Understanding and Prescribing Chemotherapy

	Earn a certificate of completion
	Intermediate
	Approximately 8 hours to complete
	100% online
	Self-paced
	English

About the course:

This course was created for all health care professionals involved in prescribing chemotherapy or looking after patients on those treatments.

It includes accessible introductions to how different chemotherapeutic drugs work and how to manage their side effects, plus a bank of prescribing scenarios for doctors and pharmacists to practice clinical decision making.

The modules have been designed to support health care professionals involved either directly in prescribing systemic anti-cancer therapies (SACT) or looking after patients on these treatments. They are designed to provide an introduction or refresher to the basic principles of SACT prescribing. They are not designed to give clinical direction in patient management or replace local guidelines and recommendations, which should be consulted when making prescribing decisions.

The more advanced content is directly aligned to the curriculae for medical oncology, clinical oncology and haemotology for specialist trainees, and to the Royal Pharmaceutical Society Cancer Care Curriculum and the BOPA competency framework for specialist oncology pharmacists.

Module 1: Background to Chemotherapy

In this module you will review the key principles of systemic anticancer therapy (SACT). The goal is to become familiar with common systemic anti-cancer drugs, including their place in therapy, their mechanisms, and their side effects.

Once you have completed this module you will:

Be familiar with the basic science of cancer to support learning about chemotherapy
Understand the rationale for chemotherapy
Understand the principles of chemotherapy
Be familiar with some of the commonly used agents and their mechanism of action

Module 2: Targeted Therapies

In this module you will cover an introduction to targeted therapies, understanding and awareness of signalling pathways, and understanding angiogenesis.

Once you have completed this module you will:

Understand the rationale for targeted therapy
Understand the principles of targeted systemic anti-cancer drugs, particularly in relation to therapeutic monoclonal antibodies and kinase inhibitors
Be aware of the HER2, VEGFR and VEGF signalling pathways
Understand the process of and the principles of inhibition by targeted therapy

Module 3: Side Effects and Supportive Therapies

In this module you will become familiar with common systemic anti-cancer drugs including roles, mechanisms, and side effects.

Once you have completed this module you will:

Be able to define the likely adverse effects associated with SACT in common usage
Be aware of how to record clinical toxicity assessments using defined systems such as the Common Toxicity Criteria
Be able to define the appropriate pharmacological and non-pharmacological supportive measures that may be required by patients receiving SACT, including growth factors, antibiotic therapy, blood product support and anti-emetics
Be aware of the situations when it is important to consider missing a dose of chemotherapy
Be aware of the management of an extravasation event
Be able to alert a senior team member when a patient is receiving SACT

Module 4: Introduction to Practical Prescribing

In this module you will review the assessment of response to therapy and the likely adverse effects of agents in common usage. The aim is to become familiar with the common systemic anti-cancer drugs including roles, mechanisms and side effects.

Once you have completed this module you will:

Be aware of the methods for assessing response to systemic anti-cancer therapy (SACT)
Understand the process of informed consent for SACT following appropriate discussion of indications and likely adverse effects of treatment
Be able to define performance status and understand its role in assessing fitness for chemotherapy
Be aware of the principle of dose delay or dose reduction
Be able to describe the relevance of liver and kidney function in chemotherapy prescribing
Be able to define parameters required to receive chemotherapy
Be able to undertake relevant calculations such as BSA, CrCl, AUC

Module 5: Practical Prescribing Case Studies

This module includes questions around the principles of prescribing systemic anti-cancer therapies, patient assessment and management of oncology emergencies relevant to systemic therapies.

The examples aim to cover the key topics and can be used to support discussion around the use systemic anti-cancer therapies.

In relation to day to day prescribing, it is important that local guidelines are consulted for the practical management of patients in your Trust.

The questions are divided into 7 sections aimed at reviewing the key principles of Systemic Anti-Cancer Therapy (SACT). Each section has a number of case studies to go through.

About the authors:

	Sarah J.L. Payne Honorary Medical Oncology Consultant Sarah Payne is a medical oncologist, who started her training in cancer medicine in London in 2003. She completed her clinical training in medical oncology at St Bartholomew’s NHS Foundation Trust and latterly Guy’s and St Thomas’ NHS Foundation Trust (GSTT) in 2014, which included a 4 year PhD in oncology at the Barts Cancer Institute. Sarah was then appointed as a post-CCT clinical fellow at GSTT in 2014, which included clinical responsibilities in oncology and undergraduate education. During this time, she completed a postgraduate certificate in clinical education and was the appointed undergraduate lead for third year clinical skills training at King's College London Medical School. In November 2015, Sarah was appointed as a medical manager for Pfizer UK, leading the lung cancer portfolio. She was additionally appointed as an Honorary Medical Oncology Consultant at GSTT, where she continues to practice clinically. Sarah has always had a passion for education and teaching, and has thoroughly enjoyed being involved in many teaching programmes at both local and national level during the course of her clinical training and beyond.
	Lizzie Provis Specialist Oncology Pharmacist Lizzie Provis is a pharmacist with experience of working in hospitals in both the NHS and independent sector. She first began working in cancer services after completing her pharmacy training. She moved to Guy’s and St Thomas’ NHS Foundation Trust (GSTT) as a Specialist Cancer Pharmacist in 2012. Whilst at GSTT, Lizzie qualified as an independent prescriber and ran a pharmacist led outpatient clinic for haematology patients. During her time at GSTT she also lectured at King’s College London on the undergraduate pharmacy course and at London South Bank University on the post graduate non-medical prescribing CPD course. During 2016/17, Lizzie participated in the Chief Pharmaceutical Officer’s Clinical Fellowship scheme. She was based at the Care Quality Commission (CQC) where she led a variety of projects related to medicines optimisation. In October 2017, Lizzie was appointed to the role of Pharmacist Specialist at the CQC. In this role she works to support the regulatory process around medicines and to develop the CQC medicines optimisation agenda.
	Kumud Kantilal Macmillan Principal Pharmacist, Lead for Education and Training Kumud Kantilal is a pharmacist with over eighteen years of experience working in NHS hospitals. She has extensive experience of delivering clinical pharmacy services to cancer patients and leading on education and training of multi-professionals working in cancer services. She was the lead cancer services pharmacist at Mount Vernon Cancer Centre (2005 – 2007), lead for cancer education and training at Guy’s and St Thomas’ NHS Foundation Trust (2007 – 2016) and clinical lecturer at King’s College London (2014 – 2016). In 2016 Kumud took on the post of Foundation Pharmacist Training Programme Director at Health Education England, London and South East, where she was responsible for managing the Foundation Pharmacist programme across Kent, Surrey and Sussex and leading on commissioning for non-medical prescribing. Kumud is a co-founder of the Cancer Pharmacy Education (CaPE) forum which aims to provide education and networking opportunities to pharmacy professionals across London with an interest in cancer services. Kumud’s interests include education and training, workforce development, medicine’s safety and developing innovative clinical pharmacy services to meet the needs of local populations. She has completed a Masters in Clinical Research, after being awarded a Research Fellowship by the Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London in 2013/14. In October 2017, Kumud joined the research team at the University of East Anglia as a PhD student to undertake research on design and implementation of novel oncology pharmacy services.
	Deepti Radia Consultant Haematologist and Postgraduate Lead for Education Deepti has been in her Haematology Consultant post at Guy’s & St Thomas’ NHS Foundation Trust since 2002. She is also Deputy Head of School of Pathology (London and South East) She is passionate about ensuring postgraduate medical education is delivered to the highest standards possible to enable the development of capable and competent professionals in a constantly changing NHS service. She has been actively involved in postgraduate haematology training and education since 1997. Her roles have included trainee rep, London STC Chair 2011-2014, Haematology SAC Chair 2011-2015, HESL/KSS Haematology TPD 2014-2017, BSH Trustee 2015 to present, FRCPath examiner 2007 to present. Deepti has been an integral member of the Board of the London School of Pathology since its inception in 2008. Her roles include Professional development lead, joint development of virtual learning environment & supervision of medical education fellows.