Prescription overdoses and addiction rates have dramatically increased in the United States since 2012, with more than 70,000 deaths attributed to the abuse of fentanyl, opioids, cocaine, and methamphetamine in 2019, a 35% increase since 2015. Addressing drug misuse is a top priority for the Biden-Harris administration, as well as researching systematic inequities in the country’s approach to criminal justice and prevention, treatment, and recovery.

In a May 2021 expansion to Section 1557 of the Affordable Care Act and the Title IX civil law, the U.S. Department of Health and Human Services (HHS), through the Office for Civil Rights, increased protections for lesbian, gay, bisexual, transgender, or queer (LGBTQ) people from discrimination. The revisions now prohibit discrimination based on sexual orientation and gender identity. 

Known as the nation’s doctor, the U.S. surgeon general provides scientific information and oversees the U.S. Public Health Service’s Commissioned Corps: more than 6,000 professionals who promote health across the United States. Vivek Murthy, MD, MBA, who served as surgeon general under President Barack Obama, once again assumed his post as the nation’s doctor in March 2021 and said he will prioritize addressing the COVID-19 coronavirus pandemic and opioid epidemic during his second tenure. Murthy was appointed during his transition as the chair of the COVID-19 advisory board.

The American Cancer Society, along with 14 other healthcare groups advocating for increased access to care, filed an amicus curiae—Latin for “friend of the court”—urging the U.S. Supreme Court to deny state imposition of engagement requirements, like monthly community service, for Medicaid beneficiaries. The U.S. Supreme Court is likely to spend spring deliberating and convey a judgment before the end of summer.

In March 2021, the U.S. Department of Health and Human Services’ Ending the HIV Epidemic initiative awarded $99 million to the Health Resources and Services Administration’s (HRSA’s) Ryan White HIV/AIDS Program. The funding will support efforts to link people who are either newly diagnosed with HIV or diagnosed but currently not in care to essential treatment and support services, helping them reach viral suppression and reduce HIV transmission.

In the early 2000s, healthcare professionals began creating theoretical frameworks to better understand racial gaps in care. Two decades later, racial disparities remain across all aspects of cancer care, from clinical trials and screening to mortality rates and survivorship. Rochelle P. Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), declared racism a serious public health threat. To put those words to action, the agency also unveiled Racism and Health, an online hub for CDC’s efforts and a catalyst for education and dialogue around the critical issue. 

Although society has tried to take steps to confront gender disparities, women remain underrepresented across various sectors. Title IX in 1972 granted every American student the right to education without gender discrimination. However, female students still bear the brunt of sex-segregated programs and gender-based violence, two major obstacles to educational equality. Women consistently earn less than their male counterparts. The wage gap is larger for most women of color, and gender discrimination and sexual harassment in the workplace perpetuate economic divides. More women work today than ever before, but they face barriers to leadership roles, such as stereotypes about their performance abilities, uneven demands of motherhood compared to male partners, and the reality that many workplaces prefer and reward masculine leadership styles. Health needs are substantially greater for older women compared to older men, but women reported fewer visits with a physician and lesser likelihood to stay in a hospital. 

Most nurses can attest to the immense personal and professional growth that takes place during the first year of their nursing practice. When I graduated in May 2019, I began working on a blood and marrow transplant (BMT) unit. The BMT process is long and intensive, but it provides opportunities to develop strong connections with our patients. We often care for the same patient for multiple weeks or months and then again a year or two later if they experience longer-term complications. As a newly minted nurse, I had a lot to learn about my specialty and about nursing in general, but my fresh perspective made learning exciting.

The two most recent administrations prioritized ending the HIV epidemic, which has claimed the lives of more than 700,000 Americans since the virus was first identified in the 1980s. To follow those initial efforts, the U.S. Department of Health and Human Services (HHS) released a strategic roadmap to end the HIV epidemic and reduce new HIV infections by 90% by 2030.

After a contentious election season, U.S. Representative Lauren A. Underwood, RN, (D-IL) returned to Capitol Hill as a new subcommittee chair and the same drive to push forward on healthcare issues, most recently with an open letter to President Joe Biden.

Since taking office, President Joe Biden has made good on his campaign promises to change federal tone and action in response to Americans’ concerns about health care and racial equity. On January 28, 2021, Biden signed an executive order (EO) extending the timeline for more Americans to apply for and receive access to the Affordable Care Act, reiterating his commitment to the law known as Obamacare. Biden also signed an EO supporting women’s health by reinstating Title X protections. 

From Teddy Roosevelt to JFK, presidents throughout history have sent legislation to Capitol Hill with the intent to expand healthcare coverage to more Americans. Finally, when Lyndon B. Johnson drafted a bill and pushed it through Congress by expanding sections of the Social Security Act, Medicare become an entitlement and is now implemented by the Centers for Medicare and Medicaid Services (CMS). During the past 50 years, federal health coverage has grown to include Medicaid, maternal and childcare assistance, public health programs, and prescription medication pricing.

In a rare moment of bicameral success, 49 U.S. House of Representatives and Senate members introduced legislation to make permanent the Medicare telehealth coverage that had been introduced as a temporary measure during the COVID-19 coronavirus pandemic.

Drug pricing is a bipartisan issue that ranks very high on public opinion polling, and patients with cancer in particular feel the effects of an unregulated market. 

Patients with cancer navigate many isolating experiences: treatment side effects such as alopecia, long stays in the hospital, loss of life’s normalcy, and limited time with friends and family.

The U.S. Senate unanimously passed a resolution designating November as National Lung Cancer Awareness Month and supporting early detection of lung cancer, a crucial awareness with smoking on the rise among young adults.

Legislation aimed at reducing health care insurance premiums, introduced by U.S. Representative Lauren A. Underwood (D-IL), is included as part of the Patient Protection and Affordable Care Enhancement Act.

As families follow public health recommendations to stay at home, many have missed routine vaccinations. In response to lower vaccination rates, the U.S. Department of Health and Human Services (HHS) released an amendment to the Public Readiness and Emergency Preparedness Act to encourage vaccinations and safeguard children at risk for life-threatening diseases.

In 2020, the number of middle and high school students who use e-cigarettes decreased by 1.8 million compared to 2019, the Centers for Disease Control and Prevention and U.S. Food and Drug Administration reported in the results of the 2020 National Youth Tobacco Survey. However, the results also showed that youth tobacco use is still an epidemic in the United States.

A hallmark principle of social work is meeting clients where they’re at. This means taking time to understand where they come from, what might be influencing how they are navigating the healthcare system, and how their cancer diagnosis personally affects them.

Oncology nursing is a complex world that continues to evolve rapidly. However, one challenge that remains consistent is the ethical dilemmas nurses face when caring for patients with cancer. Complex care needs and lengthy hospital stays are common in our patient population and allow opportunity for nurses to develop relationships with patients and their families. Over the course of treatment, various ethical issues may arise, which nurses are at the forefront of identifying and acting on.

The U.S. Food and Drug Administration’s (FDA’s) Oncology Center of Excellence confirmed that those with immunocompromised systems, including cancer, are at greater risk for serious outcomes or death after contracting the COVID-19 coronavirus.

Research influences care along every inch of the cancer continuum, from prevention to survivorship, enabling healthcare professionals and patients to share decisions that result in the most current and tailored care strategies. It’s a powerful tool that sets the groundwork for providing optimal health outcomes. However, we must work to eliminate unequal representation.

In July 2020, U.S. President Donald Trump issued four executive orders to provide solutions to the ever-increasing price of prescription medications. One of the top domestic issues in healthcare is the price of prescription medication, particularly those deemed lifesaving, such as insulin for diabetics and drugs for patients with cancer. 

Every patient deserves equal access to health care. Yet 68% of patients have at least one social determinant of health that serves as a barrier to care.

More research funding is needed to learn about and address health disparities in African Americans in the United States, Tara Schwetz, PhD, National Institute of Nursing Research (NINR) acting director, said in an open letter to the research community. In the bold announcement, NINR recognized the unequal treatment of minorities and the need for enhanced dedication to promote equality in nursing research.

One of the ways ONS celebrated Oncology Nursing Month in May was with CEO Brenda Nevidjon, MSN, RN, FAAN, interviewing U.S. Representative Donna Shalala (D-FL) about advocacy and nursing. Miami ONS Chapter Board Member Lissette Gomez-Rios, MSN, OCN®, ONS Director-at-Large Anne Ireland, MSN, RN, AOCN®, CENP, and I also had the opportunity to ask Shalala some questions.

“There’s no way you can extricate what’s been going on and the outcomes of the (COVID-19 coronavirus) from the basic racism and social injustice and inequities that have existed in this country for so many years,” American Academy of Nursing Living Legend Catherine Alicia Georges, EdD, RN, FAAN, said in a June 17, 2020, podcast. “The chronicity of racism is the issue.”

The 2019–2022 ONS Research Agenda mentions LGBTQ patients with cancer among ONS’s research priorities for the very first time. A panel discussion at the 44th Annual ONS Congress focused on this underrepresented patient population, so we are making progress. In the past few years, our field has given a little more attention to LGBTQ patients with cancer, although I suspect that many of the issues are still pervasive.

Viral infections such as HIV may increase a person’s risk for developing several malignancies. However, most investigational drug studies exclude HIV-positive patients with cancer and optimal treatment regimens remain unknown.

Along with many other healthcare organizations, including ONS, last week the American Nurses Association (ANA) took a bold stand against racism, calling it a public health crisis. On June 12, 2020, ANA President Earnest Grant shared how racism is embedded in health care and what nurses should do to end it.

The death of George Floyd on May 25, 2020, spurred a national wave of protest. United in the wake of a global pandemic, people are doing what they feel is necessary to bring social justice and equality changes to the forefront of the American experience. Across the country, people are demanding immediate changes to a biased system. In a formal statement, ONS condemned racism and called for “all of us to commit to an end to hatred, discrimination, and racism in every form.”

As early detection, treatment modalities, and symptom management advance in oncology care, we are seeing an increase in the number of adult and childhood cancer survivors. Added to the unique challenges of comorbid conditions in an aging population, oncology nurses have a lot to juggle in the spectrum of patient care. The relatively new role of the oncology nurse navigator was developed to enhance care coordination in patients with cancer.

Cancer does not stop progressing because of a pandemic. Although the COVID-19 coronavirus does not recognize that someone with leukemia has been fighting for months, even years, for remission to receive a lifesaving blood and marrow transplantation (BMT), a new program is ensuring that marrow products are available when patients need them. 

Oncology nurses must advocate for prevention and control of the COVID-19 coronavirus to minimize the risk to themselves and the patients with cancer in their care, the International Society of Nurses in Cancer Care (ISNCC) announced in its April 2, 2020, COVID-19 Position Statement. ONS is a full member of ISNCC.

Because of weakened immune systems and prolonged treatment courses, patients with cancer have a higher chance of developing sepsis. Once acquired, sepsis puts patients at risk for hospitalization and increased morbidity and mortality. Prevention and prompt management are essential to improve outcomes. 

As part of a larger understanding of the social determinants of health, geography—whether it’s rural or metropolitan, urban or suburban—plays a huge part in how patients understand, receive, and access care. Regardless of zip code, community, or travel distance, patients have a right to receive the best possible care for their cancer diagnosis. As staunch patient advocates, oncology nurses are primed to help patients navigate geographic disparities and overcome challenges they face in treatment. 

Cancer is a global health problem. According to the American Cancer Society, cancer incidence is expected to continue to grow to nearly 27 million new cases around the world by 2040. In 134 of 183 countries, cancer is the first or second leading cause of premature death for people aged 30–69 years, and it ranks third or fourth in an additional 45 countries. Although cancer is a major health issue across the world, outcomes differ depending on a patient’s country of origin.  

Jamie is completing her last cycle of carboplatin and paclitaxel for stage I ovarian cancer. The oncology infusion nurse notices that Jamie appears withdrawn and nervous, so he takes time to ask her how she is feeling about completing treatment. Jamie responds, “I feel as frightened about finishing treatment as I did when I was diagnosed with cancer.” She also shares that she doesn’t want to ring the cancer center’s bell to ceremoniously signify the end of her treatment because she doesn’t want to “jinx it.”

Throughout the country, Americans have seen the effects of opioid abuse. Rising numbers of overdoses have sent shockwaves through communities from Miami to Seattle and everywhere in between. As such, addressing the national opioid epidemic is still a major priority for the Trump administration.

As groundbreaking yet high-cost cancer treatments make their way into clinical practice, the effects of financial toxicity can put a damper on the profound effects that new, lifesaving medications can have on patients with cancer. It’s a problem that even Washington, DC, hasn’t been able to address—so what can oncology nurses do about it?

At a recent conference I attended, a presenter asked the audience to choose the best treatment option for a case study review. The choices were introduced as three separate viable treatments with the fourth option being “or just refer to palliative care.”

For years, the human papillomavirus (HPV) vaccine has been promoted for its potential role in cancer prevention. In a study released in August 2019 by the Centers for Disease Control and Prevention (CDC), the agency estimated that nearly 92% of all HPV-related cancers could be prevented through proper vaccination.

With the 2020 presidential election cycle in full swing, some Democratic candidates are pushing an aggressive proposal to combat the rising costs of prescription drugs by potentially ending patents for high-cost medications. Breaking the patent of an existing drug to allow competitors to make a cheaper version is a bold step to combat the drug pricing issue, but the potential proposal doesn't seem to be getting much negative push back from either side of the aisle. Many see it as a way to keep the industry in check, and the provision makes for great political fodder on the campaign trail.

Found along the expansive Appalachian mountain range in the Eastern United States, Appalachia is legally recognized as an economically disadvantaged area that’s home to a unique population of patients requiring special considerations.

The cancer prevention conversation is tricky for providers to navigate. Not surprisingly, people want to do everything it their power to prevent cancer. But sometimes conversations involve uncomfortable elements of health care—like sex or sexually transmitted diseases—that can quickly derail the discussion. Despite this, the human papillomavirus (HPV) vaccine is one case where prevention efforts have a led to huge increases in participation, especially among children. Following that thread, the Centers for Disease Control and Prevention (CDC) have committed to spearheading the cancer prevention conversation by encouraging people to discuss cancer prevention early in their children’s lives.

Global radiation oncology research has seen an increased commitment to addressing disparities in the world and at home. The more radiation oncology proves and improves itself as a therapeutic modality, the more we are faced with the reality that the odds for survival are related to geography, poverty, education, and race.

With our heads held high, Michelle Santizo, RN, PHN, MSN, and I walked right into Capitol Hill, ready to tackle meetings with important members of the U.S. Congress. On that day in July 2019, we spoke with staff members working for the offices of both Kamala Harris (D-CA) and Diane Feinstein (D-CA).