BOSTON—The national discourse on cancer screening has come a long way since 1988, when Ronald Reagan became the first president to say “breast cancer” in public, noted Alec Stone, MA, MPA, Health Policy Director, Oncology Nursing Society (ONS). After the US Preventive Services Task Force (USPSTF) recommended mammography screening every 2 years instead of annually, beginning at 50 years of age instead of 40, the public outcry was widespread and loud. Controversy has also been swirling about prostate cancer screening recommendations.
BOSTON—Recognizing steroid-induced hyperglycemia early and addressing it promptly can prevent significant ad - verse effects associated with this complication. Educating patients on the importance of and methods for maintaining good blood glucose control helps mitigate damage to the vascular system and kidneys from hyperglycemia. It also lessens susceptibility to infection, a complication of hyperglycemia that is of serious concern in immunocompromised patients.
BOSTON—Nurses have been involved in radiation oncology since the early 1940s, but as nursing roles in general have evolved over time, so has the role of these nurses. A group of advanced practice nurses (APNs) shared how they came to be part of their facility’s radiation oncology department and how the increased strain on healthcare is opening opportunities in this field for APNs.
BOSTON—As more targeted therapies for non–small-cell lung cancer (NSCLC) become available, experts are assessing which patients’ tumors should be genotyped and when. Although genotyping—not to be confused with genetic testing—is becoming increasingly important in developing a treatment plan, professional guidelines do not yet recommend incorporating it as a routine part of care for patients with NSCLC.
BOSTON—Recognizing steroid-induced hyperglycemia early and addressing it promptly can prevent significant adverse effects associated with this complication. Educating patients on the importance of and methods for maintaining good blood glucose control helps mitigate damage to the vascular system and kidneys from hyperglycemia. It also lessens susceptibility to infection, a complication of hyperglycemia that is of serious concern in immunocompromised patients.
BOSTON—Where most people see the end of life for a patient with cancer as a time of grief and suffering, “the final chapter…also holds the opportunity for profound healing, comfort, and growth,” believes Betty Ferrell, PhD, RN, who was honored with the Mara Mogensen Flaherty Memorial Lectureship Award. She further believes that, through compassionate and competent psychical and psychosocial care, oncology nurses can be instrumental in brightening the darkest days for patients.
BOSTON—Many patients are unaware of their risk of cancer-related lymphedema, and oncology nurses can be instrumental in raising consciousness about this debilitating adverse effect. Of breast cancer survivors, 22% to 66% develop lymphedema, said Jane Armer, PhD, RN, FAAN, Sinclair School of Nursing, University of Missouri, in her poster presentation. Approximately 15% of nonbreast cancer patients also develop lymphedema. This chronic condition is optimally managed by a lymphedema therapist.
BOSTON—Bone loss and related complications are common in patients with cancer. And the problem is growing, with more patients with cancer aged 65 years and older and increased use of newer treatments that compromise bone mineral density (BMD). “As nurses, we have a very significant role to play in both prevention and management of [bone loss] problems,” said Carrie Tompkins Stricker, PhD, RN, oncology nurse practitioner, Abramson Cancer Center, Philadelphia, Pennsylvania.
BOSTON—The national discourse on cancer screening has come a long way since 1988, when Ronald Reagan became the first president to say “breast cancer” in public, noted Alec Stone, MA, MPA, Health Policy Director, Oncology Nursing Society (ONS). In 2009, after the US Preventive Services Task Force (USPSTF) recommended mammography screening every 2 years instead of annually, beginning at 50 years of age instead of 40, the public outcry was widespread and loud. Controversy has also been swirling about prostate cancer screening recommendations.
BOSTON—As every oncology nurse knows, pain is no stranger to patients with advanced cancer. Even if background pain appears under control, studies show 23% to 89% of patients experience intermittent bouts of pain known as breakthrough cancer pain (BTCP). Variation in the incidence rates reflects variation in the definition of BTCP.
BOSTON—In an event that brought tears and laughter to those attending, CURE magazine recognized Marie Hayek, RN; Robert Martinez, LPN; and Rebecca Wojtecki, RN, BSN; as Extraordinary Healers. Nominees for the 5th annual Extraordinary Healer Award for Oncology Nursing were selected based on essays submitted by patients, caregivers, and colleagues.
BOSTON—The growing use of oral oncolytics corresponds to a growing challenge with poor adherence to therapy. With more than 40 oral oncolytics available and dozens in the pipeline, Susan Moore, RN, MSN, ANP-BC, AOCN, oncology nurse practitioner and consultant with MCG Oncology in Chicago, Illinois, warned nurses at the Oncology Nursing Society (ONS) annual meeting that “the issue is not going to fade away.”
Researchers from the National Cancer Institute report that radiation therapy for a first cancer is unlikely to lead to a second cancer diagnosis later in life. Berrington de Gonzalez and associates conducted a retrospective review of data from the Surveillance, Epidemiology, and End Results cancer registry for nearly 650,000 adults who received a cancer diagnosis between 1973 and 2002 and survived at least 5 years.
The US Food and Drug Ad ministration (FDA) held a public meeting in February to assess whether stricter criteria are needed when considering oncology drugs for accelerated approval. Measures enacted in 1992 allow the FDA to grant accelerated approval for drugs targeted at unmet needs in cancer based solely on data from single-arm studies and relying on end points other than the standard metric of overall survival.
In a randomized trial of patients with cancer who were suffering from vertebral compression fractures (VCFs), balloon kyphoplasty was associated with greater pain relief and better quality of life than nonsurgical care. According to the authors, patients who received kyphoplasty relied significantly less on pain medication, bed rest, and walking assistance 1 month after undergoing the procedure.
Every physician has a preferred way of writing prescription instructions, and pharmacists differ in how they translate those instructions to the pill bottle. A study published in the Annals of Internal Medicine by Wolf and associates found that the lack of a universal medication schedule (UMS) to standardize how prescriptions are written and filled contributes to poor patient adherence and increases safety concerns. Elderly patients or those with low health literacy are more prone to confusion when trying to follow a multidrug regimen.
Data published in the Journal of the American Medical As sociation in March indicate that for 20% of women with early-stage breast cancer, removing malignant lymph nodes from the armpit does not improve survival or prevent recurrence. Women in the phase 3 trial who underwent complete axillary lymph node dissection (ALND) had higher rates of lymphedema than those who had sentinel lymph node dissection (SLND) alone (P <.001). They also had higher rates of wound infection, axillary seromas, and paresthesias (70% vs 25%, respectively; P <.001).
Anew study shows that tamoxifen protects high-risk women against breast cancer for as long as a decade after treatment ends. Joyce Noah-Vanhoucke, PhD, Archimedes Inc, San Francisco, Cali fornia, and colleagues conducted the metaanalysis and found that using tamoxifen to prevent breast cancer in postmenopausal women aged <55 years was cost-effective and saved lives.
Asmall Canadian study found that patients who took delta-9- tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana, slept better and derived more enjoyment from eating than patients given a placebo. The University of Alberta investigators, led by associate professor Wendy Wismer, recruited terminal patients with advanced cancer who were randomly assigned to take 2.5 mg of dronabinol (a pill form of THC) or placebo twice daily for 18 days. Afterward, the participants completed questionnaires to assess whether their quality of life improved during the study.
The Centers for Medicare & Medi caid Services (CMS) has released a proposed decision memo that suggests it will cover the cost of sipuleucel-T (Provenge), the immunotherapy vaccine approved in April 2010 for men with asymptomatic or mildly symptomatic metastatic castrate-resistant prostate cancer, for on-label use. CMS contractors will have discretion as to whether they will cover it for off-label use.
Cancer treatment–induced diarrhea (CTID) occurs in 50% to 80% of patients receiving chemo therapy and 50% of patients undergoing radiotherapy. Older patients, women, patients on an irinotecan-containing regimen, and patients treated in the adjuvant setting are at higher risk of CTID, reported Kelly Markey, PharmD, BCOP. Markey is a clinical pharmacist with the gastrointestinal tumor program at Moffitt Cancer Center in Tampa, Florida, and discussed CTID at the annual meeting of the Hematology/Oncology Pharmacy Association.
Drug shortages continue to plague the United States, compromising patient safety and placing additional strain on healthcare resources. The shortages encompass common drugs used to treat a range of conditions, from everyday infections to heart attacks.
In a study funded by Pathwork Diagnostics, Inc., researchers found that using the company’s tissue of origin test for patients with hard-toidentify primary cancers enabled accurate diagnosis of the tumor in several cases and led to changes in treatment. Patients whose diagnosis was confirmed appeared less anxious.
Vandetanib (Zactima) received full approval from the US Food and Drug Administration (FDA) today for adults with nonresectable or metastatic medullary thyroid cancer (MTC). Vandetanib was initially approved under the FDA's orphan drug program, making it the first medical treatment for MTC.
Following up the combination regimen of gemcitabine (Gemzar) and FOLFOX with drugs designed to boost the immune system significantly improved progression-free survival (PFS) in patients with advanced colorectal cancer. Pierpaolo Correale MD, PhD, Siena University School of Medicine, Italy, noted that the benefits observed in the experimental arm of the trial led a monitoring committee to halt the trial early. Preliminary data were reported at the 102nd annual meeting of the American Association for Cancer Research being held in Orlando, Florida.
Recruiting adults with cancer to take part in clinical trials is an ongoing challenge in the United States, but the growing number of studies for targeted therapeutics and the positive news emerging from these studies might help turn that around. Trials of targeted agents depend heavily on pharmacokinetic and pharmacodynamic testing to assess outcomes, prompting a team of researchers to investigate how willing patients are to undergo various testing procedures in the trial setting.
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