More than one million nurses and other professionals have received training in end-of-life (EOL) care through the End-of-Life Nursing Education Consortium (ELNEC) program in the past 20 years, the American Association of Colleges of Nursing reported on November 6, 2020. The training has transformed EOL care around the world, including for patients with cancer.

Each year more than 50,000 stem cell transplantations are completed worldwide. The stimulation, harvesting, and therapeutic use of patient and donor cells has evolved as a treatment for diverse cancer diagnoses, and specially trained nurses are at the heart of the clinical trials and care delivery to propel cell transplant therapy across practice settings.

Approximately 700 members responded to ONS’s 2020 genomics survey, which gauged oncology nurses’ current genomic knowledge, applications in practice, and the specific questions they have about genetics and genomics. Here are the answers to the most frequently asked questions based on the survey responses.

The Human Genome Project determined the DNA sequence (order of base pairs) of the entire human genome. Humans are 99.9% identical at the level of base pair ordering, but the 0.1% difference contributes to disease risk. Upon completion of the human genetic blueprint, research turned to identifying and cataloguing genomic variation as well as determining the clinical relevance of variants.

Because of treatment effects on hormones, women with breast cancer and men with prostate cancer have an increased risk of frequent and severe hot flashes after treatment. As many as 80% of patients across both genders experience the symptom, which can have an impact on sleep, mood, energy, and sexual function.

Today’s new normal has changed everything at home, from what we wear to how we teach our children—and in the oncology nursing workplace, from new precautions to the rise of telehealth. It’s also affected nurse residency programs, but one institution has thrived as it adjusted.

Max, a 60-year-old patient with head and neck cancer, is receiving chemoradiation. Since his initial consult, he’s experienced a 12% weight loss from baseline, impaired swallowing, pain, anorexia, and dysgeusia. He has financial challenges, limited social support, poor health literacy, and a history of alcohol abuse. He has a feeding tube, but you suspect he is not using it. You reinforce prior education about malnutrition, and although Max refuses to be admitted to the hospital, he promises to do better.

Half of all healthcare professionals have started using telemedicine in response to the COVID-19 coronavirus pandemic. Patients and providers are trying to adjust to such rapid changes in the provision of health care. Providers want to know how to get reimbursement for telemedicine visits. Society is working together to answer the critical questions about this next wave of health care.

Malfunctioning medical products can pose safety risks to both patients and nurses and waste valuable time and resources. All medical devices and equipment used in the United States must pass specific manufacturing requirements before they can be approved for sale. But every product, regardless of performance, is subject to malfunction. A challenge for nurses is determining whether an issue is a rare failure or if the product is legitimately problematic.

Primary care for patients who are cancer survivors is multifaceted. Although my goal as a primary care physician (PCP) remains the same as with all my patients—to continue helping them lead long, healthy lives—care for this population requires some additional steps. 

With the massive paradigm shift in cancer therapy to precision medicine, the use of biomarkers and biomarker testing has also rapidly evolved to guide treatment selection. However, the terminology used in genomics is complex and inconsistent, and patient advocacy organizations recommend using a common taxonomy to prevent confusion among patients and providers alike. Nurses spend more time with patients and families than any other member of the healthcare team and can reinforce common language and terminology. As a nurse, here are the terms you need to understand.

The COVID-19 coronavirus pandemic forced oncology nurses to navigate abnormal circumstances, both at home and at work. Despite facing similar limitations, the Oncology Nursing Society (ONS) created a brand-new learning experience to give oncology nurses expert education, networking opportunities, and access to industry representatives in the wake of canceled in-person events. This September, ONS will host the inaugural ONS Bridge™, the most comprehensive conference dedicated to oncology nurses.

Doug is a 70-year-old man receiving treatment at the cancer center for metastatic renal cell carcinoma. He was initially treated with sunitinib, a tyrosine kinase inhibitor (TKI). He has been experiencing significant upper back pain and is having trouble with fine motor skills in his fingers. The oncologist, suspecting spinal cord compression (SCC), ordered a computed tomography scan, which confirmed metastatic lesions in the spine leading to instability and mild SCC. The oncologist refers Doug for surgery and advises him that a new medication, cabozantinib, will be ordered for after his surgery. The oncologist asks you, the oncology nurse, to instruct Doug on surgical preparations and educate him on cabozantinib.

It is no coincidence that May is Melanoma Awareness Month. As Americans take to the great outdoors, they also must take caution to protect their skin and prevent melanoma.  

Thrombotic events are the second-leading cause of death in patients with cancer after the disease itself. An estimated 4%–20% of patients experience venous thromboembolism at some stage on the cancer journey. 

If current trends continue, the world will see a 60% increase in cancer diagnoses through 2040, the World Health Organization said in its February 2020 Report on Cancer: Setting Priorities, Investing Wisely, and Providing Care for All.  

Sleep disturbances such as insomnia are prevalent and persistent among cancer survivors and diminish quality of life. Because of adverse effects such as continued sleep difficulty, memory disturbances, and falls associated with conventional medications, many patients prefer nonpharmaceutical options to address their insomnia.

On April 3, 2020, the U.S. Food and Drug Administration (FDA) approved luspatercept-aamt (Reblozyl^®) for the treatment of anemia failing an erythropoiesis-stimulating agent and requiring two or more red blood cell (RBC) units over eight weeks in adult patients with very low- to intermediate-risk myelodysplastic syndromes with ring sideroblasts (MDS-RS) or with myelodysplastic/myeloproliferative neoplasm with ring sideroblasts and thrombocytosis (MDS/MPN-RS-T).  

Care coordination, appropriate adverse event assessment and treatment, and rapid, continuous learning are essential priorities for oncology nurses to care for patients receiving immunotherapy, according to the experts who participated in ONS’s immunotherapy summit in March 2018. 

Have you had “aha” moments in your life? Times when you finally understood something so completely that you could now fully explain it to someone else? Perhaps you had an aha moment after a session at the recent ONS Congress or after reading an article in the Oncology Nursing Forum or Clinical Journal of Oncology Nursing. Or maybe you finally understood the benefits of dual inhibition of ER+ metastatic breast cancer with antihormonal therapy and CDK4/6 inhibitors after reviewing the recent infographic included with your ONS journal mailing in May.

To measure the value of oncology nursing certification, scientists must look at the intrinsic, qualitative outcomes associated with nurses achieving certification in practice. The research for oncology nursing certification has largely focused on perceived benefits for nurses, their colleagues, and their institutions. Data suggest that certified oncology nurses feel validated in their knowledge, report personal satisfaction for undertaking and completing the certification process, and say that it enhanced their professional credibility.

For many RNs working in oncology settings, certification might seem like the next step for their career and their commitment to patient-centered care. It’s important to understand the process of certification, along with what resources are available to help them succeed. ONS believes that oncology nursing certification benefits everyone in the cancer care continuum—from patients to family members to the nurses themselves and their employers. Certification shows that a nurse has voluntarily met the rigorous requirements for gaining cancer-based knowledge and experience and is prepared to provide high-quality, competent care to patients with cancer. It acknowledges a nurse’s commitment to career development and dedication to patient care in a constantly changing healthcare environment. 

Oncology care is a complex field in a constant state of paradigm shifts, where new information and research affect clinical practice in countless ways. Amid rapid developments in treatments, technologies, and patient-care modalities, oncology nurses must show they’re up to date with emerging knowledge in their field. Oncology nurse certification is one way nurses can demonstrate their commitment to the art and science of patient-centered oncology care.

Because of its long infusion time over 46–48 hours, 5-fluorouracil (5-FU) is usually administered with an ambulatory infusion pump in the outpatient setting. However, two types of pumps exist. On one side of the spectrum is the elastomeric pump: small, compact, but gets the job done. On the other is the electronic pump: bigger, flashy, with lots of bells and whistles (literally). Here are the advantages and disadvantages of each.

Although cancer isn’t one of the very highest causes of death in Azerbaijan, the nation still feels the impact of the global cancer burden: lung cancer and gastrointestinal cancers rank number 8 and 10, respectively, on the top 10 causes of death in the country, and their incidence is growing. As part of its commitment to sustainable international programs to support the advancement of cancer care, ONS and its members have a responsibility to disseminate knowledge to international nurses in countries like Azerbaijan. 

As the number of cancer survivors continues to increase, more oncology-trained nurses are needed to care for this population. Unfortunately, not all schools of nursing have clinical experiences in the oncology setting. However, the University of North Carolina leadership is committed to increasing the pipeline of students interested in caring for patients with cancer and their families through an innovative summer fellowship program.

When patients with cancer also suffer from psychiatric diagnoses, it can present unique challenges to healthcare professionals. Because oncology nurses build relationships with patients while addressing issues, understanding the obstacles to practice is key to providing the best possible care. By having a keen understanding of symptoms, assessment procedures, and necessary response skills, oncology nurses can work together with the mental health team to provide holistic care throughout the cancer journey. 

Nestled between Tanzania and Mozambique in eastern Africa, Malawi is a country of more than 18 million citizens. It faces a unique cancer burden that’s proven challenging for practitioners and patients alike. With a high prevalence of HIV-infected individuals, Malawi sees a proportionate rate of AIDS-related cancers, including Kaposi sarcoma, cervical cancer, and non-Hodgkin lymphoma. Currently, healthcare professionals in the country face a lack of standardized oncology education and resources. Roughly 84% of the country’s citizens live in rural areas with limited access to healthcare institutions.

Cancer is largely a disease of an aged population. Estimates suggest that about 60% of all cancers are diagnosed in individuals aged 65 or older, and that number is expected to increase to 70% by 2030. Yet many nurses have little formal geriatric-specific training to care for this population’s unique needs.

“If you know other countries and their people, there will be no wars or hatred.” That was the motto I understood when I was younger and I remember participating in international oncology and nursing conferences, exchanging knowledge, resources, and education with other countries. Cancer connects us all, and that maxim has stuck with me and marked my interest in travelling and meeting new people.

Which RN is Competent in Chemotherapy Administration?

1. One that took a chemotherapy course online 2 years ago and recently completed their annual education.
2. One that witnessed a chemotherapy competent nurse administer chemotherapy orally and parenterally on five separate occasions
3. One that took a chemotherapy course offered by her hospital and completed an administration checklist with a chemo competent nurse          
4. One who works on a unit that cares for patients receiving chemotherapy

What comes to mind when someone mentions Brazil? Do you think soccer? The 2016 Rio Olympics? Carnival? The Amazon rainforest? Although all of those are true, even more impressive is what’s happening in oncology nursing throughout Brazil. In August 2018, a small group of dedicated Brazilian oncology nurses—many of whom are ONS members—hosted the Inaugural Oncology Nursing Brazil 2018 conference in Sao Paulo.

Cancers are never confined by borders. For most disease types, the ones seen in clinics and institutions throughout the United States are the same found in other first-, second-, and third-world countries. The realities facing cancer, treatments, and patient outcomes are often challenging to address no matter where you live, and it’s one of the many common threads that tie oncology professionals together the world over.

Oncology nursing is rapidly evolving specialty. Nurses need to stay on top of a complex technologic environment, ever-changing science, and rapid assimilation of research into practice. In doing so, they attain and maintain a high level of competency to adequately and safely care for people with cancer.