Transitions in Care
For patients and their care teams, transitions are an integral part of the cancer journey. Patients may be moving from inpatient to outpatient care, an acute care setting to a community-based setting, hospital care to nursing home care, or even active treatment to ongoing survivorship. Care transitions can be times of intense information overload for patients, caregivers, and the healthcare team.
Genetic Disorder Reference Sheet: Neurofibromatosis Type 2
Neurofibromatosis type 2 is an autosomal dominant disorder characterized by bilateral vestibular schwannomas that can lead to significant hearing loss or deafness. Symptoms include tinnitus, hearing loss, and balance problems, with an average age of onset of 18–24 years and nearly 100% penetrance.
Health Disparities Have Cancer Implications for Indigenous People. Here’s How to Provide Culturally Competent Care.
Among all racial and ethnic groups, indigenous people (Native American and Alaska Natives) had the largest decline in life expectancy from 2020–2021. They also have the lowest overall life expectancy (65.2 years) than any of their Asian, Black, Hispanic, or White counterparts—in some cases, up to 20 years shorter. Indigenous people have disproportionately high rates of suicide, chronic liver disease, cardiac disorders, diabetes, and infant and maternal mortality.
Nurse Practitioner's QI Project Standardizes Transplant and Cellular Therapy Nurse Coordinator Visit Scheduling
As an oncology advanced practice provider, I saw a need to enhance the scheduling process for transplant and cellular therapy nurse coordinator visits at my institution. In response, I developed and implemented the following quality improvement project and successfully reduced scheduling error rates by 95%.
Nurse-Created Apps Help Pediatric Patients Find Their Voice and Navigate Their Cancer Journey
A nurse’s perspective in the creation of health technology tools to deliver quality patient care is important for the digital era we provide care in. Advancements can be as complex as artificial intelligence in big institutions or as simple as a mobile app for personal smartphones. I’ve been working with other healthcare providers to develop the latter to improve care for pediatric patients with cancer.
Music Therapy May Bridge Race-Related Gaps in Cancer Pain Management
Despite pain’s prevalence as a debilitating symptom correlated with poor outcomes among patients with cancer, it is often inadequately treated. Racial disparities further contribute to the challenges of assessing and managing cancer pain, with health systems reporting markedly lower doses of opioid prescriptions for Black patients compared to White patients. The inequities stem from provider biases, patient belief systems, and systemic racism.
U.S. Senators Introduce Legislation for Earlier Palliative Care
Patients must receive palliative care earlier in their disease trajectory, while they’re still in active treatment, U.S. Senators Jacky Rosen (D-NV), Senator John Barrasso (R-WY), Tammy Baldwin (D-WI), and Deb Fischer (R-NE) said. Working in rare bipartisan fashion, in June 2023 they reintroduced the Expanding Access to Palliative Care Act to pay for Medicare beneficiaries to receive comprehensive palliative care services concurrently with curative therapy.
Specialized Services Support and Improve Care for LGBTQI+ Patients With Cancer
As the founder of the LGBTQ+ Coordination of Care Consult Service and co-chair for the LGBTQI+ Clinical Advisory Committee (CAC) at Memorial Sloan Kettering (MSK) Cancer Center in New York, NY, Kelly Haviland, PhD, RN, FNP-BC, an advanced practice provider manager of professional development, is combatting the systemic disparities that LGBTQI+ patients with cancer face in accessing care.
Interprofessional Collaboration Reduces Time to Neutropenia Antibiotic Administration
A multipronged approach that incorporates all disciplines on the interprofessional cancer care team resulted in a 34% improvement in antibiotic initiation within 30 minutes of a neutropenia diagnosis on a 24-bed blood and marrow unit, according to study findings presented at the 48th Annual ONS Congress® in April 2023.
Oncology Clinician, Researcher, Advocate—and Patient Herself—to Become Second Woman to Lead NIH
Praising her vision and leadership as a world-renowned surgical oncologist, cancer researcher, and educator, on May 15, 2023, the White House announced President Joe Biden’s nomination of Monica Bertagnolli, MD, as the next National Institutes of Health director.
Nurse-Pharmacist Collaboration Improves HSCT Patient Outcomes
Collaborative, interprofessional care for hematopoietic stem cell transplantation recipients improves time to electrolyte repletion; reduces cardiac adverse events, oral mucositis severity, and bloodstream infections; and improves use of patient-controlled anesthesia, researchers reported in study findings presented at the 48th Annual ONS Congress® in April 2023.
As Institutions Establish Oral Agent Workflows, Savvy Educators Help Nurses Apply Them to Practice
Oncology nursing is a hands-on practice, and nurses’ learning must be hands-on, too. Allowing your colleagues to try out what you teach further solidifies their foundational knowledge and new concepts. With the use of oral oncolytic agents exploding in oncology care, we must adapt and learn the ins and outs of these agents. As a unit educator at The University of Kansas Cancer Center in Westwood, I help nursing staff understand my cancer center’s oral agent refill process.
The Case of the Biomarker Database Discoveries
Macy is a 57-year-old patient with a history of hormone receptor–positive invasive ductal carcinoma of the right breast, diagnosed in 2017. She achieved complete remission after chemotherapy with anthracycline plus paclitaxel followed by bilateral mastectomy with reconstruction in 2018.
Add Meaning to Your Communication With This Key Element
Meaningful communication involves more than just words traded between people. By asking open-ended questions, affirming a person’s strengths, offering reflections, and providing a summary of the conversation, you can engage others in meaningful conversation.
Advance Care Planning
Advance care planning (ACP) is an integral part of treatment planning that supports patients at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. ACP is individualized to each patient’s unique circumstances, with more support and specific decision-making provided as the planning progresses. It’s particularly important for patients with cancer, but communication challenges can delay ACP initiation.
HHS Assistant Secretary for Health Meets With Colorado Springs Community and Mental Health Providers to Discuss Care After Crisis
Bringing awareness to the importance of mental health care in times of crisis, Admiral Rachel Levine, MD, assistant secretary for health for the U.S. Department of Health and Human Services, traveled to Colorado Springs, CO, to meet with survivors of the November 2022 nightclub shooting and host a crisis mental health roundtable with healthcare providers in December 2022.
What the Evidence Says About Tai Chi in Cancer Care
A form of mind-body therapy, tai chi has been practiced in China for centuries and progressed around the world today. The practice combines a sequence of gentle body movements with meditation and coordinated breathing. Under traditional Chinese medicine theory and philosophy, tai chi harmonizes the vital forces of yin and yang and promotes the flow of qi (internal energy).
Genetic Disorder Reference Sheet: BAP1
Isolated in 1998 as a tumor suppressor gene, BAP1 pathogenic variants have been identified in at least 200 families. More cases will be found as germline pathogenic variant testing becomes more readily available and routinely offered to patients with cancer.
Religious Fasting During Cancer Treatment
Many cultures and religions across the world practice fasting, or the absence of caloric intake for a few hours to several weeks, at different times throughout the year. Islam, Judaism, Buddhism, Christianity, Hinduism, and Taoism religions most commonly use fasting for various reasons, but the overall purpose generally is to demonstrate sacrifice or spiritual cleansing.
Clinical and Pharmaceutical Nurse Educators Collaborate to Bring Training to Nurses and Improve Patient Care
In 2022 we celebrated the National League for Nursing’s Year of the Nurse Educator, but nursing staff recognize and thank nurse educators for their critical role in training and support year in and year out. Oncology nurses in particular rely on nurse educators to stay updated as treatments and patient care constantly evolve—and that requires a multipronged approach. All aspects are covered when clinical nurse educators and pharmaceutical nurse educators come together to deliver training for today’s cancer therapies.
Text-Messaging Prescreening Streamlines Treatment Visits and Care for ICI Toxicities
Prescreening patients for immune-related adverse events during treatment with immune checkpoint inhibitors using text messaging may reduce the need for some in-person, preinfusion office visits, researchers reported in JAMA Network Open. The approach may help decrease the burden of cancer care for both patients and providers.
Micro-Organospheres Create Molecular Model of Patients’ Cancer in Just Two Weeks
Biomarker- and molecular-driven technologies such as molecular models can precisely predict how an individual’s cancer will respond to certain treatments, the pinnacle of precision oncology. However, established modeling systems such as patient-derived xenografts and patient-derived organoids require large tissue samples and take months or even a year to obtain results, barriers that have limited their application in regular practice.
Predictive and Diagnostic Biomarkers
Biomarkers, also called molecular markers or signature molecules, can help clinicians characterize alterations in tumors through the detection of specific DNA, RNA, protein, or metabolomic profiles. These pieces of the cancer puzzle are part of precision oncology that the cancer care team can use to assess patients’ cancer risk and prognosis or monitor disease progression. Biomarkers are also a key factor in determining and tailoring treatment methods and their likelihood of success.
NCI Awards $23 Million to Establish Centers to Study Telehealth for Cancer Care
Four academic institutions will create centers of excellence dedicated to telehealth in cancer care to help healthcare providers increase its use in oncology practice, thanks to $23 million in National Cancer Institute (NCI) funding. The awards are part of NCI’s Telehealth Research Centers of Excellence initiative, which is supported by President Joe Biden’s Cancer Moonshot initiative.
Most Lung Cancer Genetic Variants Are Clinically Actionable and All Patients Should Get Biomarker Testing
More than 95% of germline genetic variants identified through genetic testing in patients with lung cancer are potentially clinically actionable, researchers reported in study findings during the 2022 ASCO Plenary Series Program, leading them to recommend testing all patients with the disease.
Genetic Counselors Help Patients and Oncology Nurses Predict Current and Future Cancer Diagnoses
Many of our patients are individuals who haven’t developed cancer but might have a concerning family history of the disease. We rely on healthcare providers like oncology nurses to identify individuals with concerning cancer histories and refer them to genetic counselors for a complete risk assessment, including genetic testing when appropriate, to determine their risk and recommend proactive measures to reduce it.
CHIP Drastically Reduced Uninsured Children in the Past 25 Years
The Children’s Health Insurance Program helped drop the percentage of uninsured children from 15% to 3.7% since its authorization by Congress in 1997, according to data from the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services released in celebration of CHIP’s 25th anniversary in August 2022.
New SIO-ASCO Guideline Identifies Integrative Care Recommendations for Cancer-Related Pain
Cancer-related pain, whether from the disease or its treatments, is a distressing symptom that persists through survivorship. Pain diminishes patients’ quality of life and negatively affects their cancer-related outcomes.
Sexual Considerations for Patients With Cancer
As a term, sexuality is linked to sexual functioning—the ability to engage in sexual behaviors and the body’s physiologic response—as well as sexual reproduction and fertility. But those biologic aspects are just a small part of a person’s overall sexuality. Sexual health is a state of physical, emotional, mental, and social well-being and requires a positive and respectful approach to sexuality and sexual relationships.
CMS Guides U.S. States on New Benefit to Improve Access to Care for Children With Complex Medical Conditions
A new Medicaid health home benefit could improve access to person-centered care management, care coordination, and support resources for children with complex medical conditions and their families—but only if states understand how to opt into offering it. In August 2022, the U.S. Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, released guidelines for states to better understand the benefit and its requirements.
Post-Flooding Natural Disaster Cancer Considerations and Patient Education Points
Natural disasters present unique challenges to patients with cancer and the healthcare systems that must stand ready to keep them healthy. Exposure to floodwater places patients at risk for infectious diseases, chemical hazards, and injury, and anything in the water’s path, including medical equipment, medications, homes, and vehicles, can be severely damaged or destroyed. Patients with cancer who are immunocompromised are a highly vulnerable post-flooding population and need special guidance.
Certain Cancers May Increase Risk of Type 2 Diabetes
Patients with lung, pancreatic, breast, brain, urinary tract, or uterine cancers may be more likely to develop new-onset type 2 diabetes after their cancer diagnosis, according to research findings published in Diabetes Care, and those who went on to develop type 2 diabetes experienced poorer overall health outcomes.
Nurse Scientists Are Leading Patient Care Discoveries in the Ever-Evolving World of Cancer Survivorship
The cancer survivorship program team at the University of Pennsylvania Abramson Cancer Center is conducting numerous research projects such as cancer treatment’s late effects, survivors’ quality of life and health behaviors, telemedicine for survivorship visits, and even an artificial intelligence–powered, mobile phone–based program to support patient adherence to guidance from survivorship visits.
Low Cost-Related Health Literacy May Prevent Survivors From Following Care Plans
Not understanding terms like deductible, copay, premium, coinsurance, and out-of-pocket maximum prevents many Americans from selecting a health insurance plan that meets their financial needs. Fewer than 40% of patients enrolled in high-deductible healthcare plans engage in effective financial behaviors, such as comparing prices or discussing costs with clinicians. High costs are a barrier for many patients and survivors to access high-quality cancer and survivorship care.
Oncology Nurse Educates the Public on the Evolution of Cancer Care and Survivorship
With care shifting to outpatient delivery and the increased availability of evidence-based support services, cancer care and survivor support has greatly evolved during the past 25 years, according to ONS member Carlin Callaway, DNP, MS, RN, ACNP-BC, ACNS-BC, AOCNP®, assistant professor and lead medical oncology advanced practice provider at the University of Colorado Cancer Center and member of the ONS Metro Denver Chapter, in a June 2022 public-facing blog post for the American Society of Clinical Oncology’s Cancer.Net website.
Data Coordinators and Oncology Nurses Collaborate to Create Accurate, Comprehensive Survivorship Care Plans
Coordinating survivorship care plans is an integral part of cancer care. When the Froedtert and Medical College of Wisconsin Cancer Network experienced challenges in implementing survivorship care plans, it created a brand-new medical role—survivorship data coordinator—to “initiate case findings for eligible patients, track patients completing treatment, notify physicians and advanced practice providers to populate the survivorship care plan, and schedule survivorship care plan appointments.”
Social and Community Context Matter in Cancer Care
A person’s zip code often matters more than their genetic code when it comes to their health. Where we live and work, how connected we are in our community, and how much support we have are core social determinants of health that also significantly affect cancer health outcomes.
Biden Adds New Members to Cancer Cabinet
With broad backgrounds in oncology genetics, immunology, and disparities, President Joe Biden’s three July 2022 appointments to the Cancer Cabinet will help guide the United States on opportunities to reduce cancer’s barriers and burden for underserved populations.
New Technology Tools Help Oncology APRNs Improve Patient Outcomes
Clinical decision support systems are tools integrated into electronic health records that include reminders for preventive care, evidence-based clinical practice guidelines, order sets, and alerts for drug prescribing. In health care, artificial intelligence converts data into knowledge to guide clinical decisions. When combined, the two technologies can guide advanced practice RNs and other providers with predictions and suggestions that go beyond human accuracy and specificity.
CMS Expands Access to High-Quality Care With Physician Payment Rule Proposal
To decrease cost and increase access to care, in July 2022 the Centers for Medicare and Medicaid Services proposed a conversion factor of $33.08 for the 2023 Physician Fee Schedule.
Nurses Are Pivotal to Advancing Biden’s Cancer Moonshot Initiative
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.
Promote Patient Self-Advocacy Across the Cancer Spectrum
Healthcare professionals are called to provide patient-centered care in an environment where they listen to patients’ goals and desires and support patient autonomy. However, heeding that call requires patients’ participation to voice their needs and concerns, and some patients may be reluctant to speak up for themselves.
Cost Can Prevent Patients From Receiving Follow-Up Care, Study Suggests
Financial considerations are notable barriers for patients with cancer receiving follow-up cancer care, according to study findings from the National Institutes of Health (NIH) All of Us Research Program.
Oncology Care Model Created New Opportunities for APRNs to Transform Cancer Care
Launched in 2016 as a pilot program from the Centers for Medicare and Medicaid Services Innovation Center to develop new payment and delivery system models, the Oncology Care Model had a lofty goal: drive improvements in providing high-quality and cost-effective care.
CDC Reports More Than 1.7 Million New Cancer Cases in 2019
More than 1.7 million new invasive cancer cases were reported in the United States in 2019, according to the U.S. Cancer Statistics from the Centers for Disease Control and Prevention (CDC) updated in June 2022.
CNS Survivorship Needs More Research, Funding, and Training, Expert Panel Says
Access and reimbursement, patient and provider education, core competencies, and survivorship research funding remain critical barriers for primary central nervous system (CNS) cancer survivorship, a team of National Cancer Institute Comprehensive Oncology Network Evaluating Rare CNS Tumors experts reported in a workshop summary published in Neuro-Oncology Advances.
The Clinical Pharmacist’s Role in Symptom Assessments
Healthcare professionals involved in direct patient care, such as nurses, pharmacists, advanced practice providers, and physicians, learn methods of symptom assessment during education and training, but each profession uses a slightly different lens. The ability to consider polypharmacy and drug-drug interactions in patient assessment is one of the most important skills a clinical pharmacist uses in daily practice. Clinical pharmacists caring for patients with cancer must identify drug-related side effects, monitor and manage patients during chronic drug therapy, and educate patients and members of the interprofessional team, all in the context of the intricacies of antineoplastic therapy and adherence assessment.
Symptom assessment gives oncology nurses a consistent matrix to directly evaluate the significance that symptoms have on patients’ distress, quality of life, and survival. Both symptoms and their impact can evolve throughout a patient’s cancer course, making high-quality and detail-oriented assessments an essential tool for successful treatment and management.
Community Health Centers Get Funding to Advance Equity in Cancer Screening and Follow-Up Care
With the relaunch of the Biden-Harris administration’s Cancer Moonshot initiative, the fight against cancer is back in the government spotlight. To support the Moonshot’s goals, in May 2022 the U.S. Department of Health and Human Services (HHS) allocated $5 million to the Health Resources and Services Administration-funded community health centers.