Cancer Guidelines Database

This is a clinical practice guideline for adults with suspected or confirmed pancreatic adenocarcinoma. The guideline provides recommendations for the diagnosis and staging of these patients, as well as treatment options based on disease stage. Specific recommendations are provided based on whether the patient has potentially curable pancreatic adenocarcinoma, or unresectable pancreatic adenocarcinoma, with the latter including chemotherapy, the removal of biliary obstructions, and palliative approaches.

This is a clinical practice guideline for adults who have been diagnosed with metastatic colorectal cancer. The guideline provides recommendations on the treatment of these patients for the purposes of improving quality of life and/or prolonging life, if possible. Multiple palliative chemotherapy regimens are discussed, as are recommendations for resecting lung and liver metastases.

This is a clinical practice guideline on self-expandable metal stents for patients with colonic or extracolonic cancer. The guideline specifically applies to patients with left-sided colon cancer arising from the rectosigmoid colon, sigmoid colon, descending colon, or splenic flexure and not those with rectal cancers or cancers proximal to the splenic flexure. Various aspects of colonic stenting are discussed, including technical considerations, colonic stenting as a bridge to elective surgery, palliative colonic stenting, and adverse events.

This is a clinical practice guideline for adults with advanced colorectal cancer. The guideline aims to improve the quality of life for these patients by integrating an early palliative care approach into advanced cancer care. The indications for the need to apply an early, integrated palliative approach, and the essential components of such care, are specifically addressed.

This is a clinical practice guideline for adults with esophageal cancer, including both squamous cell esophageal cancer and adenocarcinoma. The guideline provides recommendations for the diagnosis and staging of these patients, as well as treatment options based on disease stage. The treatment of potentially curable esophageal cancer, as well as palliative approaches to incurable esophageal cancer, are specifically discussed.

This is a clinical practice guideline for adults who have been diagnosed with locally advanced/metastatic bladder cancer (i.e. T4bNxM0, TxN2-3M0, TxNxM1). The guideline provides recommendations for staging of these patients, as well as treatment and follow-up options based on disease stage. Treatment modalities discussed include surgery, systemic therapy, and radiotherapy. For patients with metastatic cancer, palliative approaches 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 is a clinical practice guideline for patients with metastatic pancreatic adenocarcinoma. The guideline examines therapy options after first-line treatment in these patients. Specific topics of interest include initial patient assessment, palliative care, treatment of pain and/or symptoms, as well as follow-up and surveillance strategies.

This is a clinical practice guideline for patients aged 15-39 years who have been diagnosed with cancer. The guideline discusses screening and assessment strategies, access and participation in clinical trials, as well as approaches to treatment in this patient population. Additional topics addressed include the facilitation of psychosocial care, survivorship care planning, and the optimization of palliative care.

This is a clinical practice guideline for patients with non-small cell or small cell lung cancer. The guideline provides recommendations on diagnosis, management, follow-up, and palliative care for these patients. Outcomes of interest include length of stay in hospital and intensive care units, quality of life, and overall survival.

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 provides recommendations for the management of gastric cancer across most components of the cancer care continuum. Topics of discussion include risk factors for stomach cancer, indicated diagnostic tests, staging criteria, recommended treatment options for each stage (including palliative radiation therapy and chemotherapy), and recommended surveillance methods for follow-up. 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 physicians who work on the prevention and treatment of colorectal cancer in the ambulatory and inpatient sector. The guideline provides recommendations for prevention, screening in asymptomatic populations as well as high risk populations, the role of endoscopy in the diagnosis of polyps and colorectal cancer, pre-operative diagnostics and surgery, adjuvant and neoadjuvant therapy, management of patients with metastases, palliative care and follow-up care.

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 diagnosed with pancreatic adenocarcinoma. The main focus of the guideline is on adjuvant therapy for these patients who have undergone an R0 or R1 resection of their primary tumour, however the guideline also examines the general management of pancreatic cancer patients including initial assessment before therapy, which patients should be offered a potentially curative strategy with resection, when palliative care services should be initiated, and the frequency of follow-up care/surveillance.

This is a clinical practice guideline for patients with advanced colorectal cancer. The guideline aims to improve the quality of life for these patients by integrating an early palliative care approach into advanced cancer care. Topics of interest include illness comprehension and coping, symptoms and functional status, advance care planning as well as patient's preferred method of decision making, and coordination of care.

This is a clinical practice guideline for patients with muscle-invasive bladder cancer. The guideline examines the diagnosis, staging, treatment, follow-up, supportive care, and palliative care for these patients. Treatment methods discussed include chemotherapy, surgical management and radiotherapy. Cystectomy pathology, as well as unresectable and oligometastatic disease are also addressed.

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 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 patients with pancreatic adenocarcinoma. The guideline examines risk factors and genetic predisposition, pancreatic cancer screening, diagnosis and staging, systemic therapy approaches, radiation and chemoradiation approaches, surveillance of patients with resected disease, as well as palliative and supportive care. Management of metastatic disease, locally advanced disease, resectable and borderline resectable disease, and recurrent disease after resection is also considered.

This is a clinical practice guideline for patients aged 16 or older who have primary brain tumours or brain metastases. Specifically, the guideline examines the diagnoses and management of radiologically identified glioma, meningioma, and brain metastases. Follow-up care after treatment and supportive care are also discussed, and additional recommendations are provided on the referral of adults with primary brain tumours or brain metastases for neurological rehabilitation assessment.

This is a clinical practice guideline for the management of soft tissue sarcoma (STS) in adult patients. The guideline pertains to the following five subtypes of STS: (1) STS of extremity, superficial/trunk, or head and neck, (2) retroperitoneal or intra-abdominal STS, (3) gastrointestinal stromal tumours (GISTs), (4) desmoid tumours, and (5) rhabdomyosarcoma (RMS). The guideline provides recommendations for diagnosis, staging, treatment, palliative care, and surveillance. Surgery, chemotherapy, and radiotherapy are all examined as treatment options.

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 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 symptomatic endobronchial disease in non-small cell lung cancer. The guideline examines the use of high dose rate endobronchial brachytherapy (HDREB) for the palliation of respiratory symptoms in these patients. Specific topics discussed include the appropriate dose of HDREB, toxicity, and fatal hemoptysis.

This is a clinical practice guideline for the management of soft tissue sarcoma (STS) in adult patients. The guideline pertains to the following five subtypes of STS: (1) STS of extremity, superficial/trunk, or head and neck, (2) retroperitoneal or intra-abdominal STS, (3) gastrointestinal stromal tumours (GISTs), (4) desmoid tumours, and (5) rhabdomyosarcoma (RMS). The guideline provides recommendations for diagnosis, staging, treatment, palliative care, and surveillance. Surgery, chemotherapy, and radiotherapy are all examined as treatment options.

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 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 with pancreatic adenocarcinoma. The guideline examines risk factors and genetic predisposition, pancreatic cancer screening, diagnosis and staging, systemic therapy approaches, radiation and chemoradiation approaches, surveillance of patients with resected disease, as well as palliative and supportive care. Management of metastatic disease, locally advanced disease, resectable and borderline resectable disease, and recurrent disease after resection is also considered.

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 management of muscle-invasive and metastatic bladder cancer. The guideline provides recommendations on prevention, staging, imaging, diagnosis, treatment, and follow-up. Treatment options such as neoadjuvant chemotherapy, radiotherapy, and radical surgery are discussed. Other topics of interest include risk factors, comorbidities, quality of life, and pelvic organ preservation techniques.

This is a provisional clinical opinion (PCO) for chemotherapy-naive men with castration-resistant prostate cancer (CRPC). This PCO examines second-line hormonal therapy and provides recommendations on staging, treatment, follow-up, and palliative care for men with CRPC. Outcomes of interest include overall survival, adverse events, quality of life, and treatment efficacy (defined as response in prostate-specific antigen values).

This is a clinical practice guideline for the management of patients with advanced breast cancer (ABC), including those with locally advanced breast cancer (LABC) and metastatic breast cancer (MBC). The guideline provides recommendations for the management of these patients, and specifically discusses the use of chemotherapy, management of bone metastases, management of cancer related fatigue, as well as supportive and palliative care.

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 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 patients who have received initial treatment for chordomas, who are at risk for loco-regional recurrence. The guideline provides recommendations for pre-treatment assessment, resection of recurrent or progressive disease, radiotherapy of recurrence, other local therapies, follow-up, as well as for palliative, supportive and end-of-life care. Outcomes of interest include quality of life, recurrence-free survival, and overall survival.

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.

A clinical practice guideline for the treatment of small cell and non-small cell lung cancer. The guideline examines treatment options for multiple stages of these two cancer modalities, including surgical and non-surgical procedures. Palliative, supportive, and psychological care for lung cancer patients are also discussed. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of April 23, 2018.

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 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 clinical practice guideline discusses evaluation, treatment (primary and secondary) options, and follow-up care for patients with bladder cancer. Specific workup and treatment recommendations are provided for non-muscle invasive disease, muscle invasive disease, upper genitourinary tract (GU) tumours, urothelial carcinomas of the prostate, and primary carcinoma of the urethra. Non-urothelial carcinomas of the bladder are also discussed.

This is a clinical practice guideline for patients with colon cancer or adenocarcinomas of the small bowel and appendix. The guideline reviews staging, pathology, clinical presentation and treatment of nonmetastatic disease, management of metastatic disease, post-treatment surveillance, and survivorship. The role of vitamin D in colorectal cancer is also discussed.

This clinical practice guideline reviews workup, staging, and treatment for both noninvasive and invasive breast cancer. Special considerations include phyllodes tumor, Paget's disease, breast cancer during pregnancy, and inflammatory breast cancer. Treatment recommendations for invasive cancer are stratified by tumor receptor status and stage. Fertility and birth control is also discussed.

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 palliative oncology patients 18 years of age or older with low grade/ low volume/ malignancy-associated urogenital or gastrointestinal bleeding, or with malignant gastrointestinal obstruction, compression or invasion. External beam radiotherapy (EBRT) with or without , brachytherapy, stent placement, and surgical bypass are discussed as therapeutic options. Outcomes of interest include clinical improvement of symptoms, quality of life, and survival.

This is a clinical practice guideline for women diagnosed with invasive cervical cancer. The guideline examines the most effective antitumour and palliative care interventions for clinicians and planners. Treatment options that are discussed include cone biopsy, extrafascial hysterectomy, modified radical or radical hysterectomy, and combinations of surgery, chemotherapy, and radiation therapy.

This is a clinical practice guideline for patients with epithelial ovarian cancer including fallopian tube cancer and primary peritoneal cancer. Less common histopathologies including ovarian low malignant potential (LMP) tumor, malignant germ cell neoplasms, carcinosarcomas (malignant mixed Müllerian tumors [MMMTs] of the ovary), and malignant sex cord-stromal tumors, are also discussed. The guideline provides recommendations on diagnosis, treatment, follow-up, and relapse. Primary treatment options for ovarian cancer include surgery (risk-reducing or cytoreductive), chemotherapy (neoadjuvant and adjuvant), incomplete surgery and/or staging, anti-angiogenesis agents, and radiation therapy. The number of chemotherapy cycles and agents are reviewed, along with drug reactions.

A clinical practice guideline for patients with bone metastases and spinal compression as common causes of cancer-related pain. The guideline examines radiotherapy and prophylactic steroids to reduce pain and pain flares. Outcomes of interest include improved neurological outcomes, survival, and reduced functional interference.

This is a clinical practice guideline for patients with squamous cell carcinoma (SCC) of the penis. The guideline reviews risk factors and clinical presentation, and provides recommendations for clinical staging, management of primary legions, management of regional lymph nodes, surveillance, and management of metastatic disease. Surgery, radiotherapy, and chemotherapy are reviewed as treatment options.

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.

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 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.

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 clinical practice guideline provides recommendations on esophageal and esophagogastric junction (EGJ) cancers, including: a review of hereditary cancer predisposition syndromes associated with increased risk for esophageal and EGJ cancers, staging and pathology, imaging, and treatment including surgery, radiation therapy, combined modality therapy, chemotherapy, and targeted therapies. Surveillance, management of metastatic, or recurrent cancer, and best supportive care are also discussed. Special topics of interest include treatment and surveillance options for patients with Barrett's esophagus, and suggested strategies to help alleviate the current problems associated with leucovorin shortage.

This is a clinical practice guideline for patients over 18 years of age with esophageal cancer, including both squamous cell and adenocarcinoma. The guideline provides recommendations on diagnostic work-up, staging, treatment options for potentially curable cancer stratified by stage, and management options for incurable cancer. Esophagectomy, endoscopic therapy, primary chemoradiotherapy, radiotherapy, pre-operative chemoradiotherapy followed by esophagectomy and pre-operative chemotherapy are discussed, as well as supportive care. Outcomes of interest include survival (overall, progression-free, 5-year), morbidity, toxicity, and rate of sudden death.

This is a clinical practice guideline addressing lymphoma in the adult population. The guideline focuses on diagnosis and pathology, staging, and treatment of Non-Hodgkin Lymphomas, Hodgkin Lymphoma, HDCT and hematopoietic stem cell transplantation for lymphoma. Supportive and follow-up care is also addressed. The guideline updates the 2015 guideline of the same title.

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 clinical practice guideline reviews diagnosis and management of adenocarcinomas of the exocrine pancreas. Risk factors and genetic predisposition are discussed, and the guideline provides recommendations on screening, diagnosis and staging, and treatment options including systemic therapy, chemoradiation, and surgical management. Palliative and supportive care are also reviewed. Topics of interest include an overview of biomarkers, and suggestions for management of premalignant tumours of the pancreas.