Few things carry more stigma in the United States than death and hospice. Death is familiar in oncology, yet providers may not discuss it with patients until their cancer has progressed to the point that medical intervention is no longer an option. With the American Cancer Society estimating more than 600,000 American deaths from cancer in 2022, it’s time to change our practice.

My passion for biomarkers lies in research, specifically clinical trials. The incorporation of biomarkers in oncology clinical trials has been an important advancement in research, and we’ve seen the effect on improving patient outcomes. Identification of pathogenic variants is essential to prescribing personalized therapy for patients with cancer.

Nurses’ consistent and correct use of genomics terminology is critical to reduce confusion and provide safe genomics care to patients and their families, especially when explaining the meaning of genomic tests or findings.

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.

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.

As part of ongoing efforts to protect adolescents from tobacco, the U.S. Food and Drug Administration (FDA) launched an education campaign to prevent e-cigarette use and vaping among America Indian and Alaska Native youth in June 2022.

People with cancer have a particular risk for infection, and vaccines can be a powerful preventive tool. According to the World Health Organization, immunization prevents 2–3 million deaths every year worldwide from diseases, including diphtheria, influenza, and measles. Here’s what patients and nurses need to know about vaccines and guidelines for people with cancer.

Smokers who try to quit by switching to e-cigarettes do not have more success than those who use other smoking cessation strategies and in fact may be more likely to relapse, researchers found. They reported their study results in Tobacco Control.

Among their many benefits in practice, ONS Guidelines™ arm oncology nurses with the evidence to advocate for their patients’ care, according to findings from a fall 2021 focus group ONS conducted with nurses practicing at all levels of direct care.

Associated with more than a dozen different cancers, tobacco use is the leading cause of cancer and cancer deaths in the United States. The Centers for Disease Control and Prevention (CDC) estimated that 40% of all cancers are linked to tobacco use, and it’s responsible for 30% of cancer deaths in the United States and 22% around the world.

With a plethora of information available online, patients with cancer and their families have access to plenty of resources to learn more about their diagnosis and treatment options. However, one-third of the online articles about cancer circulating on social media contain incorrect information, according to findings from a 2021 study published in the Journal of the National Cancer Institute.

ONS collaborated with the National Community Oncology Dispensing Association, Hematology/Oncology Pharmacy Association, and Association of Community Cancer Centers to launch the IV Cancer Treatment Education (IVE) online resource. After the success of the highly used Oral Chemotherapy Education (OCE) online resource, the four oncology healthcare organizations expanded their collaboration to launch this new initiative that provides patient and caregiver resources about IV cancer therapies and their side effects.

Patients with heart failure have a 75% increased risk of developing cancer, researchers reported in ESC Heart Failure. And cancer incidence rates were even higher for specific disease sites.

President Joe Biden committed to getting at least 70% of U.S. adults their first dose of the COVID-19 coronavirus vaccine and achieve 160 million fully vaccinated American adults by July 4, 2021. However, one in five Americans reported that they aren’t planning to get vaccinated. To dispel public fear and increase understanding, several U.S. health agencies provided multiple resources to educate patients and providers on vaccine distribution and efficacy. 

Steven Pergam, MD, MPH, associate professor of the vaccine and infectious disease division at Fred Hutchinson Cancer Research Center in Seattle, WA, and infection prevention director at Seattle Cancer Care Alliance, co-led a National Comprehensive Cancer Network (NCCN) committee that issued recommendations on COVID-19 vaccination for patients with cancer. He received his first Moderna dose on December 29, 2020, and has been dispelling fear and spreading education about the vaccine.

The COVID-19 coronavirus pandemic has changed the world as we know it. The mortality rate is devasting, the economic impact is jarring, and no one can pinpoint any date for its end. But new vaccines offer a glimmer of hope—but only if the country can settle discussions about achieving adequate vaccination coverage and strategies to distribute and inoculate hundreds of millions of people.

Nearly 1.9 million people in the United States will be diagnosed with cancer in 2021. However, overall cancer screenings dropped roughly 80% in 2020 because of the COVID-19 coronavirus pandemic and statewide stay-at-home orders. To combat the decline, the Centers for Disease Control and Prevention’s (CDC’s) new outreach campaign reminds patients and providers of the importance of cancer screening. 

Patient education is an essential aspect of cancer prevention. Nearly 1.9 million people in the United States will be diagnosed with cancer in 2021, and modifiable risk factors are responsible for approximately 35% of cancer-related deaths. However, less than half of Americans understand the major risk factors that contribute to the development of cancer.

What’s the real cost of youth vaping? In a campaign to combat the ongoing epidemic, the U.S. Food and Drug Administration (FDA) and Scholastic, which publishes classroom magazines with accompanying teacher guides, provided e-cigarette education materials for middle and high school students to teach young Americans about the risks of e-cigarette use and nicotine addiction.

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.

E-cigarettes are dangerous and their risks outweigh any potential smoking-cessation benefits, the U.S. Government Accountability Office explained in a new two-page resource that analyzes the science and technology behind the devices.

Radiation therapy (RT) has been used as a safe and effective treatment option for patients with cancer for more than a century. Like any cancer therapy, it does carry risks and side effects, but RT has improved drastically over the past 20 years and has even been shown to enhance the effectiveness of immunotherapy.

Genetics testing is not just about one family member; the results have implications for an entire family. Results of genetic testing can be confusing, and families often need assistance understanding what it means for them. Genetics counseling before and after testing is very important to help individuals and families understand the results of genetic testing when they are received and over time. 

In emergencies such as the COVID-19 coronavirus pandemic, government health agencies have the authority to grant waivers for various federal health programs. Starting on March 23, 2020, the Centers for Medicare and Medicaid Services (CMS) waived certain requirements and protocols for providers and beneficiaries.   

A day after President Donald Trump was considering lifting some of the quarantine mandates, healthcare leaders from the American Hospital Association, American Medical Association and American Nurses Association (ANA) released an open letter urging Americans to stay home.

Issues pertaining to geography, socioeconomic status, or racial or ethnic background can prohibit patients from accessing the treatment and care they need to successfully navigate their cancer diagnosis. Connecting patients to healthcare professionals and tailored interventions that educate, motivate, and reduce barriers can be a tremendous boon for their care and ultimately their outcomes.

Oral oncolytics have introduced a different level of complexity to care. Many patients won’t ever receive their treatments in the infusion room, which is where nurses have traditionally offered in-depth patient education. Instead, nurses are using new tools—like the Oral Chemo Education Sheets—to ensure patients have the information they need to understand their treatment and its side effects.

“An investment in knowledge pays the best interest,” Benjamin Franklin wrote. for oncology nurses and their patients, this couldn’t be more apt. Patient education is critical throughout the cancer journey, and nurses are essential to individualizing that education.

By rebalancing the immune system and re-engaging mechanisms that tumor cells have shut off, immunotherapies such as immune checkpoint inhibitors enable patients’ own bodies to fight their cancers for them. But those same mechanisms can also result in immune-related adverse events (irAEs).

Unlike other types of breast cancer, a triple-negative diagnosis doesn’t have any of the common receptors found in other breast cancers, presenting potential treatment challenges to patients and providers. To assist patients with triple-negative breast cancer, the Centers for Disease Control and Prevention (CDC) created a new virtual program, allowing patients to consult and ask questions to a virtual coach in the comfort of their own homes.

As genetic and genomic testing become more common—and complex—in cancer diagnosis and treatment decisions, more efficient and accessible ways of providing comprehensive genetic care are needed. In their article in the February 2019 issue of the Clinical Journal of Oncology Nursing, Pierle and Mahon discussed the findings from their literature review, specifically pertaining to genetics care services across the cancer continuum, patient and system barriers to accessing care, new service delivery models, and oncology nurses’ role in providing comprehensive cancer genetics care services.

Which of the Following Should Not Be Recommended to Patients Taking Oral Antineoplastic Medication at Home?

A. Handwashing before and after handling the medication is important.

B. Use a urinal or bedpan instead of a toilet to reduce the risk of contamination via body fluids.

C. Keep oral antineoplastic drugs separate from other medications.

D. Do not touch tablets or capsules with bare hands; wear disposable gloves.      

Targeted therapies block the growth of cancer by interfering with specific molecules and may also be referred to as molecularly targeted drugs or precision oncology. Advanced practice RNs (APRNs) must be familiar with the various agents and their side effect profiles, including immunotherapies, hormone therapies, apoptosis inducers, monoclonal antibodies, angiogenesis inhibitors, and signal transduction inhibitors. 

Use of oral therapies requires healthcare teams to monitor patients for issues such as unreported side effects, medication nonadherence, and incorrect administration of medications. Although many patients do very well with this form of treatment, some patients, even with a significant amount of education before starting therapy, may have challenges. 

Betty, age 70, was diagnosed with metastatic colon cancer and started treatment with FOLFOX. Her medical oncologist changed the treatment to capcitabine after Betty developed grade 3 peripheral neuropathy. Because of disease progression, bevacizumab was added to her treatment plan. She lives with her daughter, is insured by Medicare, and receives $800 per month from Social Security.

An initial proposal from the Trump administration might cut funds for outreach related to the Affordable Care Act (ACA). As of yet no decisions are finalized and funding may still remain consistent, but limiting funding for outreach of the ACA, known to most as Obamacare, isn't a new move for the current administration. In 2017, it cut funding for navigators who educated and enrolled Americans in the ACA marketplace, leading to confusion among potential applicants and lower enrollment numbers. If funding is cut again this year, new or returning enrollees are unlikely to find success when looking for coverage.

Although all cancers have a genetic basis, a subset result from an inherited (i.e., germline) mutation that puts a person at increased risk for certain cancers. Unfortunately, the signs of hereditary cancer are often overlooked or misunderstood. Here’s what oncology nurses need to know about BRCA mutations, one of the more common mutations you’ll see in practice.

Genetic testing is becoming more recognized among the general public, due in part to news reports and celebrity endorsements. Now, people are seeking to understand cancer risks and prevention measures through genetic information. There are many companies that ask for a mere mouth swab and deliver insight into a person’s DNA. As this becomes more commonplace, those with familial predisposition to cancer will look for ways to understand their own genetic results. Recently, the U.S. Food and Drug Administration (FDA) approved an at-home test identifying some—but not all—breast cancer genes.

Identifying genetically predisposed women with breast cancer who could benefit from risk assessment and genetic counseling is an important competency for oncology nurses. However, a recent study published in the Journal of Clinical Oncology (JCO) reported that fewer than 50% of newly diagnosed patients with breast cancer who should have been given formal genetic counseling actually received the appropriate genetic testing.

Direct-to-consumer genetic testing (DTCGT) has entered the prime-time stage. It’s difficult to watch TV without seeing ads touting the simplicity of DTCGT and what it can tell you, and it even made Oprah’s 2017 Favorite Things List.

To ensure more Americans understand the public health implications of cancer, the Centers for Disease Control and Prevention (CDC) is taking an active role in creating awareness activities. By posting commonly asked questions, the CDC hopes to demystify cancer and its treatment to the uninitiated, while also helping survivors and caregivers better comprehend the cancer journey.

As an oncology nurse, you know the prevention of any infection is critical to patients. This couldn’t be truer than with flu. Although not all illnesses are preventable, the flu vaccine is the first and best way that patients with cancer can protect themselves from flu. Oncology nurses should keep the following new information for the 2017–2018 flu season in mind.

Many women face a lack of information and understanding after their breast cancer diagnoses. Currently, women have more treatment options than ever before, and patients have the ability to review the latest findings to identify the option that fits best for their lives.

So far, 2017 has seen an incredible amount of U.S. Food and Drug Administration approvals for new agents and indications. Biotherapy and targeted agents represent many of the newly approved treatment options—a great deal of which are offered in oral form, increasing the opportunity for patients to receive treatment at home.

Many Americans use dietary supplements, including herbal products, in the belief that they are natural and safe. Patients with cancer use them often to enhance the effects or to reduce the adverse reactions of cancer treatments. However, few herbs have been thoroughly studied in humans. Therefore, their interactions with prescription drugs and the clinical relevance, remain undetermined. These interactions could be pharmacokinetic in nature when an herb alters the absorption, metabolism, or excretion of other drugs, or pharmacodynamic in which it affects the mechanism of action of other drugs when consumed together. Following are a few relevant herb-drug interactions encountered in the oncology setting.