Previous Issues

Editorial

Advanced Practitioners as Allies and Advocates

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

Advanced practitioners (APs) are a growing proportion of the health-care team. As of 2019, there were approximately 325,000 nurse practitioners, 7,000 clinical nurse specialists, and nearly 140,000 physician assistants in the United States (American Academy of Nurse Practitioners, 2021; National ...

Editorial

On Becoming an Ally

Josh Epworth, ARNP

Earlier this year, I was asked to participate in a meeting titled “Virtual Summit to Define the Role of Oncology Advanced Practitioners in Equitable Cancer Care Delivery: A Closer Look at Care Coordination, Clinical Trials, and Implicit Bias” held by the Association of Community Cancer Centers (A...

Research and Scholarship

Current Testing Guidelines: A Retrospective Analysis of a Community-Based Hereditary Cancer Program

Margaret Ward,(1) DNP, APRN, AGN-BC, Betty Elder,(2) PhD, RN, and Maryon Habtemariam,(2) DNP, APRN

Approximately 5% to 10% of all cancers can be related to germline pathogenic variants (Marta et al., 2019), although that number is expected to climb as more information on the genetic origin of cancers becomes available. At this time, up to 24% of ovarian cancers (Ring et al., 2017), 10% of panc...

Research and Scholarship

Short- and Long-Term Outcomes of Hematologic Malignancy Patients After Cardiopulmonary Resuscitation: Experience of a Large Oncology Center

Mary Lou Warren, DNP, APRN, CNS-CC, FCCM, Virginia V. Schneider, MPAS, PA-C, Yun Qing, MHS, PhD, Lei Feng, MS, Jeanne Y. Campbell, MPAS, PA-C, Jason W. Myers, ACNP-BC, Marian Von-Maszewski, MD, and Cristina Gutierrez, MD

Cardiopulmonary resuscitation (CPR) can be a life-saving intervention in the right patient population. Up to 209,000 people are treated for in-hospital cardiac arrest (IHCA) each year, with a survival rate to hospital discharge of 24.8% (Benjamin et al., 2019). Although outcomes post IHCA have im...

Review Article

A Study of Advanced Practice Provider Staffing Models and Professional Development Opportunities at National Comprehensive Cancer Network Member Institutions

Annie Austin,(1) Kellyann Jeffries,(2) Diana Krause,(3) Jessica Sugalski,(3) Karen Sharrah,(4) Anne Gross,(5) Danielle Bowers,(5) Daniel Mulkerin,(6) Nancy Brandt,(6) Aaron Begue,(7) Rose Bell,(8) Cheryl Raczyk,(8) Todd Pickard,(9) David Johnson,(10) Vanna Dest,(11) Rory Randall,(12) Gabrielle Zecha,(13) and Kate Kennedy,(1)

There is growing concern that oncologists will soon be in short supply in the US, creating a significant problem for cancer centers across the nation. A 2014 study predicts a shortage of 2,258 medical oncologists and radiation oncologists by 2025. Demand is expected to increase by 40% while clini...

Review Article

Early Detection of Vulvovaginal Graft-Versus-Host Disease: An Integrative Review

Payton L. Ten Hagen, DNP, APRN, FNP-C, Christi Bowe, MSN, APRN, ANP-C, and Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAANP

Hematopoietic stem cell transplantation (HSCT) is a medical procedure used to treat a multitude of conditions, such as malignant, nonmalignant, congenital, and acquired illnesses. Stem cells may be collected from either unrelated (allogeneic) or self (autologous) sources and occurs by way of bone...

Grand Rounds

Addiction in Patients With Cancer: Challenges and Opportunities

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

Case Study Jane Doe is a 28-year-old female diagnosed 3 years ago with nodular sclerosis Hodgkin lymphoma. She completed five cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy; however, she did not return to her original treating oncologist for further care (Figur...

Prescriber's Corner

Sacituzumab Govitecan for Treatment of Refractory Triple-Negative Metastatic Breast Cancer

Patrick J. Fleming Jr., PharmD, BCOP, Sylvia Karpio, PharmD candidate, and Nicholas Lombardo, PharmD candidate

There was an estimated 276,480 new cases of breast cancer in the United States in 2020, making breast cancer the most common cancer in women (Siegel et al., 2020). While the rate of new cases has remained stable over the past decade, there has been a steady decline in the death rate. As women rec...

Diagnostic Snapshot

Persistent Fever While on Broad-Spectrum Antibiotics in a Patient With Squamous Cell Carcinoma

Xin Li, CRNP, AOCNP®

History Mr. AK is a 47-year-old male with past medical history of alcoholism, tobacco abuse, and squamous cell carcinoma of the mandible (pT4N0M0, stage IVA, p16–) diagnosed in January 2020. He was status post hemimandibulectomy, tracheostomy, and bilateral selective neck dissection with fibular ...

Editorial

2021 ASCO Annual Meeting: Takeaways for the Advanced Practitioner

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

Welcome to our special issue on highlights from the 2021 American Society of Clinical Oncology’s (ASCO) Annual Meeting, which was ASCO’s second virtual meeting. Taking place from June 4 to 8, 2021, the ASCO Annual Meeting connected around 42,700 attendees from 138 countries to discuss the latest ...

Meeting Abstract

Disparities and Access to Care: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Amy Pierre, MSN, ANP-BC

Abstract 100: Community-Based Engagement Initiative Improves Accrual of Black Participants in Clinical Trials By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/196644/abstract to read the full abstract and view author disclosures. A 5-year community outreach and engagement effor...

Meeting Report

Breast Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Sheeba Cantanelli, MPAS, PA-C

Abstract LBA1: OlympiA Trial: Adjuvant Olaparib Extends Disease-Free Survival in BRCA-Mutated Early Breast Cancer By Alice Goodman Visit https://meetinglibrary.asco.org/record/196707/abstract to read the full abstract and view author disclosures. Adjuvant therapy with the PARP inhibitor olaparib ...

Meeting Abstract

Thoracic Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC

Abstract 8500: Atezolizumab Reduces Risk of Disease Progression in Patients With PD-L1–Expressing Early-Stage NSCLC By Alice Goodman Visit https://meetinglibrary.asco.org/record/195950/abstract to read the full abstract and view author disclosures. Atezolizumab given after chemotherapy to patient...

Meeting Abstract

Melanoma: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Lisa Kottschade, APRN, MSN, CNP

Abstract 9501: High-Dose Interferon or Ipilimumab vs Pembrolizumab for High-Risk Resected Melanoma By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/195948/abstract to read the full abstract and view author disclosures. Patients with high-risk melanoma who had a course of pembro...

Meeting Abstract

Gastrointestinal Cancers: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Nina N. Grenon, DNP, AGCNP-BC, AOCN®

Abstract LBA4001: Nivolumab Plus Chemotherapy and Nivolumab Plus Ipilimumab as First-Line Treatment for Patients With Advanced Esophageal Cancer By Jo Cavallo Visit https://meetinglibrary.asco.org/record/195919/abstract to read the full abstract and view author disclosures. The first results from...

Meeting Abstract

Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Morgane C. Diven, PharmD, BCOP

Abstract LBA4: VISION Trial: Novel PSMA-Targeted Radiotherapy Improves Outcomes in Metastatic Prostate Cancer By Alice Goodman Visit https://meetinglibrary.asco.org/record/196661/abstract to read the full abstract and view author disclosures. Lutetium-177–PSMA-617 (LuPSMA)—an investigational radi...

Meeting Abstract

Genitourinary (Non-Prostate) Cancers: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Emily Lemke, DNP, AGPCNP-BC, AOCNP®

Abstract LBA5: KEYNOTE-564: Adjuvant Pembrolizumab Extends Disease-Free Survival in High-Risk Renal Cell Carcinoma By Alice Goodman Visit https://meetinglibrary.asco.org/record/196683/abstract to read the full abstract and view author disclosures. Adjuvant pembrolizumab following surgery signific...

Meeting Abstract

Gynecologic Cancers: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Laura Doherty, FNP-BC, AOCNP®

Abstract LBA3: OUTBACK: No Benefit for Adjuvant Chemotherapy in Cervical Cancer By Caroline Helwick Visit https://meetinglibrary.asco.org/record/196619/abstract to read the full abstract and view author disclosures. In women with locally advanced cervical cancer, adjuvant chemotherapy adds no ben...

Meeting Abstract

Other Solid Cancers: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abby Fuoto, DNP, ANP-BC, AOCNP®, ACHPN and Mee-young Lee, MSN, ANP-BC

Abstract LBA2: Novel Monoclonal Antibody Emerges as Potential First-Line Standard in Nasopharyngeal Cancer By Caroline Helwick Visit https://meetinglibrary.asco.org/record/196620/abstract to read the full abstract and view author disclosures. A new first-line standard of care may be emerging for ...

Meeting Abstract

Hematologic Malignancies: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

Amber B. Koehler, PA-C, MS, P. Andrew Allred, MS, PA-C, and Donna Catamero, ANP-BC, OCN®, CCRC

Abstract 7500: First Results of a Head-to-Head Trial of Acalabrutinib vs. Ibrutinib in Previously Treated Chronic Lymphocytic Leukemia By JADPRO Staff Visit https://meetinglibrary.asco.org/record/201554/abstract to read the full abstract and view author disclosures. In the first head-to-head tria...

Meeting Abstract

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

Josh Epworth, ARNP

Abstract 103: Results of a Restrictive Opioid Prescription Protocol for Patients With Cancer Undergoing Surgery By Jo Cavallo Visit https://meetinglibrary.asco.org/record/196633/abstract to read the full abstract and view author disclosures. Seeing an opportunity to safely reduce the number of op...

Editorial

Publish or Perish

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

As a newly hired nurse practitioner with barely a week of experience in the position, I was approached by a physician colleague at the end of a busy morning clinic. Excitedly, he said, “We are so happy to have you work with us. Can you see the patients in our afternoon clinic? I have a paper due ...

Research and Scholarship

Understanding Attitudes and Roles of Oncology Advanced Practitioners in the Setting of Cancer Clinical Trials: A Pilot Study

Christa Braun-Inglis,(1,2) MS, APRN-Rx, FNP-BC, AOCNP®, Yurii B. Shvetsov,(2) PhD, Ashley Springer,(3) MSN, APRN-Rx, AGPCNP-BC, Valerie Ferguson,(4) MSN, APRN-Rx, FNP-C, AOCNP®, Tyler Workman,(5) MS, APRN-Rx, AGPCNS-BC, Dee Ann Omatsu,(6) MS, APRN-Rx, PNP-BC, CPON, Francisco Conde,(7) PhD, APRN-Rx, AOCNP®, FAAN, Erin O’Carroll Bantum,(2) PhD, and Jessica Rhee,(2) MD

Nurse practitioners, physician assistants, and pharmacists, known collectively as advanced practitioners (APs), are highly trained and skilled health-care providers who contribute significantly to quality cancer care. They have been identified multiple times as part of the solution to the project...

Research and Scholarship

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

Patients need expert care throughout their disease trajectory (Kain & Eisenhauer, 2016). It is important to maximize the quality of life (QOL) of patients throughout the course of their disease in order to prevent expensive and often futile treatment that can ultimately cause increased suffer...

Review Article

Treatment Options for Germline BRCA-Mutated Metastatic Pancreatic Adenocarcinoma

Doreen Grzelak, NP-C, AOCN®, AGN-BC

Pancreatic cancer currently accounts for 3.2% of all cancers. It is the fourth leading cause of death from cancer in both men and women. In 2020, it was estimated to affect more than 57,600 adults and lead to approximately 48,000 deaths (American Cancer Society, 2020). Approximately 10% of pancre...

Review Article

Nipple-Sparing Mastectomy in Breast Cancer: Impact on Surgical Resection, Oncologic Safety, and Psychological Well-Being

Lisa Parks, MS, APRN-CNP, ANP-BC

The first mastectomy with preservation of skin and nipple-areola complex (NAC) was performed for benign disease in 1951 (Orzalesi et al., 2016). Early experience with immediate breast reconstruction came from women having mastectomies for benign disease. Nipple-sparing mastectomy (NSM) has been u...

Grand Rounds

Transitioning From Thrombopoietin Agonists to the Novel SYK Inhibitor Fostamatinib: A Multicenter, Real-World Case Series

David M. Hughes,(1) PharmD, BCOP, Charina Toste,(2) DNP, APN, Christopher Nelson,(3) ACNP-BC, Juliet Escalon,(4) ANP, Frances Blevins,(5) PA-C, and Bhavesh Shah,(1) RPh, BCOP

Case Studies Case Study 1 A 25-year-old Hispanic female was diagnosed with chronic immune thrombocytopenia (ITP) at the age of 16 in Guatemala (2012) presenting with symptoms of gingival bleeding, petechiae, and easy bruising. Her platelet count was 9,000/∝L without causality. She was initiated a...

Grand Rounds

Management of Adverse Events Associated With Tyrosine Kinase Inhibitor Use in Adult Patients With Chronic Myeloid Leukemia in Chronic Phase: An Advanced Practice Perspective

Stephanie Bauer, RN, MSN, BC-FNP, Holly Comer, MSN, APRN, Brooke Ramsey, RN, MSN, ANP-BC, and Katy Thomas, RN, MSN, ANP-C

Case Studies Case Study 1: Pleural Effusion An 82-year-old man was diagnosed with chronic-phase CML with baseline BCR-ABL1 levels of 0.56% by FISH and cytogenetics revealing t(9;22). His medical history included coronary artery disease, atrial fibrillation, hypertension, and hypothyroidism. The p...

Practice Matters

Ensuring the Safety of Hospitalized Oncology Patients During a Pandemic

Meghan Mastrangelo, MSN, AGACNP-BC, Sara Muir, MSHS, PA-C, and Erin Marturano, MBE, MSN, RN

The societal impacts of the COVID-19 pandemic have been devastating and far reaching, and the effects on the health-care industry have been unparalleled. The pandemic forced health-care systems to reinvent and restructure at a dizzying pace, with no precedent from which to learn. Hospitals in the...

Prescriber's Corner

Pegfilgrastim Biosimilars: Where Are We Now?

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

Chemotherapy-induced neutropenia is one of the major dose-limiting toxicities of many cancer treatments. Neutropenia is defined as an absolute neutrophil count (ANC) of < 500 cells/mm3 or an expected decrease to < 500 cells/mm3 during the next 48 hours. This, combined with a single oral tem...

Editorial

Quality Improvement Projects and Clinical Research Studies

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

Every day, I witness firsthand the amazing things that advanced practitioners and nurse scientists accomplish. Through the conduct of quality improvement (QI) projects and clinical research studies, advanced practitioners and nurse scientists have the opportunity to contribute exponentially not o...

Research and Scholarship

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

Sharyn Carrasco, PhD, RN

Patients with cancer experience symptoms from both their disease and treatment, yet clinicians are unaware of 50% to 80% of their patients’ symptoms (Epstein & Street, 2007; Farrell et al., 2001; Ryan et al., 2005). For most cancer patients, symptoms are poorly documented and their impacts ar...

Research and Scholarship

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

A diagnosis of incurable cancer can result in a loss of control and heightened awareness of mortality, necessitating reflection on life’s priorities (García-Rueda et al., 2016). Advance care planning (ACP) discussions represent a patient-centered experience proven to facilitate a review of end-of...

Review Article

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 (ICIs) target suppressor receptors, including cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1), which are located on the surface of immune cells. Since the activated T cells are not antigen specific, blockade of the immun...

Review Article

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

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

Cancer-related fatigue (CRF) is one of the most prevalent, debilitating symptoms, affecting a majority of cancer patients (up to 99%) worldwide and potentially persisting for up to 10 years after treatment (Gupta et al., 2007; Liu et al., 2012; Neefjes et al., 2013). The National Comprehensive Ca...

Grand Rounds

Essential Thrombocythemia in a 15-Year-Old Female: Presentation, Workup, and Treatment Considerations in the Pediatric Population

Crystal Flagg, MPAS, PA-C, and Brad Pierce, MPAS, PA-C

Case Study A 15-year-old white female with no significant past medical or surgical history presented to her primary care provider following an episode of collapse without loss of consciousness and with associated symptoms of confusion, dizziness, headache, and vomiting with neurologic symptoms, i...

Practice Matters

Practical Considerations for Integrating Biosimilars Into Clinical Practice

Megan B. May,(1) PharmD, BCOP, Kate Deen Taucher,(2) PharmD, MHA, BCOP, and Wendy H. Vogel,(3) MSN, FNP, AOCNP®

A biosimilar product is highly similar to a U.S. Food & Drug Administration (FDA)-approved biologic product and does not have clinically meaningful differences in regards to safety, purity, and potency (FDA, 2018). Multiple surveys reveal health-care providers have inadequate knowledge about ...

Prescriber's Corner

A Review of the Bruton Tyrosine Kinase Inhibitors in B-Cell Malignancies

Donald C. Moore,(1) PharmD, BCPS, BCOP, DPLA, and Daniel Thompson,(2) PharmD

Targeting the B-cell receptor (BCR) signaling pathway has become an area of interest in the development of pharmacotherapy to treat B-cell malignancies. The BCR pathway plays a role in the growth, proliferation, and survival of normal and malignant B cells (Kenkre & Khal, 2012). One of the es...

Editorial

JADPRO Live Virtual 2020: Learning Today, Leading Tomorrow

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

This past October, over 1,000 nurse practitioners, PAs, pharmacists, and other oncology professionals attended the eighth annual JADPRO Live conference, which went virtual for the first time. Amid uncertainty and unprecedented challenges from the COVID-19 pandemic, oncology advanced practitioners...

Meeting Report

Advanced Practitioner Leadership in Times of Crisis

Presented by Gabrielle Zecha,(1) PA-C, MHA, Andrew S. Guinigundo,(2) MSN, RN, CNP, ANP-BC, David Johnson,(3) PA-C, and Sara Toth,(4) RN, APRN, FNP-C, AOCNP®, AGN-BC

As health-care systems face challenges never before encountered in the era of modern medicine, advanced practitioners (APs) are playing critical roles in developing protocols, managing health-care teams, and delivering patient care. JADPRO Live 2020 kicked off its virtual meeting with a discussio...

Meeting Report

Words Matter: Use of Respectful Language in Oncology

Presented by Laura J. Zitella,(1) MS, RN, ACNP-BC, AOCN®, and Tatiana M. Prowell,(2) MD

While cancer treatments continue to evolve at a rapid pace, the culture of medicine is rife with outdated norms that reinforce gender and racial disparities, explains Tatiana M. Prowell, MD, of Johns Hopkins Kimmel Comprehensive Cancer Center. During JADPRO Live Virtual 2020, Conference Chair Lau...

Meeting Report

Are Current Metrics Adequate to Demonstrate the Value of Oncology Advanced Practitioners?

Presented by Jason Astrin, DMSc, MBA, PA-C, DFAAPA

Advanced practitioners drive revenue for oncology practices, but calculating their true value is a complicated proposition compared with other care providers. During JADPRO Live Virtual 2020, Jason Astrin, DMSc, MBA, PA-C, DFAAPA, Director of APP Services, The US Oncology Network, differentiated ...

Meeting Report

The Elevator Pitch: Communicating Your Expertise, Experience, and Value to Patients, Co-Workers, and Prospective Employers in an Instant

Presented by Andrew S. Guinigundo, MSN, RN, CNP, ANP-BC

As the saying goes, you only have one chance to make a first impression. Mastering the “elevator pitch” can be an invaluable skill for advanced practitioners. During JADPRO Live Virtual 2020, Andrew S. Guinigundo, MSN, RN, CNP, ANP-BC, defined the concept of an elevator pitch and its application ...

Meeting Report

Cardio-Oncology: The Intersection Between Cardiovascular Disease and Cancer

Presented by Jessica Shank Coviello, DNP, APRN, ANP-BC, and Kejal Amin, PharmD, MBA, BCOP

The connection between cancer and cardiovascular disease has been well established in medicine, but their shared pathophysiologic patterns remain less understood. During the JADPRO Live Virtual 2020 conference, Jessica Shank Coviello, DNP, APRN, ANP-BC, of Yale University School of Nursing, and K...

Meeting Report

Management of Diabetes in the Patient With Cancer

Presented by Lorena A. Wright, MD, FACE

Understanding the optimal management of hyperglycemia in patients with cancer is an essential responsibility of advanced practitioners. During JADPRO Live Virtual 2020, Lorena A. Wright, MD, FACE, of the University of Washington Diabetes Institute in Seattle, discussed the importance of glycemic ...

Meeting Report

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

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

Both CHEST and National Comprehensive Cancer Network (NCCN) guidelines can help advanced practitioners determine which patients with cancer should be treated with a direct oral anticoagulant (DOAC), but optimizing the risk-to-benefit ratio must still be done at the individual patient level, accor...

Meeting Report

Approach to the Hospitalized Patient With Thrombocytopenia

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

With up to 50% of hospitalized patients experiencing low blood platelet count, thrombocytopenia is a very common condition. During JADPRO Live Virtual 2020, Laura J. Zitella, MS, RN, ACNP-BC, AOCN®, of the University of California, San Francisco, discussed the most important causes of thrombocyto...

Meeting Report

Mitigating the Morbidity of Financial Toxicity in Cancer Care

Presented by Veena Shankaran, MD, MS

Financial toxicity among cancer patients is a growing and complex problem, affecting people across all socioeconomic strata with various types of insurance. During JADPRO Live Virtual 2020, Veena Shankaran, MD, MS, of the University of Washington, Seattle Cancer Care Alliance, and Fred Hutchinson...

Meeting Report

2019–2020 Drug Updates in Solid Tumors

Presented by Kirollos S. Hanna, PharmD, BCPS, BCOP

Despite the COVID-19 pandemic, numerous oncology drugs have been approved by the U.S. Food & Drug Administration (FDA) over the past 12 months for initial or expanded indications for the management of patients with solid tumors (Table 1). During JADPRO Live Virtual 2020, Kirollos S. Hanna, P...

Meeting Report

2019–2020 Drug Updates in Hematologic Malignancies

Presented by Heidi D. Finnes, PharmD, BCOP, FHOPA

From late 2019 to late 2020, the U.S. Food & Drug Administration (FDA) approved a number of medications for the management of patients with hematologic malignancies, including drugs for lymphoma, myeloma, myelodysplastic syndrome, and sickle cell anemia. During JADPRO Live Virtual 2020, Heidi...

Meeting Report

Biomarker Jeopardy

Presented by Sandra E. Kurtin,(1) PhD, ANP-C, AOCN®, Alyssa Henglefelt,(2) PharmD, BCOP, and Allyson Price,(3) MPAS, PA-C

As oncology continues to move towards precision medicine with targeted therapies, biomarker expression is playing an increasingly important role. In a session led by Sandra E. Kurtin, PhD, ANP-C, AOCN®, during JADPRO Live Virtual 2020, Alyssa Henglefelt, PharmD, BCOP, HonorHealth, Virginia G. Pip...

Meeting Report

Immune Checkpoint Inhibitors: Common Questions About Uncommon Adverse Events

Presented by Lisa Kottschade, APRN, MSN, CNP

Immune checkpoint inhibitors have been successful in advancing the field of oncologic treatment, but there is a dark side to these drugs. Immune-related adverse events (irAEs) that occur via activation of a patient’s immune system can affect any tissue, organ, or body system and pose distinct cha...

Meeting Report

FDA and Its Role in Drug Development

Presented by Richard Pazdur, MD

As the first U.S. Food & Drug Administration (FDA) Inter-Center Institute, the Oncology Center of Excellence (OCE) fosters a unified interaction between the three FDA centers: the Center for Biologics Evaluation and Research (CBER); the Center for Drug Evaluation and Research (CDER); and the ...

Meeting Report

Advanced Prostate Cancer: Considerations for Advanced Practitioners

Presented by Brenda Martone, MSN, ANP-BC, AOCNP®

With the introduction of novel agents for the treatment of advanced prostate cancer, the range of options with notable benefits has widened. The armamentarium now includes second-generation androgen receptor–targeting agents and several chemotherapeutics as well as new drugs targeting other oncog...

Meeting Report

The Landscape of the Advanced NSCLC Treatment Paradigm: Molecular Testing and Actionable Mutations

Presented by Rasheda Persinger, AGNP-C

In the past 15 years, the number of targeted therapies for non–small cell lung cancer (NSCLC) has grown from 0 to 17, as the list of oncogenic mutations continues to expand in this heterogeneous group of lung cancers. At JADPRO Live Virtual 2020, Rasheda Persinger, AGNP-C, of Johns Hopkins Univer...

Meeting Report

A Multidisciplinary Approach to Head and Neck Cancer

Presented by Casey Fazer-Posorske, PA-C

Head and neck cancer accounts for more than 550,000 cases and 380,000 deaths annually around the world. During JADPRO Live Virtual 2020, Casey Fazer-Posorske, PA-C, of Mayo Clinic, described the various types of head and neck cancers along with associated treatments and side-effect management. Ms...

Meeting Report

Developments in Hepatocellular Cancer Treatment

Presented by Bridget O’Brien, DNP, APRN, FNP-BC, AOCNP®

The death rate from hepatocellular cancer (HCC) has more than doubled in the past 30 years as the incidence of this disease continues to rise worldwide. However, the recent approvals of targeted agents and immunotherapies have dramatically changed the treatment landscape of HCC and should impact ...

Meeting Report

Infrequent Offenders: Neuroendocrine Tumors and Cancers of the Appendix, Gallbladder, and Bile Duct

Presented by Kristen O’Hagan, ANP-BC, MS, AOCNP®

During JADPRO Live Virtual 2020, Kristen O’Hagan, ANP-BC, MS, AOCNP®, of Memorial Sloan Kettering Cancer Center, described the presentation, diagnosis, and treatment algorithms of rare gastrointestinal tumors, including neuroendocrine tumors and cancers of the appendix, gallbladder, and bile duct...

Meeting Report

Kidney Cancer Combinations: Tracking and Treating Symptoms With the Challenge of Combination Therapy

Presented by Kathleen Burns, AGACNP-BC, OCN®

Over the past 10 years, the arrival of immunotherapies and targeted agents has extended the survival and improved the quality of life for patients with renal cell carcinoma (RCC), but these novel therapies have also introduced challenging new side effects. During JADPRO Live Virtual 2020, Kathlee...

Meeting Report

Sarcoma: Disease Overview and Treatment Updates

Presented by Cissimol Joseph, APRN, AOCNP®, and Prachee Singh, PA-C, MS

A rare tumor constituting less than 1% of all cancer types, sarcoma presents unique challenges for both patients and health-care providers throughout the treatment course. During JADPRO Live Virtual 2020, Cissimol Joseph, APRN, AOCNP®, and Prachee Singh, PA-C, MS, of The University of Texas MD An...

Meeting Report

Optimizing Treatment of Chronic Lymphocytic Leukemia

Presented by Sandra E. Kurtin, PhD, ANP-C, AOCN®

Treatment of chronic lymphocytic leukemia (CLL) is becoming increasingly personalized, relying on both the molecular attributes of the disease and patient characteristics. During JADPRO Live Virtual 2020, Sandra Kurtin, PhD, ANP-C, AOCN®, of the University of Arizona Cancer Center, identified key...

Meeting Report

Diagnosis and Treatment of AL and ATTR Amyloidosis

Presented by Beth Faiman, PhD, RN, MSN, APRN-BC, AOCN®, FAAN, and Tiffany Richards, PhD, ANP-BC, AOCNP®

Vast improvements in the diagnosis and management of amyloidosis have underscored the importance of prompt diagnosis and effective treatment. During JADPRO Live Virtual 2020, Beth Faiman, PhD, RN, MSN, APRN-BC, AOCN®, FAAN, of Cleveland Clinic Taussig Cancer Institute, and Tiffany Richards, PhD, ...

Meeting Report

Improving Outcomes in Hematopoietic Stem Cell Transplant: Recent Advances

Presented by Maritza Alencar, DNP, MBA, APRN-BC, BMTCN

As the number of recipients continues to rise, recent advances in hematopoietic stem cell transplant have led to improved outcomes. During JADPRO Live Virtual 2020, Maritza Alencar, DNP, MBA, APRN-BC, BMTCN, of the University of Miami Sylvester Comprehensive Cancer Center, described advances in t...

Meeting Report

Hemolytic Anemias: Autoimmune and Beyond

Presented by Ravi Krishnadasan, MD, FACP

Although hemolytic anemia is most commonly associated with autoimmune causes, not all hemolysis can be diagnosed with a positive direct antiglobulin (Coombs) test. During JADPRO Live Virtual 2020, Ravi Krishnadasan, MD, FACP, of The University of Arizona Cancer Center, focused on nonimmune hemoly...

Editorial

A Case of Unintentional Nonadherence

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

One day, as I was standing in line at the local pharmacy, I noticed an elderly woman who was visibly upset. She had stopped by to pick up medication for her husband. The woman began crying as she spoke with the pharmacist who stated the provider was unable to refill her husband’s medication witho...

Research and Scholarship

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

Cancer cells can suppress the defenses of the immune system through the overexpression of immune regulatory molecules within the tumor microenvironment (Van der Jeught et al., 2015). These molecules include immune checkpoint molecules such as cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed ...

Research and Scholarship

A Pharmacist-Led Oral Chemotherapy Program’s Impact on Chronic Myeloid Leukemia Patient Satisfaction, Adherence, and Outcomes

Taylor Dennison,(1,2) PharmD, Allison M. Deal,(3) MS, Matthew Foster,(1,3) MD, John Valgus,(1,2) PharmD, MHA, BCOP, and Benyam Muluneh,(2) PharmD, BCOP, CPP

The number of specialty drugs on the market has increased dramatically over the past decade, and specialty drugs are expected to make up over 50% of the pharmaceutical industry’s revenue by 2020 (Galante, 2018). This has prompted the growth of specialty pharmacies, especially in oncology. 60% of ...

Review Article

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

The benefits of palliative care have been documented through extensive clinical practice and research, yet workforce shortages have prevented full delivery of this care to all seriously ill cancer patients who need it (Aldridge et al., 2016). Researchers and health policy experts have concluded t...

Review Article

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

Margit Eidenberger, PT Mag

Lymphedema is a chronic progressive disease characterized by an accumulation of lymphatic fluid leading to the swelling of various body parts. Lymphedema can lead to different negative consequences, such as skin changes, connective tissue fibrosis, loss of quality of life, or social retreat (Slei...

Grand Rounds

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

Case Study MR is a pleasant 74-year-old gentleman who comes to the office complaining of increased pain in his spine. He also reports loss of appetite and a 12-lb weight loss over the past 2 weeks. MR has a history of prostate cancer metastatic to the bone diagnosed in 2018. He is status post tre...

Practice Matters

A Role to Alleviate Burnout and Maintain Quality of Care

Jessica Zucker, RN, MSN, AGNP-BC, Glen J. Peterson, RN, DNP, ACNP, Angela Falco, RN, MS, MPH, FNP-C, and Jessica Casselberry, RN, MSN, ANP-BC, AOCNP®

Burnout, high staff turnover, and reduced resiliency among health-care providers working in acute care settings have been well documented in the literature and are recognized nationally as key barriers to recruiting and retaining health-care providers (Burn et al., 2014; Hlubocky et al., 2016; Le...

Prescriber's Corner

Caplacizumab for Acute Thrombotic Thrombocytopenic Purpura

Katherine V. Katsivalis, PharmD, and Jamie Thomas, PharmD

Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare form of microangiopathic hemolytic anemia affecting 1 to 13 per million people every year (Stanley & Michalski, 2019). In clinical practice, a triad of thrombocytopenia, schistocytosis, and elevated lactate dehydrogenase is suggest...

Diagnostic Snapshot

What Is the Cause of This Biliary Stricture?

Caeli Barker, PA-C

History Mr. F is a 63-year-old male with no significant past medical or surgical history. He is physically active, drinks socially, and does not smoke. He presented to his primary care provider with a 2-month history of upper abdominal pain associated with jaundice, pruritis, dark urine, and ligh...

Editorial

Approved mRNA Vaccines for SARS-CoV-2

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

Every new year brings a time for reflection and optimism for what lies ahead. In December 2020, two newly approved mRNA vaccines were approved—BNT162b2 mRNA Covid-19 vaccine (BioNTech/Pfizer) and mRNA-1273 (Moderna/NIAID)—to protect individuals against severe acute respiratory syndrome coronaviru...

Research and Scholarship

Impact of Adherence to Ibrutinib on Clinical Outcomes in Real-World Patients With Chronic Lymphocytic Leukemia

Lauren M. Garner, PharmD, BCPPS, Theresa Kline, PharmD, BCPS, BCCP, Jordan Miller, PharmD, BCOP, CPP, Allison Deal, MS, Anqi Zhu, MS, PhD(c), Margaret R. Sketch, PharmD, MPH, Catherine C. Coombs, MD, and Benyam Muluneh, PharmD, BCOP, CPP

Chronic lymphocytic leukemia (CLL) is a B-cell neoplasm characterized by clonal expansion of small lymphocytes that are primarily found in the blood and bone marrow with varying involvement of lymph nodes, the liver, and the spleen. This B-cell malignancy is usually slow growing, with many patien...

Research and Scholarship

Development, Implementation, and Patient Perspectives of the Women’s Integrative Sexual Health Program: A Program Designed to Address the Sexual Side Effects of Cancer Treatment

Lori A. Seaborne, MPAS, PA-C, Megan Peterson, DNP, David M. Kushner, MD, Janelle Sobecki, MD, MA, and Joanne K. Rash, MPAS, PA-C

Advanced practitioners (APs) are an increasingly valuable part of the care team in oncology settings. They are being utilized to provide a wide variety of services, including managing acute outpatient issues, prescribing chemotherapy, rounding on inpatients, and assisting in surgery (Corcoran, Du...

Review Article

Roadmap to the Enhanced Thoracic Surgical Journey

TaCharra Y. D. Woodard, MSN, APRN, ACNP-BC, AOCNP®, Carla M. Patel, MSN, APRN, ACNP-BC, and Garrett L. Walsh, MD

The Enhanced Recovery Program (ERP) is a comprehensive, multidisciplinary approach that directly impacts the functional recovery and quality of life of patients after surgery. The evidence-based interventions throughout each phase of the perioperative journey synergistically work to improve the p...

Continuing Education

CE Information: Advanced Practice Perspectives on Preventing and Managing Tumor Lysis Syndrome and Neutropenia in Chronic Lymphocytic Leukemia

Advanced Practice Perspectives on Preventing and Managing Tumor Lysis Syndrome and Neutropenia in Chronic Lymphocytic Leukemia Read the certified article Provided by Release date: 1/20/2021 Expiration date: 1/19/2022 Estimated time of completion: 30 minutes Media: Certified journal ar...

Grand Rounds

Advanced Practice Perspectives on Preventing and Managing Tumor Lysis Syndrome and Neutropenia in Chronic Lymphocytic Leukemia

Amy Goodrich, RN, MSN, CRNP

Tumor lysis syndrome (TLS) is an oncologic emergency caused by the rapid release of intracellular contents of tumor cells into the peripheral blood, although it may also occur spontaneously. Laboratory TLS is characterized by hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. In la...

Grand Rounds

Metastatic Melanoma With Leptomeningeal Disease

Amanda M. Marinova, MS, PA-C, Jennifer L. Reilly, CRNP, BSN, MSN, RN, AANP, Victoria Wong, MS, PA-C, Stephanie Weiss, MD, and Anthony J. Olszanski, MD

Case Study In 2012, a 43-year-old female underwent an excisional biopsy of a mole that was present on her posterior trunk, near her midline. The pathology report was consistent with an ulcerated 2.9 mm malignant melanoma. She underwent a wide local excision and sentinel lymph node mapping. In th...

Practice Matters

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

Poonam Goswami, DNP, FNP-C, AOCNP®

The 2014 Institute of Medicine report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, identified an urgent need for improvement in health care at the end of life. To improve care at the end of life, providers and patients must engage sooner in conver...

Prescriber's Corner

Ribociclib and Abemaciclib: CDK4/6 Inhibitors for the Treatment of Hormone Receptor–Positive Metastatic Breast Cancer

Kristina F. Byers, PharmD, BCOP

Breast cancer is the most commonly diagnosed cancer in the United States, accounting for 30% of all new cancer diagnoses annually. It is estimated that 279,100 people were diagnosed with breast cancer in 2020. Although the development of newer therapies and better screening methods has increased ...

Diagnostic Snapshot

Is This Patient’s Liver Mass Cancer?

Dietrich Davis, FNP-BC, and Steven H. Wei, MS, MPH, PA-C, DFAAPA

History Ms. BP is a 38-year-old female with a past medical history significant for multiple sclerosis who has been receiving high-dose glucocorticoids and rituximab (Rituxan) treatments for the past 12 years. For the past couple of years, she has been followed by a gastroenterologist for symptom...

Editorial

JADPRO Live Virtual 2020

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

Attendees of our eighth JADPRO Live meeting were treated to a new, engaging way to learn virtually. The virtual conference platform featured over 25 educational sessions, several product theaters, and multiple ways to discuss and share insights. The meeting’s Live Stage took place from October 15...

Research and Scholarship

Evaluation of the Role and Impact of Ambulatory Clinical Pharmacists in an Academic Comprehensive Cancer Center

Laura A. Meleis, PharmD, MS, BCPS, Mallika P. Patel, PharmD, CPP, Michael DeCoske, PharmD, BCPS, Meredith Moorman, PharmD, CPP, Paul W. Bush, PharmD, MBA, BCPS, FASHP, and Sally Barbour, PharmD, BCOP, CPP, FHOPA

Currently, there is a paucity of published data on the clinical activities and impact of ambulatory oncology clinical pharmacists. In 1999, Wong and Gray evaluated the impact of a clinical pharmacist in ambulatory hematology/oncology clinics. In the 36-day study time period, 211 pharmacy interven...

Research and Scholarship

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

The journey on the cancer trajectory brings distress for patients and families, in part due to the threat of mortality and the unforeseen treatments that ensue. In the context of cancer, distress has been defined as an “unpleasant emotional experience of a psychological (cognitive, behavioral, em...

Grand Rounds

Acute Myeloid Leukemia: Advanced Practice Management From Presentation to Cure

Meredith Beaton, RN, MSN, AG-ACNP, Glen J. Peterson, RN, DNP, ACNP, and Kelly O’Brien, RN, MSN, ANP-C, ACNP-BC

Case Study This patient case is fictional and does not represent events from an actual patient. The authors developed this fictional case for educational purposes only. Thomas, a 62-year-old Caucasian male, was brought to the emergency department (ED) by his wife with severe shortness of breath, ...

Review Article

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 common and potentially physically and emotionally distressing side effect of select chemotherapeutic agents including platinum-based drugs and taxanes (Bakitas, 2007; Shah et al., 2018). Estimates of CIPN incidence and prevalence vary, rangin...

Practice Matters

Oncology Advanced Practitioners and Breast Cancer Prevention

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. It is estimated that 276,480 women and 2,620 men in the United States will be diagnosed with invasive breast cancer and 48,530 people will be diagnosed with non-invasive (in situ) breast cancer (American Cancer Society, 2020). An e...

Prescriber's Corner

Voxelotor: A Hemoglobin S Polymerization Inhibitor for the Treatment of Sickle Cell Disease

Avani Yenamandra,(1) PharmD, and Dennis Marjoncu,(2) PharmD, BCOP

Sickle cell disease (SCD) is characterized by a single amino acid substitution in the gene that encodes for the B-globin subunit of hemoglobin. The autosomal recessive gene creates hemoglobin S (HbS), which polymerizes reversibly when deoxygenated to form a gelatinous network of fibrous polymers ...

Diagnostic Snapshot

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

Allison Trail, PA-C

History Ms. D is a 53-year-old female with a past medical history of migraines, Graves’ disease, gastroesophageal reflux disease, and now metastatic distal esophageal adenocarcinoma. She initially noticed progressive dysphagia and eventually developed abdominal pain. A magnetic resonance imaging ...

Meeting Abstract

Abstracts From JADPRO Live 2020

Virtual • Live Stage: October 15–23 • Encore Stage: October 26–November 6

JL801: Antibiotic Therapy and Gastrointestinal Graft-Versus-Host Disease in Allogeneic Stem Cell Transplant Patients Jessica Thomas, MSN, APRN, FNP-C, AOCNP®, Joyce E. Dains, DrPH, JD, APRN, FNP-BC, FNAP, FAAN, Christi Bowe, DNP, APRN, ANP-C; The University of Texas MD Anderson Cancer Center Purp...

Editorial

Thank You to Our Peer Reviewers!

In this last issue of the year, we would like to acknowledge the 104 reviewers who completed peer reviews for JADPRO in the past year. Our reviewers, who are from a wide variety of oncology specialties and professions, dedicate their time and expertise to provide thoughtful feedback. We hope that...

Editorial

The Changing Landscape of Healthcare and Continuing Education

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

I am sure that many of you can agree that summer this year felt different. Few social gatherings took place, if at all. In most cities, youth sports and summer activities such as baseball and swimming were canceled. Despite these disruptions from the norm, the days of summer seemed to fly by as c...

Research and Scholarship

Revisiting Infectious Complications Following Total Parenteral Nutrition Use During Hematopoietic Stem Cell Transplantation

Halina Rubin,(1) RPh, Jayesh Mehta,(1,2) MD, Jessica L. Fong,(1) PharmD, Deborah Greenberg,(1) PharmD, Solomiya Gruschak,(1,2) BS, and Steven Trifilio,(1,2) RPh

Severe gastrointestinal complications develop frequently during hematopoietic stem cell transplantation (HSCT). Chemotherapy-induced nausea and vomiting (CINV), pain, dysgeusia, fatigue, mucositis, and loss of appetite cause pain and discomfort, and frequently impair oral nutrition. Total parente...

Research and Scholarship

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

High-grade gliomas, including glioblastoma (World Health Organization [WHO] grade IV), are the most common primary malignant central nervous tumors (Ostrom et al., 2017). Median overall survival of glioblastoma is 12 to 15 months (Alcedo-Guardia, Labat, Blas-Boria, & Vivas-Mejia, 2016). Durin...

Review Article

Pancreatic Ductal Adenocarcinoma: Characteristics of Tumor Microenvironment and Barriers to Treatment

Sujata Kane,(1) PA-C, Anne Engelhart,(1) ANP-BC, Jessica Guadagno,(1) PA-C, Aaron Jones,(1) ANP-BC, Innis Usoro,(2) and Edith Brutcher,(1) ANP-BC, AOCNP®

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive disease. According to the SEER database of the National Cancer Institute, it had a 5-year relative survival rate of 10% from 2010 to 2016. The prognosis of PDAC remains dismal, with a disappointing response to cytotoxic chemoradiother...

Grand Rounds

Optimizing Palbociclib Therapy Across the Age Spectrum: Hypothetical, Illustrative Case Scenarios in HR+, HER2– Metastatic Breast Cancer

Kimberly Podsada,(1) MSN, NP-C, Joanne C. Ryan,(2) PhD, RN, and Kristi Orbaugh,(3) RN, MSN, RNP, AOCN®

CASE STUDY 1: Hazel Hazel (Figure 1) was initially diagnosed with breast cancer at age 65. After completing 5 years of adjuvant therapy with letrozole, Hazel considered herself a cancer survivor. She and her husband had always had an active social life, and Hazel went for daily walks with a grou...

Grand Rounds

Pseudoprogression and Immunotherapy Phenomena

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC, and Donna Lee Gerber, CNS

Case Study Patricia is a Caucasian 48-year-old female who loves outdoor activities and has a history of numerous severe sunburns. Patricia did not use any type of sunscreen. During Patricia’s annual physical examination with her primary physician, a dark pigmented area on her shoulder that had ir...

Translating Research Into Practice

Clinical Trial Design and Drug Approval in Oncology: A Primer for the Advanced Practitioner in Oncology

Sandra E. Kurtin,(1) PhD, ANP-C, AOCN®, and Rashida Taher,(2) MPH, PA-C

Translating research into clinical practice is a challenging and valuable skill for the advanced practitioner (AP) in oncology. Recent analysis of 585 trials registered in the National Cancer Institute Clinical Trials database showed that 29% remained unpublished within 5 years of completion of t...

Practice Matters

The Role of Advanced Practice Providers and Telemedicine in Reinventing Care: The Transition of a CAR T-Cell Transplantation Program to the Outpatient Setting

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

Cellular therapy is a growing field of cancer treatment (Lamprecht & Dansereau, 2019). Chimeric antigen receptor (CAR) T-cell therapy is perhaps the most notable and promising of these cellular therapies. CAR T-cell therapy utilizes a patient’s own immune T cells to target antigen(s) in an ef...

Prescriber's Corner

Alpelisib: A Novel Therapy for Patients With PIK3CA-Mutated Metastatic Breast Cancer

Tori Wilhoit, PharmD, Jeannie M. Patrick, PharmD, BCOP, and Megan B. May, PharmD, BCOP

Breast cancer is the most common cancer diagnosed in women in the United States. 1 in 8 women will develop invasive breast cancer in her lifetime. It is expected that in 2019, over 268,000 women will be diagnosed with invasive breast cancer in the United States alone (National Cancer Institute, 2...

Diagnostic Snapshot

Atypical Radiculopathy in an Oncology Patient

Mark Davis, PA-C

History Mr. OH is a 73-year-old male who presented with a nonproductive cough for 1 month and an unexplained 20-pound weight loss. He presented his symptoms to his internist who then ordered a CT scan of the chest. The scan revealed three lung nodules: a 3.2 × 1.7 cm nodule in the right upper lob...

Editorial

ASCO20 Virtual Scientific Program: Takeaways for the Advanced Practitioner

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, FAAN

It is my pleasure and honor to serve you as the new Editor-in-Chief of JADPRO. I am humbled to take over for Pamela Hallquist Viale, RN, MS, CNS, ANP, a good friend and colleague of mine. Since 2010, I have had the good fortune of being involved as an author and peer reviewer for JADPRO and have ...

Meeting Report

Gastrointestinal Cancers: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Nina N. Grenon, DNP, AGCNP-BC, AOCN®

Abstract LBA4: Rates of Progression-Free Survival in MSI-H/dMMR Metastatic Colorectal Cancer Doubled by Pembrolizumab By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/186928/abstract to read the full abstract and view author disclosures. Upfront treatment with immunotherapy no...

Meeting Report

Prostate Cancer: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Morgane C. Diven, PharmD, BCOP

Abstract 5500: Lutetium-177–Labeled PSMA-617 Improves PSA Response in First Analysis From TheraP Trial in Metastatic Prostate Cancer By Alice Goodman Visit https://meetinglibrary.asco.org/record/187000/abstract to read the full abstract and view author disclosures. Initial results of the randomiz...

Meeting Report

Genitourinary (Non-Prostate) Cancers: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Jeannette Hammond, PA-C

Abstract LBA1: Advanced Bladder Cancer Survival Improved With Maintenance Avelumab By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/186872/abstract to read the full abstract and view author disclosures. According to an interim analysis of the phase III JAVELIN Bladder 100 trial...

Meeting Report

Gynecologic Cancers: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Laura Doherty, FNP-BC, AOCNP®

Abstracts 6000 and 6001: Two Studies Report Secondary Surgery Extends Survival in Recurrent Ovarian Cancer: Benefit Seen Solely in Selected Patients Treated at Specialized Centers By Alice Goodman Visit https://meetinglibrary.asco.org/record/185438/abstract and https://meetinglibrary.asco.org/rec...

Meeting Report

Breast Cancer: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Paula Anastasia,(1) RN, MN, AOCN®, and Wendy H. Vogel,(2) MSN, FNP, AOCNP®

Abstract LBA2: No Survival Benefit from Local Therapy in de Novo Metastatic Breast Cancer Study By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/186884/abstract to read the full abstract and view author disclosures. Results of the phase III E2108 study indicate that surgery an...

Meeting Report

Thoracic Cancers: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC

Abstract LBA5: Adjuvant Osimertinib in Early-Stage EGFR-Positive NSCLC By Alice Goodman Visit https://meetinglibrary.asco.org/record/191929/abstract to read the full abstract and view author disclosures. Adjuvant osimertinib significantly improved disease-free survival compared with placebo in pa...

Meeting Report

Melanoma: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Lisa Kottschade, APRN, MSN, CNP

Abstracts 10003, 10004, and 10005: Melanoma: Clinical Trials Update on PD-1 and CTLA-4 Blockade By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/185691/abstract, https://meetinglibrary.asco.org/record/185737/abstract, and https://meetinglibrary.asco.org/record/185644/abstract, ...

Meeting Report

Other Solid Cancers: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Elizabeth S. Waxman,(1) RN, MSN, AOCN®, ANP-BC, and Abby Fuoto,(2) DNP, ANP-BC, AOCNP®, ACHPN

Abstract 109: RET Kinase Inhibitor for Patients With Solid Tumors and RET Genetic Fusions By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/186874/abstract to read the full abstract and view author disclosures. The RET inhibitor pralsetinib showed activity in patients with a bro...

Meeting Report

Hematologic Malignancies: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Amy Pierre,(1) MSN, ANP-BC, P. Andrew Allred,(2) MS, PA-C, and Allyson Price,(3) PA-C

Abstract LBA3: Carfilzomib Triplet Fails to Improve Outcomes vs Standard Bortezomib-Based Regimen in Newly Diagnosed Myeloma By Alice Goodman Visit https://meetinglibrary.asco.org/record/186906/abstract to read the full abstracts and view author disclosures. For newly treated patients with standa...

Meeting Report

Issues in Oncology: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

Josh Epworth, ARNP

Abstract LBA110: Patients With Cancer Infected With COVID-19 Have More Severe Illness and Higher Mortality Rates Than the General Population By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/191968/abstract to read the full abstract and view author disclosures. Alarge cohort stu...

Editorial

A Decade of JADPRO

Pamela Hallquist Viale, RN, MS, CNS, ANP

As I write this editorial, JADPRO is celebrating a milestone. It was just over 10 years ago that the inaugural issue was published. Since that time, we’ve grown into a journal with a subscriber base of over 10,000, launched the Advanced Practitioner Society for Hematology and Oncology, APSHO (for...

Research and Scholarship

Using Social Media as a Platform for Increasing Knowledge of Lung Cancer Screening in High-Risk Patients

Aimee Strong,(1) DNP, RN, AGACNP-BC, and Michelle Renaud,(2) RN, PhD

According to the American Cancer Society (2020), lung cancer is the leading cause of adult cancer-related deaths in the United States, with approximately 228,820 new cases and 135,720 deaths predicted in 2020. The National Lung Screening Trial reported that annual low-dose CT of the chest (LDCT) ...

Research and Scholarship

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

Anna Cathy Williams, RN, PhD, PHN, Ed

Phase I trials are rigorous treatments, and geriatric patients are extremely vulnerable to the known and unknown side effects of treatments (McMahon, Decker, & Ottery, 1998). Nutrition plays a major but not always fully understood role in many aspects of cancer development and treatment. Nutr...

Review Article

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

Rita J. Wickham, PhD, RN

Over the past 40 years, major advances in knowledge and new drugs targeting chemotherapy-induced nausea and vomiting (CINV) have been incorporated into (largely) evidence-based antiemetic guidelines. Conversely, there is a thin evidence base underpinning guidelines for the palliative management o...

Review Article

Phase 1 Clinical Trials in the Elderly: Enrollment Challenges

Carol Guarnieri, RN, MSN, FNP-C, and Daniel D. Von Hoff, MD, FACP, FASCO, FAACR

Cancer is the second most common cause of death in the United States, exceeded only by heart disease, and accounts for nearly one out of four deaths (American Cancer Society, 2018). Age is the greatest risk factor for developing cancer. Approximately 60% of people who have a diagnosis of cancer a...

Grand Rounds

A Patient-Centered Approach for the Treatment of Fungating Breast Wounds

Karlyn L. Rupert, MPAS, PA-C, and Andrea J. Fehl, CRNP, AOCNP®

Case Study LB is a 51-year-old postmenopausal female with no significant past medical history who presented to the emergency department with a fungating breast mass. She delayed seeking medical care, as she was the primary caregiver for her daughter with developmental delays. Staging CT scans of ...

Practice Matters

Patient-Reported Outcomes and Assessment of Quality of Life: A Focus on Multiple Myeloma

MaryAnn Fragola, ANP-C, DNP

Many new treatment regimens have become available for patients with malignancies, particularly for patients with multiple myeloma (MM). As a result, MM has been increasingly described as a chronic illness. Newer modalities of treatment mean that patients must learn how to live with treatments whi...

Prescriber's Corner

Polatuzumab Vedotin for the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma in Transplant-Ineligible Patients

Melanie Douglas, MS, PA-C

Lymphoma is the most common hematologic malignancy, accounting for 5% of newly diagnosed malignancies (Ku, Chong, & Hawkes, 2017; National Cancer Institute, 2019). In the United States, approximately 2.2% of individuals will be diagnosed with non-Hodgkin lymphoma (NHL) in their lifetime (Nati...

Editorial

Advanced Practitioners and the COVID-19 Pandemic

Pamela Hallquist Viale, RN, MS, CNS, ANP

This is an incredibly strange time to be practicing in health care. Although predictions for a pandemic in the world have been talked and written about for decades, the COVID-19 pandemic has hit us with a vengeance, requiring health-care practitioners to step up and practice under a variety of di...

Research and Scholarship

Understanding Barriers to Oral Therapy Adherence in Adults With Acute Myeloid Leukemia

Ashley Leak Bryant,(1) PhD, RN-BC, OCN®, Ya-Ning Chan,(1) MSN, RN, Jaime Richardson,(1) BSN, RN, OCN®, CCRP, Matthew Foster,(1) MD, Susie Owenby,(2) BSN, RN, and Debra Wujcik,(2) PhD, RN

In 2020, there will be an estimated 19,940 new cases of acute myeloid leukemia (AML) and 11,180 deaths in the United States (Siegel, Miller, & Jemal, 2020). The incidence of AML is increasing, in part due to the overall aging population; the median age at presentation is 68 years (American Ca...

Research and Scholarship

Perceptions of Health-Care Workers of the Cost and Safety of Oral Oncolytic Agents for Patients: A Survey

Madeline Tompkinson,(1) PharmD, Kelly Fine,(2) RPh, FAzPA, Dean Gruber,(3) RPh, Ivo Abraham,(4) PhD, RN, and Ali McBride,(5) PharmD, MS, BCPA, BCOP

Oral oncolytic agents are being approved by the US Food and Drug Administration (FDA) at a rapid pace. There are currently more than 800 new oncology therapies in the pipeline, 25% of which are oral agents (American Cancer Society [ACS], 2016). Oral oncolytic agents have several advantages over t...

Review Article

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

Ifosfamide is an antineoplastic medication that is used to treat a variety of malignancies but has the potential for inducing serious adverse effects. One such adverse effect is central nervous system toxicity, known as ifosfamide-related encephalopathy (IRE). Ifosfamide is most commonly administ...

Grand Rounds

Waldenström Macroglobulinemia: Clinical Presentation, Diagnosis, and Management

Miriam Hobbs, DNP, APRN, CNP, Amie Fonder, PA-C, and Yi L. Hwa, DNP, APRN, CNP

Case Study Mr. P was initially incidentally noted to have an elevated total protein in 2001 on an annual physical exam. As he was asymptomatic, workup was delayed until May 2002 when he had a bone marrow biopsy that showed approximately 20% involvement with lymphoplasmacytic lymphoma. His IgM lev...

Practice Matters

Mayo Clinic Hematology Fellowship for Advanced Practice Providers

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

The American population is growing, aging, and living longer. A shortage of hematologists/oncologists has been projected due to increased numbers of patients with new cancer diagnoses, those undergoing treatment, and long-term cancer survivors (American Society of Clinical Oncology, 2017; Yang et...

Practice Matters

Development of a Hematology-Oncology Advanced Practice Provider Fellowship Program

Jenna A. Kramer, ACNP-BC, and Camille Petraitis Valente, DNP, FNP-BC

Oncology care is a topic of great interest given its ever-growing complexity. In the United States, the population is living longer, cancer care is increasingly accessible, and there has been an overall expansion of oncologic services, creating a triad of demands for providers (American Society o...

Prescriber's Corner

Advancements in Therapy for Bladder Cancer: Enfortumab Vedotin

Kirollos S. Hanna, PharmD, BCPS, BCOP

Urothelial carcinoma (UC) is the sixth most common cancer in the United States and the second most common genitourinary cancer, with 81,400 new cases and 17,980 deaths estimated in 2020 (Siegel, Miller, & Jemal, 2020). Rates for new UC cases have been falling on average by 1.2% each year over...

Prescriber's Corner

Larotrectinib and Entrectinib: TRK Inhibitors for the Treatment of Pediatric and Adult Patients With NTRK Gene Fusion

Danielle B. Dunn, PharmD

Tropomyosin-related kinase (TRK) transmembrane proteins TRKA, TRKB, and TRKC are encoded by neurotrophic tyrosine receptor kinase (NTRK) genes NTRK1, NTRK2, and NTRK3, respectively (Amatu, Sartore-Bianchi, & Siena, 2016; Vaishnavi, Le, & Doebele, 2015). When the kinase domains are bound b...

Editorial

JADPRO Live 2019: Practice Innovation

Pamela Hallquist Viale, RN, MS, CNS, ANP

This past October, over 1,500 nurse practitioners, PAs, pharmacists, and other oncology professionals gathered at the Washington State Convention Center in Seattle for the seventh annual JADPRO Live conference addressing the unique educational and professional needs of the advanced practitioner i...

Meeting Report

Precision Oncology Comes of Age: Tumor-Agnostic Approaches

Presented by Colleen Lewis, MSN, ANP-BC, AOCNP®, and R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA

As clinical oncology transitions further away from classic cytotoxic chemotherapy towards precision medicine, drug development is increasingly driven by individual tumor genetics. Patients undergoing treatment with small molecules or immunotherapy, for example, are stratified by biological marker...

Meeting Report

Immune Checkpoint Inhibitor–Based Therapy as a Backbone in Cancer Treatment

Presented by Krista M. Rubin,(1) MS, FNP-BC, and Anthony J. Olszanski,(2) MD, RPh

The armamentarium of oncology health-care providers was restricted to chemotherapy for decades, but today’s treatment landscape is dominated by a host of novel agents, including immunotherapies, which have significantly improved outcomes for many patients, even cure for some patients with disease...

Meeting Report

Biomarker BINGO

Presented by Lauren Held, PharmD, BCOP,(1) Sandra Kurtin,(2) PhD, ANP-C, AOCN®, and Lee Schwartzberg,(3) MD, FACP

The selection of cancer therapy is increasingly based on the presence of relevant biomarkers. At JADPRO Live 2019, Lauren Held, PharmD, BCOP, of Seattle Cancer Care Alliance, Sandra Kurtin, PhD, ANP-C, AOCN®, of University of Arizona Cancer Center, and Lee Schwartzberg, MD, FACP, of West Cancer C...

Meeting Report

Adoptive Cell Therapies: Keeping Pace With New and Emerging Advances

Presented by Patricia Mangan, RN, MSN, CRNP, and Edward Stadtmauer, MD

While chemotherapy is an effective front-line treatment for numerous hematologic cancers, including acute lymphocytic leukemia (ALL), non-Hodgkin lymphoma (NHL), and multiple myeloma, it doesn’t cure all patients of their disease. For those in the relapsed or refractory setting, chimeric antigen ...

Meeting Report

Challenges of Integrating Biosimilars Into Clinical Practice

Presented by Kate Jeffers,(1) PharmD, MHA, BCOP, Megan May,(2) PharmD, BCOP, and Wendy H. Vogel,(3) MSN, FNP, AOCNP®

The U.S. Food & Drug Administration (FDA) has approved 23 biosimilars, including seven in 2019 alone. Despite this spate of approvals, however, only nine biosimilars are available to be purchased (Cohen et al., 2016). What’s more, a recent survey of more than 1,200 US physicians across all sp...

Meeting Report

2018–2019 Drug Updates in Hematologic Malignancies

Presented by Lauren Held, PharmD, BCOP

With the number of drug approvals for hematologic malignancies seemingly increasing every year, it’s imperative for advanced practitioners to not only stay up to date and informed but to also understand the data supporting the approval of these drugs. At JADPRO Live 2019, Lauren Held, PharmD, BCO...

Meeting Report

2018–2019 Drug Updates in Solid Tumors

Presented by Sally Barbour, PharmD, BCOP, CPP, FHOPA

Targeted agents and immunotherapy continue to redefine the oncology treatment landscape but have also introduced a slew of side effects that pose unique challenges for providers. At JADPRO Live 2019, Sally Barbour, PharmD, BCOP, CPP, FHOPA, reviewed the pharmacology of oncology agents approved be...

Meeting Report

First-Line Therapy for Metastatic Non–Small Cell Lung Cancer: State-of-the-Art Targeted Therapy and Immunotherapy Approaches

Presented by Joshua Bauml, MD, and Christina Knepley, CRNP

The treatment paradigm for metastatic non–small cell lung cancer (NSCLC) has changed dramatically in the past few years. At JADPRO Live 2019, Joshua Bauml, MD, and Christina Knepley, CRNP, of Penn Medicine, discussed the use of biomarkers to guide the selection of first-line therapy for metastati...

Meeting Report

Expert Insights on Triple-Negative Breast Cancer: Preparing for the Next Wave of Treatments

Presented by Heather R. Greene, MSN, FNP, AOCNP®, and Lee S. Schwartzberg, MD, FACP

Triple-negative breast cancer is a cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein. Significantly more aggressive than other molecular subtypes, triple-negative breast cancer carries the highest risk of mortality in both the early-stage and metas...

Meeting Report

Improving Outcomes in HER2-Positive Breast Cancer: Analysis and Application of Evolving Data and Best Practices

Presented by Jame Abraham, MD, and Kelley D. Mayden, MSN, FNP, AOCNP®

Historical standards of care for HER2-positive breast cancer have been impacted by emerging evidence over the past several years, leading to a significant decrease in breast cancer mortality. Nevertheless, approximately 268,000 women will be diagnosed this year, and more than 20,000 patients will...

Meeting Report

Hormone Receptor–Positive, HER2-Negative Breast Cancer: Recent Advances and Best Practices

Presented by Lee Schwartzberg, MD, FACP, and Heather Greene, MSN, FNP, AOCNP®

Approximately 70% of patients with metastatic breast cancer have hormone receptor–positive, HER2-negative disease, and nearly 30,000 patients die from this disease each year, but there has been a marked change in treatment over the past 5 years. CDK4/6 inhibitors have transformed the approach to ...

Meeting Report

Creating Clarity in Metastatic Melanoma: Optimizing Treatment and Improving Outcomes

Presented by Amanda M. Viereck, PA-C, and Anthony J. Olszanski, MD, RPh

In less than a decade, metastatic melanoma has transformed from a dreaded diagnosis to one of oncology’s biggest success stories. In 2011, overall survival for patients with metastatic melanoma was approximately 8 months with chemotherapy (Korn et al., 2008). In contrast, recent data of dual chec...

Meeting Report

Improving Outcomes for Patients With Advanced Urothelial Carcinoma

Presented by Petros Grivas, MD, PhD, and Jeannette Hammond, PA-C

The sixth-most common cancer, urothelial carcinoma led to an estimated 17,670 deaths in the US in 2019, and as of 2016, nearly 700,000 people in the US were living with the disease. In addition, because the average age at diagnosis is 73, patients often present with medical comorbidities that pos...

Meeting Report

Improving Outcomes for Patients With Metastatic Colorectal Cancer: Challenges and Strategies

Presented by Leslie A. Swanson,(1) ARNP, and Kathleen Boyle,(2) PA-C

While colorectal cancer remains one of the most commonly diagnosed malignancies over the past 30 years, outcomes have improved due to increased screening, the approval of new cytotoxic and targeted drugs, and the integration of multiple different treatment regimens in patients, as described at JA...

Meeting Report

Current and Future Directions for PARP Inhibition

Presented by Megan Grudem, APRN, CNP, and Andrea Wahner Hendrickson, MD

Although immunotherapy has dramatically altered the treatment paradigm for numerous types of cancer, the results have not been nearly as positive for ovarian cancer. Fortunately, a new class of agents that target the enzyme poly(ADP-ribose) polymerase (PARP) have had a major impact, especially ag...

Meeting Report

Recent Advances in the Treatment Of Newly Diagnosed Multiple Myeloma

Presented by Edward Libby,(1) MD, and Josh Epworth,(2) ARNP

Multiple myeloma is a malignancy characterized by clonal proliferation of terminally differentiated plasma cells within the bone marrow. While this leads to a host of different issues within the body, OS has steadily improved in recent years, and approximately 50% of patients are alive 5 years pa...

Meeting Report

Integrating Best Practices to Improve Outcomes in Relapsed/Refractory Multiple Myeloma

Presented by Amy E. Pierre,(1) MSN, ANP-BC, and Joshua Richter,(2) MD

Emerging treatments for relapsed/refractory multiple myeloma (RRMM) include options beyond triplets, including immunotherapy and mutation-driven therapy. In the treatment of RRMM, advanced practitioners should employ risk-adapted treatment strategies with the most effective available agents, tail...

Meeting Report

Improving Outcomes for Patients With Chronic Lymphocytic Leukemia

Presented by Mazyar Shadman,(1,2) MD, MPH, and Amy Goodrich,(3) CRNP

With over 20,000 new cases and nearly 4,000 deaths anticipated in 2020, chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western world, accounting for approximately 30% of leukemias (American Cancer Society, 2020). At JADPRO Live 2019, Mazyar Shadman, MD, MPH, Fred Hutchinson...

Meeting Report

Addressing the Challenges of Aggressive Lymphomas

Presented by Katherine L. Byar, MSN, ANP-BC, BMTCN®, and Matthew Lunning, DO, FACP

With an estimated 74,200 new cases in 2019, non-Hodgkin lymphoma (NHL) ranks seventh among men and women as the most frequently newly diagnosed cancer in the United States (American Cancer Society, 2019). Although death from this heterogeneous group of neoplasms is in decline due to improved trea...

Editorial

The American Cancer Society’s Facts & Figures: 2020 Edition

Pamela Hallquist Viale, RN, MS, CNS, ANP

As I write this in February, the American Cancer Society (ACS) has recently published their report on the state of cancer for this year (Siegel, Miller, & Jemal, 2020). This annual compilation of statistics, which reflects on trends and improvements in cancer mortality for various cancers, pr...

Research and Scholarship

Burnout, Workplace Factors, and Intent to Leave Among Hematology/Oncology Nurse Practitioners

Laura Bourdeanu,(1) NP, PhD, Qiuping (Pearl) Zhou,(2) PhD, RN, Michelle DeSamper,(3) Kaitlin Anne Pericak,(4) MA, and Arlene Pericak,(2) FNP-BC, DA

As baby boomers reach the age of 65, the incidence of cancer is estimated to increase by 67% by 2030 (Smith, Smith, Hurria, Hortobagyi, & Buchholz, 2009). The American Society of Clinical Oncology has long recorded the growing need for oncologists to fill the ranks, as senior ones retire or l...

Research and Scholarship

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 an acute disturbance in cognition, attention, and awareness that may fluctuate throughout the course of the day and is often due to an evolving medical condition (American Psychiatric Association, 2013). Delirium occurs in 30% to 80% of patients admitted to the intensive care unit (IC...

Review Article

Beyond CAR T-Cell Therapy: Continued Monitoring and Management of Complications

Victoria Reiser, RN, BSN, BMTCN, OCN®

Chimeric antigen receptor (CAR) T-cell therapy is a novel treatment currently approved by the U.S. Food & Drug Administration (FDA) for CD19-expressing hematologic malignancies (acute lymphoblastic leukemia, chronic lymphocytic leukemia, and lymphoma), yet the management of toxicities, long-t...

Grand Rounds

A Tale of Two Sisters: Breast Reconstruction Options for Women With or at High Risk of Breast Cancer

Kathryn Trotter,(1) DNP, CNM, FNP, FAAN, Jennifer K. Plichta,(2) MD, MS, FACS, and Michael Zenn,(3) MD, MBA, FACS

Case Study LM is a 51-year-old woman with a 4-cm infiltrating ductal carcinoma of the left breast. She is prediabetic but otherwise healthy. Family history includes breast cancer in her mother at 58 and “female cancer” in her maternal grandmother. Divorced, she worries about how this diagnosis an...

Practice Matters

Precautions for Patients Taking Aromatase Inhibitors

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 (AIs) are now U.S. Food & Drug Administration approved and have been shown to be more effective than the antiestrogen drug tamoxifen in the postmenopausal population. There are three medications that are second-generation AIs, including anastrozole (Arimidex), letrozole (...

Practice Matters

Determination of the Fair Market Value of Oncology Advanced Practitioners

Wendy H. Vogel, MSN, FNP, AOCNP®

The 2020 American Cancer Society’s Annual Cancer Facts & Figures Report notes that approximately 1.8 million Americans will be diagnosed and almost 606,520 will die from cancer during the year (American Cancer Society, 2020). Over 16.9 million Americans are living with cancer, more than ever ...

Prescriber's Corner

Glasdegib: A Novel Hedgehog Pathway Inhibitor for Acute Myeloid Leukemia

Daniel L. Thompson,(1) PharmD Candidate, and Donald C. Moore,(2) PharmD, BCPS, BCOP, DPLA

Acute myeloid leukemia (AML) is an aggressive myeloid stem cell disorder that causes bone marrow failure. It is the most common acute leukemia in adults, with an estimated 21,450 new diagnoses and 10,920 deaths in 2019 (Siegel, Miller, & Jemal, 2019). The median age of diagnosis is 67 years (...

Editorial

Breast Density and Breast Cancer

Pamela Hallquist Viale, RN, MS, CNS, ANP

If a woman receives a screening mammogram that demonstrates high breast density, it is mandated that the mammogram report include a summary about how dense breast tissue is a common occurrence and that the density can make it harder to evaluate the results of the mammogram exam (American Cancer S...

Research and Scholarship

Implementation of Survivorship Care Plans in Patients With Glioblastoma

Casey B. Brown,(1) DNP, RN, AGPCNP-BC, Deborah Allen,(1) PhD, RN, CNS, FNP-BC, AOCNP®, Christina Cone,(1) DNP, APRN, ANP-BC, AOCNP®, and Susan M. Schneider,(2) PhD, RN, AOCN®, ACNS-BC, FAAN

Glioblastoma is often defined as a terminal diagnosis. Although this is sometimes inevitable, patients are living longer due to advances in therapy and symptom management (National Cancer Institute [NCI], 2013). Patients often go back to work and return to normal activities. Many report that they...

Grand Rounds

Management of Acute Pancreatitis Associated With Checkpoint Inhibitors

Barbara Barnes Rogers, CRNP, MN, AOCN®, ANP-BC, Terri Cuddahy, RN, MSN, OCN®, and Carolyn Zawislak, MPAS, PA-C

Case Study KG is a 55-year-old male who was diagnosed with stage IIIB squamous cell lung cancer (non–small cell lung cancer) in 2017. His medical history includes hypertension, diabetes, and hyperlipidemia, all of which have been under control for the past 5 years through medication. His type 2 ...

Grand Rounds

Dihydropyrimidine Dehydrogenase Deficiency: To Screen or Not to Screen?

Wendy H. Vogel,(1) MSN, FNP, AOCNP®, Ahmed Minhas,(2) MD, and Steven Baumrucker,(1) MD

Case Study SJ is a 69-year-old female with recurrent breast cancer. She was originally diagnosed with clinical stage IIIB, human epidermal growth factor receptor 2 (HER2)-positive infiltrating ductal carcinoma of the breast. She receives neoadjuvant chemotherapy with docetaxel, pertuzumab, and t...

Continuing Education

CE Information: Advances in Oral Oncolytic Agents for Breast Cancer and Recommendations for Promoting Adherence

Advances in Oral Oncolytic Agents for Breast Cancer and Recommendations for Promoting Adherence Read the certified article Provided by Release date: 1/22/2020 Expiration date: 1/21/2021 Estimated time of completion: 1.0 hour Media: Certified journal article TARGET AUDIENCE This activi...

Continuing Education

Advances in Oral Oncolytic Agents for Breast Cancer and Recommendations for Promoting Adherence

Theresa Wicklin Gillespie, RN, MA, PhD, FAAN

Breast cancer represents the most common cancer among women in the United States and worldwide. The aging of the “baby boom” generation has contributed to an increase in breast cancer cases, since increasing age is a primary risk factor for breast cancer diagnosis (National Comprehensive Cancer N...

Practice Matters

Metabolic Syndrome, Exercise, and Cardiovascular Fitness in Breast Cancer Survivors

M. Tish Knobf, PhD, RN, AOCN®, FAAN, and Sangchoon Jeon, PhD

The role of the advanced practitioner in oncology is to provide high-quality, patient-centered care to complex patients with unique needs (Ewing, 2015; Wall & Rawson, 2016). One aspect of oncology care is the challenge of managing cancer survivors who are at risk for or have comorbid illness ...

Prescriber's Corner

Gilteritinib: A Novel FLT3 Inhibitor for Relapsed/Refractory Acute Myeloid Leukemia

Dennis Marjoncu,(1) PharmD, BCOP, and Benjamin Andrick,(2) PharmD, BCOP

Acute myeloid leukemia (AML) is the most common adult leukemia, with an estimated incidence of 21,450 patients in 2019. Additionally, mortality remains high, with an estimated 10,920 deaths occurring in 2019 (American Cancer Society, 2019). The underlying pathophysiology is driven by clonal proli...

Diagnostic Snapshot

Management of Gastric Outlet Obstruction in a Patient With Gastric Cancer

Irene Thomas Thayil, PA-C

History Ms. H is a 72-year-old female with a personal history of CVA and PVD who presented with nausea, decreased appetite, and weight loss. She underwent an endoscopy that revealed a large, infiltrative, partially circumferential mass in the gastric curvature and prepyloric region of the stomach...

Editorial

Patient Safety and Disclosure

Pamela Hallquist Viale, RN, MS, CNS, ANP

Attendees of our seventh annual JADPRO Live conference in Seattle are settling back into their routines after a fun-filled conference packed with practice-changing information. Over 1,500 advanced practitioners and other oncology-focused attendees enjoyed 4 days of networking and clinical updates...

Quality Improvement

The Development of an Oncology Clinical Nurse Specialist Fellowship Program

Allison Ann de Villiers,(1) MSN, APRN-CNS, OCN®, ACNS-BC, Lisa Maree Blackburn,(1) MS, APRN-CNS, RN-BC, AOCNS®, Danette Birkhimer,(1) MS, APRN-CNS, AOCNS®, Lynne R. Brophy,(1) MSN, APRN-CNS, RN-BC, AOCN®, Jamie Tippett,(1) MS, RN, NEA-BC, Karen Meade,(1) MS, APRN-CNS, AGCNS-BC, CPAN®, OCN®, and Carlton G. Brown,(2) PhD, RN, AOCN®, NEA-BC, FAAN

With the increasingly complex needs of patients with cancer and the nurses caring for them, the clinical nurse specialist (CNS) is in an ideal position to positively affect care, nursing practice, as well as health-care systems and organizations. There are differences in the advanced practice rol...

Original Research

Associations Between Cytokine Levels and Long-Term Symptom Development in Head and Neck Cancer Patients

Benjamin Stuart Schultze, PhD, MSN, MEd, ACNP

In addition to targeting cancer as a disease process in the hopes of driving remission, the advanced practice provider must contend with a myriad of symptoms that patients often endure during their illness, such as weight loss, depression, and fatigue. Currently, there is no way of deciphering wh...

Review Article

AL Amyloidosis: Unfolding a Complex Disease

Rebecca Lu, MS, FNP, and Tiffany A. Richards, PhD, ANP-BC

Amyloidosis is a disease in which misfolded proteins deposit within the organs and tissues, leading to progressive organ failure and ultimately death (Gillmore & Hawkins, 2013). There are many different subtypes of amyloidosis, including amyloid protein immunoglobulin light chain (AL) amyloid...

Grand Rounds

The Role of Advanced Practitioners in Optimizing Clinical Management and Support of Patients With Cytokine Release Syndrome From CAR T-Cell Therapy

Sherry Adkins, MSN, ANP-C

Case Study Mr. M, a 45-year-old male with a history of relapsed/refractory diffuse large B-cell lymphoma (DLBCL), is 5 days post CAR T-cell therapy and develops a fever of 40°C and sinus tachycardia. His blood pressure is at baseline at 118/70 mm Hg. His respiratory rate is normal and oxygen satu...

Grand Rounds

Chronic Neutrophilic Leukemia: A Case Report of a Rare Myeloproliferative Neoplasm With a CSF3R Mutation

Lorinda A. Coombs, PhD, FNP-BC, AOCNP

Case Study An 84-year-old man was initially referred to hematology in 2017 for an inpatient consultation for worsening leukocytosis in the setting of a clinically identified cellulitis. The cellulitis improved with antibiotics and his complete blood count (CBC) at the time revealed an elevated wh...

Grand Rounds

Optimizing the Management of Carcinoid Syndrome to Reduce the Impact of Diarrhea

Rory Randall,(1) CNP, AOCNP®, Bonita Bennett,(2) RN, BSN, Tiffany Valone,(3) PA-C, MS, OT, and Kirsten Blue,(3) PA-C, MS

Case Study A 54-year-old male presented with complaints of periodic facial flushing and diarrhea for more than a year. He is experiencing debilitating diarrhea, with loose or watery stools accompanied by abdominal pain and fecal urgency up to 20 times per day. Medical history was significant for ...

Practice Matters

Advanced Practitioners: Collaborators in Radiation Oncology

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

According to the 2018 version of “Practice Parameter for Radiation Oncology” by the American College of Radiology (ACR) and the American Society of Radiation Oncology (ASTRO), the delivery of radiation therapy is a complex process and requires completion of 11 distinct but interrelated activities...

Prescriber's Corner

Axicabtagene Ciloleucel: The First FDA-Approved CAR T-Cell Therapy for Relapsed/Refractory Large B-Cell Lymphoma

Amber C. King, PharmD, BCOP, and Jennifer S. Orozco, PharmD

Recent advances in cancer immunology have led to novel developments in chimeric antigen receptor (CAR) T-cell therapy. The immune system provides defense against a host of potential insults, including malignancy. T cells are integral to the immune response to malignancy; they express tumor antige...

Prescriber's Corner

Mogamulizumab-kpkc: A Novel Therapy for the Treatment of Cutaneous T-Cell Lymphoma

Sutton Watson,(1) PharmD, and Justin Bradley Marx,(2) PharmD, BCPS

Cutaneous T-cell lymphoma (CTCL) is a rare non-Hodgkin lymphoma (NHL) that primarily arises in the skin but may involve the viscera, lymphatic system, and blood (National Comprehensive Cancer Network [NCCN], 2019). The overall prevalence is approximately 7.5 cases for every 1 million people in th...

Meeting Abstract

Abstracts from JADPRO Live 2019

JL701: Adapting to an Evolving Environment: The Role of the Inpatient Oncology Advanced Practitioner Team Kimberlee Gold, PA-C, MPAS, University of Washington; Leah Roess, PA-C, MSPAS, University of Washington; Justin Speyer, ARNP, University of Washington Medical Center/Seattle Cancer Care Alli...

Editorial

Thank You to Our Peer Reviewers!

In this last issue of the year, we would like to acknowledge everyone who completed peer reviews for JADPRO in the past year. Our reviewers, who are from a wide variety of oncology specialties, dedicate their expertise and time to provide insightful feedback on submitted manuscripts. We hope that...

Editorial

Timely Assessment and Management of Febrile Neutropenia

Pamela Hallquist Viale, RN, MS, CNS, ANP

It’s almost time for JADPRO Live in Seattle this October. The meeting promises to be another packed 4 days of focused and relevant education for the advanced practitioner (AP). I hope to see you there! Management of Febrile Neutropenia Assessment and management of patients experiencing an oncolog...

Quality Improvement

Long-Acting Somatostatin Analogue Safety Monitoring Protocol for Outpatients With Neuroendocrine Tumors

Jordan Gabrielsen,(1) PharmD, Gianna Girone,(1) PharmD, Bonita Bennett,(2) BSN, and Anna Jung,(2) PharmD, BCPS

Long-acting formulations of somatostatin analogues (SSAs) that are approved for use include octreotide (Sandostatin LAR Depot, Novartis Pharmaceuticals Corporation, 2019a; Sandostatin LAR, Novartis Pharmaceuticals UK Ltd, 2018a), lanreotide (Somatuline Depot, Ipsen Biopharmaceuticals, Inc, 2019; ...

Quality Improvement

Implementation of a Survivorship Care Plan Program in a Community-Based Oncology Clinic

Stephanie L. Soulia,(1) DNP, RN, ANP-BC, Elizabeth A. Duffy,(2) DNP, RN, CPNP, Kimberly A. Morley,(3) MD, and Ellen M. L. Smith,(2) PhD, APRN, AOCN®, FAAN

Fourteen million cancer survivors are living in the United States today. Due to improved early detection and treatment, this number is expected to double by 2030 (Centers for Disease Control and Prevention, 2016). This increased survival brings its own challenges: Survivors need preparation to tr...

Review Article

Aztreonam and Vancomycin for Initial Treatment of Febrile Neutropenia in Penicillin-Allergic Patients During Hematopoietic Stem Cell Transplantation

Steven Trifilio, RPh, and Jayesh Mehta, MD

Infections that occur during episodes of neutropenic fever (NF) in patients who undergo hematopoietic stem cell transplantation (HSCT) can cause serious morbidity and mortality. Guidelines suggest initiating antibiotic coverage with a broad-spectrum β-lactam antibiotic as the backbone for initial...

Grand Rounds

Treatment of Pregnancy-Associated Breast Cancer

Bernadette Labriola, RN, MSN, FNP-C

Breast cancer is the second most common cancer diagnosis during pregnancy (Shachar et al., 2017). It occurs in approximately 0.2% to 2.6% of all woman diagnosed with cancer (Shachar et al., 2017). Cervical cancer during pregnancy is the most common cancer diagnosis during pregnancy (Shachar et al...

Practice Matters

Oncology Couples’ Retreats: A Focus on Relationships Between Patients and Their Caregivers

Amy Hacker-Prietz, PA-C, Eden Stotsky-Himelfarb, BSN, RN, Beth Kozak Onners, RN, MS, CCRN, OCN®, and Janet Street

In addition to the physical health concerns that a cancer diagnosis brings, a wide spectrum of psychosocial concerns also accompanies a diagnosis. These psychosocial concerns affect not only the patient, but also the family and caregiver, and often to a greater extent. Some oncology patients are ...

Prescriber's Corner

A Review of PI3K Inhibitors in B-Cell Malignancies

Laura Cannon,(1) PharmD, MPH, Emmeline C. Academia,(2) PharmD, and Ashley E. Glode,(2) PharmD, BCOP

Activation of the phosphoinositide 3-kinase (PI3K) pathway has become an area of interest in cancer pathophysiology and drug development. The PI3K pathway plays a primary role in cell signaling and cellular responses such as proliferation and metabolism, and overexpression of PI3K isoforms may be...

Prescriber's Corner

Letermovir for Cytomegalovirus Prevention in Patients Undergoing Hematopoietic Cell Transplantation

Kori Daniels, PharmD, and Amber Clemmons, PharmD, BCOP

Cytomegalovirus (CMV) is a ubiquitous double-stranded DNA herpes virus that infects over 50% of adults by age 40 (Bhat, Joshi, Sarode, & Chavan, 2015). Transmission most commonly occurs through direct contact with bodily fluids (e.g., saliva or urine), sexual contact, perinatally (in utero, t...

Diagnostic Snapshot

Diagnostic Snapshot: What Caused This Left Renal Infiltrate in a Young, Healthy Woman?

Elizabeth Wolf, PA-C

HISTORY VD is a 44-year-old female who presented on July 10, 2018, to the Urology clinic with a left renal pelvis lesion. She initially had an episode of abdominal pain on March 29, 2018, that prompted a CT scan of the abdomen and pelvis. The CT showed an abnormality in the left upper pole with c...

Editorial

2019 ASCO Annual Meeting: Takeaways for Advanced Practitioners

Pamela Hallquist Viale, RN, MS, CNS, ANP

Welcome to our special issue on highlights from the American Society of Clinical Oncology’s (ASCO) Annual Meeting held this past June in Chicago. Although the 5-day meeting always has dozens of worthy presentations to learn from, we’ve chosen to focus on some of the more relevant presentations to...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Gastrointestinal Cancer

Carolyn Grande, CRNP, AOCNP®

Abstract 3501: IDEA Collaboration Turns to Duration of Adjuvant Treatment in Stage II Colon Cancer By Caroline Helwick Visit https://meetinglibrary.asco.org/record/171153/abstract to read the full abstract and view author disclosures. The findings of the landmark IDEA trial in stage III colorect...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Prostate Cancer

Jennifer L. Glass, PA-C, MS

Abstract LBA2: ENZAMET: Addition of Enzalutamide to Standard of Care in Metastatic Hormone-Sensitive Prostate Cancer By The ASCO Post Visit https://meetinglibrary.asco.org/record/174531/abstract to read the full abstract and view disclosures. In interim analysis of the international, randomized p...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Genitourinary (Non-Prostate) Cancers

Jeannette Hammond, PA-C

Abstract LBA4505: Enfortumab Vedotin After Checkpoint Inhibition in Metastatic Urothelial Cancer By Alice Goodman Visit https://meetinglibrary.asco.org/record/171836/abstract to read the full abstract and view disclosures. A phase II study found that treatment with the antibody-drug conjugate enf...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Gynecologic Cancers

Laura Doherty, FNP-BC, AOCNP®

Abstract 5500: Paclitaxel/Carboplatin vs Paclitaxel/Ifosfamide in Carcinosarcoma of the Uterus or Ovary By The ASCO Post Visit https://meetinglibrary.asco.org/record/173464/abstract to read the full abstract and view author disclosures. Results from the phase III NRG Oncology clinical trial GOG-0...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Breast Cancer

Wendy H. Vogel, MSN, FNP, AOCNP®

Abstract LBA1008: MONALEESA-7 Shows Overall Survival Benefit for Ribociclib/Endocrine Therapy By Caroline Helwick Visit https://meetinglibrary.asco.org/record/174827/abstract to read the full abstract and view disclosures. The first statistically significant overall survival benefit has been sho...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Non–Small Cell Lung Cancer

Elizabeth S. Waxman, RN, MSN, AOCN®, ANP-BC

Abstracts 9007 and 9008: Advances in Targeted Therapy for Non–Small Cell Lung Cancer By Alice Goodman Visit https://meetinglibrary.asco.org/record/174631/abstract and https://meetinglibrary.asco.org/record/174550/abstract to read the full abstracts and view disclosures. Targeted therapies for non...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Melanoma

Lisa Kottschade, APRN, MSN, CNP

Abstracts 2512 and 2517: Study Finds Immune-Related Adverse Events Herald Benefit With Adjuvant Pembrolizumab in Melanoma By Caroline Helwick Visit https://meetinglibrary.asco.org/record/172423/abstract and https://meetinglibrary.asco.org/record/172428/abstract to read the full abstracts and view...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Other Solid Cancers

Amy Hacker-Prietz, (1) MS, PA-C, Abby Fuoto, (2) DNP, ANP-BC, AOCNP®, ACHPN, Nanette Fong, (3) RN, MSN, and P. Andrew Allred, (4) MS, PA-C

Abstract LBA4: POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer By Caroline Helwick Visit https://meetinglibrary.asco.org/record/174488/abstract to read the full abstract and view disclosures. In patients with metastatic pancreatic cancer an...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Hematologic Malignancies

Amy Pierre, MSN, ANP-BC, and Nancy M. Nix, PharmD, BCPS, BCOP

Abstract 8001: Evidence Builds for Treating Smoldering Myeloma By Caroline Helwick Visit https://meetinglibrary.asco.org/record/172276/abstract to read the full abstract and view disclosures. In patients with intermediate- to high-risk smoldering multiple myeloma, treatment with single-agent lena...

Meeting Report

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Issues in Oncology

Pamela Hallquist Viale, RN, MS, CNS, ANP

Abstracts 10530 and 10503: Discrimination, Gender Bias in Oncology Training and Professional Meetings By The ASCO Post Visit https://meetinglibrary.asco.org/record/173416/abstract and https://meetinglibrary.asco.org/record/173397/abstract to read the full abstracts and view disclosures. Two studi...

Editorial

Improvements in Advance Care Planning Can Translate to Patient Comfort

Pamela Hallquist Viale, RN, MS, CNS, ANP

In our last issue, I reported on the highlights from the American Society of Clinical Oncology’s (ASCO) Annual Report on Progress Against Cancer. As noted in the report, we’ve experienced tremendous advances in the care of our patients with cancer, with an approximate 25 years of decline in the o...

Original Research

Incidence of Hypersensitivity Reactions to Carboplatin or Paclitaxel in Patients With Ovarian, Fallopian Tube, or Primary Peritoneal Cancer With or Without BRCA1 or BRCA2 Mutations

Andrew Garcia,(1) PharmD, Corey Frahm,(1) PharmD, Joanne M. Jeter,(2) MD, Ivo Abraham,(1) PhD, RN, Setsuko K. Chambers,(3) MD, Janiel M. Cragun,(3) MD, and Ali McBride,(1) PharmD

Many antineoplastic agents have been known to cause hypersensitivity reactions (HSRs). The incidences of HSRs are highly variable within and between all major categories of antineoplastic drugs (DeMoor et al., 2011). Of the platinum compounds, carboplatin has been reported to account for 0.73% of...

Quality Improvement

A Support Intervention for Family Caregivers of Advanced Cancer Patients

Betty Ferrell,(1) PhD, RN, MA, FAAN, FPCN, CHPN, Kate Kravits,(1) MA, RN, HNB-BS, LPC, NCC, ATR-BC, Tami Borneman,(1) RN, MSN, CNS, FPCN, Sumanta K. Pal,(1) MD, and Janet Lee,(2) EdM

Advanced practitioners (APs) in oncology spend significant time communicating with and supporting family caregivers. The family caregiver’s role has become increasingly important as cancer care has shifted from inpatient to home-based care. Family caregivers are the primary providers of cancer ca...

Quality Improvement

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

The number of patients surviving a cancer diagnosis continues to increase. Cancer survivorship reached nearly 15.5 million people in 2014, and this is projected to increase to over 20 million by 2026 (National Cancer Institute, 2016). Although improved survival is an exciting and much desired out...

Review Article

Immunoglobulin Light-Chain Amyloidosis: Clinical Presentations and Diagnostic Approach

Yi L. Hwa, DNP,(1) Teresa Fogaren, MSN, AGNP-C,(2) Allison Sams, AGPCNP-BC,(3) Douglas V. Faller, MD, PhD,(4) Dawn M. Stull, PharmD, BCOP,(5) Sara Thuenemann, RN, MSN, DHSc,(6) and Lisa Mendelson, MSN, AGPCNP-BC(7)

Systemic immunoglobulin light-chain (AL) amyloidosis is caused by plasma cell clones in the bone marrow (median 7%–10% marrow infiltration) that produce insoluble, misfolded immunoglobulin light chain proteins, which are deposited in various tissues and organs as amyloid fibrils leading to progre...

Grand Rounds

Therapy Management Using Modified 2-Weeks-On/1-Week-Off Dosing Schedule in Patients With Metastatic Renal Cell Carcinoma Receiving Sunitinib: A Hypothetical, Illustrative Case Scenario

Kimberly D. Allman,(1) CNP, Joanne C. Ryan,(2) PhD, RN, Andrew Clair,(2) PhD, and Sarah Yenser-Wood,(3) NP

An estimated 73,820 patients in the United States will be diagnosed with renal cell carcinoma (RCC) in 2019 (National Cancer Institute, 2019), and up to 40% of RCC patients will eventually experience progression to metastatic disease (Ferlay et al., 2015; Znaor Lortet-Tieulent, Laversanne, Jemal,...

Prescriber's Corner

Ivosidenib: IDH1 Inhibitor for the Treatment of Acute Myeloid Leukemia

Shelby L. Merchant, PharmD, Kathryn Culos, PharmD, BCOP, and Houston Wyatt, PharmD, CSP

Acute myeloid leukemia (AML) is a hematologic malignancy originating from abnormal proliferation of immature hematopoietic cells in the bone marrow. Patient age, performance status, molecular markers, and cytogenetics determine risk stratification and prognosis. Approximately two thirds of patien...

Prescriber's Corner

Apalutamide for the Treatment of Nonmetastatic Castration-Resistant Prostate Cancer

Urvi J. Patel, PharmD, MPH, and Sarah Caulfield, PharmD, BCOP

Prostate cancer is a male-specific oncologic disease that is one of the top four leading causes of cancer in the United States, which is evidenced by an incidence rate of 9.9% of all new cancer cases in 2019 (National Cancer Institute, 2019). It is the most commonly diagnosed cancer in males, wit...

Editorial

American Society of Clinical Oncology Reports on Clinical Cancer Advances

Pamela Hallquist Viale, RN, MS, CNS, ANP

It's always exciting to review the yearly report from the American Society of Clinical Oncology (ASCO) on our progress against cancer. The report brings attention to the most important clinical research advances of the past year and examines critical areas where we should focus future research ef...

Original Research

Real-World Experience With Cabozantinib in Metastatic Clear Cell Renal Cell Carcinoma: A Retrospective Analysis

Emily A. Lemke, DNP, RN, AGPCNP-BC, AOCNP®, Amishi Y. Shah, MD, Matthew Campbell, MD, and Nizar M. Tannir, MD

Kidney cancer continues to be among the 10 most common cancers in both men and women, with an estimated 73,820 new cases in 2019. Metastatic kidney cancer remains largely incurable, with an estimated 14,770 deaths projected in 2019 (American Cancer Society, 2019). Kidney cancer is largely a disea...

Original Research

Diversity Awareness and Documentation Practices Among Oncology Advanced Practice Providers

Victoria Poillucci, MSN, ACNP-BC, and Christina Z. Page, MSN, RN, AOCNP®, AGPCNP-BC

Health-care providers have the unique challenge of caring for widely diverse populations. The United States currently has the most polyracial, polyethnic, and polyreligious population in history (Andrews & Boyle, 2002). Health disparities are defined as “differences in health outcomes and the...

Review Article

Cardiac Toxicity and Anthracyclines: Mechanism, Interventions, and the Trouble With Troponin

Grace E. Thompson, MSN, AGACNP-BC, AGPCNP-BC, and Phyllis P. Wright, DNP, AGPCNP-BC, MPH

Cancer survivorship has increased partly due to the plethora of new cancer treatments. Half of adults diagnosed with cancer today will survive at least 10 years; in childhood cancer survivors, the survivorship number is closer to 75% (Henriksen, 2018). An estimated 14.5 million people in the Unit...

Review Article

The Advanced Practice Provider Perspective: Treating Patients With Immuno-Oncology Combination Therapy Across Tumor Types

Brianna Hoffner,(1) MSN, ANP-BC, AOCNP®, Renae Vaughn,(2) MSN, ANP-C, AOCNP®, Maureen Reed,(3) MSN, ANP-C, AOCNP®, and Melinda S. Weber,(4) DNP, RN, APN, AOCN®

Immuno-oncology (IO) is an evolving treatment modality that includes immunotherapies able to directly target and harness the patient’s immune system to kill tumor cells (Antonia, Larkin, & Ascierto, 2014). Several IO agents, many of which were approved through accelerated regulatory processes...

Grand Rounds

Breast Cancer in the Transgender Population

Andrea Fehl,(1) FNP-C, MSN, AOCNP®, Shannon Ferrari,(1) PA-C, MPAS, Zoe Wecht,(1) BS, and Margaret Rosenzweig,(2) PhD, FNP-C, AOCNP®, FAAN

Sexual and gender minorities (SGM) represent a population of individuals who experience disparities in health care that put them at risk for poor health-care outcomes. Sexual and gender minority is an umbrella term that encompasses lesbian, gay, two-spirit, bisexual, and transgender populations, ...

Translating Research Into Practice

Secondary Analysis Research

Rita J. Wickham, PhD, RN, AOCN®

Secondary analysis of data collected by another researcher for a different purpose, or SDA, is increasing in the medical and social sciences. This is not surprising, given the immense body of health care–related research performed worldwide and the potential beneficial clinical implications of th...

Prescriber's Corner

Rucaparib and Niraparib in Advanced Ovarian Cancer

Tyler Redelico, PharmD

Poly(ADP-ribose) polymerases (PARPs) are a family of enzymes, some of which are key components of the base-excision DNA repair pathway (Livraghi & Garber, 2015). There are now four approved PARP inhibitors: olaparib (Lynparza) was approved by the U.S. Food and Drug Administration (FDA) in 201...

Editorial

JADPRO Live 2018: Bringing Clarity to Complexity

Pamela Hallquist Viale, RN, MS, CNS, ANP

This past November, over 1,400 nurse practitioners, PAs, pharmacists, and other oncology professionals gathered at The Diplomat hotel in Hollywood, Florida, for the sixth annual JADPRO Live conference addressing the unique educational and professional needs of the advanced practitioner in hematol...

Meeting Report

CAR T-Cell Therapy and the Pharmacology of Managing Cytokine Release Syndrome

Presented by Jae Park, MD, and Amber C. King, PharmD, BCOP

In just over a decade, chimeric antigen receptor (CAR) T-cell therapy has gone from basic science to the American Society of Clinical Oncology’s “2018 Advance of the Year,” helping heavily pretreated patients with poor prognosis achieve durable remissions. While there are currently two CAR T-cell...

Meeting Report

2017-2018 Drug Approvals in Solid Tumors

Presented by Patrick J. Kiel, PharmD, BCPS, BCOP

Recent approvals for solid tumors by the US Food and Drug Administration (FDA) have not included new classes of agents, but new uses for existing drugs. These include cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitors, poly (ADP-ribose) polymerase (PARP) inhibitors, tyrosine kinase inhibitors w...

Meeting Report

2017-2018 Drug Updates in Hematologic Malignancies

Presented by Rebecca J. Nelson, PharmD, BCOP

Between 2016 and 2017, approval of several drugs by the US Food and Drug Administration (FDA), including four major drugs for acute myeloid leukemia (AML) and chimeric antigen receptor (CAR) T-cell therapy in acute lymphoblastic treatment (ALL), dramatically altered the landscape of treatment for...

Meeting Report

Treating Venous Thrombosis in Oncology

Presented by Rowena Schwartz, PharmD, BCOP

With the oncology landscape changing rapidly, effective care requires bringing clarity to complex data, and this is especially true for the treatment of venous thromboembolism (VTE) in cancer. Although newer options may make therapy easier to use, said Rowena Schwartz, PharmD, BCOP, of the Univer...

Meeting Report

Advances in the Treatment of HER2-Positive Breast Cancer

Presented by Reshma Mahtani, DO, and Lisa Hineman, MS, AOCN®, PHN, ANP-C

Although targeted therapies have improved outcomes, including survival, for many women with human epidermal growth factor receptor 2 (HER2)–positive breast cancer, the risk of recurrence remains an issue for many. At JADPRO Live 2018, Reshma Mahtani, DO, of Sylvester Comprehensive Cancer Center a...

Meeting Report

Surgical Implications for Women With Breast Cancer

Presented by Sherry Goldman, MSN, NP, CBCN

Treatment for breast cancer is not a one-size-fits-all approach but must correspond to the needs of the individual patient. At JADPRO Live 2018, Sherry Goldman, MSN, NP, CBCN, of Cedars-Sinai Medical Center, in Beverly Hills, California, explained the different surgical rationales for lumpectomy,...

Meeting Report

Management of Side Effects for Patients Receiving Multimodality Therapy in Thoracic Oncology

Presented by Marianne Davies, DNP, RN, CNS, ACNP, AOCNP®, and Beth Eaby-Sandy, MSN, CRNP

Annual deaths from lung cancer exceed those from breast, prostate, and colon cancer combined. Since lung cancer is frequently life-threatening, many patients are constantly on treatment, according to information presented at JADPRO Live 2018 by Marianne Davies, DNP, RN, CNS, ACNP, AOCNP®, of the ...

Meeting Report

Evolving Therapies in the Clinical Management of Melanoma

Presented by Lisa A. Kottschade, APRN, MSN, CNP, and Svetomir N. Markovic, MD, PhD

Since 2011 there has been an explosion of drugs for the treatment of metastatic melanoma, including BRAF mutation–guided therapy with BRAF/MEK inhibitors—vemurafenib (Zelboraf) plus cobimetinib (Cotellic), dabrafenib (Tafinlar) plus trametinib (Mekinist), and encorafenib (Braftovi) plus binimetin...

Meeting Report

Multimodal Therapies for Head and Neck Cancer

Presented by Julie E. Bauman, MD, MPH, and Abby Fuoto, DNP, ANP-BC, AOCNP®, ACHPN

While the majority of head and neck cancer is preventable and tobacco-related head and neck cancer is actually decreasing in the United States, throat cancer related to the human papillomavirus (HPV) has become increasingly widespread. At JADPRO Live 2018, Julie Bauman, MD, MPH, a professor of me...

Meeting Report

Sequencing of Treatments for Patients With Ovarian Cancer

Presented by Laura Doherty, FNP-BC, AOCNP®, and Katina Robison, MD

The challenge for advanced practitioners (APs) in oncology who treat women with ovarian cancer is that 80% of advanced ovarian cancers will recur during or after first-line treatment (Hanker et al., 2012). Thus, at JADPRO Live 2018, Laura Doherty, FNP-BC, AOCNP®, and Katina Robison, MD, both of t...

Meeting Report

Sequencing Therapies in Renal Cell Carcinoma

Presented by Sumanta Kumar Pal, MD, and Kathleen Burns, AGACNP-BC, OCN®

With dual checkpoint inhibition, immunotherapy and vascular endothelial growth factor (VEGF)–inhibitor combinations, and tyrosine kinase inhibitor monotherapy all viable options for advanced renal cell carcinoma, choosing the right regimen for patients has become more complicated than ever. At JA...

Meeting Abstract

Therapeutic Advances in Prostate Cancer

Presented by Robert Dreicer, MD, MS, MACP, FASCO, and Morgane C. Diven, PharmD, BCOP

With seven different agents approved by the FDA for the treatment of advanced prostate cancer since 2004, and new evidence for integrating some of these agents earlier in the disease, clinicians are increasingly challenged with determining the optimal sequencing of these agents. At JADPRO Live 20...

Meeting Report

Differential Diagnosis and Testing for Hematologic Malignancies

Presented by Sandra E. Kurtin, PhD, ANP-C, AOCN®, and Jennifer Knight, MD

Most hematologic malignancies are heterogeneous, meaning they have variable phenotypes, clinical presentation, and outlook for progression and survival—all of which also evolve over time, even within an individual patient. The types of treatments and options within drug classes are also rapidly e...

Meeting Report

Sequencing Therapies in Indolent Lymphomas

Presented by Philip A. Thompson, MB, BS, and Lisa Nodzon, PhD, ARNP, AOCNP®

Many targeted agents have emerged for treating chronic lymphocytic leukemia (CLL), which has made treatment selection more complex, according to Philip A. Thompson, MB, BS, assistant professor in the department of leukemia at The University of Texas MD Anderson Cancer Center. Dr. Thompson describ...

Meeting Report

Modern Management of Classical Hodgkin Lymphoma

Presented by Amy Goodrich, CRNP, and Jose D. Sandoval-Sus, MD

Many patients with classical Hodgkin lymphoma (cHL) have good outcomes, but some have a more challenging disease and require multiple lines of therapy. Fortunately, treatment options are growing. Since patients with relapsed or refractory HL are starting to have improved life expectancy, they may...

Meeting Report

Advances in the Management of Myeloma

Presented by Beth Faiman, PhD, MSN, APRN-BC, AOCN®, and Rachid Baz, MD

An explosion of new agents has changed the treatment paradigm of multiple myeloma and amyloidosis. Knowledge of these drugs—their individual and class effects, including toxicity—allows advanced practitioners to keep their patients on these effective drugs, according to Rachid Baz, MD, of Moffitt...

Meeting Report

New Directions in Acute Myeloid Leukemia

Presented by Kelda Gardner, PA-C, MHS, and Melinda Tran, PharmD, BCOP

Acute myeloid leukemia (AML) is diagnosed in about 20,000 people a year and remains a very challenging malignancy to treat. Advanced practitioners at JADPRO Live 2018 were updated on risk classification, response criteria, and encouraging new therapies by Kelda Gardner, PA-C, MHS, teaching associ...

Editorial

The Benefits of Nuts for Cancer Prevention

Pamela Hallquist Viale, RN, MS, CNS, ANP

The American Cancer Society estimates 101,420 new cases of colon cancer and 44,180 new cases of rectal cancer in the United States this year (American Cancer Society, 2019). Colorectal cancer remains the third leading cause of death from cancer in both sexes, with approximately 51,020 deaths expe...

Quality Improvement

Impact of a Replacement Algorithm for Vitamin D Deficiency in Adult Hematopoietic Stem Cell Transplant Patients

Sheila A. Kenny,(1) MSN, RN, ANP-BC, Karen Collum,(1) DNP, RN, OCN®, Catherine A. Featherstone,(1) MSN, RN, FNP-BC, Azeez Farooki,(1,2) MD, and Ann Jakubowski,(1,2) PhD, MD

Patients undergoing hematopoietic stem cell transplant (HSCT) are at high risk for vitamin D deficiency before and after transplant, and more so than the general population (Urbain, Ihorst, Biesalski, & Bertz, 2012; Wallace et al., 2015). The prevalence of vitamin D deficiency has been report...

Review Article

Adverse Effects of Virus-Specific T-Cell Therapy: An Integrative Review

Heidi Z. Simmons, MSN, RN, FNP-C, Angela F. Bazzell, DNP, RN, FNP-BC, AOCNP®, and Joyce E. Dains, DrPH, JD, RN, FNP-BC

Allogeneic hematopoietic stem cell transplant (HSCT) has become the standard of care in treating many hematologic malignancies and other immunodeficiency disorders, with over 1 million HSCTs performed in the past 50 years (Gratwohl et al., 2015; Singh & McGuirk, 2016). According to the Center...

Grand Rounds

Advances in HER2-Positive Breast Cancer: Novel Therapies and Adverse Event Management

Reshma Mahtani, DO, and Lisa Hineman, MS, AOCN®, PHN, ANP-C

Based on data from the American Cancer Society (ACS), survival is improving for patients with breast cancer (BC), largely because of earlier detection and improved treatment modalities (ACS, 2018). Notwithstanding these improvements, nearly 42,000 women died from metastatic breast cancer (MBC) in...

Grand Rounds

Scalp Cooling: A Patient’s Experience

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

Chemotherapy-induced alopecia (CIA) is a frequent side effect of systemic antineoplastic therapy for cancer. It occurs when chemotherapy drugs such as taxanes, anthracyclines, and alkylating agents target rapidly dividing keratinocytes cells, damaging the hair follicle and resulting in CIA (Paus,...

Prescriber's Corner

Olaparib: A Novel Therapy for Metastatic Breast Cancer in Patients With a BRCA1/2 Mutation

Sarah E. Caulfield, PharmD, BCOP, Christine C. Davis, PharmD, BCOP, and Kristina F. Byers, PharmD, BCOP

Breast cancer is the most frequently diagnosed cancer in women globally. In 2019, an estimated 268,600 new cases will be diagnosed in the United States. The rate of newly diagnosed cases has largely remained the same over the past several years, with death rates falling an average of 1.8% each ye...

Tools and Technology

Use of the Distress Thermometer in Clinical Practice

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

For many patients, the cancer care journey is fraught with distress, beginning with initial diagnosis, through the treatment decision-making process and cancer treatment, and into survivorship. Uncertainty about the future is commonly present throughout the cancer trajectory (Bultz & Holland,...

Diagnostic Snapshot

Diagnostic Snapshot: A Patient With Gastrointestinal Symptoms and Eosinophilia

Rashida Taher, MPH, PA-C, and Sandra E. Kurtin, PhD, ANP-C, AOCN®

HISTORY Mr. C, a 63-year-old Cape Verdean male, was referred to the hematology/oncology office for evaluation of eosinophilia in May 2017. The eosinophilia was first documented in December 2003 by his primary care provider. In March 2005, Mr. C underwent colonoscopy for mild rectal bleeding and w...

Editorial

The Debate Over Alcohol Consumption: How Much Is Too Much?

Pamela Hallquist Viale, RN, MS, CNS, ANP

Studies regarding safe levels of alcohol consumption are relatively easy to find in the literature. However, the conclusions of the studies vary, and it’s easy to get confused over the most accurate recommendations regarding the consumption of alcohol. In fact, it’s difficult to truly understand ...

Original Research

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

Cancer will be diagnosed in approximately 39.6% of men and women during their lifetime, according to data collected by the Surveillance, Epidemiology, and End Results Program (SEER), of the National Cancer Institute (NCI, 2015). Early detection and improved treatments continue to positively impac...

Review Article

Botulinum Toxin for Side-Effect Management and Prevention of Surgical Complications in Patients Treated for Head and Neck Cancers and Esophageal Cancer

Leah Shaw, MSN, RN, AGPCNP-BC, AOCNP®, Angela F. Bazzell, DNP, RN, FNP-BC, AOCNP®, and Joyce E. Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP

Head and neck cancers (HNC) include those of the oral cavity and pharynx. Oral cavity and pharynx cancers have the eighth highest incidence rate for men in the United States, with an estimated 37,160 new cases in 2018 (Siegel, Miller, & Jemal, 2018). Although the incidence of esophageal cance...

Review Article

Breast Implant–Associated Anaplastic Large Cell Lymphoma: What We Know

Nadia E. K. DePaola, MS, PA-C, and Heather Coggins, MS, PA-C

Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is a rare peripheral T-cell lymphoma. As a result of incomplete reporting, coupled with the rareness of the disease, understanding its history has been challenging throughout the years. Despite its rarity, BIA-ALCL has gained muc...

Prescriber's Corner

Methylnaltrexone: Peripherally Acting μ-Opioid Receptor Antagonist

Tanya J. Uritsky, PharmD, BCPS, CPE

The backbone of treatment for moderate to severe cancer pain is opioids. Opioid-induced constipation (OIC) is a common adverse effect of opioid therapy, affecting 40% to 90% of patients on long-term opioid therapy and can occur even with short-term use (Pergolizzi, 2017). Opioid-induced constipat...

Prescriber's Corner

Gemtuzumab Ozogamicin: Back Again

Chris Selby,(1) PharmD, BCOP, Lisa R. Yacko,(2) PharmD, BCPS, and Ashley E. Glode,(3) PharmD, BCOP

Acute myeloid leukemia (AML) is a malignancy characterized by differentiation abnormalities combined with uncontrolled clonal proliferation that prevents normal bone marrow hematopoiesis. These immature, undifferentiated, malignant cells are often referred to as “blasts,” as they are unable to pr...

Tools and Technology

Evidence-Based Oncology Practice: Competencies for Improved Patient Outcomes

Kelley D. Mayden, MSN, FNP, AOCNP®, IAC

Today, oncology advanced practice providers (APP) play a critical role in providing cancer care to millions of patients and families. This is a task most daunting given the volume of research dissemination, technological advancements, and the rising cost of cancer care, all in the age of precisio...

Editorial

Human Papillomavirus and Cancer

Pamela Hallquist Viale, RN, MS, CNS, ANP

Earlier this November, the sixth annual JADPRO Live meeting was held in sunny Hollywood, Florida. The weather was fantastic, we had the most attendees ever (over 1,400), and the sessions were exciting, informative, and relevant to our practice as advanced practitioners! If you weren’t able to joi...

Review Article

Potential of Biosimilars to Increase Access to Biologics: Considerations for Advanced Practice Providers in Oncology

Sara M. Tinsley,(1) PhD, ARNP, AOCN®, Carolyn Grande,(2) CRNP, AOCNP®, Karin Olson,(3) PhD, PA-C, Leah Plato,(4) PA-C, MPH, CCRP, and Ira Jacobs,(5) MD, JD, MBA, FACS

Due to their structure, chemically derived drugs such as small molecules can be readily characterized and produced with high purity on a large scale (Crommelin et al., 2005; Daller, 2016; Dombrowski, 2013; Kuhlmann & Covic, 2006; Schellekens, 2009). In contrast, biologic drugs are large compo...

Translating Research Into Practice

The Stepped-Wedge Trial Design: Paving the Way for Cancer Care Delivery Research

Ya-Huei Li, PhD, Elizabeth Mullette, RN, MSN, and Jeannine M. Brant, PhD, APRN, AOCN®, FAAN

Cancer care delivery research (CCDR) is defined as “the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and health-care provider and patient behaviors affect access to cancer care...

Practice Matters

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

Laura Melton, PhD, ABPP

Sleep is a necessary component of life; humans spend about one-third of their lives asleep (Dresler et al., 2014). Sleep helps restore the body, plays a role in temperature regulation, and influences the immune system and hormones (Hearson & Sawatzky, 2008; Van Someren et al., 2015). Sleep dr...

Prescriber's Corner

Trametinib: A Targeted Therapy in Metastatic Melanoma

Brianna Hoffner, MSN, ANP-BC, AOCNP®, and Katherine Benchich, MSN, NP-C, AOCNP®

Melanoma accounts for just 1% of all skin cancers, but the majority of skin cancer deaths (American Cancer Society, 2018). The incidence of melanoma has increased significantly over the past 30 years, with a 3% increase per year between 2005 and 2014 among those age 50 and older (American Cancer ...

Prescriber's Corner

Neratinib for the Treatment of Early-Stage HER2-Positive Breast Cancer

Jennifer Miles, PharmD, and Yahsin White, PharmD

Breast cancer is the most common type of cancer and the second leading cause of cancer death in women. The American Cancer Society (2018) estimates that about 266,120 new cases of invasive breast cancer and 63,960 new cases of carcinoma in situ will be diagnosed this year in the United States. It...

Tools and Technology

Collaboration Leads to Oral Chemotherapy Education

Ashley E. Glode,(1) PharmD, BCOP, Lisa Holle,(2) PharmD, BCOP, FHOPA, Josh Nubla,(3) PharmD, Mike Minjock,(4) Nancy Egerton,(3) PharmD, BCOP, Kris LeFebvre,(4) MSN, RN, AOCN®, Michael Reff,(3) RPh, MBA, and David DeRemer,(5) PharmD, BCOP, FCCP

Providing comprehensive chemotherapy education to patients in a busy clinical practice setting can be challenging. Potential barriers to providing patient education include work overload, low priority, difficulty in communication, insufficient knowledge and skills, and lack of comprehensive tools...

Diagnostic Snapshot

Diagnostic Snapshot: Painful Nodules and Recurrent Fever in a Patient With Acute Lymphoblastic Leukemia

Alexis C. Geppner, MLS(ASCP), PA-C

Oncologic History Mr. S is a 39-year-old Hispanic male with a diagnosis of Philadelphia chromosome–negative acute lymphoblastic leukemia, diagnosed in October 2015 with a hyperdiploid karyotype and mutations in TP53 and NRAS. He was enrolled on a clinical trial with Hyper-CVAD (cyclophosphamide, ...

Editorial

Thank You to Our Peer Reviewers!

Meeting Abstract

Abstracts from JADPRO Live 2018

JL601. Advanced Practice Nurse Orientation Sue Schwartz, MSN, RN, APN, AOCNP®, and Renee Kurz, DNP, FNP-BC, AOCNP; Rutgers Cancer Institute of NJ Objective: The Rutgers Cancer Institute of New Jersey is New Jersey’s only NCI-designated cancer center. The mission and vision of the center is to pro...

Editorial

Cancer and Obesity: Am I Part of the Problem?

Pamela Hallquist Viale, RN, MS, CNS, ANP

As a member of the American Society of Clinical Oncology (ASCO), I occasionally receive emails containing requests for survey participation. This morning, the survey requested my thoughts on how I address obesity, physical activity, and nutrition with my patients. I confess this topic was on my m...

Joint Publication

Understanding the Role of Advanced Practice Providers in Oncology in the United States

Suanna S. Bruinooge,(1) Todd A. Pickard,(2),(3) Wendy Vogel,(4) Amy Hanley,(1) Caroline Schenkel,(1) Elizabeth Garrett-Mayer,(1) Eric Tetzlaff,(5) Margaret Rosenzweig,(6) Heather Hylton,(7) Shannon N. Westin,(3) Noël Smith,(2) Conor Lynch,(8) Michael P. Kosty,(9) and Stephanie F. Williams(10)

Editor’s Note: This project is funded in part by the Conquer Cancer™ Foundation Mission Endowment of ASCO. This article was developed as a consensus document of the APPs in Oncology Work Group as part of a collaboration between the American Society of Clinical Oncology (ASCO), the American Academ...

Original Research

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

Bone health is a critical aspect of cancer management, as bone complications can significantly reduce patients’ quality of life and survival (Hernandez et al., 2015). Cancer treatments such as hormonal therapy, chemotherapy, glucocorticoids, and radiation can decrease bone mineral density (Guise,...

Review Article

Systemic Treatments for Lung Cancer Patients Receiving Hemodialysis

Tzewah V. Leung, PharmD, BCOP, Mitchell E. Hughes, PharmD, BCPS, BCOP, Christine G. Cambareri, PharmD, BCPS, BCOP, Daniel J. Rubin, PharmD, and Beth Eaby-Sandy, MSN, CRNP, OCN®

Metastatic lung cancer is the leading cause of cancer death in the United States. These patients often have several comorbidities given their risk factors for developing lung cancer. Managing lung cancer patients with severe renal impairment or end-stage renal disease requiring hemodialysis (HD) ...

Grand Rounds

Challenges and Role Changes in Caring for Adult Children With Cancer

Laura Bourdeanu, NP, PhD, and Patricia Cannistraci, DSN, RN, CNE

Cancer affects over 60,000 young adults aged 20 to 39 each year (Fidler et al., 2017). Although uncommon, caring for young adults with cancer requires addressing their unique and specific concerns. Young adulthood is a time of great change in a person’s life as he/she tries to establish an identi...

Grand Rounds

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

Cancer is a disease of aging (Howlader et al., 2017). According to the Centers for Disease Control and Prevention, 38% of people aged 65 years and over report they currently have or have had a diagnosis of cancer (Centers for Disease Control and Prevention, 2017). It is critical for advanced prac...

Practice Matters

Interdisciplinary Educational Checklist for Allogeneic Stem Cell Transplant Patients

Jean A. Ridgeway, DNP, APN, NP-C, AOCN®

Every year in the United States, thousands of adults are diagnosed with life-threatening hematologic malignancies such as leukemia and lymphoma. A successful treatment option for some of these individuals is an allogeneic hematopoietic stem cell transplant (HSCT). According to the Center for Inte...

Practice Matters

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

Febrile neutropenia is an oncologic emergency requiring immediate evaluation and treatment. It is associated with high rates of morbidity and mortality (Keng et al., 2015; Ko et al., 2015; Rosa & Goldani, 2014; Zuckermann et al., 2008). Fever may be the first or only sign that there is an und...

Prescriber's Corner

Inotuzumab Ozogamicin in Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia

Sherry Williams, PharmD, BCOP, and Miryoung Kim, PharmD, BCOP

Acute lymphoblastic leukemia (ALL) accounts for approximately 20% of all adult leukemias, with an estimated 5,960 new cases and 1,470 deaths in the United States in 2018 (Siegel, Miller, & Jemal, 2018). Currently, available induction therapy for adults with newly diagnosed disease results in ...

Diagnostic Snapshot

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

History A 54-year-old African American male with a recent diagnosis of acute myeloid leukemia status post chemotherapy 2 days presented to the emergency room with dull substernal chest pain, dyspnea, bilateral blurred vision, a nonproductive cough, and a headache described as a full-pressure sens...

Editorial

Statement of Ownership, Management and Circulation (Requester Publication)

JADPRO

1) Publication Title: Journal of the Advanced Practitioner in Oncology. 2) Publication Number: 2150-0878. 3) Filing Date: September 7, 2018. 4) Issue Frequency: Every two months. 5) Number of Issues Published Annually: 7. 6) Annual Subscription Price (if any) $315.00. 7) Complete Mailing Address ...

Editorial

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...

Editorial

Breast Cancer and Body Image Issues

Pamela Hallquist Viale, RN, MS, CNS, ANP

Breast cancer remains a common malignancy, with an estimated 366,120 new cases expected in women in the United States this year (Breastcancer.org, 2018). Although the incidence rate for this disease has decreased since the year 2000, the disease remains deadly for some: Approximately 40,920 women...

Original Research

Feasibility of Outpatient High-Dose Methotrexate Infusions in Pediatric Patients With B-Lineage Acute Lymphoblastic Leukemia

Joy L. Bartholomew, APRN, Hongying Dai, PhD, Keith J. August, MD, MS, Robin E. Ryan, MPH, and Kristin A. Stegenga, PhD, RN, CPON

Acute lymphoblastic leukemia (ALL), the most common form of pediatric leukemia, accounts for 26% of all cancers occurring in children from birth to 14 years of age (Ward, DeSantis, Robbins, Kohler, & Jemal, 2014). Of the 3,000 new pediatric cases arising each year in the United States (Ries e...

Review Article

Iron Overload in Myelodysplastic Syndromes: Pathophysiology, Consequences, Diagnosis, and Treatment

Lindsey Lyle, MS, PA-C, and Alex Hirose, MMS, PA-C

Myelodysplastic syndromes (MDS) encompass a heterogeneous group of hematologic malignancies that are characterized by ineffective hematopoiesis and risk for progression to acute myeloid leukemia (AML; Mitchell, Gore, & Zeidan, 2013; Petrou et al., 2015; Shah, Kurtin, Arnold, Lindroos-Kolqvist...

Review Article

Management of Advanced Bladder Cancer: An Update

Emily A. Lemke, DNP, AGPCNP-BC, AOCNP®, and Amishi Yogesh Shah, MD

Bladder cancer is the sixth most common malignancy in the United States, with 81,190 new cases and 17,240 deaths from bladder cancer predicted in 2018 (American Cancer Society, 2018). The most common presenting symptom is hematuria, although dysuria, frequency, and urgency occur in a certain subs...

Grand Rounds

Clinical Management of Pneumonitis in Patients Receiving Anti–PD-1/PD-L1 Therapy

Justin E. Bala-Hampton, DNP, MPH, RN, AGACNP-BC, AOCNP®, Angela F. Bazzell, DNP, RN, FNP-BC, AOCNP®, and Joyce E. Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP

Immune checkpoint blockade monoclonal antibodies have revolutionized treatment and improved the prognosis for many patients with cancer (Eigentler et al., 2016; Weber, Yang, Atkins, & Disis, 2015; Wu, Hong, Zhang, Lu, & Miao, 2017). Immunotherapeutic drugs approved by the US Food and Drug...

Practice Matters

An Oncology NP-MD Partnership: Challenges and Rewards

Catherine S. Bishop, DNP, NP, AOCNP®

The 2017 State of Cancer Care in America report by the American Society of Clinical Oncology highlights progress and opportunities in the ever-changing and challenging specialty of oncology. According to the report, the number of cancer survivors is predicted to reach 20.3 million by 2026. This i...

Prescriber's Corner

Enasidenib: An Oral IDH2 Inhibitor for the Treatment of Acute Myeloid Leukemia

Rebecca A. Myers,(1) PharmD, Scott Wirth,(2) PharmD, BCOP, Sherry Williams,(3) PharmD, BCOP, and Patrick J. Kiel,(1,4) PharmD, BCPS, BCOP

Acute myeloid leukemia (AML) is characterized by infiltration of the bone marrow, blood, and other tissues by proliferative, clonal, abnormally differentiated, and occasionally poorly differentiated cells of the hematopoietic system. The incidence of AML has increased from 3.4 per 100,000 individ...

Diagnostic Snapshot

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

Kimberly Dotter, APRN

History Mr. V is a 25-year-old man with no significant past medical history who began experiencing shortness of breath while lying supine, along with changes in swallowing over the past several months. More recently, he noted a neck mass while shaving. Mr. V presented to clinic with complaints of...

Editorial

JADPRO Live at APSHO 2017: Precision Thinking, Practical Knowledge

This past November, over 1,400 nurse practitioners, PAs, pharmacists, and other oncology professionals gathered at the Marriott Marquis in Houston, Texas, to participate in the JADPRO Live conference. This meeting was the fifth annual JADPRO Live event addressing the unique educational and profes...

Meeting Report

New Drug Updates in Solid Tumors: PARP Inhibitors in Ovarian Cancer, Immunotherapeutics, and Other Agents

Presented by Edward Li, PharmD, MPH, BCOP

From late 2016 through 2017, many drug approvals in oncology represented marginal advances over existing agents. The approvals included additions to the therapeutic categories of poly (ADP-ribose) polymerase (PARP) inhibitors, cyclin-dependent kinase (CDK) 4/6 inhibitors, programmed cell death pr...

Meeting Report

New Drug Updates in Hematologic Malignancies: CAR-T, Targeted Therapeutics, and Other Agents

Presented by R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA

Newly approved drugs are changing outcomes for a number of hematologic malignancies. At JADPRO Live 2017, an update on 2017 drug approvals was presented by R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA, Associate Professor of Hematology/Medical Oncology and Pharmacology and Director of the Phase I ...

Meeting Report

Managing Side Effects of Cancer Patients Treated With Immunotherapy

Presented by Brianna Hoffner,(1) MSN, RN, ANP-BC, AOCNP®, and Laura J. Zitella,(2) MS, RN, ACNP-BC, AOCN®

In a span of fewer than 7 years, immunotherapy has transformed the therapeutic landscape of oncology. Beginning with ipilimumab (Yervoy) in 2011, the FDA has thus far approved six immunotherapeutic agents (immune checkpoint inhibitors) for oncology indications, including five drugs that target pr...

Meeting Report

Neratinib for Extended Anti-HER2 Therapy in Early Breast Cancer

Presented by G. Thomas Budd,(1) MD, and Wendy H. Vogel,(2) MSN, FNP, AOCNP®

Neratinib (Nerlynx) is now available for the treatment of human epidermal growth factor receptor 2 (HER2)–positive early breast cancer in patients in whom extended adjuvant therapy seems advisable. At 2017 JADPRO Live, the use of this agent and the management of side effects were discussed by G. ...

Meeting Report

Advances in the Use of Targeted Therapies in the Management of Non–Small Cell Lung Cancer

Presented by Heather Wakelee,(1) MD, and Elizabeth S. Waxman,(2) RN, MSN, AOCN®, ANP-BC

Advances in tumor genetics and molecular biology created the potential to identify mutations associated with carcinogenesis and tumor progression and to develop therapies that target the mutations. Improved understanding of tumor genetics has had a major impact on the treatment of non–small cell ...

Meeting Report

Hereditary Aspects of Colorectal Cancer: Mismatch Repair Genes Drive Lynch Syndrome

Presented by Heather Hampel,(1) MS, LGC, and Michael J. Hall,(2) MD, MS

The prevalence of Lynch syndrome (previously known as hereditary nonpolyposis colorectal cancer [HNPCC]), the most common inherited form of colorectal cancer (CRC), is approximately 1 in 279 individuals, or 1.2 million people in the United States. Lynch syndrome, which is characterized by microsa...

Meeting Report

Advances in the Management of Patients With Urothelial Carcinomas of the Bladder

Presented by Amishi Shah, MD, and Emily Lemke, DNP, AGPCNP-BC, AOCNP®

Advances in treatment, including the successes achieved recently with immunotherapy, are improving outcomes for patients with bladder cancer, which is the sixth most common malignancy. At JADPRO Live 2017, this topic was discussed by Amishi Shah, MD, and Emily Lemke, DNP, AGPCNP-BC, AOCNP®, of Th...

Meeting Report

Optimizing Outcomes for Patients With Soft-Tissue Sarcoma Through the Multidisciplinary Medical Oncology/Radiation/Surgical Team Approach

Presented by Arash Naghavi, MD, Dave Johnson, PA-C, and Leah Clark, ARNP

Soft-tissue sarcomas (STS) comprise a heterogeneous group of tumors arising from transformation of mesenchymal-origin cells. Collectively, they have an annual incidence of about 12,000, and about 5,000 people die of STS each year. Historically, treatment has consisted primarily of surgery and rad...

Meeting Report

Multiple Myeloma: Risk Stratification and Toxicity Management

Presented by Tiffany Richards, PhD, ANP, AOCNP®, and Hans Lee, MD

Multiple myeloma is a complex malignancy for which the treatment landscape is rapidly changing. Risk stratification is important in determining prognosis and tailoring treatment. At JADPRO Live 2017, Tiffany Richards, PhD, ANP, AOCNP®, and Hans Lee, MD, both from The University of Texas MD Anders...

Meeting Report

A Deeper Dive Into Advanced and Future Directions in Treating Patients With Acute Myeloid Leukemia

Presented by Sandra E. Kurtin,(1) PhDc, ANP-C, AOCN®, and Gabrielle Zecha,(2) PA-C

Acute leukemia comprises a group of clonal neoplastic disorders of hematopoietic progenitor cells, one of the more common being acute myelogenous leukemia (AML). There were 21,380 new cases and 10,590 deaths AML-related deaths in 2017. The disease affects predominantly older patients with a media...

Meeting Abstract

Managing the Continuum of Myeloid Malignancies

Presented by Andrew Artz, MS, MD, and Jean A. Ridgeway, DNP, APN, NP-C, AOCN®

Myeloid malignancies remain a challenge for advanced practitioners. Their genetic profiles have become increasingly critical to diagnosis and prognosis, and patient management is changing as new therapeutics come on board. Stem cell transplant, however, remains the most effective option for many ...

Meeting Report

Contemporary Management of Hodgkin Lymphoma and Chronic Lymphocytic Leukemia

Presented by Sandra E. Kurtin,(1) PhDc, AOCN®, ANP-C, and Ann McNeill,(2) RN, MSN, APN

The identification of key molecular attributes has relevance in the risk-adapted treatment of Hodgkin lymphoma and chronic lymphocytic leukemia. Advanced practitioners in oncology play an important role in assessing patients and managing them with a rapidly expanding number of treatments, accordi...

Editorial

Chemotherapy-Induced Nausea and Vomiting: Updates and Recommendations

Pamela Hallquist Viale, RN, MS, CNS, ANP

Chemotherapy-induced nausea and vomiting (CINV) has remained a much-feared side effect of cancer therapy. Few pharmaceutical choices were available 35 years ago when I started practice, and when the first serotonin antagonist 5-hydroxytryptamine-3 (5-HT3) was approved in the late 1980s and brough...

Editorial

Cardio-oncology: A Subspecialty in its Infancy

Jessica Shank Coviello, DNP, APRN, ANP-BC

Several years ago, after spending my professional life in cardiology, I was happy to join a private practice where I could focus my energies on managing patients with heart failure (HF). It was through this experience that I noticed a growing population of women previously treated for breast canc...

Review Article

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

Jessica Shank Coviello, DNP, APRN, ANP-BC

Heart disease and cancer, although seen as two distinct diseases, have significant commonalities, including risk factors, genetic, metabolic, and inflammatory components, and shared preventative strategies. Together, they represent the most common cause of death in the United States (Curigliano e...

Review Article

Acute Promyelocytic Leukemia: A Summary

Meaghan M. Ryan, MSN, FNP-BC

Acute promyelocytic leukemia (APL) is a rare subtype of acute myeloid leukemia, which historically had been considered one of the most fatal types of this disease process. With advances in treatment regimens, namely the introduction of all-trans retinoic acid (ATRA), outcomes have drastically imp...

Review Article

Drug-Drug Interactions, Safety, and Pharmacokinetics of EGFR Tyrosine Kinase Inhibitors for the Treatment of Non–Small Cell Lung Cancer

Colleen R. Kucharczuk,(1) DNP, CRNP, Alex Ganetsky,(1) PharmD, BCOP, and J. Michael Vozniak,(2) PharmD, BCOP

The identification of activating mutations in the epidermal growth factor receptor (EGFR) has expanded treatment options for non–small cell lung cancer (NSCLC), where the presence of these mutations can sensitize tumors to EGFR inhibitors (Rosell et al., 2010). For patients whose tumors have sens...

Original Research

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

Anecita P. Fadol,(1) PhD, FNP-BC, FAANP, Tito R. Mendoza,(2) PhD, Daniel J. Lenihan,(3) MD, and Donna L. Berry,(4) PhD, RN, AOCN®, FAAN

Symptom management in patients with cancer and concurrent heart failure (HF) presents a major challenge to patients, families, and health-care providers throughout the entire trajectory of the disease process (Fadol et al., 2008). In the general population, HF diagnosis is borne by individuals ag...

Grand Rounds

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

Scott M. Rowley, MS, CNP, ANP-BC, AOCNP®

Paraneoplastic syndromes are a group of disorders that are associated with malignant diseases (cancers) but are not directly related to the physical effects of the primary or metastatic tumors (Kanaji et al., 2014). The term “paraneoplastic” was coined in the 1940s; however, paraneoplastic condit...

Practice Matters

Joining Forces: Establishing a Cardio-oncology Clinic

Caroline Austin-Mattison, DNP

The survival rate of patients with cancer has increased over the past 25 years in the United States. The 5-year relative survival rate of patients diagnosed with cancer between the years 1975 and 1977 was 49% for all cancer sites, and this number improved to 68% between 2004 and 2010. When assess...

Practice Matters

An Anecdotal Outpatient Approach to Caring for Patients With End-Stage Hematologic Malignancies

Mark Honor, PA-C

I have been managing patients with hematologic malignancies for over 10 years at the H. Lee Moffitt Cancer Center in Tampa. I spent the first 7 years in the stem cell transplant department, and more than 3 years ago I started working at a satellite location to our main hospital in the capacity of...

Prescriber's Corner

Olaratumab: A New Strategy in the Treatment of Advanced Soft-Tissue Sarcoma

Donald C. Moore, PharmD, BCPS, BCOP, DPLA, and Lesli A. Lavery, PharmD, BCOP

Sarcomas represent a heterogeneous group of mesenchymal malignancies that may arise in the soft tissue or bone (Skubitz et al., 2007). Soft-tissue sarcomas (STS) comprise less than 1% of all cancer diagnoses. About 80% of sarcoma cases in adults are STS (Siegel, Miller, & Jemal, 2018). It is ...

Diagnostic Snapshot

Diagnostic Snapshot: "I Have a Bad Cold"

Julie Kay Baker,(1) APRN, and Virginia L. Beggs,(2) MSc, APRN, CHFN

Ms. J is a 37-year-old woman with a history of Hodgkin lymphoma, presenting with symptoms due to mediastinal adenopathy, diagnosed at age 12. She was treated with vincristine, prednisone, procarbazine, and doxorubicin, then 21 Gy radiation to the mediastinum. At 36, she was diagnosed with locally...

Editorial

It’s Just the Flu…or Is It?

Pamela Hallquist Viale, RN, MS, CNS, ANP

I received my flu shot at the end of September, right when my provider’s office received their shipment of vaccine. Avoidance of the flu is high on my list, so I am always astonished when I meet friends or neighbors who avoid the vaccine because of fear of getting “sick” from the shot or simply b...

Original Research

Oncology Nurse Practitioner Web Education Resource(ONc-PoWER): An Evaluation of a Web-Enhanced Education Resource for Nurse Practitioners Who Are New to Cancer Care

Rosemary L. Hoffmann, PhD, RN, CNL, Sara Klein, MS, BSN, RN, Mary Connolly, BSN, RN, and Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP®, FAAN

Professional nursing education is a continuous process that begins with entry into a basic nursing program and continues throughout the nursing career, which often encompasses entry into advanced practice nursing. In 2009, both the American Association of Colleges of Nursing Board of Directors an...

Review Article

Combination Therapies  in Advanced, Hormone  Receptor–Positive Breast Cancer

Emily Olson, APRN, CNP, MSN, OCN®

Each year in the United States, approximately 250,000 women are newly diagnosed with invasive breast cancer (Howlader et al., 2017). Approximately 17% of those women have locally advanced or metastatic disease at the time of diagnosis (Iqbal, Ginsburg, Rochon, Sun, & Narod, 2015), but many mo...

Grand Rounds

The Role of Advanced Practitioners in Optimizing Clinical Management and Support of Patients With Polycythemia Vera

Sandra Kurtin, PhDc, ANP-C, AOCN®, and Lindsey Lyle, MS, PA-C

There are an estimated 100,000 patients with polycythemia vera (PV) in the United States (Mehta, Wang, Iqbal, & Mesa, 2014). Because there is no curative medical treatment option (Vannucchi, 2014), these patients require disease management for the remainder of their lives. Patients with PV ha...

Grand Rounds

Management of Older Patients With Metastatic Renal Cell Carcinoma Receiving Sunitinib: A Hypothetical, Illustrative Case Scenario

Susan K. Roethke,(1) CRNP, MSN, ANP-BC, AOCNP®, Joanne C. Ryan,(2) PhD, RN, and  Sarah Yenser Wood,(3) RN, MSN, ANP, AOCNP®

Kidney cancer represents 3.7% of all adult cancers in the United States, with 62,700 new cases and 14,240 deaths estimated in 2016 (SEER Cancer Statistics Factsheets, 2016). Renal cell carcinoma (RCC) accounts for 90% of kidney cancer and 70% to 75% of RCC cases are of clear-cell histology (Mugli...

Practice Matters

Precautions for Patients Taking Tamoxifen

Mary Heery, APRN, AOCNS®, CBCN, Patrick Corbett, RPh, PharmD, and  Richard Zelkowitz, MD

Tamoxifen is the most widely prescribed breast cancer therapy; millions of patients take tamoxifen worldwide. Tamoxifen is an oral medication that treats hormone-sensitive breast cancers. A hormone-sensitive breast cancer is estrogen receptor–positive (ER+), progesterone receptor–positive (PR+), ...

Practice Matters

Pharmaceutical Clinical Educators: A Resource for Advanced Practice Providers

Sheila Adams Arrington,(1) MSN, GNP-BC, AOCN®, Laurie A. Farrell,(2) MSN, ARNP,  FNP-C, and Joanne Henning,(3) ANP-BC

Over the past several decades, there have been significant scientific breakthroughs within the medical field, especially in the hematology and oncology community (Shelley, 2009; Wujcik, 2016). These breakthroughs include the awareness of new genetic markers, the development of targeted therapies,...

Prescriber's Corner

Alectinib and Brigatinib:  New Second-Generation  ALK Inhibitors for the Treatment of Non–Small Cell Lung Cancer

Tyler Beardslee, PharmD, and Justin Lawson, PharmD

Over the past several years, treatment for advanced and metastatic non–small cell lung cancer (NSCLC) has changed tremendously. Historically, NSCLC was treated primarily with chemotherapy, but advances over the past decade have allowed for treatment driven by molecular expression and genetic muta...

Diagnostic Snapshot

Tender Nodules of the Foot

Carol Guarnieri, RN, MSN, FNP-C, AOCNS®

History The patient is a 56-year-old woman who suffered a significant left foot injury in 2010 when her left foot was crushed in a car accident. Due to her injury, she favored bearing weight on her right foot. In late 2015, she started having pain along the lateral aspect of her right foot. She t...

Editorial

Thank You to Our Peer Reviewers!

In this issue of JADPRO, we would like to acknowledge everyone who completed peer reviews for JADPRO in the past year. Our reviewers, who are from a wide variety of oncology specialties, dedicate their expertise and time to provide insightful feedback on submitted manuscripts. We hope that during...

Meeting Abstract

JL501. Advanced Practice Provider Delivery of Advance Care Planning Counseling in Community Oncology

Sabrina Mikan, PhD, RN, ACNS-BC, Supportive Care Programs, Texas Oncology, Austin, Texas

Meeting Abstract

JL502. An Algorithm for Transitioning Patients From Deferasirox Dispersible Tablets to Deferasirox Film-Coated Tablets and Sprinkle Granules

Lindsey M. Lyle, MS, PA-C, University of Colorado, Denver, Colorado, and Allyson Price, MS, PA-C, The University of Texas MD Anderson Cancer Center, Houston, Texas

Meeting Abstract

JL503. Chimeric Antigen Receptor T-Cell Therapy: Management of Toxicities

Harolynn K. Adeniran, FNP-C, Karla Ow, FNP-C, and Evelyn Acosta, FNP-C; The University of Texas MD Anderson Cancer Center, Houston, Texas

Meeting Abstract

JL504. Complex Illness Support Alongside Standard Oncology Care for Patients With Incurable Cancer

Kimberly A. Bland, DNP, APRN-NP, FNP, AOCN®, Nebraska Methodist Hospital, Omaha, Nebraska, and Alice Kindschuh, DNP, APRN-CNS, AGCNS-BC, CNE, Nebraska Methodist Health System and Nebraska Methodist College, Omaha, Nebraska

Meeting Abstract

JL505. Coping Strategies of Hematology/Oncology Nurse Practitioners

Laura Bourdeanu, PhD, Excelsior College, Albany, New York, Shiyun Mai, MS, George Washington University, Washington, DC, and Arlene Pericak, MS, DA, FNP-C, FAANP, George Washington University, Washington, DC

Meeting Abstract

JL506. Dedicated Advanced Practice Provider in an Outpatient Oncology Infusion Center

Christina Z. Page, MSN, RN, AOCNP®, AGPCNP-BC, and Delores P. McNair, MHA; Duke Cancer Institute, Durham, North Carolina

Meeting Abstract

JL507. Development of a Professional Practice Model for Neuro-Oncology Advanced Practitioners at an Academic Medical Center

Christina Cone, DNP, APRN, ANP-BC, AOCNP®, and Mary Lou Affronti, DNP, APRN, ANP, MHSc; The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina

Meeting Abstract

JL508. Diversity Awareness and Documentation Practices Among Oncology Advanced Practice Providers: A Prospective Quality Improvement Project

Victoria Poillucci, MSN, ACNP-BC, and Christina Z. Page, MSN, RN, AOCNP®, AGPCNP-BC; Duke Cancer Institute, Durham, North Carolina

Meeting Abstract

JL509. Empowering the Advanced Practitioner to Champion Education of Tumor Lysis Syndrome to the Clinical Nursing Team

Allister B. Chase, MSN, RN, FNP-BC, AOCNP®, Karen Groth, MSN, RN, CNS, ARNP, Colleen Weber, BSN, RN, Linda Schnell, MSN, RN, OCN®, and Loretta Morehead, BSN, RN; Genentech Hematology

Meeting Abstract

JL510. Febrile Neutropenia Risk Assessment Prior to Chemotherapy and Use of Colony-Stimulating Factor Prophylaxis in U.S. Community Oncology Clinics

Soeren Mattke, MD, MPH, DSc, RAND Health Advisory Services, RAND Corporation, Boston, Massachusetts, Elizabeth M. Sloss, PhD, RAND Corporation, Arlington, Virginia, Nabeel S. Qureshi, MPH, RAND Corporation, Boston, Massachusetts, Carol Roth, RN, MPH, RAND Corporation, Santa Monica, California, and Jonathan W. W. Goldman, MD, University of California Los Angeles, Los Angeles, California

Meeting Abstract

JL511. Hematology/Oncology Nurse Practitioners: A Study of Job Satisfaction, Stress, and Intention to Leave the Specialty

Laura Bourdeanu, PhD, Excelsior College, Albany, New York, Shiyun Mai, MS, George Washington University, Washington, DC, Yuan Shen, MS, George Washington University, Washington, DC, Haoqi Sun, MS, George Washington University, Washington, DC, Suya Wang, MS, George Washington University, Washington, DC, and Karen Morrissey, MSN, CVS

Meeting Abstract

JL512. Impact Analysis of an Advanced Practice Nurse on Outcomes for an Inpatient Hematological Malignancies Service in an Academic Medical Center

Sarah J. Jimenez, MSN, APN-C, AOCNP®, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, Tracy Krimmel, DNP, APN-BC, AOCN®, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, and Kimyatta Washington, MHSA, Department of Oncology Services, RWJBarnabas Health, West Orange, New Jersey

Meeting Abstract

JL513. Improving Data Quality and Knowledge Management Through the Application of Artificial Intelligence to Oncology Care Model Patients

Jacqueline T. Norrell, DNP, BS-CIS, FNP-BC, Renee Kurz, DNP, MSN, FNP-BC, Janet Gordils-Perez, DNP, ANP-BC, AOCNP®, and Doris Fonseca, BS Public Health; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey

Meeting Abstract

JL515. Intra-Professional Collaboration for Safe Chemotherapy Administration

Stephanie L. Jackson, MSN, RN, AOCNS®, BMTCN, Ronald Reagan UCLA Medical Center, Los Angeles, California

Meeting Abstract

JL516. Management of Cytokine Release Syndrome and Neurologic Events in ZUMA-1

Sherry Adkins, RN, MSN, ANP-C, The University of Texas MD Anderson Cancer Center, Houston, Texas, Amy Patterson, MSN, RN, AOCNS®, BMTCN, Moffitt Cancer Center, Tampa, Florida, Nicole Kahle, MS, RN, OCN®, BMTCN, Moffitt Cancer Center, Tampa, Florida, and Carol Sheridan, RN, MSN, OCN®, BMTCN, Montefiore Medical Center, Bronx, New York

Meeting Abstract

JL517. Minimal Residual Disease in Hematological Malignancies: Implications for Practice

Mickey Stiger Register, FNP-BC, MSN, MPH, Genentech, Jennifer Giarratana, MSN, ANP, AOCNP®, Genentech, and Colleen Weber, BSN, RN, Genentech

Meeting Abstract

JL518. Mistaken Identity: The Soft Tissue Sarcoma Conundrum

Allison Lock, MPAS, PA-C, The University of Texas MD Anderson Cancer Center, Houston, Texas

Meeting Abstract

JL519. Modified Outpatient Regimen of Daratumumab to Reduce First Infusion Reaction Risk

Christopher Campen, PharmD, BCOP, Elizabeth H. Cull, MD, Brittany Wills, PharmD, Lise Langston, PharmD, Saeeda Chowdhury, MD, Susan Funk, NP, and Suzanne Fanning, DO; Greenville Health System Cancer Institute

View the poster.

Meeting Abstract

JL520. Oncology Care Model and the Transformation of the APN Role in the Care of Patients Undergoing Chemotherapy

Elsie Castrorao, MSN, APN-C, OCN®, Renee Kurz, DNP, MSN, FNP-BC, Andrew D. Kass, MSN, AGNP-C, AOCNP®, Jacqueline T. Norrell, DNP, BS-CIS, FNP-BC, and Janet Gordils-Perez, DNP, ANP-BC, AOCNP®; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey

Meeting Abstract

JL521. Oncology Nurse Practitioners’ Beliefs About Evidence-Based Practice and Barriers to Research Utilization

Rita M. Jakubowski, DNP, ANP-BC, BMTCN, Mount Sinai Hospital, New York, New York

Meeting Abstract

JL522. Optimizing Survivorship Care Plan Quality and Efficiency Through Cancer Registry Partnerships

Karen J. Hammelef, RN, DNP, Carevive Systems, Inc, Carrie Stricker, PhD, RN, Carevive Systems, Inc, Carrie Tilley, RN, MS, ANP, AOCNP®, Carevive Systems, Inc, Margaret A. O’Grady, RN, MSN, OCN®, Abington Memorial Hospital, Abington, Pennsylvania, Noel M. Arring, DNP, RN, OCN®, Mayo Clinic, Phoenix, Arizona, and Deborah A. Walker, RN, MSN, APRN®, Hartford Health Center, Hartford, Connecticut

Meeting Abstract

JL523. Outcome Evaluation of Timing Recommendations for Influenza Vaccinations in Patients Receiving Intravenous Chemotherapy

Elizabeth A. Hageman, PharmD, BCPS, Cayuga Medical Center, Ithaca, New York, Alex D. Vondracek, PharmD, Cayuga Medical Center, Ithaca, New York, and Ryan Mack, Albany College of Pharmacy and Health Sciences, Albany, New York

Meeting Abstract

JL524. Pharmacy Financial Advocacy: Benefits of a Pharmacy Financial Advocate in the Oncology Clinic

Joe Weber, PharmD, BCOP, Lynnette Coolidge, PharmD, BCPS, BCOP, Kayla M. Hinsch, CPhT, and Kelly Carlson, RN, BS, MHA; Oncology Pharmacy, Sanford Cancer Center, Sioux Falls, South Dakota

Meeting Abstract

JL525. Real-World Systemic Therapy Sequences Following a CDK 4/6 Inhibitor Regimen Among Post-Menopausal Women

Derek Tang, PhD, BSPharm, Novartis Oncology, Nicole Princic, MS, Truven Health, Ayal Aizer, MD, Brigham and Women’s Hospital, Boston, Massachusetts, David Smith, PhD, Truven Health Analytics, William Johnson, MS, Truven Health Analytics, and Aditya Bardia, MD, Massachusetts General Hospital, Boston, Massachusetts

Meeting Abstract

JL526. Rituximab and Melanoma: A Case Report

Shimika Rasha, MD, MPH, Abhishek Nair, MD, and Zdenka Segota, MD; University of Miami, Miller School of Medicine, Holy Cross Hospital, Fort Lauderdale, Florida

Meeting Abstract

JL527. Rural Infusion Centers Gaining Access to Expert Oncology and Infusion Support Through the Use of Telemedicine

Susan Halbritter, ANP-BC, AOCN®, Sanford Hematology and Oncology, Sioux Falls, South Dakota, Rachel Olson, MPA, Sanford Vermillion Medical Center, Vermillion, South Dakota, Jenna Kaiser, RN, BSN, OCN®, Sanford Hematology and Oncology, Sioux Falls, South Dakota, Janice McGuire, RN, MSN, Sanford Vermillion Medical Center, Vermillion, South Dakota, and Peggy Ann Dufek, RN, ADN, Douglas County Memorial Hospital, Armour, South Dakota

Meeting Abstract

JL528. Survivorship Care Planning in a Large, Multi-Clinic Cancer Program

Jamie Cairo, DNP, Aurora Cancer Care, and Dorry Mitchell, Aurora Health Care; Milwaukee, Wisconsin

Meeting Abstract

JL529. The Advanced Practice Provider and Subcutaneous Rituximab: Implications for Practice

Jennifer Giarratana, MSN, ANP, AOCNP®, Joanne Henning, MSN, CRNP, APCNP, Nancy Driscoll, PA-C, Marlana Mattson, MSN, ACNP, AOCNP®, Kristien Miller, BSN, RN, Kristen Morris, BSN, RN, OCN®, and Sara Orndoff, MSN, OCN®, BMTCN; Genentech

Meeting Abstract

JL530. The Creation and Sustainability of an Effective After-Hours Coverage Model Utilizing Advanced Practice Providers

LaKeisha Day, PA-C, CMQ, Anayo Mbadugha, PA-C, and Todd Pickard, MMSc, PA-C, DFAAPA; The University of Texas MD Anderson Cancer Center, Houston, Texas

Meeting Abstract

JL531. The Expanding Role of Surgical Physician Assistants in Clinical Oncology Research

Jenilette Velasco, MPAS, PA-C, and Steven H. Wei, MS, MPH, PA-C; The University of Texas MD Anderson Cancer Center, Houston, Texas

Meeting Abstract

JL532. The Quantity of Care Provided by Nurse Practitioners and Physician Assistants to Older Adults With Cancer

Lorinda A. Coombs, PhD(c), FNP-BC, AOCNP®, University of California San Francisco/Kaiser Permanente, San Francisco, California; Wendy Max, PhD, University of California San Francisco, San Francisco, California; Caroline Stephens, PhD, RN, GNP, University of California San Francisco, San Francisco, California, and Tatjana Kolevska, MD, University of California San Francisco/Kaiser Permanente, San Francisco, California

Meeting Abstract

JL533. Utilizing the COMFORT Curriculum With Advanced Practice Providers to Enhance the Family Meeting Process and Improve Patient Care

Anne M. Kolenic, MSN, RN, AOCNS®, and Linda K. Baer, MSN, NP-C, AOCNP®; University Hospitals Seidman Cancer Center, Cleveland, Ohio

Editorial

Innovations in Cancer Therapies and Rising Costs

Pamela Hallquist Viale, RN, MS, CNS, ANP

It is an exciting time to be caring for patients with cancer. Great strides are being made in the treatment landscape, with new therapies approved seemingly every month. Patients have more opportunities to receive novel and innovative treatments with improved outcomes. These therapies require adv...

Original Research

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

Marjan Mardani-Hamooleh, PhD, and Haydeh Heidari, PhD

Cancer is one of the main causes of human death in the world, but its mortality rates have been in continual decline for the past 20 years (Siegel, Miller, & Jemal, 2015). It is a growing problem in Middle Eastern countries (Daher, 2011). In Iran, an ancient country in the Middle East (Borimn...

Continuing Education

Continuing Education Information: Integrating Biosimilars Into Oncology Practice: Implications for the Advanced Practitioner

Integrating Biosimilars Into Oncology Practice: Implications for the Advanced Practitioner A continuing education activity for nurse practitioners, PAs, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: November 16, 201...

Review Article

Integrating Biosimilars Into Oncology Practice: Implications for the Advanced Practitioner

Christopher J. Campen, PharmD, BCOP

Click here for Continuing Education Information. Biologic agents play an increasingly important role in the medical care of patients. Between 2010 and 2015, biologics accounted for 22% of drugs approved by the US Food and Drug Administration (FDA). This comes at a cost, however: Although less th...

Review Article

Managing Tumor Lysis Syndrome in the Era of Novel Cancer Therapies

Ali McBride,(1) PharmD, MS, BCPS, BCOP, Steven Trifilio,(2) RPh, Nadine Baxter,(3) MNSc, APN-BC, AOCNP®, Tara K. Gregory,(4) MD, and Scott C. Howard,(5) MD, MS

Tumor lysis syndrome (TLS) is a potentially life-threatening emergency that can develop rapidly after the release of intracellular contents from lysed malignant cells (Cairo, Coiffier, Reiter, Younes, & TLS Expert Panel, 2010; Howard, Jones, & Pui, 2011; Wilson & Berns, 2014). Charact...

Grand Rounds

Practical Strategies for Management of Lenalidomide-Associated Cytopenias in Myelodysplastic Syndromes With del(5q)

Sandra E. Kurtin,(1) PhDc, ANP-C, AOCN®, Jean A. Ridgeway,(2) DNP, NP-C, AOCN®, and Sara Tinsley,(3) PhD, ARNP, AOCN®

A heterogeneous group of bone marrow (BM) failure disorders, myelodysplastic syndromes (MDS) is common in older adults. Sustained unilineage or multilineage cytopenia is included in the mandatory diagnostic criteria of MDS (Valent et al., 2007). Anemia and transfusion dependence are inevitable in...

Grand Rounds

Symptom Management Strategies for Patients Receiving Anaplastic Lymphoma Kinase Inhibitors for Non–Small Cell Lung Cancer

Jennifer Jacky, MSN, ARNP, and Christina Baik, MD, MPH

Lung cancer is the second most commonly diagnosed cancer in the United States, with an estimated 222,500 new cases in 2017 (American Cancer Society [ACS], 2017). Non–small cell lung cancer (NSCLC), the most common type (Matsuda & Machii, 2015), has a poor prognosis, with a 5-year survival rat...

Practice Matters

Li-Fraumeni Syndrome

Wendy H. Vogel, MSN, FNP, AOCNP®

Li-Fraumeni syndrome is a rare inherited autosomal-dominant disorder that is manifested by a wide range of malignancies that appear at an unusually early age. Li-Fraumeni syndrome is also known as sarcoma, breast, leukemia, and adrenal gland (SBLA) cancer syndrome. This syndrome first appeared in...

Practice Matters

Immunotherapy Through the Years

Jessica Eno, MS, PA-C

Immunotherapy’s use in oncology has emerged in recent years as an important treatment option in many different disease sites, but the concept of immunotherapy has been discussed for centuries. Although the beginning of immunotherapy itself dates back to the 18th century, the principles it is base...

Prescriber's Corner

Lenvatinib in the Treatment of Differentiated Thyroid Cancer and Advanced Renal Cell Carcinoma

Urvi J. Patel, PharmD, MPH, and Megan May, PharmD, BCOP

Differentiated thyroid cancer (DTC) is a malignancy that is occurring with greater frequency. Between the years 2006 and 2010, the incidence increased at an annual rate of 5.4% in men and 6.5% in women (Siegel, Ma, Zou, & Jemal, 2014). Although the prognosis of this cancer is favorable, optim...

Tools and Technology

Hepatitis C Virus in the Hematology/Oncology Patient

Wendy H. Vogel, MSN, FNP, AOCNP®

Hepatitis C virus (HCV) is an acute viral infection of the liver, with symptoms that may include fever, headache, malaise, anorexia, nausea, vomiting, diarrhea, and abdominal pain and either jaundice or elevated serum alanine aminotransferase (ALT) levels of > 400 IU/L (Centers for Disease Pre...

Editorial

Oral Cancer Therapy: The Importance of Adherence

When people think of cancer treatment, they frequently picture patients receiving intravenous (IV) treatments over several hours in a hospital or clinic setting. But over the past 2 decades, more and more cancer treatments that can be taken at home—in tablet, capsule, or liquid form—have become ...

Editorial

The SMARTIE Program: A Novel Initiative to Evaluate the Impact of AP Continuing Education on Clinical Practice

Sandra E. Kurtin,(1) PhDc, ANP-C, AOCN®, Constance Visovsky,(2) PhD, RN, ACNP-BC, Erik D. Brady,(3) PhD, CHCP, and Alana L. K. Brody,(4) MBA, CHCP

The landscape of cancer care in the United States continues to undergo numerous shifts and innovations, with notable progress in drug development and technologies, resulting in improved progression-free and overall survival for many cancer diagnoses (American Society of Clinical Oncology [ASCO], ...

Editorial

Breast Implants and Lymphoma: What Is the Risk for Your Patient?

Pamela Hallquist Viale, RN, MS, CNS, ANP

Breast implants require a surgical procedure and placement of medical devices designed to give the appearance of a natural-looking female breast. This surgery may be implemented for cosmetic reasons to augment the breast or to provide breast tissue after mastectomy or damage to the breast. In can...

Original Research

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

Elaine Wittenberg,(1) PhD, Betty Ferrell,(2) RN, PhD, MA, FAAN, FPCN, CHPN, and Joy Goldsmith,(3) PhD

Clear communication about pain medication and symptoms is necessary to ensure oncology patients and family caregivers understand the purpose of the medication, can anticipate side effects, and are able to administer medication on their own. Patient-centered pain management addresses the different...

Review Article

Cancer Pain Management: Opioid Analgesics, Part 2

Rita J. Wickham, PhD, RN, AOCN®

Opioids—mu (μ) agonists and buprenorphine—are essential for managing moderate to severe cancer pain. They have no analgesic ceiling, and doses can usually be escalated to pain relief without unmanageable side effects. Key strategies are to individualize opioid doses and schedules, weigh benefits ...

Grand Rounds

Managing Drug Interactions in Cancer Therapy: A Guide for the Advanced Practitioner

Christopher J. Campen,(1) PharmD, BCOP, Wendy H. Vogel,(2) MSN, FNP, AOCNP®, and Pooja J. Shah,(3) PharmD, BCPS

Drug-interaction related risk factors include the use of drugs that are significantly impacted by inhibition or induction of drug metabolism (tyrosine kinase inhibitors [TKIs]), the use of drugs that have a significant inhibitory or inducing capacity of drug metabolism (certain antifungal medicat...

Grand Rounds

Brentuximab Vedotin Infusion Reaction Management: A Case Study

Holly Comer, MSN, APRN, and Kimbra Cardwell, MSN, APRN

Infusion reactions have been reported with brentuximab vedotin therapy in both clinical trial settings (Younes et al., 2010) and in the post clinical trial experience (Baxley, Kumm, Bishop, Medina, & Holter-Chakrabarty, 2013). Infusion reactions can range from minor grade 1 infusion reactions...

Practice Matters

Role of the Advanced Practice Provider in Clinical Trials: Contributions to the Management of Patients Receiving Inotuzumab Ozogamicin

Mary Alma Welch,(1) PA-C, Joanne C. Ryan,(2) PhD, RN, and Ilene Ann Galinsky,(3) BSN, MSN, ANP-C

Successfully conducting oncology clinical trials requires the involvement of various research personnel. Advanced practice providers (APPs) are integral members of the team and play a vital role in identifying and enrolling appropriate patients, educating participants, and providing supportive ca...

Practice Matters

Advice About Screening for Prostate Cancer With Prostate-Specific Antigen

Gannel Jean-Pierre, DNP, APRN, OCN®

Prostate cancer is the second-leading cause of cancer death in male Americans, behind only lung cancer. It is estimated there will be 161,360 new cases and 26,730 deaths due to prostate cancer in 2017 (American Cancer Society [ACS], 2017). There are several treatment options for patients diagnose...

Prescriber's Corner

Venetoclax: A Novel Treatment for Patients With del(17p) Chronic Lymphocytic Leukemia

Michelle A. Borg, PharmD, and Amber Clemmons, PharmD, BCOP

Chronic lymphocytic leukemia (CLL) is a hematologic malignancy characterized by abnormal numbers of mature B lymphocytes, which can accumulate in the bloodstream, as well as lymph nodes and/or bone marrow. Patients may be diagnosed incidentally upon review of routine laboratory testing and do not...

Tools and Technology

The Oncology Care Model for Advanced Practitioners

Wendy H. Vogel, MSN, FNP, AOCNP®

The Centers for Medicare & Medicaid Services (CMS) Oncology Care Model (OCM) is a new, multipayer model that focuses on higher quality, coordinated oncology care (CMS, 2016a). The OCM will be undertaken for a 5-year period from July 1, 2016, to June 30, 2021. Practices and payers applied for ...

Editorial

Priming the Pump: Preparing the Advanced Practitioner in Oncology for Scientific Innovation

Sandra Kurtin, PhDc, ANP-C, AOCN®

The unprecedented, almost frenetic pace of scientific innovation relative to the diagnosis and treatment of cancer demands a level of continuous engagement on the part of oncology providers to safely and effectively integrate these changes into practice. There have been 209 US Food and Drug Admin...

Editorial

The Wounded Healer

Morgan Gonzales, LCSW, and Laura Melton, PhD, ABPP

Oncology clinicians skillfully and passionately provide services to patients with life-threatening cancer and are impacted daily by pain, loss, trauma, death, and grief. We understand that healing is not exclusively about treating or curing a disease, but also about finding meaning and peace whil...

Editorial

The American Society of Clinical Oncology Reports on the State of Cancer Care in America: 2017

Pamela Hallquist Viale, RN, MS, CNS, ANP

The American Society of Clinical Oncology (ASCO) has recently published its State of Cancer Care in America report for the year 2017. This is a yearly compilation of the trends and issues facing cancer care in America, giving readers a thorough look at important challenges and improvements in the...

Original Research

Developing a Clinical Program Based on the Needs of Patients With Chronic Lymphocytic Leukemia: Preparing for Illness Episodes

Rose Bell, PhD, ARNP-C, AOCNP®

Despite advances in treatment, chronic lymphocytic leukemia (CLL) is a chronic disease that is still considered an inherently incurable hematologic cancer (Abrisqueta, Crespo, & Bosch, 2011; Beusterien et al., 2010; Molica, 2005; Stephens, Gramegna, Laskin, Botteman, & Pashos, 2005). Chro...

Review Article

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

Rita J. Wickham, PhD, RN, AOCN®

About 50% of cancer patients have undertreated pain, and the percentage is even greater among minority patients (Fisch et al., 2012; Paice & Von Roenn, 2014; Stein, Alcaraz, Kamson, Fallon, & Smith, 2015). Unrelieved pain is not inconsequential and can alter immunity and organ function, i...

Review Article

Cancer Care: Supporting Underserved and Financially Burdened Family Caregivers

Betty R. Ferrell, RN, PhD, MA, FAAN, FPCN, CHPN, and Kate Kravitz, RN, HNB-BS, LPC, NCC, ATR-BC

Health-care policies in the United States now mandate earlier hospital discharge following surgery and treatment. For oncology patients, family caregiving is the primary source of care. Not only are family caregivers central to the family member’s diagnosis and treatment, but also to survivorship...

Continuing Education

Continuing Education Information: Risk Assessment and Risk-Adapted Treatment Selection: A Case-Based Approach for Chronic Lymphocytic Leukemia

Risk Assessment and Risk-Adapted Treatment Selection: A Case-Based Approach for Chronic Lymphocytic Leukemia This activity is supported by an educational grant from Pharmacyclics, LLC, an AbbVie Company, and Janssen Biotech, Inc. A continuing education article for nurse practitioners, clinical ...

Grand Rounds

Risk Assessment and Risk-Adapted Treatment Selection: A Case-Based Approach for Chronic Lymphocytic Leukemia

Sandra Kurtin, PhDc, ANP-C, AOCN®, and Ali McBride, PharmD, BCOP

Continuing Education Information Risk Assessment and Risk-Adapted Treatment Selection: A Case-Based Approach for Chronic Lymphocytic Leukemia This activity is supported by an educational grant from Pharmacyclics, LLC, an AbbVie Company, and Janssen Biotech, Inc. A continuing education article f...

Grand Rounds

Treatment of a Locally Invasive Cutaneous Fusarium Species Infection With Voriconazole and Liposomal Amphotericin B in a Patient With Relapsed Acute Myeloid Leukemia

Sara Anne Meyer, PharmD, BCPS, and Bruce M. Jones, PharmD, BCPS

The Fusarium genus, which causes various human diseases, including mycotoxicosis and locally invasive or disseminated infections, is a saprophyte commonly found in soil. Influenced by host immune status, the Fusarium fungi may lead to disseminated, life-threatening, disease. In immunocompromised ...

Practice Matters

Instruments That Predict Oncology Treatment Risk in the Senior Population

Jessica K. Schiefen, MSN, RN, FNP-C, AOCNP®, Lydia T. Madsen, PhD, RN, AOCNS®, FNAP, and Joyce E. Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP

By 2030, an estimated one out of five Americans will be over 65 years of age. An expanding senior population will profoundly impact the health-care system related to cancer care (Centers for Disease Control and Prevention, 2013). Cancer is both a disease associated with aging and the leading caus...

Prescriber's Corner

Use of Atezolizumab for Bladder and Non–Small Cell Lung Cancers

Kayla Faith Moore, PharmD

Atezolizumab (Tecentriq) is an immunotherapy agent with activity across a broad range of tumor types including bladder and non–small cell lung cancer (NSCLC). Recently, immunotherapy has shown a promising avenue of clinical research in both of these disease states. Background on bladder and lung ...

Tools and Technology

Starting an Advanced Practice Provider Professional Writing Group

Lydia T. Madsen, PhD, RN, AOCNS®, FNAP, and Kristen Starnes-Ott, PhD, BS, CRNA

A work-related professional writing group presents the opportunity for would-be authors to focus on expertise while fostering collegiality and productivity among colleagues. Across many disciplines, including nursing, the routine practice of individual writing and then meeting as a group to revie...

Editorial

The System Is All Holes and No Cheese

Krista Ramirez, PharmD, BCPS, and Christopher Campen, PharmD, BCOP

An article recently published in the Chicago Tribune exposed significant systematic failures among many retail pharmacies in detecting drug-drug interactions, even when the prescriptions for the two interacting medications were presented at the same time (Roe, Long, & King, 2016). This issue ...

Editorial

The Federal ‘Right To Try’ Act: An Answer to New Treatments During Terminal Illness?

Pamela Hallquist Viale, RN, MS, CNS, ANP

There have been many proposed changes to health care in the past few months, a natural outcome of an election and a change in political perspective. One of the newly proposed laws addresses the right of terminally ill patients to experimental medications. The Federal “Right to Try” Act, H.R. 878,...

Original Research

The Relationship Between Zinc and Quality of Life in Patients With Upper GI Cancer on Chemotherapy

Edith A. Brutcher,(1) RN, APRN-BC, AOCNP®, Zhengjia Chen,(2) PhD, Anqi Pan,(2) MSPH Candidate, and Tiffany Barrett,(1) MS, RD, CSO, LD

Malnutrition is commonly observed in patients with cancer. This prevalence could be even higher depending on the location and stage of the tumor. The highest prevalence is found in those patients with tumors of the gastrointestinal (GI) tract and the lungs (Inui, 2002). At least 80% of patients w...

Review Article

Comparison of Outcome Measures for Traditional and Online Support Groups for Breast Cancer Patients: An Integrative Literature Review

Mary Clare Houlihan, MS, RN, and Joseph D. Tariman, PhD, ANP-BC

Breast cancer is the most common cancer in women across all races and ethnicities in the United States (American Cancer Society [ACS], 2016; Centers for Disease Control and Prevention, 2015). In 2016, it is estimated that 246,660 new cases of invasive breast cancer were diagnosed and 40,890 death...

Continuing Education

Continuing Education Information: Integrating Emerging Data Into Clinical Practice: A Case-Based Approach for Multiple Myeloma

Integrating Emerging Data Into Clinical Practice: A Case-Based Approach for Multiple Myeloma This activity is supported by educational grants from Celgene Corporation and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. A continuing education article for nurse practitione...

Grand Rounds

Integrating Emerging Data Into Clinical Practice: A Case-Based Approach for Multiple Myeloma

Sandra Kurtin, PhDc, ANP-C, AOCN®

Continuing Education Information Integrating Emerging Data Into Clinical Practice: A Case-Based Approach for Multiple Myeloma This activity is supported by educational grants from Celgene Corporation and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. A continuing educa...

Grand Rounds

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

Lisa Doverspike,(1) PA-C, MPA, Sharyn Kurtz,(2) PA-C, MPAS, MA, and Kathy Selvaggi,(3) MD, MS

Malignant bowel obstruction is a common and challenging issue that affects 20%–50% of patients with metastatic ovarian cancer and 10%–28% of patients with metastatic colorectal cancer at some point in their disease course (Ripamonti, Easson, & Gerdes, 2008). Patients present at varying stages...

Translating Research Into Practice

The Challenges of Clinical Research in Rare Cancers: Bevacizumab Use in Low-Grade Serous Ovarian and Primary Peritoneal Cancers

Carolyn Grande,(1) CRNP, Constance Visovsky,(2) PhD, RN, ACNP, and Marcia S. Brose,(1) MD, PhD

Despite the designation as an uncommon disease, rare cancers exert a significant burden on the health of those affected. Rare cancers are those that have an occurrence rate of fewer than 15 cases per 100,000 individuals or those with fewer than 40,000 new cases per year (National Cancer Institute...

Practice Matters

Atypical Femoral Fractures: Implications for the Advanced Practitioner in Oncology

Kathy Sharp, MSN, FNP-BC, AOCNP®, CCD

Advanced practitioners in oncology (APs) frequently encounter bone-health issues in oncology. A significant number of oncology patients are at risk for accelerated bone loss due to treatment sequelae. Many of those patients may also have preexisting osteoporosis. Reports of atypical femoral fract...

Prescriber's Corner

Ixazomib: An Oral Proteasome Inhibitor for the Treatment of Multiple Myeloma

Krista G. Ramirez, PharmD, BCPS

Multiple myeloma (MM) is a hematologic malignancy characterized by the proliferation of plasma cells that produce monoclonal immunoglobulins, or paraproteins. Due to the rapid proliferation of these cancerous plasma cells, normal blood cells are “crowded out” of the bone marrow, and the immune re...

Tools and Technology

Establishing an Individual Writing Practice

Lydia T. Madsen, PhD, RN, AOCNS®, FNAP, and Kristen Starnes-Ott, PhD, BS, CRNA

Numerous topics encountered in both academic and clinical environments often have potential for publication; there are aspects of one’s specific practice or educational approach that can, and should, be shared with peers. Because the writing process is frequently perceived as a tedious, solitary,...

Editorial

JADPRO Live at APSHO 2016: United in Practice, United in Care

Pamela Hallquist Viale, RN, MS, CNS, ANP

This past November, over 1,000 nurse practitioners, PAs, pharmacists, clinical nurse specialists, and other oncology professionals gathered at the Gaylord National Hotel in National Harbor, Maryland, to participate in the JADPRO Live at APSHO conference. This meeting was the fourth annual JADPRO ...

Meeting Report

Advances in the Use of Immunotherapy in Oncology

Presented by Anthony J. Olszanski,(1) MD, RPh, and Laura J. Zitella,(2) MS, RN, ACNP-BC, AOCN®

One of the major breakthroughs in cancer therapy in the past 50 years, immunotherapy represents a new beginning for medical oncology, according to Anthony J. Olszanski, MD, RPh, of the Fox Chase Cancer Center, Philadelphia. “Immunotherapy is changing the way that oncologists think about patients ...

Meeting Report

CAR T-Cell Therapy: On the Verge of Breakthrough in Many Hematologic Malignancies

Presented by Edward Stadtmauer, MD, and Patricia A. Mangan, RN, MSN, APRN-BC

Chimeric antigen receptor (CAR) T-cell therapy is being studied mainly for the treatment of B-cell malignancies, but preliminary work is underway for its use in brain cancer, breast cancer, pancreatic cancer, mesothelioma, and others. The rationale for the use of CAR T-cell therapy is that refrac...

Meeting Report

Optimal Collaborative Management of Patients With Esophagogastric Cancers

Presented by David Ilson,(1) MD, PhD, and Steve Malangone,(2) MSN, FNP-C, AOCNP®

Esophageal and gastric cancers account for 2.6% of all malignancies. Survival has improved over the past 3 decades, but it still remains only about 30% at 5 years for those with this type of cancer. “Clearly, treatments that go beyond surgery alone are indicated,” said David Ilson, MD, PhD, of Me...

Meeting Report

Management of Patients With Skin Cancers: Basal Cell Carcinoma and Melanoma

Presented by Brianna Hoffner,(1) MS, ANP-BC, AOCNP®, and Daniel M. Siegel,(2) MD, MS, FAAD, FACMS

Recent advances in understanding of the molecular biology and genetics of advanced basal cell carcinoma (BCC) and melanoma have helped to expand treatment options for both conditions and improve outcomes for patients. In the process, the advances have increased the informational and clinical know...

Meeting Report

Collaborative Management of Patients With Estrogen Receptor–Positive Breast Cancer

Presented by Lee S. Schwartzberg, MD, FACP, and Heather R. Greene, MSN, FNP, AOCNP®

Although remarkable progress has been made in the treatment of early-stage breast cancer, about 20% of women will relapse from an original diagnosis of stages I–III breast cancer and develop metastatic breast cancer (MBC), according to Lee S. Schwartzberg, MD, FACP, of the West Cancer Center, Mem...

Meeting Report

What Advanced Practitioners Need to Know About the Diagnosis and Treatment of Patients With Pancreatic Cancer

Presented by Joseph M. Herman,(1) MD, and Amy Hacker-Prietz,(2) PA-C

Progress in the field of oncology in general has failed to produce a major impact on prognosis in pancreatic cancer, which continues to have one of the highest fatality rates. Reasons for the persistently poor prognosis of pancreatic cancer are multifaceted, as Joseph M. Herman, MD, of The Univer...

Meeting Report

Advances in Collaborative Practice for Patients With Head and Neck Cancers

Presented by Robert Haddad, MD, and Jason Glass, ACNP-BC

"By the year 2020, there will be more head and neck cancers linked to human papillomavirus [HPV] in the United States than cervical cancer,” according to Robert Haddad, MD, a medical oncologist at the Dana-Farber Cancer Institute, Boston. “We are seeing a change in the epidemiology of this diseas...

Meeting Report

Diagnosis and Treatment of Adenocarcinomas and Squamous Cell Carcinomas of the Lung

Presented by Millie Das,(1) MD, and Alison Holmes Tisch,(2) MSN, RN, ANP-BC, AOCNP®

In the treatment of advanced lung cancer, histology still guides treatment selection, and a wealth of new targeted and immunotherapeutic agents is changing the natural history of this challenging malignancy, according to two Stanford University clinicians who described the management of adenocarc...

Meeting Report

New Treatment Paradigms Defined for Chronic Lymphocytic Leukemia

Presented by Mollie Moran, CNP, and Jeffrey Jones, MD, MPH

Chronic lymphocytic leukemia (CLL) is the most common leukemia in the Western hemisphere, with 15,000 diagnoses each year and 4,400 deaths annually. Chronic lymphocytic leukemia is also the most prevalent leukemia because of its long survival time, with 60% of patients with CLL still alive 5 year...

Meeting Report

Nuances in the Management of Aggressive Lymphomas

Presented by Paul A. Hamlin, MD, and Michelle Wisniewski, MS, PA-C

Aggressive lymphomas are a heterogeneous population of tumors whose management is changing as their biology becomes better understood. Nuances in managing these patients, including current standards and future strategies, were discussed at 2016 JADPRO Live by Paul A. Hamlin, MD, and Michelle Wisn...

Meeting Report

New Treatment Strategies Making an Impact in Multiple Myeloma

Presented by Mollie Moran, CNP, and Jeffrey Jones, MD, MPH

New drugs with novel mechanisms of action are making a huge impact in the treatment of multiple myeloma. At JADPRO Live 2016, these agents, their unique toxicities, and their optimal use in treating patients with newly diagnosed and relapsed myeloma were described by Charise Gleason, MSN, NP-BC, ...

Meeting Report

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

Presented by James S. Lewis II, PharmD, FIDSA

Biosimilars of filgrastim for the treatment of febrile or prolonged neutropenia have already arrived on the market and will continue to increase in use based on price advantage. According to James S. Lewis II, PharmD, FIDSA, of Oregon Health & Science University, Portland, this is good news f...

Meeting Report

Management of Venous Thromboembolism for Patients With Hematologic Malignancies

Presented by Rowena N. Schwartz, PharmD, BCOP

Coagulation in cancer is a fascinating topic. Venous thromboembolism hits upon all three of the main issues we talk about in oncology: treatment of the disease, complications of the disease, and comorbidities,” said Rowena N. Schwartz, PharmD, BCOP, of the University of Cincinnati. At JADPRO Live...

Meeting Report

Management of Patients With Chemotherapy-Induced Nausea and Vomiting

Presented by Sally Yowell Barbour, PharmD, BCOP, CPP

Despite advances in the management of chemotherapy-induced nausea and vomiting (CINV), clinical management remains a challenge, said Sally Yowell Barbour, PharmD, BCOP, CPP, of Duke University Hospital in Durham, North Carolina, during a 2016 JADPRO Live presentation. “Nausea and vomiting is one ...

Editorial

Protecting Against Sun Exposure: Which SPF Will You Recommend?

Pamela Hallquist Viale, RN, MS, CNS, ANP

Cutaneous melanoma is a major cause of mortality and morbidity in the United States, and in younger adults, the disease is the second most common invasive cancer after breast cancer (Reed et al., 2012). Although recent approval of new therapies assists greatly in the treatment of melanoma, reduci...

Review Article

Advanced Care Provider and Nursing Approach to Assessment and Management of Immunotherapy-Related Dermatologic Adverse Events

Kathryn Ciccolini,(1) BSN, RN, OCN®, DNC, Anna Skripnik Lucas,(1) MSN, RN, DNC, FNP-BC, Alyona Weinstein,(2) MSN, FNP-BC, and Mario Lacouture,(1) MD

Through recent research, tumors have demonstrated the ability to shield the normal immune response by exploiting immune checkpoint pathways (Harvey, 2014). Two major immune checkpoint pathways that are being researched are cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protei...

Review Article

Managing Constipation in Adults With Cancer

Rita J. Wickham, PhD, RN, AOCN®

Constipation is a common and distressing problem for many individuals with cancer during treatment and palliative care, and perhaps even during survivorship; in too many instances, it goes unrecognized and untreated (McMillan, Tofthagen, Small, Karver, & Craig, 2013). Constipation can range f...

Grand Rounds

Current and Emerging Therapies for HER2-Positive Women With Metastatic Breast Cancer

Karlyn Porter,(1) PA-C, MPAS, and Margaret Quinn Rosenzweig,(2) PhD, FNP-BC, AOCNP®, FAAN

A crucial step in developing a treatment plan for patients with metastatic breast cancer involves repeating hormonal studies and validating the HER2 status on the biopsied metastatic lesion. Testing validation of HER2 is extremely important, as approximately 20% of all breast cancers express HER2...

Continuing Education

Continuing Education Information: Use of Diagnostic Tests in Advanced Non–Small Cell Lung Cancer

Use of Diagnostic Tests in Advances Non–Small Cell Lung Cancer This activity is supported by educational grants from AstraZeneca, Clovis Oncology, Lilly, and Merck & Co. A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology an...

Grand Rounds

Use of Diagnostic Tests in Advanced Non–Small Cell Lung Cancer

Beth Eaby-Sandy, MSN, CRNP, OCN®

Interpreting pathology reports as well as routine imaging studies is one of the many roles of the advanced practitioner (AP) in oncology. With recent advancements in the management of patients with non–small cell lung cancer (NSCLC)—in particular, the advent of molecular targeted agents and immun...

Practice Matters

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

Laura Melton, PhD, ABPP

Advanced practitioners in oncology (APs) are familiar with multidisciplinary and collaborative care; many practice in settings where they refer patients to mental health professionals for the inevitable life distress and potential mental health issues that accompany cancer. Cognitive behavioral t...

Prescriber's Corner

Osimertinib: A Novel Therapeutic Option for Overcoming T790M Mutations in Non–Small Cell Lung Cancer

Shan Li, PharmD, BCOP, and Eve M. Segal, PharmD, BCOP

Lung cancer is the leading cause of cancer death for men and women in the United States. A total of 224,390 new cases of lung cancer and 158,080 deaths were estimated to have occurred in 2016. Furthermore, one in four deaths due to cancer is expected to be from lung cancer (Siegel, Miller, & ...

Tools and Technology

NCCN Imaging Appropriate Use Criteria Compendium: An Overview

Mistie G. Hagaman, MSN, FNP-C

The National Comprehensive Cancer Network™ (NCCN™) website has an evidence-based tool called the NCCN Imaging Appropriate Use Criteria (AUC) Compendium™ to help guide practitioners in choosing appropriate imaging for their patients. The NCCN Imaging AUC Compendium was developed in early 2016. The...

Editorial

Vitamin D and Breast Cancer: Should Our Patients Be Taking a Supplement?

Pamela Hallquist Viale, RN, MS, CNS, ANP

Breast cancer remains a formidable disease in women. In 2017, the American Cancer Society notes that the estimated number of new female invasive breast cancer cases is 252,710, with an estimated 40,610 women dying of the disease (American Cancer Society, 2017). Previously published studies have r...

Grand Rounds

Anisocoria and an Array of Neurologic Symptoms in an Adult With Ewing Sarcoma

Mary Jane LaRoche, ANP-BC, AOCNS®, ACHPN

Ewing sarcoma (ES) is a rare mesenchymal malignancy that most commonly presents in adolescence as a primary bone cancer and less often as extraskeletal Ewing sarcoma (EES). Both ES and EES are part of a larger family of tumors that include small round blue cell tumors and Askin’s tumor of the che...

Review Article

Practical Guide to Bone Marrow Sampling for Suspected Myelodysplastic Syndromes

Jean A. Ridgeway,(1) DNP, APN, NP-C, AOCN®, Sara Tinsley,(2) PhD, ARNP, AOCN®, and Sandra E. Kurtin,(3) RN, MS, AOCN®, ANP-C

Characterized by ineffective hematopoiesis and progressive bone marrow failure, myelodysplastic syndromes (MDS) comprise a group of diverse clonal hematopoietic stem cell malignancies (Brunning et al., 2008; Zeidan, Faltas, Douglas Smith, & Gore, 2013). Deficiencies in hematopoiesis result in...

Review Article

Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications

Erin Armideo, RN, CRNP, CPON, Colleen Callahan, RN, CRNP, and Lara Madonia, RN, CRNP

Neuroblastoma is the most common extracranial solid tumor in children. Approximately 800 children are diagnosed with neuroblastoma each year in the United States (Ward, DeSantis, Robbins, Kohler, & Jemal, 2014). Risk stratification in children with neuroblastoma is not only based on disease s...

Review Article

Understanding and Managing Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Patients With Advanced Melanoma

Alyona Weinstein,(1) RN, MSN, FNP-BC, Ruth-Ann Gordon,(1) MSN, FNP-BC, OCN®, Mary Kate Kasler,(1) MSN, ACNP-BC, DNP(c), Matthew Burke,(2) MBA, RN, MSN, APRN-BC, Smita Ranjan,(3) MSN, APRN, Jackie Hodgetts,(4) MSc, RN, NMP, Vanessa Reed,(1) MS, AGPCNP-BC, OCN®, Yelena Shames,(1) MSA, ACNP-BC, CNRN, Nana Prempeh-Keteku,(1) MS, ANP-BC, and Karla Lingard,(5) RNBSc (Hons)

The projected incidence of melanoma within the United States is about 87,110 new cases for 2017, with an estimated 9,730 deaths from the disease in the same year (American Cancer Society, 2017). The lifetime risk of developing melanoma is 2.1%, or 1 out of every 50 men and women (National Cancer ...

Practice Matters

Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus

Mary E. Peterson, MS, APRN, AOCNP®

In 1965, in answer to the growing demand for primary care, nursing pioneer Loretta Ford, along with Dr. Henry Silver, created the first certificate program that provided nurses with the skills to provide primary care to underserved populations. Since the inception of that first program, the field...

Prescriber's Corner

Daratumumab: Dawn of a New Paradigm in Multiple Myeloma?

Joseph A. Kalis, PharmD, BCOP

Multiple myeloma is a neoplasm of the terminally differentiated B-lymphocyte, or plasma cell (Rollig, Knop, & Bornhauser, 2015). The second most common hematologic malignancy in the United States, multiple myeloma accounts for approximately 18% of all hematologic malignancies and 2% of all ne...

Meeting Abstract

JL401. A Regional Cancer Center’s Experience With Lung Cancer Screening Using Low Dose CT

Aimee Strong, MSN, AGACNP-BC, Centra Medical Group, Lynchburg, VA

Meeting Abstract

JL402. A Retrospective Study of the Incidence of Vitamin D Insufficiency in BRCA Mutation Carriers in a Community Cancer Center

Phyllis C. Everett, RN, MSN, AOCN®, APNG, NP-C, Centra Medical Group, Lynchburg, VA, and Rebekah A. Betar, BS, CPHT, Liberty University, Lynchburg, VA

Meeting Abstract

JL403. Advanced Practice and Improved Outcomes for Infusion Therapy Patients Experiencing ADRs

Kelly R. Young, DNP, ANP-C, AOCN®, Duke Raleigh Medical Center, Raleigh, NC, Emily Dill, ANP-BC, MSN, Duke Raleigh Medical Center, Raleigh, NC, Yuri Fesko, MD, Duke Medical Oncology for Wake County, Duke University, Durham, North Carolina, and Lindsay MacDiarmada, MHA, Duke Raleigh Hospital, Raleigh, NC

Meeting Abstract

JL404. An Academic Cancer Center’s Approach to Observation Management Services

LaKeisha Day, PA-C, Anayo Mbadugha, PA-C, Sunil Sahai, MD, Kimberly Tripp, MBA, BSN, RN; University of Texas MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL405. An Interdisciplinary Educational Checklist for Allogeneic Stem Transplant Patients

Jean A. Ridgeway, DNP, APN, NP-C, AOCN®, and Kaitlin Caponi-Holcomb, MSN, FNP-BC; University of Chicago Medical Center, Chicago, IL

Meeting Abstract

JL406. BMDACC Breast Cancer Program Clinical Rotation for Nurse Practitioner Students

Michele Sazama, DNP, ANP-C, Melissa Shelby, MSN, ACNP-BC, RNFA, Aida Amado, MSN, ACNP-BC, Stefanie Casey, MSN, ACNP-BC, and Lynn Schuster, DNP, ACNP-BC; Banner MD Anderson Cancer Center, Gilbert, AZ

Meeting Abstract

JL407. Burden of Phlebotomy in Patients With Polycythemia Vera in the United States: A Preliminary Analysis of Baseline Data from the REVEAL Study

Meeting Abstract

JL408. Decreasing Venous Thromboembolism in Patients With Hematologic Malignancy Through Implementation of Clinical Practice Guidelines – A Quality Improvement Project

Karley M. Trautman, DNP, ANP-BC, and Chelsey Boggs, MS, AGNP-BC; Blood Cancer and Bone Marrow Transplant Program, University of Colorado Anschutz Medical Campus, Aurora, CO

Meeting Abstract

JL409. Development of An Evidence-Based Scorecard to Assess Provider Adherence to Gastrointestinal Toxicity Management

Meeting Abstract

JL410. Identification of Continued Educational Gaps Among Oncology Nurses Treating Patients With Pancreatic Cancer: A Case for Further Education

Nina N. Grenon, DNP, AOCN®, Dana-Farber Cancer Institute, Boston, MA, and Patricia M. Repetto, M.Ed, CHCP, Medscape Oncology, New York, NY

Meeting Abstract

JL411. Implementation and Evaluation of an Influenza Adherence Toolkit in Allogeneic Bone Marrow Transplant Recipients

Tracy Krimmel, DNP, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, Susan M. Schneider, PhD, RN, AOCN®, FAAN, Duke University School of Nursing, Durham, NC, Rajat Bannerji, MD, PhD, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, and Maribel Borysyuk, PharmD, Walgreens, Dallas, TX

Meeting Abstract

JL412. Management of Endocrinopathies Associated With Nivolumab and Ipilimumab Combination Therapy in Solid Tumors

Meeting Abstract

JL413. Management of Gastrointestinal Adverse Events (AEs) Associated With Nivolumab and Ipilimumab Combination Therapy in Solid Tumors

Meeting Abstract

JL414. Multidisciplinary Management of Hepatocellular Carcinoma: The Role of Systemic Chemotherapy and Chemoembolization in Converting Patients With Large Unresectable Liver Tumors to Surgical Resectability

Jenilette D. Velasco, MPAS, PA-C, and Steven H. Wei, MS, MPH, PA-C; MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL415. Nurses Championing Exercise in Survivorship Care Clinic Visits

Bernadette Labriola, MSN, FNP-C, Duke University, Durham, NC, and Kathy Trotter, DNP, FAANP, Duke School of Nursing, Durham, NC

Meeting Abstract

JL416. Parathyroid Carcinoma Overview: A Case Study

Elizabeth Sanders-Schacht, PA-C, and Rae Brana Reynolds, MS, RN, ANP; MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL417. Performance Improvement Continuing Medical Education (CME) for the Advanced Practice Provider in Oncology

Kelly R. Maldonado, MPAS, PA-C, Maura Polansky, MS, MHPE, PA-C, Jessica Eno, MS, PA-C, Leah Theriot, MPAS, PA-C, Carolyn Zawislak, MPAS, PA-C, and Steven H. Wei, MS, MPH, PA-C; University of Texas MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL418. Primary Polycythemia Vera: Advances in Diagnosis and Treatment

Kathy Leonard, MA, ACNP-B, ANP-B, ANP-BC, AOCNP®, New York University Clinical Cancer Center, New York, NY

Meeting Abstract

JL419. Recognizing the Contributions of Advanced Practice Providers to Oncology Care: Are Current Metrics Enough?

Amanda W. Yopp, MSN, AGNP-BC, Holly Wall, RN, MSN, ACNP-BC, and Kena Miller, RN, MSN, ARNP-BC; Takeda Oncology, Cambridge, MA

Meeting Abstract

JL420. Redesigning How We Communicate Important Safety Information (ISI) Using the Universal Patient Language

Elizabeth M. Chebli, PharmD, CMPP, Bristol-Myers Squibb, New York, NY

Meeting Abstract

JL421. Review of a Genetic Risk Assessment Delivery Model in a Private Community Oncology Practice

Doreen Grzelak, NP-C, CBCN, MSN, AOCN®, Virginia Cancer Specialists, Washington, DC

Meeting Abstract

JL422. Screening for and Managing Distress in Patients With Metastatic Lung Cancer

Victoria Sherry, DNP, CRNP, ANP-BC, AOCNP®, Hospital of the University of Pennsylvania, Philadelphia, PA, Susan M. Schneider, PhD, RN, AOCN®, FAAN, Duke University School of Nursing, Durham, NC, Ranganathan Anjana, MD, Hospital of the University of Pennsylvania, Philadelphia, PA, and Carmen Guerra, MD, MSCE, FACP, Hospital of the University of Pennsylvania, Philadelphia, PA

Meeting Abstract

JL423. Soft Tissue Sarcoma: A Case Study and Multidisciplinary Management

Allison L. Lock, MPAS, PA-C, MD Anderson Cancer Center, Houston, TX

View the poster.

Meeting Abstract

JL424. The Interrelationship of Polypharmacy on Functional Status and Quality of Life in the Elderly Chronic Lymphocytic Leukemia Patient

Patricia Karwan, DNP, APRN-BC, Care New England/Women and Infant Hospital, Providence, RI

Meeting Abstract

JL425. Tumor Lysis Syndrome: An Electrolyte Emergency

Jan Garza-Dennis, RN, MSN, ANP-C, AOCNP®, University of Texas at Houston, MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL426. The Impact of the ONc-PoWER Course on the Professional Development of Nurse Practitioners

Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP®, FAAN, Sara Jo Klein, MS, BSN, RN, Mary Connolly, BSN, RN, and Rose Hoffmann, PhD, RN, University of Pittsburgh School of Nursing, Pittsburgh, PA

Meeting Abstract

JL427. The Effect of Prophylactic Naproxen, Prophylactic Loratadine, or No Prophylaxis on Bone Pain in Patients With Breast Cancer Receiving Chemotherapy and Pegfilgrastim

Meeting Abstract

JL428. Symptoms and Management of Cerebral Progression in Patients With Anaplastic Lymphoma Kinase-Positive (ALK+) Non-Small Cell Lung Cancer (NSCLC): A Clinical and Nursing Perspective

Rachael Pollina, MS, MSN, FNP-BC, Memorial Sloan Kettering Cancer Center, New York, NY, Wendi Stone, RN, NP-C, University of Texas MD Anderson Cancer Center, Houston, TX, Kate Kegg, MPAS, PA-C, University of Texas MD Anderson Cancer Center, Houston, TX, and Anne S. Tsao, MD, University of Texas MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL429. Transfusion Practice Patterns in Patients Receiving Myelosuppressive Chemotherapy for Nonmyeloid Cancer: Results From a Prospective Observational Study

Editorial

Reflections on a Name

Heather M. Hylton, MS, PA-C

When autumn comes, I often find myself reflecting upon the rich and fascinating history of advanced practitioners, in particular, that of the PA. Perhaps it is because at the time of the writing of this piece, we have just concluded the annual celebration of National PA Week. Established in 1987,...

Editorial

A Conversation With Lucy Kalanithi

Pamela Hallquist Viale, RN, MS, CNS, ANP

I’m writing this editorial just a few days after the conclusion of our very successful, fourth annual JADPRO Live at APSHO conference that was held in sunny (at least for that week!) Washington, DC. Over 750 attendees enjoyed 4 days of focused, practice-changing information designed to educate an...

Review Article

Optimizing Communication and Adherence to Iron Chelation Therapy From Diagnosis to Treatment in Patients With Myelodysplastic Syndromes

Jayshree Shah, AOCNP®, FNP-C, RN, MSN, BSN, BS, and Phyllis McKiernan, APN, MSN, OCN®

Melodysplastic syndromes (MDS) refer to a heterogeneous group of blood diseases usually associated with cytopenias (Platzbecker & Adès, 2014; Greenberg et al., 2009; National Comprehensive Cancer Network [NCCN], 2016). It is most often diagnosed in older individuals, with the median age at di...

Review Article

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

Wendy H. Vogel, MSN, FNP, AOCNP®, and Jennifer Paul, MPAS, PA-C

Lung cancer is the second most common cancer and the leading cause of cancer-related death in the United States, with approximately 221,200 new cases and 158,040 deaths estimated in 2015 (Siegel, Miller, & Jemal, 2015). Non–small cell lung cancer (NSCLC) accounts for about 85% of all lung can...

Grand Rounds

Symptom Management for Patients With Esophageal Cancer After Esophagectomy

Laura A. Pachella, RN, AGPCNP-BC, MSN, AOCNP®, and Susan Knippel, RN, MSN, FNP-C

It was estimated that 16,980 new cases of esophageal cancer were diagnosed in the United States in 2015, and 15,590 patients died of the disease (Surveillance, Epidemiology, and End Results [SEER], 2015). Esophageal cancer is a small percentage of the total malignancies diagnosed in the United St...

Practice Matters

Recognizing the Contributions of Advanced Practitioners to Oncology Care: Are Current Metrics Enough?

Amanda W. Yopp, MSN, AGNP-BC, Holly M. Wall, RN, MSN, ACNP-BC, and Kena C. Miller, RN, MSN, ARNP-BC

Oncology care has improved with the development of new treatment modalities that extend life expectancy. According to the American Cancer Society (ACS), there were more than 14 million Americans with a history of cancer in 2014, and the number of survivors is expected to increase to almost 19 mil...

Prescriber's Corner

Olaparib in Epithelial Ovarian Cancer

Paula J. Anastasia, RN, MN, AOCN®

Epithelial ovarian cancer (EOC) is the most fatal of the gynecologic malignancies, due to the lack of early screening and detection modalities and the advanced stage at the time of diagnosis (American Cancer Society [ACS], 2016). The diagnosis of EOC is often interchanged for or includes fallopia...

Grand Rounds

Chemoembolization With Drug-Eluting Beads for the Treatment of Hepatocellular Carcinoma

KATHY DIENER DASSE,1 PharmD, BCOP, MICHAEL J. LANDER,2 PharmD, and PAULA M. NOVELLI,3 MD

Primary liver cancer is one of the most common malignancies occurring worldwide as well as one of the most common causes of cancer-related deaths (American Cancer Society [ACS], 2015; El-Serag & Rudolph, 2007; Torre et al., 2015). Hepatocellular carcinoma (HCC) accounts for approximately 90% ...

Translating Research Into Practice

Liver Resection in Patients With Synchronous Colorectal Liver and Lung Metastases

ALLISON HORNER, MPAS, PA-C, and KENDALL LENCIONI, MPAS, PA-C

According to the Centers for Disease Control and Prevention (CDC), colorectal cancer (CRC) is the second leading cause of cancer death in the United States and is the third most common cancer among men and women (CDC, 2016). Approximately 50% to 60% of patients diagnosed with CRC develop distant ...

Translating Research Into Practice

Assessment of Overall Survival Benefits in Patients Undergoing Complete Hepatectomy for Synchronous Colorectal Cancer With Liver and Lung Metastases

ELSA MELISSA ARVIDE, PA-C, and JENILETTE DAMES VELASCO, PA-C

Overall survival (OS) is a statistical term referring to the percentage of a population in a group who are alive after a defined length of time, usually years. For example, a 5-year OS rate is the percentage of people who are alive 5 years after diagnosis or 5 years after the start of therapy. In...

Editorial

The Passage of CARA: Implications for Patients With Cancer Pain

Pamela Hallquist Viale, RN, MS, CNS, ANP

On July 22, 2016, President Barack Obama signed a bill into law that could have the potential to impact our practice. The Comprehensive Addiction and Recovery Act (CARA) is aimed at curbing the national opioid epidemic, a troubling phenomenon leading to increased deaths from drug overdoses. The C...

Editorial

Superhuman Strength in Cancer

Laura Melton, PhD, ABPP

Sarah was in her mid-30s with widely metastatic breast cancer when I met her. Her sole purpose in life was to be a mother. She worked with high schoolers and thought of herself as an extended mom to some of the students. When fertility issues arose, she sought treatment. In our first session, I s...

Review Article

Idelalisib: Practical Tools for Identifying and Managing Adverse Events in Clinical Practice

Nancy Driscoll, PA-C

Non-Hodgkin lymphomas (NHLs) are a diverse group of malignancies, primarily of B-cell origin (Shankland, Armitage, & Hancock, 2012). The most common NHL subtypes include diffuse large B-cell lymphoma, chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), multiple myeloma, and f...

Review Article

Clinical Management of Bowel Dysfunction After Low Anterior Resection for Rectal Cancer

Angela Bazzell, MSN, RN, FNP-BC, AOCNP®, Lydia T. Madsen, PhD, RN, AOCNS®, and Joyce Dains, DrPH, JD, RN, FNP-BC, DPNAP, FAANP

The American Cancer Society estimated that 39,610 new cases of rectal cancer were diagnosed in the United States in 2015 (Siegel, Miller, & Jemal, 2015). Current treatment options for rectal cancer include chemotherapy, radiation therapy, and surgery. The main goals in the treatment of rectal...

Grand Rounds

Case Study of a Young Adult With Ewing Sarcoma

Carol Guarnieri, RN, MSN, FNP-C, AOCNS®

Sarcoma comes from the Greek word Sarx meaning “flesh.” Sarcomas are divided into main categories of bone sarcomas and soft-tissue sarcomas. In 1921, James Ewing described a primary bone tumor composed of small round blue cells that was histologically different from osteosarcoma. Today, the Ewing...

Original Research

A Descriptive, Longitudinal Study of Quality of Life and Perceived Health Needs in Patients With Head and Neck Cancer

S. Kate Sandstrom,(1) RN, MSN, APRN-BC, AOCN®, Susan R. Mazanec,(1,2) PhD, RN, AOCN®, Haley Gittleman,(2) MS, Jill S. Barnholtz-Sloan,(2) PhD, Nancy Tamburro,(1) LISW-S, and Barbara J. Daly,(1,2) PhD, RN, FAAN

It is estimated that by the year 2020, there will be close to 18 million cancer survivors in the United States, a 30% increase from 2010 (National Cancer Institute [NCI], 2014; Hebdon, Abrahamson, McComb, & Sands, 2014). Despite the recognition of the importance of survivorship care in oncolo...

Practice Matters

Appraising Travelbee’s Human-to-Human Relationship Model

Gary Shelton, DNP, NP, ANP-BC, AOCNP®, ACHPN

Finding meaning in suffering could be one of life’s greatest quests. It is a universal question, yet we all attribute its meaning personally. Joyce Travelbee, a nurse theorist of historical significance, set about to provide the basis for such discovery. In her grand theory, the Human-to-Human Re...

Tools and Technology

Understanding Biomarkers in Early-Stage Invasive Breast Cancer: Tools From the ASCO Clinical Guideline

Kelley D. Mayden, MSN, FNP, AOCNP®

The American Cancer Society (2015) estimates that 231,840 new cases of invasive breast cancer will be diagnosed among females in the United States in 2016. The good news is that there has been a decline in the overall death rate from breast cancer. This decline is due, in part, to improvements in...

Editorial

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Editorial

Upcoming Meetings

JADPRO

October International Cancer Imaging Society Meeting and 16th Annual Teaching Course October 3-5 • Glasgow, Scotland www.icimagingsociety.org.uk 7th InterAmerican Oncology Conference ‘Current Status and Future of Anti-Cancer Targeted Therapies’ October 5-6 • Buenos Aires, Argentina www.oncolog...

Editorial

Thank You to Our Peer Reviewers!

JADPRO

In this issue of the Journal of the Advanced Practitioner in Oncology (JADPRO), we would like to acknowledge all of the professionals who completed peer reviews for JADPRO in the past year. Looking at the credentials noted in the list below, there can be no doubt that as a group, you represent a ...

Editorial

Statement of Ownership: JADPRO

JADPRO

Statement of Ownership, Management and Circulation (Requester Publication) 1) Publication Title: Journal of The Advanced Practitioner in Oncology. 2) Publication Number: 2150-0878. 3) Filing Date: September 2016. 4) Issue Frequency: Every two months. 5) Number of Issues Published Annually: 7. 6) ...

Editorial

Cancer Care in 2016: The ASCO State of Cancer Care Report and the Role of Advanced Practitioners

Pamela Hallquist Viale, RN, MS, CNS, ANP

The American Society of Clinical Oncology published their annual State of Cancer Care in America: 2016 report in March of this year (ASCO, 2016). As expected, the report detailed the many improvements in care as well as the challenges and problems that remain in cancer care in the United States t...

Continuing Education

Continuing Education Information: Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients

Virginia Ruth Corey,¹ DNP, ARNP-BC, FNP, and Priscilla Gage Gwyn,² PhD, ARNP-BC, CNS, OCN®, FCN

Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hematology nurses. Release date: July 15, 2016 Expiration date: July 15, 2017 Expected time...

Original Research

Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients

Virginia Ruth Corey,¹ DNP, ARNP-BC, FNP, and Priscilla Gage Gwyn,² PhD, ARNP-BC, CNS, OCN®, FCN

In 1995, Breaking Bad News Consensus Guidelines were published (Girgis & Sanson-Fisher, 1995). They called for improved medical provider communication with patients outlining there was a lack of research in the specific steps in delivering bad news and recommending research be undertaken both...

Review Article

How Checkpoint Inhibitors Are Changing the Treatment Paradigm in Solid Tumors: What Advanced Practitioners in Oncology Need to Know

Marianne Davies, DNP, MSN, CNS, ACNP, AOCNP®

Continuing Education Information How Checkpoint Inhibitors Are Changing the Treatment Paradigm in Solid Tumors: What Advanced Practitioners in Oncology Need to Know A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hematol...

Review Article

Biomarkers/Molecular Targets, Immunotherapy, and Treatments for Non–Small Cell Lung Cancer

Elizabeth S. Waxman, RN, MSN, AOCN®, and Frank V. Fossella, MD

Molecular targets, biomarkers, their treatments, and immunotherapy have changed the treatment paradigm for non–small cell lung cancer (NSCLC) from chemotherapy (“one-size-fits-all”) approach to specific recommendations for patients based on the presence or absence of gene mutations (“personalized...

Practice Matters

A Missed Opportunity: Understanding the Value of Documenting Occupational Exposure to Carcinogens in Adults With Acute Leukemia

AnnMarie Lee Walton,¹ PhD, MPH, RN, OCN®, CHES, Ashley Leak Bryant,¹ PhD, RN-BC, OCN®, Bob Wong,² PhD, and Kathi Mooney,² PhD, RN, FAAN

Individuals with occupational exposures to carcinogens are at increased risk for leukemia (Mills, Dodge, & Yang, 2009). Blair et al. (2001) found an increased risk of leukemia for those working in particular industries or occupations and used prior studies to illuminate suspected carcinogens ...

Prescriber's Corner

Elotuzumab: The First Monoclonal Antibody for the Treatment of Multiple Myeloma

Karen M. Fancher,(1,2) PharmD, BCOP, and Elizabeth J. Bunk,(1) PharmD

Multiple myeloma (MM) is a hematologic cancer in which malignant plasma cells are formed. Plasma cells are mainly found in bone marrow and function within the body to attack and destroy antigens. Multiple myeloma occurs when malignant plasma cells accumulate in the bone marrow, leading to marrow ...

Grand Rounds

Palbociclib Plus Letrozole for the Treatment of Metastatic Breast Cancer: An Illustrative Case Scenario

Kristi Orbaugh,¹ RN, MSN, RNP, AOCN®, Joanne C. Ryan,² PhD, RN, and Lynn Pfeuffer,3 MSN, CRNP

In 2007, Betty was one of 26% of women who were diagnosed with breast cancer in the United States, at a time when breast cancer accounted for 15% of cancer deaths (American Cancer Society [ACS], 2007). Similarly, in 2016, estimates predict that 29% of new cancer diagnoses in women are expected to...

Translating Research Into Practice

Review of the New American Cancer Society Guidelines for Breast Cancer Screening for Women at Average Risk

Sylvia S. Estrada, DNP, MSN, MSHCM, WHNP-BC, CBCN

Breast cancer is the most common cancer in women worldwide (Torre et al., 2015). In the United States, an estimated 231,840 women were diagnosed with breast cancer in 2015 (Siegel, Miller, & Jemal, 2015). After lung cancer, breast cancer continues to rank second as a cause of cancer death in ...

Translating Research Into Practice

When Should I Have a Mammogram? Recent Changes in ACS Mammography Guidelines: Implications for Practice

Karen Meneses, PhD, RN, FAAN

In the United States, breast cancer is the most common female cancer and the second leading cause of female cancer death (American Cancer Society [ACS], 2015). Breast cancer significantly contributes to morbidity and premature mortality among American women (ACS, 2015). Early detection with mammo...

Tools and Technology

Advanced Practitioners’ Favorite Books: Part III

The Editors of JADPRO

What to Expect When…Saying Goodbye to Your Prostate: How to Beat Prostate Cancer, Ease Your Mind, and Laugh While Doing It Jamie MacKenzie & Lisa Schwartz (CreateSpace Publishing, 2013) There is nothing funny about prostate cancer, but this book presents prostate cancer diagnosis and trea...

Editorial

Value and Financial Toxicity of New Cancer Drugs

Rita J. Wickham, PhD, RN, AOCN®

By now you’ve read Karen Herold’s excellent overview of the CLEOPATRA study in the January/February issue of JADPRO (2016). CLEOPATRA confirmed that PDT (pertuzumab [Perjeta], docetaxel, and trastuzumab [Herceptin]) was superior to docetaxel and trastuzumab (DT) to improve progression-free and o...

Original Research

Beyond BRCA: A Pilot Program to Assess and Improve Knowledge of Pharmacogenomic Testing Among Advanced Practitioners in a Breast Cancer Treatment Setting

Samuel L. Hoffman,(1) DNP, RN, Robert Reid Kaufman,(2) PharmD, Shannon Ferrari,(3) PA-C, MPAS, Sheila Ann Alexander,(2) PhD, RN, FCCM, Margaret Quinn Rosenzweig,(2) PhD, CRNP-C, AOCN®, FAAN, and Susan W. Wesmiller,(4) PhD, RN

Advanced practitioners (APs), including nurse practitioners (NPs) and physician assistants (PAs), are important members of the interprofessional clinical team caring for patients with cancer. Clinical care is increasingly complex, requiring knowledge of pathophysiology and genomics for everyday p...

Continuing Education

Continuing Education Information: Multigene Panel Testing for Hereditary Cancer Risk

Alyssa A. Grissom, MSN, APN, AGCNS, OCN®, and Patricia J. Friend, PhD, APN-CNS, AOCNS®, AGN-BC

Multigene Panel Testing for Hereditary Cancer Risk A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hematology nurses. Release date: May 15, 2016 Expiration date: May 15, 2017 Expected time to complete activity: 0.75 hou...

Grand Rounds

Multigene Panel Testing for Hereditary Cancer Risk

Alyssa A. Grissom, MSN, APN, AGCNS, OCN®, and Patricia J. Friend, PhD, APN-CNS, AOCNS®, AGN-BC

Cancer is a genetic disease, resulting from germline (inherited) or somatic (acquired) mutations in DNA. Although most cancers arise from acquired DNA damage over an individual’s lifetime, 5% to 10% of cancer diagnoses are caused by an inherited gene mutation (Mauer, Pirzadeh-Miller, Robinson, &a...

Review Article

Effectiveness of Granulocyte Transfusions in Neutropenic Adult Oncology Patients: A Comprehensive Review of the Literature

Asha Demla, MS, RN, AGPCNP-BC, Lydia T. Madsen, PhD, RN, AOCNS®, and Joyce Dains, DrPH, JD, RN, FNP-BC, DPNAP, FAANP

In patients with cancer, several factors may cause severe and persistent neutropenia, including intense chemotherapy regimens, underlying malignancy, and stem cell transplantation as treatment. White blood cell (WBC) counts typically reach a nadir 7 to 10 days after chemotherapy administration, i...

Practice Matters

Optimizing the Teachable Moment for Health Promotion for Cancer Survivors and Their Families

Melissa L. Frazelle, MSN, APN, FNP-BC, OCN®, and Patricia J. Friend, PhD, APN-CNS, AOCNS®, AGN-BC

Due to significant advances in screening, detection, and treatment, 70% of patients with cancer are living 5 years or longer, comprising 4% of the US population (Demark-Wahnefried et al., 2015). As of January 2014, the American Cancer Society (ACS) had estimated that there were approximately 14.5...

Prescriber's Corner

Ruxolitinib in Myelofibrosis and Polycythemia Vera

Leah Wolfe, RPh, BCOP, MTM, BscPharm

Myelofibrosis (MF) and polycythemia vera (PV) are Philadelphia chromosome (BCR-ABL1)-negative subtypes of chronic myeloproliferative neoplasms (MPNs; Hudnall, 2012; Swaim, 2014). These rare hematologic malignancies share dysregulated signaling of Janus-associated kinase-signal transducer and acti...

Prescriber's Corner

Trifluridine/Tipiracil: Old Drug, New Tricks

Kate D. Jeffers, PharmD, BCOP

Colorectal cancer is the third most commonly diagnosed cancer in the United States, with an estimated 134,490 new cases in 2016. Colorectal cancer is the third leading cause of cancer death in both men and women in the United States, with an estimated 49,190 deaths expected to occur in 2016 (Amer...

Tools and Technology

Assessment of Constipation in Patients With Cancer

Rita J. Wickham, PhD, RN, AOCN®

Constipation, a significant problem for many cancer patients, often leads to significant physical and psychological distress. Clinicians must recognize constipation in a timely manner to optimize management and minimize its adverse effects (Andrews & Morgan, 2013). There is no single accepted...

Editorial

JADPRO Live at APSHO 2015: Focus on Education and Collaboration

This past November, over 700 nurse practitioners, physician assistants, pharmacists, clinical nurse specialists, and other oncology professionals gathered at the JW Marriott Desert Ridge hotel in Phoenix to participate in the JADPRO Live at APSHO conference. This meeting was the third such JADPRO...

Meeting Report

Biosimilars: Beginning a Conversation

Panelists: Christopher J. Campen,(1) PharmD, BCPS, BCOP (Moderator), Kelley D. Mayden,(2) MSN, FNP, AOCNP®, Ali McBride,(3) PharmD, BCPS, BCOP, and Michael Swit,(4) Esq.

In 2010, the Biologics Price Competition and Innovation (BPCI) Act was passed under the Patient Protection and Affordable Care Act (FDA, 2010). It created an abbreviated pathway for the approval of biologic products demonstrated to be clinically similar (or biosimilar) to or interchangeable with ...

Meeting Report

Revolution at the Corner Drugstore

Panelists: Pamela Hallquist Viale, RN, MS, CNS, ANP (Moderator), Matthew Farber,(1) MA, Patricia J. Goldsmith,(2) Kate D. Jeffers,(3) PharmD, BCOP, and Wendy J. Smith,(4) RN, MSN, ACNP, AOCN®

An expanding armamentarium of oral oncologic drugs represents a revolution in the treatment of cancer but also presents significant challenges to adherence and the management of costs, side effects, and a growing clinician workload. Most often, identifying the urgent needs of cancer patients, inc...

Meeting Report

Getting Familiar With Biosimilars

Presented by Kelley D. Mayden, MSN, FNP, AOCNP®

Biotechnology has revolutionized the treatment of many chronic and acute illnesses, including cancer. The latest advance comes in the form of biosimilars. At JADPRO Live at APSHO, Kelley D. Mayden, MSN, FNP, AOCNP®, of Wellmont Cancer Institute, Bristol, Virginia, gave an A-to-Z talk about these ...

Meeting Report

2015 Review of Newly Approved Oncologic Therapies

Presented by Patrick Medina, PharmD, and Monique Giordana, PharmD, BCOP

A number of cancer drugs approved in 2014 and 2015 should advance the care of patients and improve treatement outcomes, according to descriptions of new agents presented by Patrick Medina, PharmD, of the University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma, and Monique Giordana, Ph...

Meeting Report

Ovarian Cancer: Current Treatment and Patient Management

Presented by Bradley J. Monk, MD, and Paula J. Anastasia, RN, MS, AOCN®

The decisions made by patients with ovarian cancer are tough ones. They affect the entire treatment paradigm, have long-lasting ramifications, and should be made through a collaboration between patients and clinicians, according to Bradley J. Monk, MD, of the University of Arizona Cancer Center, ...

Meeting Report

Collaborative Practice in the Management of Neuroendocrine Tumors

Presented by Jennifer A. Chan, MD, MPH, and Robin Sommers, DNP, ANP-BC, AOCNP®

Management of neuroendocrine tumors (NETs) requires a multidisciplinary approach, as many modalities are useful in this malignancy. Somatostatin receptor analogues (SSAs) are a mainstay of treatment, both for ameliorating symptoms and slowing disease progression, but novel approaches are emerging...

Meeting Report

Patients Living Longer With Metastatic Colorectal Cancer

Presented by John L. Marshall, MD, and Robin Sommers, DNP, ANP-BC, AOCNP®

Advances in the treatment of metastatic colorectal cancer have greatly improved survival for these patients, and novel approaches on the horizon are particularly exciting, according to John L. Marshall, MD, of Georgetown Lombardi Cancer Center in Washington, DC, who described the treatment lands...

Meeting Report

Evolving Paradigms in Melanoma Therapy

Presented by Anthony J. Olszanski, MD, RPh, and Brianna W. Hoffner, MS, ANP-BC, AOCNP®

The evolution in the treatment of melanoma has been remarkable, moving from surgery, radiotherapy, and chemotherapy to contemporary approaches, which, for the first time, have significantly improved the survival of patients with metastatic disease. At JADPRO Live at APSHO, Anthony J. Olszanski, M...

Meeting Report

New Agents for the Management of Advanced HER2-Positive Breast Cancer

Presented by Melanie Royce, MD, PhD, and Karen Herold, DNP, WHCNP-BC, FNP-BC

Recent advances in the treatment of HER2-positive metastatic breast cancer have dramatically improved outcomes. Clinicians need to understand how to position the most effective new regimens and manage their unique side effects, speakers said at JADPRO Live at APSHO. “The development of targeted ...

Meeting Report

Navigating the Landscape of Molecular Testing and Targeted Treatment of Non–Small Cell Lung Cancer

Presented by Sukhmani K. Padda, MD, and R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA

Molecular markers and the agents developed to target them have changed the landscape of non–small cell lung cancer (NSCLC) treatment. First-generation targeted agents have been proven to be more effective than chemotherapy in patients with certain driver mutations (i.e., EGFR, ALK) and the newest...

Meeting Report

Immunotherapy and the Treatment of Non–Small Cell Lung Cancer

Presented by Suzanne Walker, CRNP, MSN, AOCN®, BC

With more than 200,000 cases expected for 2016, lung cancer is the leading cause of cancer death in both men and women, accounting for more than one-quarter of all cancer deaths. “A lot of people don’t realize that lung cancer has a higher mortality than breast, prostate, and colorectal cancers c...

Meeting Report

What Radiation Oncology Wants Medical Oncology to Know

Presented by J. Nicholas Lukens, MD, and Erin McMenamin, MSN, CRNP, AOCN®, ACHPN

Optimal radiation treatment planning and symptom management for radiotherapy toxicities are keys to patient adherence and good outcomes, according to radiation oncology specialists who described the field at JADPRO Live. J. Nicholas Lukens, MD, of the University of Pennsylvania School of Medicine...

Meeting Report

Diagnostic Radiology: What the Advanced Practitioner Needs to Know

Presented by Joseph R. Steele, MD

Advanced practitioners should use imaging resources wisely by understanding the appropriate use of chest x-ray, CT, and PET/CT, according to Joseph R. Steele, MD, of the University of Texas MD Anderson Cancer Center, Houston, Texas. At JADPRO Live at APSHO, Dr. Steele described the ABCs of diagno...

Meeting Report

Risk-Stratified Treatment in Chronic Lymphocytic Leukemia

Presented by Deborah M. Stephens, DO, and Amy L. Goodrich, MSN, CRNP

Novel agents for chronic lymphocytic leukemia (CLL) are extending survival for these patients, calling for clinicians to understand the individual patient’s risk and prognosis and his or her long-term needs and optimal management, according to Deborah M. Stephens, DO, of Huntsman Cancer Institute...

Meeting Report

Risk Stratification in Multiple Myeloma: Putting the Pieces Together

Presented by Angela Mayo, MS, PA-C, and Craig Reeder, MD

Contemporary treatments have greatly extended survival in multiple myeloma (MM), and when relapse occurs, clinicians have numerous effective options at their disposal. Genetic profiling of the tumor allows for risk stratification that guides treatment selection. “Survival is improving, thanks to ...

Meeting Report

Outpatient Management of the Hematopoietic Stem Cell Transplant Patient

Presented by Sandra Kurtin, RN, MSN, AOCN®, ANP-C, and Ali McBride, PharmD, MS, BCPS, BCOP

Hematopoietic stem cell transplant (HSCT) is increasingly used for patients with hematologic malignancies, with about 20,000 performed each year in the United States. Advanced practitioners care for these patients across the disease trajectory, and should be aware of the early and late effects of...

Meeting Report

Diagnosis and Treatment of Benign Bleeding Disorders

Presented by Ravi Krishnadasan, MD

Many common bleeding disorders will be revealed through a careful examination of patient history and a mixing study, according to Ravi Krishnadasan, MD, of the University of Arizona, Tucson, Arizona. Benign bleeding disorders are understood in the context of the two main components of hemostasis:...

Meeting Report

Management of Dermatologic Toxicities Associated With Targeted Therapy

Presented by Mario E. Lacouture, MD

Oncologists who are already busy managing hematopoietic, gastrointestinal, and neurologic toxicities associated with cancer treatment must now learn to manage a consequence of new targeted agents—dermatologic side effects—according to Mario E. Lacouture, MD, Director of the Oncodermatology Progra...

Meeting Report

Management of Weight Loss in People With Cancer

Presented by Kristy K. Hager, MS, RD, CSO, LDN

Pathophysiologic changes in people with cancer can lead to anorexia and weight loss. Advanced practitioners who understand this problem can help patients maintain nutritional status and weight, according to Kristy K. Hager, MS, RD, CSO, LDN, an oncology dietitian at Wellmont Cancer Institute in ...

Meeting Report

The Role of Exercise and Rehabilitation in the Cancer Care Plan

Presented by Angelo Rizzo, MS, PT, CLT

The integration of an oncology physical therapist into the oncology team throughout the cancer survivor trajectory can benefit both advanced practitioners and survivors, according to Angelo Rizzo, MS, PT, CLT, President and Founder of Therapeutic Solutions, Inc, Oncology Rehabilitation and Lymphe...

Meeting Report

Incorporating a Survivorship Clinic Into Practice

Presented by Denice Economou, RN, MN, CHPN, and Stacie Corcoran, RN, MS, AOCNS®

The rising number of cancer survivors poses distinct challenges to the health care community. Speakers at JADPRO Live at APSHO addressed the need to improve access to care, quality of life, and health outcomes for survivors. Given their clinical expertise, their ability to practice in numerous se...

Editorial

Participation in Cancer Clinical Trials: Researching the Causes of Low Accrual

Pamela Hallquist Viale, RN, MS, CNS, ANP

Clinical trials offer seriously ill patients a chance at receiving investigative therapies containing new or innovative treatments for cancer. These trials can yield extremely valuable information regarding optimal therapies for specific cancers. Yet it’s baffling to consider the fact that less t...

Original Research

Nurse Communication About Goals of Care

Elaine Wittenberg(1) PhD, Betty Ferrell,(1) RN, PhD, MA, FAAN, FPCN, CHPN, Joy Goldsmith,(2) PhD, Haley Buller,(3) MS, and Tammy Neiman,(4) MS, RN-BC

A difficult conversation has been defined as an interaction between a provider and a patient at transition points on the disease trajectory (Svarovsky, 2013). In oncology, these transition points include sharing a new cancer diagnosis, deciding on treatment options, transitioning to survivorship,...

Review Article

Bosutinib Therapy in Patients With Chronic Myeloid Leukemia: Practical Considerations for Management of Side Effects

Patricia S. Ault,(1) DNP, FNP-BC, John Rose, PharmD,(2) PA-C, Lisa A. Nodzon, PhD,(3) ARNP, AOCNP®, and Elizabeth S. Kaled,(1) RN, ANP, CNS, FNP

Chronic myeloid leukemia (CML) is caused by a chromosomal translocation between the Abelson (Abl) gene on chromosome 9 and the breakpoint cluster region (BCR) on chromosome 22, resulting in the constitutively active BCR-ABL tyrosine kinase that promotes myeloid proliferation (Jain, Kantarjian, &a...

Review Article

Novel Uses for Lipid-Lowering Agents

Megan Brafford May, PharmD, BCOP, and Ashley Glode, PharmD, BCOP

The HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase inhibitors, more commonly referred to as statins, have historically been used for their ability to improve lipid profiles and reduce cardiovascular morbidity and mortality. Approximately 11% of the US population is prescribed statins, ...

Continuing Education

Continuing Education Information: Applying Metrics to Outpatient Oncology Advanced Practice Providers

Elizabeth Gilbert, MS, PA-C, and Victoria Sherry, MSN, CRNP, ANP-BC, AOCNP®

Applying Metrics to Outpatient Oncology Advanced Practice Providers A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: March 15, 2016 Expiratio...

Practice Matters

Applying Metrics to Outpatient Oncology Advanced Practice Providers

Elizabeth Gilbert, MS, PA-C, and Victoria Sherry, MSN, CRNP, ANP-BC, AOCNP®

Much of oncology care is now delivered through a team approach; understanding the potential benefits of the physician/advanced practice provider (APP) collaborative unit, in addition to the value of the APP individually, has never been more important. With the increased presence of APPs (nurse pr...

Continuing Education

Continuing Education Information: Belinostat for Relapsed or Refractory Peripheral T-Cell Lymphoma

Katelyn Hood, PharmD, and Arpita Shah, PharmD

Belinostat for Relapsed or Refractory Peripheral T-Cell Lymphoma A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: March 15, 2016 Expiration ...

Prescriber's Corner

Belinostat for Relapsed or Refractory Peripheral T-Cell Lymphoma

Katelyn Hood, PharmD, and Arpita Shah, PharmD

Non-Hodgkin lymphomas (NHLs) are a diverse group of lymphoproliferative disorders that affect B cells, T cells, and natural killer (NK) cells (Savage, 2007). Approximately 71,850 individuals in the United States were diagnosed with NHL in 2015, with an estimated number of deaths approaching 20,00...

Prescriber's Corner

Nivolumab in Metastatic Non–Small Cell Lung Cancer

Andrea Deel, PharmD

Lung cancer is the leading cause of cancer deaths in the United States (American Cancer Society [ACS], 2015). Non–small cell lung cancer (NSCLC) is one of the most common types of the disease and accounts for 85% to 90% of lung cancer cases (ACS, 2015). Nonsquamous NSCLC accounts for approximatel...

Grand Rounds

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

Kristy K. Hager, MS, RD, CSO, LDN

Overweight and obesity are terms used for ranges of weight that are greater than what is generally considered healthy for a given height (Centers for Disease Control and Prevention, 2012). As many as 84,000 cancer diagnoses each year are attributed to obesity, and obesity is implicated in 15% to ...

Tools and Technology

E-Cigarettes: Are They as Safe as the Public Thinks?

An important part of our practice in oncology is assisting patients in smoking cessation and providing them with information about factors that increase their cancer risk. Smoking accounts for almost 90% of all lung cancers and as much as 30% of all cancer deaths (Centers for Disease Control and ...

Editorial

Late Effects: Focus on Adolescent and Young Adult Cancer Survivors

Pamela Hallquist Viale, RN, MS, CNS, ANP

One of the most rewarding things about having worked in oncology for over 30 years has been celebrating the improvements in cancer survival. However, these improvements and higher cure rates come with their own complications. These patients require complex survivorship care, adding to the financi...

Continuing Education

Continuing Education Information

Clinically Relevant Four-Level Cancer-Related Fatigue Among Patients With Various Types of Cancer A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release ...

Original Research

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

Hsiao-Lan Wang,¹ PhD, RN, CMSRN, HFS, Ming Ji,¹ PhD, Connie Visovsky,¹ PhD, RN, ACNP-BC, Carmen S. Rodriguez,¹ PhD, RN, ACNP-BC, AOCN®, Amanda F. Elliott,¹ PhD, RN, ARNP, Clement K. Gwede,² PhD, RN, MPH, Tapan A. Padhya,^2,3 MD, Marion B. Ridley,^3,4 MD, and Susan C. McMillan,¹ PhD, RN, ARNP, FAAN

Cancer-related fatigue (CRF) was identified in the 2013 National Oncology Nurse Survey as the symptom that is the most distressing to patients and the most difficult to manage (LoBiondo-Wood et al., 2014). The National Comprehensive Cancer Network (NCCN) conceptually defines CRF as “a distressing...

Review Article

Tyrosine Kinase Inhibitors for the Treatment of Chronic-Phase Chronic Myeloid Leukemia: Long-Term Patient Care and Management

Stephanie Bauer,¹ RN, MSN, BC-FNP, Susan Buchanan,² MS, PA-C, and Irene Ryan,³ PA-C

The availability of multiple BCR-ABL tyrosine kinase inhibitors (TKIs) presents health-care professionals (HCPs) with an important decision when assigning therapy for patients with chronic-phase chronic myeloid leukemia (CML-CP; Kantarjian, Baccarani, Jabbour, Saglio, & Cortes, 2011). Health-...

Practice Matters

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

Linda Drury, PA-C, Kate Baccari, PA-C, Amy Fang, PA-C, Courtney Moller, PA-C, and Ian Nagus, PA-C

Almost daily, we are asked “How do you do this every day?” by our colleagues, our patients, and their family members. They often associate palliative care with poor patient prognosis and hospice, and they associate hospice with imminent death. During a routine workday, we also come up against man...

Prescriber's Corner

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

Joseph W. Coyne, RPh

The world is witnessing a continuous rise in the incidence of various types of cancer, which results in an increasing number of patients undergoing chemotherapy. According to the online cancer database GLOBOCAN by the International Agency for Research on Cancer (IARC), globally 14.1 million peopl...

Editorial

Information for Contributors

The Journal of the Advanced Practitioner in Oncology (JADPRO) is a bimonthly, peer-reviewed journal dedicated to addressing the multifaceted aspects of care provided by advanced practitioners involved in the management of patients with cancer. The aim of this journal is to provide the most recent...

Prescriber's Corner

Advancements in Therapy for Acute Lymphoblastic Leukemia: Blinatumomab

Lindsay Hladnik,¹ PharmD, BCOP, Kristan Augustin,² PharmD, BCOP, and Sean DeFrates,³ PharmD, BCOP

Acute lymphoblastic leukemia (ALL) is a rare form of leukemia, with an estimated 6,250 new cases diagnosed in the United States in 2015 and approximately 1,450 deaths (American Cancer Society, 2015). With current available induction therapies, complete remission (CR) rates in adults are approxima...

Translating Research Into Practice

Overview of the CLEOPATRA Trial: Implications for Advanced Practitioners

Karen Herold, DNP, FNP-BC, WHCNP-BC

Genomic biomarkers have long been known as predictors of pharmacokinetic differences among individuals that lead to differences in plasma drug exposure. Overexpression of the human epithelial growth factor receptor (HER2) proto-oncogene is seen in about 25% of human breast cancer and leads to a m...

Translating Research Into Practice

An Introduction to Survival Statistics: Kaplan-Meier Analysis

William N. Dudley,¹ PhD, Rita Wickham,² PhD, RN, AOCN®, and NICHOLAS COOMBS,³ MS

Studies of how patients respond to treatment over time are fundamentally important to understanding how therapies influence quality of life and progression of disease during survivorship. When investigators examine change over time in continuous variables (e.g., patient self-reports of pain, fati...

Tools and Technology

Suicide Screening in the Oncology Population

Mary K. Hughes, MS, RN, CNS, CT

Registered nurses spend more time with patients than other health-care workers and are in a prime position to detect and prevent suicidal behaviors in patients, but Valente (2010) found that oncology nurses had more difficulty in caring for suicidal patients because of their commitment to preserv...

Diagnostic Snapshot

Swelling and Erythema of the Lower Extremities

Beth Eaby-Sandy, MSN, CRNP, OCN®

History Mr. T is a 78-year-old male who initially presented with stage IV oligometastatic non–small cell lung cancer (NSCLC) with adrenal metastasis. He is a retired pharmacist who comes to appointments with his wife. His medical history includes hypertension, emphysema, esophageal reflux, and hy...

Meeting Abstract

JL301. Adherence to Oral Cancer Therapies in the Adult Oncology/Hematology Patient

Katherine Mitchell, APRN, AOCNP, Shana Cassady, APRN, AOCNP, and Whitney Perry, APRN, AOCNP; CBC Group, Louisville, KY

Meeting Abstract

JL302. The CARE (Clinical Assessment and Rapid Evaluation) Clinic: Improving the Oncology Patient Experience and Outcomes

Mary Jane LaRoche, MS, ANP-BC, AOCNS, ACHPN, Whitney Herter, PA-C, MHS, Sarah Eppers, RN, BSN, OCN, Nicole Giles, RN, BSN, OCN, Adam Poust, PharmD, James Bachman, Tom Purcell, MD, MBA, and Wells Messersmith, MD, FACP; University of Colorado Cancer Center, Aurora, CO

Meeting Abstract

JL303. Local Observational Study of Supportive Care, Treatment and Bone Health in Prostate Cancer Patients Receiving Androgen Deprivation Therapy (LOSST trial)

Phyllis C. Everett, NP-C, Lynchburg Hematology Oncology, Lynchburg, VA

Meeting Abstract

JL304. Evaluation of the Oncology Nurse Practitioners Web Education Resource Course

Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, Sara Klein, MS, BSN, RN, Marcus Evans, San Diego, California, Mary Connolly BSN, RN, DMC Sinai-Grace, Detroit, Michigan, and Rose Hoffmann, PhD, RN, University of Pittsburgh School of Nursing, Pittsburgh, PA; funding source: National Cancer Institute (1 R25 CA148050-01A1)

Meeting Abstract

JL305. Bringing Quality Into Your Practice

Laura Mulka, APRN, AOCN, ACHPN, Connecticut Multispecialty Group, Wethersfield, CT

Meeting Abstract

JL306. Oncology Nurse Communication Training Needs Across the Cancer Trajectory

Jo Hanson, RN, MSN, CNS, OCN, City of Hope National Medical Center, Duarte, CA, Elaine Wittenberg, PhD, University of Kentucky, Lexington, KY, Betty Ferrell, PhD, MA, RN, FAAN, FPCN, CHPN, City of Hope National Medical Center, Duarte, CA, and Denice Economou, RN, MN, CNS, CHPN, City of Hope National Medical Center, Duarte, CA; funding source: National Cancer Institute

Meeting Abstract

JL307. The Advocacy Connector: Bridging the Gap

Joanne Vanak, RN, MSN, Janssen Biotech, Washington, DC, Ellen Ivey, BS, Washington, DC, and John Kerrane, MS, RPh, New York, NY

Meeting Abstract

JL308. Utilization of Cancer Screening Guidelines by APRNs

Joyce Dains, DrPH, JD, RN, FNP-BC, FNAP, FAANP, Department of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX

Meeting Abstract

JL309. Development and Implementation of a Peer Review Process for APRNs

Marianne J. Davies, DNP, MSN, RN, APRN, CNS-BC, ACNP-BC, AOCNP, Yale University School of Nursing, West Haven, CT, and Katherine Tucker, APRN-BC, NE-BC, MSN, Yale New Haven Health, New Haven, CT

Meeting Abstract

JL310. Pilot Evaluations of Experiences of Early Stage Post-Surgical Lung Cancer Survivors

Kathleen Hopkins, PhD, RN, University of Pittsburgh, Pittsburgh, PA

Meeting Abstract

JL311. Symptom Management Strategies for Patients Receiving Anaplastic Lymphoma Kinase (ALK) Inhibitors for Non–Small Cell Lung Cancer (NSCLC)

Jennifer E. Jacky, MSN, ARNP and Christina Baik, MD, MPH; Seattle Cancer Care Alliance, Seattle, WA

Meeting Abstract

JL312. Management of Lung Cancer Patients With Chronic Obstructive Pulmonary Disease (COPD) Receiving Nivolumab

Kim Hart, ANP, AOCN, Illinois Cancer Specialists, Arlington Heights, IL, and Marilyn Borkgren, APN, MS, CCNS, Suburban Lung Associates, Chicago, IL

View the poster.

Meeting Abstract

JL313. By Nurses, For Nurses: A Successful Educational Intervention That Addressed the Clinical Challenges of Treating Elderly Patients With Multiple Myeloma

Patricia M. Repetto, MEd, MedscapeCME, New York, NY, Emily S. Van Laar, MS, Medscape, New York, NY, and Beth Faiman, PhD, APRN-BC, AOCN, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH

Meeting Abstract

JL314. Patient Reported Symptoms, Concerns and Provider Intervention in Patients With Multiple Myeloma

Meeting Abstract

JL315. The 2014 Mentorship Program: Bridging Communication and Educational Gaps in Multiple Myeloma

Beth Faiman, PhD, RN, APRN-BC, AOCN, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, and Sandra E. Kurtin, RN, MS, AOCN, ANP-C, The University of Arizona Cancer Center, Tucson, AZ

Meeting Abstract

JL316. The APSHO Practice Survey

Sandra E. Kurtin, RN, MS, AOCN, ANP-C, The University of Arizona Cancer Center, Tucson, AZ, Pamela Hallquist Viale, RN, MS, CS, ANP, University of California, San Francisco, CA, Heather M. Hylton, MS, PA-C, Memorial Sloan Kettering Cancer Center, New York, NY, Christopher J. Campen, PharmD, BCPS, BCOP, Arizona Cancer Center, University of Arizona, and Wendy H. Vogel, MSN, FNP, AOCNP, Wellmont Cancer Institute, Kingsport, TN

Meeting Abstract

JL317. Educational and Knowledge Gaps Among Community Healthcare Providers (HCPs) Treating Patients With Lower-Risk Myelodysplastic Syndromes (MDS)

Sandra E. Kurtin, RN, MS, AOCN, ANP-C, The University of Arizona Cancer Center, Tucson, Arizona, Joan Latsko, DNP, CRNP, OCN, AOCNP, Wheeling Hospital, Wheeling, West Virginia, and Elizabeth Finley-Oliver, BSN, RN, OCN, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida

Meeting Abstract

JL318. Collaborative Interventions in the Treatment of Chemotherapy-Induced Oral Mucositis With Low Level Laser Therapy (LLLT)–A Case Series

Cheryl E. Jones, CRNP, AOCN, Cynthia Castillo, ND, FABNO, Marie Winters, ND, FABNO, and Alexandra Louden, ND, Cancer Treatment Centers of America, Philadelphia, PA

Meeting Abstract

JL319. Management of Skin Adverse Events (AEs) Associated With Nivolumab and Ipilimumab in Patients With Melanoma: A Nursing Perspective

Melissa Thebeau, ARNP, AOCNP, Moffitt Cancer Center, Tampa, FL, Krista Rubin, NP, Massachusetts General Hospital Cancer Center, Boston, MA, Annette Gaul, NP, Matthias Hofmann, PhD, Julia Grimm, NP, and Alyona Weinstein, NP

Meeting Abstract

JL320. Creation of Metrics for Advanced Practice Providers in an Academic Outpatient Hematology Oncology Practice

Suzanne McGettigan, MSN, CRNP, ANP-BC, AOCN, Elizabeth Gilbert, MS, PA-C, Victoria Sherry, MSN, CRNP-BC, AOCNP, Colleen H. Erb, MSN, CRNP, ACNP-BC, AOCNP, and Genevieve Hollis, MSN, CRNP, ANP-BC, AOCN, University of Pennsylvania, Philadelphia, PA

Meeting Abstract

JL321. Use of Flow Cytometry in Clinical Practice

Dawn M. Betters, PhD, RN, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH

Meeting Abstract

JL322. Overview of Adverse Events (AEs) Seen With Combination of Nivolumab and Ipilimumab

Meeting Abstract

JL323. CREAM Principles: The Advanced Nursing Role in the Management of Dermatologic Adverse Events to Anticancer Therapy

Kathryn Ciccolini, RN, BSN, OCN, DNC, Memorial Sloan Kettering Cancer Center, New York, NY

Meeting Abstract

JL324. Identification and Application of Clinical Resources for Advanced Practitioners Supporting the Management of Neutropenia Associated With Palbociclib

Joanne C. Ryan, PhD, RN, Pfizer, New York, NY, Lynn Nicole Pfeuffer, MSN, CRNP, Allegheny Cancer Center, Pittsburgh, PA, Annamaria Crisan, Bpharm, MSc, Pfizer, New York, NY, and Kristi Kay Orbaugh, RN, MSN, RNP, AOCN, Community Reg Cancer Care Group, Indianapolis, IN

Meeting Abstract

JL325. Pilot Trial of Homebound Stem Cell Transplantation at Memorial Sloan Kettering Cancer Center

Jill M. Vanak, PhD, ACNP-BC, AOCNP, BMTCN, Memorial Sloan Kettering Cancer Center, New York, NY, Christina Bello, Memorial Sloan Kettering Cancer Center, New York, NY, Payal Dixit, Victoria Nguyen, Heather Landau, MD, Memorial Sloan Kettering Cancer Center, New York, NY, and Sergio Giralt, MD, Memorial Sloan Kettering Cancer Center, New York, NY

Meeting Abstract

JL326. Progress Towards Value in Healthcare: Implementation of Time-Driven Activity-Based Costing (TDABC) in Hematopoietic Stem Cell Transplantation

Jill M. Vanak, PhD, ACNP-BC, AOCNP, BMTCN, Memorial Sloan Kettering Cancer Center, New York, NY, Elaine Duck, RN, MS, MA, Memorial Sloan Kettering Cancer Center, New York, NY, Christopher Cheavers, Memorial Sloan Kettering Cancer Center, New York, NY, Erika Duggan, MS, Memorial Sloan Kettering Cancer Center, New York, NY, Mark Radzyner, MBA, JD, Paul Nelson, MBA, New York, NY, and Miguel-Angel Perales, MD, Memorial Sloan Kettering Cancer Center, New York, NY

Meeting Abstract

JL327. Survivorship Care Plans: Strategies to Enhance Patient Utility and Value

Carrie T. Stricker, PhD, University of Pennsylvania, Philadelphia, PA, Amanda Seltzer, MSW, University of Connecticut, Storrs, CT, Karen Hammelef, DNP, RN, On Q Health, Dearborn, Michigan, SarahLena Panzer, BS, Carevive Systems, Philadelphia, Pennsylvania, and Ellen Dornelas, PhD, Hartford Hospital, Hartford, CT

Editorial

The American Cancer Society Guidelines on Screening for Breast Cancer: What’s New?

Pamela Hallquist Viale, RN, MS, CNS, ANP

After more than 20 years of increased incidences of breast cancer, the year 2000 heralded a welcome statistic: The number of breast cancer cases had begun to decline. The biggest factor in the incidence of breast cancer is thought to be a decline in the use of hormonal therapy after menopause (Ch...

Editorial

The Advanced Practitioner and Collaborative Practice in Oncology

Sandra E. Kurtin, RN, MS, AOCN^®, ANP-C; Mary Peterson, MS, ANP-BC, AOCNP^®; Paige Goforth, MMS, PA-C; Megan Brafford May, PharmD, BCOP; Pamela Hallquist Viale, RN, MS, CNS, ANP; Wendy J. Smith, RN, MSN, ACNP, AOCN^®; Deborah Rust, AOCN^®; Carolyn Grande, CRNP, AOCNP^®; Nancy M. Nix, PharmD, BCPS, BCOP; and Catherine S. Bishop, DNP, NP, AOCNP^®

The term “advanced practitioner” (AP) refers to health-care professionals who have completed advanced training in nursing or pharmacy or who have completed training as a physician assistant (PA). Educational requirements, training, the scope of practice, governing boards (state/national), nation...

Continuing Education

Continuing Education Information

Managing Patients With Myelofibrosis in the Era of Janus Kinase Inhibitors A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: November 23, 20...

Review Article

Managing Patients With Myelofibrosis in the Era of Janus Kinase Inhibitors

Emily A. Knight, RN, BSN, OCN®,¹ Sylvia Osunsuyi-Fagbemi, RN, BSN, OCN®,² and Jessica Neely, PA-C, MMSC2

Myelofibrosis (MF) is a rare, chronic myeloproliferative neoplasm (MPN) characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis. Myelofibrosis affects mostly elderly patients (Cervantes et al., 2009; Emanuel et al., 2012), and recent estimates suggest an annual incidenc...

Practice Matters

Ketamine Protocol for Palliative Care in Cancer Patients With Refractory Pain

Brighton A. Loveday, MSN, ANP-BC, AOCNP®, ACHPN®, APRN, and Jill Sindt, MD

Pain is a common complication for cancer patients, with an incidence as high as 90% of those with advanced cancer (Lossignol, Obiols-Portis, & Body, 2005). Intractable or refractory pain has been reported to occur in 10% to 20% of patients with cancer and is difficult to control with opioids ...

Prescriber's Corner

Radium-223 for the Management of Bone Metastases in Castration-Resistant Prostate Cancer

Heather Cox, PharmD, BCOP, Megan Hames, PharmD, BCOP, and Mona Benrashid, PharmD, BCOP

In the United States, prostate cancer is the most common cancer and second leading cause of cancer-related deaths in men. It is estimated that 220,800 new cases of prostate cancer will have been diagnosed in 2015, with an estimated 27,540 deaths (American Cancer Society, 2015). Although prostate ...

Prescriber's Corner

Palbociclib: A New Option for Front-Line Treatment of Metastatic, Hormone Receptor–Positive, HER2-Negative Breast Cancer

Harmony J. Bowles, PharmD, and Kathryn L. Clarke, NP-C

Breast cancer is the second leading cause of cancer-related death in American women. However, mortality has been steadily decreasing due to improvements in early detection and advances in treatment (American Cancer Society, 2015). Clinicians consider tumor histology along with the extent of disea...

Grand Rounds

Hypercalcemia of Malignancy

Steve Malangone, MSN, FNP-C, and Christopher J. Campen, PharmD, BCPS, BCOP

Hypercalcemia is a common, potentially life-threatening clinical syndrome associated with a variety of malignancies, including lymphomas as well as aerodigestive, uterine, endometrial, breast, neuroendocrine, cervical, and renal cell carcinomas. The historic incidence of hypercalcemia in the canc...

Translating Research Into Practice

Review of a Study on Late Referral to a Palliative Care Consultation Service: Length of Stay and In-Hospital Mortality Outcomes

Regina M. Fink, RN, PhD, AOCN®, FAAN

According to the National Consensus Project, palliative care is defined as “patient/family-centered care that optimizes quality of life by anticipating, preventing, minimizing, and treating suffering. Palliative care, offered throughout the continuum of illness, involves addressing physical, inte...

Translating Research Into Practice

Hospital-Based Palliative Care: Quality Metrics That Matter

Rhonda Gradwohl, MSN, RN, and Jeannine M. Brant, PhD, APRN, AOCN®

Recent data indicate that practitioners incorporate the latest medical evidence into their treatment decisions only 50% of the time, preferring to practice what they are comfortable with (Trusko, Pexton, Harrington, & Gupta, 2007). The result has been an increased spotlight on standardizing c...

Editorial

Thank You to Our Peer Reviewers!

JADPRO

In this, the final 2015 issue of the Journal of the Advanced Practitioner in Oncology (JADPRO), we would like to acknowledge all of the esteemed professionals who completed manuscript peer reviews for JADPRO in the past year. As a group, you represent a staggering depth and breadth of experience ...

Editorial

The Cost of New Therapies: Can You Spare $300,000?

Pamela Hallquist Viale, RN, MS, CNS, ANP

The announcement that there is now a cure for hepatitis C was overwhelmingly positive, yet the cost of the cure when treated with sofosbuvir (Solvadi) is shockingly high compared with previous therapies (Ornstein, 2015). The new treatment is covered by Medicare (which is essentially paid for by t...

Original Research

Multidisciplinary Specialty Teams: A Self-Management Program for Patients With Advanced Cancer

Christine Tocchi, PhD, APRN, GNP-BC, Ruth McCorkle, PhD, FAAN, and M. Tish Knobf, PhD, RN, FAAN, AOCN®

Self-management has been used as a model of care to enable and empower patients to manage their health (Lorig & Holman, 2003). Self-management involves the formation of partnerships among providers, patients, and families to achieve patients’ own health goals, including the management of symp...

Continuing Education

Continuing Education Information

Ibrutinib: Implications for Use in the Treatment of Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians....

Review Article

Ibrutinib: Implications for Use in the Treatment of Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

Gretchen Anne McNally, PhD, ANP-BC,¹ Jennifer M. Long, APRN,² Lynne R. Brophy, RN,³ and Maria R. Badillo, MSN, RN⁴

Novel agents that target B-cell receptor (BCR) signaling pathways have afforded new treatment options for patients with B-cell malignancies, providing important clinical benefits in a number of hematologic tumor types. Ongoing studies continue to evaluate the safety and effectiveness of these age...

Grand Rounds

Use of Flow Cytometry in Clinical Practice

Dawn M. Betters, PhD, RN

For advanced practitioners (APs) working with oncology patients, “22.6% CD34+/CD117+ blasts” on flow cytometry, as seen in Mrs. K’s case study above, may be familiar, but understanding and interpreting this laboratory result may be more challenging. Flow cytometry is a powerful, well-established ...

Prescriber's Corner

Afatinib in Non–Small Cell Lung Cancer

Scott M. Wirth, PharmD, BCOP

Lung cancer is the second most common cancer and the leading cause of cancer-related deaths in both men and women (Siegel, Ma, Zou, & Jemal, 2014). Non–small cell lung cancer (NSCLC) is the most common form of lung cancer, accounting for about 85% of all lung cancers (Molina, Yang, Cassivi, S...

Translating Research Into Practice

Surgical Management of Colorectal Liver Metastases: Prognostic Indicators and the Impact of RAS Mutation Status

Steven H. Wei, MS, MPH, PA-C, and Leigh A. Samp, MPAS, PA-C

According to the Centers for Disease Control and Prevention (CDC), colorectal cancer (CRC) is the third most common cancer among men and women and the third leading cause of cancer death among men and women in the United States (CDC, 2014). The liver remains the most common site for metastases, a...

Translating Research Into Practice

Molecular Profiling in Resectable Colorectal Liver Metastases: The Role of KRAS Mutation Status in Assessing Prognosis in the Preoperative Setting

Ryanne Coulson, PA-C, MPAS

Molecular biomarkers are increasingly being utilized as both prognostic and predictive tools in the care of patients with cancer. Testing for alterations in biomarkers is currently considered the standard of care in a growing number of cancers, including breast, lung, leukemia, and colorectal. Re...

Tools and Technology

An App to Support Difficult Interactions Among Providers, Patients, and Families

Joy V. Goldsmith, PhD,¹ Elaine Wittenberg, PhD,² and Betty Ferrell, PhD, MA, FAAN, FPCN²

Oncology advanced practitioners are responsible for effective communication regarding diagnosis, prognosis, and treatment options. The Institute of Medicine’s Report on Delivering High-Quality Cancer Care recommends that patients and their families be provided understandable information and decis...

Editorial

Information for Contributors

The focus of JADPRO is to provide relevant clinical information aimed at broadening the knowledge base of the advanced practitioner (AP) in oncology, including nurse practitioners, PAs, pharmacists and other advanced oncology professionals. Therefore, language should be inclusive of the advanced ...

Editorial

Cancer Care in the United States: A System in Transition

Pamela Hallquist Viale, RN, MS, CNS, ANP

American Society of Clinical Oncology (ASCO) published its State of Cancer Care in America report for 2015 in the March issue of the Journal of Oncology Practice. The report contains many important facts about the cancer care system in the United States and focuses on several key issues. Signific...

Original Research

Subcutaneous Administration of Bortezomib: A Pilot Survey of Oncology Nurses

Jasmine R. Martin, DNP, MSN, APRN-BC,1 Nancy L. Beegle, BSN,2 Yanyan Zhu, PhD,3 and Ellen M. Hanisch, MSN, ARNP, AOCNP4

Multiple myeloma (MM) is the second most common hematologic malignancy in the United States (Siegel, Miller, & Jemal, 2015) and worldwide (Jemal et al., 2011), with an estimated 26,850 new cases and 11,240 deaths in the United States in 2015 (Siegel et al., 2015). The proteasome inhibitor bor...

Review Article

Hormone Replacement Therapy: An Increased Risk of Recurrence and Mortality for Breast Cancer Patients?

Molly Lupo, RN, MSN, ANP, NP-C, AOCNP® Joyce E. Dains, DrPH, JD, RN, FNP-BC, DPNAP, FAANP, and Lydia T. Madsen, PhD, RN, AOCNS®

More than a quarter of a million cases of breast cancer are diagnosed each year in the United States. Of these cases, 75% are estrogen receptor (ER)–positive or progesterone receptor (PR)–positive (Esserman & Joe, 2013). The treatment regimen for receptor-positive breast cancer often includes...

Continuing Education

Continuing Education Information

Shared Mental Models of Provider Roles in Cancer Survivorship Care A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: July 15, 2015 Expiration ...

Review Article

Shared Mental Models of Provider Roles in Cancer Survivorship Care

Megan Hebdon, DNP, RN, NP-c,1 Olivia Fahnestock, BS,2 and Sara McComb, PhD1,3

In 2012, the United States had an estimated 13.7 million individuals living with a history of cancer, and this number is projected to increase to 18 million by 2022 (American Cancer Society, 2014; de Moor et al., 2013). This volume of survivors places a great burden on the health-care system for ...

Practice Matters

Stereotactic Body Radiotherapy for Early-Stage Non–Small Cell Lung Cancer: When and Why Is It Appropriate Therapy?

Kim Mullins, MSN, APRN-BC, AOCNP®

Lung cancer, the second most frequently diagnosed malignancy for men and women in the United States, will account for an estimated 221,200 newly diagnosed cases and 158,040 deaths in 2015 (Siegel, Miller, & Jemal, 2015). The preferred treatment for early-stage non–small cell lung cancer (NSCL...

Prescriber's Corner

Vemurafenib: First-in-Class BRAF-Mutated Inhibitor for the Treatment of Unresectable or Metastatic Melanoma

Lindsay Shelledy, PharmD, and Danielle Roman, PharmD, BCOP

Skin cancer is the most common cancer in the United States, with more than 3.5 million people diagnosed every year (American Cancer Society, 2013). Melanoma is a life-threatening form of skin cancer that occurs due to genetic and environmental factors. The risk factors most associated with malign...

Prescriber's Corner

Obinutuzumab: A Novel Anti-CD20 Monoclonal Antibody for Chronic Lymphocytic Leukemia

Sarah S. Evans, PharmD, and Amber B. Clemmons, PharmD, BCOP

The management of chronic lymphocytic leukemia (CLL), a malignant disorder of the lymphoid lineage (primarily B cells), has changed considerably in recent years. The development of agents targeting CD20, a transmembrane calcium channel protein expressed on B cells, was a significant milestone in ...

Translating Research Into Practice

Weighing the Benefits of Fish Oil for Patients With Prostate Cancer: A Subcohort Review From the SELECT Trial

Marilyn Haas-Haseman, PhD, ANP-BC

Many individuals, both men and women, seek dietary supplements with the belief that they will protect them from developing certain chronic diseases and possibly even decrease their risk of developing cancer (National Cancer Institute, 2015). Fish oil is of the most popular dietary supplements, co...

Translating Research Into Practice

Case-Cohort Conundrum: Fish or No Fish?

Kelley D. Mayden, MSN, FNP, AOCNP®

Oncology advanced practitioners (APs) are advocates for and witnesses to the increasing interest in self-regulation of health care by patients. Data from the 2007 National Health Interview Survey (a cross-sectional household interview) suggest that one way in which patients with cancer attempt to...

Tools and Technology

Recommended Apps for 2015

Wendy H. Vogel, MSN, FNP, AOCNP®

There is a whole world of smartphone apps out there. It’s impossible to weed through all of them. Some of the best apps I have were recommended by a friend or colleague or even an airplane seatmate! So I asked some of our Journal of the Advanced Practitioner in Oncology (JADPRO) readers about th...

Editorial

Information for Contributors

Editorial

Communication of Bad News to Patients: Is Honesty the Best Policy?

Pamela Hallquist Viale, RN, MS, CS, ANP

I have always strived to be honest with my oncology patients. That doesn’t mean that all patients received every piece of information at my disposal, and it doesn’t mean that I didn’t try to frame my conversations with them in the most helpful way I could imagine. We all know that delivering bad ...

Continuing Education

Continuing Education Information

The Consequences of a BRCA Mutation in Women A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: May 15, 2015 Expiration date: May 15, 2016 Expe...

Review Article

The Consequences of a BRCA Mutation in Women

Janice Famorca-Tran, RN, MS, AOCNP®, CBCN®, NP-C, and Gayle Roux, PhD, NP-C, FAAN

Approximately 5% to 10% of breast cancer cases and 11% to 18% of ovarian cancer cases are a result of a mutation in the BRCA1 and BRCA2 genes, otherwise known as hereditary breast and ovarian cancer (HBOC; American Cancer Society [ACS], 2014; Campeau, Foulkes, & Tischkowitz, 2008; National Ca...

Review Article

The Toxicity and Benefit of Various Dosing Strategies for Interleukin-2 in Metastatic Melanoma and Renal Cell Carcinoma

Laura A. Pachella, RN, MSN, AGPCNP-BC, AOCNP®, Lydia T. Madsen, PhD, RN, AOCNS®, and Joyce E. Dains, DrPH, JD, RN, FNP-BC, DPNAP, FAANP

The administration of high-dose intravenous interleukin-2 (IL-2) for metastatic renal cell carcinoma and metastatic melanoma was first approved by the US Food and Drug Administration (FDA) in 1992 and 1998, respectively (Spanknebel et al., 2005). Interleukin-2 is a cytokine that stimulates the bo...

Grand Rounds

Hypnosis for the Management of Anticipatory Nausea and Vomiting

Kathy G. Kravits, MA, RN, HNB-BC, LPC, NCC, ATR-BC

Persistent nausea and vomiting, which occurs in 10% to 25% of patients receiving chemotherapy, creates a significant burden for patients, increases costs for the health-care system (an average daily treatment cost of $1,854.70) and increases the potential for abandonment of treatment due to the s...

Prescriber's Corner

Pembrolizumab: First in Class for Treatment of Metastatic Melanoma

Carrie Barnhart, PharmD

Malignant melanoma accounts for only 2% of skin cancers, but it is the most deadly form of skin cancer. Melanoma rates have been increasing over the past 30 years. Melanoma is 10 to 20 times more common in Caucasians than in those of Hispanic or African descent. Metastatic (or stage IV) melanoma ...

Original Research

Evaluating a Sexual Health Patient Education Resource

Marianne Matzo, PhD, APRN-CNP, FPCN, FAAN,¹ Sandi Troup, BSN, RN,² Kamal Hijjazi, PhD, RN,³ and Betty Ferrell, PhD, FAAN⁴

Findings from research studies regarding cancer survivorship indicate that compromised sexuality and intimacy, common in cancer care, can lead to diminished quality of life (QOL; Matzo & Hijjazi, 2009). Approximately 50% of women who have had long-term treatment for breast and reproductive or...

Practice Matters

Significance of Human Papillomavirus in Head and Neck Cancers

Kristy Lynn Boggs, MSN, RN

Over 45,000 Americans are estimated to be newly diagnosed with cancer of the oral cavity and pharynx in 2015, and an estimated 8,650 will die of the disease (Siegel, Miller, & Jemal, 2015). It is well known that the combination of smoking and alcohol use increases the risk for developing head...

Translating Research Into Practice

The Use of Calcium and Magnesium to Prevent Neurotoxicity in Patients Receiving Oxaliplatin

Karon Martyn, MSN, ANP-BC, AOCNP®, and Emily Petito, MSN, CRNP

A groundbreaking oral abstract was presented by Charles Loprinzi at the 2013 annual meeting of the American Society of Clinical Oncology (ASCO), addressing the controversial issue of using magnesium and calcium to prevent oxaliplatin-induced sensory neuropathy. Results of the study were subsequen...

Translating Research Into Practice

Calcium and Magnesium for Oxaliplatin-Induced Neurotoxicity: Issues in Study Design, Measurement, and Analysis

Constance Visovsky, PhD, RN, ACNP-BC

Neurotoxicity associated with chemotherapy continues to be of great concern to both advanced practitioners in oncology and the patients they care for. Chemotherapy-induced peripheral neuropathy (CIPN) is considered the dose-limiting toxicity for oxaliplatin, an agent commonly used to treat colore...

Tools and Technology

Writing a Successful Grant: Tips and Tools

Constance Visovsky, PhD, RN, ACNP-BC

As an oncology advanced practitioner, you may find yourself called upon to write or partner with a nurse scientist to write a grant to support or improve educational, patient care, or professional activities. There are different types of grants that can be used to support a variety of activities,...

Continuing Education

Basal Cell Carcinoma: What You Need to Know

JADPRO

Basal cell carcinoma (BCC) is the most common cancer in the world. One out of two people will have a BCC growth (also called a lesion or tumor) before age 65. Although BCC is rarely life threatening, it should be taken seriously. If left untreated, this cancer can be disfiguring, especially on th...

Editorial

Information for Contributors

Editorial

Refusal of Therapy: When Is It Appropriate?

Pamela Hallquist Viale, RN, MS, CNS, ANP

In our last issue, I talked about care in the context of end of life, in particular the expense and futility of care given in the last months of life or when patients are facing an incurable condition. I believe that it is entirely appropriate to refuse care or decline aggressive therapies at the...

Review Article

Thyroid Disorders in the Oncology Patient

Kari Hartmann, PA-C

Thyroid hormones regulate metabolic processes in the body, including the basal metabolic rate, nerve reflexes and conduction time, temperature regulation, cardiac contractility and heart rate, and intestinal transit time, among others. The thyroid affects the physiologic function of nearly all or...

Review Article

Biosimilars in the United States: Considerations for Oncology Advanced Practitioners

Kelley D. Mayden, MSN, FNP, AOCNP®, IAC,¹ Paul Larson, MSN, AOCNP®,² Danielle Geiger, MSN, APRN-NP,³ and Holly Watson, MS, ANP-BC⁴

Biologics are an essential part of cancer treatment and provide opportunities for the delivery of targeted therapy and supportive care (Table 1). United States patents for some first-generation biologics used in cancer care may soon expire, according to one source (Generics and Bio- similars Init...

Original Research

Postthoracotomy Pain Syndrome Following Surgery for Lung Cancer: Symptoms and Impact on Quality of Life

Kathleen G. Hopkins, PhD, RN,¹ Leslie A. Hoffman, PhD, RN,² Annette De Vito Dabbs, PhD, RN,² Peter F. Ferson, MD,³ Linda King, MD,⁴ Linda A. Dudjak, PhD, RN,² Thomas G. Zullo, PhD,² and Margaret Q. Rosenzweig, PhD, RN²

Postthoracotomy pain syndrome (PTPS) is defined as pain that develops after a surgical intervention, lasts longer than 2 months, and cannot be attributed to any other cause or condition (International Association for the Study of Pain [IASP], 2011). Following thoracic surgery, the reported incide...

Practice Matters

The Supportive and Palliative Radiation Oncology Service: A Dedicated Model for Palliative Radiation Oncology Care

Daniel Gorman, MSN, FNP-C, OCN®,¹ Tracy Balboni, MD, MPH,¹ Allison Taylor, MSN, APN-BC, AOCNP®,² and Monica Krishnan, MD²

Radiation therapy (RT) has been an established modality for treating various types of cancers since the early 1900s. It became more broadly utilized in cancer therapy beginning in the 1960s, with greater accessibility to radioactive sources such as cobalt-60 and the emergence of the linear accel...

Continuing Education

Continuing Education Information

Grand Rounds: Multidisciplinary Management of the Patient With Metastatic Colorectal Adenocarcinoma A continuing education article for nurse practitioners, physician assistants, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Releas...

Grand Rounds

Multidisciplinary Management of the Patient With Metastatic Colorectal Adenocarcinoma

Steve A. Malangone, MSN, NP-C, Hitendra Patel, MD, Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, Hina Arif Tiwari, MD, and Emad Elquza, MD

An estimated 50,310 of the 136,830 Americans diagnosed with colorectal cancer will die annually of the disease (Siegel, Ma, Zou, & Jemal, 2014). The majority of these deaths are associated with metastatic disease (Siegel et al., 2014). Outcomes for patients with unresectable metastatic diseas...

Prescriber's Corner

Ceritinib for ALK-Rearrangement–Positive Non–Small Cell Lung Cancer

Nancy M. Nix, PharmD, BCPS, BCOP, and Kaitlyn S. Brown, PharmD(c)

According to the American Cancer Society (ACS), lung cancer is the second most common diagnosis in the world and is the leading cause of death from malignancy in both men and women (ACS, 2014). Lung cancer accounts for 13% of new diagnoses and 27% of deaths from malignancy. The ACS (2014) estimat...

Translating Research Into Practice

Oncology Communication Skills Training: Bringing Science to the Art of Delivering Bad News

Mady C. Stovall, RN, MSN, ANP-BC

Few published studies reporting on controlled clinical trials in the psychosocial domain of communication techniques for delivering bad news to cancer patients exist. The landscape of oncology front-line care is dramatically changing. Nurse practitioners and physician assistants are working side ...

Translating Research Into Practice

Understanding and Evaluating Survey Research

Julie Ponto, PhD, APRN, AGCNS-BC, AOCNS®

A variety of methodologic approaches exist for individuals interested in conducting research. Selection of a research approach depends on a number of factors, including the purpose of the research, the type of research questions to be answered, and the availability of resources. The purpose of th...

Tools and Technology

Analogies in Oncology: Explanations Made Easier

Wendy H. Vogel, MSN, FNP, AOCNP®

There is little debate that it is overwhelming to receive a diagnosis of cancer. The intricacies of the disease process and the complexities of treatment are frequently difficult for patients to comprehend. Even experienced advanced practitioners (APs) may have difficulty understanding some conce...

Editorial

Going Gentle Into That Good Night

Pamela Hallquist Viale, RN, MS, CS, ANP

As a result of continued improvements in the treatment and detection of cancer, it is estimated that the population of cancer survivors will increase to approximately 19 million by the year 2024 (American Cancer Society, 2014). Healthier lifestyles undoubtedly contribute to that number as well. T...

Original Research

Top Information Need Priorities of Older Adults Newly Diagnosed With Active Myeloma

Joseph D. Tariman¹, PhD, ANP-BC, Ardith Doorenbos², PhD, RN, FAAN, Karen G. Schepp², PhD, RN, PMHCNS-BC, FAAN, Seema Singhal², MD, and Donna L. Berry², PhD, RN, FAAN, AOCN®

Providing pertinent information to patients with cancer is considered an important part of standard care (Jacobson et al., 2009). Patients seek information to understand the diagnosis (and its consequences) and to make treatment and self-care decisions. Evaluating which information needs are of h...

Review Article

Romidepsin for the Treatment of Peripheral T-Cell Lymphoma

Lisa Barbarotta, RN, MSN, AOCNS®, APRN-BC¹, and Kristen Hurley, RN, MSN, CNP²

Peripheral T-cell lymphomas (PTCLs) are a heterogeneous group of aggressive, uncommon forms of T-cell– or natural killer (NK)–cell-derived non-Hodgkin lymphomas (NHLs) that are typically associated with a poor prognosis (Foss et al., 2011; Horwitz, 2007; Vose, Armitage, Weisenburger, & Intern...

Review Article

Pain Prevention Using Head and Neck Cancer as a Model

Erin M. McMenamin, MSN, CRNP, AOCN®, ACHPN, and Marcia Grant, RN, PhD, FAAN

In 2014, it is estimated that more than 1.6 million people in the United States received new cancer diagnoses and 580,000 cancer-related deaths likely occurred (American Cancer Society [ACS], 2014). Of these patients, more than 60,000 were diagnosed with head and neck cancer (ACS, 2014). In the ...

Practice Matters

Cognitive Behavior Therapy for Patients With Cancer

Sheena Daniels, DNP, ARNP, FNP-BC

Cancer is the second most common cause of death in the United States. It is estimated that there were 1,665,540 new cases diagnosed in 2014 (American Cancer Society [ACS], 2014). The mainstay treatment options for various cancers include surgery, radiation, chemotherapy, and hormonal therapies or...

Practice Matters

Health-Care Metrics in Oncology

Elizabeth Gilbert, MS, PA-C, Victoria Sherry, MSN, CRNP, AOCNP®, Suzanne McGettigan, MSN, CRNP, AOCN®, and Anne Berkowitz, MSN, CRNP, OCN®

In 1986, the Institute of Medicine (IOM) set out to define health care in terms of quality. Its goal was to establish standards for desired health outcomes that were consistent with current professional knowledge (Donaldson & Lohr, 1990). It has become apparent, however, that variability in t...

Grand Rounds

The Role of the Advanced Practice Nurse in Survivorship Care Planning

Virginia Sun¹, RN, PhD, Jill M. Olausson², RN, MSN, CDE, Rebecca Fujinami¹, RN, CCM, OCN®, Carrie Chong³, RN, MN, NP, Rachel Dunham⁴, RN, MSN, NP, Tami Tittlefitz⁵, RN, MSN, NP-C, Kelly Greer¹, BS, and Marcia Grant¹, RN, PhD, FAAN

Comprehensive survivorship care planning (SCP) is an essential component of quality cancer care. Since the 2006 seminal publication of the Institute of Medicine’s report on cancer survivorship, it has been unclear which models of cancer survivorship care translate to improved patient and system o...

Prescriber's Corner

Ramucirumab: A New Therapy for Advanced Gastric Cancer

Andrea Landgraf Oholendt, PharmD, BCOP, and Jennifer L. Zadlo, PharmD, BCOP

Gastric cancer is the fourth most common cancer in men and the fifth most common cancer in women worldwide (Jemal et al., 2011). The American Cancer Society (ACS) has estimated there were 22,220 new cases diagnosed in 2014, with an estimated 10,990 deaths (Siegel, Ma, Zou, & Jemal, 2014). Des...

Tools and Technology

Plagiarism’s Poison: Avoiding Scientific Misconduct

Kelley D. Mayden, MSN, FNP, AOCNP®

The scientific body of literature is an integral part of oncology advanced practice that provides advanced practitioners (APs) with evidence for clinical decision-making and directly impacts patient quality of care and outcomes. Advanced practitioners not only utilize information from the literat...

Editorial

Titling the NP: Challenges and Misconceptions

Catherine Bishop, DNP, NP, AOCNP®

Nurse practitioners (NPs) have been practicing for nearly 50 years (American Association of Nurse Practitioners [AANP], 2014). So why is there still confusion over who we are and what we do? Why do we consistently get questions from patients such as “Are you my nurse?” or “Are you my doctor?” or...

Review Article

Managing Side Effects of Vemurafenib Therapy for Advanced Melanoma

Brenda Hagen, RN, FNP-BC, AOCNP®, and Van Anh Trinh, PharmD, BCOP

The incidence of melanoma has been rising over the past 30 years. In 2014, it is estimated that 76,100 new cases will be diagnosed and 9,710 individuals will die of melanoma in the United States (Siegel et al., 2014). The prognosis for patients with advanced melanoma has been grim, with a 1-year ...

Review Article

Immune Checkpoint Blockade: A New Paradigm in Treating Advanced Cancer

Kristen M. Kreamer, CRNP, MSN, AOCNP®, ANP-BC

The ability of the immune system to detect and eliminate cancer was first proposed over 100 years ago (Cann, van Netten, & van Netten, 2003). Since then, T cells reactive against tumor-associated antigens have been detected in the blood of patients with many different types of cancers, sugges...

Practice Matters

The Role of the Advanced Practitioner in a Comprehensive Lung Cancer Screening and Pulmonary Nodule Program

Amanda E. Reid1, MSN, ANP-BC, AOCNP®, Lynn Tanoue2, MD, Frank Detterbeck2, MD, Gaetane Celine Michaud2, MD, and Ruth McCorkle3, PhD, FAAN

The focus of many cancer centers has been primarily on the diagnosis and treatment of disease. While advancing treatments is important, prevention and early detection of disease needs to be formally integrated into comprehensive cancer cancers. It is the mission of the American Cancer Society to ...

Grand Rounds

Spiritual Assessment in a Patient With Lung Cancer

Tami Borneman, RN, MSN, CNS, FPCN

Lung cancer is the leading cause of cancer death for both men and women. Those diagnosed with localized lung cancer (~15%) have a 5-year survival rate of 54% (American Cancer Society, 2014). For patients with small cell lung cancer, the 5-year survival rate is 6%, and for those with non–small cel...

Prescriber's Corner

Idelalisib: The First-in-Class Phosphatidylinositol 3-Kinase Inhibitor for Relapsed CLL, SLL, and Indolent NHL

Nicholas Forcello, PharmD, BCPS, BCOP, and Nidhi Saraiya, PharmD

Chronic lymphocytic leukemia (CLL) is a malignancy arising from a monoclonal population of mature B cells (Chiorazzi, Rai, & Ferrarini, 2005). Chronic lymphocytic leukemia is typically considered a disease of the elderly with a median age at diagnosis of approximately 70 years and is the most...

Translating Research Into Practice

The Evolving Treatment Landscape for Metastatic Differentiated Thyroid Cancer

Carolyn Grande, CRNP, and MARCIA S. BROSE, MD, PhD

Review of "Sorafenib in metastatic thyroid cancer: A systematic review" by Thomas et al. (2014), The Oncologist, 19, 251–258. For a discussion of meta-analysis and forest plots used in oncology research, please see the related article by Joanne Lester here. Nearly 63,000 new cases of thyroid canc...

Translating Research Into Practice

The Use of Meta-Analysis and Forest Plots to Examine and Display Data in Oncology Research

JOANNE LESTER, PhD, CRNP, ANP-BC, AOCN®

In the article authored by Thomas et al. (2014) discussed by Carolyn Grande and Marcia Brose on page 461, there are several statistical tools used to understand the data. The data are presented in a quantitative fashion, e.g., numerical measures of outcomes. The statistical tool of meta-analysis...

Tools and Technology

What You Need to Know About the Ebola Virus

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

Although the Journal of the Advanced Practitioner in Oncology (JADPRO) is focused on publishing issues and content specific to oncology, we recognize that the current outbreak of the Ebola virus is a critical issue and one that readers should be aware of. The Ebola virus was first noted in 1976, ...

Editorial

Thank You to Our Peer Reviewers!

JADPRO

In this issue of the Journal of the Advanced Practitioner in Oncology (JADPRO), we are publishing, with our heartfelt thanks, the names of all of the esteemed professionals who completed peer reviews for JADPRO in 2014. As a group, they represent a staggering depth and breadth of experience in sp...

Meeting Abstract

JL202. PD-1 Pathway Immune Checkpoint Inhibitors: The Next Wave in Immunotherapy for Melanoma

Rajni Kannan, BS, MS, RN, ANP-BC, and Kathleen Madden, RN, MSN, FNP-BC, AOCNP®; NYU Cancer Institute, NYU Langone Medical Center

Meeting Abstract

JL203. Clinical Practice: Hypercalcemia of Malignancy

Steve Malangone, MSN, NP-C; Department of Hematology-Oncology, The University of Arizona Cancer Center, North Campus

Meeting Abstract

JL204. Efficacy of a Transdermal Granisetron Patch in Controlling Chemotherapy-Induced Nausea and Vomiting (CINV) in Head and Neck Cancer Patients

Deborah Braccia RN, MPA, Ph, Prostrakan, Inc., Bridgewater, NJ, and Gary Shelton DNP(c), MSN, NP, ANP-BC, AOCNP, NYU Langone’s Laura and Isaac Perlmutter Cancer, New York, NY

Meeting Abstract

JL205. Differences in Metabolite Activity of the Selective Estrogen Receptor Modulators Tamoxifen and Toremifene: Clinical Implications for Patients with Hormone Receptor Positive Breast Cancer

Marcelle Kaplan, RN, MS, AOCN, CBCN, Adelphi University College of Nursing and Public Health, Garden City, NY, and Deborah Braccia, RN, MPA, PhD, Prostrakan Inc. Bridgewater, NJ

Meeting Abstract

JL206. ONc-PoWER: Oncology Nurse Practitioner Web Education Resource

Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP, Sara Klein, MS, Rose Hoffmann, PhD, RN, University of Pittsburgh School of Nursing

Meeting Abstract

JL207. Decision Making Factors and Outcomes: Cancer Clinical Trials

Barbara A. Biedrzycki, PhD, CRNP, AOCNP, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD

Meeting Abstract

JL208. Medical Orders for Life Sustaining Treatment: Making the Most Out of the MOLSTs

Barbara A. Biedrzycki, PhD, CRNP, AOCNP, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD

Meeting Abstract

JL209. Vaccinations Post Hematopoietic Stem Cell Transplantation

Kathleen Leonard, RN, NP-C, AOCNP, NYU Langone Medical Center, New York, NY

Meeting Abstract

JL210. Acupuncture for the Management of Hot Flashes in Breast Cancer Survivors

Hollis McClellan Misiewicz, DNP, CRNP, AOCN, Mercy Medical Center

Meeting Abstract

JL211. PD-1 Immune Checkpoint Inhibitors: An Exciting New Approach for the Treatment of Non-Small Cell Lung Cancer

Colleen Lewis, MSN, ANP-BC, AOCNP, Emory Winship Cancer Institute

Editorial

Modifiable Risk Factors Affecting Outcomes: The Truth About Obesity

Pamela Hallquist Viale, RN, MS, CS, ANP

The American Society of Clinical Oncology (ASCO) held its annual meeting this past June. As usual, participants had the opportunity to learn and discuss the latest in oncology research findings. Although I didn’t attend the meeting in person, I noted the daily reports with interest. I was particu...

Review Article

Treatment Considerations for the Management of Patients With Hormone Receptor–Positive Metastatic Breast Cancer

Constance Visovsky, PhD, RN, ACNP-BC

In the United States, breast cancer is the most frequently diagnosed cancer among women (Siegel, Naishadham, & Jemal, 2012). Every year, more than 200,000 women are diagnosed with invasive breast cancer, and approximately 40,000 deaths are estimated to have occurred from the disease in 2012 (...

Review Article

Improving Palliative Cancer Care

Catherine Del Ferraro, MSN, ED, PHN, RN, CCRP, Betty Ferrell, PhD, FAAN, MA, FPCN, CHPN, Carin Van Zyl, MD, FACEP, Bonnie Freeman, DNPC, RN, ANP-BC, and Linda Klein, JD

Although there has been significant progress made over the past decade in implementing palliative care (PC) in the United States, barriers to its integration for all cancer patients still exist (Institute of Medicine [IOM], 2013). In addition, the population of chronically ill patients with advan...

Practice Matters

Using Technology to Advance Cancer Survivorship Programs

Mark Fosdal, RN, PA-C, DHSc

Over 12 million people in the United States are surviving after being diagnosed with cancer; this number is expected to rise as baby boomers age and emerging targeted therapies create less toxicity (Ganz, 2009). Yet in a 2012 survey, only 55% of primary care providers (PCPs) were comfortable bein...

Prescriber's Corner

Ibrutinib in Relapsed or Refractory Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

Derek Peterson, PharmD(c), and Joanna Schwartz, BCOP, PharmD

Targeted scientific advancements have produced novel therapies and made significant improvements in the clinical landscape of non-Hodgkin lymphoma (NHL) treatment. Although mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL) are both B-cell lymphocyte subtypes of NHL neoplasms, ther...

Translating Research Into Practice

Clinical Management of Pancreatic Cancer

Rae Brana Reynolds, RN, MS, ANP-BC, and Justin Folloder, MS, PA-C

Pancreatic cancer is the fourth leading cause of cancer deaths in the United States (American Cancer Society [ACS], 2014). In 2014, the ACS estimates 46,420 new cases of pancreatic cancer with 39,590 deaths in the United States. Unfortunately, 80% of patients diagnosed with pancreatic cancer pres...

Translating Research Into Practice

Use of Radiographic Criteria to Predict Outcomes Following Surgery for Pancreatic Cancer

Rae Brana Reynolds, RN, MS, ANP-BC, and Justin Folloder, MS, PA-C

Surgical resection of the pancreas is the only treatment for pancreatic cancer that offers curative potential. Because other treatment modalities such as chemotherapy and radiation only offer palliation, surgical resectability is critical, as it dictates the treatment plan and ultimately serves a...

Grand Rounds

Human Herpesvirus-6 Encephalitis After Hematopoietic Stem Cell Transplantation

Heather L. Kasberg-Koniarczyk, MSN, NP-C, AOCNP®

The International Committee on Taxonomy of Viruses (2011) describes HHV-6 as a member of the Roseolovirus genus, which is part of the herpesvirus subfamily. There are two distinct HHV-6 subspecies: HHV-6A and HHV-6B (Wang, Dong, Zhang, & Lu, 2008); however, most primary and reactivation compl...

Tools and Technology

Cancer Prediction Nomograms for Advanced Practitioners in Oncology

Lydia T. Madsen, PhD, RN, AOCNS®

Cancer prediction nomograms provide advanced practitioners (APs) with tools to assess a patient’s overall risk for development of a specific cancer. Alternatively, after a cancer diagnosis has been made, nomograms represent a standardized means to provide a statistical estimate of prognosis, part...

Diagnostic Snapshot

How Do You Triage Abdominal Pain in a Patient With Ovarian Cancer?

Paula Anastasia, RN, MN, AOCN®, Cedars-Sinai Medical Center, Los Angeles, California

History B.V. is a 53-year-old nulliparous woman who was initially diagnosed with recurrent stage 3C epithelial ovarian carcinoma in 2011. She underwent a hysterectomy, bilateral salpingo-oophorectomy, and optimal tumor debulking. Adjuvant therapy consisted of a clinical trial (Gynecologic Oncolog...

Editorial

Transparency in Medicare Reimbursement: Help or Hindrance?

Wendy H. Vogel, MSN, FNP, AOCNP®

Welcome to the latest edition of JADPRO! It is my pleasure and honor to serve as an associate editor for this elite and unique journal. As one of the co-chairs of the meeting, I would like to invite you to attend the second JADPRO Live symposium to be held in sunny Orlando, Florida, this October ...

Review Article

Targeted Therapies in Breast Cancer: Implications for Advanced Oncology Practice

Laura Bourdeanu, PhD, and Thehan Luu, MD

During the past decade, the systemic therapeutic management of breast cancer has undergone a significant transformation. Without targeted therapies, conventional treatment with cytotoxic agents has maximized its potential in terms of patient survival for most types of cancer. Enhanced understandi...

Review Article

The History and Physical in Cancer Care: A Primer for the Oncology Advanced Practitioner

Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP®, Diane Gardner, FNP, MSN, and Brenda Griffith

The oncology advanced practitioner (AP) needs to be well versed in the basics of a new patient history and physical (H & P). Most graduates of nurse practitioner and physician assistant programs feel at least moderately comfortable working through the traditional components of a new patient H...

Review Article

Approaches to Managing Safety With Lenalidomide in Hematologic Malignancies

Susan Blumel, RN, BSN, and Jackie Broadway-Duren, DNP, APRN, FNP-C

Lenalidomide (Revlimid) is an oral immunomodulatory agent approved in the United States in combination with dexamethasone for patients with multiple myeloma (MM) who have received one or more prior therapies and as a single agent for transfusion-dependent anemia due to low-/intermediate-1–risk my...

Grand Rounds

Management of Malignant Pericardial Effusion

Mart Petrofsky, MS, RN, ACNP, AOCNP®

The pericardium surrounds the heart and the great blood vessels and is composed of a thin visceral membrane, a fibrous parietal membrane, and the pericardial space between the membranes, which normally contains less than 50 mL of an ultrafiltrate of plasma known as pericardial fluid (Hoit, 2011; ...

Practice Matters

The Case for Early Palliative Care in the Treatment of Ovarian Cancer

Lauren Hardiman, MS, ARNP, AOCNP®

Once referred to as a silent killer but more recently as “the disease that whispers,” ovarian cancer’s early-stage symptoms are often vague and mimic other gastrointestinal or genitourinary illnesses. Although the median age at time of diagnosis is 63 years old, most women attribute the nonspecif...

Prescriber's Corner

Vismodegib: First-in-Class Hedgehog Pathway Inhibitor for Metastatic or Locally Advanced Basal Cell Carcinoma

Nancy M. Nix, PharmD, BCPS, BCOP, Olivia Burdine, PharmD, and Makeda Walker, PharmD

Skin cancer is the most common cancer type in the United States, affecting more than 3 million people nationally (Cirrone & Harris, 2012). Basal cell carcinoma (BCC) and squamous cell carcinoma are the two main types of nonmelanoma skin cancer, while the more serious form, melanoma, is in its...

Tools and Technology

Healthy Weight Loss for the Cancer Survivor

Kristy K. Hager, MS, RD, LDN

For most oncology patients, weight gain is not considered problematic. However, in some instances weight gain can be detrimental to health. Outpatient oncology dietitians most often work with patients who are currently undergoing treatment. Weight loss during cancer treatment is associated with i...

Review Article

Lessons Learned in Cancer Care Communication

Ronald Piana

Over the past several decades, outcomes data have traced the success stories in cancer research and therapeutics. However, during those decades of increasingly rapid scientific breakthroughs, certain psychosocial components in the continuum of cancer care were often overlooked. One such element i...

Diagnostic Snapshot

Diagnostic Snapshot: Aggressive Malignancy or Benign Lesion?

Paige M. Goforth, MMS, PA-C

History Mrs. B. is a 67-year-old Caucasian female. She is married, works as a housewife, and has two grown children. She denies alcohol or tobacco use. Her medical history includes hypertension and poorly controlled insulin-dependent type 2 diabetes mellitus. She reports a history of frequent sun...

Editorial

Thank You for NOT Smoking

Pamela Hallquist Viale, RN, MS, CNS, ANP

The Surgeon General’s report on smoking was just released, coinciding with the 50th anniversary of the original report issued in 1964. The report, entitled “The Health Consequences of Smoking—50 Years of Progress,” is alarming. Although awareness of the dangers of smoking has indeed increased, th...

Original Research

A Tailored Nurse Coaching Intervention for Oral Chemotherapy Adherence

Susan M. Schneider, PhD, RN, AOCN®, FAAN, Donna B. Adams, RN, MSN, ANP-BC, OCN®, and Tracy Gosselin, PhD, RN, AOCN®

Oral chemotherapy is prescribed to diminish tumor mass, eradicate micrometastatic disease, and increase disease-free survival in cancer patients. Although cancer patients frequently express a preference for oral medications, compliance to these medications varies. Patients often have difficulty a...

Review Article

Functional Morbidity Following Latissimus Dorsi Flap Breast Reconstruction

Susan L. Smith, ARNP-BC, MSN, DHSc, FAANP

According to recent estimates from the National Institutes of Health (NIH), over 230,000 new cases of breast cancer will be diagnosed in 2014 alone (NIH, 2013). These patients will be forced to make immediate life-altering decisions regarding surgical intervention for treatment. Timing and approa...

Review Article

Innovative Agents in Multiple Myeloma

Beth Faiman, PhDc, MSN, APN-BC, AOCN®, and Tiffany Richards, MS, ANP, AOCNP®

Multiple myeloma (MM) is a rare cancer of the bone marrow plasma cells that affects approximately 70,000 individuals in the United States (Howlader, Noone, Krapcho, Neyman, & Kroenen, 2014). Symptoms of MM include bone damage, anemia, and/or renal insufficiency in the presence of a monoclonal...

Grand Rounds

Delayed Presentation of DPD Deficiency in Colorectal Cancer

Lindsey Law, MPAS, PA-C, Jane Rogers, PharmD, BCOP, and Cathy Eng, MD, FACP

Fluoropyrimidines such as fluorouracil (5-FU) and capecitabine are commonly prescribed agents for the management of gastrointestinal, breast, genitourinary, and head and neck cancers, with millions of patients receiving them each year (Ezzeldin & Diasio, 2004; Mercier & Ciccolini, 2006). ...

Prescriber's Corner

Dabrafenib: A New Therapy for Use in BRAF-Mutated Metastatic Melanoma

Suzanne McGettigan, MSN, CRNP, AOCN®

Melanoma, the most dangerous form of skin cancer, accounts for the majority of skin cancer–associated mortality. The American Cancer Society (ACS) has estimated that there will be 76,100 new cases of melanoma diagnosed in 2014, with an estimated 9,710 deaths from melanoma (ACS, 2014). The inciden...

Practice Matters

Simulation as a Learning Tool in the Oncology Setting

Patricia C. Simmers, MSN/Ed, RN, OCN®

Simulation-based education in medicine represents a teaching paradigm shift. David Gaba, associate dean for Immersive and Simulation-Based Learning at Stanford University School of Medicine, describes simulation as a technique, not a technology, that recreates real patient experiences and gives ...

Tools and Technology

Lung Cancer Screening: Are You Ready?

Wendy H. Vogel, MSN, FNP, AOCNP®

Screening for lung cancer is now recommended for certain people at high risk for the development of this malignancy. Currently, there is no evidence that other risk groups should be screened. Risk Factors and Smoking Cessation The National Comprehensive Cancer Network (NCCN) Guidelines define per...

Diagnostic Snapshot

Can you Identify This Malignancy?

Andria N. Arrington, PA-C

History Mr. B. is a 39-year-old male with no significant medical history who began experiencing progressive abdominal girth and bloating. Ultrasound and CT of the abdomen and pelvis revealed moderate to large abdominal ascites. Ultrasound-guided paracentesis yielded 7 L of serous fluid, with cyto...

Meeting Report

The Launch of the Advanced Practitioner Society for Hematology and Oncology (APSHO)

Pamela Hallquist Viale, RN, MS, CNS, ANP, Christopher J. Campen, PharmD, BCPS, BCOP, Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, and Wendy H. Vogel, MSN, FNP, AOCNP®

Report from JADPRO Live We are pleased to announce the formation of our new organization, the Advanced Practitioner Society for Hematology and Oncology (APSHO). The Journal of the Advanced Practitioner in Oncology (JADPRO) will be the Society’s official journal and will continue to offer relevant...

Diagnostic Snapshot

What is the Etiology of Dysarthria and Ataxia in a Woman With Cancer?

Paula J. Anastasia, RN, MN, AOCN®

History R. J. is a 56-year-old woman with recurrent stage 1a, grade 3 endometrial carcinoma who was first diagnosed in 2011. She underwent hysterectomy and bilateral salpingo-oophorectomy with lymph node dissection. No adjuvant therapy was recommended, and she was followed every 3 months. Recurre...

Editorial

Celebrities and Medicine: A Potent Combination

Pamela Hallquist Viale, RN, MS, CNS, ANP

When it comes to health-related concerns, celebrity commercials and endorsements have always made me a little nervous. The direct-to-consumer advertisements with known personalities such as Bob Dole for erectile dysfunction or Sally Field for bone health often made me cringe. I couldn’t help but ...

Original Research

Improving Surgical Outcomes in Pancreatic Surgery With Preoperative Nutrition

Dwanna Ward-Boahen, DNP, NP-C, AOCNP®, and Meredith Wallace-Kazer, PhD, CNL, APRN, AGPCNP-BC, FAAN

Pancreatic cancer is the fourth leading cause of cancer-associated death. Peak incidence is in the seventh and eighth decades of life, with a slightly higher incidence in African Americans vs. Caucasians. The incidence and mortality for pancreatic cancer has not changed over the past 2 decades (N...

Prescriber's Corner

Ado-Trastuzumab Emtansine in Metastatic HER2-Positive Breast Cancer

Rena Callahan, MD

Breast cancer is the most common cancer in US women, affecting approximately 1 in 8 women over the course of a lifetime. Nearly 40,000 women die of breast cancer every year (Siegel, Naishadham, & Jemal, 2013). In the past decade, we have come to understand that breast cancer is a heterogeneou...

Practice Matters

Calculating Your Worth: Understanding Productivity and Value

Todd Pickard, MMSc, PA-C

While health-care dollars shrink and the focus on delivering more care with less grows, it is imperative that nurse practitioners (NPs) and physician assistants (PAs) understand the key concepts of productivity and value. Furthermore, with a growing shortage of oncology physicians, the role of th...

Meeting Report

Advanced Practitioners in Oncology: Diverse Experiences, Shared Challenges

Susan Reckling

Report from JADPRO Live The professional paths of advanced practitioners (APs) in oncology are as varied as the locations in which they work. At the first annual JADPRO Live educational symposium held this past January in St. Petersburg, Florida, a distinguished panel was assembled to discuss the...

Meeting Report

Leaders of ASCO, ASH, ASTRO, and NCCN Embrace Collaboration With Advanced Practitioners

Susan Reckling

Report from JADPRO Live This past January, nearly 250 advanced practitioners assembled at the first annual JADPRO Live educational symposium in St. Petersburg, Florida, hosted by the Journal of the Advanced Practitioner in Oncology (JADPRO). Leaders from four prominent oncology organizations cham...

Review Article

Distress Screening in Chronic Disease: Essential for Cancer Survivors

Lorie Petty, MS, RN, CNL, and Joanne Lester, PhD, CRNP, AOCN®

Distress can be defined as a psychological state exacerbated by physical symptoms, interpersonal challenges, psychological symptoms, social issues, and/or existential concerns. It is a common problem in patients with cancer and other chronic diseases, although screening, assessment, and intervent...

Review Article

Information Needs Priorities in Patients Diagnosed With Cancer: A Systematic Review

Joseph D. Tariman¹, PhD, ANP-BC, Ardith Doorenbos², PhD, RN, FAAN, Karen G. Schepp², PhD, RN, PMHCNS-BC, FAAN, Seema Singhal², MD, and Donna L. Berry³, PhD, RN, FAAN, AOCN®

Research studies on information needs and information-sharing in patients with cancer have been increasing steadily in the past 3 decades. These studies relating to patient information-sharing were aimed at improving patient education and ultimately increasing patient participation in health-care...

Tools and Technology

Advanced Practitioners’ Favorite Books: The Sequel

The Editors of JADPRO

Several issues ago, we published a list of advanced practitioners’ favorite books. We received so much positive feedback about that list that we thought we’d do it again. The holidays are over, and the frenetic pace of those hectic months is hopefully lessening. Now might be the time to find a ne...

Meeting Abstract

JL01. The Role of the Multidisciplinary Tumor Board in the Management of Patient with Gastrointestinal Malignancy

Steve Malangone, MSN, NP-C, Nurse Practitioner, Hematology/Oncology, University of Arizona Cancer Center

Meeting Abstract

JL02. Virtual Reality as an Adjunct Method to Alleviate Pain and Anxiety in Patients Undergoing Bone Marrow Procedures

Kelly Young, DNP, RN, AOCN, Duke University Medical Center; Susan M. Schneider, PhD, RN, AOCN, FAAN, Duke University School of Nursing; Pandora Lassiter, PharmD, Duke University Medical Center; and Louis Diehl, MD, Duke University Department of Medicine, Durham, North Carolina

Meeting Abstract

JL03. Adding to Your Tool Box: Holistic Modalities

Marilyn Haas, PhD, APN-C, and Sheri Denslow, PhD, MPH

Meeting Abstract

JL04. Adjuvant Treatment With Toremifene in Hormone Receptor–Positive Breast Cancer: A Systematic Review of the Literature

Carolyn Lavender, MSN, AOCNP, ARNP, ProStrakan Inc, Bridgewater, New Jersey; Marcelle Kaplan, RN, MS, AOCN, CBCN, Adelphi University College of Nursing and Public Health, Garden City, New York; and Deborah Braccia, RN, MPA, PhD, ProStrakan Inc, Bridgewater, New Jersey

Meeting Abstract

JL05. Efficacy and Safety of the Granisetron Transdermal System (GTS) in Elderly Patients Receiving Multiday Chemotherapy Regimens

Paula J. Anastasia, Cedars-Sinai Medical Center, Los Angeles; Vanna M. Dest, Smilow Cancer Hospital at Yale New Haven, New Haven, Connecticut; Christine Brown, ProStrakan Inc; Doris Wong, ProStrakan Inc; and Deborah Braccia, ProStrakan Inc, Bridgewater, New Jersey

Meeting Abstract

JL06. Hereditary Hemochromatosis: What the Nurse Practitioner Needs to Know

Kathy Leonard, RN, NP-C, AOCNP®, NYU Langone Medical Center, New York, New York

Meeting Abstract

JL07. Intravenous Thiotepa for Meningeal Relapse of Breast Cancer: A Case Study

Kathryn Clarke, RN, MSN, FNP-C

Meeting Abstract

JL08. Merkel Cell Carcinoma: Is It on Your Differential?

Paige M. Goforth, MMS, PA

Meeting Abstract

JL09. Personalized Medicine for Breast Cancer

Beverly Rhodes, RN, MSN, ANP, The University of Texas MD Anderson Cancer Center, Houston, Texas

Meeting Abstract

JL10. Subcutaneous Administration of Bortezomib: A Pilot Survey of Oncology Nurses

Jasmine R. Martin, DNP, MSN, APRN, Director, Scientific Alliances and Research, Millennium: The Takeda Oncology Company; Nancy L. Beegle, BSN, Yanyan Zhu, PhD, and Joan M. Agretelis, PhD

Meeting Abstract

JL11. Don’t Fall for It! Preventing Falls in Patients with Cancer

Glenda Kaminski, PhD, RN, CNS, AOCN, Clinical Nurse Specialist, Oncology, Lakeland Regional Medical Center, Lakeland, Florida

Meeting Abstract

JL12. Management of Lenalidomide-Associated Cytopenias in Myelodysplastic Syndromes: Practical Take-Aways From Clinical Trials

Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, University of Arizona Cancer Center, Tucson; Jean A. Ridgeway, MSN, APN, NP-C, AOCN®, University of Chicago Medical Center, Chicago; Sara Tinsley, ARNP, MS, AOCN®, H. Lee Moffitt Cancer Center and Research Institute, Tampa, on behalf of the MDS Foundation International Nurse Leadership Board

Meeting Abstract

JL13. Practical Guide to Management of Lenalidomide-Related Rash in Patients With MDS

Sara Tinsley, ARNP, MS, AOCN, H. Lee Moffitt Cancer Center and Research Institute, Tampa; Sandra E. Kurtin, RN, MS, AOCN, ANP-C, University of Arizona Cancer Center, Tucson; Jean A. Ridgeway, MSN, APN, NP-C, AOCN, University of Chicago Medical Center, Chicago, on behalf of the MDS Foundation International Nurse Leadership Board

Meeting Abstract

JL14. Practical Guide to Bone Marrow Sampling for Suspected Myelodysplastic Syndromes

Jean A. Ridgeway, MSN, APN, NP-C, AOCN, University of Chicago Medical Center, Chicago; Sara Tinsley, ARNP, MS, AOCN, H. Lee Moffitt Cancer Center and Research Institute, Tampa; and Sandra E. Kurtin, RN, MS, AOCN, ANP-C, University of Arizona Cancer Center, Tucson, on behalf of the MDS Foundation International Nurse Leadership Board

Diagnostic Snapshot

Hyperpigmentation of the Tongue

Lindsay Lee Stringer, MSN, RN, ACNP-BC, AOCNP®, and Laura Zitella, MS, RN, ACNP-BC, AOCN®

History Mrs. T. is a 28-year-old woman of East Asian descent. She had been in good health, with no significant medical or surgical history, until she developed low-grade fever, fatigue, and weight loss followed by headaches, orthopnea, and cough. She presented to the emergency department with rig...

Review Article

Predictors of Cervical Cancer Screening Adherence in the United States: A Systematic Review

Karen Limmer, MSN, RN, ANP, NP-C, Geri LoBiondo-Wood, PhD, RN, FAAN, and Joyce Dains, DrPH, JD, RN, FNP-CB, DPNAP

The American Cancer Society (ACS) estimates that more than 12,000 new cases of cervical cancer were diagnosed in 2011 and that more than 4,000 patients with cervical cancer died from their disease (American Cancer Society, 2013). Nonetheless, cervical cancer incidence rates have decreased dramati...

Translating Research Into Practice

Randomized Allocation to Treatment Groups and the Importance of Adjusting for Covariates

Dustin Dickerson, MS

Research questions are concerned with changing a specific quantity by imposing an intervention or treatment. To find the answers to such questions, researchers must follow the scientific method to design a study that will gather quality evidence and lead to a logical conclusion. A common challeng...

Original Research

Improving Pain Management at the Nursing Education Level: Evaluating Knowledge and Attitudes

Jessica Latchman, MS, ARNP, AOCNP®

Unmanaged pain has been identified as a major barrier in the overall care of the oncology patient. In fact, more than 70% of this population will experience chronic cancer-related pain at some point in the course of their disease, with the majority receiving ineffective treatment. Cancer pain—whi...

Translating Research Into Practice

The Long and Short of Tamoxifen Therapy: A Review of the ATLAS Trial

G. Lita Smith, MS, RN, ACNP

Since the early 1990s, the mortality rate associated with breast cancer has been declining in all industrialized nations. This continuing decline has been attributed to the implementation of more widespread breast cancer screening practices as well as advancements in systemic therapy, including c...

Tools and Technology

There’s an App for That!

Wendy H. Vogel, MSN, FNP, AOCNP®

What would we do without our smartphones? There are so many applications, or “apps,” and so little time! In a long-awaited report released in 2012, Strategy Analytics estimated that there are more than 1 billion smartphone users worldwide (Bicheno, 2012). It is even more relevant to note that an...

Prescriber's Corner

Pomalidomide for the Treatment of Multiple Myeloma

Stephen M. Clark, PharmD, Alison Steinbach, PharmD, and Amber B. Clemmons, PharmD, BCOP

Multiple myeloma (MM) is a malignancy marked by proliferation and clonal expansion of plasma cells and excessive production of monoclonal immunoglobulin, which can lead to end-organ damage presenting as hypercalcemia, renal insufficiency, anemia, and/or bone lesions (Kyle, 2012). An estimated 22,...

Review Article

Olanzapine: An Antiemetic Option for Chemotherapy-Induced Nausea and Vomiting

Megan V. Brafford, PharmD, BCOP, and Ashley Glode, PharmD, BCOP

Patients undergoing chemotherapy commonly experience nausea and vomiting, with nausea occurring in 60% of patients and vomiting occurring in 30% (Srivastava, Brito- Dellan, Davis, Leach, & Lagman, 2003). Chemotherapy-induced nausea and vomiting (CINV) can be debilitating for many patients and...

Practice Matters

Integrating Nurse Practitioners Into Radiation Oncology: One Institution’s Experience

Genevieve Hollis, MSN, CRNP, ANP-BC, AOCN®, and Erin McMenamin, MSN, CRNP, ANP-BC, AOCN®

The demand for cancer-related services is soon expected to exceed the number of available oncologists. Factors contributing to this gap include the aging population and the associated increased incidence of cancer diagnosis, expanding treatment options, a growing number of survivors, changes in r...

Prescriber's Corner

Cabozantinib for the Treatment of Metastatic Medullary Thyroid Carcinoma

Nancy M. Nix, PharmD, BCPS, BCOP, and Kirk Braun*

Thyroid cancer is increasing at a faster rate than any other cancer type in the United States, with a total of 60,220 new cases expected in 2013 (American Cancer Society, 2013). It is the fifth most commonly diagnosed cancer in women, but it is much less prevalent in men. Thyroid cancer is genera...

Grand Rounds

A Case of Complicated Survivorship Care

Jean Rosiak, DNP, RN, ANP-BC, AOCNP®, CBCN, and Candi Humphreys, DNP, RN, FNP-BC

In 2006, the Institute of Medicine (IOM) issued the report “From Cancer Patient to Cancer Survivor: Lost in Transition” (Hewitt, Greenfield, & Stovall, 2006), addressing the problem of lack of coordinated care for cancer survivors after completion of treatment. The IOM recommends that each pa...

Editorial

Increasing Use of Advanced Practitioners: Strategizing for the Future

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

In 2009, the American Society of Clinical Oncology (ASCO) commissioned a study of collaborative practice arrangements using a national survey of oncology practices. Many of you may be familiar with this interesting report and its findings. ASCO projects that the demand for oncologists will outpac...

Editorial

Can Ginseng Alleviate Cancer-Related Fatigue?

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

As many of you have probably noticed, JADPRO’s review series for 2013 has focused on topics related to integrative medicine. We’ve covered hypnosis as a modality for selected patients with cancer, the use of touch and energy healing therapies, and complementary strategies for the side effects of ...

Review Article

Ceftazidime for Neutropenic Fevers: Is It Still an Appropriate Choice?

Ellen Bethany Napier, CRNP

Infection continues to rank as a primary cause of treatment-related mortality in patients with cancer. Fever may be the first measurable sign of infection; it is also a common finding in patients whose immune systems are rebuilding. Thus, the appropriate agent for the treatment of neutropenic fev...

Review Article

Lung Cancer Screening With Low-Dose CT: Its Effect on Smoking Behavior

Meaghan McEntee Gomez, ANP-BC, AOCNP®, and Geri LoBiondo-Wood, PhD, RN, FAAN

Lung cancer is the leading cause of cancer death in the United States, with an estimated 228,190 new cases and 159,480 deaths predicted in 2013 (Siegel, Naishadham, & Jemal, 2013). Most lung cancers are diagnosed in later stages: 57% of individuals with lung cancer have distant metastases at ...

Grand Rounds

Breathlessness With Pulmonary Metastases: A Multimodal Approach

Jeannine M. Brant, PhD, APRN, AOCN®

Breathlessness, also known as shortness of breath, dyspnea, or air hunger, is a dreaded symptom for patients with cancer, especially for those at the end of life. Breathlessness contributes significantly to suffering and poor quality of life and has been associated with a poor prognosis (Cuervo P...

Practice Matters

Group Appointments in a Breast Cancer Survivorship Clinic

Kathryn Trotter, DNP, CNM, FNP-BC, Susan M. Schneider, PhD, RN, AOCN®, FAAN, and Barbara S. Turner, PhD, RN, FAAN

Breast cancer survivors have unique needs after the active treatment period is completed. They may have to deal with long-term adverse effects of cancer and its treatment such as chronic fatigue, lymphedema, pain, diminished concentration, weight gain, limited mobility, and sexual dysfunction (He...

Practice Matters

Education of Hematopoietic Stem Cell Transplant Caregivers in Preparation for Their Role

Lynora J. Metoyer, DNP, FNP

Developing appropriate coping skills, solving problems, and prioritizing are all attributes of an effective caregiver. It is imperative for the caregiver of a patient undergoing hematopoietic stem cell transplantation (HSCT) to maintain his or her own quality of life—including mental, physical, a...

Translating Research Into Practice

Assessment of Pathologic Response in Patients With Locally Advanced Rectal Cancer: Implications of the Park et al. Study

Annie R. Truong, PA-C, and Steven H. Wei, MS, MPH, PA-C

Neoadjuvant chemoradiotherapy is considered the current standard of care for patients with locally advanced rectal cancers. The study by Park et al. (2012) discussed by Wolf and Malatek on page 438 represents the largest single-institution study to date evaluating response-stratified outcomes fol...

Prescriber's Corner

Bosutinib: A Novel Src/Abl Kinase Inhibitor for Chronic Myelogenous Leukemia

Alison Steinbach, PharmD, Stephen M. Clark, PharmD, and Amber B. Clemmons, PharmD, BCOP

Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the disease-defining translocation between chromosomes 9 and 22 resulting in the Bcr-Abl tyrosine kinase fusion protein, termed the Philadelphia (Ph+) chromosome [t(9;22)(q34;q11)] (Boschelli, Arndt, & Gambacorti...

Translating Research Into Practice

Locally Advanced Rectal Cancer: Does Assessment of Response After Neoadjuvant Chemoradiotherapy Impact Management?

Elizabeth A. Wolf, PA-C, and Daniel L. Malatek, PA-C

Colorectal cancer, the fourth most common malignancy worldwide, accounts for 12% of all cancer deaths in the United States. According to National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) data estimates, 142,820 men and women will be diagnosed with colorectal cance...

Tools and Technology

Screening for Intimate Partner Violence in an Oncology Population

Lydia T. Madsen, MSN, RN, AOCNS®, and Judith McFarlane, RN, DrPH, FAAN

Intimate partner violence (IPV) is most broadly defined as behavior that is abusive and perpetrated by someone who is in a current or previous relationship with the victim (Nelson, Bougatsos, & Blazina, 2012); see Table 1. Intimate partner violence may occur on a continuum ranging from isolat...

Editorial

Deadly Viruses With Beneficial Uses: The Poliovirus as Therapy

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

I have always been fascinated by books that focus on the plague. Worldwide infectious diseases have changed history multiple times. The original bubonic plague killed an estimated 25 million people in Europe in the late 1340s; in the Great Plague (1665-1666), London lost one in five residents to ...

Review Article

Understanding CAM Natural Health Products: Implications of Use Among Cancer Patients and Survivors

Judith M. Fouladbakhsh, RN, PhD, PHCNS, AHN-BC, Lynda Balneaves, RN, PhD, and Elizabeth Jenuwine, PhD

The use of herbs, vitamins, and other complementary and alternative natural health products continues to be highly prevalent in the United States, particularly among individuals of varying ages who have been diagnosed with cancer and other chronic illnesses (Bright-Gbebry et al., 2011; Fouladbakh...

Review Article

Novel Agents for the Treatment of Multiple Myeloma: Proteasome Inhibitors and Immunomodulatory Agents

Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, and Elizabeth Bilotti, MSN, RN, APN, OCN®

Multiple myeloma (MM) accounts for only 1% of all malignancies but is the second most common hematologic malignancy, with approximately 21,700 cases diagnosed each year and approximately 10,710 deaths expected in the United States in 2013 (American Cancer Society, 2013). The average age at diagno...

Review Article

Testing Women With Endometrial Cancer for Lynch Syndrome: Should We Test All?

Jun Ma, PhD, RN, CNM, AOCNP®, Nancy Ledbetter, RN, CNS, APNG, and Lyn Glenn, MN, FNP, AOCN®

Lynch syndrome (LS), also known as hereditary nonpolyposis colorectal cancer, is one of the most common autosomal-dominant cancer syndromes. It is estimated to affect between 1 in 500 and 1 in 1000 individuals. Lynch syndrome increases an individual’s risks for developing cancers of the colon, e...

Grand Rounds

Sexuality, Lung Cancer, and the Older Adult: An Unlikely Trio?

Anna Cathy Williams, RN, MSNc, PHN, Karen Reckamp, MD, Bonnie Freeman, MSN, RN, ANP-BC, CHPN, Rupinder Sidhu, MSW, LCSW, and Marcia Grant, RN, DNSc, FAAN

Talking about sexuality in health care has slowly increased in recent years, along with efforts to augment support accompanying the occurrence of a catastrophic health event. Although some progress has been made, discussion about sexuality and intimacy, particularly in older adults, has been spa...

Prescriber's Corner

Ziv-Aflibercept Use in Metastatic Colorectal Cancer

Mabel Rodriguez, PharmD

Colorectal cancer (CRC) is the third most common cancer in both men and women (Siegel, Naishadham, & Jemal, 2013). In 2011, the global number of newly diagnosed cases worldwide was more than 1 million, with 600,000 deaths worldwide (Jemal et al., 2011). Although incidence and mortality rates...

Practice Matters

Oral Cancer Therapy: Policy Implications for the Uninsured and Underinsured Populations

Beth Faiman, CNP

Approximately 400 anticancer drugs are currently in development. The National Comprehensive Cancer Network estimates that 25% of the drugs in development will be available in oral formulations (Weingart et al., 2008; Neuss et al., 2013). It is estimated that the trend for specialty anticancer th...

Translating Research Into Practice

Review of a Study of Duloxetine for Painful Chemotherapy-Induced Peripheral Neuropathy

Rita Wickham, PhD, RN, AOCN®

The problem of chemotherapy-induced peripheral neuropathy (CIPN) has risen to the forefront for oncology professionals, who must pay greater attention to this distressing and potentially debilitating adverse effect than they did in the past. This is because CIPN may occur and even be dose limitin...

Translating Research Into Practice

Challenges in the Conduct of Research: Chemotherapy-Induced Peripheral Neuropathy

Constance Visovsky, PhD, RN, ACNP-BC

The treatment of chemotherapy-induced peripheral neuropathy (CIPN) and associated neuropathic pain continues to be of significant concern to patients and clinicians. Peripheral neuropathy is a condition resulting from damage to peripheral nerves (Stubblefield et al., 2009). Chemotherapy-induced ...

Tools and Technology

Cancer Genetic Resources

Wendy H. Vogel, MSN, FNP, AOCNP®, and Deborah F. Pencarinha, MS, LGC

Human genetics is a complicated science. There are a multitude of terms to understand, such as cancer genetics, hereditary genetics, cellular genetics, genetic engineering, human genome, predictive genetic testing, Mendelian inheritance, and many more. If we, as advanced practitioners (APs) in on...

Review Article

Novel Agents for the Treatment of Multiple Myeloma: Proteasome Inhibitors and Immunomodulatory Agents

Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, and Elizabeth Bilotti, MSN, RN, APN, OCN®

Editorial

Publishing in Open-Access Journals: Potential Pitfalls

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

As most of you know, at the Journal of the Advanced Practitioner in Oncology (JADPRO) we do not charge a fee to US readers who subscribe to the journal. We do not charge potential authors to have their work reviewed by our blind review process, nor do we charge for publication. Our publisher is t...

Original Research

Peripheral Neuropathy Caused by Paclitaxel and Docetaxel: An Evaluation and Comparison of Symptoms

Cindy Tofthagen*, PhD, ARNP, AOCNP®, FAANP, R. Denise McAllister, MS, ARNP, AOCNP®, and Constance Visovsky, PhD, RN, ACNP-BC

Advances in chemotherapy have resulted in improvements in disease-free survival and overall survival for persons with cancer, and these improved outcomes are often associated the use of taxane-based regimens (Jones et al., 2005; Wenzel, Huang, Armstrong, Walker, & Cella, 2007). Taxanes are pl...

Review Article

Complementary Strategies for the Management of Radiation Therapy Side Effects

Christine E. Stubbe, ND, FABNO, and Meighan Valero, ND, BAS

It is well established that complementary and alternative medicine (CAM) is widely used by patients with cancer for a variety of reasons (Ge et al., 2012; Gilett, Ientile, Hiscock, Plank, & Martin, 2012; Moran et al., 2012). Patients may use CAM because of a clear desire to improve their qual...

Review Article

Optimizing Adherence to Adjuvant Imatinib in Gastrointestinal Stromal Tumor

Eric D. Tetzlaff, MHS, PA-C, and Monica P. Davey, RN, BSN, MEd, MB

Gastrointestinal stromal tumor (GIST) is the most common nonepithelial tumor of the digestive tract, with an estimated incidence of 3,000 to 4,000 new cases per year in the United States (Corless & Heinrich, 2008; Nilsson et al., 2005). Gastrointestinal stromal tumors arise predominantly in t...

Grand Rounds

Two Patients With Brain Tumors Who Received Bevacizumab and Radiotherapy: Optic Neuropathy and Quality-of-Life Issues

D. Beverly Fu, MSN, NP-C, Daniela Alexandru, MD, Dana M. Curticiu, PhD, Yao Fu*, BSN, and Daniela A. Bota, MD, PhD

H igh-grade malignant gliomas, also known as glioblastoma multiforme (GBM) and anaplastic astrocytomas, are the most common primary brain tumors. These tumors are associated with a devastating prognosis. The current standard therapy for these malignancies is concomitant radiation therapy and temo...

Prescriber's Corner

Omacetaxine Mepesuccinate: A New Treatment Option for Patients With Chronic Myelogenous Leukemia

Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, and Lisa Matta, RN, MSN

T he discovery of the BCR-ABL oncogene and the subsequent development of agents targeting this oncogene revolutionized the treatment of chronic myelogenous leukemia (CML). The BCR-ABL fusion gene, located on the Philadelphia (Ph) chromosome, encodes an oncoprotein with constitutively active Abl k...

Practice Matters

Basic Review of the Cytochrome P450 System

Anne M. McDonnell, PharmD, BCOP, and Cathyyen H. Dang, PharmD, BCPS

Cytochrome P450 (CYP) is a hemeprotein that plays a key role in the metabolism of drugs and other xenobiotics (Estabrook, 2003). Understanding the CYP system is essential for advanced practitioners (APs), as the consequences of drug-drug interactions can be profound. In this article, we will desc...

Tools and Technology

Websites and Resources for Cancer Family Caregivers

Jo Hanson, RN, MSN, CNS, OCN®, Betty Ferrell, RN, PhD, MA, FAAN, FPCN, CHPN, and Marcia Grant, RN, PhD, FAAN

In the United States, over the past 12 months, more than 48 million people report serving as a family caregiver (FCG) for an adult loved one (National Alliance for Caregiving, 2009; Northouse, Katapodi, Schafenacker, & Weiss, 2012). The caregivers identify cancer as one of the most common ill...

Editorial

Youth and Tanning: A Dangerous Combination

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

As I write this from my home office in the Santa Barbara area, it is late March and the weather is a balmy 82 degrees with abundant sunshine and a promise for more of the same for the entire week. In fact, March weather in California is frequently sunny and warm, a fact that I took advantage of i...

Review Article

Energy Therapies in Advanced Practice Oncology: An Evidence-Informed Practice Approach

Pamela J. Potter, DNSc, RN, CNS

For advanced practice professionals in the oncology setting, state-of-the-art care and support for patients during the healing process are of paramount importance. An analysis of National Health Statistics data found that approximately 30% of people with lung, breast, colon, or prostate cancer us...

Practice Matters

How to Recognize and Treat Neoplastic Meningitis

Margaret M. Fields, MSN, ACNP-BC, AOCNP®

As length of survival time for many cancers has increased through the years, there has been a subsequent increase in uncommon metastatic sites. One of these sites is leptomeningeal metastases, which is cancer that has spread to the meninges, or covering of the brain, and the surrounding cerebrosp...

Translating Research Into Practice

The Need for Communication Skills Training in Oncology

Dany Michaella Hilaire, PhD(c), RN

In 2010, the US Department of Health and Human Services (HHS) launched Healthy People 2020, an initiative that provides science-based national objectives for improving the health of all Americans. Healthy People 2020 is the third such 10-year agenda to be launched by the HHS. The goals and object...

Translating Research Into Practice

Communication Skills Training: Using Evidence to Develop Programs That Improve Patient Outcomes

Lisa Kennedy Sheldon, PhD, APRN-BC, AOCNP®

It is well accepted that patient-centered communication is a cornerstone of quality oncology care (Epstein & Street, 2007; Institute of Medicine, 2007). Patient-provider communication involves complex processes, especially in oncology care. Training in effective communication has been propose...

Grand Rounds

Understanding the Implications of the Breast Cancer Pathology Report: A Case Study

Susan Beikman, MSN, CRNP, AOCNP®, Patricia Gordon, MSN, CRNP, OCN®, Shannon Ferrari, PA-C, MPAS, Monica Siegel, MSN, CRNP, AOCNP®, Mary Ann Zalewski, MSN, CRNP, AOCNP®, and Margaret Q. Rosenzweig, PhD, FNP-BC, AOCNP®

Solid tumor staging includes tumor size (T), regional lymph nodes (N), and distant metastasis (M). This TNM staging system used in solid tumor oncology is well known to oncology professionals (Edge et al., 2010). For breast cancer, stage of disease and number of positive lymph nodes influence the...

Prescriber's Corner

Enzalutamide: A New Agent for the Prostate Cancer Treatment Armamentarium

Stephanie B. McCutcheon, PharmD

Prostate cancer is one of the most common malignancies among men; it is estimated that 238,590 new cases will be diagnosed and approximately 29,720 deaths may be attributed to prostate cancer across the United States in 2013 (American Cancer Society, 2013). This disease is most frequently diagnos...

Tools and Technology

The ASCO University Website: Online Education for the Oncology Advanced Practitioner

Heather M. Hylton, MS, PA-C

Many clinicians rely upon electronic resources for information pertinent to the care they provide for their patients. While there are numerous resources to choose from, the selection process can be daunting because of the sheer volume of websites in existence and questions about the accuracy of t...

Editorial

The Continuing Impact of Oncology Drug Shortages

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Oncology drug shortages remain prevalent, and as advanced practitioners, we are continuing to experience this troubling phenomenon. We introduced this important issue previously in the July/August 2011 issue of the Journal of the Advanced Practitioner in Oncology. We noted that the number of shor...

Review Article

Hypnosis: Adjunct Therapy for Cancer Pain Management

Kathy Kravits, MA, RN, HNB-BC, LPC, NCC, ATR-BC

Pain is a symptom associated with prolonged recovery from illness and procedures, decreased quality of life, and increased health-care costs (NCCN, 2011; Montgomery et al., 2007; Green, Barabasz, Barrett, & Montgomery, 2005). It contributes to the suffering associated with cancer and its trea...

Review Article

Efficacy of Palifermin in the Hematopoietic Stem Cell Transplant Setting

Muneera Panjwani, RN, BSN, OCN®

Oral mucositis (OM) is a common and debilitating side effect of myeloablative conditioning regimens administered to patients with hematologic malignancies undergoing hematopoietic stem cell transplant (HSCT). The overall incidence of mucositis in the HSCT setting is reported to be 75% to 99% (Rad...

Review Article

Prevention and Management of Tumor Lysis Syndrome in Adults With Malignancy

Jessica Sarno, BSN, RN, OCN®

In a malignancy with a high proliferative rate, large tumor burden, or high sensitivity to treatment, initiation of chemotherapy and/or radiation therapy can induce rapid lysis of tumor cells resulting in tumor lysis syndrome (TLS; Larson & Pui, 2012a). Tumor lysis syndrome is most often brou...

Practice Matters

Polypharmacy in Older Adults: The Role of the Advanced Practitioner in Oncology

Diane G. Cope, PhD, ARNP, BC, AOCNP®

As Americans age, health-care providers will be faced with new and challenging issues related to the care of older adults. One critical issue that is unique to the aging population is polypharmacy. Older adults are frequently prescribed multidrug therapy to treat a plethora of chronic illnesses. ...

Grand Rounds

Breast Cancer and Autism

Lisa Radcliff, DNP, FNP, AOCNP®

Amy has a confirmed breast malignancy that, left untreated, will eventually progress and may shorten her natural lifespan. Physically, she is a good candidate for treatment, lacking any significant comorbidities or physical disabilities that would interfere with the action of chemotherapy. System...

Prescriber's Corner

Regorafenib: Adding to the Armamentarium for Refractory Colorectal Cancer and GIST

Danielle Roman, PharmD, BCOP, and Rachelle Whiteside, PharmD

Colorectal cancer is the third most common cancer and the second leading cause of cancer-related mortality in men and women in the United States. The overall lifetime risk of developing colorectal cancer is approximately 1 in 20, with 50,830 deaths expected in 2013 (American Cancer Society, 2013)...

Tools and Technology

Credible Complementary and Alternative Medicine Websites

Jane T. Williams, MSN, RN, FNP-BC

It seems like both patients and health-care providers are constantly bombarded with information about complementary and alternative treatments on the Internet; in health and fitness magazines; on television talk shows; and from friends, family, and colleagues who are often well-intended. Most pro...

Editorial

How Much Does That Treatment Cost?

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Having been an advanced practitioner (AP) in oncology for many years, I have witnessed the development of several innovative and effective therapies. When I started my career in the early 1980s, we had less than a dozen active antineoplastic agents; within 30 years dozens of new agents have been ...

Review Article

Screening for Prostate Cancer: The Debate Continues

Marc R. Matrana, MD, MS, and Bradley Atkinson, PharmD

In 2012, the United States Preventive Services Task Force (USPSTF) issued recommendations against routine prostate cancer screening in asymptomatic male patients regardless of age, race, ethnicity, or family history (USPSTF, 2012). Previous USPSTF guidelines had recommended against screening in m...

Review Article

Bisphosphonate-Related Osteonecrosis of the Jaw: Historical, Ethical, and Legal Issues Associated With Prescribing

Beth Faiman, PhDc, MSN, APRN-BC, AOCN®, Aiswarya Lekshmi Pillai Chandran Pillai, MBBS, MS, and Ana Gabriela Benghiac, DMD, MSD, MA

There are several synonyms for bisphosphonate-related osteonecrosis of the jaw (BRONJ). Some authors have described the phenomenon as bisphosphonate-associated osteonecrosis of the jaw, bisphosphonate-associated osteonecrosis, osteochemonecrosis of the jaws, and “bis-phossy jaw.” The term bis-pho...

Review Article

Multiple Myeloma: Cast Nephropathy, VTE, and Neurologic Complications

Ellen Sullivan, MNSC, APN, ACNP-BC, OCN®, Lisa C. Smith, MSN, FNP, AOCN®, and Angela M. Falco, RN, MS/MPH, ANP-C

Multiple myeloma (MM), also known as myeloma or plasma cell myeloma, is a progressive hematologic disease (Blade & Rosinol, 2007). This plasma cell disorder is characterized by clonal proliferation of malignant plasma cells in the bone marrow microenvironment, monoclonal protein in the blood ...

Grand Rounds

Having Difficult Conversations: The Advanced Practitioner’s Role

Therese Svarovsky, RN, MSN, OCN®

Patients with cancer report unmet needs for communication of information about the extent of their disease, prognosis, treatment options, intent, and adverse effects (Kissane et al., 2012). The oncology advanced practitioner (AP) needs to be equipped to answer patients’ questions in an honest and...

Prescriber's Corner

Pazopanib: Approval for Soft-Tissue Sarcoma

Diana T. Nguyen, PharmD, and Sepideh Shayahi, PharmD, BCOP

Sarcomas represent a diverse and relatively rare group of solid tumors of mesenchymal cell origin with distinct clinical and histologic features. They can be categorized into two broad groups: sarcomas of soft tissues (including fat, muscles, nerves, nerve sheaths, joints, blood vessels, deep ski...

Translating Research Into Practice

New Cervical Cancer Screening Guidelines: Was the Annual Pap Too Much of a Good Thing?

Margaret M. Fields, MSN, ACNP-BC, AOCNP®

Fifty years ago in the United States, the leading cause of cancer death among women was cervical carcinoma. With the advent of the Papanicolaou (Pap) test in 1945, mortality from this malignancy declined more than 70% (Datta et al., 2008; Spitzer, 2007). An annual Pap smear was the recommended gu...

Translating Research Into Practice

Guideline Evaluation

Diane Wardell, PhD, RN, WHNP-BC, AHN-BC

It is interesting to note that some guidelines remain relatively unchanged over many years, whereas others are relatively “fluid” in that they may or may not be consistent across groups and may also undergo considerable modification over time. This pattern may create confusion for both patients a...

Tools and Technology

A Computerized Tool to Support Survivorship Care

Michele R. O’Brien, MSN, ACNS-BC, RN, Kimberly K. Ness, MSN, ACNS-BC, AOCN®, RN, Chara J. Anderson, MA, CNP, AOCN®, RN, Mark D. Sborov, MD, and Jackie D. Foster, MPH, RN, OCN®

Cancer survival has improved as a result of recent advances in treatment and detection. There are currently 12 million cancer survivors in the United States; by 2020 that number is expected to reach 20 million (National Cancer Institute, 2011). The growing numbers of survivors include not only pa...

Editorial

Integrative and Complementary Therapies: Do You Know What Your Patients Are Taking?

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

As we enter the fall season, JADPRO is ready to begin publishing our next review series. Our first year highlighted the use of biomarkers in various types of cancer, and our second year provided a comprehensive look at the toxicities and adverse events advanced practitioners (APs) encounter in pr...

Review Article

Mind-Body Therapies: Evidence and Implications in Advanced Oncology Practice

Kelley D. Mayden, MSN, FNP, AOCNP®

The earliest recordings of human existence document that every society has been besieged by various maladies. Yet despite varying belief systems, the common goal has always been to restore the body to a state of wholeness. Medical models from ancient Egypt, Babylon, and Greece all incorporated tr...

Review Article

Incorporating Clinical Trial Data Into Daily Cancer Care

Jody Pelusi, PhD, FNP, AOCNP®

Despite the fact that metastatic disease remains incurable, individuals with metastatic cancer are living longer with their disease and undergoing multiple lines of therapy. It is important to recognize that clinical trials, as well as hospice/palliative care, are also viable options for patients...

Grand Rounds

Superior Vena Cava Syndrome in the Cancer Patient: A Case Study

Elaine Kinnard, MSN, CNP

Patients with lung cancer are at risk for superior vena cava syndrome (SVCS). Here we present a case study of a gentleman with small cell lung cancer who develops a swollen neck, edema, and dyspnea upon exertion. Would you, as the advanced practitioner, recognize the problem? Superior vena cava s...

Prescriber's Corner

Pertuzumab in Metastatic Breast Cancer

Rachana Patel, PharmD, BCPS, and Jill S. Bates, PharmD, MS, BCOP

The human epidermal growth factor family of receptors (HER1/EGFR, HER2, HER3, and HER4) plays an important role in the proliferation, differentiation, and transformation of tumor cells (Gianni et al., 2010). The receptors are highly expressed in many solid tumor types, including breast cancer. Ap...

Translating Research Into Practice

Effects of Aspirin on Colorectal Cancer Related to Lynch Syndrome

Sarah Leilani Beck, MS, FNP-BC, PCNP

Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States (Centers for Disease Control and Prevention [CDC], 2012) and remains the third most common cancer in men and in women (American Cancer Society [ACS], 2012a). The American Cancer Society estimates that...

Translating Research Into Practice

Aspirin and Decreased Colon Cancer Risk: Challenges Interpreting a Large Prospective Trial

Rita Wickham, PhD, RN, AOCN®

It is possible that your patients read the headline, “Aspirin may cut colon cancer risk by 60%,” published in USA Today in late October 2011, or that they saw a similar account on the Internet. This and other stories appeared the same day results of the CAPP2 trial (Burn et al., 2011) were report...

Practice Matters

Subcutaneous Administration of Bortezomib: Strategies to Reduce Injection Site Reactions

Sandra Kurtin, RN, MS, AOCN®, ANP-C, Carol S. Knop, RN, MS, AOCN®, and Todd Milliron, RN, SCN I

Bortezomib (Velcade), a reversible proteasome inhibitor, is approved by the US Food and Drug Administration (FDA) for intravenous (IV) or subcutaneous (SC) injection in patients with multiple myeloma or those with mantle cell lymphoma who have received at least one prior therapy (Millennium Pharm...

Tools and Technology

Random Periareolar Fine-Needle Aspiration: The New Pap Smear of the Breast?

Joanne Lester, PhD, CRNP, ANP-BC, AOCN®, and Lisa Diane Yee, MD

Women at increased risk of developing breast cancer rely on clinical examination, radiographic studies (e.g., mammogram, ultrasound, and MRI), biopsy, and genetic tests to predict their personal risk of breast cancer. Providers also use information such as family history of breast or ovarian canc...

Diagnostic Snapshot

Can You Determine the Cause of This Patient’s Vision Changes?

Patricia Palmer, RN, MS, AOCNS®, and Megan Nolan, RN, MS

History Mrs. G., a 56-year-old woman with a history of osteoporosis, migraine headaches, and active tobacco usage, was diagnosed with myelodysplasia in November 2009. In August 2010, she underwent related-donor allogeneic stem cell transplantation. Due to a suboptimal CD34 donor harvest, only whi...

Editorial

Advanced Practitioners Are Not Mid-Level Providers

Catherine S. Bishop, DNP, NP, AOCNP®

While I was completing my nurse practitioner program, I interviewed for a PRN position at a large private oncology practice. The oncologist with whom I spoke was aware that I was continuing my graduate nursing education; she spoke of how they might consider me for employment as an oncology nurse ...

Review Article

Fertility Issues of Breast Cancer Survivors

Hollis McClellan Misiewicz, MSN, CRNP

In the United States, more women are diagnosed with breast cancer than any other type of cancer. A woman in this country today has a 12% chance of developing breast cancer in her lifetime (National Cancer Institute, 2012). In 2011, more than 11,000 women under the age of 40 were diagnosed with br...

Grand Rounds

Response to Degarelix After Resistance to Leuprolide in a Patient With Metastatic Prostate Cancer

Mark Lazenby, PhD, AOCNP®

Androgen-deprivation therapy (ADT) is a common treatment for prostate cancer, as the androgen receptor (AR) plays a role in the development of this malignancy. Androgen-deprivation therapy agents can be classified as gonadotropin-releasing hormone (GnRH) agonists or GnRH antagonists. The most c...

Original Research

Predictors of Practice Patterns for Lymphedema Care Among Oncology Advanced Practice Nurses

Joanne C. Ryan, RN, MS, Charles M. Cleland, PhD, and Mei R. Fu, PhD, RN, ACNS-BC

Cancer-related lymphedema is a chronic, debilitating condition often resulting from surgical removal of tumor, lymphadenectomy, or radiation therapy. The incidence of cancer-related lymphedema ranges from less than 1% to 48% depending on the cancer location and treatment as well as the definition...

Original Research

Nurse Self-Evaluation of Assessment of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer

Constance Visovsky, PhD, RN, ACNP-BC, Marilyn Haas, PhD, ANP-BC, Beth Faiman, RN, MS, APRN-BC, AOCN®, Sandra Kurtin, RN, MS, AOCN®, ANP-C, Anne Marie Shaftic, MSN, RN, NP-C, AOCNP®, Elizabeth Lyden, MS, and Janique Rice, MS

In the year 2011, approximately 207,090 new cases of invasive breast cancer, 142,570 cases of colorectal cancer, and 20,180 cases of multiple myeloma were predicted to be diagnosed in the United States (American Cancer Society, 2010). Treatment of these cancers requires the use of chemotherapeuti...

Practice Matters

Tips for Transitioning to a New Electronic Health Record System

Jean Rosiak, NP

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 health record (EHR) systems,1 and the feeling of dread it br...

Prescriber's Corner

Axitinib: Newly Approved for Renal Cell Carcinoma

Timothy Tyler, PharmD, FCSHP

Data presented at the June 2012 American Society of Clinical Oncology (ASCO) annual meeting reaffirmed the use of axitinib (Inlyta), a potent and selective second-generation inhibitor of vascular endothelial growth factor receptors, for second-line treatment of metastatic renal cell carcinoma (mR...

Tools and Technology

Continuing Education Resources and Tools for the Advanced Practitioner

Wendy Vogel, MSN, FNP, AOCNP®

Clinical Care Options www.clinicaloptions.com Clinical Care Options provides free, interactive medical education programs for health-care professionals in areas such as oncology, transplantation, urology, HIV, and hepatitis. Educational opportunities translate the latest developments in science...

Diagnostic Snapshot

Can You Determine the Cause of This Patient’s Skin Changes?

Sandra Kurtin, RN, MS, AOCN®, ANP-C

History Mr. M. is an 80-year-old African American male with a long-standing history of low-back pain, urinary incontinence, and intermittent stool incontinence following external beam radiation for treatment of stage T1C prostate cancer. Additional medical history includes hypertension and diabet...

Editorial

Improvement Needed: Cancer Pain Management in 2012

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

In 32 years of practice, I have seen vast improvement in the treatment of patients with cancer. From the introduction of novel therapeutic treatments to the approval of innovative pain medications, our patients with cancer have benefited from the approval of new therapies. I eagerly anticipated n...

Review Article

Myeloid Toxicity of Cancer Treatment

Sandra Kurtin, RN, MS, AOCN®, ANP-C

Myelotoxicity is one of the most common treatment-related adverse events for patients receiving systemic antineoplastic therapy or radiotherapy to bone marrow–producing regions. Myeloid cytopenias—including neutropenia, thrombocytopenia, and anemia—are the most frequently seen manifestations of t...

Review Article

Guide to Interpreting Disease Responses in Chronic Myeloid Leukemia

Ilene Galinsky, RNP, and Susan Buchanan, PA-C

Chronic myeloid leukemia (CML) is characterized by the increased and unregulated proliferation of mature granulocytes (neutrophils, eosinophils, and basophils) and their precursors. Chronic myeloid leukemia is caused by the development of the Philadelphia chromosome (Ph), formed by the reciprocal...

Grand Rounds

Intraventricular Topotecan for the Treatment of Neoplastic Meningitis: Five Case Studies

Julie Walker, RN, FNP-C, AOCNP®, Diana Schultz, RN, MSN, ACNP, Kathleen Grisdale, RN, MSN, FNP-C, and Morris Groves, MD, JD

As patients experience longer survival times with chronic malignancies, the leptomeninges (arachnoid and pia mater) may increasingly play host to metastatic disease from a variety of primary cancers. This occurs in approximately 5% of cancer cases (Chamberlain, 2008); due to the inability of many...

Translating Research Into Practice

Vitamin D in the Prevention of Aromatase Inhibitor–Induced Musculoskeletal Symptoms: Is It Ready for Practice?

Jeannine Brant, PhD, APRN, AOCN®

Breast cancer is the most common malignancy in women. In 2012, approximately 226,870 new cases of breast cancer will be diagnosed in the United States (American Cancer Society, 2012). Depending on tumor characteristics and stage of disease, breast cancer treatment includes surgery, radiation ther...

Translating Research Into Practice

Cholecalciferol and Cancer: Is It a Big D3-eal?

Rita Wickham, PhD, RN, AOCN®

Although the associations between cholecalciferol (hereafter referred to as vitamin D) and health are only beginning to be deciphered, we have adequate understanding to apply some concepts to the care of individuals with cancer. Vitamin D, which is synthesized or ingested by every living organism...

Practice Matters

Bone Marrow Aspiration and Biopsy: A Guideline for Procedural Training and Competency Assessment

Katrina Jackson, RN, MSN, ANP-BC, CNP, Andrew Guinigundo, RN, MSN, ANP-BC, CNP, and David Waterhouse, MD, MPH

Nurse practitioners (NPs) have been providing comprehensive and complementary care for over 40 years. In the past 10 to 15 years, however, the role of the NP has expanded to include greater responsibilities and a more extensive scope of practice. The expanded role for NPs is primarily the result ...

Prescriber's Corner

Crizotinib: A Breakthrough for Targeted Therapies in Lung Cancer

Jennifer Kwon, PharmD, and ALISON MEAGHER, PharmD

Lung cancer is the leading cause of cancer-related mortality in the United States, with approximately 226,160 new cases of lung and bronchial cancer predicted to be diagnosed in 2012, along with approximately 160,340 deaths due to the disease (Siegel, Naishadham, & Jemal, 2012). Worldwide, ap...

Tools and Technology

Advanced Practitioners’ Favorite Books

Wendy Vogel, MSN, FNP, AOCNP®, and Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Read any good books lately? For many of us, a good read is one of the greatest pleasures in life. In the struggle of our busy, busy lives, it’s nice to sit down with a good book and enjoy a few moments of peace. For many, reading is a tool we have to refresh and educate ourselves. Here we’ve coll...

Diagnostic Snapshot

Can You Identify This Lesion Seen in a Patient With Melanoma?

Peg Esper, MSN, RN, ANP-BC, AOCN®

History As Mr. V., a 52-year-old male, was getting his hair cut, his barber noticed a dark bump in an area on the side of his scalp, where the hair was thinning. At Mr. V.’s next haircut, his barber indicated that the area was getting larger and that it looked like it had bled. Mr. V. made an app...

Editorial

Avoiding Plagiarism in Professional Writing

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Writing for publication is an excellent way to communicate your ideas and knowledge to other readers. Publishing in the Journal of the Advanced Practitioner in Oncology (JADPRO) offers potential authors a venue to convey information in a variety of ways, including case studies, review articles on...

Review Article

Dermatologic Toxicities in Epidermal Growth Factor Receptor and Multikinase Inhibitors

Beth Eaby-Sandy, MSN, CRNP, OCN®, Carolyn Grande, CRNP, AOCNP®, and Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Treatment of many types of tumors has evolved from chemotherapy to a more personalized approach, using strategies that can target receptors associated with the specific cancer cell. Over the past decade, numerous targeted agents have been approved for use by the US Food and Drug Administration (F...

Review Article

Interpreting Molecular Monitoring Results and International Standardization in Chronic Myeloid Leukemia

Stephanie Bauer, RN, MS, FNP-C, and Edie Romvari, RN, MS, FNP-C

Chronic myeloid leukemia (CML) affects 1 to 2 people per 100,000 annually, with an estimated 5,000 patients diagnosed in the United States each year (Altekruse et al., 2009). The underlying cause of CML is a translocation between chromosomes 9 and 22 that results in an abnormal chromosome known a...

Grand Rounds

Management of Refractory Metastatic Anal Squamous Cell Carcinoma Following Disease Progression on Traditional Chemoradiation Therapy

Ninoska N. Silva, MPAS, PA-C, and Cathy Eng, MD, FACP

Cancer of the anal canal is an uncommon malignancy comprising 2% of all gastrointestinal malignancies; most of these cancers are of the squamous cell histologic subtype (Jemal et al., 2008; Bilimoria et al., 2009; Horner et al., 2009). In most cases, patients present with localized disease that i...

Tools and Technology

Cancer Survivorship Websites and Resources

Denice Economou, RN, MN, CHPN, Marcia Grant, RN, DNSC, and Mary McCabe, RN, MA

As cancer treatment continues to improve and our strategies to prevent and detect new cancers develop, the number of survivors will continue to grow. As statistics show, these patients will number over 11 million by 2020 (National Cancer Institute [NCI], 2011). As the population of cancer survivo...

Translating Research Into Practice

Acupuncture for the Management of Chemotherapy-Induced Peripheral Neuropathy

Constance Visovsky, PhD, RN, APRN-BC

Review of “Evaluation of acupuncture in the management of chemotherapy-induced peripheral neuropathy,” by G. K. Donald, I. Tobin, and J. Stringer (2011). Acupuncture in Medicine, 29, 230–233. For a discussion of the potential threats to validity that exist in studies using a retrospective design,...

Translating Research Into Practice

Threats to Validity in Retrospective Studies

Cindy Tofthagen, PhD, ARNP, AOCNP®

The goal of most interventional studies is to establish a cause-and-effect relationship between the intervention and one or more outcomes. A retrospective study design utilizing existing clinical data is a relatively quick and inexpensive way to collect pilot data, which can be helpful in identif...

Prescriber's Corner

Brentuximab Vedotin in Hodgkin Lymphoma and Anaplastic Large Cell Lymphoma

Vivian Tsang, PharmD, BCOP

Lymphoma, a condition that is characterized by an abnormal growth of lymphocytes, can be classified into two main categories: Hodgkin lymphoma (HL) and non-Hodgkin lymphomas (NHL). Anaplastic large cell lymphoma (ALCL) is a subset of peripheral T-cell NHL. In general, HL responds well to conventi...

Practice Matters

Nutrition Screening and Counseling in Patients With Lung Cancer in an Outpatient Setting

Susan Snight Moreland, DNP, CRNP

Malnutrition is evident in 30% to 90% of patients with cancer at some point during their disease course (Molina, Yang, Cassivi, Schild, & Adjei, 2008; Nitenberg & Raynard, 2000; Read et al., 2005). Significant weight loss (> 10% of body weight) increases the risk of morbidity and morta...

Diagnostic Snapshot

Back Pain in a Patient With Lung Cancer

Lisa M. Doherty, NP

History Ms. P., a 62-year-old nonsmoker, was diagnosed with lung adenocarcinoma in April 2009. At the time of diagnosis, she underwent a left upper lobectomy for a moderately differentiated adenocarcinoma. Testing for epidermal growth factor receptor mutation revealed an exon 19 deletion, predict...

Editorial

Electronic Technologies: Can They Alter the Human Aspect of Medical Care?

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

The use of electronic health-care records (EHRs) and communication technologies has expanded considerably in the past 5 years. Electronic health-care records and computerized physician order entry have contributed to greater accuracy in care and reduced medical errors in the high-risk oncology se...

Review Article

Vaccination Recommendations for the Hematology and Oncology and Post–Stem Cell Transplant Populations

Vivian Tsang, PharmD, BCOP

Despite the implementation of appropriate vaccinations for a person with a healthy immune system, immunity is not always achieved. For example, some individuals never establish immunity after receiving a hepatitis B vaccine (HBV) series (Egea et al., 1991; Wood et al., 1993). Similarly, oncology ...

Grand Rounds

Pregnancy in a Patient With Cancer and Heart Failure: Challenges and Complexities

Anecita P. Fadol, PhD, RN, FNP-BC, FAANP; Tara Lech, PharmD; Courtney Bickford, PharmD; and Syed Wamique Yusuf, MBBS, FACC

The advent of newer treatment modalities has led to an increasing number of cancer survivors, and the number of women who have received cancer therapy with potential cardiotoxic side effects is growing rapidly. As these women contemplate pregnancy, history of prior cancer therapies is critical in...

Practice Matters

Oncology Drug Shortages in America

Wendy H. Vogel, MSN, FNP, AOCNP®, and Robert S. Ervin, PharmD

The issue of drug shortages is only one of the many crucial concerns facing oncology advanced practitioners (APs) in the United States today. However, it may be the most critical issue affecting short- and long-term patient outcomes. Short-term outcomes may be affected by treatment delays, treatm...

Translating Research Into Practice

A New Targeted Treatment for Lung Cancer Patients

Beth Eaby-Sandy, MSN, CRNP, OCN®

Review of “Anaplastic lymphoma kinase inhibition in non–small-cell lung cancer,” by Kwak et al. (2010), New England Journal of Medicine, 363(18), 1693–1703. For a discussion of waterfall plots, both in general and how they are used in the Kwak et al. article, see the related article by Theresa Gi...

Translating Research Into Practice

Understanding Waterfall Plots

Theresa W. Gillespie, PhD, MA, RN

Clinical trials in oncology continue to offer hope for tumor control. Such hope intensifies as the rapidly advancing knowledge from molecular biology, genetics, and immunology is more readily applied to targeted therapies. The ability to discern genomic or genetic risks and likelihood of response...

Prescriber's Corner

Vandetanib

J. Michael Vozniak, PharmD, BCOP, and Joanna M. Jacobs, PharmD

The incidence of thyroid cancer, the most common cancer of the endocrine system, has been steadily increasing since the mid-1990s (American Cancer Society [ACS], 2012). In 2012, it is estimated there will be approximately 56,460 new diagnoses of thyroid cancer (43,210 in women and 13,250 in men) ...

Tools and Technology

Peer Review: Publication’s Gold Standard

Kelley D. Mayden, MSN, FNP, AOCNP®

The dissemination of valuable and novel scientific information provides the pulse for biomedical publishing. Scientific journals catalog the contributions, thoughts, and opinions of researchers, investigators, and experts in the field. Authors consider the reputation and quality of a journal prio...

Diagnostic Snapshot

What is the Cause of This Patient’s Symptoms?

Mary Petrofsky, MS, ACNP-BC, and Laura Zitella, MS, RN, ACNP-BC, AOCN®

History Ms. C., a 53-year-old nonsmoking woman, presented with a productive cough, dyspnea, and orthopnea. She was sequentially treated with antibiotics, allergy medications, and steroids without symptom improvement. Chest x-ray revealed a widened mediastinum and right upper lobe (RUL) lesion. A ...

Editorial

The Role of the Physician Assistant in Oncology

Sarah Daniel, MS, PA-C

The dreaded phone call. It is a Friday afternoon, and I am sitting at my desk at the University of Arizona Cancer Center trying to decide the best way to deliver some very bad news to a lovely patient with resected pancreatic cancer. Mrs. X is a 60-year-old woman who took excellent physical care ...

Review Article

Neurotoxicity Associated With Cancer Therapy

Eva Lu Lee, MSN, RN, ANP-BC, and Laurel Westcarth, MSN, RN, ANP-BC

Cancer therapy uses a combination of treatment modalities such as surgery, radiation, and chemotherapy that may improve patient prognosis (Van Meir, Bellail, & Phyphanich, 2004; Butowski & Chang, 2005). However, combination therapy and extended survival are often associated with potential...

Review Article

Venous Thromboembolism in the Cancer Population: Pathology, Risk, and Prevention

Susan Hawbaker, MSN, APN, ANP-BC, OCN®

Patients with cancer have a two- to sixfold increase in the risk of developing venous thromboembolism (VTEs; Samama, Dahl, Quinlan, Mismetti, & Rosencher, 2003), and the incidence continues to increase with cancer-associated VTE representing nearly 20% of all cases (Heit et al., 2002). These ...

Review Article

Transition to a New Cancer Care Delivery System: Opportunity for Empowerment of the Role of the Advanced Practice Provider

Ruth McCorkle, PhD, FAAN, Constance Engelking, RN, MS, M. Tish Knobf, PhD, FAAN, AOCN®, Mark Lazenby, PhD, APRN, Marianne Davies, APRN, Rebecca Sipples, APRN, Ellyn Ercolano, Ms, and Catherine Lyons, RN, MS, NEA-BC

Recent major advances in diagnosis, treatment, and care delivery demonstrate the ever-evolving health-care system in the United States. This constant evolution places greater demands on staff members, altering their roles and requiring them to attain new competencies. This is especially true in c...

Practice Matters

The ASCO Study of Collaborative Practice Arrangements: A Physician Assistant’s Perspective

Alicia C. Ross, MPAS, PA-C

One in two men and women will be diagnosed with cancer of all types during their lifetimes, based on lifetime risk rates from 2005 through 2007; 1 in 6 men with prostate cancer, 1 in 8 women with breast cancer, 1 in 14 men and women with lung and bronchus cancer, and 1 in 20 men and women with co...

Practice Matters

The ASCO Study of Collaborative Practice Arrangements: A Nurse Practitioner’s Point of View

Hollie Devine, MSN, RN, ANP-BC, AOCNP®

As a veteran oncology nurse practitioner, the findings presented by Towle et al. (2011) in their article, “Results of the ASCO Study of Collaborative Practice Arrangements,” recently published in the Journal of Oncology Practice, were not astonishing to me. The purpose of their study was to addre...

Prescriber's Corner

Plerixafor

Susan Slater, MN, FNP-BC

Since the early 1980s, high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) has emerged as standard therapy for patients with hematologic malignancies, including non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). In 2009, 32,000 autologous transplants we...

Tools and Technology

Dietary Resource Information for the Oncology Patient: Tips and Tools

Lydia T. Madsen, MSN, RN, AOCNS®, and Sandra Cesario, PhD, RNC, FAAN

Oncology patients frequently request information about diet, exercise, and a healthy living approach during and after cancer treatment. Although a consultation with a registered dietitian is often the recommendation for patients in large multidisciplinary centers, a same-day consult may not alway...

Diagnostic Snapshot

Diagnostic Snapshot: Dyspnea in the Oncology Patient

Robin Sommers, DNP, ANP-BC, AOCNP®

History Ms. G.M. is a 79-year-old woman who was diagnosed with esophageal cancer in June 2008, at which time she underwent neoadjuvant chemoradiation. This was followed by a three-hole esophagectomy with a thorascopic right chest dissection in May 2009, with complete pathologic response. Unfortun...

Editorial

The ASCO Study of Collaborative Practice Arrangements: Defining the Role of the Nonphysician Practitioner in Oncology

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Confronted with an anticipated shortage of oncologists in the coming decade, the American Society of Clinical Oncology (ASCO) Workforce Advisory Group has proposed that the nonphysician practitioner (NPP) has a viable role in the provision of care to patients with cancer. The term NPP typically r...

Review Article

Cancer-Related Infections

Sylvia K. Wood, DNP, ANP-BC, and Judith K. Payne, PhD, RN, AOCN®

Globally, cancer is a leading cause of death, and it has the greatest impact in terms of premature death and disability worldwide (American Cancer Society [ACS], 2010). The ACS estimates 571,950 Americans are expected to die from cancer this year, and over 1.5 million new cases will be diagnosed ...

Review Article

Updates on the Understanding and Management of Chemotherapy-Induced Nausea and Vomiting

Beth Eaby-Sandy, MSN, CRNP, OCN®, and Victoria Sherry, MSN, CRNP, AOCNP®

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and widely investigated adverse events (AEs) associated with cancer treatment. Although CINV remains a significant problem for patients undergoing chemotherapy, there have been many advances in the treatment of CINV as well...

Grand Rounds

Pituitary Adenoma and Secondary Radiation-Induced Meningioma in an Adult Patient

Ronald R. Haggett, RN, MNSc, ACNP-BC, OCN®

Weighing in at 500 to 900 mg, the pituitary gland lies at the base of the skull within the sphenoid bone, bordered by the cavernous sinus and the optic chiasm (Figure 1). It is attached to the lower surface of the hypothalamus by the infundibular stalk and receives its blood supply via hypothalam...

Prescriber's Corner

Abiraterone Acetate in Castrate-Recurrent Prostate Cancer

John Perpich, PharmD, and Bradley J. Atkinson, PharmD

Prostate cancer is the most common cancer in men. It is estimated that 240,890 men will be diagnosed with prostate cancer and another 33,720 men will die from the disease in the United States in 2011 (Siegel, Ward, Brawley, & Jemal, 2011). Testosterone is the primary hormonal driver of prosta...

Practice Matters

Surviving the Titanic

Wendy J. Smith, ACNP, AOCN®

To say that we live in tumultuous times is definitely an understatement. Our nation’s debt crisis, instability in the stock market, unemployment, white collar scandals—it is all overwhelming. Who do you believe? Who do you trust? How do you sort fact from fiction? In addition to these uncertainti...

Translating Research Into Practice

Fentanyl Nasal Spray: A New Option for Breakthrough Cancer Pain

Joan Schey, RPh

Fentanyl nasal spray (Lazanda) was recently approved for breakthrough cancer pain (BTCP) in patients 18 years and older who are already receiving and are tolerant to opioid therapy for their underlying persistent cancer pain. Breakthrough cancer pain is defined as a transitory exacerbation of pai...

Translating Research Into Practice

Drug Approval: The Long and Bumpy Road to Market

Jeannine Brant, PhD, APRN, AOCN®

Novel pharmacologic agents for symptom management continue to emerge and provide options to improve quality of life in patients with cancer; however, bringing novel pharmacologic agents to the bedside can be a lengthy and arduous process. Once a new agent is available, many questions often arise....

Tools and Technology

Internet Oncology: Cure Seekers Beware!

Wendy H. Vogel, MSN, FNP, AOCNP®

When faced with the fear of death, either your own or that of a loved one, what would you do? How desperately would you seek a cure? Would you be tempted to try one of the many unproven therapies promising a cancer cure? We are educated health-care professionals, yet how many of us have tried the...

Diagnostic Snapshot

Diagnostic Snapshot: Can You Identify This Skin Rash?

Carolyn Grande, CRNP, AOCNP®

History Mrs. L., a 72-year-old non–English-speaking woman, was diagnosed with papillary thyroid cancer in 1995, at which time she underwent a total thyroidectomy. Unfortunately, her disease trajectory was riddled with multiple recurrences from April 2007 through January 2011. She developed metast...

Editorial

Prevention of Cancer? The Vitamin D Controversy

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Although I live in sunny central California, I was very surprised when my vitamin D level recently revealed I was “deficient.” After 12 weeks of supplementation with 50,000 units weekly of oral vitamin D my levels have normalized, but I continue to take daily supplements of this important vitamin...

Review Article

Gastrointestinal and Hepatobiliary Toxicities of Cancer Treatments

Margot Sweed, CRNP, ANP, BC

The combined modalities of oncologic treatment can impact multiple body systems. Chemotherapy, radiotherapy, and targeted therapies all present challenges to the balance of efficacy and toxicity. Individuals undergoing cancer treatments demonstrate these effects of treatment both at the initiatio...

Review Article

Screening HIV-Infected Men for Anal Dysplasia and Cancer: Are Practice Guidelines Needed?

Lacey L. Siekas, DNP, ARNP

Anal dysplasia is the presence of premalignant changes in cells of the anal canal extending from the transitional zone of the squamocolumnar junction between the rectum and the anus as well as perianal tissue. Dysplastic cellular changes are triggered by persistent infection with high-risk strain...

Review Article

Inflammatory Breast Cancer: Breast Cancer Without a Lump

Pamela Alizadeh, RN, OncNP, MS, AOCN®, CBCN®

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer. It accounts for 2% to 6% of all breast cancers and was once considered to be uniformly fatal with a 5-year survival rate of less than 5% (Woodward & Cristofanilli, 2009). With advances in radiation therapy, chemo...

Prescriber's Corner

Ipilimumab

Sarah Bertone, PharmD, and Kathy Diener Dasse, PharmD, BCOP

Althtough it is responsible for only 5% of all skin cancers (both benign and malignant), melanoma accounts for the majority of skin- cancer–related deaths in the United States. The incidence of melanoma has been increasing over the past 3 decades. In 2011, approximately 70,230 new cases of melano...

Tools and Technology

The Doctor of Nursing Practice Degree: A Practical Resource

Lydia T. Madsen, MSN, RN, AOCNS®

In October 2004, the American Association of Colleges of Nursing (AACN) approved a recommendation for the adoption of the Doctor of Nursing Practice (DNP) as the appropriate level of education for advanced practice in nursing (Brown-Benedict, 2008). The target date for implementation of the DNP a...

Translating Research Into Practice

How Is Your Pain…Management? Going Beyond the Fifth Vital Sign

Terri S. Armstrong, PhD, ANP-BC, FAANP

Review of “Initial psychometric properties of the Pain Care Quality survey (PainCQ)” by Beck et al. (2010), Journal of Pain, 11(12), 1311–1319. For a discussion of reliability and validity—what these terms mean and why they’re important—please see the related article by Terri S. Armstrong and Ibr...

Translating Research Into Practice

Reliability and Validity: What’s the Difference and Why Does it Matter?

Terri S. Armstrong, PhD, ANP-BC, FAANP, and Ibrahima Gning, DDS, DrPH, MPH

There has been increasing use of and support for patient-reported out-come (PRO) instruments to assess the impact of care on the patient (Brandrud et al., 2011; Cleeland & Sloan, 2010; US Department of Health and Human Services [HHS], 2006; Turk et al., 2006). The integrity of our analysis o...

Editorial

Drug Shortages: What Can Be Done? 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

It is estimated that a total of 1,596,670 new cancer cases will occur in the United States in 2011 (Siegel et al., 2011). New treatment regimens and new oncology drugs have contributed to longer survival and better outcomes for specific tumor types. But what happens when oncology agents are just ...

Review Article

Cardiovascular Adverse Events Associated With Cancer Therapy

Anecita Fadol, PhD, RN, FNP-BC, FAANP, and Tara Lech, PharmD, BCPS

Advances in technology and the development of novel cancer therapies have resulted in increased successful outcomes, with more than 11 million cancer survivors in the United States today (Altekruse, 2009). However, increased survivorship does not come without a price. The increasing use of more c...

Review Article

Nutritional Management in Adult Hematopoietic Stem Cell Transplant

Heather Kasberg, RN, MSN, OCN®, and Autumn Diligente, MS, RD, LD

Malnutrition, which is seen in anywhere from 20% to 80% of oncology patients, has been associated with reduced response to treatment, survival, and quality of life (Kubrak & Jensen, 2007). Hematopoietic stem cell transplant (HSCT) patients are at risk for and vulnerable to malnutrition. Advan...

Grand Rounds

Hereditary Breast and Ovarian Cancer Syndrome 

Nicoletta Campagna, RN, MSN, DNP, APRN-BC, AOCNP®

With the discovery of BRCA1 and BRCA2, a new area of cancer genetics emerged. As knowledge of cancer genetics has increased, so has awareness of cancer genetics among health-care providers and the general public. Advanced practitioners can be instrumental in identifying patients, informing patien...

Practice Matters

Management of Hepatocellular Carcinoma: The Role of the Advanced Practitioner in a Multidisciplinary Approach

Patrick M. Horne, MSN, ARNP, FNP-BC, and Roniel Cabrera, MD, MS

Hepatocellular carcinoma (HCC) represents a major global health challenge, as an increasing number of cases make it one of the most rapidly rising cancers. It is the fifth most common cancer in the world and the third leading cause of cancer-related death. There are over 600,000 new cases diagnos...

Translating Research Into Practice

Overview of the AVADO and RIBBON-1 Clinical Trials 

Georgia Litsas, MSN, ANP-BC, AOCNP®

Breast cancer is the most common female cancer and the second most common cause of female cancer-related death in the United States. Despite advances in the treatment of early-stage breast cancer, approximately one-third of patients will eventually develop metastatic breast cancer (MBC). It is a ...

Translating Research Into Practice

Throwing the Brake on the Drug Approval Train 

Peg Esper, MSN, RN, ANP-BC, AOCN®

One of the most meaningful developments in oncology, and health care in general, has been the move to evidence-based practice. Most would likely indicate that if they or their loved ones were ill, they would want to have the treatment that has been proven to be the most effective in achieving a p...

Prescriber's Corner

Denosumab vs. Denosumab: One Drug, Two Products, and Two Different Indications

Vivian Tsang, PharmD, BCOP, and Jennifer Kwon, PharmD

Skeletal integrity in a healthy individual requires a balance between bone formation and bone resorption. In normal bone formation, a balance exists between osteoblastic (bone formation) and osteoclastic (bone resorption) activities. When bone remodeling is disrupted by tumor cells, a significant...

Tools and Technology

The Cancer Legal Resource Center: A Tool for Oncology Professionals 

Anya Prince, Esq, MPP

A cancer diagnosis raises a myriad of medical questions for a patient. Patients and health-care professionals work together to address these medical questions and treatment decisions. However, in addition to the medical decisions, cancer also raises many other considerations and concerns. These c...

Editorial

Reevaluating Bevacizumab: The Role of VEGF Inhibitors in Metastatic Breast Cancer 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Breast cancer remains a formidable disease. This tumor is the second most frequently occurring cancer in the world and the most commonly seen tumor type in women. Metastatic breast cancer (MBC) caused approximately 46,000 deaths in the United States for the year 2010 (Jemal, Siegel, Xu, & War...

Review Article

Pancreatic Cancer 

Sarah Daniel, MS, PA-C, and Sandra Kurtin, RN, MS, AOCN®, ANP-C

Pancreatic cancer remains one of the most feared cancer diagnoses due to the poor prognosis associated with the majority of cases. The incidence of pancreatic cancer is similar in men (21,370) and women (21,770), with a total of 43,140 new cases of pancreatic cancer reported in the United States ...

Review Article

Biomarkers in Non-Small Cell Lung Cancer: Opportunity and Challenge 

Kristen Kreamer, CRNP, Beth Eaby-Sandy, CRNP, Victoria Sherry, CRNP,  and Susan Stonehouse-Lee, CRNP

According to the American Cancer Society's recently published global cancer statistics for 2008 (ACS, 2010), lung cancer was the most commonly diagnosed cancer and the leading cause of cancer death for males, and the fourth most commonly diagnosed cancer and second leading cause of cancer death f...

Grand Rounds

Carboplatin Hypersensitivity in Recurrent Ovarian Cancer 

Paula J. Anastasia, RN, MN, AOCN®

W omen with newly diagnosed with ovarian cancer (and fallopian tube and primary peritoneal) are commonly treated with combination chemotherapy consisting of IV carboplatin and a taxane. Patients who are platinum-sensitive (disease-free interval of greater than 6 months) have a longer survival adv...

Practice Matters

Ionizing Radiation and Medical Imaging: What Midlevel Providers Need to Know 

Marcia Patterson, MSN, RN, NP-C

In 1972, I had a bicycle accident that resulted in a head injury, loss of consciousness, and concussion. An emergency room physician evaluated me, sutured the laceration, and sent me home with instructions for my mother to watch me carefully for the next 72 hours. In a present day emergency cente...

Prescriber's Corner

Cabazitaxel 

Christopher Campen, PharmD, BCPS, and Emad Elquza, MD

Prostate cancer is the most common cancer in men and the second most common cause of cancer-related death in men (Jemal, Siegel, Xu, & Ward, 2010). Patients with advanced prostate cancer often derive significant benefit from androgen deprivation (chemical castration) in terms of survival and ...

Translating Research Into Practice

Adding Early Palliative Care to  Treatment of Non–Small Cell  Lung Cancer 

Kathleen N. Clifford, RN, MSN, FNP-BC, AOCNP®

Review of "Early palliative care for patients with metastatic non–small-cell lung cancer," by Temel et al. (2010), The New England Journal of Medicine, 363(8), 733–742. For a discussion of the article and how it relates to the concepts of scientific rigor, complexity science, and positive devianc...

Translating Research Into Practice

The Temel Paper on Palliative Care: When Scientific Rigor Is Not Enough 

Jeannine M. Brant, PhD, APRN, AOCN®, and Elizabeth L. Ciemins, PhD, MPH, MA

On August 19, 2010, The New England Journal of Medicine (NEJM) released the Temel et al. early palliative care study (Temel et al., 2010). The news spread like wildfire across the United States. Headlines such as, "Earlier Palliative Care Extends Life," were promptly featured in The New York Time...

Tools and Technology

Scholarly Writing: Your Professional Legacy 

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

As humans, we all want to leave our mark on this earth. In our professional lives, the same is true. What inheritance are you leaving those who will come after you? What part of your collective wisdom and knowledge are you sharing with the young people in your profession? One way to mentor many i...

Meeting Report

2011 National Comprehensive Cancer Network (NCCN) Nursing Program: Role of the Advanced Practice Nurse in Quality Cancer Care™

Journal of the Advanced Practitioner in Oncology

Improving Survivorship Care Some 13 million cancer survivors may not be receiving the type of follow-up care that addresses their long-term needs, according to Mary Ann Morgan, PhD, FNP-C, of H. Lee Moffitt Cancer Center and Research Institute in Tampa. In their 2006 report, From Cancer Patient t...

Editorial

The True Value of Mentorship 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

As I write this editorial, some very sad news has crossed my desk. Rose Mary Carroll-Johnson, MN, RN, passed away of cancer on February 21, 2011. Rose Mary was the editor-in-chief of the Oncology Nursing Forum for 20 years and guided that publication to the current standard of nursing publishing ...

Review Article

Predictive Genetic Testing: Can Specialized Advanced Practitioners Quell Consumer Confusion? 

Maureen Swiderski, APN, AOCNS®, CHPN 

The basics of our understanding of cancer are changing daily. Our knowledge base about the genetic and molecular components of cancer is continuously evolving, as are the ways in which we screen for, diagnose, and treat cancer. Genetic testing for cancer susceptibility is one field that is growin...

Review Article

Radical Prostatectomy for the Treatment of Moderate to Severe Lower Urinary Tract Symptoms in Organ-Confined Prostate Cancer 

Lydia T. Madsen, MSN, RN, AOCNS®, and Geri Lobiondo-Wood, PhD, RN, FAAN 

In the United States, prostate cancer is the most commonly diagnosed solid tumor and the second leading cause of cancer death in men (Jemal, Siegel, Xu, & Ward, 2010). The dilemma for most men diagnosed with organ-confined, clinically localized prostate cancer is that several treatment option...

Review Article

Biomarkers in Breast Cancer 

Catherine S. Bishop, DNP, NP, AOCNP®

An estimated 207,090 new cases of invasive breast cancer are estimated to have occurred in women in the United States during 2010 (American Cancer Society [ACS], 2010). Unfortunately, approximately 39,840 women in the United States are estimated to have died from breast cancer in 2010. From 1999 ...

Grand Rounds

Thrombocytopenia, Deep-Vein Thrombosis, and Pulmonary Emboli in a Patient With Primary CNS Lymphoma

Patricia Palmer, RN, MS, AOCNS®

Primary central nervous system lymphoma is an aggressive extranodal NHL that may arise from within the brain parenchyma (90%), spinal cord, eyes, or leptomeninges in the absence of systemic involvement (Abrey, DeAngelis, & Yahalom, 1998; Zhu et al., 2009; DeAngelis & Iwamoto, 2006). Unlik...

Practice Matters

An Early Postoperative Intraperitoneal Chemotherapy Policy for Patients With Colorectal Cancer

Irina Rifkind, RN, BSN, Sharon Lafever, MS, RN, AOCN®, Robin Cianos, RN, OCN®, and Terry Sparhawk, RN, OCN®

The role of the clinical nurse specialist (CNS) is complex, multifaceted, and not well understood. Dimensions of the role include expert practitioner, researcher, clinical educator, coach, role model, patient advocate, consultant, resource person, supervisor, liaison, and innovator (Hamric, Spros...

Prescriber's Corner

Eribulin Mesylate: Unique Advancement in Metastatic Breast Cancer 

Kelley D. Mayden, MSN, FNP, AOCNP®

Breast cancer is the most common malignant disease among women in the United States, with 209,060 new cases estimated in 2010. Although 40,230 deaths were predicted to occur in 2010 overall, thanks to early detection and advancing treatments, there has been a decline in breast cancer mortality (A...

Tools and Technology

Advanced Practitioners’ Favorite Websites

Jill M. Gore, MPAS, PA-C, Shannon Iakiri, RN, MSN, OCN®, FNP, Kelley D. Mayden, MSN, FNP, AOCNP®, Linda Penwarden, MN, RN, AOCN®, Shirley Triest-Robertson, PhD, APNP, ACHPN, AOCNS®, and Laura Zitella, RN, MS, NP, AOCN®

Medical Information Medscape; www.medscape.com Medscape is a health professional network that is part of WebMD. It contains original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, continuing education, and m...

Editorial

Patients With Pancreatic Cancer Need New Treatment Approaches 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Attending selected medical and nursing conferences is part of keeping up to date with changes in clinical practice. One of my favorite meetings to attend is the National Comprehensive Cancer Network (NCCN) annual conference, which includes updates to various NCCN Clinical Practice Guidelines and ...

Review Article

The Pathogenesis of Multiple Myeloma: Understanding the Mechanisms of the Bone Marrow Microenvironment 

Angela M. Falco, RN, MS/MPH, ANP-C, Lisa C. Smith, MSN, FNP, AOCN®, and  Ellen Sullivan, OCN®, MNSC, APN, ACNP-BC

Multiple myeloma (MM) is a mature B-cell malignancy that results in the clonal expansion of neoplastic plasma cells (Huff & Matsui, 2008). It is characterized by an overproduction of monoclonal proteins (M proteins), the formation of lytic lesions, and an accumulation of malignant plasma cell...

Grand Rounds

Medication Self-Management: Important Concepts for Advanced Practitioners in Oncology 

Beth Faiman, RN, MS, APRN, BC, AOCN®

Medication self-management (SM) is an emerging concept in oncology as more medications with improved efficacy are available in oral formulations that patients can administer at home. Successful home self-management of medications related to cancer treatment requires that the patient be responsib...

Review Article

Biomarkers in Prostate Cancer 

Ingrid Bowser, MS, APRN-BC, AOCNP®, ADM-BC, and  Kristan Rheinheimer, MSN, FNP-BC, AOCNP®

Prostate cancer is the most common malignancy among all races of men and the second leading cause of cancer-specific death in men in the United States (Centers for Disease Control [CDC], 2006). It is estimated that one in six men will be diagnosed with prostate cancer in his lifetime (United Stat...

Tools and Technology

Gefitinib for Advanced NSCLC Patients With EGFR Mutation 

Karen J. Oishi, MSN, APRN, ANP-BC, GNP-BC, OCN®

Review of “Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR,” by Maemondo et al. (2010). The New England Journal of Medicine, 362(25), 2380–2388. For a discussion of understanding outcomes assessment, please see the related article by Dr. Terri Armstrong. Lung cancer co...

Tools and Technology

The Maemondo Paper: Understanding Outcomes Assessment in Clinical Trials 

Terri S. Armstrong, PhD, ANP-BC, FAANP

The goal of any clinical research evaluating a new cancer therapy is to determine if the treatment provides clinically meaningful benefit and is safe (Fleming, 2006). A randomized controlled clinical trial is the primary vehicle used in oncology to compare a novel treatment to an established stan...

Practice Matters

REMS: Application for the Advanced Practitioner in Oncology

Wendy H. Vogel, MSN, FNP, AOCNP®, and Marilyn Haas, PhD, ANP-C

The Federal Food, Drug, and Cosmetic Act, passed by the United States Congress in 1939, requires a drug’s sponsors to provide evidence of the drug’s safety prior to marketing approval (Baker, 2009). Since that time, the US Food and Drug Administration (FDA) has been the primary regulatory body th...

Tools and Technology

Online Calculators: Prognosis for Non-Hodgkin and Hodgkin Lymphoma 

Laura Zitella, RN, MS, NP, AOCN®

Lymphomas are a heterogenous group of lymphoid malignancies with varied patterns of clinical behavior, response to treatment, and prognosis (National Comprehensive Cancer Network [NCCN], 2010). A main goal of therapy is to achieve the best possible response with minimum toxicity. Identifying pati...

Editorial

Rectal Cancer Incidence: Trends in Younger Patients 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

The American Cancer Society (ACS) recently published its statistics for new cancer cases and deaths expected in the United States for 2010 (Jemal, Siegel, Xu, & Ward, 2010). This year, a total of 1,529,560 new cases of cancer are anticipated, with approximately 569,490 deaths from the disease...

Review Article

Translating Evidence-Based Research into Practice 

Robin M. Sommers, DNP, ANP-BC, AOCNP®

Complex medical care systems, rising patient acuity, and the explosion of technical innovations have led to an ever-increasing demand for the delivery of safe, quality health care by the U.S. government and consumers. Integrating evidence into clinical decision-making can contribute to better qua...

Review Article

Biomarkers in Colorectal Cancer: Implications for Nursing Practice 

Carolyn Grande, CRNP, AOCNP®, Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, and Deanna Yamamoto, RN, MS, CS, AOCNP®

Over the past several years, new cases of colorectal cancer (CRC) have decreased in the United States from an estimated 150,000 in 2008 to 143,000 in 2010 (Jemal, Siegel, Xu, & Ward, 2010). In part, this decline can be directly attributed to early screening tests and the removal of colon poly...

Grand Rounds

Collaborative Approach to Managing a 59-Year-Old Woman With Stage IIB Pancreatic Cancer and Diabetes 

Michelle Bratton, RD, CSO, and Sandra E. Kurtin, RN, MS, AOCN®, ANP

The number of individuals with both cancer and diabetes is increasing as the population ages. Each of these diseases presents challenges to the patient and to the clinical team, including the advanced practitioner in oncology. The American Diabetes Association and the American Cancer Society rece...

Practice Matters

Cancer Survivorship: Developing Clinical Practice Guidelines 

Marcia Patterson, MSN, RN, NP-C

Cancer survivorship is a growing specialty, aimed at addressing the needs of more than 11 million adult cancer survivors in the United States today (American Cancer Society, 2010). This number is projected to rise as cancer is diagnosed and treated at earlier stages, and as more effective treatme...

Prescriber's Corner

Sipuleucel-T: A New Advance in the Treatment of Castrate-Resistant Prostate Cancer 

Robert Ignoffo, PharmD, FASHP, FCSHP

Prostate cancer ranks as the second most common malignancy in men with approximately 217,700 new cases in 2010 (Jemal, Siegel, Xu, & Ward, 2010). Although early-stage prostate cancer has a good prognosis and long survival, about 20%–30% of cases recur with advanced disease. Although androgen ...

Clinical Snapshot

Chemotherapy-Induced Neuropathic Pain 

Michelle C. Abramowski, RN, BSN, MSN, CRNP, APRN-BC

Download the Clinical Snapshot that accompanies this article. The advancement of chemotherapy has prolonged survival for many cancer patients. However, treatment with chemotherapeutic agents has left cancer survivors with many long-term sequelae and new and challenging problems, such as pain, sen...

Translating Research Into Practice

A New Immunotherapy for Melanoma? 

Peg Esper, MSN, MSA, RN, APN-BC, AOCN®

Review of: “Improved survival with ipilimumab in patients with metastatic melanoma,” by Hodi et al. (2010). The New England Journal of tabMedicine, 363(8), 711–723. doi:10.1056/NEJMoa1003466. For a researcher's view of this paper, please see the article by Friese on page 287. For over a decade, ...

Translating Research Into Practice

The Hodi Paper: A Researcher’s View 

Christopher R. Friese, RN, PhD, AOCN®

Review of “Improved survival with ipilimumab in patients with metastatic melanoma,” by Hodi et al. (2010). The New England Journal of Medicine, 363(8), 711–723. doi:10.1056/NEJMoa1003466. The data reported by Hodi et al. (2010) present a bright spot for patients with unresectable stage III and I...

Tools and Technology

Streamlining Needs for Everyday Practice: Three Websites That Make Your Life Easier 

Heather Greene, MSN, FNP, AOCNP®

As an oncology nurse practitioner (NP) in community practice, I spend the majority of my day seeing patients—or at least that’s what you would think. Realistically, in today’s healthcare setting, all of the paperwork, prior authorizations, non–formulary exceptions, pre–certifications, and letters...

Editorial

Adherence to Cancer Therapies: Are Your Patients Taking Their Prescriptions as Ordered? 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Patients receiving prescription medications for chronic medical conditions are not always adherent to their treatment protocols. In a recent study by Yeaw, Benner, Walt, Sian, and Smith (2009), the adherence pattern for a sample of six chronic therapies revealed variable but persistent suboptimal...

Review Article

Adherence to Oral Therapies for Cancer: Barriers and Models for Change 

Susan Moore, RN, MSN, ANP, AOCN®

Oral chemotherapy and hormonal therapies have been available for decades and include many familiar agents such as cyclophosphamide, melphalan, and tamoxifen. The past decade has witnessed an expansion of oral anticancer drugs, including cytotoxic agents, small-molecule inhibitors, and agents targ...

Grand Rounds

A Case Study Approach to Chronic Myelogenous Leukemia  

Amy Goodrich, MSN, CRNP-AC

The treatment options and prognosis for patients with newly diagnosed chronic myelogenous leukemia (CML) have improved dramatically in the past decade. From 1990 through 1992, patients in the United States with newly diagnosed CML had a 1 in 4 chance of being alive in 5 years (Jemal, Seigel, Ward...

Review Article

Laboratory Measures for the Diagnosis, Clinical Management, and Evaluation of Treatment Response in Multiple Myeloma 

Sandra E. Kurtin, RN, MS, AOCN®, ANP

Multiple myeloma (MM) is a plasma cell neoplasm characterized by malignant transformation and clonal expansion of mature plasma cells resulting in an overproduction of plasma cell proteins (immunoglobulins). Risk factors for the disease are poorly understood, but there is a higher incidence in ol...

Grand Rounds

Collaborative Approach to Managing a 47-Year-Old Male with Stage IIB Rectosigmoid Colon Cancer and New Onset of Diabetes

Betsy Dokken, PhD, RN, ANP, and Sandra E. Kurtin, RN, MS, AOCN®, ANP

Diabetes and cancer continue to present challenges to industrialized nations as the incidence of both diseases increases globally. An estimated 1.5 million new cancer cases and 1.6 million new diabetes diagnoses are expected in 2010 in the United States (Jemal, Siegel, Xu, & Ward, 2010; CDC, ...

Prescriber's Corner

Methadone 

Jeannine M. Brant, PhD, APRN, AOCN®,  Caroline Deigert, BS, MPAS, PA-C, and Doreen Guay, BS, MPAS, PA-C

Pain is a common problem in patients with cancer, and advanced practitioners in oncology are frontline managers of cancer-related pain and other deleterious symptoms. Opioids are the mainstay of cancer pain treatment, and methadone is one opioid analgesic available for management of this symptom....

Clinical Snapshot

Management of Constipation in Patients with Cancer 

Susan Bohnenkamp, RN, MS, ACNS-BC, CCM, and  Virginia T. LeBaron, MS, ACNP-BC, AOCN®, ACHPM

Download the Clinical Snapshot that accompanies this article. While certainly not the most glamorous of symptoms, constipation can have a devastating impact on a patient’s quality of life. In fact, constipation can rival, or exceed, pain as a source of distress for patients and families (Sykes, 2...

Translating Research Into Practice

Development and Use of Clinical Practice Guidelines 

Jeannine M. Brant, PhD, APRN, AOCN®

Clinical practtice guidelines are systematically developed recommendations that target specific areas of clinical practice in which sufficient evidence does not always exist. The purpose of clinical practice guidelines are many: (a) to appraise existing evidence in a specific clinical practice ar...

Tools and Technology

Mobile Applications for the Oncology Advanced Practitioner 

Wendy H. Vogel, MSN, FNP, AOCNP®

Smartphone, personal digital assistant (PDA), Blackberry, iPhone, Android,…and the list goes on! Is it a fruit, an alien, a phone, or a computer? And how can any of them assist the oncology advanced practitioner (AP) in his or her clinical tasks? Smartphones such as the Blackberry, the iPhone, an...

Editorial

Putting Statistics into Play 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Statistical analysis can be intimidating to clinicians who work with patients with cancer. My initial introduction to statistics as an undergraduate was not particularly helpful for the evaluation of clinical research as a nurse. Like many professors, my statistics instructor based the curriculum...

Review Article

Epidermal Growth Factor Receptor Inhibitors and Radiation Therapy in Head and Neck Cancer: Potential Management Strategies for Skin Reactions

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, Marilyn L. Haas, PhD, ANP-C, and Mario E. Lacouture, MD

Epidermal growth factor receptor inhibiting (EGFRI) agents have played an important role in ushering in the era of targeted therapy. These agents focus on the epidermal growth factor receptor (EGFR), which is overexpressed in many epithelial tumors, including those of the lungs, kidneys, colon, a...

Review Article

Roles of the Clinical Nurse Specialist and Nurse Practitioner in Survivorship Care 

Denice Economou, RN, MN, AOCN®, Amy Edgington, RN, NP-BC, and  Amy Deutsch, DNP(c), RN, CNS, OCN®

Survivorship care is defined by the Institute of Medicine (IOM) in the report, From Cancer Patient to Cancer Survivor: Lost in Transition (Hewitt, Greenfield, & Stovall, 2006), which describes a survivor as someone who has been diagnosed with cancer and covers the time from diagnosis to death...

Review Article

Biomarkers in Ovarian Cancer Screening 

Paula Anastasia, RN, MN, AOCN

Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women, with an estimated 15,520 dying of the disease in 2010 (American Cancer Society [ACS], 2010). There are no effective early-detection modalities, and the majority of women with ovarian cancer will be diagnosed in l...

Grand Rounds

Identifying and Treating Insomnia in the Adult Cancer Patient 

Deanna Sanchez Yamamoto, RN, MS, CS, AOCNP®

Insomnia is commonly associated with a diagnosis of cancer. One third to three quarters of cancer patients will experience sleep disturbance during their illness (Page, Berger, & Johnson, 2006). Advanced practitioners in the oncology field need to have the knowledge and skill required to addr...

Translating Research Into Practice

Translating Research Into Practice: Overview of Principles 

Terri S. Armstrong, RN, PhD, ANP-BC, Jeannine M. Brant, PhD, APRN, AOCN®, and  Peg Esper, MSN, RN, APRN-BC, AOCN®

The outcome of any serious research can only be to make two questions grow where only one grew before. —Thorstein Veblen As advanced practitioners in oncology, we are dedicated to using current best practice. Innovations in the prevention, diagnosis, and treatment of cancer, and the management ...

Practice Matters

Development of a Rapid Response Team in an Outpatient Free-Standing National Cancer Institute–Designated Comprehensive Cancer Center 

Kim Blumenfeld, RN, BS, CCRN, Iris Delfakis, RN, BSN, OCN®,  Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, Patricia Stumbo, RN, OCN®, MBA,  Kirsten Jonasson, RN, Margaret Miller, MD, Daniel Butcher, PharmD,  Anna Glennie, RN, MSN, FNP, and Agnes Sharifi, RN, MSN, FN

Improved symptom management strategies and transfusion services have shifted the bulk of cancer treatment to the outpatient setting. Many outpatient oncology centers provide high-acuity services on a daily basis to reduce the need for hospitalization and to improve continuity of care. Most outpat...

Prescriber's Corner

Ofatumumab 

Christopher Campen, PharmD, BCPS 

Ofatumumab (Arzerra) is a fully human monoclonal antibody targeting CD20. In October 2009, ofatumumab was approved as monotherapy for the management of chronic lymphocytic leukemia (CLL). Pharmacology Ofatumumab is an anti-CD20 monoclonal antibody with distinct properties that make it a potential...

Clinical Snapshot

Management of Chemotherapy-Induced Oral Mucositis 

Pamela Gebhardt, RN, MS, OCN®

Download the Clinical Snapshot to take with you. Oral mucositis (OM) continues to be a debilitating and significant problem resulting from cytotoxic chemotherapy and head/neck radiotherapy. This inflammatory process can cause severe discomfort and functional impairment (Brown, 2010). The extent a...

Tools and Technology

APA 6th Edition Update 

Susan Moore, RN, MSN, ANP, AOCN®

The American Psychological Association (APA) style guide for scientific papers, reference lists, tables, and figures is the preferred format for the social, behavioral, and nursing sciences. The APA manual provides guidance on all aspects of the writing process, including planning the manuscript,...

Meeting Report

Reports from the 2010 ASCO Annual Meeting

Terri S. Armstrong, PhD, ANP-BC, FAANP, Paula Anastasia, RN, MN, AOCN®, Carolyn Grande, CRNP, AOCNP®, Kristen Kreamer, CRNP, MSN, AOCN®, APRN, BC, Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, and Wendy H. Vogel, MSN, FNP, AOCNP®

The 2010 Annual Meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago, IL, from June 4–8, 2010. Results from this meeting have been published in many outlets, and the major results have been made readily available. In this section, members of the JAdPrO Editorial Board h...

Editorial

A Journal Whose Time Has Come 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Advanced practice has been part of my career path for 24 years. As the first oncology clinical nurse specialist (CNS) and first oncology nurse practitioner (NP) to work at my academic teaching hospital in the 1980s, I often struggled to find information in the literature specific to my needs as a...

Editorial

Advanced Practitioners in Oncology: Meeting the Challenges 

Wendy H. Vogel, MSN, FNP, AOCNP®

In the year 2020, it is estimated that office waiting rooms will overflow by 9.5 to 15 million oncology patient visits, and there may be no practitioner available to see them (Erikson, Salsberg, Forte, Bruinooge, & Goldstein, 2007). While this may feel like job security for current health car...

Review Article

Risk Analysis in the Treatment  of Hematologic Malignancies in the Elderly 

Sandra Kurtin, RN, MS, AOCN®, ANP-C

Advanced age is a leading risk factor for developing cancer. Older adults (> 65 years) are expected to exceed 20% of the overall U.S. population by the year 2030 (Jemal et al., 2009). Approximately 60% of all new cancer diagnoses are attributed to older adults, with this number expected to rea...

Review Article

Clinical Assessment of Chemotherapy-Induced Peripheral Neuropathy: The Road Less Traveled 

Constance Visovsky, PhD, RN, APRN-BC

Recent advances in cancer treatment modalities, including novel agents and dose-intensive treatment schedules, have resulted in increased survival for many patients. However, these advances often include neurotoxic chemotherapeutic agents that can cause significant side effects. Chemotherapy-indu...

Grand Rounds

Identification of an Adenomatous Polyposis Coli Mutation Associated with Attenuated Familial Adenomatous Polyposis 

Karen Roesser, RN, MS, AOCN®

H ereditary colorectal cancer syndromes can be divided into polyposis and nonpolyposis groups. Despite the implications of the term “nonpolyposis,” this syndrome is associated with polyps, though they are usually fewer in number. Advanced practitioners may use the presence of 10 or more polyps as...

Practice Matters

Role of the Oncology Clinical Nurse Specialist 

Carol S. Viele, RN, MS, CNS, OCN®

The role of the oncology clinical nurse specialist (CNS) has evolved over my 28 years of service at the University of California San Francisco (UCSF). When I was hired in June of 1981, the conceptual framework for the CNS role had four components: clinician, consultant, educator, and researcher. ...

Practice Matters

Bendamustine 

Amy Goodrich, MSN, CRNP-AC

The treatment of low-grade lymphoid malignancies has seen major progress in the past decade, with improved response rates and survival in indolent B-cell lymphomas (Hiddemann et al., 2005; Herold et al., 2007) and historic comparisons suggestive of improved survival in chronic lymphocytic leukemi...

Tools and Technology

Writing for Publication: References Made Easier 

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

Writing for publication can be a daunting process. Advanced practice clinicians have clinical experiences and knowledge that are invaluable to a reader, but the technicalities of writing can frequently be a significant barrier. The mechanics of working with bibliographies and interpreting various...

Meeting Report

2010 National Comprehensive Cancer Network (NCCN) Nursing Program: Role of the Advanced Practice Nurse in Quality Cancer Care™

Journal of the Advanced Practitioner in Oncology

Current Strategies in the Management of Peripheral Neuropathy Among several neuropathic pain syndromes seen in cancer patients, chemotherapy-induced peripheral neuropathy (CIPN) is one of the most challenging, and there are few evidence-based recommendations for its management, said Judith Pace, ...

Clinical Snapshot

Management of Chemotherapy-Induced Diarrhea

Carolyn Grande, CRNP, AOCNP