Objectives
  • To be able to screen for, assess, prevent and manage symptoms of patients with cancer such as pain, fatigue, anorexia, anxiety, depression, breathlessness and nausea

  • To communicate effectively with patients and families about illness understanding and coping with it, prognosis, difficult decisions, end-of-life and its preparation

  • To recognise the role of cancer rehabilitation, including physical therapy and nutrition

  • To recognise the importance of culturally competent, multidisciplinary care including families

  • To understand how to integrate palliative interventions in routine multidisciplinary cancer care

  • To recognise the difference between burnout, compassion fatigue and depression

Awareness
  • Appreciation of the role of palliative care interventions across the trajectory of illness for patients with cancer

  • Recognition of the effects of palliative care interventions integrated into decision-making for anticancer treatments

  • Awareness of the frequency, impact and interaction of common symptoms, including psychological and existential symptoms, associated with advanced cancer

  • Appreciation of the principles of mechanism-based, classification-guided and individualised management

  • Recognition of the role of various professions involved in palliative, supportive and postcurative rehabilitation

  • Appreciation of synergistic competencies of different disciplines in care pathways of patients with cancer

  • Appreciation of the effectiveness of structured and compassionate communication with patients and families

  • Awareness of the impact of culture on cancer management

  • Awareness of the need for self-care by oncology professionals

Knowledge
  • Familiarity with the role of multiple disciplines in the care of patients with advanced cancer

  • Familiarity with how to screen patients for common symptoms and syndromes in routine practice and how to use scales to evaluate their severity

  • Understanding of the main components of a comprehensive assessment of cancer symptoms and how to make a differential diagnosis

  • Understanding of the pharmacology and toxicity of medications used for the control of main symptoms

  • Familiarity with non-pharmacological interventions for symptom control such as counselling, nursing, physical or music therapy, including their indications, efficacy and side effects

  • Familiarity with an integrated competencies-based management approach to common symptoms in patients with advanced cancer

  • Familiarity with the evaluation and management of the complications of advanced and metastatic cancer, such as spinal cord compression, bowel obstruction, thrombosis or bleeding

  • Understanding of the main elements of a decisional process for invasive treatments and end-of-life care

  • Familiarity with the different roles and burdens of family caregivers and supportive interventions

  • Understanding of the main components of preparing for end-of-life such as legacy work, finishing business, legal preparation, premortal grief, postmortal caregiver role and place of death

  • Understanding of the approach to conducting difficult conversations with patients and families

  • Familiarity with the culturally-based preferences of patients and their families

  • Understanding of the causes of burnout and potential approaches to prevent it

Skills
  • Ability to describe criteria for referral to specialised palliative care teams, such as triggers

  • Ability to describe the mechanisms and pathophysiology of common cancer syndromes, including pain, fatigue, weakness, anorexia, cachexia, anxiety, depression, breathlessness and nausea

  • Ability to contribute actively in a structured, competencies-aware, respectful way in a multidisciplinary team to plan and coordinate care for patients with advanced cancer and their families

  • Ability to perform a comprehensive assessment of main symptoms (pain, fatigue, anorexia, anxiety, depression, breathlessness and nausea), including the use of scales

  • Ability to demonstrate understanding of the pharmacology of medications used to treat main symptoms by appropriately prescribing and titrating opioids, adjuvant analgesics and other drugs

  • Ability to demonstrate understanding of the toxicities of symptomatic medications by prescribing medications to prevent toxicities

  • Ability to assess a patient with complex symptoms using cognitive assessment, symptom assessment scales and modular assessments for main syndromes

  • Ability to discuss the role of anticancer therapies for the relief of cancer-related symptoms and to demonstrate how a patient can be prepared for the decisional encounter

  • Ability to demonstrate a structured approach to making decisions for managing complications of metastatic/advanced cancer, and how to evaluate and manage the most common, including but not limited to spinal cord compression, bowel obstruction, thrombosis or bleeding

  • Ability to demonstrate the steps required for skilled and compassionate communication with patients and families, including breaking bad news, prognosis discussion, preparation for end-of-life or family conflicts about care decisions

  • Ability to discuss specific culturally-based preferences with patients and their families

  • Ability to evaluate and manage psychological and existential symptoms and distress of having advanced cancer, including anxiety, depression, anger and despair

  • Ability to share a personal plan for self-care and to describe its importance for yourself

  • Ability to discuss the role of postcurative, supportive and palliative rehabilitation in the care of patients with advanced cancer and different models of outpatient and inpatient and home care

  • Ability to demonstrate how a patient is characterised who is in need of specialised palliative care

  • Ability to understand the causes of burnout and potential approaches to prevent it