Hematology-Oncology Rotation
Goal
To integrate basic pharmacy-related concepts and oncology patient care through
patient care activities, discussions, and selected exercises.
Objectives
At the completion of this rotation, the student should be able to:
1. Neoplastic Diseases
• Describe the general course of the disease including the clinical findings, diagnosis,
complications of disease, and prognosis.
• Describe the histopathologic classification and staging of the malignancy.
• Define the goals and rational treatment programs including surgical, radiological,
pharmacological, and immunological.
• Identify the agent or combination of agents of choice including rationale, dose,
schedule, and potential toxicities.
• Understand the metastatic process and its appropriate management.
• Malignancies for which these objectives apply are:
Hematologic malignancy
Leukemia (acute nonlymphocytic, acute lymphocytic,
chronic myelogenous, chronic lymphocytic)
Hodgkin's disease
Non-Hodgkin's
lymphoma
Multiple myeloma
Solid tumors
Breast cancer
Lung cancer (small
cell, nonsmall cell)
Gastric cancer
Colon cancer
Genitourinary tract cancer
(cervical, ovarian, endometrial, prostate, testicular, urinary bladder,
kidney)
Head and neck cancer
Cutaneous melanoma
2. Antineoplastic Agents
• Discuss the pharmacology including mechanism of action, adverse reactions, dose
ranges, and pharmacokinetics of the common cancer chemotherapeutic agents,
hormonal and immunotherapeutic agents, and monitor their use in patients with
cancer.
• Recommend dosage adjustments based on renal function tests, liver function tests,
and hematologic or other indices.
• Discuss cancer chemotherapy with respect to cell kinetics.
• Discuss the rationale for induction, consolidation, maintenance, and adjuvant
chemotherapy.
• Describe the agents implicated, time course, reversibility, symptoms, and
predisposing factors for chemotherapy-induced adverse reactions including
pulmonary disease, nephrotoxicity, cardiac toxicity, neurotoxicity,
hepatotoxicity, radiation recall, gastrointestinal toxicity, hematologic
complications, metabolic toxicity, and secondary malignancy.
3. Radiation Therapy and Surgery
• Discuss the role of diagnostic, palliative, and curative radiation therapy and surgery in
cancer management.
• Understand the monitoring and management of the complications associated with
radiation therapy and surgery.
4. Nausea and Vomiting
• Discuss the physiology of nausea and vomiting.
• Discuss the pharmacology of available antiemetic.
• Recommend appropriate therapy with consideration of the proper drug, dose, and
regimen.
• Know the relative onset, duration, and severity of nausea and vomiting with different
chemotherapeutic agents.
• Describe nondrug methods for antiemetic control.
5. Pain Control
• Discuss the pathophysiology of acute and chronic pain.
• Describe the pharmacology of narcotic and non-narcotic analgesics.
• Recommend a treatment plan based on the patient's needs and anticipated side
effects.
• Discuss nonpharmacologic methods of pain control.
6. Mouth Care
• Understand the benefits of proper oral hygiene.
• List those agents that cause stomatitis or esophagitis.
• Discuss the use of available agents in mouth care including side effects and
contraindications.
• Discuss supportive methods used in mouth care.
7. Nutrition
• Assess the nutritional needs of the patient with cancer and recommend appropriate
nutritional management.
• Discuss the rational use of enteral and parenteral nutrition.
• Know the complications associated with the use of nutritional therapy.
8. Transfusion Therapy
• Discuss the use of blood products in cancer therapy including red blood cells, white
blood cells, and platelets.
• Suggest premedication regimens to help reduce hypersensitivity reactions to blood
products.
• Know the complications associated with the use of transfusion products.
9. Infectious Disease
• Describe the types of bacterial and nonbacterial infections seen in patients with
cancer.
• Discuss the role of infection prevention in patients with cancer.
• Recommend and monitor appropriate antibiotic therapy in patients with cancer with
respect to patient specific factors.
10. Extravasation
• List drugs that are vesicants.
• Understand the management of extravasation.