A lack of information related to the safe administration of oral chemotherapy agents in the community setting for health care professionals, patients and carers was a service gap identified by stakeholders involved in the improvement of cancer care delivery, and so GICS developed Clinical Guidelines that address this gap, in order to:

1. Ensure health care professionals, patients and family have information available to them in relation to:

i. safe prescribing of oral chemotherapy agents

ii. safe handling of chemotherapy agents

iii. safe administration of chemotherapy agents

iv. safe disposal of cytotoxic waste

2. Act as a resource for health care professionals in providing information to patients and family

3. Provide a care pathway which is in alignment with best practice and the Worksafe Victoria, Jan 2003, Handling Cytotoxic Drugs in the Workplace.

Please note the guidelines are intended as a guide only.

This guide provides practical advice to employers and employees on how to prevent or minimise the risks to health associated with handling cytotoxic drugs and related waste, including their preparation, administration, handling, storage, movement and disposal, and spills management, within health care establishments and community settings.

It aims to assist in the development and implementation of safe work systems and risk control procedures.

Cancer Council Australia has been bursting the bubble on cancer myths since the launch of its new website, iheard.com.au, in November.

Research by Cancer Council indicates that Australians are confused about what causes and prevents cancer, with 50 per cent of Australians mistakenly believing that drinking plenty of water and 47 per cent believing that getting enough sleep reduces their risk of cancer.

iheard is designed to combat misleading and fanciful claims about cancer by providing evidence-based answers written by professionals in the field.

This document ((NIH Publication No. 92-2621) reviews the routes through which exposure may occur and presents recommendations for the safe handling of parenteral cytotoxic drugs by pharmacists, nurses, physicians and other personnel who participate in the preparation and administration of these drugs to patients.

These guidelines apply in any setting where cytotoxic drugs are prepared - including pharmacies, nursing units, clinics, physicians' offices and the home health care environment.

A guide to assist health professionals with the assessment, treatment and management of secondary lymphodema.

Cancer Council Australia has been commissioned by Cancer Australia to develop Clinical Practice Guidelines for the Treatment of Lung Cancer and Colorectal Cancer.  

The draft guidelines have been prepared by the Lung Cancer Working Party using Cancer Council Australia’s newly developed wiki-based Cancer Guidelines Portal.  

The guidelines address the revision of the treatment chapters 5 - Management of Non-small cell lung Cancer and 6 – Management of Small cell lung cancer - of the Clinical Practice Guidelines for the Prevention, Diagnosis, and Management of Lung Cancer 2004.

These Guidelines are an update (and a substantial expansion) of several small sections of the 2005 Clinical Practice Guidelines for the Prevention, Early Detection and Management of Colorectal Cancer.

The draft guidelines will be available for public comment on the Cancer Council Australia Cancer Guidelines Portal (http://wiki.cancer.org.au) in early April.

This program is designed to provide nurses with fundamental and practical knowledge about cancer. The goals of this program are to strengthen the knowledge of nurses who are new to the cancer specialty, and to serve as a review and teaching tool for practicing oncology nurses.

PDFs of the ten basic cancer topics can be downloaded:

• Cancer terminology
• Cancer etiology
• Early warning signs
• Cellular structure and function
• Cell cycle and cancer cell properties
• Types of tissue
• Immune system
• Hematopoietic system
• An overview of cancer therapy
• Systemic chemotherapy and resulting toxicities.

A glossary of terms is also included.

MacMillan Cancer Support (formerly Cancerbackup) site presents generic information about cancer, information about different cancer types as well as web-based fact sheets on different cancer treatments and supportive care. A searchable database of cancer trials available in the UK and Europe is also provided. Some fact sheets are available in languages other than English.

The majority of information is written for a lay audience. However, a Health professionals section provides links to UK and overseas treatment guidelines and provides a series of discussion papers on topical issues.

The main menu groups information as follows:

• About cancer
• Cancer types
• Treatments
• Resources and support
• Trials
• Health professionals
• News

Each sub-menu provides further sub-divisions allowing users to quickly identify the area of interest to them. The information is comprehensive and written in plain English.

The date of development/revision of the information is supplied at the bottom of each page.

Medscape offers specialists, primary care physicians, and other health professionals integrated oncology medical information and educational tools. It‘s mission is to provide clinicians and other healthcare professionals with timely, comprehensive and relevant clinical information to improve patient care; to make the clinician‘s task of information gathering simpler, more fruitful, and less time-consuming; and to provide physicians with the educational tools needed to stay current in their practice.

Some of Medscape‘s key features include:

• Professional medical content, including review articles, journal commentary, expert columns, patient education articles and book reviews
• over 850 online CME activities
• access to presentations from conferences and medical meetings
• a primary-source medical journal, The Medscape Journal of Medicine
• a weekly email newsletter.

The NCI website contains a broad range of structured information about cancer and cancer-related topics for doctors, patients, their families and carers.

Information ranges from introductory background information that would be useful for lay people and health professionals without a background in cancer, to more detailed information relating to particular types and stages of cancer and its treatment.

The Cancer Topics menu includes accessible explanations of:

• The nature of cancer
• Cancer types
• Management of side effects (Coping with cancer)
• Treatments
• Support and resources (US context but largely generic information)
• Screening and testing
• Prevention, Genetics, Causes.

NCCN is developing a library of chemotherapy order templates to improve the safe use of drugs and biologics in cancer care. The information contained in the NCCN Templates is based on the NCCN Clinical Practice Guidelines in Oncology (TM) and the NCCN Drugs & Biologics Compendium (TM). The NCCN Templates include chemotherapy, immunotherapy, supportive care agents, monitoring parameters, and safety instructions. Special instructions for self-administered chemotherapeutic agents are provided.

The templates enhance patient safety by allowing you to:

• Standardize patient care
• Reduce medication errors
• Anticipate and manage adverse events.

Note: NCCN Templates are a peer-reviewed statement of the consensus of the authors derived from the NCCN Clinical Practice Guidelines in Oncology (TM) regarding their views of currently accepted approaches to treatment. The NCCN Templates do not constitute orders. Any clinician seeking to treat a patient using the templates is expected to use independent medical judgment in the context of individual clinical circumstances of a specific patient‘s care or treatment. NCCN Clinical Practice Guidelines in Oncology (TM) can also be downloaded from the site.

Comprehensive, authoritative, evidence-based information regarding cancer and its associated risk factors, prevention, symptoms, diagnosis, prognosis and treatment.

Multimedia resources including anatomical drawings are available on the site. 

Information and links regarding many aspects of radiation oncology including radiotherapy services, cancer treatment options, accommodation and travel schemes and other government assistance available, and links to useful websites for patients and health professionals.

The purpose of Adjuvant! is to help health professionals and patients with early cancer discuss the risks and benefits of getting additional therapy (adjuvant therapy: usually chemotherapy, hormone therapy, or both) after surgery.

The goal is to help health professionals make estimates of the risk of negative outcome (cancer related mortality or relapse) without systemic adjuvant therapy, estimates of the reduction of these risks afforded by therapy, and risks of side effects of the therapy. These estimates are based on information entered about individual patients and their tumors (for example, patient age, tumor size, nodal involvement, histologic grade, etc.)

The information is provided as a supplement to, not substitute for, clinical judgment.

The first public national register of lymphoedema practitioners in Australia and New Zealand, the National Lymphoedema Practitioners Register (NLPR) has been developed by Australasian Lymphology Association (ALA) as a searchable database to facilitate easy,  confident, local referral for health professionals and lymphoedema consumers to lymphoedema practitioners who fulfill the accreditation and registration requirements of the ALA.

If you would like copies of the NLPR brochure to give to your clients, please email info@nlpr.asn.au

The Cancer Institute NSW has produced a range of practical resources to support cancer health professionals, patients, their carers and families including cancer directories and registries.

Based  on the AJCC/UICC 7th edition Cancer Staging Manual, the available forms and guides are provided for educational purposes and to support the implementation of structured pathology reporting of cancer.  They are optional and can be used in the absence of existing local structured reporting forms and guides or to provide guidance on what should be included in local structured pathology reporting forms and guides for these cancers.

Protocols, guides and forms are included for:

• Colorectal cancer
• Haematopoietic and Lymphoid Tumours
• Lung
• Primary Cutaneous Melanoma
• Prostate (Radical Prostatectomy)
• Breast

Practical information for health professionals to provide to their patients regarding cancer tests and procedures they may undergo, how to prepare for them, what to expect and possible side effects.

Comprehensive, reliable, easy to understand patient information about a broad range of cancer types, including about symptoms and causes, tests and treatment, current research and living with cancer.

The primary objective of Diagnostic Imaging Pathways is to achieve the appropriate application of medical imaging technology to diagnosis in order to reduce the incidence of unnecessary or excessive examinations which may expose patients to risk without benefit, including the risk of false-positive results, and increase the incidence of appropriate examinations which will result in efficient diagnosis and effective treatment.

Imaging Pathways are included for:

The NCI Dictionary of Cancer Terms is a free, searchable database with more than 6,000 terms related to cancer and medicine.

Definitions are available in English and in Spanish.

eviQ Cancer Treatments Online is a single repository of standardised, current, evidence based, peer reviewed information about clinical cancer treatments. Designed by medical oncologists to reduce unneccesary practice variation, eviQ provides clinicians, primary carers, patients and carers in all clinical and geographical settings with free 24 hour access to comprehensive information, relevant to the Australian context.

In scope and presentation eviQ represents a significant advance on its forerunner CI-SCaT. The eviQ information system offers standardised and comprehensive information that aligns to the clinical workflow and supports the clinician at the point of care. eviQ also provides treatment and procedure specific patient information for use by clinicians delivering care to cancer patients.

Information is targeted via categories:

• Cancer Genetics
• Haematology
• Marrow Transplantation
• Medical Oncology
• Medical Physics
• Nursing
• Palliative Care
• Patient Information
• Primary Health Care (Cancer Australia funded section)
• Radiation Oncology
• Adolescent and Young Adult (AYA)
• Bone Marrow Transplant (HPCT)

eviQ also includes a searchable database of cancer symptoms and cancer medications including information about adverse reactions, a freely accessible opioid calculator and links to many other credible sources of cancer information.

A poster describing the eviQ Primary Care project is available here.

A multimedia guide produced with the financial assistance of National Center for Research Resources, a component of the National Institutes of Health, these multimedia resources provide information regarding cancer etiology, biology, causes and treatments across four areas:

Hallmarks of Cancer

Causes and Prevention

Diagnosis and Treatment

Pathways to Cancer

An interactive user blog as well as a Teacher Centre, which assists in the implementation of the resources and helps students understand how modern molecular and cellular genetics are integrated into ideas about cancer diagnosis, prevention, and treatment. 

The M. D. Anderson Symptom Inventory (MDASI; Cleeland et al., 2000) is a multisymptom patient-reported outcome (PRO) measure for clinical and research use. The MDASI’s 13 core symptom items include those found to have the highest frequency and/or severity in patients with various cancers and treatment types. The MDASI has several advantages over other symptom-assessment scales in that it applies broadly across cancer types and treatments, is easy for patients to complete, includes items related to symptom interference with daily life, and it is easily translated into other languages.

The Assessment Tool features:

• Purpose: To assess the severity of multiple symptoms and the impact of symptoms on daily functioning
• Population: Patients with symptoms due to cancer and cancer treatment
• Assessment Areas: Severity of multiple symptoms and the impact of symptoms on daily functioning during the last 24 hours
• Method: Self-report, interview or via telephone-based interactive voice response (IVR) system
• Time required: Five minutes
• Scoring: Please see the MDASI User's Guide
• Reliability: Cronbach alpha reliability ranges from 0.82 to 0.94

For non-funded academic research and individual clinical practice, the  MDASI can be used free of charge.

To use the MDASI in a publication or clinical or research trial, you must obtain permission and you must agree to comply with the copyright. In other applications, fees may apply.

A range of free publications that health professionals can print to provide to their patients regarding fundamental areas of cancer care, including:

• Chemotherapy and You: Support for People with Cancer

• Radiation Therapy and You: Support for People with Cancer

• Eating Hints: Before, During, and After Cancer Treatment

• Facing Forward: Life After Cancer Treatment

• What You Need to Know About Breast Cancer

• What You Need to Know About Cancer

Radiation to the head and neck and chemotherapy for any malignancy can cause a range of oral side effects. For some patients, these complications may become dose-limiting and slow, or even halt, cancer treatment.

This brochure provides information for oncology teams to assist in the prevention and management of oral complications to help support optimal cancer treatment and patient quality of life.

This website is for people who have lymphoedema or who are concerned about developing lymphoedema following treatment for cancer. It also contains information for health professionals, including resources for professional development workshops.

Lymphoedema is a chronic swelling in part of the body that occurs because of a build-up of fluid in the body‘s tissues. Estimates suggest that about 20% of patients treated for melanoma, breast, gynaecological or prostate cancers will develop lymphoedema. There is no cure, but appropriate management and daily care can reduce swelling, improve movement and prevent infections.

The resources and information on this website aim to improve the knowledge and management of secondary lymphoedema following cancer treatment.

The RCPA website: http://www.rcpa.edu.au/ provides various cancer related information in fact sheets and articles in it‘s topical publications, Pathways and Common Sense Pathology.

The RCPA Manual at: http://www.rcpamanual.edu.au/default.asp is an informative and user-friendly online manual that explains the selection and interpretation of pathology tests relevant to cancer and an extensive list of other diseases.

An article detailing the role of Pathologists as key team players in cancer management by Wendy Pryor, Director, Education for the Royal College of Pathologists of Australasia can be be downloaded here.

A broad overview for those new to cancer care, students, patients and their families providing basic information about how and why cancer starts, how it grows, develops and spreads, why it makes people ill, and how it can be detected and treated.

The intent of this monograph is to provide current, practical clinical information and guidance to the practitioner outside the major cancer treatment center to assist in providing their patient with appropriate advice and information to provide a continuum of oral health care in preparation for cancer therapy, during therapy and after therapy .

A summary and recommendations for the educational and competency requirements for nursing caring for patients with Central Venous Access Devices (CVADs).

The document contains the following sections and includes recommendations relating to each:

• Section One: Educational standards for nurses involved in the management of central venous access devices
• Section Two: Characteristics of central venous access devices used in cancer settings
• Section Three: Patient and family caregiver education
• Section Four: Caring for a person with a central venous access device: pre-insertion
• Section Five: Caring for a person with a central venous access device: post-insertion
• Section Six: Complications related to central venous access devices and their management

Developed on the articulate rapid e-learning powerpoint template kit at the Royal Hobart Hospital, this CD-ROM chemotherapy administration competency assessment tool is delivered via an e-learning format that involves evidence-based resources and questionnaires for use by nurses throughout Australia.

The package has been peer reviewed by content experts at RHH and has undergone extensive evaluation by clinical nurses, pharmacists, oncologists and educators.

To order, contact Katrina Hodge: katrina.hodge@dhhs.tas.gov.au

Funded by Australian Government Department of Health and Ageing, this competency toolkit provide a useful framework that reflects nursing practice in the general practice setting for both registered and enrolled nurses and reflect the new ANMC competency standards for registered nurses.

Developed by D. Canning, P. Yates and J.P Rosenberg' at QUT, this framework provides a set of competency standards for specialist palliative care nursing practice in Australia.

Standards are included for each of the following domains:

• Therapeutic Relations
• Complex Supportive Care
• Collaborative Practice
• Leadership
• Improving Practice

The National Professional Development Framework for Cancer Nursing developed by EdCaN defines the core domains of practice and associated competency standards expected of nurses at various levels of practice. It provides a structure for the development of competency assessment tools (CATs). 

Competency assessment tools have been developed for:

• antineoplastic agent administration (PDF, 282kb)
• care of febrile neutropenia (PDF, 310kb)
• therapeutic communication (PDF, 283kb)
• management of central venous access devices (CVADs) (PDF, 282kb).

Full and summary reports outlining competency standards for breast nurses including care coordination role. Includes literature review and stakeholder consultation.