What is a tumor board, and how do I ask about mine?

This is not clinical evidence and not medical advice. It does not replace your care team. Discuss anything here with your clinician before you act on it. A tumor board is a meeting where cancer doctors and other specialists look at a case together and plan treatment as a group. NCI's dictionary calls it tumor board review and says the group meets regularly to go over new and complex cases. The cancer care centers' association ACCC says you may also hear multidisciplinary cancer conference. It is a team weighing a case, not a promise about treatment. ACCC adds that the treatment decision is made by the attending physician and the patient.

Usually several specialties, not one doctor. NCI lists medical oncologists, radiation oncologists, surgeons, pathologists, radiologists, genetics experts, nurses, physical therapists and social workers as people who can take part. Its dictionary names three primary disciplines in cancer treatment: medical oncology (drugs), surgical oncology (surgery) and radiation oncology (radiation). At programs accredited by the American College of Surgeons' Commission on Cancer, a general conference must include surgery, pathology, radiology, radiation oncology and medical oncology. Genetics, clinical research, palliative care, psychosocial, rehabilitation and supportive services are recommended additions, and programs can set their own list for a conference on one cancer type. The Commission calls these rules qualification criteria for accreditation, not a standard of care. That list is the Commission's. For any other program, a fair question for your oncologist is which specialties will look at your case.

Your imaging, your pathology and what to do next. MedlinePlus says doctors from different cancer specialties review x-rays, other imaging and pathology together and trade ideas on the best recommendation for you, and NCI's pathology page describes a tumor review board that looks at all of a patient's pathology results, plus any tests the pathologists ordered, together. Whether your case goes to one is a question for your team. At Commission on Cancer programs, the written protocol has to require discussing each presented case's stage and treatment planning using evidence-based guidelines. Where it applies, that also covers genetic testing, clinical research studies and supportive care. Some centers hold molecular tumor boards, which ACCC says center on biomarkers and the treatments and trials that fit tumors with them. If you have a tumor-testing report, you could ask whether the group will see it. Our page "Biomarker and genomic testing" covers what such a report is. A fair question for your team is who sends your reports and images to the board, and when. "Getting your medical records" covers how to request a copy of your file.

Not necessarily every case. NCI describes boards as reviewing new and complex cases. Commission on Cancer programs have a floor, not a ceiling: each year they must present at least 15 percent of their annual caseload, and at least 80 percent of those presentations must be prospective. The standard's examples of prospective cases include a new diagnosis before treatment starts, a recurrence or progression, or a discussion of supportive or palliative care. A program can hold one general conference or ones by cancer type, as long as a case that does not fit still has somewhere to go. ACCC's examples of disease-site boards are breast, lung, prostate, and head and neck. MedlinePlus says many hospitals and cancer centers have a tumor board. The government and society pages I read do not say whether every hospital has one, how clinics tell patients about their case, or whether another center's board takes outside cases. Those are questions for your team.

At Commission on Cancer programs, the standard leaves the frequency to the cancer program and its written protocol. Elsewhere, your oncologist's office can tell you. If your case is headed to a board, a fair question for your team is when the next meeting is, and whether your case is on that agenda.

Consider asking your oncologist whether your case will go to a tumor board or already has. MedlinePlus notes that your doctor may already have discussed your case with other doctors, often when surgery or radiation therapy is being considered. So the conversation may have happened before you heard the term. Follow-ups can be short: Which board? Who presents it? Is it the first discussion of my case, or has it come up before?

A fair question for your team is whether your center ever sends cases to a larger center's board. What is well documented is a second opinion: NCI's dictionary defines it as another doctor reviewing your medical records and giving an opinion on how the problem should be treated. That opinion may confirm or question the first plan, add information or offer other options. The how-to lives on "Second opinions and appointments".

"How will I hear what the group said, and can I have it in writing?" If I were walking into that visit, I would write it at the top of my question list. For a wider list, "Questions to ask your oncologist" is the page to open. This page is not a clinical review of any treatment option, and nothing here says what a tumor board would recommend for you.