ONCOLOGY Nurse Edition Vol 23 No 8

Melanoma continues to be a poorly understood and frequently under-recognized cancer threat to society. The authors have provided a comprehensive overview of this malignancy from diagnosis to advanced-stage therapy.

Melanoma affects persons of all ages, causing more years of lost life than any other cancer except leukemia.[1] The American Cancer Society estimates that about 68,720 new melanomas will be diagnosed in the US in 2009, with more than 8,650 deaths, and an estimated lifetime risk of 1 in 50 for whites, 1 in 200 for Hispanics, and 1 in 1,000 for blacks.[2]

While many oncology nurses have heard of survivor care plans, their details remain obscure. Ms. Houlihan has presented an excellent composite overview of what survivor care plans entail and the barriers limiting their use.

Once-daily oral inhibitor of mTOR (mammalian target of rapamycin) for the treatment of patients with advanced renal cell carcinoma (RCC) after failure of treatment with sunitinib (Sutent) or sorafenib (Nexavar).

Recognition of the growing number of cancer survivors in the United States, combined with a greater awareness of the ongoing physical and psychosocial needs after cancer treatment, has created a groundswell of interest in designing quality care initiatives for cancer survivors.

Formal recommendations for the support and management of cancer patients who are transitioning from active treatment to long-term follow-up are fairly recent, documented notably in the 2006 Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition.

Living life to the fullest is an essential goal for everyone, and cancer survivors deserve no less. Almost 12 million cancer survivors in the US today are living longer and experiencing the long-term consequences of their disease and its treatments. Nurses will be providing much of the care that these survivors will require. The quotation cited in the article by Dr. Haylock articulates the problems of survivors living with advanced cancer. The words “I can’t die yet, I still have frequent flier miles”

Oral mucositis (OM), also referred to as stomatitis, can negatively impact radiation and chemotherapy treatment schedules and add to oncology patients’ emotional and physical distress. About 35% to 40% of patients treated with cytotoxic chemotherapy will develop OM, with higher rates occurring in bone marrow transplant patients.

Cancer-related fatigue is a common side effect during cancer treatment, and research demonstrates that it is a troubling, lingering side effect for many long-term survivors. Long-term cancer survivor fatigue is under-reported, underdiagnosed, and undertreated.[1] Studies suggest that the prevalence of fatigue in breast cancer survivors may be as high as 30%,[2] and that fatigue levels are higher in cancer survivors than in healthy controls,[3] even as long as 5 years after treatment.[1]

Robyn was 63 years old when she was diagnosed with Stage III ovarian cancer. After recovering from a total abdominal hysterectomy and oopherectomy, she traveled to a comprehensive cancer center to consult with a physician specializing in ovarian cancer. She took her entire collection of pathology slides and reports, laboratory and imaging study reports, and the summary of her surgical procedure.