Cancer Management Guidelines

CCMB Cancer Management Guidelines are created to generate, disseminate, implement and evaluate evidence-based guidelines for the consistent management of common clinical scenarios encountered by oncology patients in Manitoba. These guidelines are a type of knowledge translation tool, and offer information for clinicians based on scientific research, highest quality of evidence, and/or best-practice consensus recommendations from cancer care experts.

Guidelines can be applied in various healthcare settings by administrators, clinicians and patients so the best course of action can be determined when decisions about treatment options or care delivery must be made. The ultimate aim of these guidelines is to keep patients and their families at the centre of care.

CancerCare Manitoba welcomes the input of healthcare professionals. If you’re interested in further learning or participating in the development or review of guidelines, or you have a question about guideline development or the after-care process, please contact: CCMBCPGI@cancercare.mb.ca

Clinical Practice Guidelines Process Maps

Please click on the following to view process maps from the Clinical Practice Guidelines Initiative.

Cancer Management Guidelines

CancerCare Manitoba Practice Guidelines are scheduled for regular content review and update in order to improve recommendations and to remain current.
Please view guidelines for treatment (Systemic Therapy, Radiation Therapy, Surgery) and Supportive Care below.

Acute Leukemia and Bone Marrow Transplant Practice Guidelines

Coming Soon!

Breast Practice Guidelines

Central Nervous System Practice Guidelines

Coming Soon!

Cutaneous Practice Guidelines

Melanoma

Disease & Symptom Management

 

Endocrine Practice Guidelines

Coming Soon!

Gastro-Intestinal Practice Guidelines

Head and Neck Practice Guidelines

Hematology Practice Guidelines

Immune Thrombocytopenia (ITP)

Disease & Symptom Management

Practice Guidelines for Smoking Cessation

Despite a diagnosis of cancer, some patients continue to smoke. Healthcare providers can use this document as a guide to facilitate an evidence-based, shared approach to the clinical support of smoking cessation within oncology care.

For this purpose, it may be used by qualified and licensed healthcare practitioners involved with the care of oncology patients, which may include (but is not limited to): physicians, surgeons, nurses, radiation therapists, pharmacists, psychosocial oncology caregivers and dietitians.

To view this practice guideline, click Supportive Care Smoking Cessation in Oncology Care.

Practice Guidelines for Filgrastim Use in Adults by Disease Site

Neutropenia and its complications such as febrile neutropenia and infection are major toxicities associated with myelosuppressive chemotherapy.

Adverse consequences of febrile neutropenia include hospitalization, use of antibiotics and delays in chemotherapy administration

This document is intended as a guide to facilitate an evidence-informed, shared approach to the appropriate use of filgrastim in adults.

For this purpose, it may be used by qualified and licensed healthcare practitioners involved with the care of oncology patients, which may include (but is not limited to): physicians, surgeons, nurses, radiation therapists, pharmacists, psychosocial oncology caregivers and dietitians

The recommendations are stratified by each Disease Site Group in order to help clarify the indications in which filgrastim should be used.

To view these practice guidelines, click Recommendations for Filgrastim Use in Adults by Disease Site.

Febrile Neutropenia

Thoracic (Lung) Practice Guidelines

Esophageal

Regimen Reference Orders (RROs)

These standardized, approved support documents are created at CCMB by teams of pharmacists, nurses, and guideline developers as part of the formal Manitoba Oncology Drug Review Process. Content is reviewed and approved by medical oncologists.

An RRO provides: planned course of the drug or drug regimen, indication for use, whether a central venous access devise is required or recommended, blood work parameters to proceed with treatment, pre-treatment requirements, sequence of medication administration, dosing and drug administration instructions, monitoring parameters, discharge instructions and any notable information regarding the particular drug or drug regimen.

RROs are intended as Evidence-informed Practice Tools to assist healthcare professionals in Manitoba who provide drug treatments to cancer patients. Please see the Legal Disclosure at the bottom of this page for more information.

RROs by Disease Site Group, and for Supportive Care are listed below.

Acute Leukemia and Bone Marrow Transplant Regimen Reference Orders

Breast Regimen Reference Orders

 

Central Nervous System Regimen Reference Orders

Coming Soon!

Cutaneous Regimen Reference Orders

Endocrine Regimen Reference Orders

Gastro-Intestinal Regimen Reference Orders

Carcinoid and Neuroendocrine

Cholangiocarcinoma

Coming Soon!

Colorectal

Hepatocellular

Coming Soon!

Pancreatic

Genitourinary Regimen Reference Orders

Testicular

Coming Soon!

Bladder

Renal

Prostate

Coming Soon!

Gynecologic Oncology Regimen Reference Orders

Head and Neck Regimen Reference Orders

Squamous Cell

Hematology Regimen Reference Orders

Lymphoproliferative Disorders Regimen Reference Orders

Chronic Lymphocytic Leukemia

Hodgkin Lymphoma

Coming Soon!

Mantle Cell

Multiple Myeloma

Non-Hodgkin Lymphoma

Sarcoma Regimen Reference Orders

Supportive Care Regimen Reference Orders

Thoracic Regimen Reference Orders

Esophageal

Coming Soon!

Mesothelioma

Coming Soon!

Non-Small Cell Lung Cancer

Small Cell Lung Cancer

Coming Soon!

Uknown Primary Regimen Reference Orders

Coming Soon!

Legal Disclosure for CCMB Practice Guidelines and related Evidence-informed Practice Tools

CCMB Practice Guidelines and related Evidence-informed Practice Tools represent the consensus of CCMB professionals regarding their views of currently accepted approaches to treatment. These materials have been published so that qualified and licensed healthcare practitioners can consider this information in determining appropriate care or treatment for their patients. The publication of these materials by CCMB and the consequent knowledge of them by practitioners must not preclude use of a practitioner's independent clinical judgement, nor must such publication and consequent knowledge replace the need for a practitioner to consult with the appropriate oncology care provider if warranted in a particular patient’s circumstances.

CCMB may update these materials at any time or from time to time, as it sees fit in its sole discretion. As a result, it is recommended that practitioners frequently consult this website to ensure that they are aware of the most recent Practice Guidelines and Evidence-informed Practice Tools published by CCMB.

CCMB MAKES NO REPRESENTATION, WARRANTY OR GUARANTEE OF ANY NATURE OR KIND WHATSOEVER REGARDING ANY OF THESE MATERIALS OR THEIR USE OR APPLICATION IN ANY PARTICULAR SITUATION, AND DISCLAIMS ANY RESPONSIBILITY OR LIABILITY FOR THEIR USE OR APPLICATION IN ANY WAY.

Drug Education Communication Team (DECT)

DECT is a multidisciplinary team (pharmacists, nursing educators, nursing leadership, and ARIA Information Education Specialists) working together to ensure appropriate anticancer and supportive therapy information and education is available provincially.  The team works to provide both patient and health care professionals with standardized appropriate education, information tools and be informative by the way of funding announcements, new indications for current medications, as well as any changes or amendments to current systemic therapy processes.

DECT is responsible for the identification, review, adaptation and/or development, approval, maintenance, and dissemination of appropriate drug information resources, tools for education/monitoring of anticancer systemic therapies administered throughout the provincial Oncology programs.  DECT oversees a framework for the re-evaluation, amendment, communication, and dissemination of any modifications to any education tools/resources/communication maintained by the TEAM.  All resources are reviewed and re-evaluated annually or sooner as deemed necessary by staff/patient feedback.