Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress
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.
Nurse Leads Relaunch of Bipartisan Assisting Caregivers Today Caucus
To provide education about the challenges family caregivers face and advocate for policies that support them, U.S. Representatives Jen Kiggans (R-VA), a geriatric nurse practitioner and veteran, and Debbie Dingell (D-MI), along with U.S. Senators Michael Bennet (D-CO) and Shelley Moore Capito (R-WV), relaunched the bipartisan Assisting Caregivers Today Caucus in June 2023.
Financial Navigation During Hematologic Cancer Saves Patients and Caregivers $2,500
Individuals at risk for financial toxicity from the high costs of hematologic cancer care reported saving an average of $2,500 when guided by the services of an oncology financial navigation program, researchers reported in the Journal of Oncology Practice.
Nurses Say That Oncology Inpatient Medical Cannabis Use Improves Symptom Management and Quality of Stay
An overwhelming majority of nurses say that terminally ill patients with cancer in California who use medical cannabis under Ryan’s Law in an inpatient setting have better symptom management and satisfaction with the quality of their stay, according to survey findings reported during the 48th Annual ONS Congress® in April 2023.
Nurse-Created Apps Help Pediatric Patients Find Their Voice and Navigate Their Cancer Journey
A nurse’s perspective in the creation of health technology tools to deliver quality patient care is important for the digital era we provide care in. Advancements can be as complex as artificial intelligence in big institutions or as simple as a mobile app for personal smartphones. I’ve been working with other healthcare providers to develop the latter to improve care for pediatric patients with cancer.
Respect Patients’ Religious Hair Wraps or Coverings When Taking Accurate Height and Weight Measurements
Patients who follow various religious practices may wear head coverings that can affect their height or weight measurements. Accurate height and weight measurements are essential for weight-based medication dosing to prevent inadvertent over- or underdosing.
War Imagery Metaphors May Promote Strength, Resilience for Patients With Nonmetastatic Cancer
The United States has waged a war on cancer for more than 50 years, but no patient ever willingly enlists for service. Although evidence conflicts about the psychosocial implications of using war imagery terms with patients with cancer, researchers conducting a new study found that patients with nonmetastatic disease embrace using war imagery to place meaning around their diagnosis. The researchers reported their findings in Supportive Care in Cancer.
Compensation Funds Curb Financial Burden for Certain Exposure-Related Cancers
People who live near nuclear weapons testing sites or work with uranium, U.S. Department of Energy employees, and firefighters, victims, and rescue and recovery workers from the September 11, 2001, attacks may be eligible for various government- or employer-funded compensation if they develop cancers because of their exposure to known related carcinogens. The funds can alleviate some of patients’ financial burden of cancer treatment and care and support families’ emotional well-being with a tangible reminder that the cancer is unrelated to any underlying inherited genetic disorder.
Veterans and Cancer
Veterans and active service members of the U.S. armed forces have dedicated their lives to the safety and freedom of their country. However, that honorable service may place them at risk for post-traumatic stress disorder, anxiety, depression, and cancer.
White House Appoints Mandy Cohen as New CDC Director
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.
LGBTQ+ Patients With Cancer Need Education Tailored to Their Identity
More than two-thirds of patients who identify as LGBTQ+ lack at least one vital health education resource tailored to their identity, researchers reported in study findings presented at the 15th American Association for Cancer Research Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved. Additionally, nearly three-quarters of those patients desire posttreatment plans that include LGBTQ+ specific information.
Specialized Services Support and Improve Care for LGBTQI+ Patients With Cancer
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.
Transgender Patient Populations
Transgender individuals often experience poor health outcomes, particularly when it comes to cancer. Compared with cisgender individuals, transgender individuals may be diagnosed with cancer at later stages, be less likely to receive treatment, and have worse survival for many cancer types. The disparities extend to survivorship, where transgender people report significant unmet needs, including lack of coordination between gender-affirming care and cancer care, oncology clinician understanding of transgender patient care needs, and transgender-specific resources.
AYA Champions Clinic Fills Gaps in Care and Addresses Unmet Needs
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.
Two Oncology Nurses Implement Process to Allow Patients to Disconnect Pumps From the Comfort of Their Own Homes
The explosion of telehealth transitioned many aspects of cancer care to patients and caregivers as home-based options. However, as with any shift in procedure, disconnecting their own pumps requires additional preparation and processes. Two oncology nurses share how they set up systems to support safe home care for pump disconnection.
Medicare Part D Restructure Gives CMS the Ability to Negotiate Drug Prices
Health care consumes an inordinate amount of the U.S. gross domestic product at 18.3%. In 2021, healthcare spending increased by 2.7% to $4.3 trillion, equating to $12,914 per person annually. Under that average, prescription medications are the highest expenditure. According to the Centers for Medicare and Medicaid Services, “Retail prescription drug spending increased 7.8% to $378.0 billion in 2021, a faster rate than in 2020 when spending increased by 3.7%. The acceleration in growth was due to an increase in the use of prescription drugs in 2021.” On top of that staggering national economic impact are the personal, emotional, and familial burdens that take a toll on patients and caregivers.
Clinician Biases Leave Patients Feeling Unsupported When Electing for Flat Closure Mastectomies
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.”
CMS Promotes Plans to Build a System for Patient Safety
Across disciplines, all healthcare providers take a practice oath that supports the principle of nonmaleficence (“first, do no harm”)—and so does the Centers for Medicare and Medicaid Services (CMS), several agency leaders wrote in a March 2023 blog post. The authors called for increased awareness of patient safety and highlighted ways CMS is taking action.
Delivering Holistic Cancer Care Requires Oncology Providers to Weave Spirituality in Their Practice
Spiritual care is an essential component of cancer care. Representing an individual’s “sense of peace, purpose, and connection to others and beliefs about the meaning of life, spirituality is not synonymous with religion, which is “a set of beliefs and practices that center on questions about the meaning of life and may involve the worship of a supreme being.” Several healthcare organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Multinational Association of Supportive Care in Cancer, and the Joint Commission recommend including spiritual care in cancer care guidelines.
Rare Cancer Survivor and Oncologist Speak About the Cancer Journey and Challenges in the Patient Experience
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.
Advance Care Planning
Advance care planning (ACP) is an integral part of treatment planning that supports patients at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. ACP is individualized to each patient’s unique circumstances, with more support and specific decision-making provided as the planning progresses. It’s particularly important for patients with cancer, but communication challenges can delay ACP initiation.
Uterine Cancers Added to World Trade Center Health Program List
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.
Innovative Oncology Nurses Break Down Communication Barriers for Patients Who Are Deaf or Hard of Hearing
Many patients with cancer confront complex health disparities, but those with disabilities must muddle through more barriers than those without. As nurses, we have a responsibility to help our patients obtain the best possible care and support them during treatments such as a bone marrow transplantation.
HHS Assistant Secretary for Health Meets With Colorado Springs Community and Mental Health Providers to Discuss Care After Crisis
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.
Watch Your Words to Lose the Weight Bias in Health Care
Weight bias and stigma are evident across all professionals in the health care industry, including physicians, nurses, dietitians, and mental healthcare providers, researchers reported in Nursing Clinics of North America. They said that using people-first language is critical to reducing bias and discrimination.
Disability Disparities in Cancer Care
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.
Uninsured Rate at an All-Time Low After 2022 HealthCare.Gov Insurance Enrollment Breaks Records
Almost 11.5 million people signed up for healthcare insurance on HealthCare.gov from November 1–December 15, 2022, President Joe Biden announced in December 2022. Enrollment increased 18% over the same period in 2021.
AHRQ Recognizes Nurses’ Unique Contributions to Diagnostic Processes
Nurses bring unique but critical input to diagnostic processes in the emergency department, the Agency for Healthcare Research and Quality reported in August 2022. “Nurses have unique, valuable knowledge based not only on principles of science but also on holism and intuition,” the agency said.
House Committee Passes Lymphedema Treatment Act
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.
Social and Community Context Matter in Cancer Care
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.
Support Impaired Patients’ Medical Decision-Making Capacity
John is a 58-year-old patient who was diagnosed with glioblastoma two years ago. He initially responded well to radiation, temozolomide, and a tumor-treating fields device. His cancer recurred 18 months after diagnosis, and John underwent a second craniotomy that was complicated by a stroke. He became unable to verbally communicate, but John and his partner had previously discussed his desire to participate in clinical trials to help extend his life. The medical oncologist says that John will not qualify for a clinical trial because John is unable to give an informed consent, and John’s partner is frustrated that she can’t speak for him and respect his wishes.
New Technology Tools Help Oncology APRNs Improve Patient Outcomes
Clinical decision support systems are tools integrated into electronic health records that include reminders for preventive care, evidence-based clinical practice guidelines, order sets, and alerts for drug prescribing. In health care, artificial intelligence converts data into knowledge to guide clinical decisions. When combined, the two technologies can guide advanced practice RNs and other providers with predictions and suggestions that go beyond human accuracy and specificity.
The Clinical Pharmacist’s Role in Symptom Assessments
Healthcare professionals involved in direct patient care, such as nurses, pharmacists, advanced practice providers, and physicians, learn methods of symptom assessment during education and training, but each profession uses a slightly different lens. The ability to consider polypharmacy and drug-drug interactions in patient assessment is one of the most important skills a clinical pharmacist uses in daily practice. Clinical pharmacists caring for patients with cancer must identify drug-related side effects, monitor and manage patients during chronic drug therapy, and educate patients and members of the interprofessional team, all in the context of the intricacies of antineoplastic therapy and adherence assessment.
Oncology Clinical Social Workers Add Layers of Support for Patients and Families During CAR T-Cell Therapy
The interprofessional team for chimeric antigen receptor (CAR) T-cell therapy at Smilow Cancer Center at Yale New Haven includes a transplant team, cell collection and processing unit, intensive care unit, pharmacy, telehealth for home evaluations, and social work. On that team, the oncology clinical social worker’s role is chiefly to help patients and families manage the stress associated with therapy. We provide patients and family members with ongoing clinical social work support, including listening, counseling, educating, advocating, and referring them to resources and services.
Anxiety and Depression Are Biggest Concerns for Patients With Cancer, Survivors, Caregivers
As many as 49% of patients with cancer are at risk for clinically significant levels of anxiety and 38% are at risk for clinically significant levels of depression, according to data collected through the Cancer Support Community’s (CSC’s) cancer experience registry. Additionally, nearly half of caregivers have anxiety levels that are substantially higher than the national average and one-third face substantially higher fatigue and depression levels. Nationally, the rates for levels of anxiety and depression are 19.1% of U.S. adults aged 18 and older and 8.4% of U.S. adults aged 18 and older, respectively.
Patients Cope With Intense Emotions After Clinical Trial Withdrawal
When withdrawing from a clinical trial, patients experience a spectrum of emotions ranging from regret, urgency, frustration—and trust in their healthcare professionals, like oncology nurses, according to the results of a study published in JAMA Network Open.
U.S. Supreme Court Upholds ACA Again
After a decade and three legal challenges that culminated in another U.S. Supreme Court decision to uphold the law, the Patient Protection and Affordable Care Act ([ACA], commonly known as Obamacare) is currently established canon. On June 17, 2021, the Supreme Court of the United States (SCOTUS) ruled in favor of the defendants in the case of California et al. v. Texas et al., maintaining ACA’s constitutionality. It was a firm 7-2 decision.
The Case of the Triple-Negative Breast Cancer Targeted Treatment
Ophelia is a 42-year-old patient who has been diagnosed with triple-negative breast cancer (TNBC). She completed neoadjuvant chemotherapy with dose-dense doxorubicin and cyclophosphamide, followed by paclitaxel and carboplatin. Her postsurgical pathology shows residual disease in the tumor (3.5 cm down from 4 cm) and 12 out of 18 lymph nodes that are positive for cancer. Ophelia tells you that she is very discouraged and expected a better treatment outcome.
Engagement Projects Help Patients Manage Stress and Anxiety
Patients reported lower levels of pain and stress after participating in virtual reality and art therapy programs, according to presenters sharing findings from two different pilot projects during the ONS BridgeTM virtual conference on September 14, 2021.
Patient-Advocacy-Provider Partnerships and Networks Support Rare Cancer Research
My area of research focus is adults with primary central nervous system (CNS) tumors, which represent less than 2% of all diagnosed cancers. Because of the cancers’ rarity, access to diagnosed patients for research initiatives is limited. My team’s program, NCI-CONNECT, a part of the Rare Tumor Patient Engagement Network supported by the Cancer Moonshot, is advancing our understanding of adults with rare CNS cancers by establishing patient-advocacy-provider partnerships and networks to improve care and treatment approaches.
The Time Is Now to Address Racial Disparities in Oncology Symptom Science
Although cancer mortality in the United States has decreased in most populations, non-Whites still have a disproportionately higher risk, and recent events have raised awareness of racial healthcare disparities. During a session on April 29, 2021, for the ONS 46th Annual Congress™, Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP®, FAAN, of the University of Pittsburgh School of Nursing, Susan G. Dorsey, PhD, RN, FAAN, of the University of Maryland School of Nursing, and Angela Starkweather, PhD, ACNP-BC, FAAN, FAANP, of the University of Connecticut School of Nursing and School of Medicine, explored the application of the symptom science model to address the needs of underrepresented patients.
The Case of the Transgender Considerations for Cancer Screening
Sally, a nurse practitioner in a cancer survivorship clinic, is preparing to discuss screening and surveillance guidelines with Jonah, a 32-year-old survivor of Hodgkin lymphoma. Sally reviews Jonah’s patient history form and notes that Jonah uses he and him pronouns. His gender identity is male and sex assigned at birth was female. Jonah’s surgical history includes gender-affirming surgery on chest tissue (also known as top surgery), and his current medications include supplemental testosterone. Jonah also specifies that he is transmasculine—an umbrella term used to indicate that Jonah feels a connection with masculinity.
Fear of Recurrence May Actually Contribute to Cancer Recurrence
Stress, such as fear and worry about cancer coming back or many other life burdens and concerns, may activate dormant cancer cells remaining in the body to form tumors again, researchers reported in Science Translational Medicine.
COVID-19’s Implications for People With Cancer and Oncology Nurses
Since the World Health Organization declared it a pandemic on March 11, 2020, the COVID-19 coronavirus—the greatest global public health emergency in a century—has disrupted or delayed many aspects of life, including cancer care. But it’s also opened new opportunities for nursing innovation and brought much-needed change to health care. Here’s where we are one year later.
How to Manage Survivor Guilt During a Pandemic
Pandemics have a tremendous impact on societies and individuals alike. From incidence rates to death tolls, financial hardship to job loss, and anxiety to isolation, we’ve all been affected in one way or another—although some much more than others.
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.
Always Search for Ways to Connect With Patients
While working in a palliative care clinic, I developed a connection with one of my patients through an unexpected medium: word search puzzles. She was doing one the first time I entered her exam room, so I introduced myself and asked if it was a difficult one.
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.
Cancer Rehabilitation Serves a Critical Role in Patient Care
More and more providers are recognizing that prehabilitation and rehabilitation are key components of successful patient-centered cancer care. Oncology nurses serve as a critical access point to those services and must understand rehabilitation and its indications. To better highlight cancer rehabilitation’s benefits and importance in clinical practice, ONS members Grace Campbell, PhD, MSW, RN, CNL, CRRN, and Beverly Reigle, PhD, RN, shared a conversation about the finer points of cancer rehabilitation specialty practice.