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    COVID-19 Affects Cancer Caregivers, but Here Are Ways to Support Them
    COVID-19
    COVID-19 Affects Cancer Caregivers, but Here Are Ways to Support Them
    February 19, 2021
    Celebrate Oncology Nurse Leaders During Black History Month
    ONS Leadership
    Celebrate Oncology Nurse Leaders During Black History Month
    February 03, 2021
    Am I Too Shy to Lead?
    Nurse staffing
    Am I Too Shy to Lead?
    January 29, 2021
    Zoom Through Video Job Interviews With These Tips for Applicants and Hiring Managers
    nursing professional development
    Zoom Through Video Job Interviews With These Tips for Applicants and Hiring Managers
    January 22, 2021
    The Case of Concurrent Therapy Concerns
    Treatment side effects
    The Case of Concurrent Therapy Concerns
    December 18, 2020
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    The Case of the Sensitive Staging System
    Survivorship care plans

    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.

    February 15, 2021
    How to Manage Survivor Guilt During a Pandemic
    Patient Support

    How to Manage Survivor Guilt During a Pandemic

    Pandemics have a tremendous impact on societies and individuals alike. From incidence rates to death tolls, financial hardship to job loss, and anxiety to isolation, we’ve all been affected in one way or another—although some much more than others.

    February 11, 2021
    The Case of the Targeted Therapy Toxicities
    Clinical practice

    The Case of the Targeted Therapy Toxicities

    Three years ago, Tony, a 42-year-old man, began FOLFOX chemotherapy treatment for stage III colon cancer and achieved a complete response. Two years later, a biopsy of an intraabdominal lesion uncovered metastatic disease, and he was prescribed the epidermal growth factor inhibitor (EGFRi) cetuximab. Alex, the oncology nurse educating Tony on the side effects of EGFRi therapy, understands that skin toxicities are common with the class of drugs and looks for national guidelines for prevention and management direction.

    January 19, 2021
    How to Accept Criticism With Class
    Interprofessional issues

    How to Accept Criticism With Class

    Quick: what’s your first reaction when you hear the word criticism? Do you brace yourself for feelings of failure and put up a defensive wall? It’s hard to respond otherwise, but try to look at it differently. Criticism can be positive if we accept it with class and let it help us gain knowledge about ourselves.

    January 14, 2021
    The Case of the Virtual Venture
    Clinical practice

    The Case of the Virtual Venture

    Staff in an oncology infusion unit located in an urban healthcare system watched as patient and caregiver stress increased during the COVID-19 coronavirus pandemic and the November 2020 U.S. presidential elections. During a team meeting, Holly, one of the nurses, brought up a study she read about that used virtual reality (VR) as a distraction for patients undergoing chemotherapy. The staff was interested in implementing a similar program at their institution but wasn’t sure how to start. What would you do?

    December 17, 2020
    The Case of the Chronic Cancer Condition
    Clinical practice

    The Case of the Chronic Cancer Condition

    Lisa, a 32-year-old tax accountant, completed treatment for stage III triple-negative breast cancer 18 months ago. During a follow-up appointment, Lisa reported worsening headaches and difficulty concentrating at work. A magnetic resonance imaging scan and subsequent biopsy revealed a solitary brain lesion. She completed stereotactic brain radiation two months ago.

    November 16, 2020
    How Will You Define Your New Normal?
    Nurse self-care

    How Will You Define Your New Normal?

    The phrase “a new normal” is used in the oncology setting to describe the changes a person faces as a result of cancer and its treatments. Physical and emotional scars plus activity limitations are examples of adjustments cancer survivors make as they define what will be their new normal. But in today’s media, the new normal is being used to label the changes the world’s population is facing as a result of the COVID-19 coronavirus pandemic.

    September 24, 2020
    The Case of the Delicate Discussion
    Clinical practice

    The Case of the Delicate Discussion

    Over the past three years, Sharon, age 38, has been intermittently receiving treatment for ovarian cancer. She was initially treated with carboplatin and paclitaxel and remained in remission for 20 months. She responded well to second-line therapy (carboplatin, gemcitabine, and bevacizumab), remaining on bevacizumab maintenance until she experienced a relapse eight months later.

    September 15, 2020
    If You’re Trying to Be Productive, Stop Multitasking
    Nurse self-care

    If You’re Trying to Be Productive, Stop Multitasking

    When it comes to the human brain, the ability to effectively multitask is a myth. Although computers can run two or more programs simultaneously, our brains must task-switch, and in the transfer of attention, time and productivity are lost. Monotasking, or single tasking, is now considered a way to increase productivity and actually maximize time.

    July 30, 2020
    The Case of the HPV-Positive Perk
    Clinical practice

    The Case of the HPV-Positive Perk

    Warren is a 50-year-old man recently diagnosed with human papillomavirus (HPV)-positive oropharyngeal cancer. He and his wife meet with a radiation oncologist and develop a plan of care. Lisa, the radiation oncology nurse, meets with the couple to provide education and answer questions. Darren tells her that two of his “hard living” uncles died from head and neck cancer and the treatment was horrible. He says, “I’ve only had two sexual partners and never smoked—is this cancer really worth treating?”

    July 21, 2020
    How to Practice Self-Care During Times of Uncertainty
    Nurse self-care

    How to Practice Self-Care During Times of Uncertainty

    Uncertainty prevails in times of crisis. Patients with cancer are all too familiar with the initial uncertainty surrounding a cancer diagnosis, treatments, and adjusting to a new normal. Oncology nurses are seeing parallels with the COVID-19 coronavirus pandemic as people worldwide face the unknowns of a health threat and the economic aftermath of the outbreak. Medical caregivers are confronting it head on as they work together to protect and tend to the physical and psychosocial needs of others.

    June 25, 2020
    The Case of the Medication Modification
    Treatment side effects

    The Case of the Medication Modification

    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.

    May 19, 2020
    The Case of the Cryotherapy Consequences
    Cancer treatments

    The Case of the Cryotherapy Consequences

    Janice is 32 years old and was recently diagnosed with triple-negative breast cancer. She is receiving neoadjuvant chemotherapy with doxorubicin and cyclophosphamide, followed by weekly paclitaxel. Janice is a nationally recognized performer (vocal and piano) and is distraught over the possibility of losing her hair or developing chemotherapy-induced peripheral neuropathy and mouth sores. She asks the nurse what can be done to prevent those unwanted side effects.  

    April 14, 2020
    Clear the Clutter With This Chinese Discipline
    Nurse self-care

    Clear the Clutter With This Chinese Discipline

    Physical and mental clutter can negatively affect your mood, productivity, and overall health. Think about how you feel when looking for a misplaced report on a disorderly desk covered with papers stacked atop magazines next to a conglomerate of used cups and scattered pens. Or observe your thoughts as they randomly shift from subject to object and back again. Being in a state of perceived chaos can stimulate feelings of anxiety and biologically increase cortisol levels. 

    March 19, 2020
    The Case of the CDK4/6 Inhibitors Checklist
    Immunotherapy

    The Case of the CDK4/6 Inhibitors Checklist

    Three years ago, Sarah, age 54, completed standard chemotherapy and radiation treatment for stage II, ER- and PR-positive, HER2-negative invasive breast cancer. A recent computed tomography scan, ordered to evaluate persistent hip pain, revealed bone lesions, and a biopsy and positron-emission tomography scan confirmed bone-only metastatic breast cancer. A CDK4/6 inhibitor, ribociclib, was added to the letrozole she was already taking.

    February 18, 2020
    The Case Supporting the Seasons of Survivorship
    Survivorship

    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.”

    December 17, 2019
    The Case of the Efficacy Explanation
    Treatments

    The Case of the Efficacy Explanation

    Jenni is an oncology nurse practitioner in an outpatient medical oncology clinic. She is meeting with 70-year-old Don after his first cycle of cabozantinib for treatment of metastatic medullary thyroid carcinoma when he asks why the oncologist put him on a pill instead of using IV chemotherapy. “Is it because I don’t have long to live?” Don wonders.

    November 19, 2019
    Harness Stress for Focus and Productivity
    Nurse self-care

    Harness Stress for Focus and Productivity

    Stress is generally associated with negative mental and physical consequences. But can it actually be a healthy, even sought-after phenomenon at times?

    October 29, 2019
    The Case of the Nicotine Nightmare
    Cancer risk factors

    The Case of the Nicotine Nightmare

    Jill works as an oncology nurse in a large community hospital. While attending a family gathering, her uncle proudly tells her that he and his 17-year-old son are using e-cigarettes to help them stop smoking traditional cigarettes. He comments that his wife now allows them to “smoke” in the house and car because the vapor is relatively odor free.

    October 15, 2019
    The Case of the Safety Session
    Safety

    The Case of the Safety Session

    Doug is a 48-year-old triathlete who was recently diagnosed with chronic myeloid leukemia (CML) after a routine blood test showed an increase in white blood cells and a subsequent bone marrow biopsy showed greater than 20% blast cells. The medical oncologist prescribed the oral drug dasatinib. Doug and his wife meet with Staci, RN, to receive oral therapy education. During the teaching, Doug says his wife will have no trouble dispensing the dasatinib because she already prepares all of their meals and nutritional supplements.  

    August 20, 2019
    The Case of the Explicit Exposure
    Clinical practice

    The Case of the Explicit Exposure

    Mr. Larsen presents to the clinic for his first dose of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone) for a diagnosis of diffuse large B-cell lymphoma. Elizabeth, his oncology nurse, just started the cyclophosphamide when she is paged to the desk for a call from Mr. Larsen’s oncologist. She quickly removes her face shield and gloves as she hurriedly leaves the room to take the call. After completing the call, she returns to Mr. Larsen’s room to remove her gown.  

    July 16, 2019
    How Music Can Soothe Your Savage Beast—Stress
    Nurse self-care

    How Music Can Soothe Your Savage Beast—Stress

    Where you put your attention matters more than you realize. For example, when you are thinking or talking about work-life stressors, your ability to take in other sensory input is challenged. One way to break out of the mental stress loop is to listen to music. Music can divert the brain’s attention, giving you a break from repetitive thoughts and judgments. The variety of music genres to choose from when looking for ways to shift your attention and enhance mood is ever increasing.  

    June 11, 2019
    The Case of the Terrible Toxicities
    Adverse events

    The Case of the Terrible Toxicities

    After completing neoadjuvant chemotherapy for triple-negative invasive breast cancer, Madeline, age 32, had a bilateral mastectomy with reconstructive surgery. Final pathology showed residual disease in the breast and one lymph node, and her oncologist recommended adjuvant therapy with capecitabine (1,500 mg twice a day for 14 days, off for 7 days). Five weeks postoperatively, she started cycle 1. Eight days later, her husband called the cancer clinic reporting that over the past two days, his wife developed profound weakness, unremitting diarrhea despite using diphenoxylate and atropine as directed, and painful, red, swollen hands and feet. Her symptoms represented a drastic change from her usual routine and energy level.

    May 14, 2019
    Self-Care for the Soles
    Nurse self-care

    Self-Care for the Soles

    The twenty-six bones in the foot are always being stepped on. Getting on one’s nerves takes on a whole new meaning when considering that each foot contains an estimated 200,000 nerve endings. With health enthusiasts recommending 10,000 steps per day, which translates to approximately five miles, is it any wonder that the often-abused soles deserve a little self-care? 

    April 23, 2019
    The Case of the Belated BRCA Test
    Genetics & genomics

    The Case of the Belated BRCA Test

    Eighteen months after completing surgical debulking and chemotherapy for stage III high-grade serous ovarian cancer, 56-year-old Lily experienced a rising CA-125 level. At her oncologist’s recommendation, Lily started an aromatase inhibitor, but it did not stop the rising tumor marker. After she began experiencing symptoms of bloating and mild abdominal pain, Lily and her oncologist decided to proceed with second-line chemotherapy. As she left the office, Lily remarked that she did not complete genetic testing when she was originally diagnosed because she does not have any children or a family history of ovarian cancer and she was concerned that her insurance would not cover the testing.

    April 16, 2019
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    To discuss the information in this article with other oncology nurses, visit the ONS Communities.

    To report a content error, inaccuracy, or typo, email pubONSVoice@ons.org.

    Deborah Christensen MSN, APRN, AOCNS®
     
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