Is Palliative Care the Answer to the Medical Aid in Dying Discussion?
Oncology nurse scientists have pioneered efforts in symptom management research, including palliative and end-of-life care studies. Healthcare providers and researchers have strong consensus that palliative interventions should begin at the time of diagnosis for patients with cancer. The Clinical Journal of Oncology Nursing and Oncology Nursing Forum have published excellent articles in nearly every issue on topics of palliative care, quality of life, and symptom management issues.
What Does the Research Say About Probiotics and Health?
Probiotics are live microorganisms that can offer health benefits following consumption, by reversing dysbiosis: changes in the composition or function of gut microbes associated with the development of many chronic and degenerative diseases. The majority of probiotics contain nonvirulent, lactic acid-producing bacteria, including Lactobacillus, Streptococcus, Bifidobacterium, Propionibacterium, and Enterococcus, or yeasts such as Saccharomyces boulardii. They are available as dietary supplements or can be obtained from yogurt and other fermented foods. Probiotics have grown in popularity over the past few decades because of perceived benefits such as improved digestion, immune function, and nutrient absorption.
Nurses Are Using Quality Care to Improve Patient Outcomes
Staying updated on advancements in cancer care increases the chances of improved outcomes for patients. Cara Henderson, RN, BSN, CMSRN, patient service manager of surgical oncology at Smilow Cancer Hospital in New Haven, CT; Elizabeth Rodriguez, DNP, RN, OCN®, nurse leader of outpatient services at Memorial Sloan Kettering Cancer Center in New York, NY, Amanda Choflet, DNP, RN, OCN®, director of nursing in radiation oncology at Johns Hopkins Health System in Baltimore, MD, and Megan Howe, MSN, RN, OCN®, nurse manager of Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, discussed the factors that relate to improving outcomes, the multidisciplinary approaches to the process change strategy, and the results and future direction of chosen pathways during a session at the 43rd Annual Congress in Washington, DC.
Genomics Is Revolutionizing Cancer Care Now and For the Future
As precision oncology continues to expand, so does the ability to use less-toxic targeted therapies. James Chen, MD, assistant professor of biomedical informatics and assistant professor of internal medicine at the division of medical oncology at Ohio State University in Columbus, described his work with genomics in cancer care and the challenges in precision medicine at the 43rd Annual Congress in Washington, DC.
Communication, Organization Are Top Drivers of Oral Adherence in Clinical Trials
Oncology nurses know the challenges of patient adherence to oral cancer therapies. Every dose a patient misses can affect their outcomes and chance of survival. But in clinical trials, oral adherence has even broader implications: when a study is evaluating the efficacy of a drug, it depends on study participants taking it exactly as the trial outlines.
New Gene-Based Tests Screen and Monitor for Bladder, Endometrial, and Ovarian Cancers
Researchers have developed two new gene-based tests that detect DNA mutations that lead to bladder, endometrial, and ovarian cancers. The tests, which are not yet U.S. Food and Drug Administration approved, could be used to identify a new or relapsed cancer earlier, when it is easier to treat.
Boosting T-Cell Memory Enhances Immunotherapy Effectiveness
A combination of immunotherapies may increase the formation of memory T cells and lead to a more lasting response, according to findings from a study presented at the American Association for Cancer Research’s 2018 annual meeting.
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.”
Immunotherapy Plus Chemo Improves Survival in Metastatic Lung Cancer
Combining pembrolizumab and platinum chemotherapy plus pemetrexed doubles survival in patients with nonsquamous non-small cell lung cancer (NSNSCLC) without EGFR or ALK gene mutations, according to the results of a study published in the New England Journal of Medicine.
Psychological Distress Affects Caregivers but Not Patient Symptoms in Head and Neck Cancer
Psychological stress in caregivers of patients with head and neck cancer (HNC) may impair the quality of patient care they provide and affect outcomes such as survival. However, patient symptom burden and caregiver tasks and their impact on psychological stress is not well understood.
Study Investigates How Health Literacy Affects Adherence to Oral Cancer Medications
Ensuring patients adhere to oral medications for cancer can be a complex task, especially if patients have low health literacy. Oral medications for cancer continue to be more prevalent, but rates of adherence to oral therapy vary widely by population, cancer type, and level of education. At the 2018 American Society of Clinical Oncology Annual Meeting, researchers presented the results of a study that hypothesized health literacy’s connection to oral medication adherence and whether a multilevel intervention approach would result in greater adherence.
Researchers Clarify Connection Between Night Shift Work Duration and the Risk of Colorectal Cancer
Evidence already supports a connection between night shift work and an increased risk of colorectal cancer (CRC), but the mechanism has been difficult to pinpoint. In a study presented at the 2018 American Society of Clinical Oncology Annual Meeting, researchers evaluated the insulin receptor substrate (IRS) 1 and 2 proteins and presented the role they play in the connection of night shift work and CRC.
Early Oncology Care Model Data Show Reduced Hospital Admissions
Improving quality and reducing costs in a practice are two of the Oncology Care Model’s (OCM) key goals, and one of the best ways to achieve them is to reduce unnecessary emergency department (ED) visits and hospitalizations. During a study presented at the 2018 American Society of Clinical Oncology Annual Meeting, researchers described a campaign implemented to reach those objectives.
Patients Report More Satisfaction With Multidisciplinary Care Versus Serial Care for Lung Cancer
Despite the prevalence of multidisciplinary (MD) care for cancer, rigorous studies comparing it to serial care (SC) are lacking. To address the literature gap, researchers explored the use of MD versus SC for lung cancer and presented the findings at the 2018 American Society of Clinical Oncology Annual Meeting.
Study Finds That Safety Decreases as Electronic Health Record Capability Increases
More needs to be known about how communication challenges and documentation affect ambulatory oncology care. In a presentation on Saturday, June 2, at the 2018 American Society of Clinical Oncology Annual Meeting, researchers revealed study findings about how patient safety is directly affected by electronic health record (EHR) capability and satisfaction, clinician communication, and clinicians’ actions.
Nurses Should Focus on Goal Setting and Shared Decision Making in Cancer Aftercare Conversations
Goal setting and shared decision making are important components of aftercare for cancer survivors. In the results of a study published in conjunction with the 2018 American Society of Clinical Oncology Annual Meeting, researchers shared their experience developing and pretesting a systematic conversation approach for nurses to tailor the aftercare needs and goals of cancer survivors.
Organizational Learning and Perception Tied to Improved Patient Safety Culture
Patient safety is an important focus for hospitals: protecting patients improves outcomes and quality of care, meets standards, and ensures payments and reimbursement. But what factors contribute to a culture of safety? Researchers assessed and analyzed the components of patient safety culture and published their study findings in conjunction with the 2018 American Society of Clinical Oncology Annual Meeting.
Study Quantifies Data on NPs and PAs Caring for Older Adults With Cancer
Cancer is the most common diagnosis in adults older than 65 in the United States. As the older adult population increases and drives up malignancy diagnoses, nurse practitioners’ (NPs) and physician assistants’ (PAs) contributions to their care need to be better identified. In the results of a study published in conjunction with the 2018 American Society of Clinical Oncology Annual Meeting, researchers reported on their exploration of the role of NPs and PAs in the oncology workforce.
National Capital Chapter Members Focus on Advocacy and Research Funding in DC
In our nation’s capital, healthcare policy meetings occur weekly for various government and private organizations whose aim is to improve care and conditions for patients with cancer. The ONS National Capital Chapter members are involved in lobbying on the Hill and attending meetings about improving cancer care through the ONS Capitol Hill Gang.
Tips for Creating a Multidisciplinary Research Team Focused on Symptom Management
Catherine Bender, PhD, RN, FAAN, of the University of Pittsburgh, and Amy Hoffman, PhD, RN, of Michigan State University, shared their experiences in building interdisciplinary research teams to assess symptom management during a session at the 43rd Annual Congress in Washington, DC.
The Power of a Nurse: The Mara Mogensen Flaherty Memorial Lectureship
Margaret Bevans, PhD, RN, AOCN®, FAAN, program director and clinical nurse scientist at the National Institutes of Health’s Nursing Research and Translational Science department, detailed her own journey and empowered nurses to amplify their impact during her Mara Mogensen Flaherty Memorial lecture at the 43rd Annual Congress in Washington, DC.
Immunotherapy Opens New Frontiers in Lung Cancer Care
The development of targeted therapies brought new progress to lung cancer treatment and research in the past 20 years, and new options will continue to be available in the future. Roy Herbst, MD, PhD, director of thoracic oncology research program at the Yale Comprehensive Cancer Center at Yale School of Medicine in New Haven, CT, spoke at the 43rd Annual Congress in Washington, DC, on new standards of care for non-small cell lung cancer (NSCLC), immunotherapy for NSCLC, and development of rational drug combinations using biomarkers.
Nurse Scientists Are Promoting the Future of Cancer Nursing Research at NINR and NCI
Many programs at the National Cancer Institute (NCI) are focused on cancer research, and support for cancer- and treatment-related symptoms and toxicities crosses a number of National Institutes of Health (NIH) organizations. Martha Matocha, PhD, program director and team lead of the National Institute of Nursing Research (NINR), and Ann O’Mara, PhD, RN, FAAN, program officer at NCI, provided tips and opportunities for nurses and how they can conduct or participate in cancer research programs during a session at the 43rd Annual Congress in Washington, DC.
Huntington Disease May Hold Key to Novel Cancer Treatment
The mutated huntington (HTT) gene causes the body to generate a class of small molecules that are toxic to cancer cells but not most healthy cells, according to the results of a new study published in EMBO Reports. The researchers went as far as to call it a “super assassin against all tumor cells.”
How Aromatherapy With Essential Oils May Help Patients With Cancer
Aromatherapy has grown in popularity over the past few decades for improving sleep and mood and for reducing anxiety, but its first use dates back more than 5,000 years. The practice involves using essential (aromatic) oils, derived typically from steam distillation of plants, through application to the skin as a component of therapeutic massage or inhalation with vaporizers, inhalers, or hot water baths.
Childhood Obesity May Be a Factor in Increasing Cancer Rates in Young Adults
Although overall cancer rates are on the decline, 9 of the 20 most common cancers in the United States are increasing more frequently in young adults aged 20–44. And those same 9 cancers are among the 13 cancers that have clear ties to obesity. In a new study published in Obesity, a researcher makes the case for a connection between the two.
Evidence for Nephrotoxicity Prevention With Cisplatin Therapy Is Still Limited
Cisplatin chemotherapy is used alone or in combination to treat a variety of cancers, including ovarian, testicular, lung, cervical, bladder, head and neck, and gastric cancers as well as lymphoma, melanoma, and more. Although it offers options for many cancer types, its use may result in nephrotoxicity, a dose-limiting side effect. Use of hydration and diuretics may help reduce its incidence, but no standards or best practices are in place to guide those treatments.
FDA Approves Tisagenlecleucel for Adults with Relapsed or Refractory Large B-Cell Lymphoma
On May 1, 2018, the U.S. Food and Drug Administration (FDA) approved tisagenlecleucel a CD19-directed genetically modified autologous T-cell immunotherapy, for adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, high grade B-cell lymphoma and DLBCL arising from follicular lymphoma.
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.
How Does Mentorship Help New Oncology Nurse Authors Get Published?
Writing and publishing for the first time can be a daunting experience, but the Clinical Journal of Oncology Nursing (CJON) Writing Mentorship Program is a great opportunity for oncology nurses looking to publish their own work. The program pairs published nurses who share their experiences and expertise with ONS members who are new to the publishing process.
Insurer Group Warns Against Short-Term Health Plan Proposal; Medicaid Won’t Look the Same in 2019; Rapid Autopsy Programs Seek Clues to Cancer Within Hours of Death
Earlier in 2018, the Trump administration proposed a new rule that would permit Americans to buy short-term health insurance for up to 12 months, breaking from an Obama-era regulation that limited short-term health plans to a maximum of three months. To some, the proposed extension would potentially extend coverage to Americans interested in insuring themselves and their families. However, the America’s Health Insurance Plans group is on the other side of the argument, insisting that temporary plans—for any length of time—are no substitute to real coverage. Short-term plans are not covered by Affordable Care Act regulations, and it could lead to patients with pre-existing conditions being charged more for temporary insurance.
How DNA Revolutionized Oncology Care
April 25, 2018, marks National DNA Day. Why the hype? National DNA Day commemorates the successful completion of the Human Genome Project in 2003, and the discovery of DNA's double helix in 1953. Without DNA, understanding the diseases and treatments for cancer would be nearly impossible. Genetics and genomics play huge roles in treating malignancy, and it’s crucial to the care of patients with cancer for oncology nurses to understand genetics and genomics.
Labs Differ Widely in BRCA Testing Protocols
An international survey of 86 genetic testing labs showed inconsistent protocols and standards for analyzing the BRCA1 or 2 cancer susceptibility genes and their variations. The results were reported in NPJ Genomic Medicine.
FDA Approves Fostamatinib Tablets for ITP
On April 17, 2018, the U.S. Food and Drug Administration approved fostamatinib disodium hexahydrate tablets for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment.
FDA Approves Everolimus for TSC-Associated Partial-Onset Seizures
On April 10, 2018, the U.S. Food and Drug Administration (FDA) approved everolimus tablets for oral suspension for the adjunctive treatment of adult and pediatric patients aged 2-years and older with tuberous sclerosis complex (TSC)-associated partial-onset seizures. Everolimus is also approved for two other manifestations of TSC: TSC-associated subependymal giant cell astrocytoma (SEGA) and TSC-associated renal angiomyolipoma.
NIH Funds Precision Research for Childhood Cancer; Will Congress Lift Medicaid Ban for Opioid Epidemic?; FDA-Approved Breast Cancer Test May Impact Oncology Nurses
Cancer treatments aren’t one-size-fits-all, and they differ greatly depending on age. As the leading cause of disease-related death for children, pediatric cancers pose a critical threat to this population. According to the National Institutes of Health (NIH), one reason pediatric cancer mortality rates persist is because there’s “limited knowledge” related to the biological mechanisms affecting childhood cancers. NIH-funded studies are breaking ground and uncovering new information about the genomics of pediatric cancers.
NCI Updates Cancer Trends Progress Report
The National Cancer Institute (NCI) has proactively shared new information and trends with the general public. Through its Cancer Trends Progress Report, NCI provides descriptions of research and data to help review past experiences and assist the agency in planning for future research funding.
2018 U.S. Budget Agreement Contains Key Wins for ONS—Plus an Area of Concern
The U.S. Congress continued its budget pattern in February, enacting another extension of the 2017 budget agreement into law on February 8, 2018. The current iteration of the budget law will raise caps on defense and non-defense spending over two years and keep the federal government running through March 23, but more importantly, it includes the following provisions of special interest to ONS.
Search the Literature to Critically Appraise Evidence
Changes in technology have brought about significant opportunities in how we identify and manage information. We have access to published research and clinical articles from thousands of journals to answer clinical questions. Finding the right information can be challenging, but building your skills in searching for evidence and synthesizing evidence is critical to becoming an evidence-based practice expert. Here’s how to proceed.
NIH: A Look Back at 2017 in Research
To plan for a strong future, one must understand the past. Reviewing the previous year’s accomplishments is always a good policy for reflection and improvement. It can help remind us of the accomplishments achieved in 12 short months. Such was the case at the National Institutes of Health (NIH), as director Francis Collins addressed the research achievements for 2017 in his opening blog.
FDA Clears Genomic Profiling Tests for Cancer Treatment
Former National Institutes of Health (NIH) Director, Harold Varmus, when asked about cancer treatment, once said, “One of the major advances we’ve had as a result of cancer research is deep recognition of the complexity of cancer. It’s not one disease, it’s lots of different diseases. Every single cancer is different when you look at it on a genetic level.”
National Academies Explain the Public Health Consequences of E-Cigarettes
The National Academies of Sciences, Engineering, and Medicine recently released its latest report on the consequences of smoking, specifically related to electronic cigarettes. The report discusses the new effects of e-cigarettes as a public health hazard. According to the report, the effects of long-term e-cigarette use are still unknown, especially related to morbidity and mortality.
Immunotherapy Without Immune Cells May Be on the Horizon
Researchers have generated immunotherapy in the laboratory using nonimmune cells. If the findings can be translated into treatment, it may reduce some of the immune-related adverse events that patients experience with today’s cancer immunotherapy treatments. The study was reported in Nature Chemical Biology.
FDA Broadens Afatinib Indication to Previously Untreated, Metastatic NSCLC
On January 12, 2018, the U.S. Food and Drug Administration (FDA) granted approval to afatinib for a broadened indication in first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose tumors have non-resistant epidermal growth factor receptor (EGFR) mutations as detected by an FDA-approved test.
Most Americans Are Unaware of Key Cancer Risk Factors
According to results from the first National Cancer Opinion Survey of 4,016 U.S. adults, the majority of Americans are unaware of several major risk factors for cancer, particularly obesity, which is the second-largest preventable cause of cancer in the United States, after smoking.
Discovery of Peripheral Neuropathy Cause May Lead to Preventive Treatments
Researchers have found that taxane chemotherapies such as paclitaxel impede a protein called Bclw, which leads to the side effect of peripheral neuropathy. The study results were published in Neuron.