Maintaining and restoring health through the promotion of disease screening and early detection is a vital part of nursing.
That role becomes no less important after a cancer diagnosis. Patients with cancer remain at risk for other malignancies, and that risk may even increase depending on treatment regimens. Oncology nurses are paramount in promoting recommended screening for other malignancies despite undergoing treatment for another.
Staying Current With Screening Guidelines
Oncology nurses need to be aware of the current advances in screening technology and recommendations, especially as some patients with cancer forego primary care and look to their oncology providers for all medical care during active treatment and acute follow-up. Nurses must educate patients about the need to continue all screening and early detection procedures, as well as the risk for secondary malignancies depending on the current treatment approach. (For example, alkylating agents and radiation therapy are well known to increase the risk of myelodysplastic syndrome and acute leukemia.) Patients should be encouraged to eat a healthy diet, eliminate tobacco exposure, avoid sun exposure, follow routine screening recommendations, and follow up accordingly with blood tests. Organizations such as the U.S. Preventive Services Task Force and ACS have screening guidelines based on rigorous evidence.
Tailoring Screening to Each Patient
Consideration of risk for cancer and secondary cancer development must be individualized and a conversation that should be had with each patient and his or her provider. Although in addition to prior cancer treatment regimens, there should still be consideration of age, family history and lifestyle risks. Mammography, colonoscopy, and pap and human papillomavirus (HPV) testing are well known and accepted screening procedures, but in 2014, the USPSTF endorsed low-dose CT scans for the early detection of lung cancer in adults aged 55-80 who have a 30 pack-year smoking history who are either currently smoking or quit within the past 15 years. Low-dose CT scans increase the possibility of early diagnosis when surgical intervention may still be a plausible option for curative treatment .
Remembering Special Populations
Another consideration is the implications of healthcare disparities on cancer prevention and early detection. Low socioeconomic status, racial disparities, access to health insurance, education level, and decreased social support are just some of the factors that may impact a person’s likelihood to seek out cancer screening procedures. Oncology nurses, especially nurse navigators, can ensure that patients receiving cancer care for one diagnosis continue to balance the risks and benefits of screening and receive preventive care for additional cancer diagnoses.
Healthcare advances such as genetic and biomarker testing, precise imaging, and vaccine development represent progress in the field of cancer prevention and early detection. Oncology nurses play a pivotal role in ensuring that patients maintain the best possible health status and quality of life during active cancer treatment and survivorship by participating in proper screening.