Clinical Oncology
Induction
The induction process:
Week 1
- Introduction lectures and ‘meet and greet session(s)’ SpR (inc. overview of handbook)
- Obtain pager and Dictaphone from Stuart Clough 68492
- Work through checklist and ‘pack’
- Personnel matters/permits and name badge
- Salary and wages
- Occupational health
- Inform RCR
- Firm induction
- Tour of hospital and library
- Christine - Level 7 Bexley Wing 65638/66628
- Meet Mentor post FRCR2 registrar AC,MH
- Accommodation
- Pharmacy session -Chemo care Margaret purkiss 68876
- Chemo competency Jayati Acharya 07659538943
Week 2
- Shadowing reg. on firm
- Physics introduction lecture Carolyn Richardson?
- Overview RT department - Julie Owens 67440
- IT sessions ie.
- PACS - Andy Shaw 68332
- PPM and Intranet Viv randerson ext 68712
- Intranet access and results server forms in pack to be returned Stuart Clough 68492
- Mosaiq access arranged via Julie Owens 67440
- Informal tutorials from seniors registrars
- Educational supervisor introduction Catherine Coyle
Week 3
- V.Sim training half day Alan Needham 67491
- Informal tutorials from seniors
- Meet up with college tutor(s) CC GG
- Course details (find out when start etc) Catherine Coyle
Week 4
- 1 day on machine/sim- Contact Neil Roberts 2067408
- Planning Session Stuart Wilson (inc. Planning Systems)
- IRMER regulation brief from Prof David Thwaites
- Informal tutorials from seniors
- Debrief with mentors
Names of clinicians to contact to organise some informal tutorials at a mutually convenient time:
- Ann Henry
- Julian Adlard
- Paul Hatfield
- Joji Joseph
- Kevin Franks
- Michelle Kwok-Williams
- Vanessa Gill
Common Toxicity Criteria
| FBC | GRADE 0 | GRADE 1 | GRADE 2 | GRADE 3 | GRADE 4 |
|---|---|---|---|---|---|
| WCC | ≥4 | 3.0 – 3.9 | 2.0 – 2.9 | 1.0 – 1.9 | <1 |
| PLATELETS | WNL | 75 - NORMAL | 50 – 74.9 | 25 -49.9 | <25 |
| NEUTROPHILS | WNL | 1.5 – 2 | 1.0-1.49 | 0.5 – 0.99 | <0.5 |
| HAEMOGLOBIN | WNL | 10 – NORMAL | 8 – 9.9 | 6.5 – 7.9 | <6.5 |
| GIT | >0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| ANOREXIA | NONE | MILD | MODERATE | SEVERE | |
| DIARRHOEA | NONE | INCREASE OF 2-3 STOOLS/DAY OVER PRE – TRT | INCREASE OF 4-6 STOOLS/DAY OR NOCTURNAL STOOLS | INCREASE OF 7-9 STOOLS/DAY OR INCONTINENCE,MALABSORPTION | INCREASE OF ≥10 STOOLS/DAY OR GROSSLY BLOODY DIARRHOEA,OR NEED FOR PQRENTERAL SUPPORT |
| NAUSEA | NONE | ABLE TO EAT REASONABLE INTAKE | INTAKE SIGNIFICANTLY DECREASED BUT STILL ABLE TO EAT | NO SIGNIFICANT INTAKE | |
| VOMITING | NONE | 1 EPISODE IN 24HRS | 2-5 EPISODES IN 24HRS | 6-10 EPISODES IN 24 HRS | >10 EPISODES IN 24 HRS |
| PAIN/CRAMPING(ABDOMINAL )(INCLUDES RECTAL PAIN) | NONE | MILD | MODERATE | SEVERE | |
| STOMATITIS | NONE | PAINLESS,ULSCERS,ERYTHEMA OR MILD SORENESS | PAINFUL ERYTHEMA,OEDEMA OR ULCERS BUT CAN EAT | WITH THERAPY PAINFUL ERYTHEMA,OEDEMA,OR ULCERS AND CANNOT EAT | PROCTITIS,MUCOSAL NECROSIS AND/OR REQ. PARENTAL SUPPORT |
| SKIN | 0 | 1 | 2 | 3 | 4 |
|---|---|---|---|---|---|
| ALOPECIA | NO LOSS | MILD HAIR LOSS | PRONOUNCED OR TOTAL HEAD HAIR LOSS | TOTAL BODY HAIR LOSS | |
| SKIN CHANGES | NONE | HYPERPIGMENTATION | ATRPHY | SUBCUT FIBROSIS | ULCERATION OR NECROSIS |
| DESQUAMATION | NONE | DRY DESQUAMATION | MOIST DESQUAMATION | CONFLUENT MOIST DESQUAMATION | |
| LOCAL TOXICITY(reaction at IV site) | NONE | PAIN | PAIN AND SWELLING,WITH INFLAMMATION OR PHLEBITIS | ULCERATION | PLASTIC SUREGERY INDICATED |
| RASH/ITCH(not due to allergy)(includes radiation recall) | NONE/NO CHANGE | SCATTERED MACULAR OR PAPULAR ERUPTIOIN OR ERYTHEMA THAT IS ASSYMPTOMATIC | SCATTERD MACULAR OR PAPULAR REACTION OR ERYTHEMA WITH PRURITUS OR OTHER ASSOCIATED SYMPTOMS | GENERALISED SYMPTOMATIC MACULAR,PAPULAR OR VESICULAR ERUPTION | EXFOLIATIVE DERMATITIS OR ULCERATION DERMATITIS |
IJROBP 1995 vol 31 5 1361-64 RTOG EORTC XRT SIDE EFFECTS