Balance Hope and Quality of Life for Phase I Clinical Trials
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.
Drug Clinical Trials Focus on Efficacy Over Quality of Life
The clinical trials that lead to new drug approvals or expanded indications are quick to praise a therapy’s clinical benefits, such as longer survival or time to progression, but only about one in five of those trials find improvements in patients’ quality of life, researchers reported in JAMA Oncology.
Pediatric Patients With Cancer Are Vulnerable to Sleep Disturbance
Sleep disturbance has a significant impact on quality of life, including mental and physical health and academic, cognitive, and social functioning. It is one of the most common symptoms reported by pediatric patients with cancer and is significantly related to neurocognitive function for survivors.
Health and Equity Matter for Black Mothers, HHS Says
Amid its celebration of Black Maternal Health Week in April 2022, the U.S. Department of Health and Human Services (HHS) raised awareness of a sobering fact: Black maternal mortality and morbidity are a healthcare crisis throughout the United States.
Breast-Conserving Surgery Leads to Better QOL for Young Breast Cancer Survivors
Patients younger than 40 who elected to have breast-conserving surgery instead of mastectomy to remove breast cancer reported having better quality of life (QOL) more than five years after diagnosis, according to study findings reported in JAMA Surgery.
What the Evidence Says About Traditional Chinese Medicine Herbal Formula Xiao Yao San for Depression and Anxiety
An estimated 16% of patients with cancer experience depressive spectrum disorders in oncologic, hematologic, and palliative care settings, seriously affecting their quality of life. Although conventional antidepressants can be effective in many situations, they are associated with adverse effects, such as fatigue, drowsiness, sleep difficulties, nausea, weight gain, nervousness, dry mouth, blurred vision and sexual dysfunction.
Nursing Considerations for Adolescent and Young Adult Cancer Survivorship Care
Adolescent and young adults (AYAs)—those diagnosed between the ages of 15 and 39—comprise about 5% of all annual cancer diagnoses. The population has unique challenges that must be considered as part of patient-centered survivorship care planning.
Exercise the Evidence: How I Moved From an Idea to Program Development
As a clinical nurse specialist (CNS) with a cardiovascular background, I have seen the evidence-based benefits of exercise in a variety of settings. However, several years ago, when I was working as a CNS on an acute inpatient oncology unit, I noticed that exercise was not regularly included in care plans. As I learned from staff, this was done out of concern that patients needed to rest to save their energy.
Nursing Considerations for Bladder Cancer Survivorship Care
Bladder cancer is the sixth most common cancer in the United States, with an estimated 83,730 adult diagnoses in 2021. Smoking is the greatest risk factor (47% of all cases occur in smokers), followed by advancing age and sex (assigned males are four times more likely to develop bladder cancer than those assigned female). The incidence rate in White people is double that of Black people, but Black people are twice as likely to die from the disease.
Rare Cancer Advocacy Programs Help Patients Discover Resources and Make Connections
A cancer diagnosis can be difficult for any patient to receive, but a rare cancer diagnosis can put additional stress on a patient and their family. They may feel isolated and struggle to find accurate information on their diagnosis, which may be minimal because of limited funding and research. Rare cancer advocacy groups and programs offer critical patient support and empowerment, raise awareness, and initiate research for treatments.
Biden-Harris Administration Issues Actions to Prevent Surprise Billing
In July 2021, the Biden-Harris administration, through the U.S. Departments of Health and Human Services (HHS), Labor, and Treasury and the Office of Personnel Management, issued the Requirements Related to Surprise Billing. The rule applies to billing for patients in job-based and individual health plans who obtain emergency care, nonemergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers.
HRSA Awards $99 Million to End the HIV Epidemic in the United States
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.
Cancer Support Groups Help Patients Develop Critical Connections
Many patients with cancer have supportive friends and family. However, loved ones might be uncomfortable discussing the difficult feelings that arise from a cancer diagnosis and may be afraid or unsure of what to say or do. In a support group, members are open to talking about these difficult topics and patients can feel reassured that they are in a safe space to process the array of thoughts and feelings that come with a cancer diagnosis.
The Case of Concurrent Therapy Concerns
Sharon is a 60-year-old woman with metastatic breast cancer that was originally diagnosed in 2005 and treated with a mastectomy, deep inferior epigastric artery perforator flap reconstruction, chemotherapy, post mastectomy radiation, and five years of tamoxifen. Three months ago, her breast cancer recurred, and staging scans demonstrated metastatic disease in the lungs, left axilla, liver, and left iliac bone. A biopsy of the left iliac bone was ER positive, PR negative, and HER2 negative. Sharon began treatment with radiation to the painful left hip and letrozole, with the plan to start palbociclib once radiation was completed.
CMS Proposes Amendments to Telehealth, Preventive Care, and Staffing Concerns Amid COVID-19
During a global pandemic that requires social distancing, telehealth has suddenly become routine. Seeing an opportunity, the Centers for Medicare and Medicaid Services (CMS) is breaking down barriers, enhancing patient-centered care, and bolstering the healthcare workforce with a series of regulations, with telehealth topping the list.
Nurses Present Patient-Centered Research on Survivorship and Health Disparities
Distress, uncertainty, and barriers to care are common experiences for patients with cancer and survivors. Yingzi Zhang, PhD, RN, of the School of Nursing at the University of Rochester in New York, and Jin Young Seo, PhD, WHNP-BC, RN, of Hunter College in New York, NY, reported on their research on quality of life and access to care in vulnerable patient populations.
What the Evidence Says for Use of Qigong in Patients With Cancer
Qigong is a mind-body practice that originated in China nearly five millennia ago. It integrates movement, meditation, and breath regulation to improve physical and emotional health. The actions are slow, gentle, flowing, repetitious, and weight-bearing and can be adapted or practiced while sitting, standing, or walking. Qigong styles and forms vary widely, depending on the school of thought and philosophy.
Secondary Cancers in Pediatric Survivors
A child’s cancer diagnosis can tear apart a family’s sense of security. After successfully navigating the cancer experience and all that comes with it, no one wants to face that again, and patients and families may fear an increased risk for secondary cancers. Oncology nurses can support pediatric cancer survivors and their families with resources for monitoring and reassurance about the possibility of facing secondary cancer.
Mental Well-Being Is a Focus of Primary Care Throughout Survivorship
Primary care for patients who are cancer survivors is multifaceted. Although my goal as a primary care physician (PCP) remains the same as with all my patients—to continue helping them lead long, healthy lives—care for this population requires some additional steps.
Oncology Nurses Have a Special Power of Presence
Like most nurses, my shifts as a new nurse functioned as consistently as clockwork. I would begin my afternoon shift by reviewing the assignment list. The previous shift’s nurses would handoff the patients, and I would head out to the unit to report to my assistive personnel and review the patients’ medication administration records. Every hour was dedicated to a different task, including my dinner break. That is, until a monumental moment jostled me from my systematic routine.
Psychosocial Support for Patients With Cancer During COVID-19
When the COVID-19 novel coronavirus pandemic hit the United States, in a matter of days clinicians were scrambling to find novel ways to screen, triage, and provide telehealth interventions to protect patients with chronic conditions who are especially vulnerable to COVID-19. As nurses, we are accustomed to helping patients in crisis acclimate to a changing environment, process large amounts of information, and have their psychosocial needs met.
End-of-Life Care Helps Patients Pursue Purpose in the Presence of Pain
“It’s going be okay.”
That common phrase is full of meaning, yet so vague. Often, it’s a patient’s response when they’re first diagnosed or are told that all of the treatments have failed and they only have a few months to live. Other times, a family member will voice the remark when holding a patient’s hand as they provide comforting hope or temporary relief from distress. Sometimes an oncology nurse shares the phrase in an attempt to calm the agony their patients face each day.
Cardio-Oncology Program Monitors Heart Toxicities Throughout Survivorship
Cancer is second only to heart disease as the leading cause of death in the United States. But heart conditions overlap with cancer in more ways than mortality. Chemotherapy, immunotherapy, radiation, and the myriad medication combinations used in cancer can lead to various complications, including cardiotoxic side effects. Because of the prevalence of heart disease, many patients with cancer also present with pre-existing cardiac comorbidities.
Nurses Can Make a Difference, One Shaved Leg at a Time
In nursing school and during my first clinical rotations, I was always uncomfortable with performing bed baths. To shut out my discomfort, I would focus on the task at hand, doing my best to ensure the patient’s privacy, keeping the water warm, and only exposing the one body area I was washing at the moment.
CAR T-Cell Therapy Offers Rapid QOL Improvements in Younger Patients
Children and young adults with relapsed or refractory B-cell acute lymphoblastic leukemia reported rapid improvements in quality of life (QOL) after treatment with tisagenlecleucel, a CAR T-cell therapy, according to the results of a study published in Lancet Oncology.
Digital Sherpas Enhance Nursing Care, Patient Quality of Life
Technology is great when you get it. But when you don’t, it can be a real burden, and an extra burden is the last thing a patient with cancer needs. Fortunately, at the Moffitt Cancer Center in Tampa, FL, we’ve found a program that not only helps our nurses and our patients with technology, but it also brings our older patient population together with the positive energy of younger members.
The Vital Role of Oncology Nursing in Ambulatory Care
Thanks to significant scientific and technologic advancements in the past 15 years, the majority of cancer care—an estimated 80% or higher—is being delivered in the outpatient setting.For patients, ambulatory oncology care offers comfort, flexibility, and a sense of normalcy during their difficult cancer journey while maintaining the highest-level treatment and care for optimal outcomes. Oncology nurses are key to successful outpatient care, serving as caregivers, educators, advocates, and patient champions from diagnosis through treatment and into survivorship.
Evidence Shows Tai Chi May Be Useful for Insomnia
Nearly 60% of people with cancer experience insomnia; it can persist for years if not appropriately managed. Furthermore, patients with cancer who have insomnia are at increased risk for infections, anxiety, and depression, which can negatively affect quality of life.
Tachycardia Tied to Higher Mortality in Patients With Cancer
Rates of all-cause mortality in patients with cancer increase in the presence of unexplained sinus tachycardia, the results of a new study show. Researchers presented the findings at the Advancing Cardiovascular Care of the Oncology Patient conference held January 2019 in Washington, DC.
Nurse-Devised Solutions Help Improve Patients’ Treatment Experience
Two very different projects in which nurses developed creative solutions to common patient problems and helped to improve patients’ treatment experience were the focus of a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA.
New Research Findings Will Help Improve Quality of Life for Cancer Survivors
Thanks to new treatments and technologies, the number of U.S. cancer survivors has increased to 16.9 million as of January 2019. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, several healthcare professionals presented new research to support the ever-growing population of cancer survivors.
Geriatric Assessments Can Improve Shared Decision Making, Patient Satisfaction
As people age, their risk for cancer increases, and so too does the complexity of their cancer care. Older patients with cancer typically present with age-related conditions like comorbidities, functional problems, falling, and polypharmacy, which are not as widely discussed in the oncology space as they should be. Age-
related concerns can influence outcomes for patients with cancer and their caregivers, including treatment toxicity, hospitalization, and even early mortality.
Understand the Evidence for Exercise in Gynecologic Cancer-Related Fatigue
Cervical cancer is the fourth most common cancer in women and the seventh most common overall. Cancer-related fatigue (CRF) has an estimated prevalence of 50%–90% in all patients and has been reported to affect 17%–33% of women with gynecologic cancers for as long as three to eight years after diagnosis. Many national guidelines from organizations such as the American College of Sports Medicine, American Cancer Society, National Institute for Health and Care Excellence, and ONS all recommend exercise to improve fatigue in patients with cancer. But no research has synthesized the evidence for exercise as an intervention for fatigue specifically in patients with gynecologic cancers.
Psychological Distress Is Interdependent in Patients With Cancer and Their Caregivers
About 30% of all cancer survivors and their caregivers have reported psychological distress, which encompasses diagnoses of depression, anxiety, and overwhelming stress. For both survivors and caregivers, psychological distress can negatively impact different aspects of treatment, care, and well-being. In fact, patients with lower levels of psychological distress have been shown to recover quicker, exhibit fewer symptoms, and even have lower mortality rates after treatment.
Survival Gains Make CAR T-Cell Therapy Cost-Effective for Pediatric Leukemia
When evaluated based on the cost per life-year gained, the chimeric antigen receptor (CAR) T-cell immunotherapy drug tisgenlecleucel is considered cost effective in pediatric B-cell acute lymphoblastic leukemia, researchers reported in a new study. The findings were published in JAMA Pediatrics.
HHS Proposes Policy Changes for Medicare Advantage, Part D Drug Pricing
U.S. drug pricing systems are difficult for patients to understand, cumbersome to maneuver, and limited in access and affordability. In Medicare’s current structure, certain medications are designated as a protected class of drug, and Medicare Part D plans are obligated to cover them.
The Case of the Gender Gaffe
During the morning shift change, Charlie, an RN, receives a report on Ellis, age 52, who was admitted three days ago for severe abdominal pain and persistent diarrhea after cycle 3 of high-dose ipilumumab and nivolumab.
When Charlie and the certified nursing assistant (CNA) enter Ellis’s room, the patient is sitting up in bed caressing hands with a woman of similar age. Ellis requests help getting into the shower, so Charlie says to the CNA, “Please, help him shower, and I will finish introductions.”
Ellis interrupts Charlie. “I am not a he!”
What You Need to Know About Caring for Geriatric Patients With Cancer
Cancer is largely a disease of an aged population. Estimates suggest that about 60% of all cancers are diagnosed in individuals aged 65 or older, and that number is expected to increase to 70% by 2030. Yet many nurses have little formal geriatric-specific training to care for this population’s unique needs.
WHO Cautions About Inactivity Pandemic and Disease Risk
No improvement in worldwide exercise levels has been seen since 2001, and, in fact, inactivity has worsened, data in a new report from the World Health Organization (WHO) indicated. The findings were published in Lancet Global Health.
Caring for Patients Through All Levels of Survivorship
The medical terms for living with and beyond a cancer diagnosis identify patients as entering the survivorship phase of their cancer journey. However, as science continues to develop new treatments responsible for extending patients’ lives, new levels of survivorship are being determined.
Use the Evidence to Support Physical Activity During and After Cancer Treatment
We’re familiar with the evidence: being active is better for all of us throughout our lives. In fact, regular physical activity is one of the most important things we can do for our health, according to the Centers for Disease Control and Prevention. Physical activity can help to control our weight and reduce our risk of cardiovascular disease, type 2 diabetes, and some cancers.
Animal Therapy Has Benefits for Patients—and Healthcare Staff
Animal-facilitated therapy (AFT) programs have been shown to promote a healing environment and reduce certain psychological symptoms for patients with a variety of diagnoses, including cancer. Its use was even recommended by the founder of modern nursing, Florence Nightingale, who wrote about the benefits of animals in patient care and recovery: “a pet is often an excellent companion for the sick, for long chronic cases especially.”
Regular Exercise May Improve Outcomes in Patients With Lung Cancer
In addition to lowering cancer risk, regular exercise before lung cancer surgery may improve postoperative outcomes, especially in lung cancer, according to the results of a literature review published in the British Journal of Sports Medicine.
Expressive Writing Can Help Patients Understand and Process Their Cancer Diagnosis
Writing images from one’s memory and imagination can be a healing act. According to a recent study on expressive writing and patients with cancer, some individuals may benefit from participating in expressive writing as part of their supportive cancer treatment. The writing act can be a form of healing for patients struggling with their cancer diagnoses.
President’s Cancer Panel Reports on Drug Costs and Value
Although it’s one of the less visible commissions, the President’s Cancer Panel monitors the activities of the National Cancer Program and reports on the burden of cancer. The panel reviews a number of topics and keeps current with demographic information and the latest cancer incidence research. After reviewing and recommending based on existing data, the panel releases a formal report to the president. In its most recent report, the panel found serious issues with barriers to access for cancer survivors, and it addressed the costs of drugs and the value therein.
Supportive Care Programs for Patients With Cancer
Focusing on a patient’s quality of life is often a key component to their successful cancer journey. Treating their disease is crucial, but patients have to be recognized as individuals with unique and varying needs. Addressing their emotional, physical, spiritual, and psychosocial stressors can help provide holistic treatment that’s at the heart of successful oncology care.
Managing Weight Loss in Patients With Cancer
Patients’ weight and nutrition status will often vary throughout the cancer care continuum. Weight loss might occur before the diagnosis, be one of the presenting cancer symptoms, be related to the tumor itself, or be secondary to side effects of their treatment (e.g., anorexia from chemotherapy or radiation).
Integrate Evidence With Clinical Expertise and Patient Preferences and Values
Nursing is often referred to as both an art and a science. Evidence-based practitioners must combine understanding the science of health, illness, and disease with the art of adapting care to individual patients and situations, all while thinking critically to improve patient outcomes.
Sleep-Wake Disturbances in Patients With Cancer
In bedrooms across the United States, people are crawling into bed, turning down the lights, and lying awake for hours on end. Sleep-wake disturbances and short sleep duration are extremely common, and rates are even higher in patients with cancer. Unfortunately, screening, assessment, and interventions are lacking for patients experiencing sleep-wake disturbances during their cancer journey.