This clinical practice guideline discusses the prevention and management of chemotherapy induced nausea and vomiting (CINV) in pediatric cancer patients. Acute, delayed, anticipatory, breakthrough and refractory CINV are discussed. Recommendations are provided on assessment as well as pharmacological and non-pharmacological interventions. Antiemetic dosing recommendations are also provided.
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This is a clinical practice guideline for the management of febrile neutropenia in children, including those with cancer, and/or those who are undergoing hematopoietic stem cell transplantation (HSCT). The guideline examines the signs and symptoms of febrile neutropenia, as well as the evaluation of affected patients. Antibiotic selection and dose are recommended based on factors related to patient's condition, including stability on presentation, presence of penicillin allergy, and current treatment. Continued management of inpatients and management based on culture results are also discussed.
This is a clinical practice guideline for children with cancer who are receiving chemotherapy and/or radiation therapy. Recommendations are provided for the prevention of mucositis through oral care management, and various treatment options are considered for the management of mucositis in affected patients. The guideline also lists the risk factors for mucositis, and provides an oral assessment tool.
This is a clinical practice guideline for pediatric cancer patients who are receiving chemotherapy. Guidance is provided for the diagnosis and treatment of chemotherapy-induced diarrhea in these patients. Risk factors, grading of diarrhea, dietary modifications during diarrhea, and anti-diarrheal agents are also discussed.
This is a clinical practice guideline for the prevention and management of constipation in pediatric cancer patients. Pharmacological and non-pharmacological treatment options (including dosing recommendations) are discussed. The management of refractory opioid-induced constipation is also examined.
This is a clinical practice guideline for adult patients in primary care settings or emergency departments who have signs and symptoms suggestive of colorectal cancer (CRC). The guideline examines how to define expectations for primary care providers (PCPs), endoscopists, and radiologists regarding the appropriate work up of patients who have symptoms suggestive of colorectal cancer, and outlines the communication expectations between PCPs, endoscopists, radiologists, and other health care providers and patients. Outcomes of interest include effective communication, as well as early and accurate diagnoses.
This is a clinical practice guideline for the investigation and diagnosis of suspected lung cancer and referral for treatment, particularly for patients residing in Nova Scotia. The guideline reviews the investigation process from initial presentation to treatment referral. Topics include principles of communication between patient-provider and among providers throughout the diagnostic process, standards for initial investigation, appropriate use of imaging (CT, MRI, PET, bone scan) and biopsy and laboratory testing, as well as recommendations regarding treatment referral upon diagnosis. Referrals to diagnostic specialists (thoracic surgery or respirology) and to psychosocial and supportive care are also reviewed.
This guideline discusses the clinical standards of care for the treatment of rectal cancer in Nova Scotia with all aspects of rectal cancer care covered, from diagnosis to survivorship and/or palliation. This includes recommended standards for professionals involved in care, pretreatment investigations, and surgical, neo-adjuvant, and adjuvant treatments. Other topics covered include lynch syndrome screening and referral to medical genetics. Psychosocial health services and supportive care recommendations are also reviewed.
This clinical practice guideline addresses care of adult patients with differentiated thyroid cancer, specifically within Nova Scotia. The guideline provides recommendations on pre-surgical evaluation of thyroid nodules, surgical treatment and complications, pathology reporting, grading and tumour staging (TNM), risk prognostic systems, and post-surgical radioactive iodine (RAI) therapy. Protocols for lab and diagnostic follow-up, management of local and regional recurrences, early and long-term follow-up, and supportive and palliative care management are also addressed.
This guideline is for pediatric oncology patients presenting with febrile neutropenia. The guideline treatment options stratified by risk. Treatment options for patients with penicillin allergy are also discussed.
This is a guideline for management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem cell transplantation. The guideline reviews patient evaluation and provides recommendations on initial management, with considerations made to patient condition and whether or not they are already receiving empiric antibiotics. Recommendations are also provided for continued management of inpatients, management based on culture results, and management of fever in hematology/oncology patients who have completed therapy or are on therapy but are not neutropenic.
This is a clinical practice guideline for health-care providers (HCPs) to help screen, identify and manage cancer-related distress experienced by individuals diagnosed with cancer and their families. This guideline seeks to assist HCPs to become aware/sensitive to cancer-related distress; educate HCPs about management strategies for cancer-related distress; identify referral options for management of cancer-related distress by front-line HCPs; provide direction for cancer-related distress management and treatment options; assist front-line HCPs to identify and access appropriate specialist psychosocial care referral; and support the provision of person-centred care with a focus on cancer-related distress.
This clinical practice guideline is for children with cancer and/or undergoing hematopoietic stem cell transplantation. The guideline reviews evaluation and management of fever and neutropenia, including initial empiric antibiotic selection, continued management of inpatients, and management based on culture results. Management of fever in hematology/oncology patients who have completed therapy and/or are on therapy but are not neutropenic is also discussed.
A clinical practice guideline for patients with malignant melanoma. The guideline examines management from diagnosis to follow-up, including referral processes, recommendations for pregnant patients, and supportive care. Outcomes of interest include improved recommendations for the timing and efficacy of sentinel lymph node biopsy, which is generally recommended as a first-line staging tool.
This clinical practice guideline examines staging recommendations for determining extent of local tumour invasion and tumour spread in patients with bladder cancer. The guideline examines the use of CT and MRI imaging, both comparatively and consecutively, in the pelvic region.
A clinical practice guideline for patients with Stage I nonseminomatous germ cell tumours. The guideline examines baseline staging procedures and subsequent follow-up post orchiectomy. The guideline also provides monthly follow-up screening recommendations based on risk associated with lymphovascular invasion.
This is a clinical practice guideline examining the use of cytoreductive nephrectomy in patients with metastatic renal cell cancer. The guideline examines the use of cytoreductive surgery with Interferon, and recommends both relative and absolute contraindications for the procedure.
A clinical practice guideline detailing follow-up procedures for patients who have undergone curative renal cell carcinoma surgery. The guideline provides timelines for follow-up based on ECOG performance status, and gives detailed information for physicians about the importance of pathology results, and the surgical procedures conducted.
A clinical practice guideline for asymptomatic adult males at risk for prostate cancer. The guideline examines recommendations for screening on an individual basis to increase the diagnosis of early stage prostate cancer. Considerations regarding frequency of screening include life expectancy and risk factors such as family history.
This guideline provides best practices for the handling and administration of chemotherapy drugs. Safe handling procedures of chemotherapy drugs and waste are reviewed and drug administration is outlined for intravenous, subcutaneous, intravesical, and oral/topical chemotherapy treatments.
This guideline examines best practice procedures for the storage, handling, and preparation of chemotherapy drugs. The guideline provides step-by-step instructions for health professionals involved with chemotherapy in both treatment and emergency situations, and also provides detailed information for individual chemotherapy drugs. Outcomes of interest include protection of the patient and minimization of undue hazards.
A clinical practice guideline for cervical screening in women who are, or have been, sexually active. The guideline provides screening timelines and recommendations for when screening is no longer necessary. Recommendations are also made for women in special circumstances, including immunocompromised patients, pregnant women, and women who have undergone full hysterectomies.
A clinical practice guideline detailing the use of pap smears as a screening tool for women at risk for cervical cancer. The guideline examines screening timelines, optimal sampling areas, and details the process for both professionals and patients. The guideline also examines when repeat testing and referrals for colposcopies should be conducted, and provides instructional materials and sample forms.
This is an organizational and professional guideline that provides a model and provincial standard for delivery of systemic therapy to cancer patients in Nova Scotia. Minimum standards are addressed to ensure safe administration of systemic therapy, with important aspects of consideration including therapy type, physical facilities, organizational support, supportive care, and management of oncologic emergencies.
This is a clinical practice guideline for patients requiring colon cancer screening, examining colonoscopy standards. Important aspects include ideal polyp detection conditions, monitoring during the procedure, and follow-up care.