By Khoa Phan, National Cancer Centre Singapore (NCCS)

I am Khoa Phan, currently a pharmacist working in National Cancer Centre Singapore (NCCS). I would like to share about the daily work routines of an oncology pharmacist. The pharmacy in NCCS is divided into 2 sections: Oncology Pharmacy and Specialist Outpatient Clinics (SOC) Pharmacy. Oncology Pharmacy prepares and dispenses intravenous (IV) chemotherapy and chemo-related supportive medications (anti-emetics, anti-allergy) while SOC Pharmacy dispenses oral cancer medicines, pain-killers including controlled medicines and other general medicines.

As a SOC pharmacist, I am involved in the day-to-day operations of a typical outpatient pharmacy where medicines are packed and dispensed to patients according to the prescription. Counselling is provided on the proper use of prescribed medicine, their side effects, drug interactions and management of missed doses. The pharmacy also provides medication therapy management for elderly patients above 65 years old for a detailed review of their medications (prescription, herbal and nutritional supplements) as we understand that polypharmacy is a concern, given some of their multiple comorbidities. There is even a smoking cessation counselling to offer patients support to quit smoking while focusing on their cancer treatments, which has been found to lead to better responses to treatment.  

On top of the daily dispensing duty, I am rostered to answer drug information queries from patients, doctors and other healthcare professionals. I am also in charge of the home delivery service; hence my morning usually starts with checking of any home delivery order requests through email or phone. The home delivery service is provided for patients who wish to have their purchases delivered directly to their home. They can place an order directly from home or have their prescriptions refilled from home which is of great convenience. Moreover, I am tasked with the inventory management of sample drugs. NCCS pharmacy has this system in which the sample cancer drugs can only be dispensed upon receipt of a valid endorsed voucher. Occasionally, I also conduct sharing of interesting clinical cases during continuing education (CE) sessions and teaching the pre-registration pharmacists.

On the other hand, at the oncology pharmacy, my colleagues will be involved in the preparation of IV chemotherapy (transfer the concentrated chemotherapeutics to the diluent) in the clean room. After verifying the correct order, the pharmacist will dispense the prepared drug to Ambulatory Treatment Unit (ATU) where the nurse will administer the drug to the patient according to the guidelines/protocols. Occasionally, if patients develop hypersensitivity reactions to chemotherapy, the pharmacist will give recommendations on which medicines should be used to alleviate the conditions. Since NCCS is an outpatient setting, patients may need to get admitted to Singapore General Hospital for monitoring if conditions worsen or remain critical. Occasionally, our clinical pharmacists will do ward rounds early in the morning. NCCS also has a clinical trial pharmacy where we store and supply clinical trial drugs to patients according to the protocol, which support services up to over 60 clinical trials both in-house and commercial. 

I enjoyed my role as an oncology pharmacist because I get to collaborate with other healthcare professionals to deliver best possible patient care, and I get to learn more about oncology and share my knowledge.
 

Khoa Pan (in black shirt) and his colleagues at SOC pharmacy

Khoa Pan (in black shirt) and his colleagues at SOC pharmacy

Photo of NCCS Pharmacy at Level 1