Cancer Screening - Danica Wasney, CancerCare Manitoba, Winnipeg, MB
Cancer screening programs are designed to improve patient outcomes through earlier detection of cancer diagnoses. These programs are based on evidence of reduced cancer specific mortality, and that the benefits of screening outweigh harms at the population level.
While a number of cancers have evidence-based recommendations to guide screening strategies, the majority of cancers do not have routine screening recommendations. Cancer screening requires a balance of appropriate use of health system resources/evidence as well as patient specific factors. Screening and follow up for the individual patient may vary depending on clinical judgment and/or available resources.
This presentation will explore issues related to cancer screening, including a review of current screening recommendations for breast cancer, cervical cancer, colon cancer, lung cancer, and prostate cancer. Current controversies surrounding cancer screening will also be discussed. Lastly, the pharmacist’s potential role in cancer screening will be explored.
Learning Objectives:
- Discuss which cancers have evidence-based screening recommendations and programs; and
- Discuss controversies surrounding cancer screening at both the patient-specific and population level.
Prostate Cancer - Gerry Mills, Valley Regional Hospital, Kentville, NS
A brief review of pathology and treatment of prostate cancer for oncology pharmacists.
Learning Objectives:
- Give a brief review of pathology & staging of Prostate cancer;
- Review therapies at various stages of disease with a brief review of clinical data for the various treatment modalities;
- Discuss expected outcomes of treatment modalities in terms of response and toxicities; and,
- Review the prevention, monitoring and treatment of adverse effects associated with the various individual treatments.
Gynecological Cancers - Michelle Deschamps, Saskatchewan Cancer Agency, Saskatoon, SK
This presentation will provide an overview on the epidemiology and clinical presentation of epithelial ovarian, cervical and endometrial cancers, which are the most commonly encountered gynecological cancers. We will then discuss management strategies including surgery and radiation therapy with our focus mainly on drug therapies. We will also highlight the pharmacist’s role in supportive care and symptom management.
Learning Objectives:
- Identify the common adjuvant (curative) strategies for early stage ovarian, cervical and endometrial cancers;
- Describe the first line treatment options for advanced ovarian, cervical and endometrial cancers;
- Discuss the role of hormone and targeted therapies in gynecological cancers; and
- Develop symptom management plans for patients undergoing treatment.
Myeloproliferative Neoplasms - Kyla Marien, Tom Baker Cancer Centre, Calgary, AB
Myeloproliferative neoplasms are a group of rare diseases that are characterized by overproduction of one or more blood cell lines in the bone marrow. These blood disorders are usually slow progressing, and treatment goals are to control symptoms, improve quality of life, and to slow progression of disease. There are a number of myeloproliferative neoplasms that work in different ways, the most common being chronic myelogenous leukemia (CML), Essential Thrombocytosis (ET), Polycythemia Vera (PV), and Myelofibrosis.
Learning Objectives:
- Define the three common non-Philadelphia chromosome myeloproliferative neoplasms: Essential thrombocytosis, Polycythemia Vera, and Myelofibrosis;
- Identify the different signs and symptoms associated with each neoplasm;
- Treatment options in managing symptoms and controlling each disease; and
- Pharmacist’s role in supportive care, patient education, and monitoring.
Bone Marrow Transplant - Nikki Blosser, Tom Baker Cancer Centre, Calgary, AB
Hematopoietic stem cell transplant is a modality of treatment for many hematological malignancies. Although it can offer significant disease control and in some cases, a cure, it comes with a significant risk of morbidity. This presentation will focus on the care required in the post-transplant setting to optimize outcomes. It will discuss medications used to minimize the long term impact this treatment will have on patient’s quality of life and will highlight how pharmacists can help manage the toxicities from this treatment.
Learning Objectives:
- Identify the different types of hematopoietic stem cell transplant and indications for each;
- Describe graft versus host disease (GVHD) and its risk in the post-allogeneic transplant setting;
- Discuss the immunosuppressant medications used to minimize the risk of GVHD;
- Review antimicrobial prophylaxis and the medications used at various intervals post-transplant; and
- Discuss other supportive care measures required in this patient population.
Complementary Medicines and Cancer - Scott Gavura, Cancer Care Ontario, Toronto, ON
The interest and use of complementary and/or alternative medicine as part of, or instead of, “conventional” cancer care, appears to be growing. While patients often seek out CAM independently, its use may also be endorsed by health professionals, regulators, and health care organizations that believe that CAM has something to offer cancer patients. With the growing interest in CAM, it is essential for oncology pharmacists to understand the rationale for CAM, the evidence base for CAM, the implications to cancer care, and best practices in dialogue with patients to support informed, collaborative decision-making and ethical, science-based care.
Learning Objectives:
- Understand why CAM is popular, and why cancer patients may seek out CAM;
- Understand the evidence base for CAM;
- Understand problems and risk of CAM use in cancer care;
- Understand the clinical outcomes of patients that use CAM; and
- How to talk to patients about CAM.
Cancer Pain Management - Diane Brideau-Laughlin, Horizon Health Network, Moncton, NB
Pain is a common complication of many incurable diseases such as cancer, end-stage heart disease, lung diseases and motor neuron diseases. Up to 85% of patients with advanced cancer will experience pain. Failure to manage this symptom results in suffering and poor quality of life.
The aim of this presentation is to help you acquire some basic principles of pain management.
Learning Objectives:
- Understand the concept of total pain;
- Initiate an analgesic regimen;
- Understand the basic principles of analgesic titration;
- Manage common opioid-related adverse events; and
- Switch from one opiate to another.
Immunotherapy Toxicity Management - Tom McFarlane, University of Waterloo, Kitchener, ON
Checkpoint inhibitors are rapidly becoming more prevalent in oncology treatment of various malignancies and have the potential to transform cancer care by conferring long-term survival in scenarios where treatment options have traditionally been very limited. However, these agents carry with them the potential for immune-mediated adverse effects requiring very specific management. These adverse effects have the potential for misdiagnosis and mismanagement, and it is up to us as clinicians to ensure that patients are properly educated about reporting them, and also to keep other members of the patient’s healthcare team apprised of what to do when a patient on checkpoint inhibition presents with toxicity. This presentation will delve into the different adverse effects that patients may experience on checkpoint inhibitor treatment, and give practical examples of how to manage potential toxicity from these agents.
Learning Objectives:
- Understand the mechanistic basis behind the development of adverse effects with checkpoint inhibition;
- Recognize potential adverse effects of treatment with checkpoint inhibitors; and
- Manage adverse effects of checkpoint inhibitors when they occur.
Oncologic Emergencies - Jason Wentzell, The Ottawa Hospital, Ottawa, ON
Oncologic emergencies are not infrequent and can contribute to significant morbidity and mortality in patients with a wide range of underlying malignancies. Symptoms associated with certain oncologic emergencies may be an initial presenting symptom of an underlying malignancy and timely identification or recognition by a health care provider may help to ultimately improve patient outcomes. Pharmacists practice across a spectrum of professional roles, ranging from front-line care providers to specialized oncology practitioners and each requires a basic understanding of the physiologic principles of oncologic emergencies and the resulting therapeutic management strategies to ensure their patients receive appropriate care. This session will focus on the provision of information pertinent to pharmacy practitioners involved in the care of patients at risk of, or who are experiencing various oncologic emergencies.
Pertaining to common oncologic emergencies, this lecture will briefly detail; underlying mechanisms, highlight associated malignancies, describe characteristic symptoms and appropriate therapeutic management and monitoring. The lecture will focus on tumor lysis syndrome, hypercalcemia of malignancy and malignant spinal cord compression. Emphasis will be made to demonstrate the potential role of the pharmacist and relevant therapeutics, including areas of clinical controversy, will be highlighted. Lastly, a brief introduction to contributing paraneoplastic syndromes and a re-iteration of the role of emerging immunotherapies will be discussed in their context of potential oncologic emergencies.
Learning Objectives:
- Participants will learn about the underlying mechanisms, associated malignancies, characteristic symptoms and appropriate therapeutic management and monitoring of the following oncologic emergencies:
- Tumor lysis syndrome
- Hypercalcemia of malignancy
- Malignant spinal cord compression
- Participants will receive a brief introduction to promote awareness and recognition into how paraneoplastic syndromes and immunotherapy may also contribute on oncologic emergencies