Overlapping Toxicities and Long-Term Survivorship Needs

Panelists discuss overlapping toxicities and long-term needs in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC), beginning with osimertinib consolidation after chemoradiation, where cough, dyspnea, fatigue, and esophagitis may predate targeted therapy. The conversation covers differentiating radiation pneumonitis from drug-induced interstitial lung disease using timing, imaging, and the radiation field, alongside infection and early progression, and managing esophagitis through pain, swallowing, hydration, and weight assessment with dietitian support. For central nervous system disease, panelists describe establishing a neurologic baseline with the caregiver present, watching for headache, focal weakness, balance or vision changes, confusion, speech change, and seizure, and providing a written steroid taper patients should not adjust independently while monitoring hyperglycemia, insomnia, mood change, weakness, and infection risk. The discussion closes with survivorship concerns, sexual health referral, listening as the core nursing skill, and building nurse-driven programs in community practice.