Current Issue

VOL 9 • NO 5 JUL/AUG 2018

The cover illustration of this issue depicts osteoclasts stimulated by malignant tumors secreting parathyroid hormone–related protein. Increased activity in bone resorption leads to the release of calcium in the bloodstream. Artwork by Alexandra Webber Baker, ©2018, DNA Illustrations, Inc., Asheville, North Carolina.


Do the Right Study: Quality Improvement Projects and Human Subject Research—Both Valuable, Simply Different

Theresa Wicklin Gillespie, PhD, MA, RN

Human subject research (i.e., research) has been traditionally defined in the literature and by institutional review boards (IRBs) as a systematic approach to answering a question that is hypothesis driven, or hypothesis generating, and leading to generalizable knowledge (Shirey et al., 2011). Th...

Original Research

Development of a Professional Practice Model for Neuro-oncology Advanced Practitioners at an Academic Medical Center: A Quality Improvement Project

Christina K. Cone,(1) DNP, APRN, ANP, AOCNP®, and Mary Lou Affronti,(2) DNP, RN, MHSc, ANP

Neuro-oncology is a subspecialty that involves the neurological, medical, surgical, and oncologic management of primary central and peripheral nervous system neoplasms. Neuro-oncology practice manages the neurologic complications that result directly from the disease and provides symptom manageme...

Original Research

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

Epidermal growth factor receptor inhibitors (EGFRIs) are effective agents for the treatment of a variety of cancers (e.g., breast, lung, head and neck, and colorectal) due to the overexpression of EGFR in these malignancies. Although normally EGF is responsible for the maintenance of skin health,...

Review Article

Hypercalcemia of Malignancy

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

Hypercalcemia of malignancy (HCM) has long been recognized as a common paraneoplastic syndrome associated with poor prognosis in cancer patients. It is estimated that HCM affects roughly 30% of patients with cancer, with many studies reporting an even higher incidence in those with advanced stage...

Review Article

Enhanced Recovery After Surgery

Lisa Parks,(1) MS, RN, CNP, Meghan Routt,(2) MSN, ANP/GNP-BC, AOCNP®, and Allison De Villiers,(1) MSN, RN, OCN®, ACNS-BC

There are over 234 million major surgical procedures performed worldwide annually (Feldheiser, et al., 2016). Enhanced recovery after surgery (ERAS) clinical pathways have been developed to improve the quality of perioperative care with the goal of minimizing loss of functional capacity and enhan...

Practice Matters

A Nurse Practitioner’s Experience in the Development and Implementation of a Lung Cancer Screening Program

Aimee Strong, MSN, AGACNP-BC

Lung cancer is the second most common cancer in men and women and the leading cause of cancer-related deaths. Each year, more people die from lung cancer than breast, colon, and prostate cancers combined (American Cancer Society, 2018). The American Cancer Society estimated that for 2018 there wi...

Prescriber's Corner

Subcutaneous Rituximab in Follicular Lymphoma, Chronic Lymphocytic Leukemia, and Diffuse Large B-Cell Lymphoma

Bradley J. Yelvington, PharmD

Rituximab is a humanized monoclonal antibody targeting the CD20 transmembrane protein found on B-cells. Although the mechanism of action is not completely understood, this agent exhibits antitumor effects via direct drug-mediated signaling, complement-dependent cytotoxicity, and antibody-dependen...

Prescriber's Corner

Tisagenlecleucel: The First CAR on the Highway to Remission for Acute Lymphoblastic Leukemia

Craig W. Freyer, PharmD, BCOP

Acute lymphoblastic leukemia (ALL) is an aggressive hematologic malignancy characterized by blood and bone marrow infiltration by malignant lymphoblasts. In 2018, 5,960 people are estimated to be diagnosed with ALL, and 1,470 deaths are anticipated (American Cancer Society, 2018). Acute lymphobla...

Tools and Technology

Presenting With Confidence

Wendy H. Vogel, MSN, FNP, AOCNP®, and Pamela Hallquist Viale, RN, MS, CNS, ANP

As an advanced practitioner, it is likely that you will be asked to deliver a lecture at some point in your career. Medical presentations can range from casual in-services to professional lectures given to audiences of thousands. Since public speaking is listed as one of the top fears of individu...

Diagnostic Snapshot

Diagnostic Snapshot: What Caused This Fluid?

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

History Mrs. C is a 58-year-old Caucasian female with a history of bilateral pleural effusions in 2012 after strenuous exercise. In 2014, a thoracentesis that ruled out cancer with unknown cause was performed on the fluid. Her pulmonologist referred her to an oncologist for closer observation and...



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