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.

 

Guidelines regarding healthcare provider communication about immunotherapy do not currently exist. Researchers sought to determine patient and provider preferences for this type of information and to identify barriers to communication about immunotherapy. The study’s findings were presented at the 2017 ASCO Annual Meeting.

You may remember Jay, a 62-year-old man with inoperable stage IIIA non-small cell lung cancer (NSCLC), from the case study in the April 2017 issue of ONS Voice. He was symptomatic with a persistent cough, unintentional weight loss, and fatigue.

In Washington, DC, the healthcare debate rages on. Currently, Republican senators are working behind closed doors to modify and change the House-passed American Health Care Act (AHCA). As it stands, the AHCA is the replacement plan for the Affordable Care Act (ACA), known to most Americans as Obamacare. While legislators continue to debate in Washington, the insurance marketplace carries on. United Healthcare recently announced its departure from the ACA’s marketplace exchange, another in list of insurance companies that have chosen to leave.

On April 25, 2017, the U.S. Food and Drug Administration (FDA) issued warning letters to 14 companies that were selling fraudulently marketed products claiming to prevent, diagnose, treat, or cure cancer. In total, the companies produced more than 65 products that have been sold in the United States without FDA approval.

January was cervical health awareness month, and the federal government, along with many advocacy groups, spent considerable time talking about early detection. According to the National Cancer Institute and the U.S. Food and Drug Administration (FDA), cervical cancer is largely preventable. If it’s detected early, it’s often curable too. Many experts say that the key to cervical cancer is vaccination and embracing the two tests used for early detection—Pap smears and human papillomavirus (HPV) testing.