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    The Case of Concurrent Therapy Concerns
    Treatment side effects
    The Case of Concurrent Therapy Concerns
    December 18, 2020
    In a World Where You Can Be Anything, Be Kind
    Nurse staffing
    In a World Where You Can Be Anything, Be Kind
    December 11, 2020
    Nursing Innovation Links Rural Facilities to Resources and Experts to Provide High-Quality Care Across the Country
    Access to cancer care
    Nursing Innovation Links Rural Facilities to Resources and Experts to Provide High-Quality Care Across the Country
    December 04, 2020
    Why All Oncology Nurses Should Be Environmentalists
    Oncology nurse influence
    Why All Oncology Nurses Should Be Environmentalists
    November 27, 2020
    ELNEC Milestone Marks Transformation of EOL Care for Countless Patients With Cancer
    Oncology nurse education
    ELNEC Milestone Marks Transformation of EOL Care for Countless Patients With Cancer
    November 20, 2020
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    Clinical practice

    FDA Approvals for Targeted and Immuno-Oncology
    U.S. Food and Drug Administration (FDA)

    Recent FDA Approvals Continue to Focus on Targeted and Immunotherapy

    Oncology clinicians can expect to continue to see new targeted and immunotherapy drugs emerge as clinically approved agents in the fight against cancer. Five cancer-related U.S. Food and Drug Administration (FDA) approvals occurred in the first quarter of 2017; following are their indications for treatment and associated clinical implications. You’ll recognize that some of the agents were already FDA approved for other uses, but as clinical trials continue and new data emerge, clinical use is expanding to other disease sites and indications.

    June 20, 2017
    Oncology Nurse Advisor Navigation Summit

    An Overview of Colorectal and Pancreatic Cancers

    Colorectal cancer (CRC) represents 8% of all new cancer cases and 8.4% of all cancer deaths, with a five-year survival rate of 64.9% (between 2007–2013). Pancreatic cancer represents 3.2% of all new cancer cases and 7.2% of all cancer deaths, with a five-year survival rate of just 8.2% (between 2007–2013). ONS member Christine Guarnieri, MSN, RN-BC, OCN®, of Huntington Hospital in New York, discussed both of these cancers at the Oncology Nurse Advisor Navigation Summit.

    June 16, 2017
    CancerLinQ
    Clinical practice

    How ONS and Oncology Nursing Are Helping to Define Big Data and Cancer Care

    For oncology nurses, physicians, and care professionals, the importance of implementing tools to collect and analyze big data cannot be understated. Through collaboration and multidisciplinary tactics, data can help drive improvements in the way patients are treated.

    June 15, 2017
    Substance Abuse and Addiction
    Pain management

    Managing Pain in Patients With Substance Use Disorder

    In their article in the April 2017 issue of the Clinical Journal of Oncology Nursing, Compton and Chang provided a guide for nurses caring for patients with substance use disorder (SUD), including overview, diagnosis, and treatment of SUD as well as its implications for pain management and cancer treatment considerations when a patient with SUD is diagnosed with cancer.

    June 13, 2017
    FDA Update
    U.S. Food and Drug Administration (FDA)

    FDA Approves ALA Optical Imaging Agent for Gliomas

    On June 6, 2017, the U.S. Food and Drug Administration (FDA) approved aminolevulinic acid hydrochloride, known as ALA HCl (Gleolan, NX Development Corp.) as an optical imaging agent indicated in patients with gliomas (suspected World Health Organization Grades III or IV on preoperative imaging) as an adjunct for the visualization of malignant tissue during surgery.

    June 09, 2017
    Acupuncture in Treating Hot Flashes
    Clinical practice

    The Role of Acupuncture in Treating Hot Flashes in Breast Cancer Survivors

    Hot flashes, also known as hot flushes, are marked by periods of sudden, intense feelings of warmth that begin at the chest and radiate to the neck and face, along with flushing, sweating, and heart palpitations, lasting several seconds to minutes. Compared to healthy postmenopausal women, breast cancer patients and survivors are prone to experiencing more severe and longer-lasting hot flashes. A bothersome symptom, hot flashes can occur anytime during a 24-hour period, but those occurring at night are most troubling because they interfere with sleep. Sleep deprivation negatively impacts daytime functioning as well as pain, fatigue, depression, and anxiety levels, diminishing quality of life significantly.

    June 08, 2017
    Multi-Drug Resistant Fungus
    Safety

    CDC Warns Healthcare Workers of Emerging, Multidrug-Resistant Fungus

    Candida auris is a multi-drug resistant yeast that is known to cause invasive infection and death. It first emerged in June 2016 and continues to present itself as a serious global threat. According to the Centers for Disease Control and Prevention (CDC), throughout 2017, healthcare facilities in multiple countries report serious illnesses caused by C.auris in hospitalized patients.

    May 30, 2017
    administering IV chemotherapy treatments
    Treatments

    What Special Considerations Are Needed When Setting up IV Chemotherapy?

    No solid research exists regarding IV chemotherapy administration setups, because they can vary greatly based on the regimen, equipment availability, and patient status. Of the utmost importance is that the administration setup ensures chemotherapy is given safely and allows for prompt nursing intervention in the event of an adverse reaction or infiltration.

    May 23, 2017
    Chemical Coping
    Pain management

    When Ineffective Pain Control Means Chemical Coping

    Central to our role as oncology nurses is provision of symptom relief balanced with a manageable side-effect profile. Although opioids are extremely effective at cancer pain management, they also bind to the brain’s limbic system and can produce reward responses. This can result in dependence and drug-seeking behaviors.

    May 22, 2017
    FDA Update
    U.S. Food and Drug Administration (FDA)

    FDA Grants Approval to Pembrolizumab for Locally Advanced or Metastatic Urothelial Carcinoma

    On May 18, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to pembrolizumab (Keytruda®, Merck and Co., Inc.) for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

    May 18, 2017
    Seborrheic Keratosis
    Melanoma

    Dermascopic Clues Help Identify Seborrheic Keratosis-Like Melanoma

    Melanomas that resemble seborrheic keratosis (SK) can be challenging to diagnose correctly. SKs are often removed without being evaluated dermascopically or sent for pathologic analysis, risking the possibility of missing a diagnosis of SK-like melanoma. A new study published in JAMA Dermatology outlined the key dermascopic clues that clinicians can use to identify SK-like melanomas to prevent treatment delays and achieve the best patient outcomes.

    May 18, 2017
    Caring for Multiple Patients
    Clinical practice

    The Challenge of Caring for Multiple Patients With Cancer

    As more new treatments enter practice—like immunotherapy, targeted therapy, and combination therapies—oncology nurses are required to be experts in every treatment they administer. They need to constantly walk a tightrope, balancing multiple medications for one patient then quickly moving to the next patient on a completely different treatment protocol.

    May 17, 2017
    Opioids
    Pain management

    The Case of the Omitted Opioid

    Rocky is a 56-year-old man with stage III oropharyngeal cancer. He is undergoing concurrent chemotherapy and radiation. Rocky is a long-haul truck driver, has had sporadic medical care in the past, has no primary care provider, and usually visits the emergency department in whatever town he is in when he gets sick. He was diagnosed during one of those visits after an episode of hematemesis.

    May 16, 2017
    FDA Update
    U.S. Food and Drug Administration (FDA)

    FDA Grants Accelerated Approval to Avelumab for Urothelial Carcinoma

    On May 9, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to avelumab for patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy.

    May 09, 2017
    CAR T-Cell Therapy
    Immunotherapy

    Nursing Considerations for Adverse Events From CAR T-Cell Therapy

    Chimeric antigen receptor (CAR) T-cell therapy offers options for pediatric patients with relapsed or refractory acute lymphoblastic leukemia, but it comes with a unique set of side effects that can range from mild to severe. As the primary patient providers, oncology nurses are often the first to identify signs and symptoms of adverse events and acute changes in patients’ status. Understanding what to watch for can improve outcomes and help nurses deliver safe, effective care.

    May 09, 2017
    ONS Congress

    Study Finds Guideline Training and Reinforcement of CINV Knowledge Is Important

    Chemotherapy-induced nausea and vomiting (CINV) is a side effect reported by 40%–80% of patients receiving cancer treatment. However, CINV can be prevented in 70%–80% of those cases with appropriate antiemetic prophylaxis. Few studies have evaluated approaches to improve provider adherence to antiemetic guidelines, and those who do adhere often have limited demonstrated success.

    May 06, 2017
    ONS Congress

    Educational Initiative Increases Nurse Understanding of Infusion-Related Reactions and Interventions

    Denise Portz, MSN, RN, AOCNS®, ACNS-BC, a clinical nurse specialist at the ‎Froedtert Hospital in Wisconsin, presented the findings during a poster session at the ONS 42nd Annual Congress in Denver, CO. The poster was titled “Providing Oncology Infusion Nurses Evidence-Based Guidelines and Interventions to Manage Infusion Reactions and Anaphylaxis.”

    May 05, 2017
    ONS Congress

    Use Pharmacologic and Nonpharmacologic Options to Treat Anxiety and Depression in Patients With Cancer

    Jane Rosenthal, MD, FAPM, from New York University Langone Medical Center, discussed treatment and management options patients suffering from these disorders during a session at the 42nd Annual Congress in Denver, CO.

    May 05, 2017
    Equality
    Ethics in nursing

    Are All Patients Treated Equally?

    It’s 2017, and one would think that all patients are treated equally. Nursing has certainly been educated to treat all patients with the same levels of respect and dignity and to provide excellent medical care regardless of age, race, ethnicity, or religious beliefs. In the theory of nursing, I think we all strive and believe that patients should be treated equally. However, at least for the reality of nursing that I work in, that doesn’t always feel true.

    May 05, 2017
    ONS Congress

    Interpreting Guidelines Correctly Helps Workplaces Remain Compliant

    Guidelines are established as tools to enhance patient care; however, translating guidelines can be difficult. Diana Scott, RN, MHA, CPHQ, senior director of accreditation services at Vizient, and Carma Herring, RN, MS, OCN®, from the John Stoddard Cancer Center, discussed mandates from the Joint Commission and Centers for Medicare and Medicaid Services (CMS), as well as tips for using guidelines and being compliant during a session at the 42nd Annual Congress in Denver, CO.

    May 04, 2017
    ONS Congress

    Studies Show Ways to Attain CMS Benchmark Measures for Cancer Care

    Currently, the Centers for Medicare and Medicaid Services (CMS) mandates 33 oncology-specific benchmark measures related to end-of-life care and hospice, unplanned hospital admissions (UHAs), pain, falls, medication, central venous catheter (CVC) line, pressure ulcers, tobacco cessation, catheter-associated urinary tract infections, sepsis, and function. Advanced practice nurses can play a role in achieving benchmarks and developing innovative strategies to accomplish these goals.

    May 04, 2017
    ONS Congress

    Tips for Managing Chronic Pain in High-Risk Patient Populations

    Pain management is often necessary for patients with cancer and other high-risk conditions. Despite guidelines and treatment algorithms, caring for this patient population can be challenging. Oscar DeLeon, MD, of the Roswell Park Cancer Institute, Kathleen Broglio, DNP, ANP-BC, ACHPN, CPE, FPCN, from Dartmouth Hitchcock Medical Center, and Jennifer Grimmer, DNP, FNP-BC, of the Roswell Park Cancer Institute, discussed strategies and best practice for pain management during a session at the 42nd Annual Congress in Denver, CO.

    May 04, 2017
    Darcy Burbage
    Coordinated care

    Creating and Sustaining Survivorship Care Plans in Practice

    With more than 15.5 million Americans living beyond cancer, it’s no surprise that more attention is being paid to survivorship than ever before. Once treatment ends, patients can be thrown back into a world after cancer with little or no attention paid to their concerns about recurrence, late effects from treatment, how to follow up with their future care, and a great many more unknowns.

    May 01, 2017
    FDA Update
    U.S. Food and Drug Administration (FDA)

    FDA Approves Durvalumab for Urothelial Carcinoma Treatment

    On May 1, 2017, the U.S. Food and Drug Administration granted accelerated approval to durvalumab for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or who have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.  

     

    May 01, 2017
    Immunotherapy Inquiry
    Immunotherapy

    The Case of the Immunotherapy Inquiry

    Jay is a 62-year-old man with newly diagnosed, stage IIIA (T3, N1), unresectable, non-small cell lung cancer (NSCLC) that tested negative for ALK, EGFR, and KRAS mutations. Additionally, PD-L1 (programed death receptor ligand) expression was less than 30%. Jay is symptomatic with a persistent cough, unintentional weight loss, and fatigue.

    April 18, 2017
    FDA Update
    U.S. Food and Drug Administration (FDA)

    FDA Approves Marketing of First Digital Pathology Whole Slide Imaging System

    The U.S. Food and Drug Administration (FDA) has permitted marketing of the Philips IntelliSite Pathology Solution (PIPS, Philips Medical Systems Nederland B.V.), as an aid to the pathologist to review and interpret digital images of surgical pathology slides prepared from formalin-fixed paraffin embedded (FFPE) tissue.

    April 17, 2017
    FDA Update
    U.S. Food and Drug Administration (FDA)

    FDA Removes Risk Evaluation Management Strategies (REMS) for ESAs

    On April 13, 2017, the U.S. Food and Drug Administration (FDA) removed the Risk Evaluation and Mitigation Strategy (REMS) requirements for the use of Epogen/Procrit and Aranesp to treat patients with anemia due to associated myelosuppressive chemotherapy.

    April 13, 2017
    Nurses talking
    Clinical practice

    AJCC Cancer Staging System Will See Changes in 2018

    Beginning in January 2018, oncology nurses will see changes to the way their patients’ cancers are staged with the American Joint Committee on Cancer (AJCC) system. According to a presentation at the National Comprehensive Cancer Network annual conference in March 2017, when the AJCC 8th Edition Cancer Staging System takes effect on January 1, 2018, more cases may be classified as stage I, especially for patients with breast cancer.

    April 12, 2017
    HPV Vaccines Fight Against Oral Cancers and More
    Clinical practice

    HPV Vaccines Fight Against Oral Cancers and More

    Because April is Oral Cancer Awareness Month, it’s important to understand the link between human papillomavirus (HPV) and oropharyngeal cancers. This form of oral cancer occurs in the middle part of the throat, soft palate, base of the tongue, and tonsils. HPV contributes to more than 70% of all oropharyngeal cancers, with more than half of these being related to HPV type 16. The Centers for Disease Control and Prevention (CDC) noted that approximately 9,000 new cases of oropharyngeal cancers are diagnosed annually and are typically four times more common in men than women.

    March 29, 2017
    Nurse on Computer
    Clinical practice

    ONS and ASCO CancerLinQ Partnership Will Help Institutions Use Practice Data to Drive Greater Cancer Care

    Offering personalized treatment plans to patients with cancer is one of the biggest goals for any oncology institution—big or small. ONS leaders and members have united their personal and organizational efforts to move cancer care toward personalization while still aligning the needs of patients with nationally recognized clinical guidelines. Oncology nurses consistently strive to deliver quality cancer care to their patients.

    March 08, 2017
    Chemotherapy Competence
    Clinical practice

    What Is Chemotherapy Competence Versus Chemotherapy Certification?

    The ONS clinical inbox frequently receives questions about whether nurses need to be “chemotherapy certified” to give specific chemotherapy and/or biotherapy agents.

    January 28, 2017
    nurse while pregnant
    Clinical practice

    What Is ONS’s Stance on Handling Chemotherapy While Pregnant, Breastfeeding, or Trying to Conceive?

    One of the questions that ONS commonly receives in the clinical inbox is whether nurses who are pregnant, breastfeeding, or trying to conceive can safely administer or handle chemotherapy and other hazardous drugs.

    January 03, 2017
    Husband and Wife holding hands.
    Clinical practice

    The Case of the Caregiver With Cancer

    Gwen is a 64-year-old woman, recently diagnosed with stage IIIC ovarian cancer. She has her first meeting with the medical oncologist today at 10 am. When she hasn’t arrived by 11 am, Tara, the nurse, calls Gwen’s home to check in on her.
    December 20, 2016
    Advanced practice nursing (APN)

    APRNs Now Have Full Medical Authority in Practice at VA Hospitals

    On December 13, 2016, the Department of Veteran Affairs (VA) announced that three roles of the VA’s APRNs will be able to practice to the full extent of their licensure at VA clinics and hospitals. Certified nurse practitioners, certified nurse specialists, and certified midwifes will see an increased scope in practice authority. Excluded from this ruling are certified RN anesthetists, which the VA is still accepting comment on their inclusion for future rulemaking.
    December 14, 2016
    feet on scale
    Clinical practice

    Can You Identify and Manage Sarcopenic Obesity in Cancer Survivors?

    Sarcopenic obesity, a dual condition in which patients lose muscle mass but gain fat mass, can both be caused by and complicate cancer and its treatment.
    December 13, 2016
    Clinical practice

    Precision Nursing

    As technology and scientific discovery accelerate to meet the growing needs of healthcare providers, cancer treatment and prevention are being redefined. The paradigm is shifting in care, and precision medicine is ushering in novel, individualized ways of treating patients with cancer.
    December 06, 2016
    Clinical practice

    Identifying Medication Errors in Hospice Care

    Medication errors are difficult to quantify in home hospice care, since the patients and their families are doing most of the medication administration themselves. This is a story about how one family members’ inquisitive attitude and partnership with her husband’s hospice nurse prevented a potentially serious medication error.
    November 30, 2016
    Clinical practice

    New Guidelines Suggest Radiation for More Patients With Breast Cancer

    Even women with smaller breast cancer tumors and three or fewer lymph nodes involved can benefit from radiation therapy after mastectomy, according to the results of new guidelines published.
    November 22, 2016
    Clinical practice

    Nurses Dispel Myths, Offer Valuable Education About Palliative Care

    In many ways, palliative care is central to oncology nursing. Defined as care provided to maintain or improve the quality of life of those with a serious illness or injury, this holistic, inclusive symptom control care is something oncology nurses provide as part of routine daily practice—even if they do not label this practice as such.
    November 15, 2016
    Clinical practice

    The Case of the Facebook Friend Request

    Ben is Oliver’s usual infusion room nurse; he and Oliver share a love of Pokemon Go and often roam the halls looking for particular Pokemon. Oliver’s mom, Claudia, is divorced, and Ben has mentioned that he is single as well. One evening, Ben receives a Facebook friend request from Claudia.
    October 18, 2016
    Clinical practice

    Embracing Quality Manager Roles

    Florence Nightingale, a forerunner of evidence-based practice, linked sanitation to morbidity and mortality rates. Her initiatives, such as simple hand washing, remain standards today. The attention and implementation of quality standards have helped change and shape the way our healthcare system grows to keep patients safe.
    October 06, 2016
    Clinical practice

    The Case of the Targeted Therapy Misperception

    Jessica is preparing discharge teaching for Marty, a 63-year-old woman with stage IIIB high-grade serous ovarian cancer. During the discussion, Marty asks Jessica why such harsh treatment is being recommended when targeted therapies can kill cancer without destroying the immune system and causing any severe side effects.
    September 20, 2016
    Clinical practice

    Addressing the Challenge of CLABSI Prevention

    The deck frequently seems stacked against oncology nurses who are striving to avoid central line associated bloodstream infections (CLABSIs). Consider the potential for immunosuppression, the need for prolonged central access, and the potential for poor nutritional status among our patient population, and it can seem nearly impossible to be CLABSI-free.
    September 06, 2016
    Clinical practice

    How Do You Bridge the Gap Between Ethical Dilemmas and Spirituality?

    The care of patients with cancer is fraught with ethical situations and dilemmas that begin with a patient’s initial diagnosis. Chaplains are often involved with patients with cancer and their families throughout their illness. This is especially true as their disease progresses and they must begin discussions on treatment options, withdrawal of treatment, and end-of-life care.
    September 06, 2016
    Clinical practice

    Learning More About Point-of-Care Practices for Neutropenia

    There is no doubt in the mind of oncology nurses that infection prevention is paramount to providing safe, quality cancer care. Neutropenic precautions have long been integrated into the plan of care for patients whose immune system are compromised due to cancer or cancer treatment.
    August 24, 2016
    Clinical practice

    The Case of the Feeding Tube Fear

    Owen has been prescribed radiation and chemotherapy before surgery. He has had two weeks of therapy and has lost nearly five pounds. When the dietician mentioned a feeding tube, he "just blew up." What would you do?
    August 16, 2016
    Clinical practice

    Addressing the Challenge of CLABSI Prevention

    The deck frequently seems stacked against oncology nurses who are striving to avoid central line associated bloodstream infections (CLABSIs). Consider the potential for immunosuppression, the need for prolonged central access, and the potential for poor nutritional status among our patient population, and it can seem nearly impossible to be CLABSI-free.
    August 09, 2016
    Advance care planning

    The Case of the Decision-Making Dilemma

    Daniel is a 55-year-old male diagnosed with stage III nasopharyngeal cancer. He lives with Jon, his partner of 4 years. One day, he is taken by ambulance to the ED where it is determined he had an ischemic stroke. He has no advanced directives or living relatives. What would you do?
    July 19, 2016
    Oncology Medical Personnel
    Clinical practice

    CMS Announces Oncology Care Model

    The Centers for Medicare and Medicaid Services (CMS) have opened a demonstration project in an effort to streamline the provision of care and the reimbursement processes associated with cancer care.
    July 14, 2016
    Clinical practice

    What Oncology Nurses Should Know About the Zika Virus

    Zika disease (ZIKV) is a viral infection spread to humans primarily through the Aedes species of mosquito. ZIKV can also be passed through sexual conduct and vertical transmission from mother to fetus during pregnancy. In February 2016, the World Health Organization declared the spread of ZIKV to be a public health emergency, citing clusters of neurologic-related conditions and birth defects corresponding with geographical outbreaks of the illness.
    July 05, 2016
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