Cancer-related cognitive impairment (CRCI) is a result of a slew of confounding variables, including cancer, its treatments, and other factors. Although the side effect is expected, it doesn’t have to be accepted. Patients have many options to manage CRCI, and nurses have an important role in education, assessment, and referral to support, according to speakers at a session on April 29, 2021, during the 46th Annual ONS Congress™. 

Some of the most painful side effects of cancer and its treatment occur with radiation therapy. Although patients may find the effects emotionally devastating, nurses can help take a proactive management approach by preparing patients for what’s ahead. Annette Quinn, RN, MSN, from the University of Pittsburgh Hillman Cancer Center, outlined the most common but distressing side effects and tips for managing them during a session held on April 29, 2021, for the 46th Annual ONS Congress™.

Cutting-edge advancements in radiation therapy (RT) may allow oncology practitioners to only target the current tumor and avoid damaging healthy tissue. During a session on April 29, 2021, at the ONS 46th Annual Congress, W. Neil Duggar, PhD, DABR, of the University of Mississippi Medical Center, provided an overview of RT from a medical physics perspective, with a focus on how developing technologies may revolutionize care for patients with cancer. 

Immune checkpoint inhibitors (ICPIs) mobilize the body’s own immune system to target cancer cells. However, the resulting immune-related adverse events (irAEs) vary in severity and may persist for months or years following treatment.

Although cancer mortality in the United States has decreased in most populations, non-Whites still have a disproportionately higher risk, and recent events have raised awareness of racial healthcare disparities. During a session on April 29, 2021, for the ONS 46th Annual Congress™, Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP^®, FAAN, of the University of Pittsburgh School of Nursing, Susan G. Dorsey, PhD, RN, FAAN, of the University of Maryland School of Nursing, and Angela Starkweather, PhD, ACNP-BC, FAAN, FAANP, of the University of Connecticut School of Nursing and School of Medicine, explored the application of the symptom science model to address the needs of underrepresented patients. 

More and more patients with cancer are asking their healthcare providers whether medical marijuana can help them manage symptoms and side effects. Advanced practice RNs (APRNs) must be prepared to educate patients and assess their eligibility for therapeutic cannabis.

Research and regulations regarding medical marijuana are constantly evolving. Advanced practice RNs (APRNs) caring for patients who may use cannabis need a knowledge base and guidance for practice. During her session on April 29, 2021, for the 46th Annual ONS Congress™, Kathleen Russell, JD, MN, RN, associate director of nursing regulation at the National Council of State Boards of Nursing (NCSBN), reviewed key points from NCSBN’s Guidelines for the Nursing Care of Patients Using Marijuana that are particularly relevant to oncology APRNs.

In a highly technical environment, radiation oncology nurses’ role on the interprofessional team is both critical and flourishing. But it’s also ever-evolving, speakers explained during a session on April 27, 2021, for the 46th Annual ONS Congress™.

Even before the COVID-19 coronavirus pandemic’s push to virtual in almost every aspect of society, the trend away from traditional lecture-style learning and toward more interactive learning was well underway. The approach helps busy learners better understand, retain, and apply concepts in fast-paced and ever-changing environments, such as the field of oncology, Renee Davis, MSN, RN, NPD-BC, from ProDevo Design and Consulting, said on April 27, 2021, during a session for the 46th Annual ONS Congress™.

When the COVID-19 coronavirus pandemic pushed oncology research to a remote, virtual format, the sudden adjustment was, in many ways, more convenient and more effective, but it also posed several challenges. During a presentation on April 27, 2021, for the 46th Annual ONS Congress™, two nurse researchers shared the lessons they learned when they adjusted their research protocols. 

As health care has made countless adaptations to forge on during the COVID-19 coronavirus pandemic, oncology nurse researchers haven’t escaped the effects. During a session on April 27, 2021, for the 46th Annual ONS Congress™, Kathleen Calzone, PhD, RN, AGN-BC, FAAN, and Donna Berry, PhD, RN, AOCN^®, FAAN, outlined specific ways researchers have pivoted with virtual approaches to continue their important work.

Radionuclides, also called radioisotopes, are unstable chemical elements that release radiation as they break down, and that action can be combined with cancer drugs to fight tumors with a new punch. During a session on April 27, 2021, for the 46th Annual ONS Congress, Pam Grubbs, APRN, CNS, MS, AOCNS^®, of Mayo Clinic in Rochester, MN, discussed how oncology is using radiopharmaceuticals in a variety of ways.

Breast cancer is classified by several factors, including the presence of human epidermal growth factor receptor 2 (HER2), a type of growth-promoting protein found on the surface of cells. All breast cells have HER2 receptors, but some breast cancers have more HER2 receptors than normal, which may promote tumor growth. About 60% of breast cancers have some level of HER2 expression, and approximately one in five patients has high levels of the HER2 protein, which is considered HER2-positive.

Immune checkpoint inhibitors (ICPIs) enhance treatment response while minimizing toxicities for patients with cancer. However, education is key to managing the therapies’ unique adverse events (AEs). During a session for the ONS 46th Annual Congress™, Marianne Davies, DNP, ACNP, FAAN, of the Yale Comprehensive Cancer Center, Smilow Cancer Hospital at Yale New Haven Hospital, and the Yale University School of Nursing, and Laura S. Wood, RN, MSN, OCN^®, of Cleveland Clinic Cancer Center, provided oncology nurses with a foundation for evaluating and grading AEs in immuno-oncology.

Oncology nursing has always been a challenging career with many stressors, but the moral distress brought on by a global pandemic has increased rates of depression, anxiety, and professional burnout among nurses, Patricia Jakel, RN, MSN, AOCN^®, and Devin Ballentine, RN, BSN, both of UCLA Santa Monica Medical Center, said during a session for the 46th Annual ONS Congress™ on April 22, 2021.

“Ethical issues and dilemmas are inherent in the care we provide to our patients and their families across the life span,” Joyce Neumann, PhD, APRN, AOCN^®, BMTCN^®, FAAN, from the University of Texas MD Anderson Cancer Center in Houston, said during a session on April 22, 2021, for the 46th Annual ONS Congress™. “We have a responsibility to speak up and speak out individually, through our professional organizations like ONS and the American Nurses Association (ANA), and internationally, when possible, to advocate to resolve ethical issues.”

Oncology nursing research has a powerful impact on quality care and positive patient outcomes, but the science must be grounded in clinical context because researchers’ ultimate goal is to disseminate their findings to clinicians to facilitate practice change, ONS’s 2021 Distinguished Researcher Christopher Friese, PhD, RN, AOCN^®, FAAN, of the University of Michigan and Rogel Cancer Center, said during his session for the 46th Annual ONS Congress™ on April 22, 2021.

Chimeric antigen receptor (CAR) T-cell therapy is a promising new treatment option for patients with certain types of cancer. As the field expands, institutions are exploring specialized service lines to provide the treatment, speakers said during a presentation on April 22, 2021, for the 46th Annual ONS Congress™ as they shared the lessons learned as their institutions established CAR T-cell therapy programs.

Combining the research and education components of a PhD program with the clinical practice components of a doctor of nurse practice (DNP) program completes the evidence-to-practice spectrum. It improves evidence-based care and provides outcomes to fuel future research and education. On April 20, 2021, speakers at the 46th Annual ONS Congress™ explained how their institutions created collaborative models that are now a standard component of DNP and PhD programs.

Between 10%–20% of health outcomes are a direct result of clinical care, whereas 40% are attributed to social and economic factors such as education, employment, income, family and social support, and community safety, speakers said during a session for the 46th Annual ONS Congress™ on April 20, 2021. The remaining 40%–50% correlate with health behaviors, physical environment, and genes and biology, they said.

As use of digital health or telehealth has grown, healthcare providers have had to address challenges and get buy-in on multiple levels. Will patients feel comfortable and heard during a phone call or video chat? Will staff still be able to provide optimal care? Advanced practice RNs can apply their skills and experience to create a supportive telehealth environment for patients and families as well as for professional staff.

Family members—not health professionals—are the primary providers of patient-focused care in the United States, according to Deborah Boyle, MSN, RN, AOCNS^®, FAAN, from Advanced Oncology Nursing Resources in Phoenix, AZ. “There is an unrealistic expectation that families can enact their caregiving role with no training and ongoing support,” she said during her session presentation for the 46th Annual ONS Congress™ on April 20, 2021. Oncology nurses have a responsibility to identify at-risk families that may face multiple challenges in providing care so they can prepare those families with additional resources and support.

Oncology advanced practice RN (APRNs) are in an ideal position to put their leadership, clinical practice, critical thinking, and organization management expertise to use in new ways to advance and add value to cancer care. During her April 20, 2021, session at the 46th Annual ONS Congress™, Rosanne Casal, DNP, APN-BC, AOCNP^®, from University Hospitals Seidman Cancer Center in Cleveland, OH, shared three examples: benign hematology, ambulatory acute care, and bone marrow biopsy. 

Caregivers for patients with advanced cancer provide crucial support but often have unmet needs. During a session at the ONS 44th Annual Congress in Anaheim, CA, J. Nick Dionne-Odom, PhD, RN, ACHPN, of University of Alabama at Birmingham, and Tara Albrecht, PhD, ACNP-BC, RN, of Virginia Commonwealth University School of Medicine in Richmond, discussed new research in palliative care and the role of nurses in supporting patients and their families.

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.

Spinal cord compression (SCC)—an oncologic emergency—is the initial presentation in roughly 20%–33% of patients with a malignancy, Carol S. Viele RN, MS, OCN^®, of the University of California, San Francisco, School of Nursing, said during a session on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA. Nurses can play a key role in recognizing the condition and getting patients into early treatment that may help preserve their function, she said.

Radiopharmaceuticals, or radioactive drugs, are playing an increasing role in cancer diagnosis and treatment and thus are an increasingly relevant area of practice for oncology nurses, Paul Searfoss, BS, CNMT, ARRT (N, CT), of Vanderbilt Medical Center in Nashville, TN, said during a session on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Navigating patients through radiation treatments can be challenging when they are undergoing concurrent therapy. Coordination of multiple providers across different specialties, side effect management, and scheduling can be overwhelming. During a session at the ONS 44th Annual Congress in Anaheim, CA, Dorothy Abshire, BSN, BA, RN, OCN^®, of Baylor Scott and White McClinton Cancer Center, Waco, TX, explained how oncology nurses can help patients navigate complicated treatment regimens that involve both chemotherapy and radiation therapies.

Nurses, who are frequently on the front lines of communication with patients at high risk for lung cancer, can play a critical role in increasing awareness of the relatively new option to screen for this deadly condition, Lisa Carter-Harris, PhD, APRN, ANP-C, FAAN, of Memorial Sloan Kettering Cancer Center in New York, NY, said in the Victoria Mock New Investigator Presentation on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Good documentation is the best defense a nurse can have in the event of a lawsuit. This was the take-home message of a presentation by Joann Wortham, MSN, JD, CPHQ, CPPS, CPHRM, of Beta Healthcare Group in Alamo, CA, a large provider of professional liability insurance for hospitals, and Cyndi Maag, RN, BA, LNCC, of Eckenrode-Maupin, a legal practice in St. Louis, MO, during a session on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Compassion fatigue and burnout are adding to the cost of healthcare by personally affecting the nursing workforce, and in turn, the patients they care for and the workplace milieu. In their session on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Sue Childress, MN, RN, OCN^®, of the Huntsman Cancer Institute in Salt Lake City, UT, and Pamela Bowman, MSN, RN, OCN^®, of Duke Cancer Institute in Durham, NC, discussed defining, identifying and reversing compassion fatigue and fostering resiliency in today’s nursing workforce.

Chimeric antigen receptor T-cell (CAR T-cell) therapy is an exciting but complex novel form of immunotherapy with multiple potential toxicities that nurses must be prepared to recognize and manage, Misty Lamprecht, MS, APRN-CNS, AOCN^®, BMTCN^®, of the Ohio State University Comprehensive Cancer Center – James in Columbus said during a session on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA. Lamprecht’s copresenter was Yi Lin, MD, PhD, of the Mayo Clinic Cancer Center in Rochester, MN.

Regardless of their own feelings or biases about cannabis, nurses must recognize that their patients are using it and help them to access the drug safely, Eloise Theisen, MSN, RN, AGPCNP-BC, of the Radicle Health Clinician Network in Walnut Creek, CA, said during a session on Saturday, April 13, 2019, at the ONS 44th Annual Congress in Anaheim, CA. Many patients with cancer are using cannabis and are looking to their healthcare providers for information on how they can use it to reduce their symptoms, she said.

Two very different projects in which nurses developed creative solutions to common patient problems and helped to improve patients’ treatment experience were the focus of a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Fast, safe, and effective care is a goal in all oncology treatment settings. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Lisa Pittman, RN, MSN, MHA, NEA-BC, OCN^®, of Cancer Treatment Centers of America in Zion, IL, Kerry Fuller, RN, BSN, OCN^®, of Greenville Health System Cancer Institute in South Carolina, Cameron Carr, ADN, RN, of Duke Raleigh Hospital in North Carolina, and Lisa Ciafre, RN, MSN, of Allegheny Health Network Cancer Institute in Pittsburgh, PA, shared their work on preventing infections, improving recovery after surgery, and reducing response times to hypersensitivity reactions.