Picture this: it's day 1 of fellowship and your attending needs you to "get consent for treatment." Huh? How do you educate your patient? We share our tips!

In this episode, we discuss the fundamentals and some of our favorite resources.

*********The resources we share are our OWN opinions. Naming of resources are not endorsements. We are not sponsored by any of these entities. *********

1) How do you know what regimen to use for a disease?

* www.NCCN.org :

** National Comprehensive Cancer Network

** Free resource, but need to make an account!

** Provides stepwise approach to workup, choosing a regimen, and surveillance information, treatment for refractory disease

* www.HemOnc.org :

**Organized by disease type with long lists of treatment options

** Provides a breakdown of regimen, but also provides the primary literature that lead to the regimen’s approval for use!

**We cannot highlight how important it is to remember to check out the primary literature!

2) Patient education: Use these to drive discussion; you still want to walk your patients through these

* www.Oncolink.org : Ronak’s favorite resource

* www.Chemocare.com : Vivek and Dan’s favorite resource

3) Basic Terminology:

* Cycle: The number of days between one round of treatment until the start of the next; abbreviated with “C”

* Days: Counts the actual days within a cycle; abbreviated with “D”

* Example: C1D1: Cycle 1 of a regimen, day 1 of this cycle

4) Dosing:

* Always have updated height and weight for patients

** Many drugs are dosed based on body surface area (BSA)

** Other drugs use area under the curve (AUC)

* Always get a CMP and CBC prior to giving treatment

5) General categories of cancer therapies:

* Cytotoxic: Kills cells in the body

** Analogous to antibiotics killing bacteria

** Relatively non-specific in terms of what cells they target; but they’re often specific for parts of the cell replication cycle

* Immune therapy: Harness the immune system to attack cancer

** More specific than cytotoxic agents

* Targeted therapy: Drugs made specifically for known mutations

** A cancer with a distinct mutation in a protein is then a target for this drug

** In general:

***“Mab”- antibody targeted for phenotypic expression

***“ib”- small molecule for driver mutation

** Targeted cytotoxic chemotherapy: a monoclonal antibody specific for a mutation linked to very potent chemotherapy

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Episode 020: Pharmacology 101: Part 1

The Fellow on Call: The Heme/Onc Podcast