Cancer Guidelines Database

This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include, chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.

This is a clinical practice guideline for patients undergoing potentially cardiotoxic oncological treatment, including chemotherapy, targeted therapy and radiotherapy. The guideline examines various prevention, detection, treatment and monitoring strategies available for reducing cardiovascular toxicity in these patients. Outcomes of interest include cardiovascular morbidity, and mortality.

This is a clinical practice guideline for adults and children experiencing cancer-related fatigue (CRF). The guideline discusses screening for CRF, as well as evaluation approaches using focused history, assessment of treatable contributing factors, and patient clinical status. General strategies for managing CRF are discussed, and the guideline examines pharmacological and non-pharmacological treatments for patients based on their placement within the care continuum (i.e. active treatment, post-treatment, and end-of-life).

This is a clinical practice guideline for the management of infusion reactions (IR) caused by cancer medication. The guideline examines prophylaxis, acute management of IRs, as well as re-start and re-challenge protocols. Outcomes of interest include treatment toxicity, adverse events, and the incidence and severity of IRs.

This is a clinical practice guideline on BReast CAncer gene-related (BRCA-related) cancer in adult patients. The guideline examines risk assessment, genetic counseling and genetic testing in previously undiagnosed and asymptomatic patients as well as those who have a previous diagnosis of breast, ovarian, tubal or peritoneal cancer who have completed treatment and are considered cancer-free. Outcomes of interest include the incidence of BRCA-related cancer, as well as cause-specific and all-cause mortality.

Tailored to the unique needs and concerns of patients with all types of cancer, this clinical practice guideline provides standard-of-care recommendations, techniques, and strategies on smoking cessation. The guideline outlines different interventions, including pharmacotherapy options (e.g. nicotine replacement therapy, varenicline, bupropion, nortriptyline, clonidine), motivational strategies and behaviour techniques, and alternative treatment approaches such as electronic cigarettes and other electronic nicotine delivery systems.

This is a clinical practice guideline for the identification and treatment of psychosocial problems in patients with cancer. The guideline examines screening tools for distress and meeting psychosocial needs, the initial evaluation and treatment by oncology teams, psychological/psychiatric treatment by mental health professionals, social work and counseling services, and spiritual and chaplaincy care. The Distress Thermometer (DT) is discussed as a useful clinical tool for self-assessing patient distress. Both the DT and the guideline itself use the term "distress" due to its lack of associated stigmatization when compared to terms such as psychosocial, psychiatric, or emotional.

This is a clinical practice guideline for the use of proton beam radiation therapy in the management of pediatric, adolescent, and adult patients with cancer. The guideline examines factors that should be taken into account when assessing whether to refer patients for proton bean radiotherapy, including which tumour sites should be considered for referral. At the time of publication, facilities capable of treating a broad range of tumour sites with proton beam radiation therapy are not currently available in Canada, therefore recommendations focus on which patients are appropriate candidates to receive out-of-country treatment.

This is a clinical practice guideline for children with cancer who are being treated with chemotherapy, and/or children who are receiving hematopoietic stem cell transplantation (HSCT). The guideline provides recommendations on systemic antibacterial prophylaxis for the prevention of common invasive bacterial infections in these patients. Outcomes of interest include the risk of bacteremia, and infection-related mortality.

This is a clinical practice guideline for the prevention and treatment of venous thromboembolism (VTE) in adult patients with cancer. The guideline discusses the prophylaxis of VTE in patients who have undergone surgery, prophylaxis of catheter-related thrombosis, treatment of established VTE, and maintenance treatment (both early and long-term). Risk-stratification schemes for the prophylaxis of VTE in patients with cancer, are also examined.

This is a clinical practice guideline examining the routine vaccination of children with cancer, during and after completion of chemotherapy. The guideline specifically discusses the use of vaccines for hepatitis B, hepatitis A, diphtheria, tetanus, pertussis, polio, Hemophilus influenzae, measles, mumps, rubella, influenza, meningococcus, pneumococcus, varicella, human papilloma virus (HPV), and rotavirus.

This is a clinical practice guideline for patients living with HIV (PLWH) who are diagnosed with cancer. The guideline focuses primarily on PLWH who develop non-small cell lung cancer (NSCLC), anal cancer, Hodgkin lymphoma, or cervical cancer. General advice is also provided regarding HIV management during cancer therapy, in addition to topics such as drug-drug interactions (DDI) between antiretroviral treatments and cancer therapies, initial workup, radiation therapy, surgical management, and supportive care.

This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include, chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.

This is a clinical practice guideline for adult cancer patients who are receiving chemotherapy, who are at risk for or are experiencing chemotherapy-induced nausea and vomiting (CINV). The guideline discusses prevention strategies for patients who are receiving different regimens of chemotherapy, including single day intravenous chemotherapy, high-dose chemotherapy for stem cell transplantation (SCT), and multiple day intravenous chemotherapy. Another topic of interest examined is the potential role of cannabinoids for the prevention of CINV.

This is a clinical practice guideline for patients with chemotherapy-induced peripheral neuropathy (CIPN). The guideline provides a framework for the screening, assessment and management of CIPN. Assessment tools, rehabilitation strategies, pharmacologic management options, and referral to specialists are addressed.

This is a clinical practice guideline for patients with primary amyloid light-chain (AL) amyloidosis who are being considered for treatment regimens that include either bone marrow or stem cell transplantation (SCT). The guideline compares chemotherapy (CT) and both autologous and allogeneic SCT. Side effects evaluated include cytomegalovirus or Pneumocystis carinii infections, as well as neutropenia and mucositis.

This is a clinical practice guideline for adult patients with cancer who are being treated with bone-modifying agents (BMAs). The guideline discusses the prevention and management of medication-related osteonecrosis of the jaw (MRONJ), and specific recommendations are provided for reducing the risk of MRONJ, as well as for the diagnosis and staging of MRONJ. The potential discontinuation of BMA use after a diagnosis of MRONJ, is also addressed.

This is a clinical practice guideline for adult patients with cancer and immunotherapy-related toxicities. The guideline examines the management of immune-related adverse events (irAEs) resulting from cancer immunotherapy, including immune checkpoint inhibitor (ICI) therapy and chimeric antigen receptor (CAR) T-cell therapy. Immune checkpoint inhibitors are discussed, and managing irAEs in specific patient populations, as well as specific irAE management, are considered.

This is a clinical practice guideline for adult patients with solid tumors or lymphoid blood cancers, and is especially relevant to those receiving chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) for the prevention and management of neutropenia and anemia in these patients. Specific topics addressed include red blood cell transfusion, erythropoietic therapy, as well as iron monitoring and supplementation.

This is a clinical practice guideline for patients with multiple myeloma. The guideline provides recommendations for the treatment of both newly diagnosed and relapsed patients. Outcomes of interest include overall survival, progression-free survival, response rate, and quality of life.

This is a clinical practice guideline for older patients with cancer. The guideline provides recommendations for comprehensive geriatric assessments, as well as treatment modalities such as surgery, radiation therapy (RT), chemotherapy, and targeted therapy. Disease-specific issues are also addressed for breast cancer, central nervous system cancers, gastrointestinal cancers, genitourinary cancers, gynecological cancers, head and neck cancers, lung cancers, melanoma, and hematologic malignancies.

This is a clinical practice guideline for adults and children with tumours or hematological cancers who are undergoing chemotherapy and/or other systemic therapies. The guideline provides recommendations for influenza vaccination in these patients. Outcomes of interest include post-vaccine frequency of immune-related adverse events, other infection-related adverse events, and mortality.

This is a clinical practice guideline for patients with central nervous system cancers. The guideline examines the diagnosis, staging, treatment, and follow-up of these patients. Surgical options, adjuvant therapy, and postoperative staging are specifically considered.

This is a clinical practice guideline for adult patients with lymphoma, including Hodgkin lymphoma (HL) and non-Hodgkin lymphomas (NHLs). The guideline provides recommendations for staging and re-staging, treatment, as well as follow-up. Outcomes of interest include disease progression, treatment toxicity, quality of life, progression-free survival, and overall survival.

This is a clinical practice guideline for adult patients who are receiving treatment for non-metastatic cancer, as well as adult cancer survivors. Recommendations are provided for the management of osteoporosis and osteoporotic fractures in these patients. The guideline specifically discusses which patients are at an increased risk for developing osteoporotic fractures, how these patients should be screened for, which patients should be treated for their osteoporosis, and which interventions should be used (i.e. which interventions are effective at reducing the risk of fracture).

This is a clinical practice guideline for the prevention and treatment of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), in adult patients with cancer. The guideline discusses whether anticoagulation is appropriate for the prophylaxis of VTE in hospitalized patients with cancer, ambulatory patients with cancer who are receiving systemic chemotherapy, and patients who are undergoing surgery (i.e. preoperatively). Risk prediction, awareness of VTE among patients, and the optimal methods for treating established VTE, are also discussed.

This is a clinical practice guideline for the palliative care of patients with cancer. The guideline examines interventions such as symptom management, reassessment, and after-death care. The guideline provides an overview of the many considerations surrounding palliative care, such as cultural, ethical, legal, physical, psychological, social, spiritual, and existential issues.

This is a clinical practice guideline for adults with any type of cancer. The guideline focuses on the screening, assessment, and treatment of cancer-related pain. Specific topics discussed include universal pain screening, management of pain in both opioid-naïve and opioid-tolerant patients, management of opioid-induced adverse effects, procedure-related pain and anxiety, management strategies for specific cancer pain syndromes, adjuvant analgesics for neuropathic pain, psychosocial support, and education for both patients and caregivers.

This clinical practice guideline is an endorsement of the American Society of Clinical Oncology’s 2017 guideline titled Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update. The guideline discusses the use of antiemetics for the prevention and management of nausea and vomiting in adult patients undergoing chemotherapy and/or radiotherapy. Various treatment regimens are examined based on the frequency of emesis. Other topics of interest include the use of adjunctive drugs, cannabinoids, as well as other complementary and alternative therapies.

This guideline provides recommendations on the management of adult and pediatric patients who are experiencing febrile neutropenia as a result of cancer treatment. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for the prevention and treatment of cancer-related infections. The guideline examines external risk factors for infection, major host factors that predispose patients to infectious diseases, prevention of infectious complications (including the use of antimicrobial prophylaxis and pre-emptive therapy), management of neutropenic fever, and management of site-specific infections such as pneumonia, abdominal infections, and catheter-associated infections.

This is a clinical practice guideline for survivors of adult-onset cancer in the post-treatment period. The guideline provides screening, evaluation, and treatment recommendations, and should be used to supplement the follow-up recommendations of disease-specific guidelines.

This is a clinical practice guideline for the palliative care of patients with cancer. The guideline examines interventions such as symptom management, reassessment, and after-death care. The guideline provides an overview of the many considerations surrounding palliative care, such as cultural, ethical, legal, physical, psychological, social, spiritual, and existential issues.

This is a clinical practice guideline for adult patients with cancer requiring treatment for fever and neutropenia. The guideline examines which patients can be treated as outpatients, as well as appropriate interventions for these patients. Initial diagnostic approach, eligibility of patients at low risk for medical complications, and psychosocial and logistic recommendations for eligibility are discussed. Types of antimicrobial agents and locations for initial dose(s) in these patients are also considered, as are recommended courses of action if patients do not defervesce after 2 to 3 days of treatment.

This is a clinical practice guideline for patients with cancer who are at risk of infertility due to anticancer treatment. The guideline examines fertility preservation options for this patient population. Topics discussed include options for men and women, special considerations for children, as well as the role of the health care provider.

This is a clinical practice guideline for patients with solid tumours or hematological malignancies, and those with myelodysplastic syndromes (MDS). The guideline examines the management of anemia and iron deficiency in these patients using erythropoiesis-stimulating agents (ESAs), iron preparations for intravenous or oral administration, red blood cell transfusions, or combinations of these treatments. When and for whom treatment should be considered, as well as appropriate dose, are discussed.

This is a clinical practice guideline for adults with solid tumours and non-myeloid malignancies who are receiving myelosuppressive chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) in these patients as a method for reducing the incidence of neutropenia. Topics of interest include the benefits and risks of MGFs, as well as their use in prophylactic, therapeutic, and post-transplant settings.

This is a clinical practice guideline for adults and children experiencing cancer-related fatigue (CRF). The guideline discusses screening for CRF, as well as evaluation approaches using focused history, assessment of treatable contributing factors, and patient clinical status. General strategies for managing CRF are discussed, and the guideline examines pharmacological and non-pharmacological treatments for patients based on their placement within the care continuum (i.e. active treatment, post-treatment, and end-of-life).

This is a clinical practice guideline for adolescents and young adults with cancer. The guideline discusses risk factors, screening, diagnosis, management, follow-up, supportive care, and palliative care for patients between 15 and 39 years of age. Unique issues discussed include adherence to treatment, the impact of cancer and its treatment on fertility, management of cancer during pregnancy, relationship management, and socioeconomic issues.

This is a clinical practice guideline for adult patients with cancer and immunotherapy-related toxicities. The guideline examines the management of immune-related adverse events (irAEs) resulting from cancer immunotherapy, including immune checkpoint inhibitor (ICI) therapy and chimeric antigen receptor (CAR) T-cell therapy. Immune checkpoint inhibitors are discussed, and managing irAEs in specific patient populations, as well as specific irAE management, are considered.

This is a clinical practice guideline for adults and children with cancer-induced anemia (CIA). The guideline discusses the etiology of CIA, and examines the screening, evaluation, and treatment methods for reducing CIA in affected patients. Red blood cell transfusion, erythropoietic therapy, and iron monitoring and supplementation are discussed as treatment options.

This is a clinical practice guideline for the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. The guideline examines whether geriatric assessment (GA) should be used in older adults with cancer to predict adverse outcomes from chemotherapy, which GA tools should be used, and which general life expectancy data should be considered in order to estimate mortality and best inform treatment decision-making.

This is a clinical practice guideline for survivors of adult-onset cancer in the post-treatment period. The guideline provides screening, evaluation, and treatment recommendations, and should be used to supplement the follow-up recommendations of disease-specific guidelines.

This is a guideline for facilitating collaborative and effective family involvement in the cancer setting. The guideline examines practical strategies to guide effective communication for the clinician-patient-family trio, and specifically addresses the positive and effective involvement of adult patients' family caregivers in consultations and patient care.

This is a clinical practice guideline on the use of erythropoiesis-stimulating agents (ESAs) and biosimilars for the management of cancer-associated anemia in adult patients. Outcomes of interest include mortality, frequency of RBC transfusion, thromboembolic risk, quality of life, fatigue, progression-free survival and overall survival. In the case of biosimilars, hemoglobin (HgB) response and immunogenicity were additional outcomes of interest. Patient counselling and talking tips are also included to help clinicians implement the guideline's recommendations.

This is a clinical practice guideline for the prevention and treatment of clostridium difficile infection (CDI) in children and adolescents with cancer as well as in pediatric hematopoietic stem-cell transplantation (HSCT) patients. The guideline provides initial treatment recommendations for non-severe, severe and recurrent CDI. The efficacy and appropriateness of probiotics, monoclonal antibodies and fecal microbiota transplantation are also considered.

This is a clinical practice guideline for adult and pediatric patients with cancer. The guideline examines the practicality of palliative care delivery models for these patients and their family caregivers in resource-constrained settings. Recommendations are provided for palliative care models at the district, regional, and national level, as well as in the primary health care setting. For each model, the timing for addressing palliate care needs as well as the workforce, knowledge, and skills required are discussed. Nurses' roles in pain management, as well as spiritual care, social work/counseling, and opioid availability are also considered.

This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.

This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include, chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.

This is a clinical practice guideline for adult patients who are experiencing immune suppression or increased susceptibility to infection as a result of cancer or and/or its treatment. The guideline discusses antimicrobial prophylaxis and the potential impacts on reducing the incidence of and mortality from febrile neutropenia (FN). Fluoroquinolone, oral triazole, antivirals, and neutropenic diets are all examples of management options that are discussed.

This is a clinical practice guideline for adult and pediatric patients with cancer. The guideline examines influenza immunization in these patients, including recommended vaccine, dosing, as well as the effect of age, duration, and systemic therapy on the patient's response to the vaccination. Patients undergoing hematopoietic stem cell transplant (HSCT) are further discussed, as is the immunization of individuals in contact with these patients.

This is a clinical practice guideline for survivors of childhood cancer. The guideline provides recommendations for the endocrine treatment of hypothalamic-pituitary and growth disorders in these patients. Specific conditions discussed include impaired linear growth, growth hormone deficiency, central precocious puberty, hypogonadotropic hypogonadism, and thyroid-stimulating hormone deficiency.

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.

This is a clinical practice guideline for adult cancer patients. The guideline examines the management cancer-related pain, and provides recommendations on treatment options such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and medical cannabis. The principles of pain management, and the treatment of mild, moderate, and severe pain are discussed, as is the invasive management of refractory pain.

This is a clinical practice guideline for children undergoing treatment for leukemia, or other forms of cancer. The guideline examines strategies for the prevention, assessment, and treatment of venous thromboembolism (VTE). Management of thrombocytopenia and coagulopathy, as well as therapy options for menstrual suppression, are also discussed.

This is a clinical practice guideline for patients living with HIV (PLWH) who are diagnosed with cancer. The guideline focuses primarily on PLWH who develop non-small cell lung cancer (NSCLC), anal cancer, Hodgkin lymphoma, or cervical cancer. General advice is also provided regarding HIV management during cancer therapy, in addition to topics such as drug-drug interactions (DDI) between antiretroviral treatments and cancer therapies, initial workup, radiation therapy, surgical management, and supportive care.

This is a clinical practice guideline for adults with any type of cancer. The guideline focuses on the screening, assessment, and treatment of cancer-related pain. Specific topics discussed include universal pain screening, management of pain in both opioid-naïve and opioid-tolerant patients, management of opioid-induced adverse effects, procedure-related pain and anxiety, management strategies for specific cancer pain syndromes, adjuvant analgesics for neuropathic pain, psychosocial support, and education for both patients and caregivers.

This is a clinical practice guideline for the management of critically ill cancer patients. The guideline examines multiple aspects of patient care in intensive care units (ICUs), including ICU eligibility criteria, indications and screening for organ dysfunction, interprofessional collaboration, and treatment within ICUs. Infection prevention (including immunization), and the treatment of infections are both discussed, as is the selective use of Granulocyte colony stimulating factor (GCSF).

This is a clinical practice guideline for adult patients with active cancer. The guideline examines screening, assessment, and management strategies for cancer-related pain of any severity in these patients. Pharmacological management options discussed include acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), adjuvant analgesics, opioid drugs, and management of cancer pain in patients with renal impairment. Non-pharmacological management options including radiotherapy, vertebroplasty and kyphoplasty, anesthetic interventions, surgical interventions, and complementary therapies are also discussed. The guideline also considers supportive care of these patients.

This is a clinical practice guideline for children with solid or hematological malignancies. The guideline provides recommendations for the use of anthracycline chemotherapy in these patients, while specifically focusing on the timing of therapy (i.e. prolonged infusion duration versus shorter infusion duration). The primary outcomes of interest being compared between regimens are tumour response, quality of life, progression-free survival, overall survival, cardiotoxicity (i.e. clinical and subclinical heart failure, etc.) and adverse effects other than cardiac manifestations.

This is a clinical practice guideline for survivors of childhood, adolescent, and young adult cancers. The guideline provides recommendations for the screening and management of therapy-related complications or adverse effects that persist or arise after the completion of treatment (i.e. late effects). Different therapeutic exposures and their potential late effects are explored and organized by cancer site and type of exposure (e.g. chemotherapy, radiation).

This is a clinical practice guideline for older patients with cancer. The guideline provides recommendations for comprehensive geriatric assessments, as well as treatment modalities such as surgery, radiation therapy (RT), chemotherapy, and targeted therapy. Disease-specific issues are also addressed for breast cancer, central nervous system cancers, gastrointestinal cancers, genitourinary cancers, gynecological cancers, head and neck cancers, lung cancers, melanoma, and hematologic malignancies.

This is a clinical practice guideline for patients living with HIV (PLWH) who are diagnosed with cancer. The guideline focuses primarily on PLWH who develop non-small cell lung cancer (NSCLC), anal cancer, Hodgkin lymphoma, or cervical cancer. General advice is also provided regarding HIV management during cancer therapy, in addition to topics such as drug-drug interactions (DDI) between antiretroviral treatments and cancer therapies, initial workup, radiation therapy, surgical management, and supportive care.

This is a clinical practice guideline for adults with solid tumours and non-myeloid malignancies who are receiving myelosuppressive chemotherapy. The guideline examines the use of myeloid growth factors (MGFs) in these patients as a method for reducing the incidence of neutropenia. Topics of interest include the benefits and risks of MGFs, as well as their use in prophylactic, therapeutic, and post-transplant settings.

This is a clinical practice guideline for adult patients with cancer being treated with immune checkpoint inhibitor (ICPi) therapy. The guideline examines how to manage immune-related adverse events (irAEs) in these patients. Adverse events considered include skin, gastrointestinal, lung, endocrine, musculoskeletal, renal, nervous system, hematologic, cardiovascular, and ocular toxicities. Patient and clinician communication, health disparities, and multiple chronic conditions are also discussed.

This is a clinical practice guideline for adult patients with advanced cancer who are experiencing constipation due to diagnosis or treatment. The guideline discusses the assessment, diagnosis, and management of constipation in these patients. Specific recommendations are provided for managing constipation in older adults with cancer, opioid-induced constipation, and fecal impaction. Management options considered include prevention and self-care, laxatives, suppositories, and enemas.

This is a clinical practice guideline for adults with cancer who are at risk for, or have been diagnosed with, delirium. The guideline provides recommendations regarding delirium prevention, diagnosis, screening, treatment and experiential impact. Pharmacological and non-pharmacological interventions are discussed. Guidance is also provided on education and support for the healthcare team and family members.

This is a clinical practice guideline for the identification and treatment of psychosocial problems in patients with cancer. The guideline examines screening tools for distress and meeting psychosocial needs, the initial evaluation and treatment by oncology teams, psychological/psychiatric treatment by mental health professionals, social work and counseling services, and spiritual and chaplaincy care. The Distress Thermometer (DT) is discussed as a useful clinical tool for self-assessing patient distress. Both the DT and the guideline itself use the term "distress" due to its lack of associated stigmatization when compared to terms such as psychosocial, psychiatric, or emotional.

This is a clinical practice guideline for patients with any type of cancer who are experiencing or are at high risk for experiencing nausea and/or vomiting due to treatment. The guideline examines treatment options for nausea and/or vomiting induced by radiation therapy (RT), chemotherapy, targeted therapy, and immunotherapy. In addition to antiemetic treatment options, the guideline discusses the emetogenic potentials of different anticancer therapies.

This is a clinical practice guideline examining communication strategies for clinicians who are treating adult cancer patients. The guideline specifically addresses the management of challenging interactions between clinicians and the family caregivers of adult cancer patients. Types of challenges examined include those involving family dysfunction, anger, and conflicting treatment wishes.

This is a clinical practice guideline for adult and adolescent cancer patients who are experiencing cancer-related pain. The guideline examines various pharmacological and radiotherapeutic management options. Topics of interest include initiation of pain relief, maintenance of pain relief with opioids, cessation of opioids, and the use of radiotherapy.

This is a clinical practice guideline for adult patients with cancer. The guideline examines comprehensive oncology nutrition practice for the care of this patient population. Topics of interest include validated tools for malnutrition screening and nutrition assessment, evaluation of nutritional status as key component in patient care process, and dietary supplements.

This is a clinical practice guideline for fever of unknown origin (FUO) in adult neutropenic patients. The guideline updates recommendations for diagnosis and empirical therapy of these patients in light of the challenges of antimicrobial stewardship. Specific recommendations are provided for taking down patient history and performing a physical examination, ordering chest radiograph, and taking nasal/pharyngeal (MRSA) or rectal (VRE) swabs.

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 the prevention and treatment of cancer-related infections in neutropenic and immunocompromised non-neutropenic patients with cancer. This guidelines aims to provide an overview of the risk categorization and recommended strategies for prevention of infections in high-risk patient populations, as well as monitoring in patients with signs and/or symptoms of infections. Outcomes of interest include a finding that advances in treatment further emphasize the need for multidisciplinary care.

This is a clinical practice guideline for patients who are receiving systemic anticancer therapy. The guideline examines the management of infusion reactions (IRs), which can be either allergic reactions to foreign proteins, or non-immune-mediated reactions. Specific topics discussed include risk assessment, diagnosis, management, how to document an IR, drugs which may frequently cause IRs, and cases of rechallenge.

This is a clinical practice guideline discussing the treatment and prophylaxis of venous thromboembolism (VTE) in patients receiving treatment for solid (i.e. non-hematologic) tumours. The guideline examines the pharmacologic therapy and dosing options for both inpatients and ambulatory patients with established VTE or who are at risk for VTE (i.e. prophylaxis). The guideline also discusses common complications associated with antithrombotic therapy, as well as the follow-up of patients during its administration.

This is a clinical practice guideline on pneumococcal immunization for adult and pediatric cancer patients with solid tumours or hematologic cancers. The guideline provides recommendations on the type of vaccine and timing of immunization in relation to the type of treatment, therapy cycle, and severity of immunosuppression. Guidance is also provided on restrictions for immunization.

This is a clinical practice guideline for adult patients with desmoid tumours. The guideline provides recommendations for diagnosis, staging procedures, treatment, and follow-up. Treatment options including active surveillance, surgery, radiation therapy, and chemotherapy are examined. Topics of interest include desmoid tumours occurring during pregnancy, pain management, and rehabilitation.

This is a clinical practice guideline discussing influenza immunization for adult and pediatric cancer patients. The guideline provides guidance on the timing of influenza immunization in relation to severity of immunosuppression and chemotherapy schedules, number of administrations, types of influenza vaccines, and contraindications and precautions for immunization. Recommendations for the immunization of family members and hospital or clinic staff are also provided.

This is a clinical practice guideline for the palliative care of patients with cancer. The guideline examines interventions such as symptom management, reassessment, and after-death care. The guideline provides an overview of the many considerations surrounding palliative care, such as cultural, ethical, legal, physical, psychological, social, spiritual, and existential issues.

This is a clinical practice guideline for the prevention of acute chemotherapy-induced nausea and vomiting (CINV) in pediatric cancer patients. The guideline provides recommendations on the use of pharmacological treatments for CINV, such as aprepitant and palonosetron. Outcomes of interest include CINV control rate and adverse events.

This is a clinical practice guideline for adult and pediatric patients who receive antineoplastic agents or radiation therapy for cancer. The guideline examines important developments in antiemetic management options for patients undergoing the above treatments. Comparisons are made between antiemetic management options on the basis of potential benefits, potential harms, and quality of evidence. Outcomes of interest include new evidence regarding antiemetic efficacy and new antiemetic management options.

This is a clinical practice guideline for adult patients who have undergone cancer treatment, and are at risk for developing secondary upper quadrant lymphedema (SUQL). The guideline provides recommendations for the diagnosis of SUQL, using methods such as clinical examination and patient-reported symptom assessments, bioimpedance analysis, circumferential measurement, water displacement, and imaging techniques such as magnetic resonance imaging (MRI), and computed tomography (CT). The primary outcomes of interest are decreases in both morbidity as well as activity and participation restrictions, and an increase in overall quality of life (QOL).

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 patients with leptomeningeal metastases from solid tumours. The guideline discusses the diagnosis, treatment, and follow-up of these patients, and a treatment algorithm is presented based on life expectancy. Treatment options examined include systemic pharmacotherapy, intra-cerebrospinal fluid pharmacotherapy, focal radiotherapy (RT), and whole brain radiotherapy (WBRT).

Tailored to the unique needs and concerns of patients with all types of cancer, this clinical practice guideline provides standard-of-care recommendations, techniques, and strategies on smoking cessation. The guideline outlines different interventions, including pharmacotherapy options (e.g. nicotine replacement therapy, varenicline, bupropion, nortriptyline, clonidine), motivational strategies and behaviour techniques, and alternative treatment approaches such as electronic cigarettes and other electronic nicotine delivery systems.

This is a clinical practice guideline for the prevention and treatment of cancer-related infections. The guideline examines external risk factors for infection, major host factors that predispose patients to infectious diseases, prevention of infectious complications (including the use of antimicrobial prophylaxis and preemptive therapy), management of neutropenic fever, and management of site-specific infections such as pneumonia, abdominal infections, and catheter-associated infections.

This clinical practice guideline is an adaptation of Cancer Care Ontario’s 2016 guideline titled Interventions to Address Sexual Problems in People With Cancer. The guideline examines the effectiveness of pharmacological interventions, psychosocial counseling, or devices to manage sexual problems experienced after cancer treatment. Recommendations are based on patient gender, and condition. Specific topics discussed are sexual response, body image (women), intimacy/relationships, overall sexual functioning and satisfaction, vasomotor symptoms, genital symptoms (women) and genital changes (men).

This guideline provides recommendations on use of vertebroplasty or kyphoplasty as treatment options for cancer patients with vertebral compression fractures. The guideline outlines clinical criteria for when vertebroplasty, kyphoplasty, or focal tumour ablation (FTA) assisted vertebroplasty/kyphoplasty should be performed, and provides recommendations on selecting the most appropriate procedure. The role of radiation treatment, absolute contraindications, and service provider requirements are also discussed.

This is a clinical practice guideline for adults who have completed treatment and have been cured of cancer. The guideline examines different models of follow-up care, organized both by clinical setting, and by which health professionals are responsible for the coordination of care. The appropriateness of different models of care for different types of cancer is discussed, with focuses on clinical outcomes (e.g. surveillance, recurrence) and quality of life outcomes (e.g. quality of life, patient satisfaction).

This is a clinical practice guideline for adults and children who are taking anti-resorptive or anti-angiogenic medications. The guideline, aimed at dental care practitioners, provides recommendations for reducing the risk of medication-related osteonecrosis of the jaw (MRONJ) in these patients. Risk factors for MRONJ are discussed, and recommendations are provided for assessing and classifying patients' risk.

This is a clinical practice guideline for adult patients with solid tumour malignancies. The guideline provides recommendations for administering influenza vaccines to these patients. The timing of vaccination, and for whom vaccination is appropriate, are both discussed.

This is a clinical practice guideline for adults with cancer-related fatigue. The guideline examines the appropriate screening, assessment, and management of these patients. Interventions discussed include pharmacological management, physical activity, functional and occupational therapy interventions, psychosocial and educational interventions, complementary therapies, nutrition, and management of anemia. Recommendations are provided based on the severity of fatigue.

This is a clinical practice guideline for adults and children with cancer-induced anemia (CIA). The guideline discusses the etiology of CIA, and examines the screening, evaluation, and treatment methods for reducing CIA in affected patients. Red blood cell transfusion, erythropoietic therapy, and iron monitoring and supplementation are discussed as treatment options.

This is a clinical practice guideline for oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. The guideline examines the core communication skills and tasks that apply across the continuum of cancer care. Topics include the discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating family involvement in care, and clinician training in communication skills.

This is a clinical practice guideline for adult patients with incurable cancer or other end-stage diseases. The guideline examines strategies for the assessment and management of pain and other symptoms associated with advanced disease in this patient population. In addition to pain, the guideline discusses constipation, delirium, depression, dyspnea, fatigue and weakness, as well as nausea and vomiting.

This is a clinical practice guideline for male survivors of childhood, adolescent, and young adult (CAYA) cancers. The guideline specifically discusses treatments associated with increased risk of impaired spermatogenesis, testosterone deficiency, and physical sexual dysfunction. Surveillance strategies for these outcomes are examined, including which patients require surveillance, which surveillance modality should be used, frequency of surveillance, and what should be done when abnormalities are identified.

This is a clinical practice guideline on the perioperative care of patients undergoing surgery for adrenocortical carcinoma (ACC). Topics covered in the guideline include the optimal preoperative investigations, surgical approach, quality criteria of the operative note and pathological report, follow-up after surgery, surgical management of metastatic and/or recurrent ACC, and debulking or palliative surgery. The guideline also emphasizes the need for inclusion in collaborative and/or prospective databases to advance research and evidence on the topic.

This is a clinical practice guideline for patients with epithelial occult primary cancer. The guideline provides recommendations for the evaluation, workup, management, and follow-up of two pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma, or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Management options considered include, chemotherapy, radiation therapy, locoregional therapeutic options, and specialized approaches, as well as supportive care and management of psychosocial distress.

This is a clinical practice guideline for adults and children with hematologic malignancies, solid tumours, or hypoproliferative thrombocytopenia. The guideline examines when and how clinicians should use platelet transfusion to prevent or manage bleeding in these patients. Recommendations are made on topics such as the preparation of platelet products, the prevention of Rhesus (Rh) alloimmunization, and platelet transfusion thresholds for patients with different conditions.

This is a clinical practice guideline for the empirical management of fever and neutropenia (FN) in children with cancer, and those who have received hematopoietic stem-cell transplantation (HSCT). The guideline examines initial presentation, ongoing management, and empirical antifungal therapy. Topics of interest include risk stratification to define patients with high-risk invasive fungal disease (IFD), recommended biomarkers and radiologic investigations for the evaluation of IFD in prolonged FN, and empirical antifungal therapy in IFD low-risk patients with prolonged FN.

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 adolescents and young adults with cancer. The guideline discusses risk factors, screening, diagnosis, management, follow-up, supportive care, and palliative care for patients between 15 and 39 years of age. Unique issues discussed include adherence to treatment, the impact of cancer and its treatment on fertility, management of cancer during pregnancy, relationship management, and socioeconomic issues.

This consensus guideline provides recommendations on safe handling of oral anti-cancer drugs (OACDs) in community pharmacies across the medication lifecycle, from manufacturer packaging to waste management and incident reporting. Specifically, the guideline addresses packaging, labeling, receiving and unpacking, storage, drug preparation and handling, verification and dispensing, transportation, personal protective equipment (PPE), disposal, waste management and cleaning, and incident reporting. Recommendations for training and education are also discussed, along with staffing considerations.

This is a clinical practice guideline for adult patients with incurable cancer or other end-stage diseases. The guideline examines palliative care assessment and management strategies for these patients. Topics discussed include the establishment of goals of care with patients and families, coordination of care with allied health care providers, monitoring of the patient's functional capacity, evaluation of symptom burden, non-pharmacologic and pharmacologic management strategies, referral to specialists (including referral to tertiary palliative care units or local hospice palliative care programs), medical assistance in dying, the end-of-life care checklist, as well as approaches to death and bereavement.

This is a clinical practice guideline for the management of venous thromboembolism (VTE) in patients with cancer. The guideline examines the use of direct oral anticoagulants (DOACs) for the treatment of VTE. Topics of interest include initial treatment of VTE, maintenance, long-term treatment, and recurrence.

This is a clinical practice guideline for children with cancer. The guideline examines the effective delivery of education to these patients and their families. Educational methods, time after initial diagnosis, location, and educational content are considered. The influence of demographic and/or clinical attributes of these patients and their families on the successful transfer of initial educational information is discussed, as are interventions that have been developed to improve the comprehensiveness of information related to diagnosis, treatment, and care of these patients.

This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. Recommendations are provided on implementation of the brief tobacco intervention using the evidence-based AAR Brief Tobacco Intervention Model which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. The 2015 guideline was revised in June 2016 to abbreviate the cessation intervention model to best support adoption across all CCA clinics and settings. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes, and the impact of tobacco use on cancer treatment is reviewed with a specific focus on erlotinib and irinotecan.

This clinical practice guideline discusses specific issues related to the management of cancer in adults aged 65 years or older. Topics include screening and comprehensive geriatric assessment (CGA), assessing risks and benefits of treatment, preventing or decreasing complications from therapy, and managing disease-specific issues. Recommendations are also provided for management of patients deemed to be at high risk for toxicity from standard treatment.

This is a clinical practice guideline for the use of myeloid growth factors in adult patients with solid tumours and non-myeloid malignancies. Benefits and risks are reviewed, the role of biosimilars is discussed, and recommendations are provided for prophylactic and therapeutic uses of both granulocyte and granulocyte-macrophage colony stimulating factors (CSFs). Recommendations are also given regarding the use of CSFs in the hematopoietic cell transplant setting. Outcomes of interest include efficacy of CSFs, mortality, length of hospitalization, toxicity, and adverse effects.

This is a clinical practice guideline for the management of chronic pain in survivors of adult cancers. Whereas other guidelines have largely focused on relieving acute pain or pain associated with advanced disease, this guideline focuses on the care required when pain persists months or years after the completed cancer treatment. Areas addressed in the guideline include: screening and comprehensive assessment; treatment and care options; nonpharmacologic interventions; pharmacologic interventions; as well as risk assessment, mitigation, and universal precautions with opioid use.

A clinical practice guideline for the prevention of chemotherapy and radiotherapy-induced nausea and vomiting in advanced cancer patients. The guideline examines the emetogenic potential of antineoplastic agents and recommended pharmacological treatments. Outcomes of interest include antiemetic prophylaxis, efficacy, and optimal dosing.

This is a clinical practice guideline for patients (children/adolescents and adults) who are experiencing cancer-related fatigue. The guideline discusses evaluation and intervention for patients on active treatment, post-treatment, and at end of life. Education and counselling, nonpharmacologic interventions, and pharmacologic interventions are all discussed along with general strategies for management of fatigue.

This clinical practice guideline provides recommendations on assessment and management of cancer pain in adult patients, including pain in adult cancer survivors. Pathophysiologic classification of cancer pain syndromes is reviewed, and recommendations are provided for pain assessment, management/intervention, and reassessment. Both pharmacologic and non-pharmacologic interventions are discussed.

This clinical practice guideline provides recommendations on influenza vaccinations for children and adults with solid tumours or hematologic malignancies. Recommendations are provided for vaccine type (live versus inactivated) and administration in relation to the therapy cycle, and are stratified by patient age (adult versus pediatric). Topics of discussion include the effects of age, duration, and type of systemic therapy in regards to response of patients to the influenza vaccine, as well as contraindications and precautions for immunization.

This is a clinical practice guideline on the identification and treatment of psychosocial problems in patients with cancer. The guideline discuss screening tools for distress, initial evaluation and treatment by the oncology team, psychological/psychiatric treatment by mental health professionals, social work and counselling services, and spiritual and chaplaincy care. Psychological/psychiatric treatment guidelines are reviewed. Special topics of interest include oncologist burnout.

This is a clinical practice guideline for patients with soft-tissue sarcoma (STS). The guideline examines the therapeutic decision-making processes used for the management of STS in order to improve patient care. Recommendations are provided for staging, diagnosis, and treatment.

This is a clinical practice guideline for cancer patients with community-acquired respiratory virus (CRV) infections. The guideline examines the diagnosis of CRV infections using virology and radiology techniques, as well as the management of CRV infection with infection control and supportive measures. Causal treatment is also discussed for influenza, respiratory syncytial virus (RSV), parainfluenza (PIV), adenovirus, human metapneumovirus (hMPV), rhinovirus, coronavirus, and others.

This is a clinical practice guideline for the prevention and treatment of cancer-associated venous thromboembolism (VTE). The guideline provides recommendations for the appropriate workup to search for occult malignancy in patients with idiopathic VTE, the identification of high-risk cancer patients for primary thromboprophylaxis, the appropriate immediate and long-term treatment for people with cancer diagnosed with acute thromboembolism, the appropriate duration of anticoagulation and the appropriate treatment strategy in patients with recurrent VTE on anticoagulation.

The guideline provides recommendations for management and treatment of patients 18 years of age and older who have malignant superior vena cava obstruction (SVCO) or airway obstruction, compression, or invasion, or those experiencing hemoptysis. The course of management is dependent on symptoms, primary histology, urgency of histology, previous treatment, and access to resources. External beam radiotherapy (EBRT), endobronchial brachytherapy, chemotherapy, radiotherapy, bronchoscopic debulking, surgical resection, photodynamic therapy, and Neodymium-doped yttrium aluminum garnet (Nd:YAG) are discussed as treatment options. For superior vena cava obstruction, external beam radiation EBRT, RT dose fractionation, SVC stent insertion, steroids, and palliative intent chemotherapy are discussed.

This is a clinical practice guideline for teleoncology models of care. Teleoncology seeks to offer solutions to some of the access issues faced by patients and health professionals from regional, rural and remote communities around the world. The focus of the guideline is shaped by a number of clinical questions that include: what teleoncology models of care are available to health services in Australia and overseas; what models of care for teleoncology are available to nursing services; what models of care for teleoncology are available to allied health services; is teleoncology as effective as standard oncology care for the screening of cancer; is teleoncology as effective as standard oncology care for the diagnosis of cancer; is teleoncology as effective as standard oncology care for the treatment of cancer; and is teleoncology as effective as standard oncology care for the palliative care of cancer patients.

This is a clinical practice guideline on the indications and methods for prophylaxis against Pneumocystis jirovecii pneumonia (PCP) in pediatric oncology patients undergoing treatment for solid malignancies. Recommendations are provided for the following patient populations: those receiving corticosteroids, temozolamide, or radiotherapy in combination with corticosteroids and/or chemotherapy, or rituximab in combination with other cancer treatments (e.g. chemotherapy, radiotherapy, corticosteroids), as well as those with underlying lung pathology or previous PCP.

This is a clinical practice guideline for antiemesis. The guideline examines emesis, types of nausea/vomiting (e.g., chemotherapy induced), antiemetic therapies, and treatment issues associated with antiemetic therapies.

These clinical practice guidelines for survivorship provide screening, evaluation, and treatment recommendations for common consequences of cancer and cancer treatment to aid health care professionals who work with survivors of adult-onset cancer in the post-treatment period, including those in specialty cancer survivor clinics and primary care practices. The guidelines focus on the vast and persistent impact both the diagnosis and treatment of cancer can have on the adult survivor’s health, physical and mental states, health behaviors, professional and personal identity, sexuality, and financial standing.

A guideline for the management of fluorouracil for treating solid tumours. The guideline examines the safe management of fluorouracil in medication pumps, and recommendations for treating and monitoring patients who have overdosed. Important aspects include specific dosing regimens, fluid administration calculations, and outpatient management.

This clinical practice guideline is for patients undergoing major abdominal surgery, including patients with cancer. The guideline provides recommendations for preoperative care before procedures such as colorectal surgery, gastrectomy, gastric bypass, hysterectomy, prostatectomy, and cystectomy, as well as other oncological, gynecological, and urological surgeries. Outcomes of interest include the prevention of surgical complications and reductions in hospital stays.

This is a clinical practice guideline for children aged 1 month to 18 years who are receiving chemotherapy. The guideline examines the management of chemotherapy-induced nausea and vomiting (CINV), including the treatment of breakthrough CINV and the prevention of refractory CINV. The primary outcome of interest is a decrease in the incidence of CINV.

This is a clinical practice guideline for adult men and women that have sexual function side effects as a result of cancer diagnoses and/or treatment. The guideline examines strategies/interventions to manage sexual function side effects with the aim of decreasing distress, and improving quality of life for cancer survivors and their partners. Both pharmacologic and non-pharmacologic interventions are discussed.

A clinical practice guideline for the use of palliative radiation therapy (RT) in adults with bone metastases. The guideline discusses the appropriateness of different fractionation schemes depending on clinical context, and examines the risks of experiencing long-term side-effects associated with single fractionation. The efficacy of advanced RT techniques for initial treatment and retreatment is also discussed, and the guideline examines the potential impacts that surgery, radionuclides, bisphosphonates, and kyphoplasty/vertebroplasty have on the appropriateness of palliative RT. Outcomes of interest include reductions in pain, spinal cord compression, hypercalcemia, and pathologic fracture.

This clinical practice guideline examines the impact of fertility drugs on the risk of cancer in women. The guideline looks at the association between use of fertility drugs and increased risk of developing invasive ovarian, breast, endometrial, colon and thyroid cancers as well as non-Hodgkin lymphoma and malignant melanoma. The association between fertility drugs and borderline ovarian tumours is also examined.

This is a clinical practice guideline for adults with cancer who may be considering cardiotoxic anticancer therapies. The guideline examines surveillance and monitoring approaches for cardiac dysfunction in survivors of adult-onset cancers, both during and after treatment. Determining which patients are at risk for developing cardiac dysfunction, and identifying strategies to minimize risk before and during the administration of potentially cardiotoxic therapy, are also discussed.

This is a clinical practice guideline for patients with advanced cancer and their caregivers. The guideline examines the integration of palliative care into standard oncology care, including the most practical models of palliative care, when and to who this care should be provided, and which palliative care interventions are helpful to caregivers. Outcomes of interest include quality of life, symptom relief, psychological outcomes, survival, and satisfaction.

This is a clinical practice guideline for survivors of childhood, adolescent, and young adult cancer who have received hematopoietic cell transplantation (HCT). Topics discussed include growth hormone deficiency, thyroid disease, gonadal function, obesity, dyslipidemia, diabetes, bone health, ocular toxicity, and ototoxicity. Neurocognitive, pulmonary, cardiovascular, renal, gastrointestinal, dental, dermatological, and immunologic impacts are also addressed.

This is a clinical practice guideline for the identification, prevention, and treatment of reversible elements of malnutrition in adult cancer patients. The specific objectives of this guideline are to improve early detection and treatment of malnutrition and metabolic derangements in cancer patients and cancer survivors; to provide guidance to health care workers and patients on the most appropriate and effective management of nutritional and metabolic problems in cancer patients; and, by this, to lower the incidence and impact of malnutrition and metabolic derangements in cancer patients and survivors. Topics considered include: effects of nutritional intervention during cytostatic and targeted therapies on treatment tolerance, response to treatment and overall survival, as well as effect of artificial nutrition on treatment tolerance, treatment completion, relapse rate and overall survival.

A clinical practice guideline for adult and pediatric patients with cancer, including hematological cancers and solid tumours. The guideline examines pneumococcal immunization in order to prevent secondary infections. Outcomes of interest include reduced pneumonial mortality and improved immunization scheduling.

This clinical practice guideline is for adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, who have been diagnosed with cancer. The guideline discusses issues specific to AYAs and recommends interventions unique to these patients. Topics include an overview of risk factors, screening, diagnosis, and special considerations for management of AYA patients such as adherence to treatment and fertility preservation, contraception for women during and after cancer treatment, and management of cancer during pregnancy. Psychosocial and behavioural issues, survivorship issues, and palliative and end-of-life care are also discussed.

This is a clinical practice guideline for smoking cessation in patients with cancer. The guideline emphasizes the importance of smoking cessation in all patients with cancer and seeks to establish evidence-based, standard of care recommendations tailored to the unique needs and concerns of patients with cancer. Treatment plans are provided that include recommendations that evaluate the merits of pharmacotherapy, behaviour therapy, and follow-up. The guideline developers acknowledge that smoking and nicotine addiction is a chronic relapsing disorder and as a result, the guideline also provides recommendations around retreatment and the management of relapse.

This is a clinical practice guideline for adult patients with cancer-induced anemia, with an emphasis on patients with anemia who are receiving concomitant chemotherapy. The guideline reviews etiology and provides recommendations on screening, follow-up risk assessment, and management. Red blood cell transfusion, erythropoietic therapy (ESA), and iron monitoring and supplementation are reviewed as treatment options.

This clinical practice guideline provides recommendations for evaluation, workup, management, and follow-up of 2 pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Diagnostic tests are recommended based on disease location and patient gender. Treatment options for disseminated or localized disease for adenocarcinoma and site-specific SCC are also discussed.

This is a clinical practice guideline for postoperative care in gynecologic/oncology surgery. The guideline reviewed existing evidence to make recommendations for elements of postoperative care. Postoperative care elements considered in the guideline include: preoperative medical optimization, bowel preparation, carbohydrate loading, thromboembolism prophylaxis, skin preparation, standard anesthetic protocol and intraoperative fluid management. This guideline is part 2 of 2 in the Enhanced Recovery After Surgery (ERAS®) Society Recommendations guidelines.

This clinical practice guideline provides an update to a key recommendation for the use of antiemetics for patients receiving cancer therapy. More specifically, the update focuses on recommendations regarding the use of netupitant and palonosetron (NEPA), a drug used for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of chemotherapy. Areas addressed in the guideline include: dosing information for NEPA and other antiemetics summarized in a table, as well as cost consideration for the use of NEPA.

This clinical practice guideline provides recommendations on the use of colony-stimulating factors (CSFs) in adults or children with a solid tumour or lymphoma who are being treated with chemotherapy. The guideline reviews indications for use of CSFs as primary or secondary prophylaxis, as well as initiation, duration, dosing, and administration. Other topics covered include the use of CSFs to increase chemotherapy dose density, and the role of CSFs as: adjuncts to progenitor-cell transplantation; in the setting of acute leukemia or myelodysplastic syndromes; and in the treatment of radiation injury. Outcomes of interest include neutropenia- and infection-related outcomes, survival (progression-free and overall survival), and outcomes related to stem-cell mobilization or transplantation.

This is a clinical practice guideline on the identification and treatment of psychosocial problems in patients with cancer. The guideline discusses screening tools for distress, initial evaluation and treatment by the oncology team, psychological/psychiatric treatment by mental health professionals, social work and counselling services, and spiritual and chaplaincy care. Psychological/psychiatric treatment guidelines are reviewed. Special topics of interest include oncologist burnout.

This is a clinical practice guideline for patients (children/adolescents and adults) who are experiencing cancer-related fatigue. The guideline discusses evaluation and intervention for patients on active treatment, post-treatment, and at end of life. Education and counselling, nonpharmacologic interventions, and pharmacologic interventions are all discussed along with general strategies for management of fatigue.

This clinical practice guideline provides recommendations for evaluation, workup, management, and follow-up of 2 pathologic diagnoses in patients with epithelial occult primary cancer: adenocarcinoma or carcinoma not otherwise specified (NOS), and squamous cell carcinoma (SCC). Diagnostic tests are recommended based on disease location and patient gender. Treatment options for disseminated or localized disease for adenocarcinoma and site-specific SCC are also discussed.

An organizational guideline for the processing and administration of chemotherapy to cancer patients. This guideline is an update to the 2013 guideline of the same title. The guideline examines the different stages and stakeholders in the chemotherapy treatment process, and the roles and responsibilities therein. Important aspects include accountability checks and staff safety procedures.

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.

A clinical practice guideline for patients with any type of cancer. The guideline examines the benefits of smoking cessation, and education for quitting once a patient has been diagnosed with cancer. Outcomes of interest include quality of life and treatment-related toxicity.

This clinical practice guideline discusses specific issues related to the management of cancer in adults aged 65 years or older. Topics include screening and comprehensive geriatric assessment (CGA), assessing risks and benefits of treatment, preventing or decreasing complications from therapy, and managing disease-specific issues. Recommendations are also provided for management of patients deemed to be at high risk for toxicity from standard treatment.

This clinical practice guideline is for adolescents and young adults (AYAs), defined as individuals aged 15 to 39 years, who have been diagnosed with cancer. The guideline discusses issues specific to AYAs and recommends interventions unique to these patients. Topics include an overview of risk factors, screening, diagnosis, and special considerations for management of AYA patients such as adherence to treatment and fertility preservation, contraception for women during and after cancer treatment, and management of cancer during pregnancy. Psychosocial and behavioural issues, survivorship issues, and palliative and end-of-life care are also discussed.

This is a clinical practice guideline for adult patients with cancer-induced anemia, with an emphasis on patients with anemia who are receiving concomitant chemotherapy. The guideline reviews etiology and provides recommendations on screening, follow-up risk assessment, and management. Red blood cell transfusion, erythropoietic therapy (ESA), and iron monitoring and supplementation are reviewed as treatment options.

This is a clinical practice guideline for the prevention and management of venous thromboembolism (VTE) in patients with cancer. The guideline also provides guidance on an approach to screening for cancer in patients with unprovoked VTE in whom cancer was not initially suspected based on clinical grounds. The guideline probes the association between cancer and thrombosis, with areas of interest including the prevention of catheter-related thrombosis, treatment of symptomatic cancer-associated VTE, and screening for cancer in patients with apparently unprovoked VTE.

This is a clinical practice guideline for children receiving chemotherapy or undergoing hematopoietic stem call transplantation (HSCT) for cancer. The guideline examines the effectiveness of prophylactic interventions for preventing or reducing the severity of oral and oropharyngeal mucositis in these patients. Interventions considered include cryotherapy, low-level light therapy and the use of keratinocyte growth factor (KGF).

This guideline addresses person-centred care for adults 18 years and older in Ontario using oncology services. The guideline discusses the importance of treating patients as individuals and provides recommendations on putting patients first and ensuring that essential requirements of care such as respect for the patient, patient concerns, nutrition, pain management and personal needs, patient independence, and consent and capacity, are met. Additionally, the guideline provides recommendations on tailoring healthcare service for each patient and enabling patients to actively participate in their care.

A clinical practice guideline for patients with solid and hematological malignancies undergoing antineoplastic treatment. The guideline examines risk-adapted approaches to viral infections, including reactivated viruses and seasonal viruses. Outcomes of interest include secondary complications, including bacterial pneumonia, and increased risk of contracting infections.

This is a clinical practice guideline for patients undergoing gynecologic/oncology surgery. The guideline examines supporting pre- and intra-operative management of surgery, including counselling, pre-operative bowel preparations, and the importance of minimally invasive surgery. Outcomes of interest include improving surgical outcomes with readmission optimization and reducing length of hospital stay. This guideline is part 1 of 2 in the Enhanced Recovery After Surgery (ERAS®) Society Recommendations guidelines.

This is a clinical practice guideline for adult and pediatric patients with solid tumours or hematologic cancers. The guideline provides recommendations on influenza immunization including immunization interval and dosage, type of vaccine (activated versus inactive), and timing of administration in relation to the cancer treatment cycle. Special topics of interest include immunization of patients undergoing blood and marrow transplant (BMT, autologous and allogeneic), as well as immunization of family members and hospital or clinic staff who are in contact with cancer patients.

This is a clinical practice guideline for the screening, assessment and management of cancer-related fatigue in adults. The guideline examines the efficacy of interventions (pharmacological, non-pharmacological, and/or combinations) for reducing cancer-related fatigue in adults and comparisons are made to usual care and attention control. Outcomes of interest include clinically significant improvement in fatigue or clinically significant reduction in cancer-related fatigue (measured by severity) or differences in fatigue severity between intervention group and controls using self-reported outcome measures.

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 guideline provides recommendations on the use of advanced practice nurses (APNs) to optimize patient, provider, and health system outcomes across the cancer care continuum. Specifically, the guideline reviews patient populations and situations (types of needs, practice settings, phase of the cancer care continuum) for which APN roles have demonstrated equivalent or improved outcomes, or reduced harms in cancer care. Outcomes of interest include quality of life, physical, functional, psychosocial, and mental health, as well as morbidity, mortality, symptom management, patient and provider satisfaction, health care utilization, costs, and quality of care.

This clinical practice guideline provides recommendations on assessment and management of cancer pain in adult patients, including pain in adult cancer survivors. Pathophysiologic classification of cancer pain syndromes is reviewed, and recommendations are provided for pain assessment, management/intervention, and reassessment. Both pharmacologic and non-pharmacologic interventions are discussed.

This clinical practice guideline provides recommendations on exercise for adult patients living with cancer (including those on active treatment and who have completed treatment). Benefits of specific types of exercise are considered along with safety concerns, and recommendations are provided for delivery models and exercise regimens for patients living with cancer at different points in the cancer journey, as well as pre-screening requirements for new referrals. Outcomes of interest include quality of life, safety, and muscular and aerobic fitness.

This is a clinical practice guideline for adult women (18 years and older) either without breast cancer or with a recent diagnosis of breast cancer, who have a family history of breast, ovarian or a related cancer; the guideline also provides recommendations for men affected by male breast cancer. The guideline discusses oncogenetic testing aspects of breast cancer and ovarian, specifically hereditary breast cancer, the Li-Fraumeni syndrome, and the Cowden syndrome. Topics include criteria and indications for genetic testing, tests for which genes have clinical utility, and appropriate follow-up depending on results and family history.

This is a clinical practice guideline for patients at risk of Birt-Hogge-Dubé Syndrome, the familial atypical multiple mole melanoma syndrome and neurofibromatosis 1&2, either based on clinical suspicion or family history. The guideline reviews indications for genetic testing, clinical utility of specific genetic tests, and follow-up depending on test results and family history. Impact of genetic counselling and test on patient behaviour and distress levels is also reviewed.

This guideline is an update to "Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update" (2013). The guideline is for cancer patients who may be at risk for venous thromboembolism (VTE), and provides recommendations on prophylaxis and the treatment of VTE in the outpatient, inpatient, and perioperative settings. Interventions considered include mechanical and pharmacologic thromboprophylaxis and patient education. The role of inferior vena cava (IVC) filters is also discussed. Outcomes of interest include symptomatic and asymptomatic thrombotic events found on screening, major and minor bleeding, mortality (early and overall), sudden death, and adverse events.

This is a clinical practice guideline on the hyperinflammatory syndrome hemophagocytic lymphohistiocytosis (HLH). As the developers state, HLH can occur in the context of malignancies and malignancy-triggered HLH should be regarded separately from HLH during chemotherapeutic treatment, which is frequently associated with an infectious trigger. Because the overlap between the features of HLH and the features of neoplasms makes it difficult to identify HLH when it occurs in malignant conditions, the guideline developers focus their recommendations on the recognition and diagnostic workup, as well as the treatment of malignancy-associated HLH.

This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. The guideline provides recommendations on implementation of the brief tobacco intervention, using the evidence-based 5 A’s model (ASK, ADVISE, ASSESS, ASSIST, ARRANGE) which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes. The impact of tobacco use on cancer treatment is also reviewed with a specific focus on erlotinib and irinotecan.

This is a clinical practice guideline for smoking cessation in patients with cancer. These guidelines emphasize the importance of smoking cessation in all patients with cancer and seek to establish evidence-based, standard of care recommendations tailored to the unique needs and concerns of patients with cancer. These guidelines provide treatment plans that include recommendations that evaluate the merits of pharmacotherapy, behaviour therapy, and follow-up. The guideline developers acknowledge that smoking and nicotine addiction is a chronic relapsing disorder and as a result, the guideline also provides recommendations around retreatment and the management of relapse.

This is a clinical practice guideline for the use of myeloid growth factors in adult patients with solid tumours and non-myeloid malignancies. Benefits and risks are reviewed, the role of biosimilars is discussed, and recommendations are provided for prophylactic and therapeutic uses of both granulocyte and granulocyte-macrophage colony stimulating factors (CSFs). Recommendations are also given regarding the use of CSFs in the hematopoietic cell transplant setting. Outcomes of interest include efficacy of CSFs, mortality, length of hospitalization,, toxicity, and adverse effects.

This is a clinical practice guideline for patients with recurrent spinal metastasis resulting in metastatic epidural spinal cord compression. The guideline examines the appropriateness of various treatment options including systemic therapy, surgical intervention, radiation therapy, osteoclast inhibitors and hospice care. The appropriateness of different techniques for unique clinical situations is discussed. Outcomes of interest include neurologic status, performance status, extent of disease, spine stability and life expectancy.

This is a clinical practice guideline for patients of all age groups suspected of having cancers including lung and pleural, upper gastro-intestinal, lower gastrointestinal, breast, gynecological, urological, skin, head and neck, brain and central nervous system, haematological, sarcomas, and childhood cancers. Recommendations are provided on recognition and referral or investigations of cancer in primary care. Outcomes of interest include quality of life, sensitivity and specificity of diagnostic tests and signs/symptoms, positive and negative predictive values of diagnostic tests and signs/symptoms, and cost effectiveness.

This is a clinical practice guideline for patients diagnosed with or at risk of hereditary gastrointestinal cancer syndromes including lynch syndrome, familial adenomatous polyposis (FAP), attenuated familial adenomatous polyposis (AFAP), MUTYH-associated polyposis (MAP), Peutz–Jeghers syndrome, juvenile polyposis syndrome, Cowden syndrome, serrated (hyperplastic) polyposis syndrome, hereditary pancreatic cancer, and hereditary gastric cancer. The guideline reviews initial assessment, genetic testing for a germline mutation when indicated, pre- and post-test genetic counselling, and management of patients who meet clinical criteria for a syndrome as well as those with identified pathogenic germline mutations. Outcomes of interest include cancer risk, quality of life, and survival benefit from surveillance.

A clinical practice guideline for cancer patients. The guideline examines the screening, diagnosis, and management of depression in patients with major depressive disorder or who have a suspected depressive disorder. Outcomes of interest include improved health outcomes and reduced adverse events.

A clinical practice guideline for the screening, assessment and management of psychosocial distress, depression and anxiety in adults with cancer. The guideline examines appropriate clinical intervals for psychosocial screening, contributing factors, and interdisciplinary care. Outcomes of interest include improvement in cancer-related worry and reduced post traumatic stress.

These clinical practice guidelines for survivorship provide screening, evaluation, and treatment recommendations for common consequences of cancer and cancer treatment to aid health-care professionals who work with survivors of adult-onset cancer in the post-treatment period, including those in specialty cancer survivor clinics and primary care practices. The guidelines focus on the vast and persistent impact both the diagnosis and treatment of cancer can have on the adult survivor’s health, physical and mental states, health behaviours, professional and personal identity, sexuality, and financial standing.

The purpose of this clinical practice guideline is to provide guidance to the primary oncology team so as to help ensure each patient within their care experiences the best quality of life possible throughout the illness trajectory. The guideline was developed to facilitate the appropriate integration of palliative care into oncology practice. The guideline outlines procedure for screening, assessment, palliative care interventions, reassessment, and after-death care. The panel initially focused on the needs of patients in their last 12 months of life. More recent versions, however, have expanded the focus to all patients and family experiencing cancer throughout the disease trajectory.