Nursing Considerations for Colorectal Cancer Survivorship Care
As the third most common cancer among both men and women, colorectal cancer is a reality for the more than 1 million people in the United States who are living with or have a history of the disease. Advancements in early detection and treatment have improved outcomes, but many survivors experience late and long-term side effects that may vary in duration, intensity, and impact on their quality of life. Clinicians must tailor each survivorship care plan for a patient’s cancer type, stage, treatment received, psychosocial implications, and side effects or toxicities. Studies have shown that experiencing long-term side effects and symptoms can reduce survivors’ quality of life.
The Case of the Sensitive Staging System
Marianne, an oncology nurse navigator, is preparing a cancer treatment summary and survivorship care plan for Sylvia, who finished breast cancer treatment six weeks ago. Sylvia was treated with neoadjuvant therapy followed by mastectomy, reconstruction, and radiation. Her tumor was characterized as multifocal invasive ductal carcinoma, grade 2, estrogen and progesterone positive, and HER2/neu negative. Sylvia has no family history of breast cancer. Marianne notices that the oncologist recorded Sylvia’s cancer as a stage IB. Marianne wonders if the stage was determined before or after chemotherapy and surgery.
Nursing Considerations for Lymphoma Survivorship Care
As treatments have advanced and patients and providers have more options, cure and survivorship rates for lymphomas are improving: five-year survival rates for Hodgkin and non-Hodgkin lymphoma are 86% and 71%, respectively. Despite good results from treatment, research indicates that lymphoma survivors carry a significant amount of late and chronic effects. Even in a complete remission, late effects of treatment present a burden for patients' physical and psychosocial well-being.
Nursing Considerations for Breast Cancer Survivorship Care
More than 3.5 million people in the United States are living with a breast cancer diagnosis. Despite their large number, patients often report they do not receive appropriate follow-up care after completing treatment—and the situation is worsening, with pandemic-related delays in care affecting approximately half of breast cancer survivors.
Help AYA Survivors and Patients With Cancer Navigate Infertility
In part thanks to advancements in both cancer treatment and supportive care, the number of cancer survivors is expected to reach 22 million by 2030. Adolescent and young adult (AYA) patients aged 15–39 constitute only 5% of new cancer diagnoses but have an 85% relative five-year survival rate. They represent a significant portion of all current and future cancer survivors and have unique needs, including reaching developmental milestones, coping with disruptions in personal and professional relationships, and encountering potential difficulties in family planning.
Pediatric Cancer Survivors Require Additional Care and Monitoring
Most cancer diagnoses in the United States occur later in life, in patients older than 60 years, although most of the common pediatric diagnoses occur in those younger than 10 years. Pediatric and adult patients receive similar cancer therapies. The goal is to kill rapidly dividing cancer cells. Unfortunately, most of a child’s cells also undergo rapid division, and treatment can damage healthy tissue. Therefore, treatment that cures pediatric cancer can also cause long-term survivorship issues.
The Case Supporting the Seasons of Survivorship
Jamie is completing her last cycle of carboplatin and paclitaxel for stage I ovarian cancer. The oncology infusion nurse notices that Jamie appears withdrawn and nervous, so he takes time to ask her how she is feeling about completing treatment. Jamie responds, “I feel as frightened about finishing treatment as I did when I was diagnosed with cancer.” She also shares that she doesn’t want to ring the cancer center’s bell to ceremoniously signify the end of her treatment because she doesn’t want to “jinx it.”
Nurses Can Address the Challenges of Survivorship Care
Early diagnosis and advancements in cancer treatment have markedly improved five-year cancer survival rates. By 2026, an anticipated 20.3 million cancer survivors will be living in the United States. On Saturday April 13, 2019, Kathleen Wiley, RN, MSN, AOCNS®, discussed survivorship care and the challenges that nurses are perfectly positioned to address during a clinical chat at the ONS 44th Annual Congress in Anaheim, CA.
How Are You Supporting Survivors Through EMR-Integrated Survivorship Care Plans?
Incorporating survivorship care plans into a hospital’s electronic medical records (EMRs) can be a tremendous aid for oncology nurses supporting their patients entering survivorship. Using the National Comprehensive Cancer Network treatment guidelines as a template for care, the oncology team can prepare a patient’s medical record with the necessary individualized information.
Do Survivorship Care Plans Decrease Cancer Treatment Distress?
Researchers conducted a randomized study to assess the impact of survivorship care plans (SCPs) on cancer survivors who underwent hematopoietic cell transplantation (HCT). They assessed confidence in survivorship information (primary analysis), as well as cancer treatment distress, knowledge of transplant exposures, health behaviors, healthcare use, and health general self-efficacy. Navneet S. Majhail, MD, MS, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
How One Institution Implemented Survivorship Care Plans in the Age of the Electronic Medical Record
More than a decade ago, the National Academy of Medicine first proposed that “all patients should be given a comprehensive summary and a clear explanation of the details of their cancer therapy as well as recommendations for necessary follow-up.” This seemingly simple task has proved difficult to deliver in many cancer care settings.
Certification and Survivorship Care Plans Present Challenges for Nurse Navigators
During a session at the Oncology Nurse Advisor Navigation Summit, ONS member Pamela J. Haylock, PhD, RN, FAAN, at the Association for Vascular Access in Medina, TX, and Cindy Stern, RN, MSN, CCRP, of the University of Pennsylvania Cancer Network, delivered a joint presentation about some of the hurdles nurse navigators face.
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.