Download How to survive Hematology

How to survive Hematology-Oncology Fellowship
Useful websites for patients to have:
www.cancer.gov
www.cancer.net
www.lls.org [leukemia and lymphoma society]
Useful website for clinical trial search:
www.cancer.gov/clinicaltrials/search
www.massey.vcu.edu/trials/?pid=2006
Useful websites for you:
www.nccn.org/index.asp
-workup, staging, treatment, great discussions!
www.uptodate.com
-workup, staging, treatment
http://www.adjuvantonline.com/index.jsp -benefit of adjuvant chemotherapy
www.chemoregimen.com/
-common regimens and article references
(Caveat: Some of the regimens are not totally up to date)—website is gone and was out of
date. Would remove
www.mpnconnect.org/default.aspx
-mpns
www.asco.org/
-guidelines from asco and meeting abstracts
www.hematology.org/
-ASH-SAP online, guidelines
www.pubmed.com
-literature searches
www.chemocare.com
-can print out chemo info for patients
http://ecog.dfci.harvard.edu/general/common_tox.html
-grading for chemo toxicity
http://ctep.info.nih.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf
or http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm (version 4) or
just google the toxicity with nci, ie “NCI diarrhea toxicity grading” -grading for chemo toxicity
Other good resources:
-Devita, Hellman, and Rosenberg’s Cancer Principles and Practice of Oncology (copy in
fellows office).
-William’s Hematology (copy in fellows office [note this is on Josh’s desk] and have online
access thru VCU library)
-Hoffman’s Hematology (copy in fellows office at VA)
-AJCC staging book (copy in fellows office at VA and in fellows work room at MCV) great for
staging to see detail of what nodes are considered regional and also great for overall
survival stats.
-Cancer chemotherapy Drug Manuel by Chu and DeVita.
-Cancer Management: A Multidisciplinary Approach by Pazdur et al. (copy in fellows office at
MCV)
Good Journals
-NEJM
-JCO-Journal of clinical oncology
-Blood
-Acta Haematologica
-Clinical cancer research
-British Journal of hematology
- Qx reader that pulls in most read articles from certain journals
How to approach a newly diagnosed cancer patient:
1. Look at pmhx, meds, etc…biopsy report. Read from up-to-date, Devita’s, or NCCN about
the cancer and figure out staging. (Note: Our clinic note format is a good start for things to
know about any patient)
2. Important things to tell the patient: what type of cancer they have, what stage they have,
whether it is curable, what are the treatment options(sx, xrt, chemo, hospice), what the
intent of treatment is(curative vs. palliative), what are the benefits and side effects of the
treatment that you recommend, if incurable ask them if they want to know how much time
to expect.
3. Ask your upper levels after levels after you have done initial leg work on their thoughts
and feedback on your plan
Some tips about chemo:
1. Can use BSA calculator through cerner or calculate by yourself:
BSA (m2) = square root of [ {Height (cm) x Weight (kg)} / 3600 ]
2. Carboplatin dose(mg) = (target AUC) x ( GFR + 25)
*Note max carbo given is 900mg(125 GFR cap) regardless of the dose calculated.
Can use website: https://hccapps.musc.edu/hemonc/carboplatin_dose_calculator.htm
3. Use the chemo card that Patty will give you.
4. As for dose reduction for low counts, use original article for this(esp if it’s combination of
chemos) and if not in the article I google prescribing information on the particular chemo or
can use uptodate.
5. If someone’s BSA is large, some will consider using ideal weight or adjusted to calculate
BSA.
6. Remember to use chemo template if one available here at MCV.
-There's a dropbox account that Patty Corrigan set up- with commonly used chemo
templates. This is extremely useful: Dropbox.com -> acct: [email protected],
password: Templates (case sensitive)
Patient tracking:
-Use whatever method works for you; some ideas are…Cerner reminders, index cards,
printing out your note, keeping a calendar with follow up.
Dictations:
-phone numbers: 403-3305, 403-3306
-type of dictation: old visit #47, new visit #46, BMT inpatient #85.
Fellows also recommend using Cerner Power Notes for clinic notes. There is a template
made by Dr. Baker, which can be edited to fit personal taste.
Grant/Award Opportunities
 ASCO Young Investigator Award
 Also go to AACR if interested in translational research or basic science
 Drug company sponsored (such as Bristol Myers Squibb) small grants also available for
fellowship.
 Dr. Yazbeck is also a good resource .