What Is Metformin’s Impact on Pancreatic Cancer Risk?
Metformin is one of the oldest and most reliable pharmacologic treatments for type-2 diabetes and had, in the past, been suggested as a potential pancreatic cancer risk reducer in the National Comprehensive Cancer Network (NCCN) guidelines for pancreatic adenocarcinoma. Although more recent versions of the guidelines have removed that language, our team was curious about the possible link between metformin and pancreatic cancer risk.
Patient Stress Linked to More Advanced Leukemia
Patients with chronic lymphocytic leukemia (CLL) who experience more stress also have more cancer cells in their blood and elevated levels of three other advanced disease markers, according to results of a study published in Cancer. It is the first study to link stress with biologic disease markers in patients with CLL.
Fitness Trackers Provide Helpful Postsurgical Data on Patients With Cancer
With the ubiquity of smartphones and, more recently, smart watches and fitness trackers, the potential to use these devices to monitor and assist patients with cancer has never been greater. Being able to monitor and respond to patient data through fitness trackers could help healthcare professionals provide swift, accurate interventions in the future. Our proof-of-concept study, “Wireless Monitoring Program of Patient-Centered Outcomes and Recovery Before and After Major Abdominal Cancer Surgery,” explored the feasibility and acceptability of using technology, including fitness monitors, to efficiently monitor patient-generated health data by answering the following questions:
Circulating Tumor Cells Predict Survival
Circulating tumor cells (CTCs) are identified in 20%–25% of patients with nonmetastatic breast cancer, and recent research suggests that detection of CTCs at five-year follow-up may predict late recurrence for nonmetastatic, estrogen receptor-positive (ER+), human epidermal growth factor receptor 2-negative (HER2–) breast cancer. In a study presented at the , researchers from the University of Texas MD Anderson Cancer Center found that the presence of CTCs in patients with nonmetastatic breast cancer was associated with shortened relapse-free survival (RFS), regardless of the subtype.
HPV 9-Valent Vaccine Approved for People Aged 27–45
In October 2018, the U.S. Food and Drug Administration expanded the approved use of the human papillomavirus (HPV) 9-valent vaccine to include women and men aged 27–45 years. Previously, the vaccine had been approved for males and females aged 9–26 years, but the expanded approval was granted after the application had undergone priority review.
Manage Afatinib’s Adverse Events to Keep Patients on Treatment
Ongoing therapy with afatinib—an oral, irreversible ErbB family blocker—for as long as it is effective and tolerable is considered first-line treatment for metastatic non-small cell lung cancer in patients with EGFR mutations. In their article in the October 2018 issue of the Clinical Journal of Oncology Nursing, Edwards, Adan, Lalla, Lacouture, O’Brien, and Sequist discussed the most common adverse events (AEs) associated with afatinib and their real-life experiences managing them in clinical practice to keep patients on therapy.
Trastuzumab Remains Standard HER2+ Breast Cancer Therapy Despite Cardiac Risks
Trastuzumab can improve disease-free survival (DFS) and overall survival (OS) in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer. Although some studies suggest that short-term treatment (less than one year) may reduce cardiac toxicity and cost without compromising outcomes, the results of a new study presented at the disagree.
Socioeconomic Factors Predict Survival in Nonmetastatic Breast Cancer
Racial and regional disparities impact the incidence of, mortality from, and survival from breast cancer, but the role of other socioeconomic factors is unclear. Researchers from Fudan University in Shanghai, China, conducted a large study and found that marital status, insurance status, median household income, and residence also contribute to survival from nonmetastatic breast cancer. They presented the findings at the .
Tumor Heterogeneity May Affect Outcomes in Patients With DCIS
Intratumor heterogeneity can lead to cancer progression, and tumors with the highest levels of heterogeneity may be more likely to progress. Researchers compared mutational loads from separate areas of pure ductal carcinoma in situ (DCIS) to genetic heterogeneity in DCIS lesions that coexist with invasive cancer and presented the findings at the .
Geriatric Assessment in Hematology Scale Classifies Frailty Phenotype
Researchers in Spain developed the Geriatric Assessment in Hematology (GAH) scale to classify patients as robust (those with strength or vigorous health) or frail (those with a poorer prognosis). The tool is validated for use in myelodysplastic syndromes, acute myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia. Researchers assessed its use and validity among patients with lymphoma. Raul Cordoba, MD, PhD, of Fundacion Jimenez Diaz University Hospital in Madrid, Spain, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Mobile Health Technology Provides Symptom Management Information for Pediatric BMT Recipients
Improved monitoring of pediatric patients undergoing blood and marrow transplant (BMT) may result in better precision symptom management strategies. Mobile health and wearable technologies may aid in such efforts by providing data on complex symptom patterns, trajectories, and interactions. Researchers conducted a pilot study and found that integrating mobile health technology into care was feasible, although they had concerns about compliance. Nirmish Shah, MD, of Duke University School of Medicine in Raleigh, NC, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Study Provides Guidance for Transfusion Practices in Patients With Leukemia Who Experience ICH
Intracranial hemorrhage (ICH) is a common complication in patients with acute leukemia and is associated with significant morbidity and mortality. Information on platelet transfusion practice in patients following ICH is limited, so researchers assessed clinical features and outcomes to better guide transfusion practices after ICH. Shannon Nixon, NP, of the Princess Margaret Cancer Centre at the University of Toronto, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Long-Term Lymphoma Survivors Describe Unmet Needs in Cancer Care
Although patients with Hodgkin lymphoma can experience long-term survival, they may face difficulty in coping with treatment-related adverse outcomes. Researchers assessed the needs of lymphoma survivors and their caregivers and identified unmet patient-oriented research needs: quality of life after treatment, messaging and communication between the scientific community and patients, and emotional well-being. Jackelyn B. Payne, MPH, BS, BA, of Stony Brook University in New York, discussed the findings at the ASH Annual Meeting on December 2, 2018.
Hematology Training Is Suboptimal for APPs
Advanced practice providers (APPs) may have limited subspecialty training options for hematology, and postgraduate fellowships focused on education in both malignant and nonmalignant hematologic disorders appear to be lacking for APPs. Yi L. Hwa, DNP, of the division of hematology at the Mayo Clinic in Rochester, MN, discussed the findings of a research team’s web-based needs assessment survey that found significant gaps in subspecialty hematology training for APPs at the ASH Annual Meeting on December 1, 2018.
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.
Research Shows That Telephone Triage Is a Vital Part of Patient Experience
The field of telehealth encompasses many efforts in oncology practice and research. When focusing specifically on telephone triage, we examine patient-initiated requests, such as speaking directly with their nurses on the phone, reporting side effects, or seeking answers to questions about plan of care and treatment. This provides oncology nurses with an opportunity for assessment and intervention. Although many current research efforts focus on proactive phone calls nurses make to their patients, it is also important to understand the impact of incoming calls on patient care and workflow.
Recent NSAID Use May Improve Ovarian Cancer Survival
Researchers have found that use of nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis appears to improve survival for patients with epithelial ovarian cancer. The study results were published in Lancet Oncology.
Action Plan May Reduce CLABSIs in Hospitalized Patients With Cancer
Despite being preventable, central line-associated bloodstream infections (CLABSIs) result in thousands of deaths each year and cost the U.S. healthcare system billions of dollars. Infection is a common problem in patients with cancer, particularly those receiving chemotherapy and radiation.
Oncology Nursing Foundation Refocuses Commitment to All Oncology Nurses
Support for oncology nursing is critical to the advancement of the profession and the future of care for patients with cancer. The Oncology Nursing Foundation—formerly known as the Oncology Nursing Society (ONS) Foundation—is a nonprofit, tax-exempt, charitable organization dedicated solely to supporting oncology nurses both nationally and internationally. Today, the Foundation announced its name change to wholly encapsulate the organization’s longstanding focus and goals. Through continuing education scholarships, research grants, and career development funding, the Oncology Nursing Foundation supports oncology nurses in their pursuits to provide safer and more effective cancer care for their patients.
Psychosocial Support May Reduce Stigma for Patients With Lung Cancer
Because of the relationship between cigarette smoking and lung cancer, patients who receive a lung cancer diagnosis may feel judgment compared to patients with other cancer diagnoses, which could affect social interactions between family, caregivers, and healthcare professionals. Perceived lung cancer stigma can lead to depression, anxiety, poor self-esteem, guilt, shame, blame, poor social identity, and reduced social support. A recent study indicated that lung cancer stigma might be behind the low lung cancer screening rates among high-risk smokers.
Tailored Psychotherapy Combats Depression in Advanced Cancer
Just three to six sessions of a tailored psychotherapy program called CALM, or Managing Cancer and Living Meaningfully, reduced symptoms of depression or prevented the onset of depression in patients with recently diagnosed advanced cancer, according to findings from a study published in the Journal of Clinical Oncology.
Advance Care Planning Initiative Promotes Patient Preference
Advance care planning (ACP) involves communication with the patient, his or her family and/or caregivers, and the healthcare team to plan for the future and promote shared decision making that incorporates patient preferences. Guidelines from the American Society of Clinical Oncology and National Comprehensive Cancer Network recommend that ACP discussions take place within three months of a diagnosis of incurable cancer; however, ACP conversations may not occur because patients, family members, and providers each wait for the other to initiate the discussion.
President Trump Enacts FY 2019 Labor/HHS Funding Package for Nursing and Cancer Research
Budget season on Capitol Hill is always a complicated time. It’s a tug-of-war between funding priorities and fiscal responsibility. Often, budget debates end up in a stalemate and the government shuts down. However, for the first time in 22 years, the president signed the fiscal year 2019 Labor Department of Health and Human Services Appropriations package before the September 30 budget deadline.
Liquid Biopsy May Predict Breast Cancer Late Recurrence
Liquid biopsies—blood tests that detect circulating tumor cells—may help healthcare providers predict which women with hormone receptor-positive (HR+) breast cancer are at higher risk of recurrence, according to the results of a study published in JAMA Oncology.
ONS Member Featured in NCI Supportive and Palliative Care Research Video
The National Cancer Institute (NCI) released a short video featuring ONS member Ann O’Mara, PhD, RN, MPH, program director in the NCI’s Division of Cancer Prevention. She speaks directly about research projects focusing on supportive and palliative care for patients with cancer. O’Mara specifically highlights a recent study determining the impact of acupuncture on pain for patients with cancer.
NCI Releases Annual Strategic Plan and Budget Proposal
Every federal agency is required to submit a plan and proposal to Congress outlining its budget for the next fiscal year—or years—as well as justifications for how and why the department needs the requested allotment. In September 2018, the National Cancer Institute (NCI) released its Annual Plan and Budget Proposal for Fiscal Year 2020.
Neuroendocrine Prostate Cancer Subtype Is Aggressive and More Common Than Expected
Nearly 20% of men with metastatic, castration-resistant prostate cancer had tumors that developed into the treatment-emergent small-cell neuroendocrine (t-SCNC) subtype, which is associated with shorter survival than other subtypes, according to findings from a study published in the Journal of Clinical Oncology.
FDA Approves Talazoparib for gBRCAm HER2-Negative Locally Advanced or Metastatic Breast Cancer
On October 16, 2018, the U.S. Food and Drug Administration (FDA) approved talazoparib, a poly (ADP-ribose) polymerase inhibitor, for patients with deleterious or suspected deleterious germline BRCA-mutated, HER2‑negative locally advanced or metastatic breast cancer. Patients must be selected for therapy based on an FDA-approved companion diagnostic for talazoparib.
U.S. Pediatric Cancer Incidence Varies by Geography
A new study demonstrated that pediatric cancer rates vary by U.S. state and geographic region, with the highest rates in the Northeast, specifically New Hampshire; Washington, DC; and New Jersey. The study findings were published in Morbidity and Mortality Weekly Report.
Further Research Can Help Nurses Balance Cardiovascular Conditions With Cancer Treatments
As the leading cause of death for adult Americans, cardiovascular disease is a complication found in many patients with cancer. Many cancer treatments have the potential to impact existing cardiac comorbidities or develop new cardiovascular conditions in patients undergoing treatment. Understanding and recognizing this issue is paramount for oncology nurses and is the focus of current research efforts impacting clinical practice.
Oncology Nurse Appointed to PCORI Board of Governors
As the U.S. government’s arm of patient-centered research, the Patient-Centered Outcomes Research institute (PCORI) is driving new initiatives and opportunities focused on unlocking novel treatment methods and cutting-edge interventions to better care for patients. On September 24, 2018, PCORI announced its new Board of Governors, naming ONS member Christopher Friese, PhD, RN, AOCN®, FAAN, as the agency’s first nursing research representative to hold a seat on the board.
Ketogenic Diet May Overcome Drug Resistance With PI3K Inhibitors
Researchers have shown in mouse models that using PI3K inhibitor targeted therapy along with a ketogenic diet may help prevent or overcome the drug resistance that can eventually occur. The findings were reported in Nature.
Biden Cancer Summit; PCORI Governing Board; Low-Income Smokers
The Biden Cancer Summit was held in Washington, DC, on September 21, 2018. The day-long event was filled with cancer-related educational sessions—some hosted by ONS leadership—discussing ways to move cancer research and care forward. Formerly dubbed the National Cancer Moonshot Initiative, the country-wide effort to make a quantum leap in cancer care has evolved in into the Biden Cancer Initiative (BCI). BCI’s ongoing work will continue to break down barriers and help providers and researchers overcome obstacles as they work toward progress in cancer care.
Emory University Appoints Oncology Nurse as Senior Vice President of Research
Building on a long career as a pioneer in oncology nursing research and cancer clinical trials, ONS member Deborah Watkins Bruner, RN, PhD, FAAN, has been named the senior vice president of research at Emory University in Atlanta, GA, a newly created position that serves on the Emory president’s leadership team. Effective October 1, 2018, Bruner’s leadership, expertise, and research experience will guide Emory’s interprofessional research efforts and promote education and training for future researchers, including nurse scientists.
Moonshot Moves Forward Thanks to Biden Initiative
Like all great adventures, it began as an idea. What if the United States could make huge advancements in the fight against cancer in a short amount of time? How could that be accomplished? What are the metrics? How much would it cost? Who could direct such an effort?
Older Patients Respond Better to Checkpoint Inhibitors for Melanoma
Patients aged 62 and older are more likely to respond to immune checkpoint inhibitors for melanoma, such as pembrolizumab, according to findings from a study published in Clinical Cancer Research. A follow-up study showed that it may be because of age-related changes in the immune cells in melanoma tumors.
Global Cancer Burden Rises to 18.1 Million New Cases and 9.6 Million Deaths in 2018
As global populations grow, so does the cancer burden, a new study from the World Health Organization’s International Agency for Research on Cancer (IARC) reported. The results of the latest analysis of the incidence and mortality of 36 types of cancer in 185 countries were published in CA: A Cancer Journal for Clinicians in September 2018.
VA and NCI Collaborate on Access to Cancer Clinical Trials
A new cross-government program is underway to improve veterans’ access to clinical cancer trials. Together with the National Cancer Institute (NCI), the Department of Veterans Affairs (VA) Interagency Group to Accelerate Trials Enrollment launched in 12 VA facilities in summer 2018.
NIH Launches Study Focused on Prostate Cancer Rates in African American Men
To better understand environmental and genetic impacts associated with prostate cancer in African American men, the National Institutes of Health (NIH) began a new study, Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor Markers, and Social Stress (RESPOND). The research program has received more than $26 million in funding and seeks to understand why African American men have disproportionally higher rates of aggressive prostate cancer than any other racial or ethnic population.
“It Prevents Cancer” May Be Key to HPV Vaccine Communication
In 2016, only 43% of U.S. adolescents had received routine human papillomavirus (HPV) vaccinations. Findings from a new study published in Cancer Epidemiology, Biomarkers, and Prevention indicate that the type of strategy providers use to communicate the need for the vaccine may influence parents’ choices.
How Inhaled Cannabis May Contribute to Pulmonary Toxicity in Patients With Cancer
As medical use of cannabis is increasingly legalized across the United States, oncology nurses need to become more familiar with the implications of patients using it for cancer symptom management. According to Merkle and Tavernier in their article in the August 2018 issue of the Clinical Journal of Oncology Nursing, little research has been conducted in medical cannabis use and the efficacy and toxicity of cancer treatment. Their article reviewed current literature to better understand the effects that cannabis may have on the lungs in patients with cancer.
What the Research Says About Supporting Cancer Survivors in Non-Oncology Settings
In 2016, the American Cancer Society (ACS) reported that the number of currently living cancer survivors is estimated at 15.5 million Americans. For 2018, ACS is projecting another 1.7 million new cases of cancer diagnoses. On one hand, the growing number of survivors indicates that early diagnosis, new technologies, targeted interventions, treatment options, and access to care are making a huge difference for patients.
Longstanding NINR Director Retires After Two Decades of Developing Nursing Science
Patricia Grady, RN, PhD, FAAN, has defined a generation of nurse science and patient-centered research, serving as the National Institute of Nursing Research (NINR) director for more than 23 years. Under her charge, NINR has grown into one of the foremost federal agencies supporting the scope of the nursing research community, driving groundbreaking initiatives and furthering clinical practice.
Recommended Surveillance Periods May Be Incorrect for Gynecologic Cancers
Standardized surveillance recommendations may be too short for patients with ovarian cancer and too long for other gynecologic cancers, according to findings from a study presented at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer.
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.
Care Coordination Standardizes Monitoring for Patients Prescribed Oral Cancer Agents
Use of oral therapies requires healthcare teams to monitor patients for issues such as unreported side effects, medication nonadherence, and incorrect administration of medications. Although many patients do very well with this form of treatment, some patients, even with a significant amount of education before starting therapy, may have challenges.