Who Decides Your — Chemotherapy Plan?
Your chemotherapy plan is not made by a single doctor. It is reviewed by a group of specialists from different fields — working together — before a recommendation is made. Knowing how that works puts you in a much better position to ask the right questions.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026
- A group decision, not one doctor's — Specialists from several disciplines review your case together before any plan is agreed.
- Called a tumour board or MDT — The formal name for this group is a multidisciplinary team. Most specialist cancer centres hold these meetings weekly.
- You can ask for it — Asking whether your case was reviewed by a tumour board is a reasonable, informed question — and the right one.
- The plan can be revisited — If your cancer responds differently than expected, the board may review your case again and revise the recommendation.
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Your chemotherapy plan is decided by a group of specialists, not a single doctor. This group — called a tumour board or multidisciplinary team — reviews your scans, biopsy results and medical history together before recommending treatment. You can ask your oncologist whether your case has been reviewed by a tumour board.
What is the difference between a single specialist and a tumour board?
| Single specialist opinion | Tumour board review | |
|---|---|---|
| Who reviews your case | One doctor within their specialty | Medical oncologist, surgeon, radiation oncologist, pathologist and radiologist — together |
| What they see | Findings relevant to their own field | All test results and scans reviewed as a whole picture |
| How the plan is made | Based on one perspective | Consensus recommendation from multiple disciplines |
| When it happens | At an outpatient appointment | A scheduled case conference, usually held weekly |
| Where the result goes | Given to you in clinic | Entered into your medical record as a formal recommendation |
Who is on a tumour board — and what does each specialist contribute?
- Medical oncologist
- The doctor who leads your chemotherapy plan. They oversee systemic treatment — medicines that work throughout the body — and coordinate with the rest of the team.
- Surgical oncologist
- A surgeon who specialises in removing tumours. They advise on whether surgery is needed and how it fits with other treatments.
- Radiation oncologist
- A specialist who plans radiation therapy. They advise on whether radiation is part of your treatment and how it is timed around other treatments.
- Pathologist
- A doctor who examines your biopsy sample under a microscope. Their report tells the team exactly what type of cancer it is and how it is behaving at the cellular level.
- Radiologist
- A specialist who reads your scans. Their interpretation tells the team how far the cancer has spread and whether it is responding to treatment.
- Tumour board (multidisciplinary team / MDT)
- The formal meeting where all these specialists review your case together and agree on a treatment recommendation before your plan is set.
Can you ask for your case to be reviewed by a tumour board?
Yes — and it is a reasonable, informed question to ask. Most cancer centres with the capacity to do so present new cases at a tumour board before treatment starts. Asking does not imply doubt in your oncologist; it reflects that you understand how good cancer care is made.
If your oncologist tells you the board has already reviewed your case, ask what the recommendation was and which specialists were present. That information belongs to you.
If your centre does not hold tumour board meetings, your oncologist may refer your case to a larger or specialised centre for review, or seek a formal second opinion from specialists there. Ask whether that is an option.
Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. Each centre also names the areas it serves, so you can place it without a map. Consultation and day-care Chemotherapy run at every one of them.
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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What should you ask before agreeing to a chemotherapy plan?
- Has my case been reviewed by a tumour board or multidisciplinary team?
- Which specialists were involved in making this recommendation?
- What did the pathologist's report say about my cancer type?
- Is this the standard treatment recommendation for my specific diagnosis?
- If my cancer responds differently than expected, will the board review my case again?
- Could my case be reviewed by the tumour board at a specialist centre?
Did you know?
Tumour board review changes the initial treatment recommendation in a meaningful proportion of cases — meaning the plan agreed after group discussion differs from what any one specialist would have recommended alone.
ASCO and ESMO both include multidisciplinary team review as a quality standard in cancer care guidelines.
Source: ASCO and ESMO Cancer Care Quality Standards
What else do families want to know about who makes the decision?
Does a tumour board meeting delay the start of my treatment?
A well-run tumour board review rarely causes a meaningful delay. Most centres hold these meetings weekly as part of their routine, so the time taken is usually a few days at most. What delays treatment more consistently is late referral or missing test reports at the time of the meeting. If you are concerned about timing, ask your team when the next meeting is and whether your case is already on the agenda.
What if my oncologist's recommendation differs from the tumour board's?
This can happen and is not necessarily a sign that something has gone wrong. Your oncologist knows your medical history, your fitness and your wishes in ways that a board reviewing a file may not fully capture. What matters is that the difference is explained to you — what the board recommended, what your oncologist is proposing, and why. If you are not satisfied with that explanation, a second opinion from a specialist at another centre is a legitimate next step, and a responsible oncologist will not discourage you.
We have heard there are better hospitals with bigger tumour boards — should we go there?
The size of a tumour board matters less than whether one exists and whether it includes the right specialties for your cancer type. What you can ask is whether the treating centre sees your diagnosis frequently, and whether the board includes a pathologist, radiologist and all relevant treating specialties. If the answers raise doubts, seeking a review at a specialist centre is reasonable — it does not mean transferring all your care elsewhere.
Can I attend the tumour board meeting?
Most tumour board meetings are held as clinical conferences without the patient present — this is the standard format in India and globally. You are, however, entitled to know what was discussed, what was recommended and who was in the room. Ask your oncologist to explain the board's recommendation in full, or ask for a written summary if the centre records it formally. The conclusion is yours to know.
What is the difference between a second opinion and a tumour board review?
A second opinion is when you ask an individual specialist — usually at a different centre — to review your case independently and give their view. A tumour board review is a structured group meeting where specialists from different disciplines review the case together and reach a consensus recommendation. Both are valuable and not mutually exclusive. A second opinion at a specialist centre can sometimes include that centre's own tumour board, giving you both an independent and a group view.
My family wants to take my reports to a senior doctor privately — is that useful?
It can be, especially for a rare or complex diagnosis, or when you want reassurance that the plan is right for you. Take not just imaging discs but the full pathology report, the tumour board recommendation if you have one, and a summary of any treatment already given and how your cancer has responded. A specialist reviewing your complete file is far more useful than one who has only seen your scans. Tell your treating team you are doing this — a responsible oncologist will support it.
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Frequently asked questions
Who actually makes the final decision about my chemotherapy?
Your treating oncologist makes the recommendation, but in good practice that recommendation is built on the consensus of the tumour board rather than a single judgement. The oncologist then translates the board's collective view into a plan suited to your specific situation — your fitness, your other medical conditions, your wishes. The final plan is agreed with you, not imposed on you. You have the right to ask questions and request more time before agreeing to anything.
What if the hospital I am at does not have a tumour board?
Smaller facilities may not run regular multidisciplinary team meetings. Ask your oncologist directly whether a tumour board review is available at this centre. If not, ask whether your case can be referred to a specialist centre for review — many accept referrals for the purpose of a board opinion without requiring you to transfer all your care. CION coordinates care across 35+ centres and can advise on what is appropriate for your diagnosis.
Can I ask for a second opinion even if my oncologist seems confident?
Yes. Confidence on the part of your doctor is not a reason to forgo a second opinion if you would feel more settled having one. A second opinion is standard practice for complex diagnoses, and ASCO and ESMO both describe it as a reasonable step in cancer care. A responsible oncologist will not be offended. If raising it feels difficult, you can frame it as wanting the reassurance that comes from having more than one specialist look at the case.
How do I know whether a tumour board has reviewed my case?
Ask directly: "Has my case been reviewed by a multidisciplinary team or tumour board?" Your oncologist should be able to tell you when it was reviewed, which specialists were present, and what the recommendation was. If your case has not yet been reviewed, you can ask for that to happen before treatment starts. Most centres will accommodate this request for a newly diagnosed patient, and the time involved is rarely more than a week.
What should be ready before my case goes to the tumour board?
You do not attend the meeting yourself, but the quality of what the board sees shapes the quality of the recommendation. Make sure your oncologist has the complete pathology report from your biopsy, all imaging in digital form, and a summary of any previous treatment if you have been seen elsewhere. If you have reports from another hospital, hand them over in full. Incomplete information leads to qualified recommendations.
Can the treatment plan change after the tumour board has reviewed my case?
Yes, and for legitimate reasons. If your cancer responds differently than expected, or does not respond at all, the board may review your case again and revise the recommendation. New test results — a repeat scan or a further biopsy — can also change the picture. This is not a sign the original plan was wrong; it is how oncology care is meant to work. Ask your oncologist under what circumstances your case would go back to the board.
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