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Abstract:
To surgery, radiation, and chemotherapy for cancer has been added a fourth modality: multidisciplinary therapy, which is improving the survival and cure rate among children. Specialists working together in a coordinated effort suspect, confirm, then treat cancer; follow and rehabilitate the patient; analyze and report results. Prospective protocols for the different cancer types are written. Research discoveries are constantly introduced to refine diagnosis and treatment, minimize morbidity, and improve results. A series of confrontations and agreements concerning each individual patient takes place among representatives from the specialties to review submitted information, select research and diagnostic tests, plan and carry out precisely coordinated treatment and rehabilitation, modify protocols according to patients' tolerance, and categorize response. Personal and single therapeutic modality bias lessens, house staff education is provided, and competent and understanding professionals function in the child's best interest. Documentation of input leading to decisions at serial meetings and of the extent to which they were carried out during each patient's course provides a particular dimension of the case record which is needed by subsequent participants over months and year.