Testicular Cancer Survivors May Need Fewer Monitoring Scans
Monitoring early-stage testicular cancer survivors for disease recurrence after surgery using either magnetic resonance imaging or fewer computed tomography scans is just as effective as more frequent intervals, researchers reported in study findings published in the Journal of Clinical Oncology.
Nurse Scientists Are Leading Patient Care Discoveries in the Ever-Evolving World of Cancer Survivorship
The cancer survivorship program team at the University of Pennsylvania Abramson Cancer Center is conducting numerous research projects such as cancer treatment’s late effects, survivors’ quality of life and health behaviors, telemedicine for survivorship visits, and even an artificial intelligence–powered, mobile phone–based program to support patient adherence to guidance from survivorship visits.
Low Cost-Related Health Literacy May Prevent Survivors From Following Care Plans
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.
Oncology Nurse Educates the Public on the Evolution of Cancer Care and Survivorship
With care shifting to outpatient delivery and the increased availability of evidence-based support services, cancer care and survivor support has greatly evolved during the past 25 years, according to ONS member Carlin Callaway, DNP, MS, RN, ACNP-BC, ACNS-BC, AOCNP®, assistant professor and lead medical oncology advanced practice provider at the University of Colorado Cancer Center and member of the ONS Metro Denver Chapter, in a June 2022 public-facing blog post for the American Society of Clinical Oncology’s Cancer.Net website.
Data Coordinators and Oncology Nurses Collaborate to Create Accurate, Comprehensive Survivorship Care Plans
Coordinating survivorship care plans is an integral part of cancer care. When the Froedtert and Medical College of Wisconsin Cancer Network experienced challenges in implementing survivorship care plans, it created a brand-new medical role—survivorship data coordinator—to “initiate case findings for eligible patients, track patients completing treatment, notify physicians and advanced practice providers to populate the survivorship care plan, and schedule survivorship care plan appointments.”
Nurse-Led Survivorship Programs
Survivors need support to resume a high-quality, healthy “new normal” life after they complete their treatment. The services of a cancer survivorship clinic or program may help them manage the physical and emotional implications involved with ongoing care.
Medicaid Expansion Under Affordable Care Act Reduces Health Disparities in Cancer Survival, New Study Suggests
A greater increase in cancer survivorship may be an outcome from Medicaid expansion under the Affordable Care Act (ACA), according to study results published in the Journal of Clinical Oncology in May 2022.
CNS Survivorship Needs More Research, Funding, and Training, Expert Panel Says
Access and reimbursement, patient and provider education, core competencies, and survivorship research funding remain critical barriers for primary central nervous system (CNS) cancer survivorship, a team of National Cancer Institute Comprehensive Oncology Network Evaluating Rare CNS Tumors experts reported in a workshop summary published in Neuro-Oncology Advances.
Childhood Cancer Survivors Have Healthy but Riskier Pregnancies
Babies born to adult survivors of childhood cancers are as healthy as those born to adults without a history of cancer, but survivors have a higher risk of severe complications during pregnancy, researchers reported in the Journal of the National Cancer Institute.
Naive T-Cell Depletion Prevents Chronic GVHD in Transplantation Survivors
A novel stem cell transplantation strategy reduces both the incidence and severity of chronic graft-versus-host disease (GVHD) in patients with acute leukemia, researchers reported in the Journal of Clinical Oncology. The investigational treatment removes naïve T cells from donor cells before transplanting into patients.
Anticipate and Address Anxiety in Survivorship Care
Some people may be overjoyed at the prospect of completing their cancer treatment and returning to normal life, but for many others, fear and anxiety can overshadow feelings of elation. The survivorship phase of a cancer journey can be confusing and uncertain. Comments like, “I don’t know what is next” and “The responsibility for care is now up to me” can alert oncology nurses that patients need additional communication and strategies to transition into healthy survivorship.
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.
NCI Office of Cancer Survivorship Funded More Than $100 Million for Survivorship Research in 2020
More than 150 Office of Cancer Survivorship grants totaling nearly $112 million funded research on cancer survivorship in 2020, including “resources for implementation of the STAR Act and additional resources provided through legislation such as the 21st Century Cures Act, which authorized funding for the Cancer Moonshot,” according to the office’s 25th anniversary report.
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.
New Radiopharmaceutical Improves Survival in Advanced Prostate Cancer
Among patients with metastatic, castration-resistant prostate cancer, treatment with the experimental 177Lu-PSMA-617 radiopharmaceutical, along with other standard treatments, improved survival by four months over treatment with standard therapies alone, researchers reported in the New England Journal of Medicine. The therapy targets the PMSA protein and may one day be an option when other treatments have failed.
Combination Immunotherapy May Further Increase Melanoma Survival Length
Using two agents that target two different receptors more than doubles length of survival for advanced melanoma than a single agent alone, researchers reported at the 2021 American Society of Clinical Oncology annual meeting.
Nurses Are Key to Patients Navigating Genitourinary Cancers
Nurses must serve as care coordinators for patients with genitourinary cancers because of the many tests, procedures, and self-care instructions they require, Clara Beaver, MSN, RN, AOCNS®, ACNS-BC®, and Joan Livingstone, BScN, RN, OCN®, both of Karmanos Cancer Institute at Wayne State University in Detroit, MI, said during a session at a ONS BridgeTM virtual conference on September 9, 2021. They emphasized the complexity of genitourinary cancers throughout diagnosis, treatment, and survivorship. Key nursing responsibilities include communicating with the care team, referring patients to other members of the interprofessional team, and advocating for patients’ needs.
U.S. Senators Introduce Metastatic Breast Cancer Access to Care Act
In April 2021, U.S. Senators Chris Murphy (D-CT) and Joni Ernst (R-IA) introduced the Metastatic Breast Cancer Access to Care Act, legislation that would waive the five-month waiting period for social security disability insurance (SSDI) and the 24-month waiting period for eligible Medicare benefits.
Nursing Considerations for Lung Cancer Survivorship Care
As Americans reduce tobacco use and treatment and diagnosis advance, lung cancer survivorship rates are improving; however, it still remains the second most common type of cancer. The growing population needs appropriate survivorship care.
Nursing Considerations for Ovarian Cancer Survivorship Care
Historically, ovarian cancer is often diagnosed at advanced stages because of vague symptoms and presentation, but with new advancements in diagnosis and treatment options, patients with the disease are living longer than ever.
APRNs Are Essential in Survivorship Programs
As the number of cancer survivors continues to grow in the United States, so too does the need for cancer survivorship programs. Oncology advanced practice RNs (APRNs) are essential team members as institutions develop and deliver comprehensive and holistic programs to meet survivors’ needs.
Electroacupuncture and Auricular Acupuncture for Chronic Musculoskeletal Pain in Cancer Survivors
Chronic pain is a common but debilitating late effect for many patients with cancer. When undertreated, patients may experience negative functional, mental, and cancer-related outcomes. Although opioids are often effective for managing cancer pain, they may not be appropriate for some patients and others may struggle to access them because of the opioid crisis. The need for nonpharmacologic pain management options is critical.
Nursing Considerations for Head and Neck Cancer Survivorship Care
Despite accounting for only 3% of all cancer survivors, patients with head and neck cancers often require significant support and survivorship care. And oncology nurses can expect survivorship to grow with recent improvements in prognosis and treatment options, such as with reductions in human papillomavirus-related oropharyngeal cancers, which tend to affect young people and offer improved long-term survival rates.
Nursing Considerations for Colorectal Cancer Survivorship Care
As the third most common cancer among both men and women, colorectal cancer is a reality for the more than 1 million people in the United States who are living with or have a history of the disease. Advancements in early detection and treatment have improved outcomes, but many survivors experience late and long-term side effects that may vary in duration, intensity, and impact on their quality of life. Clinicians must tailor each survivorship care plan for a patient’s cancer type, stage, treatment received, psychosocial implications, and side effects or toxicities. Studies have shown that experiencing long-term side effects and symptoms can reduce survivors’ quality of life.
Nursing Considerations for Lymphoma Survivorship Care
As treatments have advanced and patients and providers have more options, cure and survivorship rates for lymphomas are improving: five-year survival rates for Hodgkin and non-Hodgkin lymphoma are 86% and 71%, respectively. Despite good results from treatment, research indicates that lymphoma survivors carry a significant amount of late and chronic effects. Even in a complete remission, late effects of treatment present a burden for patients' physical and psychosocial well-being.
Nursing Considerations for Breast Cancer Survivorship Care
More than 3.5 million people in the United States are living with a breast cancer diagnosis. Despite their large number, patients often report they do not receive appropriate follow-up care after completing treatment—and the situation is worsening, with pandemic-related delays in care affecting approximately half of breast cancer survivors.
Pancreatic Cancer Risk Factors, Diagnosis, Treatment, Side Effects, and Survivorship Considerations
Pancreatic cancer is the ninth most common cancer in the United States, accounting for 3% of all cancers but causing 7% of cancer-related deaths, which equates to about 57,500 diagnoses and 47,050 deaths each year. The average person’s risk for pancreatic cancer is about 1 in 64.
The Case of the Chronic Cancer Condition
Lisa, a 32-year-old tax accountant, completed treatment for stage III triple-negative breast cancer 18 months ago. During a follow-up appointment, Lisa reported worsening headaches and difficulty concentrating at work. A magnetic resonance imaging scan and subsequent biopsy revealed a solitary brain lesion. She completed stereotactic brain radiation two months ago.
Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship
Lung cancer is the leading cause of cancer death in the United States, accounting for about one quarter of cancer deaths, and more than a quarter of million lung cancer diagnoses are projected in the United States for 2020. Lung cancer has various types, pathologies, and histologies, each with its own prognosis and treatment plan. Non-small cell lung cancer consists of about 80%–85% of lung cancer diagnoses.
NCI Appoints New Director for Office of Cancer Survivorship
Until recently, past ONS President Deborah Mayer, PhD, RN, AOCN®, FAAN, served as interim director of the National Cancer Institute’s (NCI’s) Office of Cancer Survivorship, a part of the Division of Cancer Control and Population Sciences. As an oncology nurse, Mayer brought a special perspective to the office’s mission to better understand and meet the unique needs of the growing number of U.S. cancer survivors.
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.
Glioblastoma Diagnosis, Treatment, Side Effect Management, and Survivorship Recommendations
Glioblastoma or glioblastoma multiform (GBM) is a primary central nervous system tumor. Approximately 23,890 new brain tumors are diagnosed in the United States each year, with GBM accounting for 38%. GBM can present as a primary diagnosis or evolve from a lower grade brain tumor.
Opioid-Related Death Rates Are Increasing, But Less So in Cancer Survivors
Although opioid-related deaths are increasing in the general U.S. population, leading to the U.S. Department of Health and Human Services declaring it a public health emergency, new research shows that the increase is much smaller among patients with cancer, even though opioids are used as an option for cancer-related pain. The findings were published in JAMA Oncology.
Pediatric Cancer Survivors Require Additional Care and Monitoring
Most cancer diagnoses in the United States occur later in life, in patients older than 60 years, although most of the common pediatric diagnoses occur in those younger than 10 years. Pediatric and adult patients receive similar cancer therapies. The goal is to kill rapidly dividing cancer cells. Unfortunately, most of a child’s cells also undergo rapid division, and treatment can damage healthy tissue. Therefore, treatment that cures pediatric cancer can also cause long-term survivorship issues.
Myeloproliferative Neoplasm Symptoms, Diagnosis, Treatment, and Survivorship Recommendations
Myeloproliferative neoplasms are a group of blood cancers that start with a small mutation in the stem cells of the bone marrow. Although MPNs are quite rare, essential thrombocythemia, polycythemia vera, and myelofibrosis are the most common types. Each represents a mutation of a different source of stem cell.
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.
Colorectal Cancer Prevention, Screening, Treatment, and Survivorship Recommendations
Colorectal cancer (CRC) is the third most common cancer affecting men and women in the United States. When CRC is found at an early stage before it has spread, the five-year relative survival rate is about 90%, yet it remains a leading cause of cancer-related death among both genders.
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.
Commission on Cancer Revises Its Standards. Here Are the Takeaways for Oncology Nurses.
Oncology nurses are critical to meeting three components of the newly revised Commission on Cancer (CoC) standards released in fall 2019: certification, survivorship, and barriers to care.
The Case Supporting the Seasons of Survivorship
Jamie is completing her last cycle of carboplatin and paclitaxel for stage I ovarian cancer. The oncology infusion nurse notices that Jamie appears withdrawn and nervous, so he takes time to ask her how she is feeling about completing treatment. Jamie responds, “I feel as frightened about finishing treatment as I did when I was diagnosed with cancer.” She also shares that she doesn’t want to ring the cancer center’s bell to ceremoniously signify the end of her treatment because she doesn’t want to “jinx it.”
Nurses Need Resources, Data to Support Patients Transitioning to Survivorship
Since the National Academies of Medicine (formerly the Institute of Medicine) issued Cancer Patient to Cancer Survivor: Lost in Transition in 2005, the oncology field has made small strides to implement successful survivorship resources to support patients after their treatment. Because of the vast differences in patient populations, disease types, study locations, and institutional resources, best practices to support patients transitioning from treatment to survivorship care are often unclear. This poses an issue for providers, and patients hear mixed messaging or little information for follow-up care. With many patients receiving treatment in outpatient settings, ambulatory oncology nurses must understand how to provide support for patients during their transition.
Pediatric Cancer Survivors Have Higher Mortality After Adult Breast Cancer Diagnosis
Women who survived pediatric cancer but developed breast cancer as an adult are more than twice as likely to die prematurely, mostly from comorbid conditions, according to results of a study published in the Journal of Clinical Oncology.
Hematologic Cancers Have Higher Long-Term Risk of Clots and Bleeding
Patients with hematologic cancers have a 19% increased risk for blood clots or bleeding events even 10 years after diagnosis, according to the results of a study published in the Journal of Thrombosis and Haemostasis.
Healthcare Price Transparency; Cancer Survivor Caucus; Insurers Sue for ACA Backpay
Since 2016, then-candidate Trump promised he was going to bring healthcare costs under control. In a White House announcement on June 24, 2019, the president took steps to add transparency to the process by requiring insurance companies, hospitals, and physicians to identify fees and costs in public and simple ways for patients to see in advance and to understand.
Survivorship Considerations After CAR T-Cell Therapy
As more patients receive treatment with chimeric antigen receptor (CAR) T-cell therapy, oncology nurses will need to be aware of the long-term effects of treatment that may persist into survivorship. However, because the treatment is so new, studies measuring those patient-reported concerns are still forthcoming. The majority of today’s recommendations for survivorship management are based on experts’ clinical experience.