oncology pharmacy, what is it like?

[iphetamine]

I want to know what is it like to be a specialized pharmacist? I'm mostly interested in oncology as a science, but of course don't know what's it like to be an oncology specialist. Obviously it's not a prestigious as an oncologist and probably not as rewarding.

FYI i'm in Canada so I'm not really looking for employment opportunities in the US...it's a general discussion.

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[croquemonsieur]

It's not prestigious at all, really. You check to see if patients are on reasonable regimens of chemo, anti-emetics, growth factors, etc. A lot of sitting at a computer, reading medical records in the shadows. The places I rotated, the pharmacist was always on the phone with charitable organizations trying to get financial assistance for patients; a lot of the job is administrative work. If you work at an infusion center, sometimes nurses ask you how to deal with a potential extravasation and you read the protocol to them (although they probably know it better than you do). It's possible you'll counsel patients who are starting new regimens. It's not much different from other "clinical" jobs.

 

[FarmerE]

Depends on what you find rewarding, I guess. I think being an oncologist would be rough...get more attached to patients and see the effects of the disease/drugs more closely. As a pharmacist, I feel like I'm able to help these patients be cured or live the best life possible until the disease wins, without the close relationship that would tear me up inside. Lessons learned the hard way, trust me.

Clinical inpatient oncology (not including BMT, I've never done that)--lots of patient monitoring (not just oncologic but also other co-morbid conditions), counseling on chemo, checking/double checking inpatient chemo regimens etc. People with cancer still have other diseases too, so you have to know more than just oncology.

Outpatient infusion oncology--checking of chemo mixtures, checking labs and dose verification before mixing, chemo counseling with patients, drug info questions from providers, premed tweaking, etc. Many outpatient centers are doing oral chemo counseling clinics now, too.

Unfortunately a cure for cancer is a long way off; fortunately for oncology pharmacists that means job security.

 

[Gosondth]

Agree with above.

If the clinic is a smaller one, oncologists may ask about uncommon 3rd/4th line therapies, therapies outside of his/her subspecialty, and relatively off-label drug questions that cannot be commonly found in up-to-date. To keep the clinic process smooth (since there is not an effective emr in place), I have also had to re-evaluate and build out preformatted paper chemo orders to keep everything clear for physicians (dosing/schedule), nurses (order of administration/rate), and pharmacy (compatibility/antiemetics/anti-infusion rxns).

Due to the highly proliferative nature of new oncologic discoveries, it's hard for any one health care provider to know all the information for all therapies. Pharmacy can bridge that knowledge gap and build an effective niche practice.

 

[RedheadRPh]

Agree with the above posters. I am an oncology consultant pharmacist and I work in an outpatient hospital based clinic. There are about 16 of us that verify chemo regimens, associated pre-meds, and check for interactions with home meds.

The pharmacists don't ever mix, which is fine by me as I haven't mixed chemo in a while. We do have the opportunity to counsel on new start oral treatments (more common than counseling the IV patients) and we do answer a lot of questions from the docs. It really is a collaborative effort between the MDs, nurses and the pharmacists here. When I catch an error, it gives me tremendous job satisfaction.

As FarmerE stated, I am not as affected by the patients dying as the nurses might be as I don't have as close a relationship with the patients as they do. I have also learned to deal with death better given what I have seen in my various positions over the years, but I have never lost my compassion for the patients and their families.

 

[Quiksilver]

I find it very rewarding and get connected to my patients. I work in an outpatient connected to a hospital and handle issues for both practice sites. We manage pts in the hospital with oncologic related issues... febrile neutropenia, tumor lysis, hypercalcemia, etc.

My job works vertically, basically from billing and ordering up through mixing and dispensing through administrative duties and policy and representing pharmacy for oncologic topics. Patient and staff education (from nurses through providers). We mix, we monitor, we counsel, we recommend supportive regimens and tweaking such (N/V/D/C, pain, neutropenia/infection, electrolytes, etc.). We also are involved slightly in regimen selection (usually comparing contrasting one agent to another). In short, theres nothing we dont do from a pharmacists point of view that would be different from any other practice site. Our unique skill set in an general hospital setting allows us a bit more utility then what would likely be in a major cancer center.

In my opinion and my experience, you can choose to do the minimum or you can find a way to expand and get some satisfaction from your job.

 

[iphetamine]

Is there an online oncology course I could take?

What can I do/take if I want to get into Clinical Research/Data coordination in a cancer center?

 

[FarmerE]

Is there an online oncology course I could take?

What can I do/take if I want to get into Clinical Research/Data coordination in a cancer center?

There's not really an online course you can take that I'm aware of. Oncology is like this whole other world...what you learn in pharmacy school really only skims the surface. And by the time you graduate there's a good chance a lot of that info has changed anyway. Your best bet would be to order the BCOP study materials as a starting point, or to try to get into a PGY2 Oncology residency. Qualifications for the exam (if you wanted to take it eventually) are an Oncology PGY2 + 1 year of practice in an oncology setting, or 4 years of at least 50% time practicing in an oncology setting. Depending on where you are now in your career, it could be hard to get a foot in the door for oncology, but nothing is impossible.

I have no idea how you would go about getting into research/data coordination, hopefully someone else may be able to help.

 

[hurx]

I had a rotation with an inpatient oncology pharmacist. She had been there well over 10 years and had become somewhat familiar with the patients that were receiving chemotherapy. She would go over their previous regimens and their labs to see if anything had changed (weight, kidney function, neutrophils, anything that might affect their dose or their eligibility to receive the chemo) and then let the MD know what the dose should be. She also had to take into account how emetogenic the regimen was and the patient's history of chemo induced nausea/vomiting to decide what prophylactic measures needed to be taken.

If they had not received their chemo at that hospital before she would have to call the hospital or doctor's office they had been to before so she could get the pertinent lab information and know what doses were used.

Oncology is a very quickly growing and changing field. She was always reading new chemo studies in order to stay current, but there is so much new information that it is impossible to keep up with them all. At that hospital the pharmacists had their students counseling the patients so I very rarely saw them have patient interaction but I'm sure they did earlier on in their careers or during times when they had no students. She worked very closely with the MDs regarding the patients' regimens and any concerns she may have had. There were times that she had to educate the nurses on a chemo medication that was rarely used at that hospital so they would know how to infuse, what side effects to look out for, etc. They were very familiar with regular chemo medications on the formulary. However, there was no protocol for which drugs needed to be handled with caution (i.e. wearing gloves when holding the medication) so she was working on a system to inform them so that they would be safe (in the meantime she would just verbally tell the nurses who were assigned to that patient).

At any given time there were no more than 5 patients receiving chemo regimens, usually a lot less than that. A lot of the sickle cell patients came to that unit so she was very familiar with caring for them. It was also somewhat of an overflow unit so she needed to be familiar with all other basic conditions that pharmacists should be familiar with.

 

[LOLO]

Ay one of you guys kept ACCP BCOP material from previous year and you can share it with me , will really appreciate it. Thanks

 

[iphetamine]

Well my experience is kind of mixed up
I never really practiced and never worked in retail but I worked in sales and then currently doing an MSc
However I want to get back to the clinical game and i'm really interested in oncology

(my punctuation keys don't work sorry)

 

[mp808]

Hi,

I will be starting my PharmD/PhD next year and am interested in oncology pharmacy as well. For those of you who are oncology pharmacist, do you work with drugs still in clinical trials? Is medication management a large part of your job? I didn't like the thought of being "stuck at the bottom of a hospital dungeon" (as some refer to hospital pharmacist). Do you ever feel like your job is this way?

Thanks much!