Core Adult Internal Medicine Disciplines

Medical Oncology

Topics

• Assessment of the acutely ill patient with malignancy.
  
• Practice of common symptom control problems: pain, dyspnoea, nausea and vomiting, diarrhoea, constipation and bowel obstruction.
  
• Management of oncological emergencies due to disease or therapy: including hypercalcaemia; superior vena caval obstruction; spinal cord compression; cardiac tamponade; neutropenic infection.
  
• Principles of cancer staging.
  
• Principles of the management of solid tumours with an emphasis on lymphoma, cancer of the breast, ovary, testis and prostate, and lung cancer.
  
• Principles of anticancer therapies: endocrine and cytotoxic chemotherapy, radiation therapy and palliative care.
  
• Principles of monitoring of patients receiving anti-cancer treatments: assessment and management of toxicity; assessment of response to therapy.
  
• Concepts of 'adjuvant', 'neo-adjuvant', 'palliative' and 'curative' therapies for malignancy.
  
• Knowledge of cancers that can be cured by primary chemotherapy: including testicular cancers and lymphomas.
  
• Knowledge of cancers in which adjuvant or neo-adjuvant chemotherapy may enhance the outcomes of local treatment: including breast, head and neck, lung, colon and ovarian cancers and osteosarcoma.
  
• Knowledge of those common cancers that can be palliated by nonsurgical cancer therapies: including breast cancer, lung cancer, colorectal cancer, and prostate cancer.
  
• Knowledge of the paraneoplastic syndromes associated with cancer.
  
• Principles of palliative therapies: the aims of treatment and the concept of balance between efficacy and toxicity/quality of life.
  
• Understanding of the genetic pathophysiology of common malignancies: including breast, colon, and stomach cancer, and leukaemia.
  
• Mechanism of action and toxicities of various classes of cytotoxic drugs.
  
• Principles of clinical drug development and randomised clinical trials.
  
• Practice of pain control: knowledge of the pharmacological and nonpharmacological modalities available.
  
• Counselling of patients on the practicalities of administration and toxicities induced by chemotherapy and radiotherapy.

Practical Skills for all Trainees

• Prescription and safe administration of intravenous chemotherapy.
  
• Acute management of extravasation.
  
• Performance of thoracocentesis, ascitic tap and lumbar puncture.
  
• Discussion with patients, and their relatives, about the diagnosis of malignancy and its attendant prognosis.

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