Back Module: S-G-S8-1

Cancer

Module information

Module details

Title
Cancer
Type
Specialist
Module code
S-G-S8-1
Credits
10
Phase
3
Requirement
Compulsory

Aim of this module

This module will provide the trainee with knowledge and understanding of the role and application of genetic and genomic testing in the diagnosis and management of patients with acquired cancers and those with germline susceptibility.

The content for this module will focus on patients who present with acquired cancers, including CML, colorectal and lung cancer, and for those patients with germline cancer susceptibility, including Ovarian cancer and Lynch syndrome.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1, 2, 3, 4, 5 Training activities

Perform duty scientist tasks for cancer investigations to include:

  • Triage of referrals
  • communication with other specialties to inform genomic testing and clinical management
 Type DTA Action View
# 2 Learning outcome 1, 4, 5 Training activities

Select, analyse, interpret and report the appropriate genomic testing for acquired Chronic Myeloid Leukaemia (CML).

 Type DTA Action View
# 3 Learning outcome 1 ,4, 5 Training activities

Select, analyse, interpret and report the appropriate genomic testing for acquired Colorectal Cancer (CRC).

 Type DTA Action View
# 4 Learning outcome 1, 4, 5 Training activities

Select, analyse, interpret and report the appropriate genomic testing for Non-Small Cell Lung Cancer (NSCLC).

 Type DTA Action View
# 5 Learning outcome 2, 4, 5 Training activities

Select, analyse, interpret and report the appropriate genomic tests for patients referred with germline cancer susceptibility for Lynch syndrome.

 Type DTA Action View
# 6 Learning outcome 2, 4, 5 Training activities

Select, analyse, interpret and report the appropriate genomic tests for patients referred with germline cancer susceptibility for ovarian cancer.

 Type DTA Action View
# 7 Learning outcome 3, 4, 5 Training activities

Select, analyse, interpret and report the appropriate genomic testing for patients referred for pharmacogenomic testing, for example DPYD or MGMT.

 Type DTA Action View
# 8 Learning outcome 4, 5 Training activities

Prepare a case for presentation at an MDT/GTAB for either acquired or germline cancer.

 Type DTA Action View
# 9 Learning outcome 4, 5 Training activities

Prepare a CML case study for investigations that require the integration of laboratory results from different technologies such as morphology, flow cytometry, karyotyping and FISH for full interpretation.

 Type DTA Action View
# 10 Learning outcome 4, 5 Training activities

Prepare a case study for an investigation that requires the integration of both somatic and germline molecular laboratory results from different technologies for full interpretation such as immunohistochemistry (IHC), microsatellite instability (MSI), methylation, sequence analysis).

 Type DTA Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Identify if a referral for investigation of acquired or germline cancer is appropriate for the testing required.
  • Analyse and interpret results for a somatic genomic investigation.
  • Analyse and interpret results for a germline genomic investigation.
  • Analyse and interpret results for a pharmacogenomics investigation.
  • Analyse chromosomes from a CML.
  • Classify a somatic or germline variant.
  • Prepare a clinical report for acquired or germline cancer investigations.

Observed Clinical Event Title

  • Provide advice to another healthcare professional on the requirements for a sample for an acquired cancer investigation.
  • Provide advice to another healthcare professional on the requirements for a sample for a germline cancer investigation.
  • Provide an urgent result from a cancer investigation to another healthcare professional.

Learning outcomes

# Learning outcome
1

Select the laboratory testing strategy, analyse, interpret and report tests for patients referred with acquired cancer.
2

Select the laboratory testing strategy, analyse, interpret and report tests for patients referred with germline cancer.
3

Select the laboratory testing strategy, analyse, interpret and report pharmacogenomic testing in cancer patients.
4

Apply integrative knowledge of laboratory techniques applied to the investigation of cases referred for cancer.
5

Demonstrate appropriate communication skills to present the results of investigations into acquired and germline cancer cases clearly to healthcare professional colleagues.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty’s impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  1. Attend multidisciplinary team meetings to appreciate the role of genetics in the patient pathway.
  2. Visit histopathology to appreciate sample preparation prior to genetic testing.
  3. Attend a cancer clinic to appreciate patient experience and the role of genetics in the patient pathway.
  4. Attend a genetic counselling session for familial cancer to appreciate feedback of information to patient, impact on patients and the role of genetics in the patient pathway.
  5. Observe a bone marrow sample being taken to appreciate the patient experience.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

  1. Demonstrate extended understanding of the biological basis of oncogenesis.
  2. Explain the use of genetic and genomic testing in acquired and inherited malignancies with specific reference to diagnosis, prognosis, monitoring and treatment.
  3. Explain the clinical presentation and assessment of patients with the common referrals for acquired and inherited cancers.
  4. Critically evaluate the design, operation and performance of a range of genomic tests relevant to cancer.
  5. Apply integrative knowledge of genomic testing of cell free tumour DNA in blood, for the diagnosis and monitoring of solid cancers.
  6. Discuss the implications of the genomic tests considering diagnosis, prognosis and treatment of cancer patients within a patient-centred service, considering the views and wishes of patients and their families.
  7. Discuss the partnership between genetics services and other clinical specialisms in the cancer patient’s care pathways and the impact of national and international guidance.
  8. Describe the role of clinical trials and the requirements for genetic and genomic testing therein.

Indicative content

  • Clinical presentation, genomic mechanisms and testing strategies relevant to acquired cancers, to include:
    • CML
    • Acquired colorectal cancer.
    • Non-small cell lung cancer.
  • Clinical presentations, genomic mechanisms and testing strategies relevant to germline cancer susceptibility syndromes, to include:
    • Ovarian cancer, to include HRD
    • Lynch syndrome
  • Understand the principles of pharmacogenetic testing in oncology patients, including DPYD.
  • Understand genomic testing of cell free tumour DNA in blood, for the diagnosis and monitoring of solid cancers.
  • The use and limitations of a range of sample types to analyse tumour DNA, including:
    • Formalin fixed paraffin embedded material.
    • Fresh frozen tumour tissue.
    • Cell free circulating tumour DNA.
    • Bone marrow and peripheral blood.
  • Challenges of the analysis of mixed cell populations and sampling for testing.
  • Awareness of the importance of turnaround time in the pathway of care.
  • Importance of adopting a multidisciplinary approach to cancer diagnosis, including the role of MDT’s and international guidance, such as improving outcomes guidance and NICE guidelines in the cancer patient care pathways.
  • Consent for testing and sample storage.
  • Follow-up management including repeat testing for disease status (remission, relapse, transformation, progression) and treatment monitoring, with consideration of the principles underpinning quantitation of residual disease.
  • Cancer prognosis and clinical care pathways associated with precision medicine.
  • Use of current actionable genetic biomarkers in the management and treatment of cancer, including acquired resistance mutations.
  • The basis of large-scale national and international projects focused on cancer and the importance of clinical trials.

 

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SLS4-1-27 Specialty title Genomics [2027] Action View
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