Start With the Diagnosis and Staging Question
An MDT discussion is only as good as the diagnostic material it reviews. The first question it must answer is whether the prostate cancer diagnosis is confirmed and whether the available staging is complete enough to support a treatment recommendation. That means the team needs to see the biopsy report with Gleason score or grade group, the number and location of positive cores, and any imaging that has already been performed, such as MRI or PSMA PET if available. If the case is still being verified, the discussion should state clearly what is missing rather than proceed on assumptions.
For an overseas patient, this matters because records are often fragmented. Biopsy slides may be held at one laboratory, imaging at another, and clinical notes with a local urologist. A useful MDT review should identify whether the pathology has been reviewed by the treating centre's own pathologist, whether the imaging is adequate for staging, and whether any prior treatment has changed the picture. If the diagnosis is not yet confirmed, the discussion should focus on what further assessment is needed, not on choosing a definitive treatment.
Ask the coordinating team a direct question: will the MDT see the original pathology report and images, or only a summary? If only a summary is available, the discussion may be limited to general options rather than a case-specific recommendation. This is not a reason to delay urgent local care, but it is a reason to clarify the evidence base before travelling.
What Treatment Options Are Actually Suitable
The second question an MDT should answer is which treatment options are suitable for this specific cancer and this specific patient. For localised prostate cancer, options may include active surveillance, radical prostatectomy, or radiotherapy, depending on risk category, life expectancy, and patient preference. For more advanced disease, the discussion may involve systemic therapy, hormone treatment, or a combination of approaches. The MDT should not simply list every possible treatment; it should explain why some options are reasonable and others are not, based on the stage, grade, and the patient's overall health.
This is where the distinction between cancer control and function goals becomes concrete. Radical prostatectomy removes the prostate for selected prostate cancers, and robotic instruments are controlled by the surgeon. The MDT should discuss whether surgery is technically feasible, what the expected cancer control might be, and how urinary continence and sexual function might be affected. It should also discuss whether radiotherapy or other options could offer similar cancer control with different trade-offs. No discussion can guarantee continence or sexual function outcomes, and any plan should acknowledge that uncertainty.
Ask whether the MDT includes a urologist, a radiation oncologist, and a medical oncologist, or whether the review is limited to one specialty. A single-specialty opinion may still be useful, but it is not the same as a multidisciplinary discussion. The hospital decides which specialties participate, so confirm this in writing before relying on the review.
How Previous Treatment Changes the Discussion
If the patient has already received treatment for prostate cancer, the MDT must answer a different set of questions. Previous surgery, radiotherapy, or hormone therapy can change what is feasible now. For example, a man who has had radiotherapy may not be a candidate for further radiotherapy to the same area, and surgery after radiotherapy carries different risks. The MDT should review the prior treatment records, including dates, techniques, and any complications, and explain how those factors affect the current options.
For an overseas patient, this means gathering treatment summaries, discharge letters, and any follow-up PSA results. If the previous treatment was incomplete or the records are unclear, the MDT should state what it cannot determine. It is reasonable to ask whether the team has experience managing patients who have had prior treatment in another country, and whether they need additional imaging or tests to assess the current situation. The treating clinicians decide what tests are appropriate; the patient's role is to provide accurate records and ask what is missing.
A common mistake is to assume that a previous treatment rules out all further options. The MDT should clarify what is still possible and what is not, rather than leaving the patient with a vague impression. If the discussion cannot answer this because records are incomplete, that is itself an important answer: it tells the patient what to obtain next.
Balancing Cancer Control With Urinary and Sexual Function
One of the most important questions an MDT should answer is how the proposed plan balances cancer control with urinary and sexual function. These goals can conflict. A more aggressive treatment may offer better cancer control but carry a higher risk of incontinence or erectile dysfunction. A less aggressive approach may preserve function but leave more uncertainty about cancer control. The MDT should explain these trade-offs in plain terms and ask the patient what matters most to him.
This is not a decision the MDT can make alone. The patient's age, overall health, personal priorities, and support system all matter. The discussion should produce a recommendation, but it should also make clear that the final choice belongs to the patient after a full conversation with the treating clinicians. Ask whether the MDT has discussed nerve-sparing approaches, pelvic floor rehabilitation, or other strategies that might affect recovery. These are clinical decisions, and the treating team must confirm what is appropriate for this individual.
It is also reasonable to ask what the MDT would recommend if the patient's priorities were different. For example, if preserving sexual function is the top priority, would the recommendation change? If cancer control is the top priority, what would change? This helps the patient understand the reasoning behind the plan rather than simply accepting a single option.
What the MDT Cannot Guarantee
An MDT discussion cannot guarantee that a hospital offers this format, that a particular treatment will be available, or that the outcome will be as hoped. It also cannot guarantee hospital acceptance, a specific surgeon, or a fixed timeline. These are administrative and clinical decisions made by the hospital and treating team. The value of an MDT review is that it brings multiple specialties together to discuss the case and produce a reasoned recommendation, but it is not a promise of a particular result.
For overseas patients, it is important to ask whether the MDT review is a formal documented process or an informal conversation. Ask who participates, how the recommendation is recorded, and whether the patient will receive a written summary. If the hospital does not offer a formal MDT, the coordinating team may be able to arrange a records-based opinion from relevant specialists, but this is different from an in-person multidisciplinary discussion. The scope and fee should be agreed in writing before any review begins.
It is also important to understand that an MDT recommendation is not a final treatment plan. The treating clinicians will still need to examine the patient, confirm the diagnosis, and discuss consent. Any plan may change after further assessment. This is normal and does not mean the MDT was wasted; it means the process is iterative.
How to Prepare Records and Questions for an MDT Review
To get the most from an MDT discussion, prepare a clear record package and a focused list of questions. The record package should include the pathology report, imaging reports and images if available, PSA results over time, treatment summaries from any previous care, and a list of current medications and allergies. Do not send passport numbers, payment details, or a complete medical archive in the first enquiry; a brief summary is enough to start.
The question list should be specific. Ask whether the diagnosis is confirmed and staged, which treatments are suitable, how cancer control and function goals are balanced, what previous treatment changes, and what the MDT cannot guarantee. Ask who participates in the discussion and whether a written summary will be provided. If the hospital does not offer an MDT, ask what alternative review is possible and what it includes.
For patients considering care in China, the practical next step is to send a short summary through the enquiry form, email, or WhatsApp. The initial case review is free and non-clinical; it checks the available diagnosis, records, and the patient's main question, identifies missing information, and suggests the relevant next step. This is not a diagnosis or a promise of acceptance. If a multidisciplinary review is appropriate, the scope and fee can be agreed first. The hospital decides suitability, and no review can guarantee treatment availability or outcome.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.