Supportive Care

Infusion-Related Reaction Management With Amivantamab for EGFR Exon 20 Insertion Mutation NSCLC: A Practical Guide for Advanced Practitioners

By Lindsay Dougherty, CRNP, DNP, Whitney E. Lewis, PharmD, BCOP, Meghan O’Neill, CRNP, MSN, Amitabha Bhaumik, PhD, Denise D’Andrea, MD, Andy L. Johnson, PhD

Many targeted therapies to treat genetic mutations in non–small cell lung cancer (NSCLC) have been developed. Amivantamab(Rybrevant), a bispecific antibody targeting the epidermal growth factor receptor (EGFR) and mesenchymal-epithelial ...

The Effect of Music Therapy as an Adjunctive Treatment in Pediatric Cancer Patients Receiving Traditional Therapies: A Systematic Review

By Debra M. Cole, EdD, PA-C, DFAAPA, Kaitlin Beane, PA-S, Madeleine Engel, PA-S, Madison Shaffer, PA-S, Sarah Tartabini, PA-S

Aim: This study aimed to analyze articles that discussed the effect of music as adjunctive therapy to traditional treatments of pediatric cancer patients compared to a control of no music therapy. Background: Cancer is a leading cause of...

Intravenous Cetirizine Premedication to Mitigate Infusion-Related Reactions

Timothy Tyler,(1) PharmD, Erik Stojanoff,(2) PharmD, Joan Cannon,(2) PharmD, MBA, Jessie J. Um,(2) PharmD, BCPS, Stacia Young,(2) PharmD, BCOP, MBA, Jarrod P. Holmes,(3) MD, FACP, Lonnie D. Brent,(2) PharmD, and Nancy Martin,(2) MD, PharmD

Infusion-related reactions (IRRs) are a recognized concern for chemotherapy, biologic agents, and newer immunotherapies. Antihistamines are frequently recommended to prevent or manage these reactions. For over 60 years, diphenhydramine h...

‘My Choices, My Wishes’ Program and Its Effect on Chemotherapy at the End of Life and Advance Care Directive Documentation

Jessica Tamar Davis, DNP, AOCNP®, ACHPN

Background: Oncology patients have tremendous symptom burden both physically and emotionally. Palliative care (PC) improves quality of life and prevents suffering. Advance care planning (ACP) empowers patients to articulate goals of thei...

Silent Conversations: Goals of Care and End-of-Life Quality in Relapsed High-Risk Leukemia

Lacy Jo Graham, DNP, APRN-C, Amy Hite, DNP, APRN-C, Jennifer Harris, PhD, FNP-C, and Greg Belcher, PhD

Background: Advanced practice providers (APPs) affect high-quality health care through leadership, evidence-based practice implementation, and quality improvement projects. When planning solutions to clinical problems, leadership must so...

Best Practices in the Management of Infectious Complications for Patients With Cancer: Management of Febrile Neutropenia

Presented by Kyle C. Molina, PharmD, BCIDP, AAVHIP

Managing infection in patients with neutropenia is a difficult challenge, as fever is often the only clinical symptom. At JADPRO Live 2022, Kyle C. Molina, PharmD, BCIDP, AAVHIP, of the University of Colorado Hospital, discussed the epid...

Cancer-Associated Thrombosis: Risk Assessment, Prevention, and Treatment

Presented by Keri Halsema, NP, and Brandon McMahon, MD

The risk of developing venous thromboembolism (VTE) is four to seven times higher in patients with cancer than in those without. At JADPRO Live 2022, presenters discussed risk factors and assessing patients for VTE, as well as how to pro...

Integration of an APP-Led Supportive and Palliative Oncology Care Program: A Quality Improvement Project

Cecilia Motschenbacher, DNP, ARNP, FNP-C, ACHPN, AOCNP®, and Tanya Cohn, PhD, MEd, RN

Patients with advanced cancer have been found to demonstrate severe symptoms and low quality of life at diagnosis; therefore, it is imperative that they have early access to palliative care services along the continuum of care. Oncology ...

Advanced Practice Provider Model for Urgent Oncology Care

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...

Predictors of Nurse Practitioner Prescription of Opioids for Cancer Pain: Quantitative Results

Erin McMenamin,(1,2) PhD, CRNP, Marye Kellermann,(3) PhD, CRNP, FAANP, Regina Cunningham,(1,2) PhD, FAAN, and Janet Selway,(3) DNSc, AGNP-C, CPNP-PC, FAANP

Background: Nurse practitioners (NPs) have assumed a greater role in the management of pain related to cancer. Several studies have associated adequate management of cancer pain with improved survival. Opioids are an essential treatment ...

Advanced Practitioner-Led Shared Visits: A Novel Approach to Cancer Survivorship

Dana McDaniel, DNP, APRN, FNP-C, AOCNP®

Background: The continued increase in the number of cancer survivors is encouraging and credited to better prevention, screening, and treatment. Cancer care authorities call for survivorship follow-up focusing on surveillance, health beh...

Management of Adverse Events in Early Clinical Trials by Advanced Practice Providers in the Outpatient Setting: The University of Texas MD Anderson Cancer Center Experience

Fedricker D. Barber (1), Erick Campbell (1), Yuko Yamamura (1), Clover J. Patterson (1), Audrey C. Hartnett (1), Holly Kinahan (1), Victoria A. Miller (1), Amanda L. Brink (1), Anna Poullard (1), Gabriele E. Urschel (1), Andre Brantley (1), Isabel G. Cepeda (1), Poonam Goswami (1), Sheena Charles (1), Shincy Philip (1), Sara Bresser (1), Sandra Musekiwa-Adjei (1), Nageli Perez (1), Hung Le (1), Penny Phillips (2), Vivek Subbiah (1), Funda Meric-Bernstam (1,3,4), and Ecaterina E. Dumbrava (1)

Background: Advanced practice providers (APPs) play important roles in enrolling, educating, and caring for patients in clinical trials. However, much remains unknown about the role of APPs in managing adverse events (AEs) in early (phas...

Evaluation of Emergency Department Visits by Oncology Patients: A Running Comparison to Admissions and ED Visits Under the CMS OP-35 Ruling

Nada Alsuhebany,(1,2,3) BSPharm, PharmD, BCOP, Jamie Brown,(4) PharmD, MBA, Jacquelyne Echave,(5) and Ali McBride,(5) PharmD, MS, BCPS

Background: Cancer is the second leading cause of death in the United States. The incidence of emergency department (ED) visits by oncology patients has grown over the past years. Some ED visits are medically unnecessary and could be pre...

Implementing a Clinical Decision Tool to Improve Oncologic Venous Thromboembolism Management

Jibran Majeed,(1,2) DNP, ACNP-BC, CCRN, Barbara S. Turner,(1) PhD, RN, FAAN, Deirdre Kelly,(2) ACNP-BC, Chester Poon,(2) Julie A. Thompson,(1) PhD, John Barrett,(3) DNP, FNP-BC, AGACNP-BC, and Gerald A. Soff,(4) MD

Background: Cancer patients with venous thromboembolic (VTE) disease are complex, and many factors must be considered when initiating anticoagulation management. Clinical decision support systems can aid in decision-making by utilizing g...

Mental Health in the Oncology Setting: General Considerations and Treatment Tips

Lisa W. Goldstone, MS, PharmD, BCPS, BCPP

Patients with comorbid mental health and substance use disorders are at greater risk for mortality and have higher cancer care costs. At JADPRO Live Virtual 2021, Lisa W. Goldstone, MS, PharmD, BCPS, BCPP, talked through general consider...

Direct Oral Anticoagulants and Cancer Thrombosis: What APs Need to Know

Mailey L. Wilks, DNP, APRN, NP-C

Patients with cancer are at high risk for developing cancer-associated blood clots. Mailey L. Wilks, DNP, APRN, NP-C, led a session at JADPRO Live Virtual 2021 on the risk of venous thromboembolism in patients with cancer, available anti...

Survivorship Care Challenges: Navigating Changing Concerns

Carrie Tompkins Stricker, PhD, RN, ANP-BC

Advanced practitioners are often in charge of planning and implementing care for cancer survivors, as noted by Carrie Tompkins Stricker, PhD, RN, ANP-BC, during JADPRO Live Virtual 2021. During a session at the conference, Dr. Stricker r...

Herbal Medicine: Friend or Foe?

Roberta Bourgon, ND

Many cancer patients report the use of supplements and herbal medicines but may not always disclose their use to their health-care team. Along with potential interactions, these therapies may also affect outcomes of treatment. During JAD...

Oncology Urgent Care Clinics: Understanding Utilization and Best Practices

Cara Fleming, AGPCNP-BC, AOCNP®, and Deirdre Kelly, AGACNP-BC

An oncology urgent care clinic can improve patient satisfaction, reduce emergency room visits, and lower health-care costs for patients and facilities. At a session taking place at JADPRO Live Virtual 2021, presenters on the frontlines o...

The Critical Role of Nutrition and Exercise: Optimization in the Patient With Cancer

Paul Wischmeyer, MD, EDIC, FCCM, FASPEN

Undergoing surgery is one of the greatest physical and emotional challenges a patient can face, and doing so without preparation can lead to increased complications and mortality. At JADPRO Live Virtual 2021, Paul Wischmeyer, MD, EDIC, F...

The 4 T’s of ITP: Tailoring Therapies to Treat Thrombocytopenia

David Hughes, PharmD, BCOP

Immune thrombocytopenia (ITP) is an acquired autoimmune bleeding disorder characterized by the destruction of platelets and megakaryocytes. Its management has changed significantly in recent years, and at JADPRO Live Virtual 2021, David ...

Impact of Music on Postoperative Pain, Anxiety, and Narcotic Use After Robotic Prostatectomy: A Randomized Controlled Trial

Kirtishri Mishra, MD, Erin Jesse, MD, Laura Bukavina, MD, MPH, Emily Sopko, APRN, CNP, Itunu Arojo, MD, Austin Fernstrum, MD, Al Ray III, MD, Amr Mahran, MD, MS, Adam Calaway, MD, Seneca Block, MA, MT-BC, and Lee Ponsky, MD

Background: Music is a safe and cost-effective intervention that can reduce postoperative pain and anxiety. We investigated the effects of music therapy on postoperative recovery in patients undergoing robotic-assisted laparoscopic prost...

Shared Decision-Making in Managing Breakthrough Cancer Pain in Patients With Advanced Cancer

Jeannine M. Brant,(1) PhD, APRN, AOCN®, FAAN, Debra Wujcik,(2) PhD, RN, FAAN, William N. Dudley,(3) PhD, Alison Petok,(4) MSW, LSW, Brooke Worster,(4) MD, Diane Jones,(1) MSN, NP, Kim Bosket,(1) RN, BSN, OCN®, Christian Brady,(1) MSN, AGNP, APRN, and Carrie Tompkins Stricker,(4) PhD, RN, ANP-BC

Background: Pain is a significant problem in patients with cancer. Breakthrough cancer pain contributes to the pain experience, but it is often underassessed and underrecognized. Shared decision-making (SDM), where patient preferences, g...

Premedications for Cancer Therapies: A Primer for the Hematology/Oncology Provider

Amber Clemmons,(1,2) PharmD, BCOP, Arpita Gandhi,(3) PharmD, BCOP, Andrea Clarke,(2) PharmD, Sarah Jimenez,(2) APN-BC, AGACNP, AOCNP®, Thuy Le,(2) MD, and Germame Ajebo,(2) MD

Chemotherapeutic agents and radiation therapy are associated with numerous potential adverse events (AEs). Many of these common AEs, namely chemotherapy- or radiation-induced nausea and vomiting, hypersensitivity reactions, and edema, ca...

Addiction in Patients With Cancer: Challenges and Opportunities

Gretchen A. McNally, PhD, ANP-BC, AOCNP®, and Ashley Sica, MSN, RN, CNL

Addiction is complex and multifactorial. Recognition provides the opportunity to provide potentially life-saving treatment. Oncology patients are not excluded from substance use disorders (SUDs) and the opioid epidemic. Patients with cur...

Issues in Oncology: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Josh Epworth, ARNP

Josh Epworth, ARNP, of University of Washington Medical Center, considers the findings of three important abstracts from the 2021 ASCO Annual Meeting and reflects on how advanced practitioners can improve access and care for their patien...

Pegfilgrastim Biosimilars: Where Are We Now?

Christopher Selby,(1) PharmD, BCOP, Breanne Peyton-Thomas,(2) PharmD, BCOP, and Parnian Eslami,(3) PharmD

In 1991, the U.S. Food & Drug Administration (FDA) approved rmetHuG-CSF for human use. This recombinant methionyl human granulocyte colony-stimulating factor, or filgrastim, saw use in over 1 million patients in its first 5 years on ...

Early Palliative Care for Oncology Patients: How APRNs Can Take the Lead

Heidi Mason,(1,2) DNP, ACNP-BC, Mary Beth DeRubeis,(2) MSN, FNP-BC, and Beth Hesseltine,(2) MSN, FNP-C

Background: Patients with cancer need expert and multidisciplinary care throughout the trajectory of their illness. Palliative care should be instituted early in the course of their disease. Early palliative care enables patients and the...

Management of Hematologic Adverse Events Associated With Immune Checkpoint Inhibitors

Barbara Barnes Rogers, CRNP, MN, AOCN®, ANP-BC, Carolyn Zawislak, MPAS, PA-C, and Victoria Wong, PA-C

Immune checkpoint inhibitors target suppressor receptors, including cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4), programmed cell death protein 1 (PD-1), and programmed cell death ligand 1 (PD-L1). The activated T cells are not a...

Ginseng for the Management of Cancer-Related Fatigue: An Integrative Review

Emily A. Lemke, DNP, AGPCNP-BC, AOCNP®

Background: Cancer-related fatigue (CRF) is one of the most prevalent, debilitating symptoms affecting a majority of patients with cancer worldwide. It can lead to poor compliance with anticancer therapy and discontinuation of treatment....

Patients’ Communication Preferences Around Cancer Symptom Reporting During Cancer Treatment: A Phenomenological Study

Sharyn Carrasco, PhD, RN

Background: The purpose of this descriptive phenomenological study was to gain an in-depth understanding of cancer patients’ experiences and perspectives on self-reporting their symptoms. Patients with cancer experience a wide variety of...

Palliative Integration Into Ambulatory Oncology: An Advance Care Planning Quality Improvement Project

Amanda Hudson Lucas,(1) DNP, RN, ACNS-BC, ACHPN, and Amy Dimmer,(2) DNP, RN, ACCNS-AG

Advance care planning (ACP) is essential to ensuring that patient-centered end-of-life goals are respected if a health crisis occurs. Advanced practitioner barriers to ACP include insufficient time and limited confidence in discussions. ...

Sticky Issues: What APs Need to Know About Anticoagulants and Patients With Cancer

Presented by Val R. Adams, PharmD, FCCP, FHOPA, BCOP

During the JADPRO Live Virtual 2020 conference, Val R. Adams, PharmD, FCCP, FHOPA, BCOP, discussed how to determine which patients with cancer should be treated with direct oral anticoagulants (DOACs), the similarities and differences be...

Approach to the Hospitalized Patient With Thrombocytopenia

Presented by Laura J. Zitella, MS, RN, ACNP-BC, AOCN®

During the 2020 JADPRO Live Virtual conference, Laura J. Zitella, MS, RN, ACNP-BC, AOCN®, educated the audience on the most important causes of thrombocytopenia in hospitalized patients and diagnostic approaches to employ. 

Immune Checkpoint Inhibitors: Common Questions About Uncommon Adverse Events

Presented by Lisa Kottschade, APRN, MSN, CNP

At JADPRO Live Virtual 2020, Lisa Kottschade, APRN, MSN, CNP, highlighted considerations for advanced practitioners on the recognition and monitoring of rare and life-threatening immune-related adverse events (irAEs), as well as strategi...

Management of Diabetes in the Patient With Cancer

Presented by Lorena A. Wright, MD, FACE

During JADPRO Live Virtual 2020, Lorena A. Wright, MD, FACE, reviewed the principles of antihyperglycemic management and discussed the importance of working as a team to collaborate in the management of patients with cancer.

Patient-Reported Outcome Measures With Secondary Lower Limb Lymphedemas: A Systematic Review

Margit Eidenberger, PT Mag

Background: Patient-reported outcome measures are measures of patients’ health-related quality of life. They should be added to other lymphedema measurements. With an improved disease-free survival of secondary lower limb lymphedema, att...

Exploring the Use of Medical Marijuana for Supportive Care of Oncology Patients

Deena Damsky Dell,(1) MSN, APRN, AOCN®, LNC, and Daniel P. Stein,(2) MD

Medical marijuana, also known as cannabis, is being sought by patients and survivors to alleviate common symptoms of cancer and its treatments that affect their quality of life. The National Academy of Sciences (2017) reports conclusive ...

Integration of Palliative Care in the Role of the Oncology Advanced Practice Nurse

Betty R. Ferrell,(1) RN, PhD, MA, FAAN, FPCN, CHPN, Rose Virani,(1) RNC, MHA, FPCN, Elinor Han,(1) BA, and Polly Mazanec,(2) PhD, ACNP-BC, AOCN®, FPCN, FAAN

Numerous organizations have cited the increasing demand for palliative care in oncology and the challenge of a limited workforce to deliver specialty palliative care. Advanced practitioners in oncology can provide generalist or primary p...

An Evaluation of the Use of Corticosteroids for the Management of Immune-Mediated Adverse Events in Cancer Patients Treated With Immune Checkpoint Inhibitors

Adrian Tsui,(1) PharmD, Lindsay Edmondson,(2) PharmD, BCOP, Justin Julius,(3) PharmD

Immune checkpoint inhibitors (ICIs) have gained prominence for the treatment of a variety of malignancies. However, they are associated with the development of immune-mediated adverse events (IMAEs). Appropriate management of IMAEs and s...

Advance Care Planning and End-Of-Life Communications: Practical Tips for Oncology Advanced Practitioners

Poonam Goswami, DNP, FNP-C, AOCNP®

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...

Can You Diagnose the Cause of This Patient’s Diarrhea?

Allison Trail, PA-C

This article will review the case of a 53-year-old female with a diagnosis of metastatic esophageal cancer receiving treatment on a clinical trial protocol combining chemotherapy/immunotherapy with FOLFOX and nivolumab, who presents to t...

Using a Quality Improvement Model to Implement Distress Screening in a Community Cancer Setting

Nancy Jo Bush,(1) DNP, RN, MA, AOCN®, FAAN, Joy R. Goebel,(2) RN, PhD, FPCN, Kholoud Hardan-Khalil,(2) PhD, RN, and Kayo Matsumoto,(3) MS, MFT

Background: Quality cancer care includes routine screening for psychosocial distress. This quality improvement project focused on the implementation of distress screening at a licensed affiliate of Cancer Support Community, a community-b...

The Impact of Peripheral Cooling on Chemotherapy-Induced Peripheral Neuropathy: An Integrative Review

Bethany G. Sphar, MSN, APRN, FNP-C, AOCNP®, Christi Bowe, DNP, APRN, ANP-C, NPD-BC, CPHQ, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent, potentially long-lasting side effect of select chemotherapies. It contributes to suboptimal chemotherapy dosing, and its symptoms negatively impact patients’ quality of li...

Utilizing a Palliative Care Screening Tool in Patients With Glioblastoma

Jung Young Kim,(1) DNP, APRN, ANP, Katherine B. Peters,(1) MD, PhD, FAAN, James E. Herndon II,(2) PhD, and Mary Lou Affronti,(1) DNP, RN, MHSc, ANP

Patients with glioblastoma have poor overall survival and experience significant burden from neurologic decline and adverse treatment effects. Despite the well-known benefits of early palliative care integration with oncology care, utili...

Nutritional Risk in Cancer Patients 65 and Older Undergoing Systemic Phase I Treatment

Anna Cathy Williams, RN, PhD, PHN, Ed

Malnutrition is common in cancer patients and recognized as an important component of adverse outcomes, including increased morbidity, mortality, and decreased quality of life (QOL). Quality of life is an overarching term for quality of ...

Nausea and Vomiting Not Related to Cancer Therapy: Intractable Problem or Clinical Challenge?

Rita J. Wickham, PhD, RN

Purpose: Unlike therapy-related nausea and vomiting (chemotherapy or radiotherapy induced), nausea and vomiting (N/V) in patients with advanced cancer is often multicausal and thus presents unique challenges. Few professional guidelines ...

Risk Factors for Ifosfamide-Related Encephalopathy in Adult Cancer Patients: An Integrative Review

Amanda Lee Brink, DNP, APRN, FNP-BC, AOCNP®, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Patients receiving ifosfamide as part of their cancer treatment are at risk for ifosfamide-related encephalopathy (IRE), a potentially serious adverse event affecting up to 60% of patients. Symptoms range from transient altered mental st...

An Advanced Practice Provider Initiative for Delirium Management in the ICU

Sarah Rebal, MS, RN, ACNP-BC, Caroline Shirzadi, MS, RN, ACNP-BC, Jennifer Agatep, Ms, RN, AGACNP, Konstantina Matsoukas, MLIS, Kay See Tan, PhD, Kenneth Seier, MS, Yesne Alici, MD, Beatriz Korc-Grodzicki, MD, PhD, and Louis Voigt, MD

Delirium is the most common neuropsychiatric challenge in cancer patients, particularly in the critically ill population. Without a screening method and constant vigilance by providers, delirium is often misdiagnosed. The purpose of our ...

Timely Assessment and Management of Febrile Neutropenia

Pamela Hallquist Viale, RN, MS, CNS, ANP

The Integration of Survivorship Care Planning at a Comprehensive Cancer Center

Elizabeth B. McGrath, DNP, APRN, AGACNP-BC, AOCNP®, ACHPN, Anna Schaal, MSN, APRN, and Claire Pace, MSN, APRN

Abstract Research has demonstrated that cancer survivors who receive a survivorship care plan (SCP) have better coordinated follow-up care, higher overall satisfaction, and report significantly fewer posttreatment emotional concerns. Th...

Improvements in Advance Care Planning Can Translate to Patient Comfort

Pamela Hallquist Viale, RN, MS, CNS, ANP

Treating Venous Thrombosis in Oncology

Presented by Rowena Schwartz, PharmD, BCOP

According to Rowena Schwartz, PharmD, BCOP, it is important to consider broad treatment options, both direct oral anticoagulants and older agents such as heparin, when treating patients with venous thromboembolism, as the newer agents ma...

Scalp Cooling: A Patient’s Experience

Lynn Weatherby, RN, BSN, OCN®, and Lynne Brophy, MSN, RN-BC, APRN-CNS, AOCN®

Case Study Ms. X is a 23-year-old female who presented to clinic with stage 2A endometrial cancer of the ovary. At her first visit, Ms. X was prescribed paclitaxel and carboplatin on day 1 for 6 cycles. During the visit, the nurse noted...

Use of the Distress Thermometer in Clinical Practice

Kristin K. Ownby, PhD, RN, ACHPN, AOCN®, ANP-BC

Distress is experienced by many cancer patients, adversely affecting quality of life and cancer care. Although it is often manageable, it remains woefully underidentified and underreported. Distress can occur anytime during the cancer ex...

Fitness and Quality of Life Outcomes of Cancer Survivor Participants in a Community Exercise Program

Rita Musanti, PhD, APN-BC, Ying-Yu Chao, PhD, GNP-BC, and Katelyn Collins, BS, RDN

Abstract Exercise is recommended for cancer survivors, as it mitigates treatment side effects and improves overall wellness. Therefore, survivors attend community-based exercise programs and report positive results, but published evalua...

Methylnaltrexone: Peripherally Acting μ-Opioid Receptor Antagonist

Tanya J. Uritsky, PharmD, BCPS, CPE

Abstract Opioid-induced constipation (OIC) is a common adverse effect associated with opioid therapy, with many patients never developing tolerance to this effect. There are many traditional laxatives available to help patients combat t...

Cognitive Behavioral Therapy for Sleep in Cancer Patients: Research, Techniques, and Individual Considerations

Laura Melton, PhD, ABPP

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...

Development of a Practice Standard for Monitoring Adult Patients Receiving Bone-Modifying Agents at a Community Cancer Center

Anton Nguyen,(1) PharmD, Joseph A. Kalis,(2) PharmD, BCOP, Theresa R. Sutz,(1) PharmD, and Kate D. Jeffers,(2) PharmD, BCOP

Abstract The purpose of this study is to develop a standard for monitoring outpatients starting bone-modifying agents (BMAs) at a community cancer center. The National Comprehensive Cancer Network (NCCN) and American Society of Clinical...

Comprehensive Geriatric Assessment in Oncology: Best Practices in Caring for Older Patients

Janine Overcash,(1) PhD, GNP-BC, FAANP, Nikki Ford,(2) BA, BSN, RN, OCN®, H. Paige Erdeljac,(2) PharmD, BCACP, Susan Fugett,(2) MSW, LISW-S, OSW-C, Brittany Knauss,(2) PT, DPT, CLT, Elizabeth Kress,(2) CNP, Cari Utendorf,(2) PT, DPT, MBA, CLT-LANA, and Anne Noonan,(3) MD, MB BCh BAO, MSc, MRCPI

Case Study Michele Green received the results of her breast cancer biopsy last week. Before surgery for infiltrating ductal carcinoma to her left breast, Michele was advised to meet with the members of the Senior Adult Oncology Program ...

Assessment of Initial Febrile Neutropenia Management in Hospitalized Cancer Patients at a Community Cancer Center

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...

Diagnostic Snapshot: Acute Edema in the Oncology Patient

Alexandra Trudeau, BSN, BS, RN, CNOR, Danielle Bean, BSN, RN, Donna Fleming, MSN, RN, FNP-C, Glaiza Boado, BSN, RN, Natalia Samuels, MSN, RN, and Reshmi Kurup, BS, RN

Epidermal Growth Factor Receptor Inhibitor Skin Rash Prophylaxis in a Community Oncology Setting

Micah S. Pepper,(1) PharmD, BCPS, and Megan May,(2) PharmD, BCOP

Abstract Epidermal growth factor receptor inhibitors (EGFRIs) can potentially cause a debilitating rash despite use of reactive-based treatment. Prophylactic rash management is a controversial rash-mitigating approach. The impact of a p...

Hypercalcemia of Malignancy

Kaitlin L. Feldenzer,(1) DNP, RN, OCN®, and Jessica Sarno,(2) MSN, ACNP-BC, AOCNP®

Abstract Hypercalcemia of malignancy (HCM) is a common concern in patients being treated for cancer, affecting over a quarter of this population. There are multiple causes of HCM, including humoral HCM, osteolytic HCM, ectopic hyperpara...

Diagnostic Snapshot: What Caused This Fluid?

Courtney Robb, RN, MS, CRNFA, FNP-C

Obstructive Dysphagia and Positional Dyspnea: Can You Identify the Cause?

Managing Side Effects of Cancer Patients Treated With Immunotherapy

Immunotherapy has proven activity in several types of cancer; however, the mechanisms of action of immunotherapy can cause several different immune-related toxicities. Advanced practitioners are in a unique position to recognize the timi...

Chemotherapy-Induced Nausea and Vomiting: Updates and Recommendations

Addressing the Symptom Management Gap in Patients With Cancer and Heart Failure Using the Interactive Voice Response System: A Pilot Study

Abstract Patients with cancer and concurrent heart failure (HF) have severe symptoms that may adversely affect patients’ quality of life in addition to limiting effective anticancer therapy. A system of frequent monitoring could alert c...

Paraneoplastic Encephalopathy in a Patient With Metastatic Lung Cancer: A Case Study

Case Study RS, a 36-year-old female, presented to the emergency department (ED) of a large academic medical center upon the advice of her primary care provider because of 3 weeks of progressive mental status changes, weakness, and decre...

Diagnostic Snapshot: "I Have a Bad Cold"

Psychosocial Distress as a Factor in Patients With Cancer Seeking Support: A Hermeneutic Study

As the incidence of new cases of cancer increases every year, breaking bad news to patients is very important. The purpose of our study was to explore the lived experiences of Iranian cancer patients about hearing such bad news. This qua...

Atypical Femoral Fractures: Implications for the Advanced Practitioner in Oncology

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...

Best Practices in the Management of Infectious Complications for Patients With Cancer

As antibiotic resistant bacteria are becoming ubiquitous, managing infection becomes more complex. Optimizing preventive measures, early diagnosis, and management of infection is of the highest priority in cancer care.

Management of Patients With Chemotherapy-Induced Nausea and Vomiting

Despite advances in the management of chemotherapy-induced nausea and vomiting (CINV), clinical management remains a challenge and CINV continues to be a side effect that patients fear most. Advanced practitioners can play a major role i...

Managing Constipation in Adults With Cancer

Abstract Constipation is common in individuals with cancer, occurring in almost 60% of patients overall. The incidence increases in patients with advanced disease, particularly in those receiving opioid analgesics or medications with an...

Brief Introduction to Cognitive Behavioral Therapy for the Advanced Practitioner in Oncology

Management Strategies for Adverse Events Associated With EGFR TKIs in Non–Small Cell Lung Cancer

Abstract New advances in the treatment of non–small cell lung cancer (NSCLC) have afforded patients longer progression-free survival times, but these therapies are also associated with specific side effects that may not be seen with che...

Assessment of Constipation in Patients With Cancer

Management of Dermatologic Toxicities Associated With Targeted Therapy

Management of Weight Loss in People With Cancer

The Role of Exercise and Rehabilitation in the Cancer Care Plan

Incorporating a Survivorship Clinic Into Practice

A Case-Based Look at Healthy Weight Loss for Survivors of Cancer

Patients with cancer are generally encouraged to prevent weight loss during their active treatment phase. Yet when a patient completes active treatment and transitions into survivorship, weight loss may be needed. Although it is ideal fo...

Late Effects: Focus on Adolescent and Young Adult Cancer Survivors

Clinically Relevant Four-Level Cancer-Related Fatigue Among Patients With Various Types of Cancer

The purpose of this study was to identify the association between clinically relevant four-level cancer-related fatigue (CRF) and quality of life (QOL). This secondary data analysis included 152 participants who completed both the 0 to 1...

The First Oral Fixed-Dose Combination of Netupitant and Palonosetron for the Treatment of Chemotherapy-Induced Nausea and Vomiting

Swelling and Erythema of the Lower Extremities

Cancer Pain Management: Opioid Analgesics, Part 2

Opioid analgesics are the cornerstone of moderate to severe cancer pain management, and do not have ceiling doses unless unmanageable adverse effects occur. Oral, short-acting pure μ agonists such as morphine are most frequently used, bu...

Cancer Pain Management: Comprehensive Assessment and Nonopioid Analgesics, Part 1

Pain is still undertreated and thus a significant problem for at least half of all cancer patients. Inadequately managed cancer pain may cause significant morbidity and even affect mortality, as well as patient quality of life. One endur...

The Passage of CARA: Implications for Patients With Cancer Pain

Assessing the Plain Language Planner for Communication About Common Palliative Care Medications

Using plain language to communicate about oncology and palliative care medications and symptoms is recommended as a communication strategy to address patient/family health literacy demands. This study tested the Plain Language Planner©, ...

Palliative Chemotherapy: Does It Only Provide False Hope? The Role of Palliative Care in a Young Patient With Newly Diagnosed Metastatic Adenocarcinoma

Case Study A 48-year-old female with recent diagnosis of adenocarcinoma of unknown origin and metastatic disease to the peritoneum initially presented to a nearby academic hospital with abdominal pain. She underwent exploratory laparoto...

Nurse Communication About Goals of Care

Abstract Conversations about goals of care with the patient and family are a critical component of advanced practice in oncology. However, there are often inadequate team structures, training, or resources available to assist advanced p...

Providing Intensive Palliative Care on an Inpatient Unit: A Full-Time Job