Recommended Resources for Oncology Practice
For a comprehensive, rapid-access overview of cancer diagnosis and treatment across all tumor types, the NCCN Clinical Practice Guidelines in Oncology (available at NCCN.org) represent the gold standard resource for practicing oncologists. 1, 2
Why NCCN Guidelines Are Your Best Resource
The NCCN Guidelines are the most detailed and frequently updated clinical practice guidelines available in any area of medicine and are recognized as the standard for cancer care worldwide. 2 These guidelines:
- Cover approximately 90% of all cancer patients across disease sites 3
- Are updated continuously through an iterative process based on critical review of best available evidence 2
- Provide evidence-based, consensus-driven guidance from multidisciplinary panels of oncology experts at 28 leading cancer centers 2
- Include algorithmic decision trees that guide management from initial presentation through surveillance 1
What You'll Find in NCCN Guidelines
Disease-Specific Coverage
The NCCN provides separate, comprehensive guidelines for each major cancer type, including:
- Solid tumors: Colon cancer 1, breast cancer 1, soft tissue sarcomas 1, and many others
- Each guideline includes: Clinical presentation, workup algorithms, pathologic staging (TNM system), surgical management, perioperative treatment, systemic therapy options with specific regimens, surveillance protocols, and management of recurrent/metastatic disease 1
Critical Clinical Elements
Biomarker testing requirements: Each guideline specifies mandatory molecular testing (e.g., ER/PR/HER2 for breast cancer, RAS/BRAF for colorectal cancer) that directs therapy selection 1, 4
Treatment sequencing: Guidelines provide preferred regimens versus other recommended options, with clear categorization of evidence strength (Category 1, 2A, 2B, or 3) 1
Stage-specific algorithms: Management is organized by stage with distinct pathways for early/operable disease versus locally advanced versus metastatic disease 4
Accessing NCCN Guidelines
- Free online access: Visit www.NCCN.org for the complete, most current versions 1
- Mobile accessibility: Guidelines are optimized for point-of-care use 2
- Regular updates: Check the version number and date, as guidelines are updated multiple times annually based on emerging evidence 1, 2
Complementary Resources Within NCCN
Beyond disease-specific guidelines, NCCN provides essential supportive care guidelines that every oncologist must integrate into practice:
- Palliative Care Guidelines: Address symptom management, quality of life optimization, and end-of-life care planning—applicable at any disease stage, not just terminal care 1
- Distress Management Guidelines: Screen and manage psychological distress throughout the cancer trajectory 1
- Adolescent and Young Adult (AYA) Oncology Guidelines: Address unique needs of patients aged 15-39, including fertility preservation, psychosocial support, and age-appropriate communication 1
Special Populations and Situations
Cancer of Unknown Primary (CUP): For the 3-5% of patients presenting with metastatic disease without identified primary, specific diagnostic algorithms and treatment approaches exist based on clinicopathologic subsets 1
Multidisciplinary coordination: Guidelines emphasize the critical importance of pathologist-oncologist communication, including use of synoptic reporting formats to ensure complete information exchange 5
Common Pitfalls to Avoid
- Don't rely on outdated versions: Guidelines change frequently based on new evidence; always verify you're using the current version 1, 2
- Don't skip biomarker testing: Molecular characterization is mandatory before initiating systemic therapy for most cancers 1, 4
- Don't delay palliative care consultation: Palliative care should be introduced early in the disease course, not reserved for end-of-life situations 1
- Don't overlook clinical trial options: NCCN uniformly endorses clinical trial participation as the preferred management approach when available 1
International Adaptations
If practicing outside the United States, be aware that NCCN Guidelines can be adapted for local resources, drug availability, and payment systems while maintaining the core evidence-based recommendations. 6 Regional adaptations exist for Latin America and other areas. 6
Practical Implementation
At initial consultation: Reference the appropriate disease-specific guideline to ensure complete staging workup and biomarker testing 1, 4
At treatment planning: Use the algorithmic pathways to identify preferred regimens based on stage, molecular profile, and performance status 1, 4
During active treatment: Consult supportive care guidelines (palliative care, distress management) to optimize quality of life 1
For surveillance: Follow guideline-specified monitoring schedules and imaging protocols 1