Objectives
  • To be able to perform specialist assessment, treatment and counselling of patients with gastric cancer

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

  • Appreciation of worldwide regional differences in the incidence of gastric cancer

  • Recognition of specific lifestyle risk factors and premalignant conditions for gastric cancer

  • Awareness of the existence of different prognostic factors

  • Appreciation of the importance of the multimodality approach to treat patients with gastric cancer

  • Appreciation of the importance of adequate imaging techniques to allow for exact pretreatment staging

  • Appreciation of human epidermal growth factor receptor 2 (HER-2) as the only established biomarker guiding therapy for gastric cancer

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

  • Familiarity that gastric cancer in early stages is treated differently

  • Understanding of the pattern of metastases of gastric cancer

  • Familiarity with the indications and diagnostic tools available for gastric cancer (such as upper endoscopy with or without endoscopic ultrasound, computed tomography (CT) and positron emission tomography (PET)/CT imaging, diagnostic laparoscopy) and their implications for an appropriate therapeutic strategy

  • Understanding of the importance of cancer precursor lesions and premalignant conditions for the development of gastric cancer

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

  • Familiarity with the indications and the value of multimodality approach of radiotherapy, chemotherapy and surgery in non-metastatic gastric cancer

  • Understanding of the neoadjuvant, perioperative and adjuvant treatment setting

  • Understanding of the role of chemotherapy and monoclonal antibodies in the management of patients with advanced gastric cancer

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

  • Understanding of the value of lines of treatment in case of disease progression

  • 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 gastric cancer scenarios and patient presentations

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

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

  • Ability to follow individual patients with gastric cancer throughout their patient history from initial diagnosis to hospice care

  • 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 adequately prescribe various chemotherapeutic agents and monoclonal antibodies considering their potential interactions with radiation therapy

  • 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 manage side effects of various chemotherapeutic agents and monoclonal antibodies

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