Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Cancer related pain
- Dyspnoea
- Fluid and electrolyte disturbances
- Side effects of systemic cancer therapy, such as:
- diarrhoea
- mucositis
- nausea
- vomiting
Conditions
- Cancer:
- breast
- colorectal
- lung
- pancreatic
- prostate
- skin:
- basal cell carcinoma
- premalignant skin lesions
- squamous cell carcinoma
- Metastatic disease manifestations:
- cardiac tamponade or malignant pleural effusion and ascites
- cerebral metastases
- hypercalcaemia of malignancy
- spinal cord compression
- superior vena cava (SVC) obstruction
- Neutropenic sepsis
- Side effects of systemic cancer therapy, such as:
- alopecia
- bone marrow suppression
- cardiomyopathy
- drug induced interstitial lung disease
- peripheral neuropathy
- Thromboembolism
- Tumour lysis syndrome (TLS)
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Conditions
- Cancer:
- carcinoma of unknown primary
- laryngeal
- melanoma
- mesothelioma
- mouth
- pharyngeal
- Cerebral neoplasms
- Endocrine syndromes associated with malignancy
- Hormone secreting tumours
- Malignancies
- genitourinary malignancies:
- bladder
- testicular
- gynaecological malignancies:
- cervical
- ovarian
- uterine
- liver malignancy:
- primary
- secondary
- genitourinary malignancies:
- Paraneoplastic syndromes
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Broad pharmacological principles and complications of chemotherapy, endocrine therapy, immunotherapy, molecularly targeted therapy, and radiotherapy
- Concept of clinical trials
- Indication and complications of bone marrow transplant
- Processes of:
- cell growth and ageing, cell injury, and apoptosis
- immune evasion and immune surveillance
- metastatic spread
- molecular and cellular oncogenesis
- Purpose and principles of cancer staging
- Rationale, accuracy, benefits, and harms of screening tests
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Body fluid analysis, including cytology
- Chest X-ray
- CT of head, chest, abdomen, and pelvis
- Endobronchial ultrasound
- Faecal occult blood testing
- Fine needle aspiration and excisional biopsy
- Genetic testing, such as BRCA
- Histopathology
- Liver function tests
- Mammography or breast ultrasound
- MRI and PET scans
- Nuclear bone scan
- Papanicolaou test (Pap smear)
- Pre-chemotherapy screening investigations
- Tumour markers
Procedures
- Bronchoscopy
- Endoscopy
Clinical assessment tools
- Assessment of performance status, such as ECOG performance status and Karnofsky performance status scale
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- End-of-life decision making
- Immune toxicity
- Oncology in different patient age groups, such as elderly and adolescent patients
- Palliative care
- References to patients in the remainder of this document may include their families or carers.