care. So the best approach is to be in uh avid communicator and one that's able to be um y you know, malleable and uh adaptable to various circumstances because no one situation is the same and um you know, doing your best to accommodate that diversity is the best strategy. In my opinion, I wanna dive into a little bit of the, the science of it. OK. Doctor Li. So emerging therapies have pretty intricate inclusion and exclusion criteria um that poses a challenge for MDT S. But um uh what do we need to do? What, what, what uh what can a community team tee up so that when patients are um being seen by you, that they are identified in the most efficient way as to whether they are suitable for participation in some of the most promising clinical trials, what what data do you need? Maybe touch on some of those inclusion exclusion criteria so that we can begin to uh tee tee patients up. So that so that they get decisions as, as fast as they possibly can. So it's a great question. And I think um the best counseling I can provide is to be comprehensive in the workup and uh fastidious in trying to follow guidelines for the best practice and care um in the vein of pro you know, in, in the world of prostate cancer um following the NCCN. So National Cancer Consortium Network Guidelines or the American Society of Clinical Oncology um Guidelines uh is a good place to start and information pertains within, you know, that guideline infrastructures that will um you know, uh allow for about 90% of the information necessary to evaluate for clinical trials a little more granularly. We're looking to ensure that patients have a tissue diagnosis, which is a necessity for most clinical trials. So a biopsy will have been performed and then relatively up to date imaging in the world of prostate cancer, CT Scan and bone scan still dominate the research land.