Columbia University Medical Center

In March 2012, Columbia University announced the opening of the Center for Lymphoid Malignancies in New York City. The center’s focus is on the care of patients with the various forms of non-Hodgkin lymphoma, chronic lymphocytic leukemia, acute lymphoblastic leukemia, and Hodgkin disease. The highly skilled and experienced staff at the center comprises more than 25 personnel, including physicians, nurses, clinical trial coordinators, regulatory specialists, laboratory scientists, and other support staff under the directorship of Owen A. O’Connor, MD, PhD.

Although the healthcare professionals at the center are focused on lymphoid malignancies, they also have expertise in most hematologic cancers, including multiple myeloma, myelodysplastic syndrome, and acute myeloid leukemia.

At the center, the emphasis is on research that translates the latest scientific discoveries into promising and innovative treatments for these complex malignancies. The center has a portfolio of nearly 20 clinical trials in various phases, some of which have led to the development of several pioneering treatments for various forms of lymphoma and lymphoid leukemia.

The center offers a multidisciplinary approach with experts from various fields related to hematologic malignancies, collaborating on the management of patients and their cancers, including treatment-related side effects. Care of individual patients is coordinated by experts in drug development, pharmacology, radiation oncology, and bone marrow transplantation. These experts are working on novel approaches that will change the paradigms for how patients with these diseases are managed. The center also offers highly skilled nursing care, as well as skilled psychiatric and social support.

The Oncology Nurse-APN/PA spoke with Ellen A. Neylon, MSN, FNP-BC, CCRP, OCN, about the trajectory of her own career path as an oncology nurse practitioner and also about her experience at the Center for Lymphoid Malignancies.

What are you excited about right now in the cancer field?

Ellen A. Neylon (EAN): I am excited about the number of new and effective treatments becoming available. In this specialized practice where we primarily see patients with lymphoid malignancies, a significant portion of our practice involves working with an extensive portfolio of clinical trials. I have been fortunate to be involved in clinical trials of 3 medications that have shown efficacy and have been approved by the FDA. With these treatments, I was able to witness firsthand the positive benefits that patients experienced when receiving the drugs. The continual growth and development of new treatments, specifically the molecules targeted to specific parts of the cancer cell, make it an exciting time to be involved in oncology.

What approach does the Center for Lymphoid Malignancies take to treating people with cancer?

EAN: At our center, each patient has a treatment plan that is tailored to his or her individual diagnosis and needs. As part of a large academic medical center, we have access to specialists in every aspect of medicine, as well as some highly sophisticated resources, including innovative imaging technologies. Our patients are treated with the specialized oncologic care that they require but also have access to outstanding physicians in other fields, as needed. Throughout the patient’s treatment course, a comorbid condition or severe side effect can require the skills beyond those of the oncology team. As an oncology nurse, I know that it is essential to have a strong hospital support system to care for my patients as they undergo treatment.

How does that translate to better outcomes for your patients?

EAN: The benefit of having access to premier physicians in cardiology, pulmonology, neurology, dermatology, and surgery while undergoing specialized oncologic treatment is that this allows for comprehensive patient care. As new health concerns arise, the patient can be seen promptly by an appropriate specialist, often allowing an earlier diagnosis of the problem.

Through receiving an early and accurate diagnosis, a treatment plan can be implemented with the hope of alleviating long-term side effects for the patient. By having this multidisciplinary approach available while undergoing chemotherapy, patients are able to continue with their regimen without lengthy interruptions or delays. The literature clearly shows that maintaining the administration of treatment with the fewest interruptions is associated with a superior outcome.

How has the role of the oncology nurse changed over the past 5 years?

EAN: As nurses, we have made great strides to improve the management of side effects induced by chemotherapy and radiation. These advances have helped our patients to maintain more independence and improved quality of life by receiving treatments in an outpatient setting. I believe that this in - dependence helps patients remain engaged in their daily lives, interacting with friends and family, and ultimately maintaining their strength to fight their disease. With the increased number of patients receiving treatment outside of the hospital setting, nurses must educate patients about potential side effects that can occur. Making sure that each patient and their respective caregivers are familiar with possible side effects, including when to alert the clinician, is critical information to be communicated clearly and routinely throughout treatment.

What inspired you to enter the field of oncology nursing?

EAN: I became interested in nursing in my first postbaccalaureate job when I had the opportunity to work directly with several nurse practitioners. These professionals were not only educated in their specific fields but were knowledgeable about emerging treatments. Ad - ditionally, their caring and compassion as medical providers inspired me as I sought my career path. As I prepared for medical school, I found myself drawn to the nursing profession, a path similar to that of mentors I had worked with in the past. It became clear that I was better suited to being a nurse practitioner than a physician, caring for the patient from a holistic view. I was inspired to work in oncology because of the challenge and complexity involved in managing cancer patients. I know that I must continue to enhance my skills in physical examination and symptom management, as well as be able to identify abnormal findings. The complexity in oncology—in particular, how treatments are increasingly tailored to the biological context—keeps me in trigued for the next challenging case.

Do you have any advice for nurses just entering the field?

EAN: The best advice I can give to a nurse entering oncology is to listen to your patients. Most patients know their bodies well and may have experienced a similar pain or symptom previously. By carefully listening to the patient, you can often identify the underlying cause of their problem.

My colleague, Kathleen Maignan, RN, and I often talk about the physical and emotional demands associated with advanced cancer patients. We would tell new nurses that it is important to be aware that this profession can be emotionally taxing, both at work and in your personal life. Establish time for yourself by finding activities outside of work that you enjoy; this will clear your mind and be rejuvenating. While you will have difficult days, the numerous smiles, hugs, and kind words you will receive from your patients and their families are affirmations that you have chosen a rewarding and life-changing career.

If you weren’t working in this field, what would you be doing?

EAN: How funny you should ask! I love animals almost as much as I love and enjoy helping people. If I weren’t doing what I do now for my 2-legged patients, I would be doing something similar for all of our 4-legged furry friends.