Working With Oncologists on Immunotherapy

Collaboration between dermatologists and oncologists has been challenging, historically, primarily because our jobs and work environments are so different; however, new immunotherapy options for advanced skin cancer have created more overlap, therefore managing that overlap between the two specialties effectively is necessary for optimal patient care.

If a dermatology practice carries a sufficient volume of skin cancer cases, instituting an infusion center may be a consideration. There are certain regulations that must be adhered to, but a return on investment might be achieved. Our clinic has made significant advances in prevention and management of adverse events to maximize outcomes. However, anyone doing infusions should be familiar with the full range of possible adverse effects, both immediate and delayed, and be comfortable managing them in the acute and chronic settings with the help of a multidisciplinary team. The general dermatologist without an infusion center, however, can still be part of the process when referring a patient to an oncologist for immunotherapy. The dermatologist’s presence on the multidisciplinary team is a benefit for the patient—and from a liability standpoint.

Tumor boards and meetings with oncologists can be difficult to accomplish in the community setting because of time and location constraints, but having a multidisciplinary discussion with the patient about what is next is much better for them than bouncing them back and forth between physicians. The more formal, the better for that discussion, but it can be accomplished by phone or video call if necessary.