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.

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.

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.

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.”

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.

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.

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 (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.

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.

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. 

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.

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.

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.

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. 

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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. 

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.  

Every patient deserves equal access to health care. Yet 68% of patients have at least one social determinant of health that serves as a barrier to care.

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. 

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.

Dylan sat on the plastic chair with his elbows rested on his knees, staring blankly at the white tile floor in the clinic exam room. He was listening to me talk about the side effects of chemotherapy, but I could tell he had more on his mind. He lifted his head and touched his red baseball cap with his left hand.

“This is a lot to take in,” he said in a befuddled tone.

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. 

Sharon, age 40, was diagnosed with invasive ductal carcinoma. Pathologically, her tumor was grade I, estrogen- and progesterone-receptor positive, and HER2 negative. The mass measured 0.5 cm on ultrasound. Sharon has no family history of cancer and is devastated by the diagnosis. One of her close friends recently died from metastatic breast cancer, and she is certain will have the same fate. She tells Jennifer, an RN in the breast center, that she is going home to “get her affairs in order.”

During a recent speech at the 2018 Medicaid Management Care Summit, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma expressed a continued commitment to Medicaid’s legacy of supporting Americans in need.

My story, like many of your patients, is unfortunately not that uncommon: I’m a motherless daughter. I lost my mom to breast cancer when I was 26 years old; she lost her mother to the disease before she graduated high school. The BRCA1 mutation has been passed down in my family, and I, too, carry the mutation. Even though it was expected, I was devastated and desperately looking for resources to help manage my cancer risk. It was scary not knowing where to turn. I needed to know that I wasn’t alone. 

Cancer prevention is a full-time job, and the Centers for Disease Control and Prevention (CDC) works around the clock to raise awareness and promote necessary early detection and screening methods. Cancer survivors are a unique subset of patients and require information that’s been individualized to the survivorship experience.

Incorporating survivorship care plans into a hospital’s electronic medical records (EMRs) can be a tremendous aid for oncology nurses supporting their patients entering survivorship. Using the National Comprehensive Cancer Network treatment guidelines as a template for care, the oncology team can prepare a patient’s medical record with the necessary individualized information. 

Cancer doesn’t discriminate. It can strike anyone at any time. Being told that you have cancer can be a frightening experience, and feelings of loneliness and isolation are not uncommon, especially for young adults with cancer.

More than 13,000 children are diagnosed with cancer every year in the United States. Because treatment options continue to improve, more than 80% of those children will survive at least five years after their 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.