Adolescents and young adults (AYAs) aged 20–39 account for the steepest increase in the rising rates of early-onset colorectal cancer, but identification of early warning signs and vigilant screening can prevent the predictions of the incidence doubling by 2030 in patients younger than 50 years. According to the results of a new study published in the Journal of the National Cancer Institute, four red flags should trigger clinicians to refer younger individuals for early detection testing. 

When we use the term “trauma,” we’re often referring to experiences like war, being attacked or assaulted, or witnessing a terrible tragedy. However, other traumas can be just as harmful. Patients with cancer may have experienced multiple kinds of trauma throughout their lives, which can contribute to myriad challenges such as chronic health problems, mental illness, and difficulty seeking care. 

In 2019, the mood was hopeful. As we looked ahead to the next decade, Republicans and Democrats in both the U.S. House of Representatives and Senate appeared to be at a consensus point on a major policy issue: access to affordable prescription medications for the American public.

Reinforcing a commitment that palliative care is a priority, U.S. Senators Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) reintroduced the Palliative Care and Hospice Education and Training Act (PCHETA), an ONS health policy priority that benefits both patients and healthcare providers, in July 2023. The bipartisan legislation would bolster the palliative care and hospice workforce and meet the increasing need for care by investing in training, education, and research.

A growing literature base supports the use of medical cannabis in cancer care and symptom management, and as of April 2023, 42 states, including 3 territories and the District of Columbia, allow for medical use. As more patients use or seek to use medical cannabis during their cancer trajectory, oncology nurses are looking to the latest research behind medical cannabis, how cannabis can impact their patients’ treatment plans and symptom management, and legislation in the state in which they practice.

ONS member Janice Phillips, PhD, RN, CENP, FAAN, took the reins as the Illinois Department of Public Health’s (IDHP’s) latest assistant director in July 2023. Her new role positions Phillips, a longtime ONS advocate, to eliminate health disparities and inequities by establishing and strengthening collaboration between IDPH and community partners across the state.

A geriatric nurse practitioner who served as a Navy helicopter pilot in the Persian Gulf through two deployments, U.S. Representative Jen Kiggans (R-VA) introduced new legislation that would allow more providers to use telehealth services, expanding access and reducing barriers for their patients.

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.

Throughout the COVID-19 pandemic, both the Trump and Biden-Harris administrations used the Centers for Disease Control and Prevention (CDC) as a primary authority to collect and disseminate information about the virus. Although the public initially lauded the agency’s efforts, the changing protocols and communication directions. In Washington, DC’s, often-polarizing political environment, CDC Director Rochelle P. Walensky, MD, MPH, bore the brunt of the blame, and in May 2023, she announced her resignation effective June 30.

Most people are versed in the flu, measles, and chicken pox vaccines, but fewer know the importance of the human papillomavirus (HPV) vaccine. HPV can cause six different cancers, but early vaccination in younger individuals helps prevent those cancers later in life.

Less than 20% of National Cancer Institute Community Oncology Research Program practices routinely report collecting sexual orientation and gender identity data, limiting the available evidence to support recommendations for oncology nursing care of a vulnerable LGBTQ+ population that faces biases, stigma, cultural insensitivity, inequities, and disparities. In a 2022 Clinical Journal of Oncology Nursing article, ONS member Georgina T. Rodgers, BSN, RN, OCN®, NE-BC, and colleagues evaluated the latest studies to identify best practices and care considerations for LGBTQ+ patients with cancer.

Cancer affects millions of people worldwide, and certain populations face a disproportionate burden of incidence, mortality, access to care, and representation in clinical trials. Oncology nurses can be a voice for their patients and an advocate for vulnerable individuals.

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.

Successfully addressing sensitive topics, such as homophobia and LGBTQ+ biases, is best achieved in small, interactive groups, clinical nurse scientists said in a quality improvement project report published in the Clinical Journal of Oncology Nursing.

Nearly all adolescent and young adult (AYA) patients with cancer who use the services of a population-specific clinic would recommend it to other AYAs with cancer, researchers reported during a session at the 48th Annual ONS Congress® in April 2023. They said that more than 90,000 AYAs aged 15–39 are diagnosed with cancer every year in the United States, a critical life stage in which cancer can deeply affect individuals’ social, developmental, educational, professional, and financial growth, making services like specialized clinics critical to an AYA patient population.

Although 74%–84% of patients with breast cancer who undergo mastectomies are satisfied with their bodies and outcomes after electing to have a flat closure, 20%–35% say that they felt unsupported by their cancer care team during the process. Patients report feeling marginalized or stigmatized, not being told that flat closure is an option, and even left with excess skin against their wishes because the care team wanted to give them “future options.”

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.

Almost 22 years after the September 11, 2001, atacks, the World Trade Center Health Program has added all types of uterine cancer to its list of WTC-related health conditions. The WTC Health Program assists patients with treatment costs for uterine cancers that meet WTC-related health condition eligibility and certification requirements.

Individuals who identify as transgender and non-binary may no longer use their birth or legal name but rather choose a new name that aligns with their identity. When they ask that you use their new name instead, calling them by their old name is referred to as deadnaming and can be a stressful and traumatic experience for the individual and is even considered an act of verbal violence.

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.

More than one billion individuals worldwide have some type of disability, and the population often faces higher rates of cancer, social determinants of health disadvantages, and greater health disparities. They are also more likely to have risk factors associated with a cancer diagnosis and require close care after a diagnosis that accommodates for their disability.

The National Institutes of Health, through its All of Us Research Program, announced in January 2023 research funding opportunities to expand the use of the program’s data to advance precision medicine. NIH allocated up to $4.75 million in fiscal year 2023 for the research grants.

The complexity of cancer care may affect patients’ financial toxicity more than we’ve realized. Many patients struggle with the economic burden of out-of-pocket spending for cancer care, including insurance copayments, transportation, and reduced income, as well as their psychological burden of worry and coping with less funds for food and medications. Multimodality treatments, maintenance and ongoing therapies for metastatic disease, and geographic factors such as travel for clinical trials and specialized services or paying for out-of-network care can put patients’ finances in a deeper hole. The adverse implications are significant: decreased quality of life, increased anxiety and depression, lower adherence to prescribed medications and oncology care, and reduced survival.

Continuing the fight toward health equity, the Centers for Medicare and Medicaid Services’ Office of Minority Health released a report in November 2022 on current progress and future actions to improve health equity data collection.

ONS member Ryne Wilson, DNP, RN, OCN®, care coordinator at University of Minnesota Physicians, joined an expert panel to discuss policy solutions for advancing equitable cancer care for the LGBTQ+ community during the National Comprehensive Cancer Network Patient Advocacy Summit in December 2022. The panel focused on issues affecting LGBTQ+ people with cancer, including homophobia, transphobia, systemic racism, and social determinants of health.

The White House Office of Science and Technology Policy updated policy guidance in August 2022 to allow the average American easier access to publications. The new guidance applies to taxpayer-funded research studies and makes the results publicly available for free.

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.

Along with outlining monetary spending for the upcoming years, the National Cancer Institute’s 2024 annual plan and budget proposal highlights areas of opportunity to advance cancer research, Douglas R. Lowy, MD, who was NCI acting director at the time, said in a September 2022 NCI’s director message.

Under the Inflation Reduction Act, patients will pay lower premiums for the Medicare Advantage and Medicare Part D prescription drug plans during the 2023 coverage year, the Biden-Harris administration announced in September 2022. People with Medicare prescription drug coverage will also receive better and more affordable benefits, including a $35 cost-sharing limit on covered insulin product and coverage for adult vaccines recommended by the Advisory Committee on Immunization Practices.

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.

Anthony Fauci, MD, reflected on his career in government and gave insight into what he’s doing next in a statement released in August 2022 addressing his departure from his positions as director of the National Institute of Allergy and Infectious Diseases (NIAID), chief of the NIAID Laboratory of Immunoregulation, and chief medical advisor to President Joe Biden. Fauci served as NIAID director for 38 years and held a career spanning more than 50 years in government service.

As monkeypox continues to spread, the Congressional LGBTQ+ Equality Caucus urged the Biden-Harris Administration in August 2022 to request funding from U.S. Congress to combat the virus.

Sexual dysfunction is one of the most common side effects of cancer treatment, yet oncology professionals often under address patients’ sexuality and sexual dysfunction concerns. Providers cite lack of time, training, and resources as barriers to initiating important discussions about sexual side effects, and studies show that patients’ age and prognosis are additional hindering factors.

Cancer and its treatments can affect a patient’s body in many ways, including sexual function. However, the historical evidence base is focused on cisgender men and their sexual health post-cancer treatment, with sexual health of women and LGBTQIA+ patients largely ignored. I, and many others, are working to change these disparities in research and practice.

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.

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.

By prohibiting discrimination on the basis of “race, color, national origin, sex, age, and disability,” the U.S. Department of Health and Human Services’ July 2022 proposed rule strengthens Section 1557 of the Affordable Care Act, improving civil rights protections for patients in certain federally funded health programs.

Leita, a 42-year-old patient with locally advanced pancreatic cancer, was treated with 5-fluorouracil, irinotecan, and oxaliplatin followed by capecitabine and radiation therapy. After she completed initial treatment, a computed tomography scan conducted in preparation for a possible surgical resection revealed metastatic liver lesions. Leita’s surgery was cancelled, and she began second-line therapy with gemcitabine and nab-paclitaxel.

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.

Although they’ve conquered cancer, survivors may develop late or long-term physical, psychosocial, practical, or spiritual effects from the disease or its treatment. For example, patients with breast cancer who have completed surgery, radiation, or chemotherapy should be monitored for recurrence, lymphedema, osteoporosis, and cardiac, hormone-related, and sexual issues.

Pending legislation would help residents save on prescription drug costs by empowering Medicare to negotiate lower drug prices, capping out-of-pocket costs, and limiting pharmaceutical price increases to the rate of inflation, U.S. Senator Jack Reed (D-RI) said during a discussion with a plethora of healthcare professionals, including ONS member Heather Murphy, MSN, FNP, OCN®, president of the ONS Rhode Island and Southeastern Massachusetts Chapter, about rising prescription drug prices at a Rhode Island conference in July 2022.

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.

To improve cancer care and lower costs, the Centers for Medicare and Medicaid Services created the Enhancing Oncology Model in June 2022.

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.

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.

We’ve made incredible progress against tobacco’s reign over youth, but the battle is far from over. Tobacco use is responsible for the death of nearly half a million Americans and more than 8 million people worldwide each year.

Propensity to adhere to cervical cancer screening recommendations varies widely by sexual orientation, researchers reported in study findings published in Cancer. They found that those in sexual minority groups are nearly 50% less likely to have ever undergone a Pap test.

To improve safety and regulation for drugs and devices, U.S. Senators Patty Murray (D-WA) and Richard Burr (R-NC) introduced the Safety and Landmark Advancements (FDASLA) Act in May 2022. The act reauthorizes and builds on the U.S. Food and Drug Administration’s (FDA’s) prescription drug, generic drug, biosimilar, and medical device user fee agreements.

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.

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.