Oncology pharmacy is the emerging pharmacist specialty within the country. Their specific knowledge and skills set them apart from the conventional pharmacists and earn them a unique place in the cancer healthcare team.

In Malaysia, pharmacists who provide the cytotoxic drugs reconstitution (CDR) service will be at the forefront of the oncology service. Among the established job scopes include the responsibility to safely reconstitute cancer drugs according to individual patient needs under strict clean room standards, to dispense safe and accurate chemotherapy, and to provide necessary advice to patients. Counselling of chemotherapy side effects is a particularly important task to help patients go through these challenging treatments and to ensure a relatively good quality of life.

Oncology pharmacy services growing in Malaysia

Cancer is recognised as one of the most important non-communicable diseases in the country. It was attributed to over 13% of deaths in all Ministry of Health hospitals in 2015 and was ranked as the third most common cause of death.

Statistics from the Malaysian National Cancer Registry revealed that between the 5-year period of 2007-2011, the most common cancers that affected Malaysian males were cancers of the colorectum, lung, nasopharynx, lymphoma and prostate; while the most common cancers that affected females were cancers of the breast, colorectum, cervix uteri, ovary and lung. The number of cancer patients in the country is expected to increase proportionally as our nation continues to progress.

The role of oncology pharmacists in the country has also come a long way since its inception. The Malaysian Pharmaceutical Services Divisions reported, in 2014, there was a total of 64 public hospitals offering oncology pharmacy services as an integral part of their overall pharmacy responsibilities. These hospitals are equipped with an aseptic unit (including a qualified clean room).

Pharmacists working with these potentially hazardous materials must be appropriately trained prior to engaging any drug reconstitution activities. In the same year, oncology pharmacists had reconstituted or otherwise prepared more than 275,000 cancer drugs, and attended to more than 100,000 oncology cases. Such achievements further consolidated the indispensable role of oncology pharmacists in taking care of our cancer patients.

In addition to preparing chemotherapies, an oncology pharmacist also has to take up the responsibility as a health educator. Among the chief goals of an educator is to counsel patients about the efficacies of the treatment regimen. Inevitably, this varies from one patient to another and it takes a skilful pharmacist to convey the appropriate advice while addressing the underlying anxiety and frustration of cancer patients. Proper methods to manage side effects also become vital when it comes to helping patients to endure cancer treatments. With the ability to communicate effectively, pharmacists are also strategically placed in the position to educate patients on the possible harmful effects of mixing traditional or herbal medicines with their anticancer drugs.

Career advancement

Managing patient expectation of treatment outcome is another vital role of oncology pharmacists. Cancers are complicated diseases and they come in different types and severity, along with vastly diverse prognoses. Pharmacists should ensure each individual patient has a realistic understanding of their condition, and what is the likely scenario they will face if they undergo treatment. If the patient is unfortunate enough to suffer late-stage cancer, it is appropriate to switch the treatment goal from achieving remission to providing optimal comfort to the patient. 

There is an increasing need for pharmacists who specialise in oncology. Nonetheless, unlike our counterparts in developed countries, oncology pharmacists in the country are yet to be officially recognised as pharmacist specialists. Should the Ministry of Health decide to take oncology pharmacy services to a more advanced and specialised level, such a move will certainly be welcomed by our fellow colleagues, making their firm stand against cancer at the forefront of the battle. MIMS

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