JADPRO

Editorial Commentary

The Role of the Physician Assistant in Oncology

Sarah Daniel, MS, PA-C

The dreaded phone call. It is a Friday afternoon, and I am sitting at my desk at the University of Arizona Cancer Center trying to decide the best way to deliver some very bad news to a lovely patient with resected pancreatic cancer. Mrs. X is a 60-year-old woman who took excellent physical care ...

Review Article

Neurotoxicity Associated With Cancer Therapy

Eva Lu Lee, MSN, RN, ANP-BC, and Laurel Westcarth, MSN, RN, ANP-BC

Cancer therapy uses a combination of treatment modalities such as surgery, radiation, and chemotherapy that may improve patient prognosis (Van Meir, Bellail, & Phyphanich, 2004; Butowski & Chang, 2005). However, combination therapy and extended survival are often associated with potential...

Review Article

Venous Thromboembolism in the Cancer Population: Pathology, Risk, and Prevention

Susan Hawbaker, MSN, APN, ANP-BC, OCN®

Patients with cancer have a two- to sixfold increase in the risk of developing venous thromboembolism (VTEs; Samama, Dahl, Quinlan, Mismetti, & Rosencher, 2003), and the incidence continues to increase with cancer-associated VTE representing nearly 20% of all cases (Heit et al., 2002). These ...

Review Article

Transition to a New Cancer Care Delivery System: Opportunity for Empowerment of the Role of the Advanced Practice Provider

Ruth McCorkle, PhD, FAAN, Constance Engelking, RN, MS, M. Tish Knobf, PhD, FAAN, AOCN®, Mark Lazenby, PhD, APRN, Marianne Davies, APRN, Rebecca Sipples, APRN, Ellyn Ercolano, Ms, and Catherine Lyons, RN, MS, NEA-BC

Recent major advances in diagnosis, treatment, and care delivery demonstrate the ever-evolving health-care system in the United States. This constant evolution places greater demands on staff members, altering their roles and requiring them to attain new competencies. This is especially true in c...

Practice Matters

The ASCO Study of Collaborative Practice Arrangements: A Physician Assistant’s Perspective

Alicia C. Ross, MPAS, PA-C

One in two men and women will be diagnosed with cancer of all types during their lifetimes, based on lifetime risk rates from 2005 through 2007; 1 in 6 men with prostate cancer, 1 in 8 women with breast cancer, 1 in 14 men and women with lung and bronchus cancer, and 1 in 20 men and women with co...

Practice Matters

The ASCO Study of Collaborative Practice Arrangements: A Nurse Practitioner’s Point of View

Hollie Devine, MSN, RN, ANP-BC, AOCNP®

As a veteran oncology nurse practitioner, the findings presented by Towle et al. (2011) in their article, “Results of the ASCO Study of Collaborative Practice Arrangements,” recently published in the Journal of Oncology Practice, were not astonishing to me. The purpose of their study was to addre...

Prescriber's Corner

Plerixafor

Susan Slater, MN, FNP-BC

Since the early 1980s, high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) has emerged as standard therapy for patients with hematologic malignancies, including non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). In 2009, 32,000 autologous transplants we...

Tools and Technology

Dietary Resource Information for the Oncology Patient: Tips and Tools

Lydia T. Madsen, MSN, RN, AOCNS®, and Sandra Cesario, PhD, RNC, FAAN

Oncology patients frequently request information about diet, exercise, and a healthy living approach during and after cancer treatment. Although a consultation with a registered dietitian is often the recommendation for patients in large multidisciplinary centers, a same-day consult may not alway...

Diagnostic Snapshot

Diagnostic Snapshot: Dyspnea in the Oncology Patient

Robin Sommers, DNP, ANP-BC, AOCNP®

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. Unfortunately, i...

Editorial Commentary

The ASCO Study of Collaborative Practice Arrangements: Defining the Role of the Nonphysician Practitioner in Oncology

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Confronted with an anticipated shortage of oncologists in the coming decade, the American Society of Clinical Oncology (ASCO) Workforce Advisory Group has proposed that the nonphysician practitioner (NPP) has a viable role in the provision of care to patients with cancer. The term NPP typically r...

Review Article

Cancer-Related Infections

Sylvia K. Wood, DNP, ANP-BC, and Judith K. Payne, PhD, RN, AOCN®

Globally, cancer is a leading cause of death, and it has the greatest impact in terms of premature death and disability worldwide (American Cancer Society [ACS], 2010). The ACS estimates 571,950 Americans are expected to die from cancer this year, and over 1.5 million new cases will be diagnosed ...

Review Article

Updates on the Understanding and Management of Chemotherapy-Induced Nausea and Vomiting

Beth Eaby-Sandy, MSN, CRNP, OCN®, and Victoria Sherry, MSN, CRNP, AOCNP®

Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and widely investigated adverse events (AEs) associated with cancer treatment. Although CINV remains a significant problem for patients undergoing chemotherapy, there have been many advances in the treatment of CINV as well...

Grand Rounds

Pituitary Adenoma and Secondary Radiation-Induced Meningioma in an Adult Patient

Ronald R. Haggett, RN, MNSc, ACNP-BC, OCN®

Weighing in at 500 to 900 mg, the pituitary gland lies at the base of the skull within the sphenoid bone, bordered by the cavernous sinus and the optic chiasm (Figure 1). It is attached to the lower surface of the hypothalamus by the infundibular stalk and receives its blood supply via hypothalam...

Prescriber's Corner

Abiraterone Acetate in Castrate-Recurrent Prostate Cancer

John Perpich, PharmD, and Bradley J. Atkinson, PharmD

Prostate cancer is the most common cancer in men. It is estimated that 240,890 men will be diagnosed with prostate cancer and another 33,720 men will die from the disease in the United States in 2011 (Siegel, Ward, Brawley, & Jemal, 2011). Testosterone is the primary hormonal driver of prost...

Practice Matters

Surviving the Titanic

Wendy J. Smith, ACNP, AOCN®

To say that we live in tumultuous times is definitely an understatement. Our nation’s debt crisis, instability in the stock market, unemployment, white collar scandals—it is all overwhelming. Who do you believe? Who do you trust? How do you sort fact from fiction? In addition to these uncertainti...

Translating Research Into Practice

Fentanyl Nasal Spray: A New Option for Breakthrough Cancer Pain

Joan Schey, RPh

Fentanyl nasal spray (Lazanda) was recently approved for breakthrough cancer pain (BTCP) in patients 18 years and older who are already receiving and are tolerant to opioid therapy for their underlying persistent cancer pain. Breakthrough cancer pain is defined as a transitory exacerbation of pai...

Translating Research Into Practice

Drug Approval: The Long and Bumpy Road to Market

Jeannine Brant, PhD, APRN, AOCN®

Novel pharmacologic agents for symptom management continue to emerge and provide options to improve quality of life in patients with cancer; however, bringing novel pharmacologic agents to the bedside can be a lengthy and arduous process. Once a new agent is available, many questions often arise....

Tools and Technology

Internet Oncology: Cure Seekers Beware!

Wendy H. Vogel, MSN, FNP, AOCNP®

When faced with the fear of death, either your own or that of a loved one, what would you do? How desperately would you seek a cure? Would you be tempted to try one of the many unproven therapies promising a cancer cure? We are educated health-care professionals, yet how many of us have tried the...

Diagnostic Snapshot

Diagnostic Snapshot: Can You Identify This Skin Rash?

Carolyn Grande, CRNP, AOCNP®

History Mrs. L., a 72-year-old non–English-speaking woman, was diagnosed with papillary thyroid cancer in 1995, at which time she underwent a total thyroidectomy. Unfortunately, her disease trajectory was riddled with multiple recurrences from April 2007 through January 2011. She developed metas...

Editorial Commentary

Prevention of Cancer? The Vitamin D Controversy

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Although I live in sunny central California, I was very surprised when my vitamin D level recently revealed I was “deficient.” After 12 weeks of supplementation with 50,000 units weekly of oral vitamin D my levels have normalized, but I continue to take daily supplements of this important vitamin...

Review Article

Gastrointestinal and Hepatobiliary Toxicities of Cancer Treatments

Margot Sweed, CRNP, ANP, BC

The combined modalities of oncologic treatment can impact multiple body systems. Chemotherapy, radiotherapy, and targeted therapies all present challenges to the balance of efficacy and toxicity. Individuals undergoing cancer treatments demonstrate these effects of treatment both at the initiatio...

Review Article

Screening HIV-Infected Men for Anal Dysplasia and Cancer: Are Practice Guidelines Needed?

Lacey L. Siekas, DNP, ARNP

Anal dysplasia is the presence of premalignant changes in cells of the anal canal extending from the transitional zone of the squamocolumnar junction between the rectum and the anus as well as perianal tissue. Dysplastic cellular changes are triggered by persistent infection with high-risk strain...

Review Article

Inflammatory Breast Cancer: Breast Cancer Without a Lump

Pamela Alizadeh, RN, OncNP, MS, AOCN®, CBCN®

Inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer. It accounts for 2% to 6% of all breast cancers and was once considered to be uniformly fatal with a 5-year survival rate of less than 5% (Woodward & Cristofanilli, 2009). With advances in radiation therapy, chemo...

Prescriber's Corner

Ipilimumab

Sarah Bertone, PharmD, and Kathy Diener Dasse, PharmD, BCOP

Althtough it is responsible for only 5% of all skin cancers (both benign and malignant), melanoma accounts for the majority of skin- cancer–related deaths in the United States. The incidence of melanoma has been increasing over the past 3 decades. In 2011, approximately 70,230 new cases of melano...

Tools and Technology

The Doctor of Nursing Practice Degree: A Practical Resource

Lydia T. Madsen, MSN, RN, AOCNS®

In October 2004, the American Association of Colleges of Nursing (AACN) approved a recommendation for the adoption of the Doctor of Nursing Practice (DNP) as the appropriate level of education for advanced practice in nursing (Brown-Benedict, 2008). The target date for implementation of the DNP a...

Translating Research Into Practice

How Is Your Pain…Management? Going Beyond the Fifth Vital Sign

Terri S. Armstrong, PhD, ANP-BC, FAANP

Review of “Initial psychometric properties of the Pain Care Quality survey (PainCQ)” by Beck et al. (2010), Journal of Pain, 11(12), 1311–1319. For a discussion of reliability and validity—what these terms mean and why they’re important—please see the related article by Terri S. Armstrong and Ibr...

Translating Research Into Practice

Reliability and Validity: What’s the Difference and Why Does it Matter?

Terri S. Armstrong, PhD, ANP-BC, FAANP, and Ibrahima Gning, DDS, DrPH, MPH

There has been increasing use of and support for patient-reported out-come (PRO) instruments to assess the impact of care on the patient (Brandrud et al., 2011; Cleeland & Sloan, 2010; US Department of Health and Human Services [HHS], 2006; Turk et al., 2006). The integrity of our analysis ...

Editorial Commentary

Drug Shortages: What Can Be Done? 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

It is estimated that a total of 1,596,670 new cancer cases will occur in the United States in 2011 (Siegel et al., 2011). New treatment regimens and new oncology drugs have contributed to longer survival and better outcomes for specific tumor types. But what happens when oncology agents are just ...

Review Article

Cardiovascular Adverse Events Associated With Cancer Therapy

Anecita Fadol, PhD, RN, FNP-BC, FAANP, and Tara Lech, PharmD, BCPS

Advances in technology and the development of novel cancer therapies have resulted in increased successful outcomes, with more than 11 million cancer survivors in the United States today (Altekruse, 2009). However, increased survivorship does not come without a price. The increasing use of more c...

Review Article

Nutritional Management in Adult Hematopoietic Stem Cell Transplant 

Heather Kasberg, RN, MSN, OCN®, and Autumn Diligente, MS, RD, LD

Malnutrition, which is seen in anywhere from 20% to 80% of oncology patients, has been associated with reduced response to treatment, survival, and quality of life (Kubrak & Jensen, 2007). Hematopoietic stem cell transplant (HSCT) patients are at risk for and vulnerable to malnutrition. Advan...

Grand Rounds

Hereditary Breast and Ovarian Cancer Syndrome 

Nicoletta Campagna, RN, MSN, DNP, APRN-BC, AOCNP®

With the discovery of BRCA1 and BRCA2, a new area of cancer genetics emerged. As knowledge of cancer genetics has increased, so has awareness of cancer genetics among health-care providers and the general public. Advanced practitioners can be instrumental in identifying patients, informing patien...

Practice Matters

Management of Hepatocellular Carcinoma: The Role of the Advanced Practitioner in a Multidisciplinary Approach 

Patrick M. Horne, MSN, ARNP, FNP-BC, and Roniel Cabrera, MD, MS

Hepatocellular carcinoma (HCC) represents a major global health challenge, as an increasing number of cases make it one of the most rapidly rising cancers. It is the fifth most common cancer in the world and the third leading cause of cancer-related death. There are over 600,000 new cases diagnos...

Translating Research Into Practice

Overview of the AVADO and RIBBON-1 Clinical Trials 

Georgia Litsas, MSN, ANP-BC, AOCNP®

Breast cancer is the most common female cancer and the second most common cause of female cancer-related death in the United States. Despite advances in the treatment of early-stage breast cancer, approximately one-third of patients will eventually develop metastatic breast cancer (MBC). It is a ...

Translating Research Into Practice

Throwing the Brake on the Drug Approval Train 

Peg Esper, MSN, RN, ANP-BC, AOCN®

One of the most meaningful developments in oncology, and health care in general, has been the move to evidence-based practice. Most would likely indicate that if they or their loved ones were ill, they would want to have the treatment that has been proven to be the most effective in achieving a p...

Prescriber's Corner

Denosumab vs. Denosumab: One Drug, Two Products, and Two Different Indications

Vivian Tsang, PharmD, BCOP, and Jennifer Kwon, PharmD

Skeletal integrity in a healthy individual requires a balance between bone formation and bone resorption. In normal bone formation, a balance exists between osteoblastic (bone formation) and osteoclastic (bone resorption) activities. When bone remodeling is disrupted by tumor cells, a significant...

Tools and Technology

The Cancer Legal Resource Center:  A Tool for Oncology Professionals 

Anya Prince, Esq, MPP

A cancer diagnosis raises a myriad of medical questions for a patient. Patients and health-care professionals work together to address these medical questions and treatment decisions. However, in addition to the medical decisions, cancer also raises many other considerations and concerns. These c...

Editorial Commentary

Reevaluating Bevacizumab:  The Role of VEGF Inhibitors  in Metastatic Breast Cancer 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Breast cancer remains a formidable disease. This tumor is the second most frequently occurring cancer in the world and the most commonly seen tumor type in women. Metastatic breast cancer (MBC) caused approximately 46,000 deaths in the United States for the year 2010 (Jemal, Siegel, Xu, & War...

Review Article

Pancreatic Cancer 

Sarah Daniel, MS, PA-C, and Sandra Kurtin, RN, MS, AOCN®, ANP-C

Pancreatic cancer remains one of the most feared cancer diagnoses due to the poor prognosis associated with the majority of cases. The incidence of pancreatic cancer is similar in men (21,370) and women (21,770), with a total of 43,140 new cases of pancreatic cancer reported in the United States ...

Review Article

Biomarkers in Non-Small Cell Lung Cancer: Opportunity and Challenge 

Kristen Kreamer, CRNP, Beth Eaby-Sandy, CRNP, Victoria Sherry, CRNP,  and Susan Stonehouse-Lee, CRNP

According to the American Cancer Society's recently published global cancer statistics for 2008 (ACS, 2010), lung cancer was the most commonly diagnosed cancer and the leading cause of cancer death for males, and the fourth most commonly diagnosed cancer and second leading cause of cancer death f...

Grand Rounds

Carboplatin Hypersensitivity in Recurrent Ovarian Cancer 

Paula J. Anastasia, RN, MN, AOCN®

W omen with newly diagnosed with ovarian cancer (and fallopian tube and primary peritoneal) are commonly treated with combination chemotherapy consisting of IV carboplatin and a taxane. Patients who are platinum-sensitive (disease-free interval of greater than 6 months) have a longer survival adv...

Practice Matters

Ionizing Radiation and Medical Imaging: What Midlevel Providers Need to Know 

Marcia Patterson, MSN, RN, NP-C

In 1972, I had a bicycle accident that resulted in a head injury, loss of consciousness, and concussion. An emergency room physician evaluated me, sutured the laceration, and sent me home with instructions for my mother to watch me carefully for the next 72 hours. In a present day emergency cente...

Prescriber's Corner

Cabazitaxel 

Christopher Campen, PharmD, BCPS, and Emad Elquza, MD

Prostate cancer is the most common cancer in men and the second most common cause of cancer-related death in men (Jemal, Siegel, Xu, & Ward, 2010). Patients with advanced prostate cancer often derive significant benefit from androgen deprivation (chemical castration) in terms of survival and ...

Translating Research Into Practice

Adding Early Palliative Care to  Treatment of Non–Small Cell  Lung Cancer 

Kathleen N. Clifford, RN, MSN, FNP-BC, AOCNP®

Review of "Early palliative care for patients with metastatic non–small-cell lung cancer," by Temel et al. (2010), The New England Journal of Medicine, 363(8), 733–742. For a discussion of the article and how it relates to the concepts of scientific rigor, complexity science, and positive devianc...

Translating Research Into Practice

The Temel Paper on Palliative Care: When Scientific Rigor Is Not Enough 

Jeannine M. Brant, PhD, APRN, AOCN®, and Elizabeth L. Ciemins, PhD, MPH, MA

On August 19, 2010, The New England Journal of Medicine (NEJM) released the Temel et al. early palliative care study (Temel et al., 2010). The news spread like wildfire across the United States. Headlines such as, "Earlier Palliative Care Extends Life," were promptly featured in The New York Time...

Tools and Technology

Scholarly Writing: Your Professional Legacy 

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

As humans, we all want to leave our mark on this earth. In our professional lives, the same is true. What inheritance are you leaving those who will come after you? What part of your collective wisdom and knowledge are you sharing with the young people in your profession? One way to mentor many i...

Meeting News

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...

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

Editorial Commentary

The True Value of Mentorship 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

As I write this editorial, some very sad news has crossed my desk. Rose Mary Carroll-Johnson, MN, RN, passed away of cancer on February 21, 2011. Rose Mary was the editor-in-chief of the Oncology Nursing Forum for 20 years and guided that publication to the current standard of nursing publishing ...

Review Article

Predictive Genetic Testing: Can Specialized Advanced Practitioners Quell Consumer Confusion? 

Maureen Swiderski, APN, AOCNS®, CHPN 

The basics of our understanding of cancer are changing daily. Our knowledge base about the genetic and molecular components of cancer is continuously evolving, as are the ways in which we screen for, diagnose, and treat cancer. Genetic testing for cancer susceptibility is one field that is growin...

Review Article

Radical Prostatectomy for the Treatment of Moderate to Severe Lower Urinary Tract Symptoms in Organ-Confined Prostate Cancer 

Lydia T. Madsen, MSN, RN, AOCNS®, and Geri Lobiondo-Wood, PhD, RN, FAAN 

In the United States, prostate cancer is the most commonly diagnosed solid tumor and the second leading cause of cancer death in men (Jemal, Siegel, Xu, & Ward, 2010). The dilemma for most men diagnosed with organ-confined, clinically localized prostate cancer is that several treatment option...

Review Article

Biomarkers in Breast Cancer 

Catherine S. Bishop, DNP, NP, AOCNP®

An estimated 207,090 new cases of invasive breast cancer are estimated to have occurred in women in the United States during 2010 (American Cancer Society [ACS], 2010). Unfortunately, approximately 39,840 women in the United States are estimated to have died from breast cancer in 2010. From 1999 ...

Grand Rounds

Thrombocytopenia, Deep-Vein Thrombosis, and Pulmonary Emboli in a Patient With Primary CNS Lymphoma

Patricia Palmer, RN, MS, AOCNS®

Primary central nervous system lymphoma is an aggressive extranodal NHL that may arise from within the brain parenchyma (90%), spinal cord, eyes, or leptomeninges in the absence of systemic involvement (Abrey, DeAngelis, & Yahalom, 1998; Zhu et al., 2009; DeAngelis & Iwamoto, 2006). Unlik...

Practice Matters

An Early Postoperative Intraperitoneal Chemotherapy Policy for Patients With Colorectal Cancer

Irina Rifkind, RN, BSN, Sharon Lafever, MS, RN, AOCN®, Robin Cianos, RN, OCN®, and Terry Sparhawk, RN, OCN®

The role of the clinical nurse specialist (CNS) is complex, multifaceted, and not well understood. Dimensions of the role include expert practitioner, researcher, clinical educator, coach, role model, patient advocate, consultant, resource person, supervisor, liaison, and innovator (Hamric, Spros...

Prescriber's Corner

Eribulin Mesylate: Unique Advancement in Metastatic Breast Cancer 

Kelley D. Mayden, MSN, FNP, AOCNP®

Breast cancer is the most common malignant disease among women in the United States, with 209,060 new cases estimated in 2010. Although 40,230 deaths were predicted to occur in 2010 overall, thanks to early detection and advancing treatments, there has been a decline in breast cancer mortality (A...

Tools and Technology

Advanced Practitioners’ Favorite Websites

Jill M. Gore, MPAS, PA-C, Shannon Iakiri, RN, MSN, OCN®, FNP, Kelley D. Mayden, MSN, FNP, AOCNP®, Linda Penwarden, MN, RN, AOCN®, Shirley Triest-Robertson, PhD, APNP, ACHPN, AOCNS®, and Laura Zitella, RN, MS, NP, AOCN®

Medical Information Medscape; www.medscape.com Medscape is a health professional network that is part of WebMD. It contains original, professional medical content, including review articles, journal commentary, expert columns, patient education articles, book reviews, continuing education, an...

Editorial Commentary

Patients With Pancreatic Cancer Need New Treatment Approaches 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Attending selected medical and nursing conferences is part of keeping up to date with changes in clinical practice. One of my favorite meetings to attend is the National Comprehensive Cancer Network (NCCN) annual conference, which includes updates to various NCCN Clinical Practice Guidelines and ...

Review Article

The Pathogenesis of Multiple Myeloma: Understanding the Mechanisms of the Bone Marrow Microenvironment 

Angela M. Falco, RN, MS/MPH, ANP-C, Lisa C. Smith, MSN, FNP, AOCN®, and  Ellen Sullivan, OCN®, MNSC, APN, ACNP-BC

Multiple myeloma (MM) is a mature B-cell malignancy that results in the clonal expansion of neoplastic plasma cells (Huff & Matsui, 2008). It is characterized by an overproduction of monoclonal proteins (M proteins), the formation of lytic lesions, and an accumulation of malignant plasma cell...

Grand Rounds

Medication Self-Management: Important Concepts for Advanced Practitioners in Oncology 

Beth Faiman, RN, MS, APRN, BC, AOCN®

Medication self-management (SM) is an emerging concept in oncology as more medications with improved efficacy are available in oral formulations that patients can administer at home. Successful home self-management of medications related to cancer treatment requires that the patient be responsi...

Review Article

Biomarkers in Prostate Cancer 

Ingrid Bowser, MS, APRN-BC, AOCNP®, ADM-BC, and  Kristan Rheinheimer, MSN, FNP-BC, AOCNP®

Prostate cancer is the most common malignancy among all races of men and the second leading cause of cancer-specific death in men in the United States (Centers for Disease Control [CDC], 2006). It is estimated that one in six men will be diagnosed with prostate cancer in his lifetime (United Stat...

Tools and Technology

Gefitinib for Advanced NSCLC Patients With EGFR Mutation 

Karen J. Oishi, MSN, APRN, ANP-BC, GNP-BC, OCN®

Review of “Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR,” by Maemondo et al. (2010). The New England Journal of Medicine, 362(25), 2380–2388. For a discussion of understanding outcomes assessment, please see the related article by Dr. Terri Armstrong. Lung cancer c...

Tools and Technology

The Maemondo Paper: Understanding Outcomes Assessment in Clinical Trials 

Terri S. Armstrong, PhD, ANP-BC, FAANP

The goal of any clinical research evaluating a new cancer therapy is to determine if the treatment provides clinically meaningful benefit and is safe (Fleming, 2006). A randomized controlled clinical trial is the primary vehicle used in oncology to compare a novel treatment to an established stan...

Practice Matters

REMS: Application for the Advanced Practitioner in Oncology 

Wendy H. Vogel, MSN, FNP, AOCNP®, and Marilyn Haas, PhD, ANP-C

The Federal Food, Drug, and Cosmetic Act, passed by the United States Congress in 1939, requires a drug’s sponsors to provide evidence of the drug’s safety prior to marketing approval (Baker, 2009). Since that time, the US Food and Drug Administration (FDA) has been the primary regulatory body th...

Tools and Technology

Online Calculators: Prognosis for Non-Hodgkin and Hodgkin Lymphoma 

Laura Zitella, RN, MS, NP, AOCN®

Lymphomas are a heterogenous group of lymphoid malignancies with varied patterns of clinical behavior, response to treatment, and prognosis (National Comprehensive Cancer Network [NCCN], 2010). A main goal of therapy is to achieve the best possible response with minimum toxicity. Identifying pati...

Editorial Commentary

Rectal Cancer Incidence:  Trends in Younger Patients 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

The American Cancer Society (ACS) recently published its statistics for new cancer cases and deaths expected in the United States for 2010 (Jemal, Siegel, Xu, & Ward, 2010). This year, a total of 1,529,560 new cases of cancer are anticipated, with approximately 569,490 deaths from the disease...

Review Article

Translating Evidence-Based Research into Practice 

Robin M. Sommers, DNP, ANP-BC, AOCNP®

Complex medical care systems, rising patient acuity, and the explosion of technical innovations have led to an ever-increasing demand for the delivery of safe, quality health care by the U.S. government and consumers. Integrating evidence into clinical decision-making can contribute to better qua...

Review Article

Biomarkers in Colorectal Cancer: Implications for Nursing Practice 

Carolyn Grande, CRNP, AOCNP®, Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, and Deanna Yamamoto, RN, MS, CS, AOCNP®

Over the past several years, new cases of colorectal cancer (CRC) have decreased in the United States from an estimated 150,000 in 2008 to 143,000 in 2010 (Jemal, Siegel, Xu, & Ward, 2010). In part, this decline can be directly attributed to early screening tests and the removal of colon poly...

Grand Rounds

Collaborative Approach to Managing a 59-Year-Old Woman With Stage IIB Pancreatic Cancer and Diabetes 

Michelle Bratton, RD, CSO, and Sandra E. Kurtin, RN, MS, AOCN®, ANP

The number of individuals with both cancer and diabetes is increasing as the population ages. Each of these diseases presents challenges to the patient and to the clinical team, including the advanced practitioner in oncology. The American Diabetes Association and the American Cancer Society rece...

Practice Matters

Cancer Survivorship: Developing Clinical Practice Guidelines 

Marcia Patterson, MSN, RN, NP-C

Cancer survivorship is a growing specialty, aimed at addressing the needs of more than 11 million adult cancer survivors in the United States today (American Cancer Society, 2010). This number is projected to rise as cancer is diagnosed and treated at earlier stages, and as more effective treatme...

Prescriber's Corner

Sipuleucel-T: A New Advance in the Treatment of Castrate-Resistant Prostate Cancer 

Robert Ignoffo, PharmD, FASHP, FCSHP

Prostate cancer ranks as the second most common malignancy in men with approximately 217,700 new cases in 2010 (Jemal, Siegel, Xu, & Ward, 2010). Although early-stage prostate cancer has a good prognosis and long survival, about 20%–30% of cases recur with advanced disease. Although androgen ...

Clinical Snapshot

Chemotherapy-Induced Neuropathic Pain 

Michelle C. Abramowski, RN, BSN, MSN, CRNP, APRN-BC

Download the Clinical Snapshot that accompanies this article. The advancement of chemotherapy has prolonged survival for many cancer patients. However, treatment with chemotherapeutic agents has left cancer survivors with many long-term sequelae and new and challenging problems, such as pain, se...

Translating Research Into Practice

A New Immunotherapy for Melanoma? 

Peg Esper, MSN, MSA, RN, APN-BC, AOCN®

Review of: “Improved survival with ipilimumab in patients with metastatic melanoma,” by Hodi et al. (2010). The New England Journal of tabMedicine, 363(8), 711–723. doi:10.1056/NEJMoa1003466. For a researcher's view of this paper, please see the article by Friese on page 287. For over a decade,...

Translating Research Into Practice

The Hodi Paper: A Researcher’s View 

Christopher R. Friese, RN, PhD, AOCN®

Review of “Improved survival with ipilimumab in patients with metastatic melanoma,” by Hodi et al. (2010). The New England Journal of Medicine, 363(8), 711–723. doi:10.1056/NEJMoa1003466. The data reported by Hodi et al. (2010) present a bright spot for patients with unresectable stage III and ...

Tools and Technology

Streamlining Needs for Everyday Practice: Three Websites That Make Your Life Easier 

Heather Greene, MSN, FNP, AOCNP®

As an oncology nurse practitioner (NP) in community practice, I spend the majority of my day seeing patients—or at least that’s what you would think. Realistically, in today’s healthcare setting, all of the paperwork, prior authorizations, non–formulary exceptions, pre–certifications, and letters...

Editorial Commentary

Adherence to Cancer Therapies: Are Your Patients Taking Their Prescriptions as Ordered? 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Patients receiving prescription medications for chronic medical conditions are not always adherent to their treatment protocols. In a recent study by Yeaw, Benner, Walt, Sian, and Smith (2009), the adherence pattern for a sample of six chronic therapies revealed variable but persistent suboptimal...

Review Article

Adherence to Oral Therapies for Cancer: Barriers and Models for Change 

Susan Moore, RN, MSN, ANP, AOCN®

Oral chemotherapy and hormonal therapies have been available for decades and include many familiar agents such as cyclophosphamide, melphalan, and tamoxifen. The past decade has witnessed an expansion of oral anticancer drugs, including cytotoxic agents, small-molecule inhibitors, and agents targ...

Grand Rounds

A Case Study Approach to Chronic Myelogenous Leukemia  

Amy Goodrich, MSN, CRNP-AC

The treatment options and prognosis for patients with newly diagnosed chronic myelogenous leukemia (CML) have improved dramatically in the past decade. From 1990 through 1992, patients in the United States with newly diagnosed CML had a 1 in 4 chance of being alive in 5 years (Jemal, Seigel, Ward...

Review Article

Laboratory Measures for the Diagnosis, Clinical Management, and Evaluation of Treatment Response in Multiple Myeloma 

Sandra E. Kurtin, RN, MS, AOCN®, ANP

Multiple myeloma (MM) is a plasma cell neoplasm characterized by malignant transformation and clonal expansion of mature plasma cells resulting in an overproduction of plasma cell proteins (immunoglobulins). Risk factors for the disease are poorly understood, but there is a higher incidence in ol...

Grand Rounds

Collaborative Approach to Managing a 47-Year-Old Male with Stage IIB Rectosigmoid Colon Cancer and New Onset of Diabetes

Betsy Dokken, PhD, RN, ANP, and Sandra E. Kurtin, RN, MS, AOCN®, ANP

Diabetes and cancer continue to present challenges to industrialized nations as the incidence of both diseases increases globally. An estimated 1.5 million new cancer cases and 1.6 million new diabetes diagnoses are expected in 2010 in the United States (Jemal, Siegel, Xu, & Ward, 2010; CDC, ...

Prescriber's Corner

Methadone 

Jeannine M. Brant, PhD, APRN, AOCN®,  Caroline Deigert, BS, MPAS, PA-C, and Doreen Guay, BS, MPAS, PA-C

Pain is a common problem in patients with cancer, and advanced practitioners in oncology are frontline managers of cancer-related pain and other deleterious symptoms. Opioids are the mainstay of cancer pain treatment, and methadone is one opioid analgesic available for management of this symptom....

Clinical Snapshot

Management of Constipation in Patients with Cancer 

Susan Bohnenkamp, RN, MS, ACNS-BC, CCM, and  Virginia T. LeBaron, MS, ACNP-BC, AOCN®, ACHPM

Download the Clinical Snapshot that accompanies this article. While certainly not the most glamorous of symptoms, constipation can have a devastating impact on a patient’s quality of life. In fact, constipation can rival, or exceed, pain as a source of distress for patients and families (Sykes, ...

Translating Research Into Practice

Development and Use of Clinical Practice Guidelines 

Jeannine M. Brant, PhD, APRN, AOCN®

Clinical practtice guidelines are systematically developed recommendations that target specific areas of clinical practice in which sufficient evidence does not always exist. The purpose of clinical practice guidelines are many: (a) to appraise existing evidence in a specific clinical practice ar...

Tools and Technology

Mobile Applications for the Oncology Advanced Practitioner 

Wendy H. Vogel, MSN, FNP, AOCNP®

Smartphone, personal digital assistant (PDA), Blackberry, iPhone, Android,…and the list goes on! Is it a fruit, an alien, a phone, or a computer? And how can any of them assist the oncology advanced practitioner (AP) in his or her clinical tasks? Smartphones such as the Blackberry, the iPhone, a...

Editorial Commentary

Putting Statistics into Play 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Statistical analysis can be intimidating to clinicians who work with patients with cancer. My initial introduction to statistics as an undergraduate was not particularly helpful for the evaluation of clinical research as a nurse. Like many professors, my statistics instructor based the curriculum...

Review Article

Epidermal Growth Factor Receptor Inhibitors and Radiation Therapy in Head and Neck Cancer: Potential Management Strategies for Skin Reactions

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, Marilyn L. Haas, PhD, ANP-C, and Mario E. Lacouture, MD

Epidermal growth factor receptor inhibiting (EGFRI) agents have played an important role in ushering in the era of targeted therapy. These agents focus on the epidermal growth factor receptor (EGFR), which is overexpressed in many epithelial tumors, including those of the lungs, kidneys, colon, a...

Review Article

Roles of the Clinical Nurse Specialist and Nurse Practitioner in Survivorship Care 

Denice Economou, RN, MN, AOCN®, Amy Edgington, RN, NP-BC, and  Amy Deutsch, DNP(c), RN, CNS, OCN®

Survivorship care is defined by the Institute of Medicine (IOM) in the report, From Cancer Patient to Cancer Survivor: Lost in Transition (Hewitt, Greenfield, & Stovall, 2006), which describes a survivor as someone who has been diagnosed with cancer and covers the time from diagnosis to death...

Review Article

Biomarkers in Ovarian Cancer Screening 

Paula Anastasia, RN, MN, AOCN

Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women, with an estimated 15,520 dying of the disease in 2010 (American Cancer Society [ACS], 2010). There are no effective early-detection modalities, and the majority of women with ovarian cancer will be diagnosed in l...

Grand Rounds

Identifying and Treating Insomnia in the Adult Cancer Patient 

Deanna Sanchez Yamamoto, RN, MS, CS, AOCNP®

Insomnia is commonly associated with a diagnosis of cancer. One third to three quarters of cancer patients will experience sleep disturbance during their illness (Page, Berger, & Johnson, 2006). Advanced practitioners in the oncology field need to have the knowledge and skill required to addr...

Translating Research Into Practice

Translating Research Into Practice: Overview of Principles 

Terri S. Armstrong, RN, PhD, ANP-BC, Jeannine M. Brant, PhD, APRN, AOCN®, and  Peg Esper, MSN, RN, APRN-BC, AOCN®

The outcome of any serious research can only be to make two questions grow where only one grew before. —Thorstein Veblen As advanced practitioners in oncology, we are dedicated to using current best practice. Innovations in the prevention, diagnosis, and treatment of cancer, and the managemen...

Practice Matters

Development of a Rapid Response Team in an Outpatient Free-Standing National Cancer Institute–Designated Comprehensive Cancer Center 

Kim Blumenfeld, RN, BS, CCRN, Iris Delfakis, RN, BSN, OCN®,  Sandra E. Kurtin, RN, MS, AOCN®, ANP-C, Patricia Stumbo, RN, OCN®, MBA,  Kirsten Jonasson, RN, Margaret Miller, MD, Daniel Butcher, PharmD,  Anna Glennie, RN, MSN, FNP, and Agnes Sharifi, RN, MSN, FN

Improved symptom management strategies and transfusion services have shifted the bulk of cancer treatment to the outpatient setting. Many outpatient oncology centers provide high-acuity services on a daily basis to reduce the need for hospitalization and to improve continuity of care. Most outpat...

Prescriber's Corner

Ofatumumab 

Christopher Campen, PharmD, BCPS 

Ofatumumab (Arzerra) is a fully human monoclonal antibody targeting CD20. In October 2009, ofatumumab was approved as monotherapy for the management of chronic lymphocytic leukemia (CLL). Pharmacology Ofatumumab is an anti-CD20 monoclonal antibody with distinct properties that make it a potenti...

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 ...

Tools and Technology

APA 6th Edition Update 

Susan Moore, RN, MSN, ANP, AOCN®

The American Psychological Association (APA) style guide for scientific papers, reference lists, tables, and figures is the preferred format for the social, behavioral, and nursing sciences. The APA manual provides guidance on all aspects of the writing process, including planning the manuscript,...

Meeting News

Reports from the 2010 ASCO Annual Meeting

Terri S. Armstrong, PhD, ANP-BC, FAANP, Paula Anastasia, RN, MN, AOCN®, Carolyn Grande, CRNP, AOCNP®, Kristen Kreamer, CRNP, MSN, AOCN®, APRN, BC, Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, and Wendy H. Vogel, MSN, FNP, AOCNP®

The 2010 Annual Meeting of the American Society of Clinical Oncology (ASCO) was held in Chicago, IL, from June 4–8, 2010. Results from this meeting have been published in many outlets, and the major results have been made readily available. In this section, members of the JAdPrO Editorial Board h...

Editorial Commentary

A Journal Whose Time Has Come 

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®

Advanced practice has been part of my career path for 24 years. As the first oncology clinical nurse specialist (CNS) and first oncology nurse practitioner (NP) to work at my academic teaching hospital in the 1980s, I often struggled to find information in the literature specific to my needs as a...

Editorial Commentary

Advanced Practitioners in Oncology: Meeting the Challenges 

Wendy H. Vogel, MSN, FNP, AOCNP®

In the year 2020, it is estimated that office waiting rooms will overflow by 9.5 to 15 million oncology patient visits, and there may be no practitioner available to see them (Erikson, Salsberg, Forte, Bruinooge, & Goldstein, 2007). While this may feel like job security for current health car...

Review Article

Risk Analysis in the Treatment  of Hematologic Malignancies in the Elderly 

Sandra Kurtin, RN, MS, AOCN®, ANP-C

Advanced age is a leading risk factor for developing cancer. Older adults (> 65 years) are expected to exceed 20% of the overall U.S. population by the year 2030 (Jemal et al., 2009). Approximately 60% of all new cancer diagnoses are attributed to older adults, with this number expected to rea...

Review Article

Clinical Assessment of Chemotherapy-Induced Peripheral Neuropathy: The Road Less Traveled 

Constance Visovsky, PhD, RN, APRN-BC

Recent advances in cancer treatment modalities, including novel agents and dose-intensive treatment schedules, have resulted in increased survival for many patients. However, these advances often include neurotoxic chemotherapeutic agents that can cause significant side effects. Chemotherapy-indu...

Grand Rounds

Identification of an Adenomatous Polyposis Coli Mutation Associated with Attenuated Familial Adenomatous Polyposis 

Karen Roesser, RN, MS, AOCN®

H ereditary colorectal cancer syndromes can be divided into polyposis and nonpolyposis groups. Despite the implications of the term “nonpolyposis,” this syndrome is associated with polyps, though they are usually fewer in number. Advanced practitioners may use the presence of 10 or more polyps as...

Practice Matters

Role of the Oncology Clinical Nurse Specialist 

Carol S. Viele, RN, MS, CNS, OCN®

The role of the oncology clinical nurse specialist (CNS) has evolved over my 28 years of service at the University of California San Francisco (UCSF). When I was hired in June of 1981, the conceptual framework for the CNS role had four components: clinician, consultant, educator, and researcher. ...

Practice Matters

Bendamustine 

Amy Goodrich, MSN, CRNP-AC

The treatment of low-grade lymphoid malignancies has seen major progress in the past decade, with improved response rates and survival in indolent B-cell lymphomas (Hiddemann et al., 2005; Herold et al., 2007) and historic comparisons suggestive of improved survival in chronic lymphocytic leukemi...

Tools and Technology

Writing for Publication: References Made Easier 

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

Writing for publication can be a daunting process. Advanced practice clinicians have clinical experiences and knowledge that are invaluable to a reader, but the technicalities of writing can frequently be a significant barrier. The mechanics of working with bibliographies and interpreting various...

Meeting News

2010 National Comprehensive Cancer Network (NCCN) Nursing Program: Role of the Advanced Practice Nurse in Quality Cancer Care™

Journal of the Advanced Practitioner in Oncology

Current Strategies in the Management of Peripheral Neuropathy Among several neuropathic pain syndromes seen in cancer patients, chemotherapy-induced peripheral neuropathy (CIPN) is one of the most challenging, and there are few evidence-based recommendations for its management, said Judith Pace,...

Clinical Snapshot

Management of Chemotherapy-Induced Diarrhea

Carolyn Grande, CRNP, AOCNP

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