What Special Considerations Are Needed When Setting up IV Chemotherapy?
No solid research exists regarding IV chemotherapy administration setups, because they can vary greatly based on the regimen, equipment availability, and patient status. Of the utmost importance is that the administration setup ensures chemotherapy is given safely and allows for prompt nursing intervention in the event of an adverse reaction or infiltration.
When Ineffective Pain Control Means Chemical Coping
Central to our role as oncology nurses is provision of symptom relief balanced with a manageable side-effect profile. Although opioids are extremely effective at cancer pain management, they also bind to the brain’s limbic system and can produce reward responses. This can result in dependence and drug-seeking behaviors.
FDA Grants Approval to Pembrolizumab for Locally Advanced or Metastatic Urothelial Carcinoma
On May 18, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to pembrolizumab (Keytruda®, Merck and Co., Inc.) for patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.
Dermascopic Clues Help Identify Seborrheic Keratosis-Like Melanoma
Melanomas that resemble seborrheic keratosis (SK) can be challenging to diagnose correctly. SKs are often removed without being evaluated dermascopically or sent for pathologic analysis, risking the possibility of missing a diagnosis of SK-like melanoma. A new study published in JAMA Dermatology outlined the key dermascopic clues that clinicians can use to identify SK-like melanomas to prevent treatment delays and achieve the best patient outcomes.
The Challenge of Caring for Multiple Patients With Cancer
As more new treatments enter practice—like immunotherapy, targeted therapy, and combination therapies—oncology nurses are required to be experts in every treatment they administer. They need to constantly walk a tightrope, balancing multiple medications for one patient then quickly moving to the next patient on a completely different treatment protocol.
The Case of the Omitted Opioid
Rocky is a 56-year-old man with stage III oropharyngeal cancer. He is undergoing concurrent chemotherapy and radiation. Rocky is a long-haul truck driver, has had sporadic medical care in the past, has no primary care provider, and usually visits the emergency department in whatever town he is in when he gets sick. He was diagnosed during one of those visits after an episode of hematemesis.
FDA Grants Accelerated Approval to Avelumab for Urothelial Carcinoma
On May 9, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to avelumab for patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy.
Nursing Considerations for Adverse Events From CAR T-Cell Therapy
Chimeric antigen receptor (CAR) T-cell therapy offers options for pediatric patients with relapsed or refractory acute lymphoblastic leukemia, but it comes with a unique set of side effects that can range from mild to severe. As the primary patient providers, oncology nurses are often the first to identify signs and symptoms of adverse events and acute changes in patients’ status. Understanding what to watch for can improve outcomes and help nurses deliver safe, effective care.
Study Finds Guideline Training and Reinforcement of CINV Knowledge Is Important
Chemotherapy-induced nausea and vomiting (CINV) is a side effect reported by 40%–80% of patients receiving cancer treatment. However, CINV can be prevented in 70%–80% of those cases with appropriate antiemetic prophylaxis. Few studies have evaluated approaches to improve provider adherence to antiemetic guidelines, and those who do adhere often have limited demonstrated success.
Educational Initiative Increases Nurse Understanding of Infusion-Related Reactions and Interventions
Denise Portz, MSN, RN, AOCNS®, ACNS-BC, a clinical nurse specialist at the Froedtert Hospital in Wisconsin, presented the findings during a poster session at the ONS 42nd Annual Congress in Denver, CO. The poster was titled “Providing Oncology Infusion Nurses Evidence-Based Guidelines and Interventions to Manage Infusion Reactions and Anaphylaxis.”
Use Pharmacologic and Nonpharmacologic Options to Treat Anxiety and Depression in Patients With Cancer
Jane Rosenthal, MD, FAPM, from New York University Langone Medical Center, discussed treatment and management options patients suffering from these disorders during a session at the 42nd Annual Congress in Denver, CO.
Are All Patients Treated Equally?
It’s 2017, and one would think that all patients are treated equally. Nursing has certainly been educated to treat all patients with the same levels of respect and dignity and to provide excellent medical care regardless of age, race, ethnicity, or religious beliefs. In the theory of nursing, I think we all strive and believe that patients should be treated equally. However, at least for the reality of nursing that I work in, that doesn’t always feel true.
Interpreting Guidelines Correctly Helps Workplaces Remain Compliant
Guidelines are established as tools to enhance patient care; however, translating guidelines can be difficult. Diana Scott, RN, MHA, CPHQ, senior director of accreditation services at Vizient, and Carma Herring, RN, MS, OCN®, from the John Stoddard Cancer Center, discussed mandates from the Joint Commission and Centers for Medicare and Medicaid Services (CMS), as well as tips for using guidelines and being compliant during a session at the 42nd Annual Congress in Denver, CO.
Studies Show Ways to Attain CMS Benchmark Measures for Cancer Care
Currently, the Centers for Medicare and Medicaid Services (CMS) mandates 33 oncology-specific benchmark measures related to end-of-life care and hospice, unplanned hospital admissions (UHAs), pain, falls, medication, central venous catheter (CVC) line, pressure ulcers, tobacco cessation, catheter-associated urinary tract infections, sepsis, and function. Advanced practice nurses can play a role in achieving benchmarks and developing innovative strategies to accomplish these goals.
Tips for Managing Chronic Pain in High-Risk Patient Populations
Pain management is often necessary for patients with cancer and other high-risk conditions. Despite guidelines and treatment algorithms, caring for this patient population can be challenging. Oscar DeLeon, MD, of the Roswell Park Cancer Institute, Kathleen Broglio, DNP, ANP-BC, ACHPN, CPE, FPCN, from Dartmouth Hitchcock Medical Center, and Jennifer Grimmer, DNP, FNP-BC, of the Roswell Park Cancer Institute, discussed strategies and best practice for pain management during a session at the 42nd Annual Congress in Denver, CO.
Creating and Sustaining Survivorship Care Plans in Practice
With more than 15.5 million Americans living beyond cancer, it’s no surprise that more attention is being paid to survivorship than ever before. Once treatment ends, patients can be thrown back into a world after cancer with little or no attention paid to their concerns about recurrence, late effects from treatment, how to follow up with their future care, and a great many more unknowns.
FDA Approves Durvalumab for Urothelial Carcinoma Treatment
On May 1, 2017, the U.S. Food and Drug Administration granted accelerated approval to durvalumab for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or who have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.
The Case of the Immunotherapy Inquiry
Jay is a 62-year-old man with newly diagnosed, stage IIIA (T3, N1), unresectable, non-small cell lung cancer (NSCLC) that tested negative for ALK, EGFR, and KRAS mutations. Additionally, PD-L1 (programed death receptor ligand) expression was less than 30%. Jay is symptomatic with a persistent cough, unintentional weight loss, and fatigue.
FDA Approves Marketing of First Digital Pathology Whole Slide Imaging System
The U.S. Food and Drug Administration (FDA) has permitted marketing of the Philips IntelliSite Pathology Solution (PIPS, Philips Medical Systems Nederland B.V.), as an aid to the pathologist to review and interpret digital images of surgical pathology slides prepared from formalin-fixed paraffin embedded (FFPE) tissue.
FDA Removes Risk Evaluation Management Strategies (REMS) for ESAs
On April 13, 2017, the U.S. Food and Drug Administration (FDA) removed the Risk Evaluation and Mitigation Strategy (REMS) requirements for the use of Epogen/Procrit and Aranesp to treat patients with anemia due to associated myelosuppressive chemotherapy.
AJCC Cancer Staging System Will See Changes in 2018
Beginning in January 2018, oncology nurses will see changes to the way their patients’ cancers are staged with the American Joint Committee on Cancer (AJCC) system. According to a presentation at the National Comprehensive Cancer Network annual conference in March 2017, when the AJCC 8th Edition Cancer Staging System takes effect on January 1, 2018, more cases may be classified as stage I, especially for patients with breast cancer.
HPV Vaccines Fight Against Oral Cancers and More
Because April is Oral Cancer Awareness Month, it’s important to understand the link between human papillomavirus (HPV) and oropharyngeal cancers. This form of oral cancer occurs in the middle part of the throat, soft palate, base of the tongue, and tonsils. HPV contributes to more than 70% of all oropharyngeal cancers, with more than half of these being related to HPV type 16. The Centers for Disease Control and Prevention (CDC) noted that approximately 9,000 new cases of oropharyngeal cancers are diagnosed annually and are typically four times more common in men than women.
FDA Approves Ribociclib for Breast Cancer Treatment
On March 13, 2017, the U.S. Food and Drug Administration (FDA) approved ribociclib (KISQALI®, Novartis Pharmaceuticals Corp.), a cyclin-dependent kinase 4/6 inhibitor, in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer.
ONS and ASCO CancerLinQ Partnership Will Help Institutions Use Practice Data to Drive Greater Cancer Care
Offering personalized treatment plans to patients with cancer is one of the biggest goals for any oncology institution—big or small. ONS leaders and members have united their personal and organizational efforts to move cancer care toward personalization while still aligning the needs of patients with nationally recognized clinical guidelines. Oncology nurses consistently strive to deliver quality cancer care to their patients.
Sepsis Identification and Early Goal-Directed Therapy
Infection represents a leading cause of death and treatment-related toxicities among patients with cancer in the United States. It stands to interfere with antineoplastic treatment plans by forcing dose modifications, delays, or discontinuation and instead turning to a less aggressive treatment plan.
Nurses Lend Voice to End-of-Life Decisions
Patients rely on oncology nurses to translate the world of health care. They lean heavily on our expert knowledge when undergoing treatments for cancer. It’s not simply the facts we provide—like the pros and cons of a certain treatment—it’s helping patients understand how these facts impact their lives. This knowledge allows patients nearing the end of life to make informed decisions about whether they should continue treatment or seek referral to hospice care.
The Case of the Breast Cancer Biology
Molly is a 48-year-old biology professor at a prestigious university. She was recently diagnosed with stage II invasive ductal carcinoma. She is referred to Anna, the breast nurse navigator, for breast cancer education and coordination of care.
The Case of the Dietary Dilemma
Cicely, who is being treated for stage III colon cancer, has lost seven pounds between her first and second cycles of chemotherapy. She admits to Julie, an outpatient oncology nurse, that her nausea is well controlled but she just doesn’t feel like cooking meals anymore. What Would you do?
What Is ONS’s Stance on Handling Chemotherapy While Pregnant, Breastfeeding, or Trying to Conceive?
One of the questions that ONS commonly receives in the clinical inbox is whether nurses who are pregnant, breastfeeding, or trying to conceive can safely administer or handle chemotherapy and other hazardous drugs.
The Case of the Caregiver With Cancer
APRNs Now Have Full Medical Authority in Practice at VA Hospitals
What Oncology Nurses Need to Know About Biosimilar Drugs
Generic, bioidentical, and biosimilar are terms used to identify a drug that has a comparable chemical structure and intended effect as the original patented drug. However, the terms are not necessarily interchangeable. The differences between these can impact the way you practice.