CMS Proposes Amendments to Telehealth, Preventive Care, and Staffing Concerns Amid COVID-19
During a global pandemic that requires social distancing, telehealth has suddenly become routine. Seeing an opportunity, the Centers for Medicare and Medicaid Services (CMS) is breaking down barriers, enhancing patient-centered care, and bolstering the healthcare workforce with a series of regulations, with telehealth topping the list.
Nurses Present Patient-Centered Research on Survivorship and Health Disparities
Distress, uncertainty, and barriers to care are common experiences for patients with cancer and survivors. Yingzi Zhang, PhD, RN, of the School of Nursing at the University of Rochester in New York, and Jin Young Seo, PhD, WHNP-BC, RN, of Hunter College in New York, NY, reported on their research on quality of life and access to care in vulnerable patient populations.
What the Evidence Says for Use of Qigong in Patients With Cancer
Qigong is a mind-body practice that originated in China nearly five millennia ago. It integrates movement, meditation, and breath regulation to improve physical and emotional health. The actions are slow, gentle, flowing, repetitious, and weight-bearing and can be adapted or practiced while sitting, standing, or walking. Qigong styles and forms vary widely, depending on the school of thought and philosophy.
Secondary Cancers in Pediatric Survivors
A child’s cancer diagnosis can tear apart a family’s sense of security. After successfully navigating the cancer experience and all that comes with it, no one wants to face that again, and patients and families may fear an increased risk for secondary cancers. Oncology nurses can support pediatric cancer survivors and their families with resources for monitoring and reassurance about the possibility of facing secondary cancer.
Mental Well-Being Is a Focus of Primary Care Throughout Survivorship
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.
Oncology Nurses Have a Special Power of Presence
Like most nurses, my shifts as a new nurse functioned as consistently as clockwork. I would begin my afternoon shift by reviewing the assignment list. The previous shift’s nurses would handoff the patients, and I would head out to the unit to report to my assistive personnel and review the patients’ medication administration records. Every hour was dedicated to a different task, including my dinner break. That is, until a monumental moment jostled me from my systematic routine.
Psychosocial Support for Patients With Cancer During COVID-19
When the COVID-19 novel coronavirus pandemic hit the United States, in a matter of days clinicians were scrambling to find novel ways to screen, triage, and provide telehealth interventions to protect patients with chronic conditions who are especially vulnerable to COVID-19. As nurses, we are accustomed to helping patients in crisis acclimate to a changing environment, process large amounts of information, and have their psychosocial needs met.
End-of-Life Care Helps Patients Pursue Purpose in the Presence of Pain
“It’s going be okay.”
That common phrase is full of meaning, yet so vague. Often, it’s a patient’s response when they’re first diagnosed or are told that all of the treatments have failed and they only have a few months to live. Other times, a family member will voice the remark when holding a patient’s hand as they provide comforting hope or temporary relief from distress. Sometimes an oncology nurse shares the phrase in an attempt to calm the agony their patients face each day.
Cardio-Oncology Program Monitors Heart Toxicities Throughout Survivorship
Cancer is second only to heart disease as the leading cause of death in the United States. But heart conditions overlap with cancer in more ways than mortality. Chemotherapy, immunotherapy, radiation, and the myriad medication combinations used in cancer can lead to various complications, including cardiotoxic side effects. Because of the prevalence of heart disease, many patients with cancer also present with pre-existing cardiac comorbidities.
Nurses Can Make a Difference, One Shaved Leg at a Time
In nursing school and during my first clinical rotations, I was always uncomfortable with performing bed baths. To shut out my discomfort, I would focus on the task at hand, doing my best to ensure the patient’s privacy, keeping the water warm, and only exposing the one body area I was washing at the moment.
CAR T-Cell Therapy Offers Rapid QOL Improvements in Younger Patients
Children and young adults with relapsed or refractory B-cell acute lymphoblastic leukemia reported rapid improvements in quality of life (QOL) after treatment with tisagenlecleucel, a CAR T-cell therapy, according to the results of a study published in Lancet Oncology.
Digital Sherpas Enhance Nursing Care, Patient Quality of Life
Technology is great when you get it. But when you don’t, it can be a real burden, and an extra burden is the last thing a patient with cancer needs. Fortunately, at the Moffitt Cancer Center in Tampa, FL, we’ve found a program that not only helps our nurses and our patients with technology, but it also brings our older patient population together with the positive energy of younger members.
The Vital Role of Oncology Nursing in Ambulatory Care
Thanks to significant scientific and technologic advancements in the past 15 years, the majority of cancer care—an estimated 80% or higher—is being delivered in the outpatient setting.For patients, ambulatory oncology care offers comfort, flexibility, and a sense of normalcy during their difficult cancer journey while maintaining the highest-level treatment and care for optimal outcomes. Oncology nurses are key to successful outpatient care, serving as caregivers, educators, advocates, and patient champions from diagnosis through treatment and into survivorship.
Evidence Shows Tai Chi May Be Useful for Insomnia
Nearly 60% of people with cancer experience insomnia; it can persist for years if not appropriately managed. Furthermore, patients with cancer who have insomnia are at increased risk for infections, anxiety, and depression, which can negatively affect quality of life.
Tachycardia Tied to Higher Mortality in Patients With Cancer
Rates of all-cause mortality in patients with cancer increase in the presence of unexplained sinus tachycardia, the results of a new study show. Researchers presented the findings at the Advancing Cardiovascular Care of the Oncology Patient conference held January 2019 in Washington, DC.
Nurse-Devised Solutions Help Improve Patients’ Treatment Experience
Two very different projects in which nurses developed creative solutions to common patient problems and helped to improve patients’ treatment experience were the focus of a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA.
New Research Findings Will Help Improve Quality of Life for Cancer Survivors
Thanks to new treatments and technologies, the number of U.S. cancer survivors has increased to 16.9 million as of January 2019. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, several healthcare professionals presented new research to support the ever-growing population of cancer survivors.
Geriatric Assessments Can Improve Shared Decision Making, Patient Satisfaction
As people age, their risk for cancer increases, and so too does the complexity of their cancer care. Older patients with cancer typically present with age-related conditions like comorbidities, functional problems, falling, and polypharmacy, which are not as widely discussed in the oncology space as they should be. Age-
related concerns can influence outcomes for patients with cancer and their caregivers, including treatment toxicity, hospitalization, and even early mortality.
Understand the Evidence for Exercise in Gynecologic Cancer-Related Fatigue
Cervical cancer is the fourth most common cancer in women and the seventh most common overall. Cancer-related fatigue (CRF) has an estimated prevalence of 50%–90% in all patients and has been reported to affect 17%–33% of women with gynecologic cancers for as long as three to eight years after diagnosis. Many national guidelines from organizations such as the American College of Sports Medicine, American Cancer Society, National Institute for Health and Care Excellence, and ONS all recommend exercise to improve fatigue in patients with cancer. But no research has synthesized the evidence for exercise as an intervention for fatigue specifically in patients with gynecologic cancers.
Psychological Distress Is Interdependent in Patients With Cancer and Their Caregivers
About 30% of all cancer survivors and their caregivers have reported psychological distress, which encompasses diagnoses of depression, anxiety, and overwhelming stress. For both survivors and caregivers, psychological distress can negatively impact different aspects of treatment, care, and well-being. In fact, patients with lower levels of psychological distress have been shown to recover quicker, exhibit fewer symptoms, and even have lower mortality rates after treatment.
Survival Gains Make CAR T-Cell Therapy Cost-Effective for Pediatric Leukemia
When evaluated based on the cost per life-year gained, the chimeric antigen receptor (CAR) T-cell immunotherapy drug tisgenlecleucel is considered cost effective in pediatric B-cell acute lymphoblastic leukemia, researchers reported in a new study. The findings were published in JAMA Pediatrics.
HHS Proposes Policy Changes for Medicare Advantage, Part D Drug Pricing
U.S. drug pricing systems are difficult for patients to understand, cumbersome to maneuver, and limited in access and affordability. In Medicare’s current structure, certain medications are designated as a protected class of drug, and Medicare Part D plans are obligated to cover them.
The Case of the Gender Gaffe
During the morning shift change, Charlie, an RN, receives a report on Ellis, age 52, who was admitted three days ago for severe abdominal pain and persistent diarrhea after cycle 3 of high-dose ipilumumab and nivolumab.
When Charlie and the certified nursing assistant (CNA) enter Ellis’s room, the patient is sitting up in bed caressing hands with a woman of similar age. Ellis requests help getting into the shower, so Charlie says to the CNA, “Please, help him shower, and I will finish introductions.”
Ellis interrupts Charlie. “I am not a he!”
What You Need to Know About Caring for Geriatric Patients With Cancer
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.
WHO Cautions About Inactivity Pandemic and Disease Risk
No improvement in worldwide exercise levels has been seen since 2001, and, in fact, inactivity has worsened, data in a new report from the World Health Organization (WHO) indicated. The findings were published in Lancet Global Health.
Caring for Patients Through All Levels of Survivorship
The medical terms for living with and beyond a cancer diagnosis identify patients as entering the survivorship phase of their cancer journey. However, as science continues to develop new treatments responsible for extending patients’ lives, new levels of survivorship are being determined.
Use the Evidence to Support Physical Activity During and After Cancer Treatment
We’re familiar with the evidence: being active is better for all of us throughout our lives. In fact, regular physical activity is one of the most important things we can do for our health, according to the Centers for Disease Control and Prevention. Physical activity can help to control our weight and reduce our risk of cardiovascular disease, type 2 diabetes, and some cancers.
Animal Therapy Has Benefits for Patients—and Healthcare Staff
Animal-facilitated therapy (AFT) programs have been shown to promote a healing environment and reduce certain psychological symptoms for patients with a variety of diagnoses, including cancer. Its use was even recommended by the founder of modern nursing, Florence Nightingale, who wrote about the benefits of animals in patient care and recovery: “a pet is often an excellent companion for the sick, for long chronic cases especially.”
Regular Exercise May Improve Outcomes in Patients With Lung Cancer
In addition to lowering cancer risk, regular exercise before lung cancer surgery may improve postoperative outcomes, especially in lung cancer, according to the results of a literature review published in the British Journal of Sports Medicine.
Expressive Writing Can Help Patients Understand and Process Their Cancer Diagnosis
Writing images from one’s memory and imagination can be a healing act. According to a recent study on expressive writing and patients with cancer, some individuals may benefit from participating in expressive writing as part of their supportive cancer treatment. The writing act can be a form of healing for patients struggling with their cancer diagnoses.
President’s Cancer Panel Reports on Drug Costs and Value
Although it’s one of the less visible commissions, the President’s Cancer Panel monitors the activities of the National Cancer Program and reports on the burden of cancer. The panel reviews a number of topics and keeps current with demographic information and the latest cancer incidence research. After reviewing and recommending based on existing data, the panel releases a formal report to the president. In its most recent report, the panel found serious issues with barriers to access for cancer survivors, and it addressed the costs of drugs and the value therein.
Supportive Care Programs for Patients With Cancer
Focusing on a patient’s quality of life is often a key component to their successful cancer journey. Treating their disease is crucial, but patients have to be recognized as individuals with unique and varying needs. Addressing their emotional, physical, spiritual, and psychosocial stressors can help provide holistic treatment that’s at the heart of successful oncology care.
Managing Weight Loss in Patients With Cancer
Patients’ weight and nutrition status will often vary throughout the cancer care continuum. Weight loss might occur before the diagnosis, be one of the presenting cancer symptoms, be related to the tumor itself, or be secondary to side effects of their treatment (e.g., anorexia from chemotherapy or radiation).
Integrate Evidence With Clinical Expertise and Patient Preferences and Values
Nursing is often referred to as both an art and a science. Evidence-based practitioners must combine understanding the science of health, illness, and disease with the art of adapting care to individual patients and situations, all while thinking critically to improve patient outcomes.
Sleep-Wake Disturbances in Patients With Cancer
In bedrooms across the United States, people are crawling into bed, turning down the lights, and lying awake for hours on end. Sleep-wake disturbances and short sleep duration are extremely common, and rates are even higher in patients with cancer. Unfortunately, screening, assessment, and interventions are lacking for patients experiencing sleep-wake disturbances during their cancer journey.
Evidence Shows How Music Therapy Can Affect Patients With Cancer
Music has historically been associated with health and healing in cultures around the world. As a therapeutic intervention in patients with cancer, it is used to address physical and psychological symptoms. The sessions are tailored to meet patients’ individual needs and abilities and can involve listening to, writing, performing, or discussing music and lyrics, guided by a trained therapist. Although music does not affect the disease itself, it produces more immediate effects compared to pharmacologic agents, has a positive impact on mood, and strengthens patients’ ability to cope.
The Case of the Physical Activity Prescription
Raj recently presented to the emergency department for hemoptysis and shortness of breath. Subsequent computed tomography scan and biopsy reveal metastatic small cell lung cancer. He is a 62-year-old former smoker who is 25 pounds overweight and works as an accountant for a large automobile dealership.
Patients With CLL Report Worse QoL and Other Factors
Researchers assessed how patients with chronic lymphocytic leukemia (CLL) describe quality of life (QoL) compared to other U.S. populations, as well as the effects on daily living, finances, and professional and family relationships. Joanne S. Buzaglo, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Sweet Dreams Discourage Inflammation
Do you consider sleep to be part of your self-care regimen? Does a spinning wheel of thoughts keep you from restful sleep, or do you consciously sacrifice sleep time? If so, you are not alone. The Centers for Disease Control and Prevention (CDC) declared that insufficient sleep is a public health epidemic with an estimated 25% of the United States population suffering from some type of sleep disturbance.
The Crucial Role of Symptom Management in Cancer Care
Listening to feedback from patients is still one of the most important ways providers can assess and plan treatments for patients with cancer. However, symptom management is never as simple as screening for pain or asking about fatigue: it involves complex decision making, evidence-based interventions, and the support of the entire care team. It’s a central practice to oncology nursing, and it’s paramount to the successful outcomes of patients with cancer.
Safety of Medicinal Mushrooms in Patients With Cancer
Mushrooms have been valued for their health-promoting and medicinal effects for thousands of years. Research over the past few decades has focused on maitake (Grifola frondosa), reishi (Ganoderma lucidum), coriolus (Coriolus versicolor), shiitake (Lentinula edodes), and agaricus (Agaricus blazei), which are predominantly used in Asia.
Patients’ Out-of-Pocket Cancer Costs Are Higher Than Expected
Despite having healthcare coverage, a third of patients with cancer end up paying more out of pocket than they expected for their cancer treatments, a new study found. The results were published in JAMA Oncology.
Exercise's Role in Cancer Care
Until the 1980s, the value of exercise was unrecognized in the oncology setting. It was widely believed that patients with cancer undergoing cytotoxic treatments needed to rest and avoid exercise. But a 1989 study conducted by Winningham and Mac Vicar, both oncology nurses at the Ohio State University, dispelled this notion. The trial involved 45 women receiving adjuvant chemotherapy for operable breast cancer and showed that a 10-week interval-based, aerobic exercise was not only safe but also significantly improved body composition, aerobic capacity, and patient-reported nausea.
Management of Immunotherapy-Related Endocrinopathies
Advanced practice oncology nurses know how complex the care of patients with cancer can be. Every day seems to bring further advancements in the treatment and management of cancer. It can be difficult to keep up with the onslaught of new information, but our patients rely on us to bring them the latest, greatest, and safest treatment options available.
Walls and a Blue Ribbon
I arrived at work on Tuesday morning to find my charge nurse handing out blue ribbons, beads, and bracelets to staff.
"March is National Colon Cancer Awareness Month,” she said. “Put on the blue, we're promoting awareness and encouraging people to get their screenings!" I stared at some of my coworkers with ribbons tied neatly in their hair.
It’s important to know that I routinely have to field the question, "Are you sure you're old enough to be a nurse?" I had a feeling the ribbon wasn't going to help my credibility. This was also my second day of caring for a patient struggling to cope in a very tough fight against colon cancer. Would she mind? Would it be insensitive?
Massage Has Therapeutic Value for Patients With Cancer
An ancient form of bodywork that encompasses hands-on manipulation of muscles and soft tissues, massage increases circulation, reduces muscular tension and promotes relaxation. It also produces emotional and psychological benefits.
Adverse Events Influence Patient-Reported Quality-of-Life Scores
Researchers conducted a single-center, cross-sectional study to examine the relationship between patient-reported quality-of-life (QOL), adverse events (AEs), and treatment characteristics (including tumor type, drug class, number of cycles, and treatment intent). The study’s findings were presented at the 2017 ASCO Annual Meeting.
Location of Discharge Affects Quality of Life and Symptom Burden for Those With Advanced Cancer
Patients with advanced-stage cancer experience frequent hospitalizations, followed by post-discharge transitions of care that can influence patient quality of life. A study presented at the ASCO Annual Meeting sought to examine predictors of discharge location for these patients.
Occupational and Physical Therapy May Improve Mental Health for Older Adults With Cancer
Older adults with cancer can have limited functional and health status; however, occupational (OT) and physical therapy (PT) are underused resources of care in this patient population. Researchers evaluated an outpatient CAncer REhabilitation (CARE) intervention program for this older adults in comparison to usual care. The study’s findings were presented at the ASCO Annual Meeting.