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. 2016 Sep 29;1(5):e000097. doi: 10.1136/esmoopen-2016-000097
Objectives
  • To be able to perform specialist assessment, management and counselling of patients with cancer, including supportive, palliative, end-of-life and survivorship care

  • To know the risk factors, epidemiology, screening, prevention, pathophysiology, genetics, biomarkers, signs and symptoms, diagnostic work-up, treatment, follow-up as well as supportive and palliative measures for each specific disease

  • To be able to communicate and discuss these topics with patients; for each tumour, specific items may be more important

Awareness
  • Awareness of the existence of different prognostic factors

  • Awareness of the existence of different biological and pathological subtypes of cancer for the selection of the appropriate treatment strategies

  • Awareness of the availability of different diagnostic procedures

  • Recognition of the importance of the multimodality approach to treat patients with cancer

  • Awareness of the principles of the multimodality approach in patients with different extents of disease (limited-stage disease or advanced disease)

  • Awareness of the established biomarkers guiding therapy for selected tumours

  • Appreciation of the importance and timing of follow-up for the main tumour entities

Knowledge
  • Knowledge of the implications of the different biological and pathological subtypes of different tumours for the selection of the appropriate treatment strategies

  • Knowledge of the indications for, expectations from and limitations of the different diagnostic tools available for the identification of different kinds of tumours (including fine needle aspiration (FNA), open biopsy, surgery or radiological assessment and imaging)

  • Knowledge of the risk assessment workup of prognostic factors, especially the staging system for the main tumour types

  • Knowledge of the indications for and impact of surgery, radiation therapy, systemic therapy such as chemotherapy, immunotherapy and targeted therapy, or supportive and palliative care in cancer

  • Knowledge of the limitations of therapy (eg, criteria of inoperability, contraindications to radiation, other loco-regional or systemic treatment)

  • Understanding of the role of systemic therapy in the management of patients with different stages of disease such as localised, locally advanced or metastatic disease

  • Understanding of the strengths of treatment personalisation opportunities and the importance of offering individualised targeted therapies on the basis of molecular findings, specifically for each type of tumour

  • Understanding of the complications that derive from disease progression and those that are treatment-associated, in the context of being familiar with supportive and palliative care strategies

  • Familiarity with clinical trials in specific tumour entities

Skills
  • Ability to contribute actively to a variety of clinical tumour scenarios

  • Ability to contribute actively to present patient cases

  • Ability to discuss critically the available treatment options/recommendations

  • Ability to perform a history and physical examination (in patients with different tumour entities, including different subtypes)

  • Ability to contribute to discussions on general management strategies (in patients with different tumour entities, including different subtypes) in order to understand all the considerations on which treatment to use and which sequence to select for the multidisciplinary strategy

  • Ability to prescribe various chemotherapeutic and non-chemotherapeutic agents considering their potential interactions with different kinds of loco-regional therapy

  • Ability to make differential indications for the neoadjuvant/preoperative and the adjuvant therapy in the different tumour entities

  • Ability to take regard to the advanced stage particularities for the different tumour entities

  • Ability to evaluate conditions (such as performance status, concomitant disease(s), previous treatments etc) that are important for considering when to start and to stop treatment or to switch to another treatment option

  • Ability to determine therapy according to molecular marker status

  • Ability to manage side effects of various chemotherapeutic and non-chemotherapeutic agents, and potential pharmacological interactions

  • Ability to use information technology to improve knowledge and patient care

  • Ability to discuss prevention strategies with patients

  • Ability to interpret clinical trials results with a critical mind and to incorporate this knowledge into daily patient care as appropriate to practice evidence-based medicine