Presentations
- Altered bowel habit
- Anorexia, malnutrition, and weight loss
- Dyspnoea / Cough
- Fatigue
- Fever
- Nausea
- Organ failure
- Malignant effusions
- Pain
- Psychospiritual crisis
- Weakness
Conditions
- Brain metastasis and raised intracranial pressure
- Cancer-related thromboses
- Cardiac tamponade
- Febrile neutropenia
- Severe acute electrolyte abnormalities of malignancy
- Severe immune-related complications of immunotherapy
- Spinal cord compression
- Superior vena cava obstruction
- Tumour lysis syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Acknowledge:
- contributing factors
- emergencies
- pathophysiology
- risks of acute oncological presentations
- Diagnose, systematically assess, and manage acute oncological emergencies requiring urgent intervention
- Manage a range of symptoms and syndromes associated with an initial presentation of malignancy, and formulate appropriate diagnostic and treatment plans
- Recognise the limitations of diagnostic investigations
Clinical assessments tools
- Accurately stage cancers
- Assessment of performance status:
- Eastern Cooperative Oncology Group (ECOG) and Karnofsky Performance Scale (KPS) scores
- frailty screening tools, as appropriate
- Interpretation of diagnostic testing, such as:
- biochemistry, haematology, and tumour markers
- imaging
- tissue pathology
- Psychospiritual
- Quality of life
Procedures
- Insertion of subcutaneous or intravenous devices for drug delivery
- Lumbar puncture
- Pleural and ascitic paracentesis and pleurodesis
- Selection and interpretation of biopsy techniques to obtain diagnostic tissue
- Clinical trials in cancer:
- consider suitability of clinical trials for all patients presenting with cancer
- recognise vital role of research in advancing cancer care
- Fertility considerations in men and women of child-bearing potential
- Indications for urgent systemic therapy for acute symptomatic presentations of cancer
- Recognition of the impacts of cancer on a patient and their family:
- cultural
- financial
- psychosocial
- spiritual
- Recognition of the importance of:
- a multidisciplinary approach to care
- supportive care, including early introduction to palliative care teams
