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with fundraising events or displaying awareness posters. See the link for an awareness pack: Bowel Cancer Australia bowelcanceraustralia. org/bowel-cancer-awareness-month References 1. Australian Institute of Health and Welfare, 2018. ‘Colorectal and other digestive-tract cancers’. Cancer series no. 114. Cat no CAN 117. Canberra: AIHW. 2. Brown KG, et al. ‘Management of colorectal cancer’. BMJ, 2019; l4561. 3. Dekker E, et al. ‘Colorectal cancer’. Lancet, 2019; 394: 1467-1480. 4. Australian Government, Cancer Australia. ‘Colorectal cancer statistics’. bowel- cancer.canceraustralia.gov.au/statistics Updated 26/8/19. Cited April 2020 5. Eleonora F, et al. ‘Trends in colon and rectal cancer incidence in Australia from 1982 to 2014: Analysis of data on over 375,000 cases’. Cancer Epidemiol Biomarkers Prev, 2019; 28 (1): 83-90. 6. Jenkins M, et al. ‘Revised Australia guidelines for colorectal cancer screening: Family history’. MJA, 2018; 209 (10): 455-460. 7. Australian Institute of Health and Welfare, 2017. ‘Cancer in Australia 2017’. Cancer series no.101. Cat. no. CAN 100. Canberra: AIHW. 8. Macrae F, et al. ‘Colorectal cancer: Epidemiology, risk factors, and protective factors’. In: UpToDate, Tanabe K. (Ed), UpToDate, Waltham, MA. Updated Feb 2020. Cited Mar 2020. 9. Macrae F, et al. Clinical presentation. Diagnoses and staging of colorectal cancer. In: UpToDate, Savarese D (Ed), UpToDate, Waltham, MA. Updated Jan 2020. Cited Mar 2020. 10.Luck A, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party COL1-2a-b: What is the optimal approach to resection of colorectal cancers? (a: colon) \[Version URL: wiki.cancer.org.au/australiawiki/index.php?oldid=173082, cited April 2020\]. 11. Heriot A, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. COL1-2a-b: What is the optimal approach to resection of colorectal cancers? (b: rectal) \[Version URL: wiki.cancer.org.au/australiawiki/index. php?oldid=173083, cited April 2020\]. 12.eviQ Cancer Treatments Online 2020, Cancer Institute NSW, viewed April 2020, eviq.org.au/ 13.Gibbs P, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. \[Version URL: wiki.cancer.org.au/australiawiki/index.php?oldid=173091, cited April 2020\]. 14.Grothey A, et al. ‘Duration of adjuvant chemotherapy for stage III colon cancer’. N Engl J Med, 2018; 378: 1177-88. 15.Therapeutic Goods Administration. Product information for AusPAR Bevacizumab Avastin, Aug 2012 \[cited April 2020\]. Sponsored by Roche Products Pty Ltd. tga.gov.au/sites/default/files/auspar-bevacizumab-120806.pdf 16.Bevacizumab Drug Monograph. Greenwood Village, Colorado, US: Truven Health Analytics. Available from: micromedexsolutions.com/home/dispatch/ssl/ true. Updated Jan 2020. Accessed April 2020. 17. Cetuximab Drug Monograph. Greenwood Village (CO): Truven Health Analytics. Available from: micromedexsolutions.com/home/dispatch/ssl/true. Updated Dec 2019. Accessed April 2020. 18.Panitumumab Drug Monograph. Greenwood Village (CO): Truven Health Analytics. Available from: micromedexsolutions.com/home/dispatch/ssl/true. Updated Dec 2019. Accessed April 2020. 19. Nott L, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. \[Version URL: wiki.cancer.org.au/australiawiki/index.php?oldid=173114, cited Apr 2020\]. 20. Macrae F, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. \[Version URL: wiki.cancer.org.au/australiawiki/index. php?oldid=173036, cited April 2020\]. 21.National Health and Medical Research Council. Nutrient Reference Values for Australia and New Zealand. nrv.gov.au/nutrients/dietary-fibre. Updated 9/3/19. Cited Mar 2020. 22. Macrae F, et al. Cancer Council Australia Colorectal Cancer Guidelines Working Party. PPR1: What is the risk-benefit ratio for use of aspirin for prevention of colorectal cancer stratified by risk of colorectal cancer itself? (What is the optimal dose and frequency of administration?) \[Version URL: wiki.cancer.org.au/ australiawiki/index.php?oldid=196954, cited April 2020\]. 23. Van Blarigan EL, et al. ‘Association of survival with adherence to the American Cancer Society Nutrition and Physical Activity Guidelines for cancer survivors after diagnosis. JAMA Oncol, 2018; 10.1001/jamaoncol.2018.0126. Accreditation Number: A2106RP2 (exp: 31/05/2023). This activity has been accredited for 1 hour of Group One CPD (or 1 CPD credit) suitable for inclusion in an individual pharmacist’s CPD plan, which may be converted to 1 hour of Group Two CPD (or 2 CPD credits) upon successful completion of the associated assessment activity. 1. Geoff is 51 years old, an “on and off smoker”, obese, has hypertension and gout. He presents a prescription for colchicine and you explain the need to cease treatment if diarrhoea develops. Geoff then explains he has had loose motions on and off for a couple of months, seemingly without cause. What is the most common symptom of colorectal cancer? A) Changes in bowel habit. B) Fatigue. C) Weight loss. D) Melaena. E) None of the above. 2. You suggest Geoff revisits the GP to discuss the change in bowel habit. He returns to your pharmacy three weeks later having had a colonoscopy procedure which was not completed as there is a large tumour in the rectum. He is undergoing neoadjuvant therapy. What will this consist of? A) Aspirin 300mg daily. B) Two chemotherapy agents as the backbone and a monoclonal antibody. C) Cetuximab only. D) Radiation and a fluoropyrimidine. E) Capecitabine. 3. Susan is 55 years old. She has colon cancer and had surgery six weeks ago with resection of the main tumour and lymph nodes from her colon. She recovered well and does not have a stoma, which was her main worry. She is to start chemotherapy next week but can’t understand why she must have chemotherapy, as all the cancer was removed. Why does she require a course of chemotherapy? A) Just for good measure. B) To remove any circulating cancer cells, micro-metastases and reduce the risk of distant recurrence. C) She must have metastatic disease. D) She is in the average risk age group, being 55 years old. 4. Arthur has become a notable presence in the pharmacy often on a weekly basis, having jokes with the pharmacy team. His lovely wife provides cakes and biscuits around times of celebration. He laughs with your staff as he recounts a story of receiving a test kit in the post for bowel cancer screening. He describes promptly throwing it in the bin as the thought of “posting poo” was ridiculous. You take Arthur aside on another occasion, and: A) Advise bowel cancer screening is not necessary unless you have heart disease. B) Advise that bowel cancer screening is only recommended every 20 years after the age of 55. C) Discuss the benefits and risks of bowel cancer screening. D) Explain he needs to opt off the bowel screening program. 5. Geoff returns to your pharmacy and he is struggling. He shows you his hands, which are red, puffy and painful. He is four weeks into his neoadjuvant treatment and taking oral chemotherapy. You recognise it as hand-foot syndrome and offer urea 10 per cent cream and a trial of regular paracetamol. Which part of his neoadjuvant therapy is causing this side effect? A) Radiation. B) Cetuximab. C) Fluoropyrimidine. D) 5-Fluorouraci. E) Oxaliplatin. CPD ACTIVITY 53 Colorectal cancer 2 CPD CREDITS RETAIL PHARMACY • JUN 2021