CAPhO Connections Podcast

AINV is a common dose limiting toxicity that can impact adherence and quality of life. Pharmacists are in an ideal position to optimize management.

Learning Objectives:

• Describe the pathophysiology of AINV
• Apply recommendations from practice guidelines to the treatment of patients with AINV
• Recognize challenges with completing AINV assessment using patient examples
• Explain the importance of the multidisciplinary approach to AINV management

When pharmacists provide education about oral chemotherapy medications, there are often recommendations regarding food around administration. This can lead to questions from patients about the well-known myth that sugar feeds cancer cells. Listen to an oncology dietitian as she provides tips on having discussions about sugar and cancer with your patients.

Learning Objectives:

• Discuss the origin of the myth that sugar causes cancer (or that myth that patients with cancer must avoid sugar)
• Review the evidence behind dietary intake of sugar and incidence of cancer or cancer outcomes
• Provide tips for having effective discussions with patients regarding this topic
• Review dietary recommendations for patients undergoing cancer treatment

About the Author - Grace Beda:

Grace completed her bachelor's and master’s degrees in human nutrition at the University of Guelph in 2013, and has since worked as a Registered Dietitian for 10 years in Calgary, Alberta. She spent the first 5 years of her career in acute and tertiary care hospitals, covering a wide range of wards from general medicine to surgery and ICU. She transitioned to outpatient oncology 5 years ago at the Tom Baker Cancer Centre in Calgary in the GI radiation clinics, then spent a year at the Red Deer Cancer Centre as the only oncology dietitian where she provided 1 on 1 consultation for patients from every tumor group. She moved back to the Tom Baker in 2020, working in the Head and Neck radiation clinics, then moved to malignant hematology and specifically bone marrow transplants in 2021, where she has happily settled in as part of a diverse multidisciplinary team in the Southern Alberta Blood and Marrow Transplant Program.

References:

Alberta Health, Alberta Government, Alberta Health Services. (2015, May 1). ABOUT 4 IN EVERY 10 CANCERS IN ALBERTA ARE CAUSED BY FACTORS THAT WE CAN CHANGE. Retrieved from healthiertogether.ca: https://www.healthiertogether.ca/health-conditions/cancer/

Arends, J. e. (2017). ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition, 36:11-48.

Dashty, M. (2013). A quick look at biochemistry: Carbohydrate metabolism. Clinical Biochemistry, 46:1339-1352.

FAO. (2011). Dietary Protein Quality Evaluation in Human Nutrition. Auckland, New Zealand: Food and Agriculture Organization of the United Nations.

Fenton, T. H. (2016). Systematic review of the association between dietary acid load, alkaline water and cancer. BMJ Open, 6(6): e010438.

Ford, K. A. (2022). The importance of protein sources to support muscle anabolism in cancer: An expert group opinion. Clinical Nutrition, 41:192-201.

Gallagher, E. L. (2020). Hyperinsulinaemia in cancer. Nat Rev Cancer, Nov;20(11):629-644.

Hamaguchi, R. I. (2022). Clinical review of alkalization therapy in cancer treatment. Front Oncol, 12: 1003588.

Liberti, M. L. (2016). The Warburg Effect: How Does it Benefit Cancer Cells? Trends Biochem Sci, Mar; 41(3): 211–218.

Mintziras I, M. M. (2018). Sarcopenia and sarcopenic obesity are significantly associated with poorer overall survival in patients with pancreatic cancer: systematic review and meta-analysis. Int J Surg , 59:19–26.

Prado, C. L. (2022). Examining guidelines and new evidence in oncology nutrition: a position paper on gaps and opportunities in multimodal approaches to improve patient care. Supportive Care in Cancer, 30:3073–3083.

Vigneri, R. S. (2020). Rethinking the Relationship between Insulin and Cancer. Trends Endocrinol Metab, Aug;31(8):551-560.

Xiao J, C. B. (2020). Association of low muscle mass and low muscle radiodensity with morbidity and mortality for colon cancer surgery. JAMA Surg, 155:942–949.

Zhang, A. W. (2021). Hyperinsulinemia in Obesity, Inflammation, and Cancer. Diabetes Metab J, May; 45(3): 285–311.

For geriatric cancer patients with multiple comorbidities, the management of cancer may present many therapeutic challenges, so treatment should be tailored to this demographic.

Learning Objectives:

• Discuss the need and role of (GA) Geriatric Assessment for older patients with cancer. 

• Explain what GA is.
• Introduce tools used in GA.
• Highlight the role of pharmacists in geriatric oncology and medication review for older patients.

ICIs are increasingly being used in the management of oncologic conditions. Although it provides an effective treatment option with the opportunity for long-term positive outcomes, it has the potential for autoimmune toxicities with a variable and prolonged time course. Tune in to hear how the pharmacist can play a key role in imAE management in patients receiving ICIs.

The Topic of Episode 12: Immune Checkpoint Inhibitor (ICI) Management.

Learning Objectives:

• Summarize the spectrum of immune mediated adverse events (imAE) with ICIs and apply management principles using the five pillars of imAE management
• Discuss challenges with identification and management of imAEs with combination therapy such as ICI + TKIs
• Review clinically relevant pharmacodynamic drug interactions with ICIs and with practical management tips
• Describe the role of the pharmacist in caring for patients receiving ICIs

Glenn Myers is a pharmacist with a focus in outpatient medical oncology at the Dr. Sheldon H Rubin Oncology Clinic in Moncton, New Brunswick. Glenn completed a BSc (Pharmacy) at Dalhousie University in 2011 and subsequently went on to complete his hospital residency at the Saint John Regional Hospital in New Brunswick. Glenn has been practicing in ambulatory oncology for over 10 years and focuses on clinical assessment and management of chemotherapy, oral anti-cancer and immune related adverse effects in patients with cancer. Glenn maintains an active role as the chair of the sponsorship committee with the Canadian Association of Pharmacy in Oncology (CAPhO). Glenn’s other professional interests include teaching and mentoring various levels of pharmacy learners, providing practical education to healthcare professionals, working with retail pharmacies to improve oncology patient care in the community, and performing oncology pharmacy practice-based research to advance the scope of oncology pharmacy.

Although continuing education is an obligation, it doesn’t need to be daunting.  Professional development activities can be engaging, rewarding, and a regular part of your professional routine.  Let’s explore ways to stay motivated and strategies to prioritize your learning.  

The topic of episode 7: How to stay up to date in oncology pharmacy

Learning Objectives:

• Identify personal areas of knowledge which require updates
• Identify resources for continued education in oncology pharmacy
• Create personal learning goals for continued education
• Create a plan and schedule for continued education

Guest for this episode: Tara Leslie

Tara Leslie attained her Bachelor of Science in Pharmacy (BSP) degree from the University of Saskatchewan.  After several years of oncology practice in Calgary, she obtained her Board Certification in Oncology Pharmacy (BCOP) in 2010, acquired her Additional Prescribing Authority (APA) in 2013 and attained a Masters of Education in 2020. In 2017, Tara was the recipient of the Larry Broadfield CAPhO Distinguished Service Award for her commitment to CAPhO and contributions to oncology service.  Currently, she is a Clinical Assistant Professor with the Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta where she teaches oncology related curriculum in a variety of courses and is a part of the experiential education team. Tara maintains a clinical practice within an ambulatory hematology/oncology clinic at the Tom Baker Cancer Centre.  She is very passionate about lifelong learning and the important role that pharmacists have in supportive care for people with cancer.