CAPhO Oncology Fundamentals Day Saturday, October 1, 2016

The Canadian Association of Pharmacy in Oncology Presents
CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
www.capho.org
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Accreditation
CAPhO Oncology Fundamentals Day is accredited by the Canadian Council on
Continuing Education in Pharmacy (CCCEP) for 6.67 continuing education credits
(CEUs). Participation on October 1st is required to receive a letter of participation.
CCCEP Number: 1152-2016-1830-C-P
Program at a Glance
Click on the session title or presenter name to go directly to the session description or presenter
biography.
Note: All times indicated are Eastern Daylight Times (EDT).The program below is subject to change.
Time
Session
09:30 – 09:40
Welcome Remarks
09:40 – 11:50
Fundamentals of Hematologic Cancer
09:40 – 10:20
Lymphoma - Kyla Marien, Tom Baker Cancer Clinic, Calgary, AB
10:25 – 11:05
Chronic Leukemias - Danica Wasney, CancerCare Manitoba, Winnipeg, MB
11:10 – 11:50
Multiple Myeloma - Tina Crosbie, The Ottawa Hospital, Ottawa, ON
11:50 – 12:30
Break
12:30 – 14:55
Fundamentals of Solid Tumours
12:30 – 13:15
Breast Cancer - Melanie Danilak, Alberta Health Services, Edmonton, AB
13:20 – 14:05
Colorectal Cancer - Tom McFarlane, University of Waterloo, Kitchener, ON
14:10 – 14:55
Lung Cancer - Jason Wentzell, The Ottawa Hospital, Ottawa, ON
14:55 – 15:20
Break
15:20 – 18:00
Chemotherapy Toxicity Management
15:20 – 16:00
Chemotherapy Induced Nausea and Vomiting - Sally Waignein, BC Cancer
Agency, Vancouver, BC
Other Gastro-Intestinal Toxicities - Glenn Myers, Horizon Health Network,
Moncton, NB
Febrile Neutropenia - Tara Leslie, Tom Baker Cancer Centre/University of
Alberta, Calgary, AB
16:05 – 16:45
16:50 – 17:20
17:25 – 18:00
Skin, Nail and Hair Toxicities – Lynn Hartery, Eastern Health, St. John’s, NL
18:00 – 18:10
Closing Remarks
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Session Descriptions and Presenter Biographies
Fundamentals of Hematologic Cancers
Lymphoma - Kyla Marien, Tom Baker Cancer Clinic, Calgary, AB
Lymphomas are a heterogeneous group of over 40 different malignancies originating from T
cells and B cells in the lymphatic system. Within this group of diseases there are similarities
and differences within the pathophysiology, natural history, and prognosis. As treatment
options differ dependent on the specific disease, the adverse effects patients experience can
be diverse. Pharmacists are well positioned to assist in monitoring lymphoma patients for
therapy toxicities and optimizing supportive care measures.
Learning Objectives:
1. Appreciate the numerous types of lymphoma and gain understanding in the
differences between Hodgkin and Non-Hodgkin, indolent and aggressive, and Bcell versus T-cell lymphoma;
2. Discuss the incidence, pathophysiology, typical presentation, and prognostic
factors for lymphomas;
3. Describe some common treatment regimens, associated side effects, and
monitoring parameters for common types of lymphoma; and
4. Explore the role of CD20 monoclonal antibodies in lymphoma and discuss the
associated supportive care requirements.
Kyla Marien graduated from University of Saskatchewan in 2003
and currently works for Alberta Health Services at the Tom Baker
Cancer Centre as clinical hematology pharmacist. Over the past 13
years she has practiced in many diverse settings, including
community, geriatrics, hospital outpatient, and oncology. Kyla truly
believes each setting provided her with different skills and
knowledge to allow her to practice today in oncology with an
appreciation for a patient’s experiences both in the center and in
the community. Before joining the hematology clinical pharmacy team, Kyla developed her
oncology clinical skills with the oral chemotherapy management clinic. Kyla is a proud
CAPhO member.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Chronic Leukemias - Danica Wasney, CancerCare Manitoba, Winnipeg, MB
Systemic therapy for both Chronic Lymphocytic Leukemia (CLL) and Chronic Myelogenous
Leukemia (CML) has evolved significantly over the past 10-15 years. Systemic therapy for
both CLL and CML is complex due to both the regimens used and the patient populations,
as patients often present with comorbidities and multiple medications. Pharmacists are well
equipped to optimize clinical outcomes for patients with CLL and CML through education,
monitoring, symptom management, and medication management.
For CLL, selection of systemic therapy is based on a variety of patient and disease factors,
including staging, patient performance/functional status, and genetic markers. Systemic
therapy regimens for CLL are complex, consisting of both oral and parenteral anticancer
agents in addition to crucial supportive care agents. In addition, these regimens require
careful attention with regards to drug interactions and medication adherence. Pharmacists
can play a key role in optimizing care for patients with CLL.
For CML, the introduction of targeted therapies has resulted in significant advances in
patient survival and outcomes. Treatment selection is based on a variety of patient and
disease factors, including CML phase, patient performance/functional status, and genetic
markers. Since systemic therapies used to manage CML are usually orally administered on
an outpatient basis, pharmacists are positioned to support patients with CML through
management of drug interactions, symptom management, and medication adherence.
Learning Objectives:
After this presentation, participants should be able to:
1. Discuss the incidence, prevalence, pathophysiology, and staging for Chronic
Lymphocytic Leukemia (CLL);
2. Discuss the incidence, prevalence, pathophysiology, and staging (phases) for
Chronic Myelogenous Leukemia (CML);
3. Describe systemic treatment selection, monitoring parameters, and expected
outcomes for patients with CLL and CML; and
4. Explain common supportive care issues for patients with CLL and CML.
Danica Wasney is a Clinical Pharmacist for the Provincial Oncology
Drug Program at CancerCare Manitoba. In this role, she participates
in the provincial oncology drug review process including the
management of the provincial oncology drug formulary. She is a
member of the Expert Review Committee for the pan-Canadian
Oncology Drug Review (pCODR) at the Canadian Agency for Drugs
and Technologies in Health (CADTH).
Danica has clinical experience in breast, colorectal, thoracic and gynecologic cancers,
neuro-oncology, and hematologic malignancies.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Danica graduated from the Faculty of Pharmacy at University of Manitoba and completed an
Accredited Hospital Pharmacy Residency at The Ottawa Hospital. She is a Board Certified
Oncology Pharmacist, a member of the CAPhO Research Committee, and a past member of
the CAPhO Education Committee.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Multiple Myeloma - Tina Crosbie, The Ottawa Hospital, Ottawa, ON
Multiple Myeloma is the second most common blood cancer. Every day, seven Canadians
are diagnosed with myeloma; most commonly people are in their early 60’s at diagnosis.
Myeloma can affect other parts of a person’s body including the kidneys and bones.
Knowing what a patient can expect when diagnosed with myeloma can help the pharmacist
be a valued resource when providing care to that patient. 2016 has seen a wealth of
treatment options for patients with multiple myeloma. The pharmacist is in a great position to
explain the treatment chosen to manage the disease and answer questions so the patient
can benefit from their therapy.
Learning Objectives:
1. Define myeloma and how frequently it occurs in Canada;
2. Discuss how a patient may appear when ready to start myeloma therapy;
3. Identify key patient needs and how the pharmacist can assist their patient with
myeloma; and
4. Review what treatment combinations are available for patients with newly diagnosed
and for patients with relapsed myeloma.
Tina Crosbie holds a Bachelor of Science in Pharmacy from
Memorial University of Newfoundland and completed her hospital
pharmacy residency at The Ottawa Hospital.
She has over 20 years experience in hospital and retail pharmacy
practice in Newfoundland and Ontario.
For the last 17 years Tina has been part of the hematology team at
The Ottawa Hospital. Currently, she is the clinical pharmacist for
the ambulatory hematology chem unit. Here she oversees patients with lymphoma, multiple
myeloma and chronic lymphocytic leukemia who are receiving care on an outpatient basis.
Tina has written educational materials and has given presentations on numerous topics in
hematology. She also enjoys being a peer reviewer for the Canadian Council on Continuing
Education in Pharmacy (CCCEP), and is a proud member of CAPhO.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Fundamentals of Solid Tumours
Breast Cancer - Melanie Danilak, Alberta Health Services, Edmonton, AB
This presentation will provide the pharmacist with an introduction to the treatment of breast
cancers, with a focus on the early breast cancer setting.
Learning Objectives:
1. Recommend appropriate screening for breast cancer to patients in the community;
2. Describe the methods used to detect and classify breast cancer;
3. Differentiate between the main treatment options offered to patients with breast
cancer, including surgery, radiation therapy, chemotherapy, targeted therapy, and
endocrine therapy;
4. Describe common or significant toxicities that arise from systemic breast cancer
treatments;
5. Evaluate common drug interactions involving breast cancer treatments;
6. Identify resources available to health professionals and patients about breast cancer
treatment; and
7. Recognize the role of the pharmacist in providing care to patients with breast cancer.
Melanie Danilak obtained her BSc. in Pharmacy in 2004 and Master
of Education in Health Sciences Education in 2016 from the
University of Alberta. She has completed an accredited pharmacy
residency with a focus in oncology at the Cross Cancer Institute and
has obtained additional prescribing authorization from the Alberta
College of Pharmacists.
Melanie is currently a Clinical Practice Leader and Residency
Coordinator with Alberta Health Services. Her clinical practice is focused on breast cancer
endocrine therapy. She is also a clinical adjunct professor with the Faculty of Pharmacy &
Pharmaceutical Sciences at the University of Alberta.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Colorectal Cancer - Tom McFarlane, University of Waterloo, Kitchener, ON
Colorectal cancer is one of the most prevalent types of cancer in Canada, with nearly 25,000
cases diagnosed in 2014 and over 9,000 deaths attributed to the disease. It is 90% curable if
detected at an early stage, yet unfortunately screening is still not done optimally. Treatments
for colorectal cancer are advancing, and patients are living longer, thus creating a need for
management as a chronic disease. This presentation is intended to give the pharmacy
practitioner a basic understanding of the pathogenesis of the disease, basic workup,
treatment options, and management of adverse effects.
Learning Objectives:
After attending, participants will be able to:
1. Understand the etiology, pathogenesis, and prevalence of colorectal cancer;
2. Apply screening guidelines for colorectal cancer to patients;
3. Outline agents used to treat colorectal cancer in the curative, neoadjuvant, and
adjuvant settings; and
4. Detail the management of adverse effects related to colorectal cancer treatments.
Tom McFarlane received his Bachelor of Science in Pharmacy
degree from the University of Toronto in 1996 and his Doctor of
Pharmacy degree from Idaho State University in 2011. He is
currently a Clinical Lecturer and researcher at the UW School of
Pharmacy in Kitchener, Ontario, where he created, coordinates,
and teaches the oncology curriculum in the Doctor of Pharmacy
program. He also holds memberships in CPhA, CAPhO, and ISOPP
and is Chair of the CAPhO Research Committee as well as being a
member of the CAPhO Executive and Education Committees.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Lung Cancer - Jason Wentzell, The Ottawa Hospital, Ottawa, ON
The changing therapeutics of lung cancer is becoming more complex and requires an
understanding of management principles by the primary care pharmacist in order to identify
and resolve drug therapy issues and optimize the care of patients with lung cancer. This
session will focus on the provision of information pertinent to pharmacy practitioners involved
in the care of patients with various types of lung cancer. A brief overview highlighting the
demographic, genetic, therapeutic and prognostic differences between small cell lung cancer
and non-small cell lung cancers will be provided. The predominant focus of the session will
be to review common therapeutic agents used in the treatment of lung cancers. Particular
emphasis will be given to current and emerging oral anticancer therapies that participants
may see in clinical practice, including information on identifying and managing potential drug
interactions. In addition, a summary and strategy will be provided to front-line pharmacy
care providers on how to identify, manage or refer toxicity caused by immune-related
anticancer therapies. Lastly, some practical information on managing anticancer therapy
related adverse effects and reiterating the importance of smoking cessation where
applicable will be provided.
Learning Objectives:
1. Participants will learn the basic demographic, genetic, and prognostic differences
between small cell lung cancer and non-small cell lung cancers;
2. Participants will learn about the indications, pharmacology, schedules and toxicities
of current anti-cancer therapies for respective lung cancer types; and
3. Participants will be provided with practical information on the identification and
management of anti-cancer therapy related toxicities and drug-drug interactions that
can be incorporated into daily practice.
Jason Wentzell completed his pharmacy degree at Dalhousie
University and his Pharmacy Residency at The Ottawa Hospital.
He has been practicing as an inpatient Medical Oncology
pharmacist for 5 years and has recently received his Board
Certification as an Oncology Pharmacist. Jason is the pharmacist
representative in the Ottawa Hospital Cardio-Oncology clinic and is
involved in research in the areas of cardio-oncology, adverse drug
reaction reporting, simulation education and oral anticancer
therapy. He is currently serving as a Regional Clinical Coordinator for the University of
Waterloo PharmD program.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Chemotherapy Toxicity Management
Chemotherapy Induced Nausea and Vomiting - Sally Waignein, BC Cancer Agency,
Vancouver, BC
Chemotherapy-induced nausea and vomiting (CINV) is one of the most distressing, yet
manageable toxicities associated with chemotherapy treatment. Appropriate prevention
strategies can minimize the risk of CINV, and thus, the potential complications of CINV. This
presentation will briefly review the generally management strategies of acute, delayed and
anticipatory CINV, and highlight the unique role that pharmacists can play in optimizing CINV
management in cancer patients.
Learning Objectives:
Upon completion of this program, participants will be able to:
1. Define the 3 types of CINV, and their associated onset and duration of symptoms;
2. Identify the chemotherapy agents commonly associated with CINV;
3. Describe the general pharmacologic approach to the prevention and management of
CINV; and
4. Recognize the role of the pharmacist in helping to prevent and manage CINV in
cancer patients.
Sally Waignein obtained her Bachelor of Pharmaceutical Sciences
from the University of British Columbia (UBC) in 2006, completed a
Pharmacy Residency at Fraser Health, BC in 2007, and obtained
her Doctor of Pharmacy degree from UBC in 2010. She is currently
the Residency Coordinator and Provincial Pharmacy Education
Coordinator at the BC Cancer Agency. Her clinical practice is
focused in breast cancer and drug information, and she is also
involved in the Agency’s Priorities and Evaluations Committee.
Sally is actively involved in the training of undergraduate Pharmacy students and residents,
and is a Clinical Instructor with the UBC Faculty of Pharmaceutical Sciences. She holds
membership in CAPhO and CSHP, and is an active member of the CAPhO Pharmacist
Education Committee.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Other Gastro-Intestinal Toxicities - Glenn Myers, Horizon Health Network, Moncton,
NB
The presentation will briefly outline non-CINV related toxicities of chemotherapy, targeted
anti-cancer and immunotherapy that affect both the upper and low gastro-intestinal (GI) tract.
This will specifically include mucositis, diarrhea, constipation, and enterocolitis.
Learning Objectives:
1. Identify the specific chemo-, targeted and/or immune-therapies responsible for
causing diarrhea, constipation, mucositis and enterocolitis;
2. Compare and contrast the clinical presentation and timeline of each GI toxicity as it
relates to their respective chemo-, targeted or immunotherapies;
3. Apply the CTCAE guidelines when grading each of the respective GI toxicities in
order to guide appropriate treatment; and
4. Discuss the general non-pharmacologic and pharmacologic treatment strategies for
GI toxicities and identify when these strategies may differ depending on the causative
agent.
Glenn Myers is a clinical pharmacist in outpatient oncology and
emergency medicine at The Moncton Hospital 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 Saint
John, NB. Glenn has been in oncology for 4 years and specializes
in assessment and management of chemotherapy and immune
related adverse effects.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Febrile Neutropenia - Tara Leslie, Tom Baker Cancer Centre/University of Alberta,
Calgary, AB
Febrile neutropenia is a common complication for patients receiving treatment for cancer. It
is considered a medical and oncologic emergency with a mortality rate estimated between 520%. Timely recognition of symptoms, assessment, and initiation of empiric treatment is
critical. In select patients, prophylaxis of febrile neutropenia and/or infection is indicated.
Within this session, we will discuss febrile neutropenia patient education, monitoring,
prophylaxis, and treatment.
Learning Objectives:
Upon completion of this program, participants will be able to:
1. Define febrile neutropenia (FN) and appreciate the urgency and implications of this
oncologic emergency;
2. Discuss the importance of patient education and self monitoring for fevers;
3. Understand primary and secondary prophylaxis of FN and the roles of filgrastim and
peg-filgrastim; and
4. Describe the stepped approach to antibiotic therapy of FN.
Tara Leslie attained her Bachelor of Science in Pharmacy (BSP)
degree from the University of Saskatchewan in 1997, obtained her
Board Certification in Oncology Pharmacy (BCOP) in 2010, and
acquired her Additional Prescribing Authority (APA) in 2013. She is
a Clinical Pharmacist at the Tom Baker Cancer Centre in Calgary
and Clinical Assistant Professor with Experiential Education at the
Faculty of Pharmacy, University of Alberta. Tara maintains a
clinical practice within the ambulatory lymphoma and chronic
leukemia clinics and is actively involved with student education as a preceptor and instructor
for malignant hematology and oncology complications. She is an active member of CAPhO
and ISOPP serving as Chair of the CAPhO Pharmacist Education Committee and Co-Chair
of the ISOPP 2017 Symposium Annual Program Task Force.
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CAPhO Oncology Fundamentals Day
Saturday, October 1, 2016
Skin, Nail and Hair Toxicities – Lynn Hartery, Eastern Health, St. John’s, NL
Provide a general overview of dermatological toxicities (skin, nail and alopecia) associated
with chemotherapy treatment.
Learning Objectives:
Upon completion of this program, participants will be able to:
1. List potential dermatological toxicities of chemotherapy, including list of causative
agents, and briefly describe what causes them;
2. Discuss skin toxicities, including dry skin/pruritis, macular rash, papulopustular
EGFR/targeted therapy rash, hand/foot reaction, and management of these
reactions;
3. Discuss nail changes and management;
4. Discuss alopecia and management; and
5. Recognize the role of pharmacists in counselling and monitoring patients on
dermatological toxicities of chemotherapy agents.
Lynn Hartery is a Clinical Pharmacist II at Eastern Health Pharmacy
Services, St. John’s, NL. She graduated from Memorial University
of Newfoundland School of Pharmacy with BScPharm in 1991.
In 2005, Lynn moved to Eastern Health and in 2006 began clinical
duties as Oncology Pharmacist at Dr. H. Bliss Murphy Cancer
Center. Lynn still continues to spend part of her time in the
Pharmacy Department where she has a lead role in the
chemotherapy preparation room. As part of the oncology team, she performs patient
assessments and medication reviews, counsels patients on chemotherapy and performs
patient toxicity assessments.
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