Objectives
  • To be able to perform specialist assessment, treatment and counselling of patients with small-cell lung cancer (SCLC), including secondary prevention

Awareness
  • Recognition that staging and determining the extent of SCLC are critical for guiding initial therapy

  • Awareness of the availability of different diagnostic procedures and that not all are appropriate to be ordered

  • Awareness of the existence of different prognostic factors

  • Appreciation of the importance of the multimodality approach to treat patients with SCLC

  • Awareness of the principles of personalising the multimodality approach in limited-stage and extensive-stage disease

  • Recognition of the importance of avoiding delays in diagnostic work-up and management, compared to other solid malignancies

Knowledge
  • Familiarity with the different presentations of SCLC, especially the limited versus extensive and TNM staging of SCLC

  • Familiarity with the indications for and limitations of the different diagnostic tools available for the identification of SCLC (including fine needle aspiration (FNA), bronchoscopy)

  • Familiarity with the available treatments and the usual sequence in which they are given

  • Familiarity with the indications and value of surgery, radiation therapy and chemotherapy in SCLC, but also with their limitations (eg, limited role of surgery in most patients)

  • Understanding of the role of chemotherapy and therapeutic/prophylactic irradiation in the management of patients

  • Understanding of the importance of initial response to therapy (and its duration) in determining patient survival

  • Knowledge which complications arise from disease progression and which are treatment-associated

  • Familiarity with supportive and palliative care strategies

Skills
  • Ability to perform a history and physical examination in SCLC patients and to interpret imaging studies to appropriately stage the patients

  • Ability to effectively identify and present relevant information about the patient at multidisciplinary settings

  • Ability to contribute to discussions on general management strategies, including limited and extensive stage in order to understand the rationale for selecting and sequencing treatments in a multidisciplinary setting

  • Ability to identify situations where initiating systemic therapy quickly is more appropriate than waiting to start multimodality therapy

  • Ability to prescribe various chemotherapeutic agents considering their potential interactions with radiation therapy

  • Ability to effectively discuss data with patients regarding the impact of various treatments, and what would be recommended for them specifically

  • Ability to minimise and manage side effects from various systemic therapies and irradiation to the brain/thorax

  • Ability to guide a patient discussion about continuing systemic or radiation therapy versus pursuing supportive care only