Join us on the Irish Haematology Oncology Podcast as we delve into the critical topic of chemotherapy extravasation. We'll explore what it is, why it happens, and the potential consequences. More importantly, we'll discuss how to prevent it and effectively manage it if it occurs. Whether you're a seasoned healthcare professional or new to the field, this episode offers valuable insights to enhance patient safety and optimize cancer care. Key Points: Understanding Extravasation: The 'leaky pipe' analogy and the varying risks associated with different chemotherapy drugs. Incidence and Risk Factors: Understanding the odds and identifying potential vulnerabilities. Prevention is Key: The importance of meticulous administration techniques and staff training. Early Recognition: The fire alarm analogy and the crucial role of prompt identification. The Extravasation Kit: A lifeline in emergencies and the importance of preparedness. Managing Extravasation: The first response and the tailored approach to treatment. The Unique Challenge of CVAD Extravasation: The 'basement leak' analogy and the complexities involved. The Road to Recovery: Follow-up care, patient education, and the importance of documentation. Resources: ESMO-EONS Clinical Practice Guidelines on extravasation management Feedback Form: https://forms.gle/DzC4ye9edfV4rMZF8 CPD IIOP Example: https://docs.google.com/document/d/1RIJK6JPQDKRU-ZUTOCBlvA_I3_hS0Yd9thPibZpN0QA/edit?usp=sharing
Join host Eoin Tabb on the Irish Haematology Oncology Podcast as he delves into the critical role of ancillary medications in chemotherapy. This episode focuses on essential supportive care drugs like vitamins, steroids, and hydration protocols, highlighting their mechanisms, administration, and importance in mitigating side effects and optimizing treatment outcomes. Learn about: Hydration in cisplatin and methotrexate regimens Folinic acid rescue in high-dose methotrexate treatment Mesna prophylaxis for hemorrhagic cystitis in cyclophosphamide and ifosfamide regimens Practical tips for managing common chemotherapy side effects 2. Podcast Show Notes: Hydration Protocols: The importance of maintaining adequate fluid intake before, during, and after chemotherapy to protect kidney function and minimize toxicity. Cisplatin and Nephrotoxicity: The risks of kidney damage associated with cisplatin and the specific hydration strategies used to mitigate these risks. Methotrexate and Folinic Acid: The combined use of hydration, alkalinization, and folinic acid rescue to prevent kidney damage and protect healthy cells from methotrexate's effects. Hemorrhagic Cystitis: The role of mesna in preventing bladder inflammation and bleeding caused by cyclophosphamide and ifosfamide. Practical Tips: Additional strategies for managing common side effects like nausea, vomiting, diarrhea, and fatigue. Feedback Form: https://forms.gle/ctCHDcc7d4W4NfB18 IIOP Education Document (same as last episode): https://docs.google.com/document/d/1d1KEtJ6yrZ_fMGMLgTFgQ762rX0-y5vbb4ikDsr_U6s/edit?usp=sharing
Summary This episode of the Irish Hematology Oncology podcast explores the importance of ancillary medications in chemotherapy regimens. The host discusses specific medications used to address the side effects and risks of chemotherapy drugs, including Pemetrexed with vitamin B12 and folic acid, Docetaxel with corticosteroids, Irinotecan with atropine, and 5-FU with leucovorin. Each medication is explained in detail, highlighting its role in managing side effects and enhancing the effectiveness of chemotherapy. Takeaways Ancillary medications play a crucial role in managing side effects and enhancing the effectiveness of chemotherapy drugs. Pemetrexed can deplete the body's stores of vitamin B12 and folic acid, so supplementation is necessary to prevent deficiencies and reduce the risk of severe side effects. Corticosteroids like dexamethasone are prescribed alongside Docetaxel to manage fluid retention. Atropine is used as an antidote to counteract the cholinergic reaction caused by Irinotecan. Leucovorin is used to protect healthy cells and enhance the action of 5-FU in chemotherapy. Consult with healthcare professionals for personalized guidance and stay updated on the latest recommendations in cancer care. IIOP CPD Example: https://docs.google.com/document/d/1d1KEtJ6yrZ_fMGMLgTFgQ762rX0-y5vbb4ikDsr_U6s/edit?usp=sharing Feedback Form: https://forms.gle/ortbvq6Ld19zSCDG7
Join Eoin Tabb on the Irish Haematology Oncology Podcast as he delves into the common skin reactions caused by cancer treatments. This episode is a must-listen for healthcare professionals seeking to enhance patient care by understanding, preventing, and managing these often-overlooked side effects. From acneiform rash to hand-foot syndrome, hair loss, drug-induced pruritus, paronychia, and onycholysis, Eoin breaks down the incidence, diagnosis, pathology, and treatment options for each condition. Gain valuable insights and practical tips to improve your patients' quality of life during their cancer journey. Tune in and empower yourself to make a real difference in your patients' well-being. In this episode of the Irish Haematology Oncology Podcast, host Eoin Tabb discusses common skin reactions caused by cancer treatments. He covers the following topics: Acneiform Rash: Incidence, diagnosis, pathology, prevention, and treatment options, including topical steroids, oral antibiotics, and oral steroids. Hand-Foot Syndrome (HFS): Incidence, diagnosis, pathology, prevention strategies (moisturizing, avoiding friction, protecting from heat), and treatment options (topical corticosteroids, pain relievers, keratolytics, cooling). Chemotherapy-Induced Alopecia (CIA) and Endocrine Therapy-Induced Alopecia (EIA): Incidence, diagnosis, pathology, prevention (scalp cooling for CIA), and supportive care options (wigs, hairpieces, nutritional supplements). Drug-Induced Pruritus: Incidence, diagnosis, severity rating scales, management options for mild, moderate, and severe cases (moisturizers, anti-itch creams, topical corticosteroids, oral antihistamines, gabapentin, pregabalin, oral corticosteroids). Paronychia: Incidence, diagnosis, pathology, prevention (nail care, hygiene, moisturizing), and treatment options (topical antiseptics, corticosteroids, antibiotics, nail removal). Taxane-Induced Onycholysis: Incidence, diagnosis, pathology, prevention (moisturizing, nail protection, cooling), and treatment options (nail care, antibiotics, nail removal). Eoin emphasizes the importance of early intervention, open communication with patients, and tailoring treatment plans to individual needs. He also provides resources for further learning and encourages listeners to stay informed about the latest research and treatment options. References: Lacouture, M. E., Sibaud, V., Gerber, P. A., van den Hurk, C., Fernández-Peñas, P., Santini, D., ... & Jordan, K. (2021). Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines. Annals of Oncology, 32(2), 157-170. Feedback Form: https://forms.gle/AEcFAHCnykCNkKDJ9 CPD IIOP Example Link: https://docs.google.com/document/d/1l6UeJ1hMIQaeVChTCq3_l5A_f9MPms_DaY4EZ-WNBv4/edit?usp=sharing
In this episode, Eoin Tabb, a clinical cancer services pharmacist, unravels the complexities of immune checkpoint inhibitors (ICIs), the superheroes of cancer therapy. We'll explore how ICIs unleash the immune system to fight cancer, the potential side effects known as immune-related adverse events, and how healthcare professionals can effectively manage them. From common skin reactions and endocrine disruptions to rare neurological and cardiac complications, we'll cover it all. Tune in to understand how ICIs are revolutionizing cancer treatment while being prepared for their unique challenges Introduction: Immune checkpoint inhibitors (ICIs) as revolutionary cancer treatments. What are ICIs? How ICIs work by removing cancer's "invisibility cloak" to the immune system. Immune-Related Adverse Events (irAEs): Explanation of irAEs as a side effect of overactive immune response. Common irAEs: Other irAEs: Neurological, cardiovascular, renal, hematologic, ocular. Overlapping Syndromes: Myocarditis-myositis overlap, myasthenia gravis. Management of irAEs: Long-Term Management: Ongoing monitoring for late-onset or recurrent irAEs. Emerging Therapies: Targeted therapies, personalized medicine. Important Disclaimer: Consult healthcare providers for personalized guidance. CPD IIOP Example: https://docs.google.com/document/d/1lI2B0iiLxYAHkvkWo8AjHvw-fjnCwc4DcioSiVF4Ptw/edit?usp=sharing Feedback Form: https://forms.gle/AEcFAHCnykCNkKDJ9 References: ESMO Guidelines: https://www.annalsofoncology.org/article/S0923-7534(22)04187-4/fulltext
Join Eoin Tabb on the Irish Haematology Oncology Podcast for a deep dive into hepatic impairment in cancer patients. We'll break down the vital functions of your liver, how we measure its health, and why this is crucial when planning chemotherapy. Whether you're a new healthcare professional or a seasoned expert, this episode is packed with insights on how to navigate the complexities of chemo dosing when the liver isn't functioning at its best. Tune in to learn how to keep your patients safe and optimize their treatment outcomes! Podcast Show Notes: The Liver: Your Body's Metabolic Powerhouse and Detoxification Center The liver's multiple roles: detoxification, nutrient processing, production of essential substances The liver's role in medication metabolism The impact of hepatic impairment on chemotherapy: increased drug levels, decreased drug activation, altered blood flow, and protein binding issues When the Liver Hits a Snag: Types and Causes of Hepatic Impairment Degrees of hepatic impairment: mild, moderate, severe Common causes: chronic liver diseases (cirrhosis, hepatitis, NAFLD), medications (chemotherapy, other drugs), alcohol abuse, other causes Types of liver damage: hepatocellular, cholestatic, mixed Measuring Liver Health: The Tools and the Challenges Child-Pugh score: assessing liver function based on bilirubin, albumin, INR, ascites, and encephalopathy NCI Organ Dysfunction Criteria: focusing on bilirubin and liver enzymes (ALT, AST) The importance of context and clinical judgment in interpreting test results The Domino Effect of Hepatic Impairment on Chemo: Increased risk of toxicity Issues with prodrugs Impact on biliary excretion, blood flow, and protein binding The importance of individualizing treatment based on cancer type, treatment goals, and patient resilience The challenges of dose adjustments Sign up for Irish Haematology Oncology Podcast mailing list to keep in touch: http://eepurl.com/iPyGn-/ CPD IIOP Example: https://docs.google.com/document/d/1qDbcXuLKcPCvufJCfAg0tjsaH5uuUqaaQhjHC7xGmJU/edit?usp=sharing Feedback Form: https://forms.gle/EqQU4tVr84STHftS9
1. Podcast Description: Join Eoin Tabb on the Irish Haematology Oncology Podcast for a deep dive into renal impairment in cancer patients. We'll break down the vital functions of your kidneys, how we measure their health with eGFR, and why this is crucial when planning chemotherapy. Whether you're a new healthcare professional or a seasoned expert, this episode is packed with insights on how to navigate the complexities of chemo dosing when kidneys aren't functioning at their best. Tune in to learn how to keep your patients safe and optimize their treatment outcomes! 2. Podcast Show Notes: In this episode, we discuss: The Many Roles of Your Kidneys: Waste removal, fluid balance, blood pressure control, red blood cell production, and bone health. The Nephron: Your Kidney's Filtration Powerhouse: Glomerulus and tubule explained. Understanding Renal Impairment: Chronic vs. acute kidney injury, cancer-related causes, and chemo toxicity. eGFR: Your Kidney Speed Limit: What it measures, how it's calculated, and what the numbers mean. Chemo Drugs and Kidney Function: Kidney superstars, moderates, and independent drugs. Pharmacists: Your Medication Safety Guardians: The importance of dose adjustments and ongoing monitoring. Carboplatin Dosing: A Calculated Approach: The Calvert equation, CKD-EPI, and why precision matters. Beyond Dose Adjustments: Holistic approaches to managing renal impairment in cancer patients. Feedback Form: https://forms.gle/E1hfwqbDqGseSyLu7 CPD IIOP Example: https://docs.google.com/document/d/1TX02mrNwg4UnkDJe74qu7TMmz_DGl_MQEjfZfBLZv7g/edit?usp=sharing Sign up for Irish Haematology Oncology Podcast mailing list to keep in touch: http://eepurl.com/iPyGn-/
This episode of the Irish Haematology Oncology Podcast delves into common but potentially devastating complications of cancer treatment: febrile neutropenia, chemotherapy-induced thrombocytopenia, and chemotherapy-induced anemia. We break down the medical jargon, explore risk factors, and discuss early detection and treatment strategies. Whether you're new to oncology or seeking a refresher, this episode equips you with essential knowledge to provide the best possible care for your patients facing these challenges. Podcast Show Notes: Topic: Febrile neutropenia, chemotherapy-induced thrombocytopenia, chemotherapy-induced anemia Key Points: Understanding the terminology and mechanisms behind these complications Identifying patients at higher risk Importance of early detection and rapid response Overview of treatment strategies, including antibiotics, G-CSF, and supportive care Emerging therapies and the role of personalized medicine Resources: ESMO Clinical Practice Guidelines for the management of febrile neutropenia NCCN Guidelines for Chemotherapy-Induced Thrombocytopenia Patient education materials on febrile neutropenia, thrombocytopenia, and anemia Additional Notes: CPD document for IIOP requirements available here: https://docs.google.com/document/d/1b3ZZoTS-pLLVrxKB1_8-AYh4enNwUusg5mEljKiKE1k/edit?usp=sharing Podcast now available on YouTube and LinkedIn: https://www.youtube.com/@EoinTabb www.linkedin.com/in/eointabb Feedback Form: https://forms.gle/skwi7x6qpuDtQCUp8 Disclaimer: This podcast is for educational purposes only. Consult with your team for personalized guidance.
1. Podcast Description: Join oncology pharmacist Eoin Tabb as he dives into the world of infusion-related reactions (IRRs). This podcast is a must-listen for all healthcare professionals involved in cancer care. Learn how to identify, grade, and manage IRRs to ensure the safety and comfort of your patients. From mild rashes to severe emergencies, we'll cover it all, providing practical tips and real-life scenarios to enhance your knowledge and confidence. 2. Podcast Show Notes: What are infusion-related reactions (IRRs)? Why are IRRs different from typical side effects? How are IRRs graded using the CTCAE scale? What are the most common premedications used to prevent IRRs? How to manage mild and severe IRRs, including the role of an "IRR kit" Real-life scenarios illustrating the importance of prompt and appropriate intervention The impact of IRRs on the patient experience and how healthcare professionals can minimise negative effects References: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for specific cancer types and treatments (available to members at nccn.org) European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the management of infusion reactions to systemic anticancer therapy: https://www.esmo.org/guidelines/guidelines-by-topic/esmo-clinical-practice-guidelines-supportive-and-palliative-care/infusion-reactions-to-systemic-anticancer-therapy https://docs.google.com/document/d/1JtUGEhbW-9D5yjSpyDbQZyZJ38-sdz0vX2l1yeVthIo/edit?usp=sharing https://forms.gle/K4zzbKJsXhnrax2aA
Join Eoin Tabb, Chief 2 Clinical Cancer Services Pharmacist, for a crash course on cancer staging. In this episode, we break down the essentials of cancer staging, from the different types of staging and the tests involved to the TNM system and stage groupings. Learn why staging is crucial for personalized treatment plans, prognostic information, and effective collaboration within the cancer care team. This episode is a valuable resource for all healthcare professionals involved in cancer care, regardless of experience level. Key Points: What is cancer staging? Analogy of creating a detailed map to guide treatment decisions. Key questions staging answers: tumor size, lymph node involvement, metastasis. Types of Cancer Staging: Clinical staging: initial assessment before treatment. Pathological staging: more precise assessment after surgery. Re-staging: evaluating response to treatment. Staging Tests: Imaging tests: X-rays, CT scans, MRI scans, PET scans. Biopsies: needle biopsies, core needle biopsies, surgical biopsies. Blood tests: FBC, tumor markers, liver/kidney function tests. TNM Staging System: T: Tumor size and invasiveness. N: Lymph node involvement. M: Metastasis (spread to distant organs). Stage grouping (I-IV): overall classification based on TNM scores. Why Staging Matters: Guides treatment decisions. Provides prognostic information. Facilitates research and comparison of treatment outcomes. Importance for Healthcare Professionals: Tailors treatment plans. Manages side effects. Educates and counsels patients. Enhances interdisciplinary collaboration. Additional Resources: National Cancer Institute - Cancer Staging American Cancer Society - How is Cancer Staged? European Society for Medical Oncology - TNM Classification of Malignant Tumours CPD IIOP Example: https://docs.google.com/document/d/1eAdmWOmnnGpWwyVQpqTmWs-0Bp4eTQkJmYyxz5czWIU/edit?usp=sharing Feedback Form: https://forms.gle/ebaoNCNe9Hg2fAMk6
In this episode, Eoin Tabb takes you beyond traditional chemotherapy, exploring the fascinating world of targeted therapies and immunotherapy. Learn how these cutting-edge treatments are revolutionizing cancer care by precisely targeting cancer cells and harnessing the power of the immune system. Discover the different types of targeted therapies and immunotherapies, their mechanisms of action, and their potential to improve patient outcomes. Key Points: Targeted Therapies: Precision medicine approach Targets specific vulnerabilities in cancer cells Often fewer side effects than traditional chemotherapy Types of Targeted Therapies: Tyrosine Kinase Inhibitors (TKIs) Block communication networks within cancer cells Examples: Imatinib (CML), Erlotinib, Gefitinib (lung cancer) Monoclonal Antibodies Harness the immune system, block growth signals, or deliver toxic payloads Examples: Rituximab (lymphoma), Trastuzumab (breast cancer), Cetuximab (colorectal/head and neck cancers) Hormonal Therapies Disrupt hormone supply lines in hormone-dependent cancers Examples: Tamoxifen (breast cancer), Aromatase inhibitors (breast cancer), Androgen blockers (prostate cancer) Antibody-drug conjugates (ADCs) Combine targeting ability of antibodies with potent cell-killing drugs Examples: Trastuzumab emtansine (breast cancer), Brentuximab vedotin (lymphoma) Proteasome Inhibitors Clog the cellular recycling system in cancer cells Examples: Bortezomib, Carfilzomib, Ixazomib (multiple myeloma/lymphoma) Immunotherapy: Empowers the immune system to fight cancer Types of Immunotherapy: Immune Checkpoint Inhibitors Release the brakes on the immune system Examples: Ipilimumab, Nivolumab, Pembrolizumab, Atezolizumab Adoptive Cell Transfer (ACT) Supercharges immune cells to target cancer Example: CAR-T cell therapy Bispecific T-cell Engagers (BiTEs) Bridge immune cells and cancer cells for targeted attack Example: Blinatumomab Cancer Vaccines Teach the immune system to recognize and destroy cancer cells Additional Notes: Targeted therapies require specific biomarkers to be effective. Immunotherapies are effective in certain cancers but can have unique side effects. Ongoing research is expanding the use of targeted therapies and immunotherapies. CPD IIOP Example: https://docs.google.com/document/d/1yd3jZv6upddu2V2qP61WdD7xE8joOXHR6ISQ4BNmIGY/edit?usp=sharing Feedback Form: https://forms.gle/ebaoNCNe9Hg2fAMk6
Get an easy-to-follow breakdown of systemic anticancer treatments (SACT)! This episode explains how SACT works against cancer with simple analogies. We dive into traditional cytotoxic chemotherapy drugs and the mechanisms that make them effective. Great for healthcare professionals and anyone interested in cancer treatments. Tune in next week for the world of targeted therapies! Show Notes Systemic Anticancer Treatments (SACT) target the hidden and traveling aspects of cancer that surgery or radiation might miss. They disrupt essential processes in cancer cells or harness the immune system against them. Cytotoxic Chemotherapy works by disrupting cell division and damaging DNA. Types of cytotoxic drugs: Alkylating Agents (e.g., cyclophosphamide) disrupt DNA replication. Antimetabolites (e.g., 5-FU) mimic essential cell building blocks to cause errors. Antimicrotubule Agents (e.g., taxanes, vinca alkaloids) target cell division machinery. DNA Topoisomerase Inhibitors (e.g., irinotecan) cause irreparable DNA breaks. Cytotoxic drugs can affect healthy cells, leading to side effects. SACT is often used in combination with surgery, radiation, or other therapies. Next Episode: Targeted therapies and immunotherapy. Feedback Form: https://forms.gle/ebaoNCNe9Hg2fAMk6 CPD IIOP Example: https://docs.google.com/document/d/1__hbl-9aO7CT7vCEV-RXgb4zFRYAApi7LIpYIoQy3sg/edit?usp=sharing
Understand the risks of handling cytotoxic drugs (cancer medications) and learn how to protect yourself as a healthcare worker. Intro * Cytotoxic drugs target rapidly dividing cells, but also affect healthy cells. * Not just strong chemo – includes hormone therapies, antivirals, and more. * Exposure routes: inhalation, skin contact, injection, patient fluids. * Health effects: nausea, hair loss, infertility, organ damage, secondary cancers. Segment 2: Risk Assessment * HSE guidelines are your roadmap (See HSE Safe Handling of Cytotoxic Drugs 2022 Policy: https://healthservice.hse.ie/filelibrary/staff/hse-guideline-on-the-safe-handling-and-use-of-cytotox-drugs.pdf) * List ALL hazardous drugs you use. * Identify at-risk groups: pharmacy, nurses, cleaning staff, others. * Break down the drug's journey to pinpoint exposure risks. Segment 3: Control Measures * Hierarchy of controls: eliminate, substitute, engineer, procedures, PPE (last resort). * Engineering controls: ventilation, negative pressure rooms, closed-system transfer devices. * PPE: specialized gloves, gowns, eye protection, maybe respirators. Segment 4: Staff Training * Training is essential, not optional. * Includes knowledge, specific skills, and evolving procedures. * Mix up formats: demos, scenarios, spill simulations. * Competency checks: observation, assessments. Segment 5: Where to Learn More References * HSE Safe Handling of Cytotoxic Drugs 2022 Policy (https://healthservice.hse.ie/filelibrary/staff/hse-guideline-on-the-safe-handling-and-use-of-cytotox-drugs.pdf) Feedback form: https://forms.gle/Rgw59ofWL1b8SuNm8 IIOP CPD Example: https://docs.google.com/document/d/1WUYnhHblEtNeCVWgKutGynC44qwlxwLuRBzltiEW_wY/edit?usp=sharing
Ready to navigate the world of cancer care? The Irish Haematology Oncology Podcast is your guide! Hosted by experienced clinical pharmacist Eoin Tabb, we demystify complex topics, treatments, and terminology for healthcare professionals. Launching May 6th—subscribe now!