Previous Issues

    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 ...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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, ...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    Grand Rounds

    Use of Diagnostic Tests in Advanced Non–Small Cell Lung Cancer

    Beth Eaby-Sandy, MSN, CRNP, OCN®

    Continuing Education Information USE OF DIAGNOSTIC TESTS IN ADVANCED 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, advanc...

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    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...

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    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, & ...

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    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...

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    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,...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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% ...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    Editorial

    Information for Contributors

    JADPRO

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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...

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    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 ...

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    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) ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    Prescriber's Corner

    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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 ...

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    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...

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    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, ...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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:...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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,...

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    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...

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    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, ...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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 ...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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 physician...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

    Read More
    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...

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    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...

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    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...

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    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 Expirati...

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    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 ...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

    Read More
    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 ...

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    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 ...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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,...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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. Rele...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 (...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 Oncolo...

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    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 ...

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    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...

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    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...

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    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...

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    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; ...

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    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...

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    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...

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    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...

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    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...

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    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 su...

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    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...

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    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...

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    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...

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    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...

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    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). ...

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    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...

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    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 ...

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    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 p...

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    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 cyt...

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    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 ri...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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,...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

    Read More
    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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. ...

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    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...

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    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)...

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    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...

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    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 ...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 wh...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 sci...

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    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 diabe...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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 ap...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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,...

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    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...

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    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 convent...

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    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...

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    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, predic...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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) ...

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    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...

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    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...

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    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 ...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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. Unfortu...

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    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...

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    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 ...

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    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...

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    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...

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    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 prost...

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    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...

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    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...

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    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....

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    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...

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    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 metas...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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 ...

    Read More
    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

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    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...

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    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...

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    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 ...

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    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...

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    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...

    Read More
    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 ...

    Read More
    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...

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    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...

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    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...

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    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, an...

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    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 ...

    Read More
    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...

    Read More
    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 responsi...

    Read More
    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...

    Read More
    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 c...

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    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...

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    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...

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    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...

    Read More
    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...

    Read More
    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...

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    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...

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    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...

    Read More
    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...

    Read More
    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 ...

    Read More
    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, se...

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    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,...

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    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 ...

    Read More
    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...

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    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...

    Read More
    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...

    Read More
    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...

    Read More
    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...

    Read More
    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, ...

    Read More
    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....

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    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, ...

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    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...

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    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, a...

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    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...

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    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...

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    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...

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    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...

    Read More
    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...

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    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 managemen...

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    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...

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    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 potenti...

    Read More
    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 ...

    Read More
    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,...

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    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...

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    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...

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    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...

    Read More
    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...

    Read More
    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...

    Read More
    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...

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    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. ...

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    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...

    Read More
    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...

    Read More
    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, ...

    Read More
    Clinical Snapshot

    Management of Chemotherapy-Induced Diarrhea

    Carolyn Grande, CRNP, AOCNP

    Read More


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