Objectives
  • To be able to perform specialist assessment, treatment and counselling of patients with colon and rectal cancer, including secondary prevention

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

  • Awareness of the existence of different prognostic factors

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

  • Appreciation of the principles of the multimodality approach in patients with limited or oligometastatic disease

  • Familiarity with established biomarkers guiding therapy for colon and rectal cancer

  • Awareness of the hereditary syndromes associated with colon cancer

Knowledge
  • Familiarity with the implications of the different biological and pathological subtypes of colon and rectal cancer in order to select the appropriate treatment strategies

  • Familiarity that colon and rectal cancer in early stages are treated differently

  • Familiarity with the indications and diagnostic tools available for colon and rectal cancer (such as colonoscopies, endosonography and magnetic resonance imaging (MRI)) and their implications for therapies

  • Familiarity with the risk assessment of prognostic factors, especially the TNM staging system for colon and rectal cancer

  • Familiarity with the indications and value of surgery, radiotherapy and chemotherapy in the adjuvant and neoadjuvant setting of colon and rectal cancer

  • Understanding of the role of surgery in resectable liver and lung metastases and the role of chemotherapy in borderline or unresectable situations in order to achieve resectability

  • Understanding of the role of chemotherapy, monoclonal antibodies and targeted therapy in the management of patients with advanced disease

  • Knowledge of the strengths of personalised medicine and the importance of offering individualised targeted therapies based on molecular findings such as K-Ras, N-Ras or B-Raf mutations

  • Familiarity with hereditary syndromes, the management of families with these and implications for individual patients

  • Understanding of the value of lines of treatment in case of disease progression and in the continuum of care

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

Skills
  • Ability to contribute actively to a variety of colon and rectal cancer scenarios and patient presentations

  • Ability to discuss critically the treatment options and recommendations for various phases of the disease (early or metastatic disease)

  • Ability to perform a history and physical examination in colorectal patients with cancer, including different subtypes and different stages of disease

  • Ability to contribute to discussions on general management strategies 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 agents, monoclonal antibodies and targeted therapy considering their potential interactions with radiation therapy where applicable

  • Ability to understand the neoadjuvant and adjuvant setting, especially in rectal cancer as well as in patients with isolated liver or lung metastases

  • Ability to recognise conditions or clinical prognostic factors such as performance status, tumour load, number of metastases, prior adjuvant chemotherapy, concomitant diseases and other previous therapies that are important for considering when to start and to stop a treatment or switch to another option

  • Ability to determine therapy according to molecular marker status

  • Ability to manage side effects of various therapeutic agents

  • Ability to discuss prevention strategies with patients and, if applicable, potential implications for family members