Background:

Although multidisciplinary teams (MDTs) are essential for high-quality cancer care, the role of GPs remains undervalued in many countries, including Bulgaria. Their involvement typically ends after the initial referral, resulting in fragmented care and missed opportunities for continuous, patient-centered support throughout the cancer pathway.

Research questions:

Is it feasible to involve GPs in the management of prostate cancer across all stages of care in Bulgaria, and how is their collaborative role perceived outside formal oncology commissions?

Method:

A descriptive, qualitative feasibility study was conducted in one Bulgarian region. The research team initiated a series of informal multidisciplinary meetings involving oncology specialists and GPs. Real prostate cancer cases were reviewed collaboratively to explore the GPs’ potential roles in ongoing care. The lead author served as both facilitator and observer, systematically documenting observations through structured field notes, focusing on GP contributions, communication dynamics, and practical barriers. No formal interviews or recordings were used, preserving the informal nature of the intervention. Reflective thematic analysis and content mapping of observation notes were used to identify emerging themes regarding feasibility, perceived value, and challenges of GP involvement in MDTs.

Results:

Field notes indicated that GPs contributed critical patient information, including comorbidities, social context, and outpatient management possibilities. Their inclusion facilitated improved mutual understanding and coordination of care. Both GPs and specialists expressed openness to ongoing collaboration. However, structural barriers (lack of protocols, administrative workload) and cultural norms around professional boundaries were identified as obstacles to formalizing such collaboration.

Conclusions:

Integrating GPs into oncology MDTs is feasible and beneficial for coordinated cancer care. Structured frameworks and policy adjustments are required to formalize their role beyond the initial referral stage in Bulgaria.

Points for discussion:

How can informal collaboration evolve into structured practice?

What protocols can support GP involvement in oncology MDTs?

How to measure patient outcome benefits of GP-specialist collaboration?