Introduction to Oncology

Introduction to Oncology Gauri Sabnis, PhD 1 Learning Resources ✥National Comprehensive Cancer Network ❊www.nccn.org ✥National Cancer Institute ❊www.cancer.gov ✥American Cancer Society ❊www.cancer.org ✥American Society for Clinical Oncology ❊www.asco.org 2 Scope of Practice ✥General practitioner ❊ Review chemotherapy and supportive care orders ❊ Recommend supportive care treatment plans ❊ Provide drug information ✥Oncology Pharmacist ❊ Conduct quality assurance of chemotherapy and supportive care orders ❊ Recommend or prescribe personalized supportive care treatment plans ❊ Collaborate with oncology care team to design personalized chemotherapy treatment plans ❊ Serve as drug expert in the oncology care team ❊ Review and evaluate literature data to provide pharmaceutical care ❊ Conduct clinical and outcome research 3 Scope of Practice ✥Community/ambulatory pharmacist ❊Many new oral drugs for cancer treatments Taken for 5 - 10 years ❊Supportive care (including OTC meds) ❊Drug interactions with cancer medication ❊Additive side effects of cancer medication and other medication ❊Cancer survivors ❊Cancer screenings, preventive measures, vaccination awareness 4 Supportive Care ✥Management of fluid and electrolytes (CPR-1) ✥Kidney function (CPR-1) ✥Cardiovascular support (CPR-2 and CPR-3) ✥HPG axis, Glucocorticoids, estrogens, progestins, gonadotropins (Endo) ✥Nausea-vomiting and diarrhea (GI/Nutrition, Foundations) ✥Nutrition Support for cancer patients (GI/Nutrition) ✥Anti-microbial treatment of immunocompromised patient (ID) ✥Pain management and depression (Neuro/Psych) ✥Tumor lysis syndrome/Hyperurecemia (Sp. Pop) ✥Organ transplant (Sp. Pop) 5 concert2ndLeadingcauseofdeath ✥Second leading cause of death in the US Cancer Facts and Figures, ACS 2024 6 Cancer Facts and Figures, ACS 2024 ✥ Almost 2 million new cases of cancer diagnosed per year and 600,000 deaths due to cancer per year! ❊ ~32% mortality rate! ❊ ~1 in 3 patients diagnosed with cancer will die from the disease 7 sie Changes in cancer incidence over time Cancer Facts and Figures, ACS 2025 8 9 Cancer prevalence in the US 10 Cancer Facts and Figures, ACS 2021 11 Trends in Cancer Death Rates 12 Trends in Cancer Death Rates 13 Trends in Cancer Death Rates ✥Cancer death rates have been consistently declining since the 1990s ✥More than 15.5 million children and adults with a history of cancer were alive on January 1, 2016, in the United States (~ 2million in California). Cancer Facts and Figures, ACS 2020 14 Cancer Facts and Figures, ACS 2024 15 Why does it still feel like a death sentence? Cancer Facts and Figures, ACS 2024 ✥ Not all cancers are the same ✥ Early Diagnosis is the key! 16 Clinical symptoms ✥Changes in bowel or bladder habits se ✥A sore that does not heal ✥Unusual bleeding or discharge ✥Thickening or lump in the breast, testes or elsewhere i when ✥Indigestion or difficulty swallowing ✥Obvious change in a wart or mole ✥Nagging cough or hoarseness ✥Sudden unexplained drastic weight loss ❊Cancer anorexia cachexia 17 Clinical symptoms in children ✥Continued unexplained weight loss ✥Headaches with vomiting in the morning ✥Increased swelling or persistent pain in bones or joints ✥Lump or mass in abdomen, neck or elsewhere ✥Development of whitish appearance in the pupil of the eye ✥Recurrent fevers not caused by infections ✥Excessive bruising or bleeding ✥Noticeable paleness or prolonged tiredness 18 Disparities ✥Race/ethnicity ❊ Higher risk for developing certain types of cancers White patients are 20 - 30 X likely to develop melanoma compared to AA ❊ Higher risk of dying from certain types of cancers Hispanic patients - cancer is the leading cause of death t ✥Socio-economic status/insurance 19 ✥ Race/ethnicity can play in increasing a Disparities person’s chance of getting a certain type of cancer ❊ African American men are at a higher risk (1.6X) for developing prostate cancer compared to white patients ❊ White patients are 20 - 30 X likely to develop melanoma compared to AA ❊ Mortality risk is even higher for AA men 2.4 X compared to white patients Socio-economic factors • Access to healthcare and preventative care, screenings • Health literacy Tend to get diagnosed at a later stage where the prognosis is poorer ❊ Physiologic factors Skin is more likely to burn if there is less melanin - ↑ risk of melanoma for white patients Cancer Facts and Figures, ACS 2020 Higher amount of testosterone in AA patients - ↑ risk of prostate cancer for AA 20 patients Preventive care and disparities ✥HPV vaccine is recommended to reduce the risk of cervical cancer ✥HPV vaccine is recommended to reduce the risk of cervical cancer PSN 21 Age Cancer Facts and Figures, ACS 2020 The biggest risk factor for developing cancer is AGE! 22 Age and cancer The biggest risk factor for developing cancer is AGE! 23