Essentials of Oncology
for Pharmacists


Patient and Caregiver Stories

Tony and Jane will outline their personal journeys with cancer.  They will describe their perspectives on the role and impact of the pharmacist on people (patients and caregivers) living with cancer.  They will outline the opportunities that pharmacists have on the management of complex drug therapies and the emotional impact that this has on patients and caregivers.

Module 1: Cancer Basics

This module provides an introduction and overview to the basics of cancer and treatment.  Key concepts include cell growth and differentiation, goals of treatment and the theory behind chemotherapy regimens.

Module 2: Systemic Therapy of Cancer: The Patient's Journey

When patients are diagnosed with cancer, they often face challenges that include understanding the cancer system within hospitals and how this integrates with primary care in the community.  This module provides an understanding of the cancer journey that patients and caregivers go through so that pharmacists can have a better understanding of the issues around navigation challenges, which also includes access to medications and barriers to effective communication.

Module 3: Complementary and Alternative Medicine in Cancer Care

This tutorial will provide an overview of complementary and alternative medicine (CAM) and the most prevalent CAM therapies and practitioners utilized by people living with cancer. A particular emphasis will be on natural health products and their potential risks and benefits in cancer care. How CAM therapies and practitioners are regulated in Canada is also rviewed. The relevance of CAM use for community-based health professionals is highlighted throughout the tutorial.

Module 4: Common Toxicity of Traditional Chemotherapy Agents
     Part 1: Common Toxicities
     Part 2: GI Toxicities 

Community pharmacists have a very important role in supporting people through their chemotherapy.  Learn about the common side effects of chemotherapy, why they occur and when they can be expected.  Take away key messages on how to enable people to prevent or minimize the expected toxicities and, if they occur, what pharmacists can do to help manage them. 

Module 5: Toxicity of Endocrine Therapies

Endocrine therapies are important treatment alternatives in both breast cancer and prostate cancer.  The use of these treatments is on the rise with evidence showing benefit for longer durations (breast cancer) and earlier stage disease (prostate cancer).  As a pharmacist, management of toxicities associated with these agents is important to improve a patient’s quality of life. 

Module 6: Toxicity of Targeted Therapies

The pharmacology of molecularly targeted therapies give rise to unique side effect profiles that characterizes the major classes of these drugs.  While often considered more tolerable than the toxicities of traditional chemotherapy, these side effects can still have significant impact on functioning and quality of life.  This module will review the mechanisms that contribute to these toxicities and review prevention and management strategies that will assist your patient to tolerate, adhere and persist on oral treatments from the major classes of molecularly targeted therapy.

Module 7: Basics of Cancer Pain Management

We know from the literature that approximately 1 in 3 patients report pain at the time of their cancer diagnosis.  In the advanced stages of the illness, this number rises to 3 out of 4.  The World Health Organization estimates that 8.2 million people died from cancer around the world in 2012, and that 80% of them are experiencing moderate to severe pain at the end of their lives.  We know that poorly controlled pain can significantly impair a person’s function, appetite, sleep, mood and quality of life.  But we also know that approximately 90% of patients with cancer can achieve good pain control by following pain treatment guidelines.  So where’s the disconnect?  It has been shown that knowledge deficits and inadequate pain assessment are the most frequent professional barriers to adequate pain management.  That’s where you come in!  After completing this module, you will be able to 1) describe the pathophysiology of cancer related pain and 2) make pharmacological and non-pharmacological recommendations to treat or support patients experiencing pain due to cancer.             

Module 8: Adherence to Oral Anti-cancer Medications in the Oncology Setting

This module will discuss barriers and enhancers of adherence to oral anticancer agents.  The implications of non-adherence and over-adherence will also be discussed as they relate to patients on cancer treatment.

Module 9: Common Drug Interactions with Oral Anticancer Agents

Oral anti-cancer therapies have increased over the past decade and many of these agents are prescribed on a continuous basis to cancer patients. Oral anti-cancer agents provide numerous benefits to patients but have the potential for more drug interactions. These drug interactions may increase or decrease the efficacy of the treatments or produce major toxicity. Pharmacists have a thorough understanding of the mechanisms of drug interactions (including the cytochrome P450 system) and the ability to identify and resolve complex drug interactions, providing enhanced care to oncology patients. After completing this module you will understand the importance of drug interactions for oncology patients and identify and resolve clinically significant oral anti-cancer therapy drug interactions through a case based approach.

Module 10: Checking an Oral Anticancer Prescription

This module highlights and expands upon the key components of an oral anticancer prescription.  Key considerations during the prescription review process are also discussed.

Module 11: Safe Handling of Oral Anticancer Agents

This module focuses on the essential considerations and recommendations necessary to ensure the safe handling, dispensing and disposal of oral anticancer agents. Recommendations from the literature will be presented to guide safe practices by pharmacy staff, patients and caregivers.

Module 12: Palliative Care
     Part 1: Introduction to Palliative Care
     Part 2: Difficult Conversations

What does palliative care mean to you?  Is it end-of-life care?  Symptom management?  A focus on quality of life?  The evidence base for palliative care is growing, and under the new model, palliative care is not limited to the end of life.  Early palliative care has been associated with improved quality of life, reduced psychological distress, fewer costs and in some cases, longer survival.  But even in oncology centres where palliative care services exist, they are often underutilized, and many patients are referred only very late in the course of their illness after having suffered from inadequately controlled symptoms.  In this module, you will learn about a new model of palliative care and its role within cancer care.  You will learn strategies to provide person-centred care that is aligned with patients’ unique goals of care, and you’ll learn how to use a communication tool called SPIKES to enhance your interactions with patients receiving palliative care and/or end of life care. 

Module 13: Pharmacology of Antineoplastic

Despite all of the advances in cancer treatment, chemotherapy remains the backbone of most protocols.  This module will describe a brief history of chemotherapy, discuss some of the major classes of chemotherapy used in practice today and also provide information on common toxicities as well as clinical pearls related to the more commonly used chemotherapy agents.