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.

Thanks to new treatments and technologies, the number of U.S. cancer survivors has increased to 16.9 million as of January 2019. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, several healthcare professionals presented new research to support the ever-growing population of cancer survivors.

Bothersome and distressing sexual dysfunction is common in both men and women living with cancer. Treatments can potentially alter a person’s sexual health in the physical, emotional, mental ,and social well-being realms of care. Literature has shown that time constraints and level of comfort with sexual health content are barriers to addressing patients’ sexual health concerns. On Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, speakers provided an overview of sexual health concerns and strategies to assure a positive and respectful approach to female and male patients with cancer who are experiencing them.

Oncology nurses must remain vigilant to protect patients and themselves from chemotherapy exposure. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Martha Polovich, PhD, RN, AOCN^®, of Georgia State University in Atlanta, and MiKaela Olsen, APRN-CNS, MS, AOCNS^®, FAAN, of Sidney Kimmel Comprehensive Cancer Center in Baltimore, MD, instructed nurses on how to ensure safe handling of hazardous drugs (HDs) in their practice settings.

Using the best evidence to inform care leads to better patient outcomes and can prevent over- or underuse of healthcare resources. Clinical practice guidelines are an important tool for healthcare providers to ensure they are using informed care in their practice. On Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Pamela Ginex, EdD, RN, discussed ONS’s symptom management guidelines and a new initiative to develop and implement guidelines into clinical care.

Infusion reactions, hypersensitivity reactions, anaphylaxis, and tumor lysis syndrome are oncologic emergencies that are seen in both inpatient and ambulatory settings. Advanced practice RNs (APRNs) are often the first providers to respond to those emergencies. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Patricia Jakel, RN, MN, AOCN^®, of the University of California, Los Angeles, Health System in Santa Monica, discussed oncologic emergencies and the APRN’s role in rapid identification of a diagnosis.

The number of U.S. adults aged 65 and over is rapidly increasing: by 2030, they’re estimated to represent about 70% of cancer diagnoses. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, speakers discussed how the complexities of cancer care can affect the expanding population of older adults with cancer.

What the parents of a child dying from cancer need to hear above all from the healthcare professionals caring for their child is that everything possible has been done, to the best of the health care team’s ability, said Pamela S. Hinds, PhD, RN, FAAN, in the 2019 Mara Mogensen Flaherty Memorial Lecture on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Workplace violence is both highly prevalent and underreported in health care settings, according to Melissa Weigel, RN, and Lorina Welper, APRN, CNS, MS, of the Mayo Clinic in Rochester, MN, who spoke during a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Many times, when patients are asked about their wishes at the end-of-life, they perceive it as asking how they want to die, which can be scary for patients and a hard conversation for nurses. What if there was a way to change that conversation to suggest that it is way more about how the patient would want to live? In her session “Advance Care Planning: It’s About Life,” on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Erin Dickman explained how the advance care planning process can help nurses hold those conversations.

Keynote speaker and ONS member Rachel Walker, PhD, RN, nurse inventor and assistant professor at the University of Massachusetts, emphasized the vital role nurses play as agents of innovation and invention in practice during the opening session on Thursday, April 11, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Combining radiation with immunotherapy can enhance the immune system’s ability to fight cancer, and evidence now suggests that this synergy may lead to improved patient survival, Annette E. Quinn, RN, MSN, of the University of Pittsburgh Hillman Cancer Center, said during a session on Thursday, April 11, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Robotic surgery represents the most significant advancement to date in minimally invasive surgery, Lisa Parks, MS, APRN-CP, ANP-BC, of James Cancer Hospital and Solove Research Institute at the Ohio State University Wexner Medical Center in Columbus, said during a session on Thursday, April 11, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Radiation therapy may cause traumatic side effects in patients with cancer, yet many standard management strategies lack strong evidence. During their session at the ONS 44th Annual Congress in Anaheim, CA, Renata Benc, RN, BA, MSc(A), CON(C), of Jewish General Hospital of the Integrated Health and Social Services University Network for West-Central Montréal in Quebec, Canada, and John Hillson, RN, BSN, BA, OCN^®, of Duke Cancer Institute in Durham, NC, instructed nurses on how to support patients undergoing radiation treatment.

Oncology nurses are a vital source of education and support for patients undergoing radiation therapy, enabling patients to complete therapy and minimize side effects, Richard L.S. Jennelle, MD, of the Keck School of Medicine at the University of Southern California in Los Angeles, said during a session on Thursday, April 11, 2019, at the ONS 44th Annual Congress in Anaheim, CA.

Oncology care has shifted from the hospital inpatient setting to outpatient ambulatory care. Indications are that this will be a continuing and expanding trend for the future, increasing the need for ambulatory care nurses. Ambulatory care is complex and requires highly specialized nursing skills gained with education and experience. Most new graduate nurses are employed in acute care settings rather than ambulatory settings because they lack the skill set needed for ambulatory care. How can ambulatory care settings bridge the education and experience gap to fill this expanding need?