Managing toxicities and adverse events (AEs) so that patients can continue to stay on effective treatments is essential to improving outcomes. Catherine Hill, BSN, RN, OCN^®, Margaret Blaney, RN, BSN, Ashley Layton, BSN, RN, OCN^®, and Kaddie Lopez, BSN, RN, OCN^®, PHN, discussed ways to manage and prevent symptoms in cancer care during a session at the 43rd Annual Congress in Washington, DC.

Ibrutinib is a first-in-class, once-daily inhibitor of Bruton’s tyrosine kinase. In 2017, the U.S. Food and Drug Administration approved ibrutinib for the treatment of adult patients with chronic graft-versus-host disease (cGVHD) after failure of one or more lines of systemic therapy.

Chimeric antigen receptor T-cell (CAR T-cell) therapy has become an integral part of the advancement of lymphoma and other cancer treatments. However, educational resources and available published literature are still lacking for oncology and intensive care nurses.

Electronic health records (EHRs) can offer so much more than a way to keep all processes and procedures linked to a patient. Christina Boord, BSN, RN, OCN^®, and Cori Kopecky, MSN, RN, OCN^®, discussed electronic health records, patient data, and outcomes during a session at the 43rd Annual Congress in Washington, DC.

Advanced practice nurses (APNs) are creating new and innovative programs that educate patients and help them live better, healthier lives. Lorraine Drapek, DNP, FNP-BC, AOCNP^®, Geline Joy Tamayo, MSN, RN, ACNS-BC, OCN^®, TTS, Suzanne McGettigan, MSN, CRNP, AOCN^®, ANP-BC, and Edward Bentlyewski, MSN, APN, NP-C, AOCNP^®, discussed their experiences with APN-run clinics and program implementation during a session at the 43rd Annual Congress in Washington, DC.

Staying updated on advancements in cancer care increases the chances of improved outcomes for patients. Cara Henderson, RN, BSN, CMSRN, patient service manager of surgical oncology at Smilow Cancer Hospital in New Haven, CT; Elizabeth Rodriguez, DNP, RN, OCN^®, nurse leader of outpatient services at Memorial Sloan Kettering Cancer Center in New York, NY, Amanda Choflet, DNP, RN, OCN^®, director of nursing in radiation oncology at Johns Hopkins Health System in Baltimore, MD, and Megan Howe, MSN, RN, OCN^®, nurse manager of Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, discussed the factors that relate to improving outcomes, the multidisciplinary approaches to the process change strategy, and the results and future direction of chosen pathways during a session at the 43rd Annual Congress in Washington, DC.

As precision oncology continues to expand, so does the ability to use less-toxic targeted therapies. James Chen, MD, assistant professor of biomedical informatics and assistant professor of internal medicine at the division of medical oncology at Ohio State University in Columbus, described his work with genomics in cancer care and the challenges in precision medicine at the 43^rd Annual Congress in Washington, DC.

An estimated 266,120 new cases of invasive breast cancer and 40,920 related deaths will occur in the United States in 2018. Patients with distant disease have a poorer five-year relative survival rate (26.9%) compared with localized (98.9%) and regional (85.2%) disease. HER2+ breast cancer accounts for approximately 20%–25% of all breast cancer diagnoses, and this type of breast cancer is more common in younger women, decreasing in frequency with age across all stages.

If it seems like a new oncology drug or indication comes to market every month, you wouldn’t be wrong. The U.S. Food and Drug Administration (FDA) has approved a record number of oncology agents in 2017 and 2018. Teresa Knoop, MSN, RN, AOCN^®, assistant director of clinical operations at the Clinical Trials Shared Resource at Vanderbilt-Ingram Cancer Center in Nashville, TN, gave an update on the latest therapies during a session at the 43rd Annual Congress in Washington, DC.

As the opioid abuse epidemic prevails in the United States, patients with cancer can be affected. Yu-Ping Chang, PhD, RN, FGSA, associate dean for research and scholarship in the School of Nursing at the University at Buffalo in New York, and Tonya Edwards, MS, MSN, BSN, FNP-C, a nurse practitioner of supportive care at MD Anderson Cancer Center in Houston, TX, discussed how the opioid epidemic affects patients and how to identify and prevent opioid and substance abuse during a session at the 43rd Annual Congress in Washington, DC.

During the State-of-the-Science Lecture at the 43rd Annual Congress in Washington, DC, Jane Fall-Dickinson, PhD, RN, AOCN®, of Georgetown University School of Nursing and Health Studies, discussed chronic graft-versus-host disease (cGVHD), specifically its oral cavity complications. She presented challenges, clinical data, and goals for improving its treatment and management options.

Catherine Bender, PhD, RN, FAAN, of the University of Pittsburgh, and Amy Hoffman, PhD, RN, of Michigan State University, shared their experiences in building interdisciplinary research teams to assess symptom management during a session at the 43rd Annual Congress in Washington, DC.

Margaret Bevans, PhD, RN, AOCN®, FAAN, program director and clinical nurse scientist at the National Institutes of Health’s Nursing Research and Translational Science department, detailed her own journey and empowered nurses to amplify their impact during her Mara Mogensen Flaherty Memorial lecture at the 43rd Annual Congress in Washington, DC.

During the American Association for Cancer Research/ONS Bench to Bedside session at the 43rd Annual Congress in Washington, DC, Victor Velculescu, MD, PhD, of Johns Hopkins University School of Medicine, and Maura Kadan, RN, MSN, of Personal Genome Diagnostics, dissected the science behind precision oncology, including an understanding of genetic alterations, the use of immunotherapy, and how to advance survival with these clinical breakthroughs.

During a session at the 43rd Annual Congress in Washington, DC, various speakers discussed the latest findings in patient safety.

During a session at the 43rd Annual Congress in Washington, DC, various speakers discussed symptom management and supporting patient needs.

Immunotherapy is becoming an important role in cancer care and having an understanding of immune-related adverse events (irAEs) is critical for oncology nurses to provide safe and effective patient care. Rowena Schwartz, PharmD, BCOP, of the University of Cincinnati in Ohio, discussed strategies for managing these AEs during a session at the 43rd Annual Congress in Washington, DC.

Geographic location impacts life expectancy and even cancer care. Marylynn Ostrowski Ireland, PhD, of Viability, Inc., and Deborah Watkins Bruner, PhD, RN, FAAN, of Emory University in Atlanta, GA, discussed geographic health disparities during a session at the 43rd Annual Congress in Washington, DC.

The development of targeted therapies brought new progress to lung cancer treatment and research in the past 20 years, and new options will continue to be available in the future. Roy Herbst, MD, PhD, director of thoracic oncology research program at the Yale Comprehensive Cancer Center at Yale School of Medicine in New Haven, CT, spoke at the 43rd Annual Congress in Washington, DC, on new standards of care for non-small cell lung cancer (NSCLC), immunotherapy for NSCLC, and development of rational drug combinations using biomarkers.

As the opioid crisis continues in the United States, helping patients find effective and safer ways to manage their pain becomes increasingly important. During a session at the 43rd Annual Congress in Washington, DC, Jeannine Brant, PhD, APRN, AOCN^®, FAAN, of Billings Clinic in Montana, instructed nurses on ways to treat cancer-related pain and discomforts other than (or in addition to) narcotic pain medicines.

Speakers discussed nurse-led initiatives to improve patient care during a session at the 43rd Annual Congress in Washington, DC.

During a session at the 43rd Annual Congress in Washington, DC, various speakers discussed their work in providing quality health care to vulnerable patient populations.

Nurses can foster data-powered health through getting involved in research and ensuring that data collection is in patients’ best interest and accessible to all. Patricia Brennan, PhD, RN, director of the National Library of Medicine, and Suzanne Bakken, PhD, RN, FAAN, a professor at Columbia University, discussed how data can empower health and what nurses can do to advance research during a session at the 43rd Annual Congress in Washington, DC.

Kathleen McDermott, RN, BSN, OCN®, BMTCN®, of the Dana-Farber Cancer Institute, and coauthors presented the background for axicabtagene ciloleucel’s approval and nursing best practices for managing patients receiving CAR T-cell therapy during a poster session at the ONS 43rd Annual Congress in Washington, DC.

Keynote speaker Lee Tomlinson, founder of the C.A.R.E. Effect, discussed his journey from cancer survivor to patient advocate, calling for compassionate care and thanking nurses for being the reason he is alive today, during the opening session at the 43^rd Annual Congress in Washington, DC, on Thursday, May 17, 2018.

Professional incivility, rudeness, and bullying are not new to the world of nursing. Nurses can see escalated teasing or bullying as “a rite of passage” or “earning our stripes.” However, changes in the workplace have shown that no matter what it’s called, bullying and professional incivility has no place in the working environment. Anne Ireland, MSN, RN, AOCN®, CENP, clinical director of the Solid Tumor Program at City of Hope National Medical Center in Duarte, CA, and Tracy Gosselin, PhD, RN, AOCN®, NEA-BC, chief nursing and patient care services officer at Duke University Hospital in Durham, NC, gave a lecture at the 43rd Annual Congress in Washington, DC, on their work with professional incivility and bullying and ways to teach nurses how to intervene and become powerful bystanders.

It’s hard to imagine life without social media, even though the active use of it is less than 15 years old. People use social media to stay connected to family and friends, for information on communities, and more. And although social media is most often used as a personal outlet, it has become much more prevalent in the professional realm as well.

Many programs at the National Cancer Institute (NCI) are focused on cancer research, and support for cancer- and treatment-related symptoms and toxicities crosses a number of National Institutes of Health (NIH) organizations. Martha Matocha, PhD, program director and team lead of the National Institute of Nursing Research (NINR), and Ann O’Mara, PhD, RN, FAAN, program officer at NCI, provided tips and opportunities for nurses and how they can conduct or participate in cancer research programs during a session at the 43rd Annual Congress in Washington, DC.

“This has been a historic year in oncology pharmacology,” Rowena Schwartz, PharmD, BCOP, associate professor at the University of Cincinnati, told the audience during a session at the 42nd Annual Congress in Denver, CO. “There were new drugs, yes, but we’re really learning how to use the drugs that we have.”

Quality of life (QOL) is a complicated construct and has been defined many ways. Barbara Anne Biedrzycki, PhD, CRNP, AOCNP^®, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, presented the following view: “Quality of life is achieved when our hopes are matched and fulfilled by our experiences.” She encouraged participants to have a holistic perspective of QOL but to keep in mind that QOL is very individualized—its definition and meaning are different to each individual, and each person finds some factors to be more important than others.

Carole Elledge, DNP, RN, AOCN^®, clinical program specialist at Methodist Hospital in San Antonio, TX, described the concept of nursing competencies with a kitchen metaphor: “It’s kind of like baking a cake. If you’re going to bake a cake, you need all the ingredients.” For nurses, she said, the ingredients of competency include not only hands-on clinical skills, but also an ability to see past the disease, compassion, critical thinking, self-motivation, patience and insight, leadership, a team approach, and more. “There’s much more to competency than just skills.”

Patients with cancer can face a number of complications as they undergo treatment. Assessment can be difficult because some crises emerge because of the cancer or cancer treatment, whereas others arise unrelated to either cancer or treatment. Moreover, some patients may not look as sick as they are because of the progressive decline in their condition, and long-term abnormalities can diminish symptoms. Although these emergencies are common, Brenda Shelton, RN, MS, and Cynthia Chernecky, PhD, RN, CNS, argued, at the 41st Annual ONS Congress, that many of these complications could be avoided with diligent monitoring and early intervention.

An interview with Jeannine Brant, PhD, APRN, AOCN®, FAAN

Precision medicine, which evaluates differences in patient’s genetic makeup, aids in the development of individualized treatments. Personalized medicine is rapidly evolving with the advancement of genetics and genomics. This is especially true of cancer treatments, which have seen a development from generalized traditional chemotherapy to targeted therapies. “The term targeted therapy [has] emerged,” said Cheryl Lynn, BSN, RN, HNB-BC. “This is so exciting because it is only recently that we have been able to so precisely treat our patients.”

Nurses caring for patients undergoing treatment in an inpatient setting can face a number of challenges that include keeping patients safe from infections or other injuries, such as falls, and ensuring patients are supported in the necessary ways to ensure positive outcomes.

By following guidelines for antiemetic regimens, chemotherapy-induced nausea and vomiting (CINV) can be prevented in most patients. Oncology nurses can be an important member of a multidisciplinary health care team to promote and reinforce those guidelines to achieve optimal patient care.

Health care is an issue at the center of the 2016 presidential election, with cancer among some of the top concerns. Alec Stone, MA, MPA, the health policy director at ONS, discussed the latest on the political and policy scene and valuated the candidates based on how they line up with the ONS health policy legislative and regulatory agenda. Though he cautioned that with this election, “No one knows how this will turn out!”

Oral health and dental hygiene are often overlooked before, during, and after cancer treatment. Chemotherapy, radiation therapy, and other drugs used in the treatment of cancer can have compounding effects that result in increased risk of infection, delayed wound healing, dental caries, and chronic periodontal disease.

In an amazing four days in Texas during the ONS 41st Annual Congress, I had the opportunity to learn from experts in oncology care. Four session tracks (Clinical Practice, Leadership/Management/Education, Advanced Practice, and Research) allowed attendees to tailor learning and skill building to their specific needs. We heard from many of you about how much you appreciated the advanced learning level of presentations during interactive sessions that allowed you get the information you needed.

Patient care can be improved in a variety of areas, particularly with regard to symptom management. Marie Flannery, RN, PhD, Debra Kelly, PhD, RN, OCN®, Amy Moore, MSN, RN, ACNS-BC, Karen Pekle, RN, ANPC, MS, AOCN®, and Chao Hsing Yeh, PhD, each presented studies they conducted that examined different aspects of symptom burden and management in oncology care during a session at the 41st Annual Congress in San Antonio, TX.

To help improve nurse-focused patient outcomes through evidence-based resources, ONS created its popular Putting Evidence Into Practice (PEP) resources. The print and web-based resources integrate the best evidence from well-designed studies with a clinician’s expertise, including patient assessment and practice data and patients’ preferences and values. The first volume of PEP was released in 2006 and has had several revisions ever since.

The relationship between cancer and the immune system is complicated but is the key to understanding the growing field of immunology and personalized medicine. Many cancers have already been demonstrated to respond to immunotherapy, including non-small cell lung, melanoma, renal, head and neck, Merkel cell, prostate, bladder, colon, Hodgkin lymphoma, and non-Hodgkin lymphoma.

Approximately 20%–40% of patients with cancer show significant stress; however, less than 10% identify that they are distressed. Distress impacts quality of life, employment functioning, medical adherence, medical costs, health risk behaviors, and health protection behaviors. Treating distress properly in this patient population can lead to better treatment adherence, better communication, fewer calls and visits, avoidance of feelings, and better trust between patients and all healthcare providers.

Although 5%–10% of patients with cancer have a hereditary, germline mutation, or familial link in the development of the disease that can predict the risk for other types of cancers, coordinated care, surveillance, and screening is often not a part of this high-risk population’s treatment plan. The Cancer Risk Management Program model is a patient-centered and preventative model that includes care given by four genetic counselors and an advanced practice RN-clinical nurse specialist (APRN-CNS). Through coordinated care, the program adheres to current nationally recommended surveillance recommendations for all organ systems at risk and addresses the needs of the whole patient.

Nurses at the Wilmot Cancer Institute at the University of Rochester Medical Center noticed an increase in patient volume at the outpatient oncology infusion center. With limited space and difficult scheduling around the original hours of operation (7 am–7 pm), nurse leaders at the center decided to expand normal hours to include Saturday and Sunday infusion appointments, which required a change in RN staffing at the center.