Oncology Nursing

We still have much to do to fully understand the potential of complementary therapies as important elements in cancer treatment and health. Mind-body and body-based interventions may be able to improve health and prevent disease as effectively as pharmacologic agents—without the toxicities associated with pharmacologics, and as adjuncts to pharmacologic therapies they may help to maximize health and diminish disease with less toxicity.

Many cancer patients experience cachexia. In collaboration with an interdisciplinary team including dietitians, oncology nurses are well positioned to implement proactive, multimodality interventions that improve clinical outcomes and quality of life for these patients.

In a multicenter phase III trial of 360 patients with muscle-invasive bladder cancer, synchronous chemoradiotherapy provided better locoregional control without significant added toxicity, investigators for the Bladder Cancer 2001 trial have found.

A web-based interactive support system tailored for cancer patients reduced patients’ feelings of depression and improved their sense of well being, compared with being given access to resources that are publically available on the internet, results of a large 1-year randomized controlled trial have shown.

A multicenter telephone-interview study has found that cancer patients often perceive that communication problems with healthcare providers have contributed to a breakdown in their care, but very few formally report their concerns.

Children diagnosed with non-central nervous system cancers at a very young age tend to reach some neurodevelopmental milestones later than healthy children, according to a new study.

Oral nutritional interventions can improve quality of life and overall nutritional intake in some cancer patients, but do not appear to have any effect on mortality outcomes, according to a recent meta-analysis.

Using detailed patient data and mathematical modeling programs, a US–international team of investigators has concluded that in the US, public health efforts beginning in the 1950s prevented nearly 800,000 deaths from lung cancer between 1975 and 2000.

Reporting interim findings from a multi-institutional assessment of more than 50,000 people 50 to 69 years of age, COLONPREV Study Group investigators from Spain have concluded colonoscopy is better than fecal immunochemical testing (FIT) at detecting adenomas.

Following a large survey of more than 22,000 US women, researchers from H. Lee Moffitt Cancer Center, in Tampa, Florida, have concluded that a significant proportion of female cancer survivors have poor health behaviors, compared with women who have not had cancer.

A multi-institutional, NCI-funded retrospective study in the New England Journal of Medicine highlights the significant long-term benefit of colonoscopic polypectomy in preventing death from colon cancer, with polypectomy cutting the incidence of colon cancer–related mortality in half compared with the general population.

Researchers from Wellspring, a Canadian nonprofit organization that supports and educates people with cancer, together with a team of patient-support consultants, have developed a 1-day program that appears to have reduced emotional exhaustion and burnout in oncology nurses.

Epidemiologist Jack Cuzick, PhD, and colleagues, writing in the Journal of the National Cancer Institute in April, concluded that “tamoxifen-induced reductions in breast density can be used to identify women who will benefit the most from prophylactic treatment with this drug.”

A team of researchers from the University of Connecticut at Storrs and the National Cancer Institute, analyzing US national health data on more than 4,000 racially diverse adults aged 75 years and older, has concluded that despite “ambiguity of recommendations for this group,” cancer screening rates are high in this population.

In a Canadian study of more than 14,000 breast cancer survivors over 65 years of age, current use of tamoxifen appears to be associated with a small increased risk of diabetes. The findings do not mean tamoxifen is a direct cause of diabetes in this patient population, the study authors emphasized, but they said its use may increase diabetes risk in older women who already have known risk factors for diabetes, such as obesity or a family history of the disease.

A survey of more than 500 long-term survivors of non-Hodgkin’s lymphoma (NHL) has revealed that more than one-third experience persistent or worsening symptoms of post-traumatic stress disorder (PTSD), with nearly 4 of 10 cancer survivors stating they still experience symptoms of PTSD more than a decade after their cancer diagnosis.

The often-weakened immune systems of cancer patients receiving chemotherapy put them at greater risk of acquiring life-threatening infections in community and hospital settings, including during appointments for outpatient treatment.

CME
Patient education and counseling are essential in women at increased risk for ovarian and endometrial cancer. Women must be educated regarding the signs, symptoms, and risks associated with these cancers.
•The Complexity of Hereditary Cancer Syndromes

Dying from cancer is predominantly an elder experience. The person with major responsibility to provide care for the ill family member is often the patient’s spouse, who frequently is an older adult.