ONCOLOGY Nurse Edition Vol 22 No 4

The care of cancer survivors is gaining new, much needed attention as the number of survivors in this country tops 11 million and there is recognition of the unique unmet needs of this group as a whole. In their article, Marcia Grant and Denise Economou trace the emergence of the cancer survivorship movement through private and federal agency reports and advocacy and service-based programs.

People living with cancer may experience nerve pain often described as tingling, burning, or numbness. Problems with coordination also may be present. These symptoms may be associated with a peripheral neuropathy. In this condition, nerves outside the brain and spinal cord have been damaged, often by the cancer treatments themselves.

Drug is a kinase inhibitor that blocks the action of mTOR (mammalian target of rapamycin). mTOR plays an important role in regulating key cellular functions, such as cell proliferation, survival, movement, and angiogenesis. It is part of the P13K (phosphoinositide 3-kinase)/Akt (protein kinase) signaling pathway which is often mutated in cancer. When mTOR is blocked, this leads to cell cycle arrest in the G1 phase of the cell cycle.

Increasing attention is now being focused on cancer care as a continuum with expectations for the development and evaluation of a seamless set of medical, psychosocial, and spiritual services that flow from diagnosis through survivorship and end of life care.

Cisplatin is effective in treating several types of childhood cancers (eg, CNS tumors, osteosarcoma, hepatoblastoma, neuroblastoma, germ cell tumors). It is the most ototoxic drug used clinically, and hearing loss is a well-recognized toxicity of cisplatin therapy.

Palliative care is an integral part of comprehensive cancer care. Every oncology nurse, regardless of specialty, integrates elements of palliative care into daily practice-whether meeting a newly diagnosed patient for the first time or helping a patient and family through the final phase of life.

The three words “You’ve got cancer” can change someone’s life. After being diagnosed with cancer, questions arise: Can it be cured? Why me? Am I going to die? Luckily, as advances have been made in the treatment of cancer, the diagnosis of cancer is not necessarily a terminal one. In fact, many cancers, such as breast or colon cancer, when detected early enough, are curable, and treatment advances have resulted in long-term survivorship across many cancers.

The patient, DB, is a 47-year-old woman who has been married 24 years. Her daughter is away at college and her son is a high school senior. Last summer, DB was diagnosed with invasive ductal carcinoma of the breast. She had one positive lymph node with an estrogen receptor/progesterone receptor strongly positive tumor.

Current US statistics on cancer reveal that more than 11 million cancer survivors live among us today, and that number is expected to double by 2050.[1,2] One important contributing trend has been a fall in cancer deaths driven by earlier detection and improved treatment. Deaths resulting from cancer declined from 206.7 per 100,000 population in 1980 to 185.7 per 100,000 in 2004. Meanwhile, the adjusted 5-year survival rate for cancers overall increased from 50% to 66% between 1975–1977 and 1996–2003,[3] and these statistics speak only to relatively short-term survival. About 1 in every 7 survivors today received their diagnosis more than 20 years ago.[4]

The patient, KC, is a 41-year-old Caucasian female. She has been married to SC for 16 years and has three children, aged 14, 11, and 9 years old. She has always been a homemaker with plenty of energy and says that she has been “the rock” during any crisis. KC was diagnosed with T2N1M0 poorly differentiated invasive ductal carcinoma of the breast with lobular features in 2007. She decided to have a mastectomy without immediate reconstruction because she did not know if reconstruction was what she wanted. She has also undergone four courses of chemotherapy (doxorubicin [Adriamycin] and paclitaxel [Taxol]) followed by radiation therapy.