Recharting the trajectory of cancer in the United States requires involvement from everyone—government and private investors, researchers, clinicians, and people with cancer, their caregivers, and advocates, the National Cancer Institute said in April 2023 as it launched the National Cancer Plan. The plan supports the Cancer Moonshot initiative and “aligns broad societal engagement and focuses on critical needs to end cancer as we know it.”

Deanna Fournier, a cancer survivor, and Eli Diamond, MD, a neuro-oncologist at Memorial Sloan Kettering Cancer Center in New York, NY, discussed Fournier’s cancer journey and the progress toward a better patient experience during a National Cancer Institute Office of Cancer Survivorship lecture. Communicating with patients throughout their cancer journey can help healthcare providers, including oncology nurses, support patients and advocate for their unique needs.

From President Richard Nixon’s war on cancer in 1971 to President Joe Biden’s commitment to “ending cancer as we know it” in 2022, fighting the disease has been a bipartisan focus. Yet in that era, when cancer hit home, policymakers often hushed their own diagnoses. But times change, and many of today’s lawmakers are now boldly sharing their personal experiences with cancer as inspiration for action.

In the final days of 2022, as the world turned the calendar to celebrate a new year, the cancer advocacy community also celebrated: One of ONS’s longtime priority bills, the Lymphedema Treatment Act, achieved a landmark legislative win, passing the U.S. Senate as part of the fiscal year 2023 omnibus funding package. President Biden signed it into law on December 29, 2022, securing access to treatment supplies for patients with cancer-related lymphedema.

Midterm elections occurring halfway through a U.S. president’s first cycle are a referendum on that administration’s policies. Unable to take out their frustrations directly with the country’s chief executive, voters historically punish the president’s party at the ballot box. Still, politics is about people, and political scientists discourage attempts to quantify reactions and unexpected results. November 2022’s realignment of the federal power structure was an expected outcome.

The Lymphedema Treatment Act, a key piece of legislation for ONS’s health policy priorities, passed the U.S. House of Representatives in November 2022. The bill is now in the U.S. Senate for review along its journey to becoming law.

The U.S. Department of Health and Human Services, through the Health Resources and Services Administration, awarded more than $5 million in September 2022 to 11 HRSA-funded community health centers to help underserved populations access cancer screenings and early detection services in partnership with National Cancer Institute-designated cancer centers.

Since the late 1990s, U.S. Congress has made a concerted effort to increase federal funding for the National Institutes of Health’s (NIH’s) biomedical research and clinical trials. Through rare but always bipartisan largess, legislative appropriators have seen the benefits of investing in the science for precision medicine; supporting genetic-grounded, patient-centered care; and changing the quality and longevity of life for millions of people, including those with cancer diagnoses.

Nurses’ valuable insight can bring a new perspective to every industry. Extreme dedication, unique experiences, and essential problem-solving skills help nurses to create an impact locally and nationally, and decision-makers have learned that these healthcare professionals have a plethora of valuable insight that must be heard in boardrooms across the country.

Advocacy can mean many things to nurses, and the meaning may even change depending on your position and perspective. The dictionary definition is “the act or process of supporting a cause or proposal,” but being an oncology nursing advocate goes far beyond that. It’s about having a vision for something and not settling for the status quo. It’s about striving for the best in whatever that cause may be—our patients, the profession, or health care in general.

Veterans exposed to toxic substances in service will have more access to cancer care and other medical assistance thanks to the recently signed Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act. The PACT Act passed with bipartisan effort by Congress in August 2022 and later signed into law.

Recognizing the 60th anniversary of President John F. Kennedy’s historic moonshot speech, on September 12, 2022, President Joe Biden delivered an update on his relaunched Cancer Moonshot Initiative and progress made on its moonshot goal of “ending cancer as we know it.”

In a key step that would expand Medicare coverage for necessary lymphedema compression treatment items, the House Energy and Commerce Committee passed the Lymphedema Treatment Act in July 2022, advancing the bill’s journey to becoming law.

For the past 244 years, the world has envied the Great American Experience. Civics 101 class equipped us with the U.S. checks and balances system’s elementary pillars:

• Government has three equal branches: executive (the president), legislative (the congress), and judiciary (the courts).
• When legislative laws are disputed, the judicial system interprets a law’s constitutionality.

As the most trusted professionals for 20 years in a row, nurses witness the needs of those in our care and are suited to translate them to legislatures, regulatory agencies, nongovernmental organizations, and insurers. We do that by speaking plainly about the impact that cancer has on patients and their families. As experts, our ideas and language can translate into practice changes to transform cancer care.

Created from $226.5 million in American Rescue Plan Funding, the Community Health Worker Training Program will increase the number of community health workers; mental health and substance use disorder prevention, treatment, and recovery services; chronic disease care; and other important health services, according to an April 2022 press release from the U.S. Department of Health and Human Services (HHS).

U.S. Representative Fred Upton (R-MI) announced that he would not seek another term in the U.S. Congress during his April 2022 House of Representatives floor remarks. In November 2021, Upton and his colleagues introduced the Cures 2.0 Act, which created the Advanced Research Projects Agency for Health (APRA-H) dedicated to finding and researching a cure for cancer.

Among the first set of nearly 100,000 whole genome sequences from participant partners in the National Institutes of Health’s (NIH) All of Us Research Program, “about half come from people who self-identify with a racial or ethnic minority group,” Joshua Denny, MD, MS, All of Us chief executive officer, and Lawrence Tabak, DDS, PhD, NIH acting director, said. “That’s extremely important because, until now, over 90% of participants in large genomic studies were of European descent. This lack of diversity has had huge impacts—deepening health disparities and hindering scientific discovery from fully benefiting everyone.”

National Cancer Institute (NCI) Director Norman Sharpless, MD, announced his decision to step down as the institute’s director in April 2022, a position he has held since 2017. According to NCI, the institute’s principal deputy director, Douglas R. Lowy, MD, will serve as acting director at the end of the month.

People who use electronic cigarettes have unique microbial communities in their mouths that more closely resembled those of smokers than nonsmokers, which may signal an increased risk of gum disease for those individuals, according to findings from research funded in part by the National Institute of Health’s (NIH’s) National Institute of Dental and Craniofacial Research.

More than $560 million in provider relief fund (PRF) phase four distribution payments reached more than 4,100 healthcare institutions across the United States in February 2022, according to the U.S. Department of Health and Human Services (HHS). The funding will be used to help healthcare institutions prevent, prepare for, and respond to the COVID-19 pandemic, including maintaining operations at facilities and recruiting and retaining healthcare professionals during the workforce shortage.

Internationally recognized for expertise in health services research, the U.S. healthcare system, and health policy analysis, Robert Otto Valdez, PhD, MHSA, was appointed as director of the Agency for Healthcare Research and Quality (AHRQ) in February 2022, where he leads the agency’s work in improving and promoting patient safety.

Climate change affects more than weather patterns or the environment; it also has a substantial impact on human health. Its contribution to the cancer burden includes increased levels of carcinogens, comorbidity factors, cancer incidence, and cancer mortality and reduced access to care.

Systemic racism persists throughout today’s society, presenting barriers to basic human rights and services, including quality health care for millions of people. Overcoming those disparities and achieving social justice require advocacy from all—but especially nurses.

Building support for the Cancer Moonshot reignition, President Joe Biden appointed temporary leaders to streamline the White House Office of Science and Technology Policy’s (OSTP’s) agenda of creating the Advanced Research Projects Agency for Health. Alondra Nelson, PhD, will serve as OSTP director and Francis Collins, MD, PhD, as science advisor to the president and co-chair of the President’s Council of Advisors on Science and Technology until permanent leaders are in place. Biden made the appointments in February 2022 after Eric Lander, his science advisor who also served as OSTP director, announced his resignation from the role.

Provider Relief Fund Phase 4 payments distributed approximately $9 billion to more than 69,000 healthcare institutions that have experienced revenue losses and expenses related to the COVID-19 pandemic, the U.S. Department of Health and Human Services (HHS) announced in December 2021.

Consumers will more easily find affordable healthcare coverage in 2023, thanks to the Biden-Harris administration’s December 2021 Notice of Benefit and Payment Parameters 2023 Proposed Rule, according to the U.S. Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS). The rule also improves shopping for healthcare coverage, establishes rules to ensure people have access to care, and advances health equity for consumers purchasing Marketplace coverage.

On December 23, 1971, the National Cancer Act was signed into law by Former President Richard Nixon, granting authority to the National Cancer Institute (NCI) director to develop a national cancer program. In December 2021, First Lady Jill Biden celebrated the legislation’s 50th anniversary in an NCI video, in which she recognized the importance of the act, cancer advocacy, and the disease’s personal impact on her family.

Before clinical trials proved otherwise, physicians hailed cigarettes’ therapeutic benefits in black-and-white television commercials and old-time newspaper ads, such as easing tension and enhancing cognition. But as a popular cigarette slogan from the 1970s suggests, we’ve “come a long way, baby!” In the 1950s, researchers began publishing study findings implicating smoking as a cause of lung cancer. Today, the evidence is conclusive: nicotine is addictive and damaging to a person’s health.

Citing his extensive medical background and leadership experience, in November 2021, President Joe Biden nominated Robert Califf, MD, MACC, adjunct professor of medicine, professor of cardiology, and member of the Duke Clinical Research Institute at the Duke University School of Medicine in Durham, NC, as U.S. Food and Drug Administration (FDA) commissioner. Califf will assume the role once confirmed by the U.S. Senate.

Out-of-state RNs can now practice in Maryland and certain qualified nursing students are fast tracking graduation, according to Maryland Governor Larry Hogan’s (R-MD) September 2021 announcements. The Old Line State’s steps will help increase the workforce and curtail the nursing shortage.

Serving on the team that launched the Cancer Moonshot Initiative was just one of the many achievements in Francis Collins’, MD, PhD, 12-year tenure as the director of the National Institutes of Health (NIH). Collins announced in October 2021 that he is stepping down from his role by the end of 2021 after serving as NIH director for three presidential appointments, during which he advocated for increasing NIH’s research budget, learning more about the human genome, and developing treatments tailored to unique genetics.

Biomedical research is what transforms medicine. Oncology nurses see the evidence of that daily, from discoveries like immunotherapy that have revolutionized cancer treatment to novel nursing approaches to managing symptoms and adverse events. And thanks to the studies that brought a COVID-19 coronavirus vaccine to market in record-breaking time, the world understands research like never before, too.

ONS member Christopher R. Friese, PhD, RN, AOCN^®, FAAN, oncology nurse researcher and professor at the School of Nursing in the University of Michigan in Ann Arbor, was named one of seven researchers and clinicians that President Joe Biden appointed to the National Cancer Advisory Board on September 15, 2021.

To achieve value-based, person-centered care, the U.S. healthcare system must promote sustainability and readiness to prepare for future public health emergencies such as the COVID-19 coronavirus pandemic, the Centers for Medicare and Medicaid Service (CMS) said. In August 2021, CMS announced that the Hospital Inpatient Prospective Payment System and Long Term Care Hospital Prospective Payment System final rule will take effect on October 1, 2021, in support of that work.

Nursing has long been associated with healing hands. Laying hands on patients’ bodies is personal and intimate, providing comfort, soothing reassurance, strength, and hope. It builds a sacred trust that engenders care. When that foundational element of nursing was removed to follow social distancing protocols during the COVID-19 coronavirus pandemic, nurses found a new avenue to connect with their patients—through the use of telehealth.

In its first year, new presidential administrations release a skinny budget that contains more topline items rather than deep dives into each agency and subdivision. Following suit, in April 2021 the Biden-Harris administration released its request for discretionary funding with limited definition, but it was enough to foreshadow the fiscal year (FY) 2022 funding cycle.

Achieving health equity tops the list of the Patient-Centered Outcomes Research Institute’s (PCORI’s) newly updated National Priorities for Research, which the institute released on June 24, 2021.

The COVID-19 coronavirus pandemic was a wake-up call for preparedness: it caught society unaware and highlighted gaps in virtually every modern-day system. With those lessons learned, when the United States started removing pandemic-related public health restrictions and we began a return to “normal,” experts from all corners of society started looking to what the future will bring.

The Centers for Disease Control and Prevention (CDC) is “committed to continuing to advance the science around COVID-19, moving more vaccines into more communities—especially those communities most at risk for COVID-19 infection—and working to improve health equity,” CDC Director Rochelle Walensky, MD, MPH, said during a March 2021 U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP) hearing. She joined Anthony Fauci, MD, David Kessler, MD, and Peter Marks, MD, PhD, in sharing witness testimonies about their agencies’ response to the pandemic and how to better prepare for future threats.

In July 2021, the Biden-Harris administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury and the Office of Personnel Management, issued the Requirements Related to Surprise Billing interim final rule to restrict surprise billing. The rule applies to billing for patients in job-based and individual health plans who obtain emergency care, nonemergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.

Those without healthcare coverage can now purchase annual policies through state exchanges until August 15, 2021, under the Centers for Medicare and Medicaid Services’ (CMS’s) extended Special Enrollment Period (SEP), ensuring continued access to affordable coverage for Americans during a time of healthcare uncertainty.

In a bipartisan effort that recognizes patients' concerns about telehealth’s accessibility, the U.S. Senate promoted legislation to reduce barriers to care. Senators Brian Schatz (D-HI), Roger Wicker (R-MS), Ben Cardin (D-MD), John Thune (R-SD), Mark Warner (D-VA), and Cindy Hyde-Smith (R-MS), along with 50 colleagues, introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2021. The bill would “expand coverage of telehealth services through Medicare, make permanent COVID-19 telehealth flexibilities, improve health outcomes, and make it easier for patients to safely connect with their doctors.”

Nurses have an innate drive to improve healthcare delivery. When I was a unit director, I focused on nursing unit turnarounds to improve quality of care. I used mediation as the model for resolving long-time conflicts and provided training to effectively engage and communicate. I started my mediation practice in 2003 to help physicians, nurses, and administrators resolve the complex issues that get in the way of patient care and create stressful work environments.

In May 2021, U.S. Representative Lauren Underwood, RN (D-IL), introduced the Primary and Behavioral Health Care Access Act that, if passed, would require private health insurance plans to cover three primary care visits and three behavioral health or substance abuse disorder visits per year without cost sharing. Underwood’s goal was to promote legislation that would make health care more accessible and affordable. 

A shining light to guide a burgeoning field—often referred to as “the lady with the lamp”—Florence Nightingale was a revolutionary figure in nursing, transforming care by simple but radical actions. Through scientific research she showed that sanitation and healthy diets improved patient outcomes, and through advocacy she fought for access to those conditions for all of her patients. She modeled the way for nurse advocates throughout history and into today. 

Although not expressly written as part of the U.S. Constitution, from the earliest days of the republic, strong presidents have issued proclamations, instructions, and statements that eventually evolved into executive orders carrying the weight of the federal government on new directives meant to change policy. George Washington issued his first presidential edicts to have his Cabinet report on departmental activities. 

For a long time, like so many other nurses, I thought of myself as the “regular kind” of advocate for my patients, speaking out for their needs on an individual basis at the institutional level while supporting them as they navigate a cancer diagnosis. But I’ve more recently discovered an even more empowering role: I’m now a health policy advocate.

The ONS Board of Directors had a full agenda for its longer quarterly meeting on February 18–19, 2021. Among other work, it evaluated the results of the annual member satisfaction survey, discussed the fiscal health of the organization based on year-end financials, and continued the conversation on diversity, equity, and inclusion in nursing and cancer care. Details on the Board’s decisions in key areas follow, and ONS members can review the full meeting minutes at ons.org/board-minutes.  

More nurses are diagnosed with the COVID-19 coronavirus than healthcare providers in any other discipline. Despite that sober statistic, very few congressional committees’ COVID-19 legislation proposals support essential workers like nurses. U.S. Representatives Jackie Speier (D-CA) and Joe Neguse (D-CO) introduced a bill to address those concerns.