Title:
Women, Thrombosis, and Cancer
Release date:
December 1, 2015
Expiration date:
UEMS: November 23, 2017, McGill (RCPSC): June 28, 2016
Topics:
Hematology, Intensive Care, Oncology
Primary Audiences:
Oncologists, obstetricians and gynaecologists, and other specialists and family physicians with an interest in thrombosis in women with cancer
Activity Format:
Patient Case Studies
Credits:
UEMS: 11 European CME Credits (ECMEC), McGill: 16 CME credit: RCPSC: MOC Section 1

Needs Assessment

To consult the Needs Assessment, click here.

Activity Abstract

There is an increased risk of venous thromboembolism (VTE) in cancer patients. In fact, VTE is the most common complication and the second most common cause of death in patients with cancer. Pregnancy and use of hormone therapies can also increase the risk of VTE, which is particularly concerning for women. This case-based educational program has 11 modules, including an up-to-date overview of VTE in women with cancer and 10 challenging clinical scenarios in women with VTE and cancer. Learners will have the opportunity to earn CME credit for each module they choose to complete. All modules include recommendations from the international clinical practice guidelines for the treatment and prophylaxis of VTE in patients with cancer, and provide appropriate treatment and prevention strategies. The educational continuum concludes with a self-reflective exercise, which will provide Learners with an opportunity to measure effects of the learning activity on clinical practice for additional credits.

Learning Objectives

Module 1. Overview of Women, Thrombosis and Cancer
At the end of this module, participants will be able to:
  • Describe the risks and consequences of venous thromboembolism (VTE), including deep vein thrombosis (DVT), pulmonary embolism (PE), and central venous catheter-related thromboembolism (CRT) in women with cancer
  • Apply international clinical practice guidelines and appropriate treatment recommendations for established and recurrent VTE in women with cancer
  • Establish personalized VTE prophylaxis in women with cancer, in both surgical and medical settings
  • Evaluate challenging clinical scenarios specific to women with cancer and thrombosis, including hormonal therapies and pregnancy

Module 2. VTE in Surgical Cancer: Cervical Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate treatment of VTE in a woman diagnosed with early-stage cervical cancer
  • Evaluate strategies for appropriate perioperative VTE prophylaxis

Module 3. VTE in Surgical Cancer: Endometrial Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate thromboprophylaxis for a woman undergoing hysterectomy for endometrial cancer
  • Evaluate use of extended prophylaxis
  • Evaluate alternate strategies if anticoagulant treatment was contraindicated

Module 4. VTE in Surgical Cancer: Colorectal Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate thromboprophylaxis for a woman undergoing colorectal surgery for cancer
  • Evaluate strategies for appropriate treatment of established VTE

Module 5. Central Venous Catheter-Related Thrombosis: Early-stage Breast Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate prophylaxis and treatment strategies for venous thromboembolism (VTE) in a woman with early-stage breast cancer undergoing chemotherapy administered via central venous catheter (CVC)
  • Evaluate appropriate strategies to manage VTE recurrence

Module 6. Catheter-Related Thrombosis: Ovarian Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate prophylaxis and treatment strategies for venous thromboembolism (VTE) in a woman with ovarian cancer undergoing chemotherapy administered via a peripherally inserted central catheter (PICC) line

Module 7. VTE in Medical Cancer: Advanced Breast Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate treatment strategies for venous thromboembolism (VTE) in a woman with metastatic breast cancer undergoing systemic chemotherapy
  • Evaluate the association between tamoxifen treatment and risk of developing VTE

Module 8. VTE in Medical Cancer: Advanced Lung Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate thromboprophylaxis and venous thromboembolism (VTE) treatment strategies in a woman with advanced non-small-cell lung cancer undergoing chemotherapy
  • Evaluate the association of hormone replacement therapy (HRT) and risk of developing VTE
  • Review strategies for treatment of VTE in the presence of severe renal failure

Module 9. VTE in Medical Cancer: Advanced Pancreatic Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate thromboprophylaxis in a woman with reduced mobility and advanced pancreatic cancer undergoing chemotherapy
  • Evaluate the risk of venous thromboembolism (VTE) associated with hormone replacement therapy (HRT) and erythropoiesis-stimulating agents (ESAs)

Module 10.VTE in Pregnancy: Thyroid Cancer Patient
At the end of this module, participants will be able to:
  • Apply appropriate venous thromboembolism (VTE) treatment strategies in a young woman with thyroid cancer
  • Evaluate the association of oral contraceptives and the risk of developing VTE
  • Assess the management approach if the patient were to become pregnant

Module 11. VTE in Pregnancy: Melanoma Cancer Patient
At the end of this module, participants will be able to:
  • Assess the use of venous thromboembolism (VTE) prophylaxis in a young woman with melanoma
  • Evaluate the approach to VTE management if the patient were to become pregnant, or if the patient was already pregnant at melanoma diagnosis

Faculty and Disclosures

Co-Chairs (ITAC-CME)
Pr. Dominique Farge-Bancel (France)
Professor of Internal Medicine and Vascular Disease, St Louis Hospital, APHP, Paris 7 University, France
Receipt of grants/research supports: LEO Pharma
Receipt of honoraria or consultation fees: Aspen Pharmacare, Daiichi Sankyo, Pfizer, Sanofi, GlaxoSmithKline

Pr. Henri Bounameaux (Switzerland)
Dean of Faculty of Medicine, University of Geneva, Switzerland
Receipt of honoraria or consultation fees: Bayer Pharma (Switzerland)

Steering Committee (ITAC-CME)
Pr. Rupert Bauersachs (Germany)
Professor and Doctor, Vascular Medicine, Klinikum Damstadt GmbH, Darmstadt, Germany
Receipt of honoraria or consultation fees: Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo
Participation in a company-sponsored speaker's bureau: Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, LEO Pharma

Pr. Benjamin Brenner (Israel)
Director, Institute of Hematology and Bone Marrow Transplantation, Rambam Medical Centre, Haifa, Israel
Participation in a company-sponsored speaker's bureau: Aspen Pharmacare, Bayer Pharmaceuticals, Daiichi Sankyo, Pfizer, ROVI Laboratories, Sanofi

Dr. Philippe Debourdeau (France)
Oncologist, Institut Sainte Catherine, Avignon, France
Receipt of grants/research supports: Sanofi
Receipt of honoraria or consultation fees: Aspen Pharmacare
Participation in a company-sponsored speaker's bureau: Aspen Pharmacare, Daiichi Sankyo, Pfizer

Pr. James Douketis (Canada)
Professor, Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, Canada
Associate Director, Clinical Teaching Unit, St. Joseph's Hospital, Hamilton, Canada
Staff Physician, Clinical Thromboembolism and General Internal Medicine Services, St. Joseph’s Hospital, Hamilton, Canada
Receipt of grants/research supports: Boehringer Ingelheim
Receipt of honoraria or consultation fees: AGEN Biomedical, Astra Zeneca, Bayer,
Biotie Therapies, Boehringer Ingelheim, Bristol-Myers Squibb, Janssen-Ortho, Pfizer, Portola, Sanofi, The Medicines Company

Pr. Manuel Monréal (Spain)
Hospital Universitario Germans Trias i Pujol, Servicio de Medicina Interna, Ctra. de Canyet, Spain
Receipt of grants/research supports: Bayer Pharma AG, Sanofi
Receipt of honoraria or consultation fees: Bayer, Boehringer Ingelheim, Daiichi Sankyo, LEO Pharma
Participation in a company sponsored speaker's bureau: Bayer, Daiichi Sankyo, LEO Pharma, Sanofi

Pr. Ingrid Pabinger (Austria)
Professor of Hemostaseology, Medical University of Vienna, Vienna, Austria
Receipt of honoraria or consultation fees: Bayer, Boehringer Ingelheim, Pfizer

Consultant (ITAC-CME)
Rt. Hon. Pr. Lord Ajay Kakkar (United Kingdom)
Professor of Surgery, University College London, London, UK
Receipt of grants/research supports: Bayer HealthCare, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo Europe, Eisai, Pfizer, Sanofi S.A.
Receipt of honoraria or consultation fees: Bayer HealthCare, Boehringer Ingelheim, Daiichi Sankyo Europe, Sanofi S.A

Commercial Support

This activity is supported by an unrestricted educational grant from Aspen Pharmacare.

Other Sponsoring Organization

This CME/CPD activity is sponsored by the not-for-profit professional organization, ITAC-CME, which has provided access to its mobile app, “International Clinical Practice Guidelines for the Treatment and Prophylaxis of Venous Thromboembolism in Patients with Cancer” on this website. This mobile app is based on the international clinical guidelines that form the basis of the prophylaxis and treatment recommendations in the Learning Modules in this CME/CPD activity.

Accreditation and Credit Designation

This event is approved for up to 16 credits by the Office for Continuing Professional Development. The Office for CPD, Faculty of Medicine, McGill University is fully accredited by the Committee on Accreditation of Canadian Medical Education (CACME).

This event is an Accredited Group Learning Activity as defined by the Maintenance of Certification program of the Royal College of Physicians and Surgeons of Canada.

Through an agreement between the Royal College of Physicians and Surgeons of Canada and the American Medical Association, physicians may convert Royal College MOC credits to AMA PRA Category 1 Credits™. Information on the process to convert Royal College MOC credit to AMA credit can be found at www.ama-assn.org/go/internationalcme.

Each physician should claim only credit commensurate with the extent of their participation in the activity

The Women, Thrombosis and Cancer, made available on http://www.wtccme.com and organized by CME Solutions Canada ULC, is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists.

The Women, Thrombosis and Cancer, made available on http://www.wtccme.com and organized by CME Solutions Canada ULC, is awarded 11 European CME credits (ECMEC's).

Each medical specialist should claim only those credits that he/she actually spent in the educational activity. The EACCME is an institution of the European Union of Medical Specialists (UEMS). Only those e-learning materials that are displayed on the UEMS-EACCME website have formally been accredited.

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity.

This activity is designed to be completed within the time designated on the title page; Learners should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, Learners must complete the activity online during the valid credit period that is noted on the title page.

Instructions for Claiming Credits

Note that the credit you receive is based on your user profile.
  1. Read the target audience, learning objectives, and author disclosures on this page.
  2. Prior to studying a module, you must complete the pre-activity test associated with the module.
  3. Study the educational content of each module you would like to complete.
  4. Complete the post-activity test at the end of each module you choose to study. You must receive a passing score (75% or higher) in order to receive a Certificate of Completion and claim credit.
  5. Complete the activity Evaluation for the module to provide feedback for future programming.
  6. Click “Claim Credit” and follow the instructions to print out the Certificate of Completion. Note that you cannot alter the Certificate. Keep this Certificate in your files.

Hardware/Software Requirements

To access this activity, Learners will need:
  • A computer with an Internet connection
  • The latest version of Google Chrome
  • Adobe Acrobat Reader
  • An HTML5-capable browser
  • Adobe Flash Player may be required for video or audio playback.

More Information

For questions regarding the content of this activity, contact info@cmesolutions.ca.

Technical Assistance

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