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.

As many as 50% of patients with head and neck cancer experience pretreatment weight loss. In addition, treatment frequently involves chemotherapy and radiation, which can also result in weight loss, as well as mucositis and dysphagia, which can affect patients’ ability to eat. This could lead to treatment delays that may impact treatment efficacy.

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.

As more immunotherapies come to market, advanced practitioners need to know how to prescribe and recognize, triage, and manage immune-related adverse events (irAEs) as well as champion education about the agents’ benefits and risks.

In 2017, the National Comprehensive Cancer Network and American Society of Clinical Oncology released new antiemetic guidelines that recommended adding an NK1 receptor antagonist (RA) to standard 5-hydroxytryptamine RA plus dexamethasone upfront for patients receiving carboplatin area under the curve (AUC) ≥ 4. In January 2018, the Centers for Medicare and Medicaid Services instituted a new quality outcome measure, OP-35, which assesses “potentially avoidable” acute care for nausea, vomiting, or eight other common chemotherapy-related toxicities (anemia, dehydration, diarrhea, fever, neutropenia, pain, pneumonia, and sepsis).

Asparaginase is part of treatment for acute lymphocytic leukemia (ALL) and is associated with improved outcomes in those who complete this course of treatment. Despite the necessity of PEG-asparaginase, 20%–30% of patients can experience toxicities.

Emergency department visits by patients with cancer can be unnecessary, costly, and potentially dangerous. Most symptom management concerns can be safely and quickly handled in the outpatient setting, but provider access can be a barrier.

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.