Oral Anticancer Medicines

1. Understanding Cancer in Ireland

This module focuses on some background information on cancer suitable for healthcare professionals working in a primary care setting. At the end of this module, pharmacists will be able to;

• • Describe cancer including causes, prevention and incidence in Ireland
  • Outline the roles and implications of national advisory bodies in the prevention, early detection, treatment and management of cancer e.g. NCCP, ICPN, NCPE, Healthy Ireland
  • Identify sources of guidance for obtaining information on specific treatments and side effects.
  • Describe pathways for referral of patients from primary to secondary care
  • Identify education and patient information leaflets patients and carers should receive from their treating hospital/ other sources

2. Cancer Treatment Options

This module highlights the different treatment modalities available for cancer but focuses on the use of OAM. At the end of this module, pharmacists will be able to;

• Describe the use of systemic therapy (including chemotherapy / immunotherapy / hormonal therapy / monoclonal antibodies etc.), radiotherapy, surgical oncology and supportive care to achieve treatment goals.
• Differentiate between curative, adjuvant, neo-adjuvant and palliative treatment goals, when these each apply and the clinical implications of same
• Describe classification of OAM and hormonal agents
• Discuss common OAM regimens used and awareness of national NCCP chemotherapy regimens
• Identify sources of further guidance for obtaining information on specific treatments and side effects

3. OAM Prescribing and Dispensing

This module focuses on the aspects involved in the prescribing and safe dispensing of OAM. At the end of this module, pharmacists will be able to;

• Accurately verify OAM prescriptions within scope of practice
  • • Use of national NCCP chemotherapy regimens and other reference sources
• Perform pharmaceutical dosing calculations accurately, e.g.

• Weight or Body Surface Area calculations
  • Demonstrate awareness of dose banding, capping and rounding
  • Demonstrate basic understanding of occupational hazards of exposure to;
    •  Systemic Anti-Cancer Therapy drugs including oral anti-cancer medicines (OAM)
    • Waste
      • including basic safe handling procedures i.e. disposal of chemotherapeutic waste

Explain the processes for acquisition, storage and supply of Oral Anti-Cancer Medicines

4. OAM - Patient Counselling including Toxicity

This module focuses on some key points in relation to patient counselling for patients on OAM. At the end of this module, pharmacists will be able to;

• • Identify ways to support patient adherence to OAM regimens
    • Include importance of adhering to dosing schedule
  • Describe issues surrounding adverse events and toxicity management in relation to OAM
• Identify symptoms and management of toxicity
  • • Awareness of the requirement for monitoring blood counts with some OAM  (at hospital level)
    • Dose reductions in renal and hepatic impairment
    • Knowledge on  identification, monitoring and appropriate reporting of adverse drug events
• Recognise the clinical significance of drug-drug and drug-food interactions with OAM and drugs used to prevent and alleviate symptoms
  • Outline the effectiveness, safety and potential for interactions of OAM with complementary and alternative medicines
  • Identify sources of further guidance for obtaining information on specific treatments and side effects