Steven Sorscher,(1) MD, and Alisha T. DeTroye,(2) MMS, PA-C, DFAAPA
Once an individual has been identified as a carrier of an inherited cancer-predisposing gene or pathogenic germline variant (PGV), there are measures that have been proven to prevent and diagnose the associated cancers at an earlier, mor...
Anna Poullard, DNP, MSN, APRN-BC, and Sheena Charles, MS, FNP-BC
The primary objectives of early phase clinical trials are to determine the safety, tolerability, and recommended doses of an investigational agent for patients with advanced cancer. Although these advances in cancer treatment have result...
Shannon Holloway, PA-C, Kelly McConn, Pa-C, Roy Borchardt, PA-C, PhD, Victor E. Mulanovich, MD, and Javier A. Adachi, MD
Burnout among health-care workers is highly prevalent and profoundly impacts the quality of patient care. In addition to affecting patient safety, burnout results in higher staff turnover, revenue deficits due to decreased productivity, ...
Lisa K. Lohr, PharmD, Kimball T. Blake, BS, Cindy M. Chan, BS, Sabrina Sturm, PharmD, and Gavyn T. Walsh, BA
The use of oral anticancer treatments is widespread and vital to modern cancer treatment. Novel oral chemotherapy and targeted therapy treatments continue to receive US Food and Drug Administration approval every year, making knowledge o...
Mallika P. Patel, PharmD, CPP, Sally Y. Barbour, PharmD, BCOP, CPP, FHOPA, and Meredith T. Moorman, PharmD, BCOP, CPP
A review of the published literature confirms the challenge in quantifying the value of oncology pharmacists. This editorial expands on a 2020 study by Meleis and colleagues published in the Journal of the Advanced Practitioner in Oncolo...
Marie Iannelli, MSN, CRNP, Alexis Brimm-Akins, MSN, CRNP, Anessa M. Foxwell, MSN, CRNP ACHPN, Beth Sandy, MSN, CRNP, Krista Winalski, BSN, RN, OCN®, Kara Gatto, BSN, RN, Suzanne McGettigan, MSN, CRNP, AOCN®, and Carolyn Grande, MSN, CRNP, AOCNP®
Inherent to the cancer disease trajectory are heightened risks for a plethora of comorbid diagnoses. As the treatment landscape for oncology therapeutics continues to rapidly advance, patients are living longer and potentially experienci...
With the aging population and increasing number of cancer survivors contributing to a projected provider shortage, one solution is the specialization of nurse practitioners and physician assistants (part of the advanced practice provider...
Katharine Lord,(1) PA-C, Sara Toth,(2) APRN, FNP-C, AOCNP®, AGN-BC, Jennifer Potter,(3) PA-C, Katherine Sellers,(4) PA-C, Monica White,(5) APRN, CNS-AH, ACNP-BC, AOCNP®, Anne Neugent,(4) APRN, FNP-C, and Tracy Martin,(4) APRN, ANP-C, AOCNP®, BMTCN, NursEd
Bone marrow procedures are a common diagnostic tool utilized in hematology/oncology and can be completed in the office by trained clinicians. Currently, there are limited guidelines for appropriate training and competency for bone marrow...
Richter transformation (RT) is the development of high-grade lymphoma in patients with B-cell chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). CLL/SLL is a heterogenous disease with a highly variable clinical cour...
Oncology patients are at greater risk of morbidity and mortality from coronavirus disease 2019 (COVID-19) infection than the general population. Patients with malignancies were prioritized in vaccine distribution to confer protection to ...
Implicit bias (IB) is the involuntary activation of thoughts, feelings, attitudes, or stereotypes that exist outside of conscious awareness. Implicit bias develops early in life and research documents the existence of IB across health-ca...
Meghan Mastrangelo, MSN, AGACNP-BC, Sara Muir, MSHS, PA-C, and Erin Marturano, MBE, MSN, RN
Patients with hematologic malignancies present a unique set of circumstances during the COVID-19 pandemic; they are at increased risk of complications and death from COVID-19 infection, but the treatment of their cancer cannot be delayed...
Megan B. May,(1) PharmD, BCOP, Kate Deen Taucher,(2) PharmD, MHA, BCOP, and Wendy H. Vogel,(3) MSN, FNP, AOCNP®
The development of innovator biologics and now their biosimilars has created some unique challenges in oncology practice. The oncology advanced practitioner (OAP) must understand the key differences between the innovator biologic and bio...
Health care in acute care settings has become increasingly complex and stressful with rapidly evolving treatment options, a growing aging population with multiple comorbidities, and expectations to deliver high-quality care with less res...
Advance care planning discussions ensure patients’ values and goals of care, including the freedom to choose their place of death, are respected. The benefits of advance care planning and early end-of-life care discussions are often dela...
Wendy H. Vogel,(1) MSN, FNP, AOCNP®, Haley Pace,(2) MS, CGC, and Matthew Brignola,(3) PharmD
One in eight American women will be diagnosed with breast cancer. Advanced practitioners in oncology can offer risk assessments, counseling, genetic testing, and make both behavioral and pharmacologic recommendations for breast cancer ri...
Kiersten LeBar,(1) DNP, MMHC, APRN, CPNP-AC, Sarah Murawski,(2) MPAS, PA-C, Sherlyn Umayam,(2) MSN, AGACNP-BC, AOCNP®, and Virginia Quinn,(2) MSN, AGACNP-BC
As the health-care industry continues to be pushed to find new, innovative ways to deliver quality care with an emphasis on enhancing quality of life, the use of advanced practice providers and telemedicine technology are two promising d...
Patients with multiple myeloma are living longer, yet the chronicity of newer treatment modalities has led to increased symptom burden and a notable effect on quality of life (QOL). The assessment of QOL and evaluation of patient-reporte...
Yi L. Hwa,(1) DNP, APRN, CNP, Jessica L. Shelly,(1) MSN, APRN, Darci L. Zblewski,(1) MSN, APRN, Megan T. Spychalla,(1) PA-C, Dawn M. Udenberg,(1) DNP, APRN, Kathryn R. Cieslak,(2) MS, Grzegorz S. Nowakowski,(1) MD, Martha Q. Lacy,(1) MD, and Ariela L. Marshall,(1,3) MD
Advanced practice providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs), are part of a growing cancer care workforce. Current hematology-specific education provided by most graduate NP and PA school educati...
Jenna A. Kramer, ACNP-BC, and Camille Petraitis Valente, DNP, FNP-BC
New graduate advanced practice providers (APPs) who accept jobs within the hematology-oncology field face many challenges when beginning their careers. Specific challenges include a lack of specialty-specific training, expedited orientat...
Mary Heery,(1) APRN, AOCNS®, CBCN, Stephen Farley,(2) PharmD, BCOP, Rhett Sparkman,(2) PharmD, John Healy, BS, Pharmd, William Eighmy,(3) PharmD, George Zahrah,(2) MD, and Richard Zelkowitz,(1) MD
Aromatase inhibitors are the drug of choice for the treatment of estrogen receptor– or progesterone receptor–positive breast cancer in postmenopausal women. Aromatase is an enzyme that catalyzes the final and rate-limiting step in the bi...
It is essential for the advanced practitioner to have an understanding of how fair market value is determined by employers in order to successfully negotiate a compensation package or salary raise. However, because of the compliance and ...
M. Tish Knobf, PhD, RN, AOCN®, FAAN, and Sangchoon Jeon, PhD
Comorbid illness contributes to poorer cancer outcomes and higher mortality. Metabolic syndrome (MetS) includes a cluster of risk factors that are associated with an increased risk of comorbidities. Routine physical activity represents a...
P. Andrew Allred,(1) MS, PA-C, Maura N. Polansky,(2) MS, MHPE, PA-C, Kathryn Doerksen,(3) MSPAS, PA-C, and Steven H. Wei,(4) MS, MPH, PA-C
Advanced practitioners (APs), including physician assistants (PAs) and nurse practitioners (NPs), are medical professionals with advanced training, degrees, and certifications that qualify them to diagnose and treat medical conditions in...
Amy Hacker-Prietz, PA-C, Eden Stotsky-Himelfarb, BSN, RN, Beth Kozak Onners, RN, MS, CCRN, OCN®, and Janet Street
A cancer diagnosis not only affects multiple aspects of a patient’s life, but can also have a significant impact on the caregiver, who is often the spouse as well. Beginning in 2012, the Johns Hopkins Gastrointestinal Oncology group has ...
Abstract
This article reviews cognitive behavioral therapy techniques for sleep in the cancer realm. There are unique factors associated with cancer that can exacerbate sleep issues. Stimulus control, sleep restriction, relaxation, para...
Abstract
Allogeneic hematopoietic stem cell transplant (HSCT) has emerged as a unique treatment modality. Patients who receive an allogeneic HSCT report feeling inadequately equipped to manage their postdischarge plan of care. It is ess...
Chelsea Goldsmith,(1) PharmD, Joseph Kalis,(2) PharmD, BCOP, and Kate D. Jeffers,(2) PharmD, BCOP
Abstract
Fever may be the only sign of an underlying infection in neutropenic cancer patients. Unrecognized fever and untreated infections can lead to progressive sepsis and possibly death. The importance of early recognition, timely an...
Abstract
Lung cancer screening with low-dose computed tomography of the chest is now a service covered by the Centers for Medicare and Medicaid Services and most private insurers. However, providers may experience many barriers that cou...
Abstract
The State of Cancer Care in America report shines a spotlight on the significant increase of cancer survivors by 2026. One strategy to help care for the increased number of patients that require ongoing care is to hire more adv...
Abstract
Patients have been surviving cancer diagnoses at a steadily increasing rate over the past few decades. Despite the encouraging decline in cancer morbidity, the cardiovascular effect of some chemotherapy medications is concernin...
Abstract
Historically, hospice has been a poor option for patients with end-stage hematologic malignancies, largely due to the need for regular transfusions to sustain life near the end, and to a lesser extent the treatment of curable e...
Tamoxifen is a lifesaving treatment for millions of breast cancer patients worldwide. Yet taking tamoxifen may be challenging for some patients due to issues of compliance, drug interactions, and surgical considerations. Educating patien...
One of the main challenges within clinical practice today involves attaining the knowledge necessary to treat patients safely and effectively. The explosion of scientific breakthroughs within the health-care setting has created a new cha...
Bone-health issues may arise for oncology patients as a side effect of their treatments. One of these may be the development of an atypical femoral fracture. Advanced practitioners should be aware of the risk factors for atypical femoral...
At the Abramson Cancer Center (ACC) of the University of Pennsylvania, 83% of the MDs collaborate with an advanced practice provider (APP). With the widening gap between the demand for oncology services and providers, it is estimated tha...
For breast cancer survivors, returning for the necessary periodic mammograms and checkups can be emotionally stressful. Read about how one cancer center employed the group appointment model in a breast cancer survivorship clinic.
It is imperative for caregivers of patients who have undergone hematopoietic stem cell transplant to be given the proper resources to take on their new role, yet all too often this is not the case. Read about an intervention that was uni...
Approximately 25% of the nearly 400 anticancer drugs that are currently in development will be available in oral formulations. Yet in many states, while IV medications are reimbursed without substantial out-of-pocket costs to the patient...
Cytochrome P450 (CYP) is a hemeprotein that plays a key role in the metabolism of drugs and other xenobiotics. Understanding the CYP system is essential for advanced practitioners, as the consequences of drug-drug interactions can be pro...
Neoplastic meningitis (NM) needs to remain in the differential diagnosis of any cancer patient with new, particularly multifocal, neurologic symptoms. While a diagnosis of NM carries a poor prognosis, early identification and treatment c...
As Americans age, health-care providers will be faced with new and challenging issues related to the care of older adults. One critical issue unique to the aging population is polypharmacy. Cancer-related medications can add to the compl...
Bortezomib (Velcade) is approved by the FDA for IV or SC injection in select patients with multiple myeloma or mantle cell lymphoma. The SC route functions as an alternative to IV administration for patients with poor IV access. Learn ab...
The dreaded memo came on a Friday afternoon (as dreaded memos often seem to do). It read: “You must sign up for training for the change from Cerner to the Epic System.” Insert any vendor’s name in place of either of these two electronic ...
The growing role of nurse practitioners (NPs) in today’s demanding health-care system has allowed for a more comprehensive and complementary approach to patient care. Within the past few years, NPs have expanded their role to include inv...
Health care as we know it is in trouble. Most people agree that reform is needed (new models of care and more cost-effective care), but who can answer the overwhelming number of questions that come to mind? And how will anyone ever agree...
The management of cirrhosis in conjunction with hepatocellular carcinoma (HCC) can be an overwhelming, time-consuming task. However, close monitoring and detection for early complications from cirrhosis, with appropriate treatment, can s...
Medical imaging relies heavily on the use of ionizing radiation, which is a known carcinogen. Its increasing use, particularly through CT scans, has come under scrutiny due to safety concerns over cumulative radiation exposure. Midlevel ...
The focus of this article is a project that entailed creating and implementing a new policy on early postoperative intraperitoneal (IP) chemotherapy for patients with colorectal cancer (CRC). Colorectal cancer is a systemic malignancy th...
Title IX of the 2007 Food and Drug Administration Amendments Act (FDAAA) authorizes the FDA to require pharmaceutical and biological sponsors to develop and manage a Risk Evaluation and Mitigation Strategy (REMS) program for products wit...
Cancer survivorship is a growing field, and advanced practitioners in both oncology and primary care will likely see an increasing number of cancer survivors in their practices. Despite the numerous recent publications and conferences on...
