The multidisciplinary team requires administrative support in developing the agenda for the meeting, for collating patient information and to ensure appropriate expertise around the table to create an effective treatment plan for the patient. The MDM has a chair and multiple lead clinicians. Each patient case will be presented by a lead clinician (usually someone who has seen the patient before the MDM). In public hospital settings, the registrar or clinical fellow may take this role. A member of the team records the outcomes of the discussion and treatment plan in the patient history and ensures these details are communicated to the patient’s general practitioner.

When developing treatment recommendations for each patient, MDM participants ensure:

• the tumour has been adequately staged
• all appropriate treatment modalities are considered
• psychosocial and medical comorbidities that may influence treatment decisions are considered
• the patient’s treatment preferences are known and considered
• clinical trial eligibility, availability and participation are considered
• relevant optimal care pathway timeframes are considered.

The team should consider the patient’s values, beliefs and cultural needs as appropriate to ensure the treatment plan is in line with these. There may be early consideration of post-treatment pathways at this point – for example, shared follow-up care.

MDMs should aim to develop and agree by consensus an individualised treatment plan for each patient discussed. At times when there is a divergence of opinion about a patient’s management or equivalent options, these differing opinions should be discussed with the patient to enable them to make an informed decision. Patients should be given time to discuss treatment options with others before making this decision.

MDM recommendations should be communicated in a timely manner to the patient and referring doctor/general practitioner with formal documentation. Further details regarding MDM requirements can be found via the Victorian cancer multidisciplinary team meeting quality framework.