Previous Issues

Read More

The Importance of Endpoints in Oncology Clinical Trials

Innovative clinical trials identify appropriate endpoints when seeking to evaluate potential new cancer treatments, better ways of using existing medications, or enhanced supportive care techniques. A recent X (formerly Twitter) post highlighted a workshop held in July 2023 sponsored by the FDA, ...

Read More

Precautions for Patients Taking Tamoxifen or Aromatase Inhibitors

Tamoxifen and aromatase inhibitors are widely prescribed therapies for the treatment of breast cancer. Tamoxifen is a selective estrogen receptor modulator that treats hormone-sensitive breast cancers. Research has demonstrated that tamoxifen therapy improves survival and reduces the risk of deve...

Read More

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

Oncology care has experienced a shift over the past decade, becoming more focused on providing goal-concordant care for seriously ill patients. The need for effective communication and clear treatment plans to match patients’ values and goals has become essential (Sanders et al., 2018). Researche...

Read More

Patient-Reported Outcomes With Belantamab Mafodotin Treatment in Patients With Triple-Class Refractory Multiple Myeloma

Multiple myeloma (MM) is a relapsing, incurable hematologic cancer that eventually becomes refractory to treatments. Therapies to treat relapsed/refractory MM (RRMM) aim to control disease progression, prolong survival, reduce disease-related symptoms, and optimize health-related quality of life ...

Read More

Post-Transplant Cyclophosphamide for the Prevention of Graft-vs.-Host Disease in Allogeneic Hematopoietic Cell Transplantation: A Guide to Management for the Advanced Practitioner

Since its first US Food and Drug Administration (FDA) approval in 1959, cyclophosphamide use has expanded to solid and hematologic malignancies, autoimmune diseases, and mobilization and conditioning regimens for hematopoietic cell transplantation (HCT). More recently, cyclophosphamide has emerge...

Read More

Pancreatic Cancer and the Family Connection: The Role of Advanced Practitioners in Screening and Educating Genetically At-Risk Individuals

Pancreatic cancer is one of the deadliest cancers in the United States, accounting for 8% of cancer deaths each year. It is surpassed only by lung cancer (23%) and colorectal cancer (9%) in terms of causes of cancer deaths annually (Centers for Disease Control and Prevention [CDC], 2022). Pancrea...

Read More

Surgical Management of Gastrointestinal Stromal Tumors

Case Study SY is an 86-year-old female who presented to the emergency department with an initial complaint of dizziness, fatigue, and generalized weakness over the past several days. Past medical history is significant for hyperlipidemia and esophagitis with esophageal structuring. Previous surg...

Read More

Knowing Your Target: Altered Mental Status From an Unsuspected Source

History and Chief Complaint KS is a 52-year-old female with a history of chronic kidney disease, hypertension, and relapsed IgG kappa multiple myeloma who is postautologous stem cell transplant and receiving therapy with daratumumab (Darzalex), lenalidomide, dexamethasone, and denosumab. KS pres...

Read More

Providing Care During Cancer Drug Shortages

Drug shortages have become a global phenomenon, reaching an all-time high and affecting nearly every therapeutic area of medicine. Even short-term drug shortages cause deleterious effects in critical populations such as our patients with cancer or blood disorders. The lack of available therapies ...

Read More

Anti-Spike Antibody Responses in Allogeneic Stem Cell Transplant Recipients to Two Doses of COVID-19 mRNA Vaccination: A Retrospective, Single-Center Analysis

COVID-19 mRNA vaccinations have been shown to be effective by reducing severe disease-related symptoms and hospitalization in phase III trials (Polack et al., 2020). Patients with malignancies have been shown to be at higher risk for morbidity and mortality from severe acute respiratory syndrome ...

Read More

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

The consistent provision of high-quality health care by advanced practice providers (APP) has been clearly established and increasingly recognized in literature. Initially utilized only in rural, underserved primary care settings, value recognition and good outcomes have prompted mass expansion o...

Read More

Quality of Life in Adult Cancer Patients With Underage Children: An Integrative Review

Approximately half of new cancers are diagnosed in adults younger than 65 years of age (National Cancer Institute, 2021). Some of these adults face a cancer diagnosis while parenting children younger than 18 years of age. A recent systematic review estimated that between 14% and 24.7% of cancer p...

Read More

Polycythemia Vera: Thinking Beyond the Hematocrit

Polycythemia vera (PV) is a chronic and debilitating myeloproliferative neoplasm (MPN) with life-threatening complications. It was first formally identified in 1892 as “maladie de Vaquez,” by French physician Louis Henri Vaquez. Polycythemia vera is the most common MPN, although rarely is it mali...

Read More

Hyperammonemia Secondary to 5-Fluorouracil

Case Study Our patient is a 65-year-old male who was previously diagnosed with non-secretory lambda light chain multiple myeloma in 2007. He initially received induction chemotherapy with bortezomib and later underwent autologous stem cell transplant in 2008, which was complicated by fluid reten...

Read More

Managing Drug Interactions With Oral Anticancer Treatments

Oral antineoplastic agents have proved essential for the treatment of many types of cancer. They may be prescribed alone, in combination with intravenous chemotherapy, or with immune checkpoint inhibitors. One difference between oral chemotherapy (OC) agents and intravenous agents is that oral ag...

Read More

Can You Establish the Cause of This Patient’s Shortness of Breath?

Background Mr. B is a 56-year-old male who presented to our institution with a past medical history of renal stones, deep vein thrombosis (DVT) with an inferior vena cava filter, and cerebrovascular accident (CVA). He was initially diagnosed with metastatic gastroesophageal junction (GEJ) adenoc...

Read More

Tips for Writing a Research Protocol

A brilliant advanced practitioner colleague, whose article you will find in this issue, asked whether JADPRO would publish her successfully funded grant application. When I asked about her motivation to become a researcher and seek grant funding after years of a successful clinical career, she ha...

Read More

Research Strategy for the Development of a Quality-of-Life Decision-Making Model for Older Patients With Acute Myeloid Leukemia

Prior to becoming a nurse and then nurse practitioner, I wanted to make an impact on the world by being a researcher. My career goals included a PhD. My desire to get married and start a family pushed that career goal down my life timeline to mid-career, after my children graduated from high scho...

Read More

Distress in Neuro-Oncology Patients and Its Implications for Communication

Patients with cancer experience a significant burden in their daily life resulting from a variety of symptoms, such as physical or cognitive impairment, as well as fatigue. Furthermore, psychosocial stress due to prognostic awareness, disturbed social or role functioning, and a premature end to w...

Read More

Management of Ocular Toxicity in Patients Receiving Belantamab Mafodotin

Multiple myeloma is a malignancy of the plasma cell characterized by the production of monoclonal immunoglobulins, bone marrow infiltration of malignant plasma cells, anemia, lytic bone lesions, hypercalcemia, and renal failure. In 2023, it is estimated that approximately 35,730 new cases of mult...

Read More

Rethinking Medical Aid in Dying: What Does It Mean to ‘Do No Harm?’

In 1999, long-time euthanasia advocate, Dr. Jack Kevorkian, was found guilty of second-degree murder for the death of Thomas Youk, a 52-year-old man suffering through end-stage amyotrophic lateral sclerosis. Kevorkian was an American pathologist who assisted patients with their own “suicides.” Al...

Read More

Management of Patients With Advanced Gastrointestinal Stromal Tumor: Emphasis on Fourth-Line Treatment With Ripretinib

Case Study A 65-year-old female who was working full time and caring for her special needs child presented to her primary care physician with long-term abdominal pain and weight loss (Figure 1). She was referred for imaging where an abdominal/pelvic CT scan revealed a 4-cm mass at the gastroesop...

Read More

Value Assessment of Oncology Pharmacist Interventions

In a 2020 study by Meleis and colleagues in the Journal of the Advanced Practitioner in Oncology, the authors report on the role and perceived impact of ambulatory oncology clinical pharmacists (AOCPs). This article seeks to further investigate this data. The AOCPs are integrated into the clinic ...

Read More

Heart Failure in a Patient With Metastatic Well-Differentiated Neuroendocrine Tumor

History Mrs. R is a 47-year-old Hispanic female with no significant past medical history who initially presented in Mexico with a 6-month duration of epigastric abdominal pain, abdominal bloating, watery diarrhea, and facial flushing. She underwent a CT of the chest/abdomen/pelvis with contrast ...

Read More

JADPRO Live 2022: Reaching the Peak of Practice

Last fall, the tenth JADPRO Live conference welcomed over 1,300 attendees to the Gaylord Rockies in Aurora, Colorado. After 2 years of virtual conferences, it was refreshing to see new and old acquaintances against the backdrop of the Rocky Mountains. The theme of this year’s conference was “Reac...

Read More

What Does Dobbs v. Jackson Mean for Oncology Patients and Providers? Current Considerations for Pregnancy and Fertility in the Oncology Setting

The recent US Supreme Court decision in the Dobbs v. Jackson Women’s Health Organization case, which held that the Constitution of the United States does not confer a right to abortion, could have a lasting effect on oncology providers and patients, especially those with cancer who may be faced w...

Read More

Uncovering and Addressing Implicit Bias in Oncology

Implicit bias in oncology not only undermines fair and equitable health care, but also contributes to the perpetuation of health disparities among marginalized patient populations, according to recent research. During JADPRO Live 2022, Rose DiMarco, PharmD, BCPS, BCOP, of Sidney Kimmel Cancer Ce...

Read More

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

Febrile neutropenia, a life-threatening condition characterized by fever and low neutrophil count, places a significant burden on both patients and the health-care system. Although the incidence of febrile neutropenia varies by malignancy, between 10% and 50% of patients with solid tumors and at ...

Read More

Medical Aid in Dying: Ethical and Practical Issues

Medical aid in dying presents a unique set of challenges for health-care providers, including determining patient capacity, managing timing issues, and addressing the intersection of state and federal laws. During JADPRO Live 2022, Jonathan Treem, MD, of the University of Colorado Palliative Care...

Read More

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

Cancer-associated thrombosis, a life-threatening complication of cancer, can strike without warning and turn a patient’s fight against the disease into a harrowing battle on multiple fronts. During JADPRO Live 2022, Keri Halsema, NP, and Brandon McMahon, MD, of the University of Colorado, discuss...

Read More

Managing the Patient With Multiple Primary Tumors

As the incidence of patients presenting with multiple primary tumors continues to rise, it is crucial for health-care providers to have a comprehensive understanding of the unique challenges and management strategies involved in caring for this complex patient population. During JADPRO Live 2022...

Read More

Biomarker Pursuit: Keeping Current With Novel Biomarkers in Hematology/Oncology

Revolutionizing the way we diagnose, monitor, and treat cancer, biomarkers have emerged as a powerful tool to tailor therapy and improve outcomes for patients with cancer. In a session called “Biomarker Pursuit” during JADPRO Live 2022, Beth Faiman, PhD, MSN, APRN-BC, AOCN®, BMTCN, FAAN, FAPO, of...

Read More

2021–2022 Drug Updates in Solid Tumors

From late 2021 to late 2022, there were around 20 drug approvals for solid tumors, including four approvals in breast cancer, three in melanoma, three in lung cancer, and two in cervical cancer. During JADPRO Live 2022, Kirollos Hanna, PharmD, BCPS, BCOP, of M Health Fairview and Mayo Clinic Coll...

Read More

2021–2022 Drug Updates in Hematologic Malignancies

Leading up to JADPRO Live 2022, there were notable approvals from the US Food and Drug Administration (FDA) for therapeutics in hematologic malignancies, changing the treatment paradigms for malignancies such as multiple myeloma, lymphoma, and acute leukemia. During the conference in Aurora, Col...

Read More

2021–2022 Drug Updates: Investigational Therapeutics in the Pipeline

The pipeline for investigational therapeutics in hematology/oncology is constantly evolving, with many promising new treatments being developed to address the unmet needs of patients. While these treatments are still in the investigational stage, they offer hope for patients who currently have li...

Read More

Updating the Targeted Therapy Paradigm for Patients With Metastatic NSCLC

The targeted therapy paradigm for patients with metastatic non–small cell lung cancer (NSCLC) has revolutionized treatment options, offering new hope for patients with previously limited options. During JADPRO Live 2022, Narjust Florez (Duma), MD, of Dana-Farber Cancer Institute and Harvard Medic...

Read More

Advancing the Care of Women With HER2-Positive Metastatic Breast Cancer

Human epidermal growth factor receptor 2 (HER2) is a receptor on cells that helps promote growth and, in some cases, migration and survival. However, when these receptors are overexpressed and overactive in HER2-overexpressed breast cancer, they cause cells to grow too quickly and metastasize. Ap...

Read More

Novel Treatments for Patients With Relapsed/Refractory Multiple Myeloma

The field of myeloma therapeutics is entering a new age with unprecedented outcomes in overall response rate and progression-free survival. During JADPRO Live 2022, Cesar Rodriguez, MD, and Donna Catamero, ANP-BC, OCN®, CCRC, of Mount Sinai School of Medicine, explained mechanisms of action of ag...

Read More

The Importance of Professional Communities and Collaborations

Picture this scenario. You are a provider who began a job in hematology at an outpatient community practice. A generally healthy 56-year-old patient with no past medical history of illness presents to you with complaints of bruising. They have not seen a provider in 15 years. You order appropriat...

Read More

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

Patients with advanced cancer have been found to demonstrate severe symptoms and low quality of life at diagnosis (Siemens et al., 2020). Advanced or metastatic cancer refers to disease that is unlikely to be cured or controlled with treatment. Treatment goals for this stage of illness are pallia...

Read More

Characteristics of Distress and Support Group Participation in Caregivers of Older Allogeneic Hematopoietic Cell Transplantation Patients: A Single Institution Retrospective Review

Older adults represent a significant population of allogeneic hematopoietic cell transplant (allo-HCT) recipients; in 2018, 38% of allo-HCT recipients were 60 or older (D’Souza et al., 2020). Allo-HCT is a potentially curative therapy for hematologic malignancy, but one that comes with significan...

Read More

Tisotumab Vedotin Safety and Tolerability in Clinical Practice: Managing Adverse Events

Cervical cancer is the fourth most frequently diagnosed and fourth most deadly cancer in women worldwide (Arbyn et al., 2020; Bray et al., 2018). Patients with recurrent or metastatic cervical cancer (r/mCC) experience a significant burden from disease-related symptoms, such as vaginal bleeding a...

Read More

Physical Activity in Multiple Myeloma: A Review of the Current Literature

Being and staying active as a daily routine can be a significant challenge for patients diagnosed with multiple myeloma (MM). Not only do patients have to deal with the concomitant symptoms of the disease, but they also must face the limiting side effects of treatment. Fatigue, increased muscle t...

Read More

Using Pleomorphic Adenoma Gene 1 (PLAG1) to Distinguish Carcinoma of the Parotid Gland From Primary Lung Cancer: A Case Study

Case Study A 40-year-old female never-smoker with no significant medical history presented with right-side facial swelling worsening over the course of 3 months, with progressive discomfort emanating from her right cheek and radiating to her right ear. An MRI of the skull base with and without c...

Read More

Teclistamab-cqyv: The First Bispecific T-Cell Engager Antibody for the Treatment of Patients With Relapsed or Refractory Multiple Myeloma

Multiple myeloma (MM) is a plasma cell disorder characterized by the clonal proliferation of malignant plasma cells in the bone marrow with monoclonal protein in the serum and/or urine and associated organ dysfunction (Kyle & Rajkumar, 2004). Multiple myeloma is the second most common hematol...

Read More

Convergence of Hematology and Rheumatology: A Case Study

History MG is a 55-year-old male with a past medical history that is significant for type 2 diabetes mellitus, hypothyroidism, and auricular chondritis (Figure 1). Chief complaint He presented to the emergency room with reports of fevers up to 100.8°F, significant fatigue, and weakness. Dia...

Read More

Oncology Advanced Practice Posters: New Research and Insights Into Our Future

Presenting a poster at a conference is an important way for us as advanced practitioners to showcase our work, receive feedback, and affect future directions in the way we care for our patients. Conversely, as an attendee, I am always inspired by the work of my colleagues and energized to find ne...

Read More

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

The nurse practitioner (NP) role has evolved over time within the health-care workforce. The addition of prescriptive privileges for NPs has led to greater role independence. Nurse practitioners have the ability to prescribe controlled substances in all states (American Association of Nurse Pract...

Read More

Serious Illness Conversation Training for Inpatient Medical Oncology Advanced Practice Providers: A Quality Improvement Project

The American Cancer Society estimated in 2022 there would be 1.9 million new cancer cases, 609,360 cancer deaths, and 18 million cancer survivors in the United States (National Cancer Institute, 2022). These large numbers reflect the magnitude of people living with cancer. The primary site for 70...

Read More

Interventions to Improve Advanced Practitioner Work-Related Quality of Life and Patient Satisfaction

Nurse practitioners (NPs) and physician assistants (PAs) serve a critical role in the care of hospitalized patients with cancer. Given the rising demand for cancer treatments and shortage of physicians within the United States, NPs and PAs are well positioned to meet patient needs (Yang et al., 2...

Read More

The Role of the Research Advanced Practice Provider in CAR T-Cell Clinical Trials

In recent years, chimeric antigen receptor (CAR) T-cell therapy has emerged as an effective therapy for patients with refractory lymphoma and myeloma. To date, six CAR T-cell therapies have been approved by the US Food and Drug Administration (FDA) for this patient population (Table 1). These app...

Read More

Polatuzumab Vedotin for the Front-Line Treatment of Diffuse Large B-Cell Lymphoma: A New Standard of Care?

Case Study Mr. D is a well-educated 71-year-old male who presents to clinic with complaints of an enlarging neck mass, general malaise, and fatigue. A core needle biopsy is performed that reveals a diagnosis of non-germinal center B-cell diffuse large B-cell lymphoma. A subsequent PET scan revea...

Read More

Advanced Practice Provider Model for Urgent Oncology Care

There was an estimated 1.9 million cancer cases diagnosed and 609,360 cancer-related deaths in 2022 in the United States (American Cancer Society, 2022). Cancer treatment advances have expanded through the years to more complex regimens and novel therapies with diverse mechanisms of action and un...

Read More

Role of Luspatercept in the Management of Lower-Risk Myelodysplastic Syndromes

Myelodysplastic syndromes (MDS) are a group of malignant stem cell disorders characterized by clonal hematopoiesis, cytopenias (anemia, neutropenia, and/or thrombocytopenia), and progression to acute myeloid leukemia in approximately 20% of cases (Falantes et al., 2018; Pereira et al., 2011). App...

Read More

Indeterminate Thyroid Nodules: When to Worry?

History Mrs. C is a 56-year-old woman with a history of depression, anxiety, and kidney stones, and was diagnosed with multiple thyroid nodules in February 2020. She was seeing a local endocrinologist for abnormal thyroid function tests when the endocrinologist palpated the nodules on physical e...

Read More

Clinical Posters From JADPRO Live 2022

JL1001C: A Bone Marrow Aspirate and Biopsy Educational Program for Advanced Practice Providers Utilizing Task Trainers Jessica Casselberry, DNP, ANP-BC, AOCNP, Glen J. Peterson, RN, DNP, ACNP, Jessica Zucker, MSN, AGNP-BC; University of Colorado, School of Medicine, Division of Hematology Backg...

Read More

---

2022 ASCO Annual Meeting: Takeaways for the Advanced Practitioner

Welcome to our special issue on highlights from the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting. Taking place from June 3 to 7, 2022, oncology professionals from around the world convened in Chicago to discuss the latest in cancer research. The more than 2,800 abstracts prese...

Read More

Breast Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract LBA3: DESTINY-Breast04 Trial: T-DXd Significantly Improves Survival in Patients With HER2-Low Metastatic Breast Cancer By Alice Goodman Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.17_suppl.LBA3 to read the full abstract and view author disclosures. The antibody-drug conjuga...

Read More

Thoracic Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract 8501: Neoadjuvant Nivolumab and Chemotherapy: A New Standard for Resectable Stage IIIA NSCLC? By JADPRO Staff Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.8501 to read the full abstract and view author disclosures. At the annual American Society of Clinical Oncology...

Read More

Gastrointestinal Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract LBA1: In Metastatic RAS Wild-Type Left-Sided Colorectal Cancer, Panitumumab Proves Superior to Bevacizumab By Caroline Helwick Visit https://ascopubs.org/doi/10.1200/JCO.2022.40.17_suppl.LBA1 to read the full abstract and view author disclosures. The preferred targeted therapy for lef...

Read More

Genitourinary Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract LBA4503: MET and CTLA-4 Inhibitors Do Not Add to Efficacy of Durvalumab in Advanced ccRCC By JADPRO Staff Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.17_suppl.LBA4503 to read the full abstract and view author disclosures. Adding the MET inhibitor savolitinib or the CTLA-4 i...

Read More

Gynecologic Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract LBA5500: Rucaparib Maintenance Improves Progression-Free Survival in Patients With Newly Diagnosed Advanced Ovarian Cancer Who Responded to Platinum-Based Therapy By Alice Goodman Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.17_suppl.LBA5500 to read the full abstract and view...

Read More

Melanoma: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract LBA9500: KEYNOTE-716: Adjuvant Pembrolizumab Significantly Improves DMFS and RFS in Patients With Stage II Melanoma By JADPRO Staff Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.17_suppl.LBA9500 to read the full abstract and view author disclosures. After 27.4 months of follo...

Read More

Head and Neck Cancer: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract 6000: Radiation Alone Instead of Concurrent Chemotherapy for Intermediate-Risk Nasopharyngeal Carcinoma By JADPRO Staff Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.6000 to read the full abstract and view author disclosures. In patients with intermediate-risk (stage...

Read More

Hematologic Malignancies: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract LBA4: Early Transplant With Triplet Therapy May Delay Progression of Myeloma, but Individualized Approach Recommended By Caroline Helwick Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.17_suppl.LBA4 to read the full abstract and view author disclosures. In the phase III DETERM...

Read More

The AP Role in Clinical Research: 2022 ASCO Annual Meeting Highlights for the Advanced Practitioner

Abstract 1503: Oncology Clinical Pharmacist Intervention Leads to Increased Clinical Trial Enrollment in The US Oncology Network’s MYLUNG® Consortium By JADPRO Staff Visit https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.1503 to read the full abstract and view author disclosures. The ...

Read More

Complexities of Care and the Interdisciplinary Team

Many of you who are reading this article are advanced practitioners (APs) and experts in the management of complex patient symptoms. Despite managing “side effects” of treatment for years as a nurse, then an advanced practitioner, I did not fully comprehend the concepts of symptom management, sym...

Read More

Improving Cancer Care Delivery: Learnings for Oncology Nurses and Patient Navigation From a National Quality Survey

Cancer of the lung and bronchus remained the leading cause of cancerspecific mortality and was the second leading cause of newly diagnosed cancer cases in the United States in 2019 (Siegel et al., 2019). Non–small cell lung cancer (NSCLC) accounts for the majority (80%–85%) of histological confir...

Read More

Solid Pseudopapillary Neoplasm: A Single Institutional Case Series of a Rare Pancreatic Tumor

The incidental finding of pancreatic cystic lesions has increased with the use of cross-sectional imaging, with prevalence up to 3% in CT and up to 20% in MRI (Laffan et al., 2008). Pancreatic cystic neoplasms (PCN) are a subtype accounting for approximately 15% of pancreatic cystic lesions (Krom...

Read More

Measuring Advanced Practice Provider Productivity at the National Comprehensive Cancer Network’s Member Institutions

Advanced practice providers (APPs) specializing in oncology are critical team members in cancer centers across the US. Many cancer patients will see an APP team member, which enables oncologists to see more patients, thereby increasing access to care. As the US population ages and fewer medical o...

Read More

Barriers to Adherence to Cancer Treatments Among Head and Neck Cancer Patients

Head and neck cancer (HNC) includes cancers of the mouth, throat, larynx, nasal cavity, and sinuses. The American Cancer Society (2021a) estimates there were over 54,000 new cases and 10,000 deaths attributed to HNCs in 2021. The most common risk factors for HNC include alcohol and tobacco use, a...

Read More

Richter Transformation: Clinical Manifestations, Evaluation, and Management

Case Study Presentation A 70-year-old Caucasian woman who was diagnosed 2 months ago with chronic lymphocytic leukemia (CLL) via complete blood cell count and peripheral flow cytometry on active surveillance presented to the clinic with a 2-week history of night sweats along with low-grade feve...

Read More

An Approach to Diagnosis of Richter Transformation in Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is a chronic incurable heterogenous B-cell disease with a highly variable clinical course (Ding, 2018; Rosati et al., 2018; Khan et al., 2018). Richter transformation (RT) is defined as a histologic transformation of CLL to an aggressive lymphoma known as diffus...

Read More

The Current Landscape for METex14 Skipping Mutations in Non–Small Cell Lung Cancer

There are an estimated 609,360 cancer deaths projected to occur in the United States in 2022 (Siegel et al., 2022). Almost one quarter of those cancer deaths are due to lung cancer. These low survival rates reflect 57% of patients diagnosed with metastatic disease for which the 5-year survival ra...

Read More

Do You Employ Shared Decision-Making in Your Practice?

Imagine this scenario: A patient is scheduled to see you for a routine follow-up appointment. You are co-managing this patient with a physician. In preparation for the encounter, you review the chart and note that the patient obtained surveillance labs and CT scans earlier in the week in preparat...

Read More

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

Malignancy is the second leading cause of death in the United States and was attributed to 44.9% of all mortality in 2016 (Heron, 2016). The incidence of emergency department (ED) visits by cancer patients has grown over the past years and continues to do so (Delgado-Guay et al., 2015). In additi...

Read More

Implementing a Clinical Decision Tool to Improve Oncologic Venous Thromboembolism Management

Venous thromboembolic (VTE) disease in cancer patients is associated with significant morbidity, mortality, and cost (Seroussi et al., 2019). Cancer patients are also at greater risk for hospitalization and bleeding compared with non-cancer patients (Frere et al., 2019; Nene & Coyne, 2017). P...

Read More

Practical Management of the Venetoclax-Treated Patient in Chronic Lymphocytic Leukemia and Acute Myeloid Leukemia

Venetoclax (Venclexta) is a potent, selective, and orally bioavailable small-molecule inhibitor of B-cell lymphoma 2 (BCL-2), a protein that is overexpressed in chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and acute myeloid leukemia (AML; Jia et al., 2008; Tzifi et al., 201...

Read More

Practical Strategies for Advanced Practitioners Streamlining the Integration of Oncology Biosimilar Therapies Into Practice

Biologics derived from living organisms comprise half of the pharmacologic market share in oncology (Konstantinidou et al., 2020). Manufacturing exact copies of any biologic is impossible, given their inherent variability (Congressional Research Service Report, 2019). Biosimilars are highly simil...

Read More

COVID-19 Vaccine Effectiveness in Oncology Patients

In 2019, a global pandemic emerged from a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), now a ubiquitous household term. COVID-19 has caused significant morbidity and mortality, resulting in nearly 1 million deat...

Read More

Encorafenib and Binimetinib Combination Therapy in Metastatic Melanoma

Incidence rates of cutaneous melanoma have increased over the past few decades, currently accounting for 1% of all skin cancers. In 2022, an estimated 108,480 new cases will be diagnosed, and 11,990 people are expected to die of melanoma. Metastatic melanoma is associated with high mortality, wit...

Read More

JADPRO Live Virtual 2021: New Paths to Patient Care

This past October, over 1,000 nurse practitioners, PAs, pharmacists, and other oncology professionals attended the ninth annual JADPRO Live conference, which was held virtually from October 7 to 17. The conference featured educational sessions, networking opportunities, and poster presentations t...

Read More

Positive Practice Changes After the COVID-19 Pandemic: From the Advanced Practice Provider Perspective

The COVID-19 pandemic may have changed some aspects of health care forever. At JADPRO Live Virtual 2021, a panel discussion focused on how several cancer centers faced challenges, and what changes the participants view as positive. JADPRO Live is an annual educational conference for advanced prac...

Read More

Pull Up a Seat: Engaging Patients as Empowered Partners in Health Equity Transformation

As an immigrant from Liberia, Maimah Karmo has experienced disparities firsthand. Today, the CEO and Founder of Tigerlily Foundation is a leader in the field of women’s health—and a breast cancer survivor. By working with members of Congress, Ms. Karmo has created and implemented national health ...

Read More

Identifying the Leader in You

Achieving a goal may look like sunshine and rainbows from afar, but the leadership journey is rarely a smooth and unbroken path towards success. During JADPRO Live Virtual 2021, Elisabeth King, FNP-C, Executive Director of Genomics and Precision Medicine, City of Hope, and Sara Toth, FNP-C, Direc...

Read More

Thriving, Not Just Surviving: Recognizing Burnout and Simple Tips to Start Feeling Better

An estimated one third of oncology providers had burnout prior to COVID-19. Unfortunately, these percentages have risen substantially since the start of the pandemic. During JADPRO Live Virtual 2021, Margaret Leddy, PA-C, MMSc, physician assistant and Duke Wellness Ambassador, defined burnout in ...

Read More

A Call to Action: The Role of the Oncology AP in Equitable Cancer Care

In the spring of 2021, the Association of Community Cancer Centers (ACCC), Harborside, and collaborative partner Pfizer Oncology hosted a 3-day virtual summit to define the role of oncology advanced practitioners (APs) in equitable cancer care delivery. During JADPRO Live Virtual 2021, Brianna Ho...

Read More

The Advanced Practice Role in Clinical Trials: Past, Present, and Future

Although enrollment has increased slightly in recent years, it is estimated that only 8% of patients with cancer in the United States enroll in a clinical trial (Hillyer et al., 2020). According to Colleen Lewis, MSN, ANP-BC, AOCNP®, Director of Clinical Operations, Phase I Program, Winship Cance...

Read More

Race, Social Determinants of Health, and Cancer: How Can APs Address and Improve Patient Outcomes?

Advancements in the fight against cancer have not equitably benefitted all population groups. Between 1991 and 2016, the overall cancer death rate declined by 27%, yet socioeconomic disparities in cancer mortality widened, with the most striking disparities observed in cancers most amenable to pr...

Read More

Multidisciplinary Tumor Boards and Guiding Patient Care: The AP Role

Discussion of cancer cases in a multidisciplinary setting goes back more than a century, but in recent decades, multidisciplinary tumors boards (MTBs) have taken on a greater role in cancer care as the field grows in complexity. During JADPRO Live Virtual 2021, Joan Okasako, MSN, FNP-BC, RN, AOCN...

Read More

Clinically Relevant Drug Interactions in the Cancer Setting

Recognizing clinically relevant drug interactions—drug-drug, drug-food, and drug-herbal—remains an important challenge for advanced practitioners. At JADPRO Live Virtual 2021, David DeRemer, PharmD, BCOP, FCCP, FHOPA, discussed the pharmacodynamic and pharmacokinetic mechanisms of drug interactio...

Read More

Cardio-Oncology Considerations in Oncologic Treatment Decisions

The growing awareness that many anticancer agents can be cardiotoxic to patients has led to a subspecialty field now known as cardio-oncology. As part of the interdisciplinary oncology team, advanced practitioners play a critical role in identifying, monitoring, and managing the cardiac complicat...

Read More

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

Patients with comorbid mental health and substance use disorders are at greater risk for mortality and have higher cancer care costs. During JADPRO Live Virtual 2021, Lisa W. Goldstone, MS, PharmD, BCPS, BCPP, of the University of Southern California School of Pharmacy, discussed the need for rou...

Read More

An AP Perspective on Infusion Reactions in the Era of Immunotherapy

Although rare, infusion-related reactions to immunotherapy can lead to longer infusion times, medical interventions, hospitalizations, treatment discontinuations, and even death. According to Carrie Peterson, DNP, RN, AGNP-c, knowing how these medications work and how the body responds to these m...

Read More

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

Cancer significantly increases the risk of developing venous thromboembolism (VTE), which is the second leading cause of death in people with cancer. During JADPRO Live Virtual 2021, Mailey L. Wilks, DNP, APRN, NP-C, of the Cleveland Clinic, reviewed the currently available anticoagulants, includ...

Read More

Survivorship Care Challenges: Navigating Changing Concerns

With a growing population of more than 17 million cancer survivors in the United States, survivorship care is more important than ever. During JADPRO Live Virtual 2021, Carrie Tompkins Stricker, PhD, RN, ANP-BC, of Thomas Jefferson University, in Pennsylvania, described the evolving demographic, ...

Read More

Herbal Medicine: Friend or Foe?

The practice of naturopathic medicine is growing rapidly in the United States, with 23 states currently licensing naturopathic physicians from six approved schools in the United States. During JADPRO Live Virtual 2021, Roberta Bourgon, ND, a naturopathic physician at Billings Clinic in Montana, d...

Read More

Oncology Urgent Care Clinics: Understanding Utilization and Best Practices

During JADPRO Live Virtual 2021, Cara Fleming, AGPCNP-BC, AOCNP®, and Deirdre Kelly, AGACNP-BC, of Memorial Sloan Kettering Cancer Center, discussed the metrics, logistics, and workflow used when establishing a successful advanced practitioner (AP)-led oncology urgent care clinic (OUCC). The pres...

Read More

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

Approximately 2 out of 3 patients with gastrointestinal cancer are malnourished at the time of surgery, but only 1 out of 5 patients receives any preoperative nutrition intervention. According to Paul Wischmeyer, MD, EDIC, FCCM, FASPEN, Professor of Anesthesiology and Surgery, Associate Vice Chai...

Read More

2020–2021 Drug Updates in Solid Tumors

Between October 2020 and September 2021, there were 32 drug approvals in solid tumor oncology, including 23 regular approvals and 9 accelerated approvals. During JADPRO Live Virtual 2021, Christine Cambareri, PharmD, BCPS, BCOP, CSP, of the University of Pennsylvania Abramson Cancer Center, revie...

Read More

2020–2021 Drug Updates in Hematologic Malignancies

With multiple new approvals and new indications, 2021 was the year of CAR T-cell therapies in hematologic malignancies. Joining the list of approvals were PI3K inhibitors, anti-CD38 monoclonal antibodies, and expanded indications for immunotherapy.  During JADPRO Live Virtual 2021, Kirollos Hann...

Read More

2020–2021 Drug Updates: Investigational Therapeutics in the Pipeline

Investigators are currently evaluating many new agents in the hematology/oncology pipeline, including novel immunotherapies that can potentially complement existing immunotherapies. Emerging therapeutics are also being evaluated in very difficult-to-treat patient populations, such as TP53-mutant ...

Read More

Biomarker Jeopardy

Biomarker expression is playing an increasingly important role with the continued approval of a growing number of targeted therapies. In a session called “Biomarker Jeopardy” during JADPRO Live Virtual 2021, Alyssa Henglefelt, PharmD, BCOP, HonorHealth – Virginia G. Piper Cancer Care Network, and...

Read More

Immunotherapy for the Treatment of Triple-Negative Breast Cancer

Checkpoint inhibitors as monotherapy have demonstrated limited activity in metastatic triple-negative breast cancer, but when given in combination with chemotherapy, significant improvements in disease control and survival have been made. During JADPRO Live Virtual 2021, Sara M. Tolaney, MD, MPH,...

Read More

Lung Cancer Biomarker Speak: Teach Me the Language

There are currently nine actionable biomarkers in non–small cell lung cancer (NSCLC), and the list of targeted therapies continues to grow. During JADPRO Live Virtual 2021, Beth Sandy, MSN, CRNP, and Jennifer Morrissette, PhD, FACMG, reviewed the importance of molecular testing in NSCLC and descr...

Read More

Multidisciplinary Management of Resectable Early-Stage Non-Small Cell Lung Cancer

In 2021, approximately 235,760 Americans were diagnosed with lung cancer, which remains the leading cause of cancer-related deaths in the United States. In fact, last year, more than three times as many Americans lost their lives to lung cancer (155,870) than colorectal cancer (50,260), which is ...

Read More

Multidisciplinary Management of Pancreatic Cancer

An aggressive disease with a high mortality rate, the 5-year relative survival of pancreatic cancer remains a dismal 10.8%. A multidisciplinary approach with supportive oncology and palliative care expertise continues to offer the best chance for successful care.  During JADPRO Live Virtual 2021...

Read More

Updates in the Management of Renal Cell Carcinoma

The most common kidney cancer, renal cell carcinoma is diagnosed in over 300,000 patients worldwide each year, including 74,000 patients in the US. Despite therapeutic advances, 5-year survival is still less than 12% for patients with metastatic disease.  During JADPRO Live Virtual 2021, Kirollo...

Read More

Updates in Cholangiocarcinoma

A rare and deadly cancer, the incidence of cholangiocarcinoma is on the rise, and prognosis remains dismal. For patients with resectable disease, the 5-year survival rate is between 15% to 25%, and for those with metastatic disease, the survival drops to only 2% at 5 years. The recent approvals o...

Read More

Molecular Testing in Hematologic Malignancies

As molecular testing technologies are increasingly integrated into clinical research and patient care, they have become essential tools for the treatment of hematologic malignancies. According to Laura J. Zitella, MS, RN, ACNP-BC, AOCN®, nurse practitioner and Associate Clinical Professor at the ...

Read More

New Frontiers: The Role of CAR T-Cell Therapy in Multiple Myeloma

The second most common hematologic malignancy, multiple myeloma remains incurable, with high rates of relapse. Recent advances in combination therapies and new treatment options, however, continue to improve prognosis and survival.   During JADPRO Live Virtual 2021, Alli McClanahan, APRN, and Me...

Read More

Role of the Advanced Practitioner in the Management of Oral Chemotherapy for Adults With AML

Acute myeloid leukemia (AML) is the most common form of acute leukemia among adults and accounts for the largest number of annual deaths due to leukemias in the US. Recent advances in targeted therapies and low-intensity regimens, however, have resulted in an expansion of treatment options for pa...

Read More

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

The treatment of chronic immune thrombocytopenia (cITP) has changed significantly in recent years with the approval of several new drugs, but patient preference still plays an important role in the management of this disease. During JADPRO Live Virtual 2021, David Hughes, PharmD, BCOP, of Boston ...

Read More

Updates in the Diffuse Large B-Cell Lymphoma Treatment Landscape

A number of novel agents have entered the therapeutic arena for diffuse large B-cell lymphoma (DLBCL). Chief among these are antibody-drug conjugates and chimeric antigen therapy (CAR) T-cell therapies. While new treatments are improving survival, the COVID-19 pandemic has added another layer to ...

Read More

Letter to the Editor

Beth Faiman, PhD, MSN, APRN-BC, AOCN®, BMTCN, FAAN JADPRO, Editor-in-Chief Dear Dr. Faiman, We read with interest the April 2022 JADPRO meeting report article, “Molecular Testing in Hematologic Malignancies”, as presented by Laura Zitella, MS, RN, ACNP-BC, AOCN®. We were pleased that Ms. Zitell...

Read More

How to Succeed as an Advanced Practitioner in a Multifaceted Role

Nearly 20 years ago, I was one of the first in an advanced practitioner (AP) role in the outpatient area of a major academic institution. There was one other AP at the time I was hired, so I asked to shadow her for a day. I could see that she was a highly respected expert in her clinical area, an...

Read More

Role of Oncology Advanced Practitioners to Enhance Clinical Research

Oncology advanced practitioners (APs), including nurse practitioners, clinical nurse specialists, physician assistants, and clinical pharmacists, contribute significantly to quality cancer care. Advanced practitioners enhance value across the spectrum of cancer care. Research is an underdeveloped...

Read More

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

Radical prostatectomy is a commonly performed cancer treatment for men with prostate cancer, and approximately 90,000 cases are performed annually in the United States (Lowrance et al., 2012). While a significant reduction in postoperative pain has been observed with widespread implementation of ...

Read More

Cardiovascular Adverse Events and Mitigation Strategies for Chronic Myeloid Leukemia Patients Receiving Tyrosine Kinase Inhibitor Therapy

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the Philadelphia (Ph) chromosome that results from the reciprocal translocation of the Abelson murine leukemia (ABL1) gene on chromosome 9 with the Breakpoint cluster gene (BCR) on chromosome 22 thereby producing a c...

Read More

Evidence-Based Criteria Supporting Early Discharge for Pediatric Patients With Osteosarcoma Receiving High-Dose Methotrexate: A Retrospective Chart Review

High-dose methotrexate (MTX) is a commonly used chemotherapeutic agent for multiple types of pediatric malignancies and has remained one of the gold standards of chemotherapies in treatment for osteosarcoma for the past few decades. Methotrexate was first used for osteosarcoma in the early 1970s ...

Read More

Myasthenia Gravis: A Rare Neurologic Complication of Immune Checkpoint Inhibitor Therapy

Case Studies A 64-year-old female with a history of hypertension, hypothyroidism, irritable bowel syndrome, and cutaneous malignant melanoma was started on treatment with a combination of ipilimumab (Yervoy) and nivolumab (Opdivo). Eight days after her first infusion of ipilimumab and nivolumab,...

Read More

Tazemetostat: EZH2 Inhibitor

A growing area of interest within cancer treatment are the targeted epigenetic regulators. Epigenetic regulation is a genomic process that reversibly modifies gene expression without altering DNA sequencing (Zhao et al., 2018). This process involves transcription regulation, which is vital for no...

Read More

Lower Extremity Edema: More Than Just the Routine Workup

The patient, NG, is a 51-year-old male diagnosed with widespread recurrent follicular lymphoma after a multitude of prior chemotherapy and immunochemotherapy regimens, including high-dose radioimmunotherapy with autologous stem cell support. He has an extensive past medical and surgical history. ...

Read More

Resolving Not to Make New Year’s Resolutions

Recently, a colleague and I aimed to discuss something other than the surge in the number of COVID-19 cases that have affected the country. Advanced practitioners (APs) across the nation are facing unpredictable and stressful situations such as critically short staffing and decision-making challe...

Read More

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

Pain is a significant problem in patients with cancer. A meta-analysis of 22 studies indicates that pain is prevalent in 55.0% of patients undergoing active anticancer treatment and in 66.4% of patients with advanced, metastatic, or end-stage disease. Pain is uncontrolled and rated as moderate to...

Read More

General and Unique Communication Skills Challenges for Advanced Practice Providers: A Mixed-Methods Study

Advanced practice providers (APPs) play an increasing role in the United States health-care system, and they are often on the front lines of patient care in ambulatory, inpatient, and specialty care settings (Auerbach et al., 2018; Pastores et al., 2019). Advanced practice providers are independe...

Read More

Emerging Treatment Options for Advanced or Recurrent Endometrial Cancer

Endometrial cancer (EC) is the most common gynecologic malignancy in the United States, with an estimated 65,950 new cases and 12,550 deaths in 2022 (American Cancer Society, 2022). Over the past decade, the incidence has increased by about 1% per year, which is thought to be related to longer li...

Read More

Antibiotic Therapy and Gastrointestinal Graft-Versus-Host Disease in the Allogeneic Stem Cell Transplantation Population

Hematopoietic stem cell transplantation (HSCT) is a treatment option for many individuals who have been diagnosed with cancers such as leukemia, lymphoma, and myeloma. In particular, allogeneic stem cell transplantations (aSCTs) may be associated with long-term sequelae that can affect an individ...

Read More

Uterine Leiomyosarcoma

CASE STUDY LM is a 51-year-old African American female (gravida 5, para 5) who presented to her primary care provider with complaints of postmenopausal bleeding for 3 days and associated pelvic pain radiating to the left hip. An ultrasound revealed an enlarged uterus (9.9 × 6.1 × 5.6 cm) with mu...

Read More

Belantamab Mafodotin-blmf: A Novel Antibody-Drug Conjugate for Treatment of Patients With Relapsed/Refractory Multiple Myeloma

Multiple myeloma (MM) is a hematologic malignancy characterized by proliferation of plasma cells with or without production of monoclonal immunoglobulins. The median age of diagnosis is 69 years, with a 5-year survival rate of 54% (American Society of Clinical Oncology, 2021a). Symptomatic multip...

Read More

Mysterious Arm Swelling in a Patient With Non-Hodgkin Lymphoma Complicated by Superior Vena Cava Syndrome

History OJ is a 40-year-old female with no significant past medical history. In January 2021, she noticed that her left neck veins were bulging, and she was diagnosed with a left internal jugular deep vein thrombosis. She was placed on apixaban and subsequently rivaroxaban and had a workup for t...

Read More

JADPRO Live Virtual 2021

The JADPRO Live 2021 conference for advanced practitioners in oncology was held virtually from October 7 through 17. Attendees were able to earn up to a whopping 31.25 credits from the comfort of their home or work. For those of you who were able to attend, I hope you enjoyed the sessions and the...

Read More

Development and Implementation of an Advanced Practitioner–Led Survivorship Clinic for Patients Status Post Allogeneic Transplant

More patients have the opportunity to undergo the intensive treatment of hematopoietic cell transplantation (HCT) for leukemia, lymphoma, and multiple myeloma, in part due to expanding sources of stem cells and less toxic conditioning regimens. More than 20,000 transplants are performed annually ...

Read More

Assessment of Oncology Provider Knowledge and Cardiovascular Screening Practices: A Call for Heightened Screening

Advancements in screening technologies and increasingly effective novel treatments for cancer have led to vast improvements in cancer survival rates. The improved outcomes have changed the demographics of cancer survivors to a larger population of aging individuals who are subject to late-onset s...

Read More

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

Virtually all anticancer regimens have potential adverse events. Often, some of these adverse events, such as chemotherapy- and radiation-induced nausea and vomiting (CINV; RINV), infusion reactions (IRs), and edema, can be prevented or ameliorated by the administration of premedications. Therefo...

Read More

Telehealth Interventions for Supportive Management and Early Recognition of Treatment-Related Symptoms in Patients With Hematologic Malignancies

Across the globe, as we work to navigate through the COVID-19 pandemic and adapt to the changing landscape of health-care delivery, providers are searching for ways to continue to provide high-quality care to patients, without compromising the health and safety of the public. To do this, the util...

Read More

Retroperitoneal Liposarcoma: An Unusual Presentation of a Rare Cancer

Case Study Patient X is a 37-year-old otherwise healthy male who presented for a second opinion regarding treatment for his RLPS. According to the patient report, he initially visited his local emergency department (ED) with complaints of right groin and testicular pain. He had an ultrasound, wh...

Read More

Improving Health Equity: The Role of the Oncology Advanced Practitioner in Managing Implicit Bias

The Institute of Medicine’s report, To Err is Human: Building a Safer Health System, shocked institutional health care with the revelation that as many as 98,000 people die per year in hospitals due to medical error (IOM, 2000). The IOM followed this report with Crossing the Quality Chasm: A New ...

Read More

Abstracts From JADPRO Live 2021

JL901: A Comprehensive Bone Marrow Aspirate and Biopsy Educational Program for Advanced Practice Providers Utilizing Task Trainers Jessica Casselberry, MSN, ANP-BC, AOCNP®, Glen J. Peterson, RN, DNP, ACNP, Jessica Zucker, RN, MSN, AGNP-C; University of Colorado School of Medicine Background: Ad...

Read More

---

Editorial

Thank You to Our Peer Reviewers!

In this last issue of the year, we would like to acknowledge the 71 reviewers who completed peer reviews for JADPRO in the past year. Our reviewers practice in a range of oncology specialties and professions and dedicate their time and expertise to provide thoughtful, constructive feedback. Their...

Read More

---

2021 ASCO Annual Meeting: Takeaways for the Advanced Practitioner

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Melanoma: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Publish or Perish

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

Read More

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

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

Read More

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

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

Read More

Treatment Options for Germline BRCA-Mutated Metastatic Pancreatic Adenocarcinoma

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Ensuring the Safety of Hospitalized Oncology Patients During a Pandemic

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

Read More

Pegfilgrastim Biosimilars: Where Are We Now?

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

Read More

Quality Improvement Projects and Clinical Research Studies

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

Read More

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

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

Read More

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

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

Read More

Management of Hematologic Adverse Events Associated With Immune Checkpoint Inhibitors

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

Read More

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

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

Read More

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

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

Read More

Practical Considerations for Integrating Biosimilars Into Clinical Practice

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

Read More

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

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

Read More

JADPRO Live Virtual 2020: Learning Today, Leading Tomorrow

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

Read More

Advanced Practitioner Leadership in Times of Crisis

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

Read More

Words Matter: Use of Respectful Language in Oncology

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

Read More

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

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

Read More

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

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

Read More

Cardio-Oncology: The Intersection Between Cardiovascular Disease and Cancer

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

Read More

Management of Diabetes in the Patient With Cancer

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

Read More

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

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

Read More

Approach to the Hospitalized Patient With Thrombocytopenia

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

Read More

Mitigating the Morbidity of Financial Toxicity in Cancer Care

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

Read More

2019–2020 Drug Updates in Solid Tumors

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

Read More

2019–2020 Drug Updates in Hematologic Malignancies

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

Read More

Biomarker Jeopardy

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

Read More

Immune Checkpoint Inhibitors: Common Questions About Uncommon Adverse Events

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

Read More

FDA and Its Role in Drug Development

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

Read More

Advanced Prostate Cancer: Considerations for Advanced Practitioners

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

Read More

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

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

Read More

A Multidisciplinary Approach to Head and Neck Cancer

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

Read More

Developments in Hepatocellular Cancer Treatment

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

Read More

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

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

Read More

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

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

Read More

Sarcoma: Disease Overview and Treatment Updates

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

Read More

Optimizing Treatment of Chronic Lymphocytic Leukemia

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

Read More

Diagnosis and Treatment of AL and ATTR Amyloidosis

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

Read More

Improving Outcomes in Hematopoietic Stem Cell Transplant: Recent Advances

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

Read More

Hemolytic Anemias: Autoimmune and Beyond

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

Read More

A Case of Unintentional Nonadherence

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

A Role to Alleviate Burnout and Maintain Quality of Care

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

Read More

Caplacizumab for Acute Thrombotic Thrombocytopenic Purpura

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

Read More

What Is the Cause of This Biliary Stricture?

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

Read More

Approved mRNA Vaccines for SARS-CoV-2

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

Read More

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

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

Read More

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

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

Read More

Roadmap to the Enhanced Thoracic Surgical Journey

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

Read More

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

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

Read More

Metastatic Melanoma With Leptomeningeal Disease

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

Read More

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

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

Read More

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

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

Read More

Is This Patient’s Liver Mass Cancer?

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

Read More

JADPRO Live Virtual 2020

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

Read More

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

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

Read More

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

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

Read More

Acute Myeloid Leukemia: Advanced Practice Management From Presentation to Cure

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

Read More

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

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

Read More

Oncology Advanced Practitioners and Breast Cancer Prevention

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

Read More

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

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

Read More

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

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

Read More

Abstracts From JADPRO Live 2020

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

Read More

Thank You to Our Peer Reviewers!

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

Read More

---

ASCO20 Virtual Scientific Program: Takeaways for the Advanced Practitioner

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

Read More

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

Abstract LBA4: Rates of Progression-Free Survival in MSI-H/dMMR Metastatic Colorectal Cancer Doubled by Pembrolizumab By The ASCO Post Staff Visit https://meetinglibrary.asco.org/record/186928/abstract to read the full abstract and view author disclosures. Upfront treatment with immunotherapy...

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Melanoma: ASCO20 Virtual Scientific Program Highlights for the Advanced Practitioner

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

A Decade of JADPRO

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Phase 1 Clinical Trials in the Elderly: Enrollment Challenges

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Advanced Practitioners and the COVID-19 Pandemic

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Waldenström Macroglobulinemia: Clinical Presentation, Diagnosis, and Management

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

Read More

Mayo Clinic Hematology Fellowship for Advanced Practice Providers

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

Read More

Development of a Hematology-Oncology Advanced Practice Provider Fellowship Program

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

Read More

Advancements in Therapy for Bladder Cancer: Enfortumab Vedotin

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

Read More

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

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

Read More

JADPRO Live 2019: Practice Innovation

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

Read More

Precision Oncology Comes of Age: Tumor-Agnostic Approaches

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

Read More

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

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

Read More

Biomarker BINGO

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

Read More

Adoptive Cell Therapies: Keeping Pace With New and Emerging Advances

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

Read More

Challenges of Integrating Biosimilars Into Clinical Practice

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

Read More

2018–2019 Drug Updates in Hematologic Malignancies

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

Read More

2018–2019 Drug Updates in Solid Tumors

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Creating Clarity in Metastatic Melanoma: Optimizing Treatment and Improving Outcomes

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

Read More

Improving Outcomes for Patients With Advanced Urothelial Carcinoma

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

Read More

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

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

Read More

Current and Future Directions for PARP Inhibition

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

Read More

Recent Advances in the Treatment Of Newly Diagnosed Multiple Myeloma

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

Read More

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

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

Read More

Improving Outcomes for Patients With Chronic Lymphocytic Leukemia

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

Read More

Addressing the Challenges of Aggressive Lymphomas

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

Read More

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

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

Read More

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

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

Read More

An Advanced Practice Provider Initiative for Delirium Management in the ICU

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

Read More

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

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

Read More

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

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

Read More

Precautions for Patients Taking Aromatase Inhibitors

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

Read More

Determination of the Fair Market Value of Oncology Advanced Practitioners

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

Read More

Glasdegib: A Novel Hedgehog Pathway Inhibitor for Acute Myeloid Leukemia

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

Read More

Breast Density and Breast Cancer

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

Read More

Implementation of Survivorship Care Plans in Patients With Glioblastoma

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

Read More

Management of Acute Pancreatitis Associated With Checkpoint Inhibitors

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

Read More

Dihydropyrimidine Dehydrogenase Deficiency: To Screen or Not to Screen?

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Management of Gastric Outlet Obstruction in a Patient With Gastric Cancer

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

Read More

Patient Safety and Disclosure

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

Read More

The Development of an Oncology Clinical Nurse Specialist Fellowship Program

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

Read More

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

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

Read More

AL Amyloidosis: Unfolding a Complex Disease

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Advanced Practitioners: Collaborators in Radiation Oncology

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

Read More

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

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

Read More

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

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

Read More

Abstracts from JADPRO Live 2019

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

Read More

---

Editorial

Thank You to Our Peer Reviewers!

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

Read More

---

2019 ASCO Annual Meeting: Takeaways for Advanced Practitioners

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Melanoma

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Improvements in Advance Care Planning Can Translate to Patient Comfort

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

Read More

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

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

Read More

A Support Intervention for Family Caregivers of Advanced Cancer Patients

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

Read More

The Integration of Survivorship Care Planning at a Comprehensive Cancer Center

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

Read More

Immunoglobulin Light-Chain Amyloidosis: Clinical Presentations and Diagnostic Approach

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

Read More

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

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

Read More

Ivosidenib: IDH1 Inhibitor for the Treatment of Acute Myeloid Leukemia

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

Read More

Apalutamide for the Treatment of Nonmetastatic Castration-Resistant Prostate Cancer

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

Read More

American Society of Clinical Oncology Reports on Clinical Cancer Advances

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

Read More

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

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

Read More

Diversity Awareness and Documentation Practices Among Oncology Advanced Practice Providers

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

Read More

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

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

Read More

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

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

Read More

Breast Cancer in the Transgender Population

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

Read More

Secondary Analysis Research

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

Read More

Rucaparib and Niraparib in Advanced Ovarian Cancer

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

Read More

JADPRO Live 2018: Bringing Clarity to Complexity

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

Read More

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

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

Read More

2017-2018 Drug Approvals in Solid Tumors

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

Read More

2017-2018 Drug Updates in Hematologic Malignancies

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

Read More

Treating Venous Thrombosis in Oncology

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

Read More

Advances in the Treatment of HER2-Positive Breast Cancer

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

Read More

Surgical Implications for Women With Breast Cancer

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

Read More

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

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

Read More

Evolving Therapies in the Clinical Management of Melanoma

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

Read More

Multimodal Therapies for Head and Neck Cancer

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

Read More

Sequencing of Treatments for Patients With Ovarian Cancer

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

Read More

Sequencing Therapies in Renal Cell Carcinoma

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

Read More

Therapeutic Advances in Prostate Cancer

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

Read More

Differential Diagnosis and Testing for Hematologic Malignancies

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

Read More

Sequencing Therapies in Indolent Lymphomas

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

Read More

Modern Management of Classical Hodgkin Lymphoma

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

Read More

Advances in the Management of Myeloma

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

Read More

New Directions in Acute Myeloid Leukemia

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

Read More

The Benefits of Nuts for Cancer Prevention

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Scalp Cooling: A Patient’s Experience

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

Read More

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

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

Read More

Use of the Distress Thermometer in Clinical Practice

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

Read More

Diagnostic Snapshot: A Patient With Gastrointestinal Symptoms and Eosinophilia

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Methylnaltrexone: Peripherally Acting μ-Opioid Receptor Antagonist

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

Read More

Gemtuzumab Ozogamicin: Back Again

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

Read More

Evidence-Based Oncology Practice: Competencies for Improved Patient Outcomes

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

Read More

Human Papillomavirus and Cancer

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Trametinib: A Targeted Therapy in Metastatic Melanoma

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

Read More

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

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

Read More

Collaboration Leads to Oral Chemotherapy Education

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

Read More

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

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

Read More

Thank You to Our Peer Reviewers!

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

Read More

---

Meeting Abstract

Abstracts from JADPRO Live 2018

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

Read More

---

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

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

Read More

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

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

Read More

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

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

Read More

Hypercalcemia of Malignancy

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

Read More

Enhanced Recovery After Surgery

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Presenting With Confidence

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

Read More

Diagnostic Snapshot: What Caused This Fluid?

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

Read More

Breast Cancer and Body Image Issues

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

Read More

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

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

Read More

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

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

Read More

Management of Advanced Bladder Cancer: An Update

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

Read More

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

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

Read More

An Oncology NP-MD Partnership: Challenges and Rewards

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

Read More

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

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

Read More

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

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

Read More

JADPRO Live at APSHO 2017: Precision Thinking, Practical Knowledge

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

Read More

---

Meeting Report

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

Presented by Edward Li, PharmD, MPH, BCOP

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

Read More

---

Meeting Report

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

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

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

Read More

---

Meeting Report

Managing Side Effects of Cancer Patients Treated With Immunotherapy

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

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

Read More

---

Meeting Report

Neratinib for Extended Anti-HER2 Therapy in Early Breast Cancer

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

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

Read More

---

Meeting Report

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

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

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

Read More

---

Meeting Report

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

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

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

Read More

---

Meeting Report

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

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

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

Read More

---

Meeting Report

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

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

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

Read More

---

Meeting Report

Multiple Myeloma: Risk Stratification and Toxicity Management

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

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

Read More

---

Meeting Report

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

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

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

Read More

---

Meeting Abstract

Managing the Continuum of Myeloid Malignancies

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

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

Read More

---

Meeting Report

Contemporary Management of Hodgkin Lymphoma and Chronic Lymphocytic Leukemia

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

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

Read More

---

Chemotherapy-Induced Nausea and Vomiting: Updates and Recommendations

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

Read More

Cardio-oncology: A Subspecialty in its Infancy

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

Read More

Cardiovascular and Cancer Risk: The Role of Cardio-oncology

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

Read More

Acute Promyelocytic Leukemia: A Summary

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Joining Forces: Establishing a Cardio-oncology Clinic

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

Read More

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

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

Read More

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

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

Read More

Diagnostic Snapshot: "I Have a Bad Cold"

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

Read More

It’s Just the Flu…or Is It?

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

Read More

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

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

Read More

Combination Therapies 
in Advanced, Hormone 
Receptor–Positive Breast Cancer

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

Read More

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

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

Read More

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

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

Read More

Precautions for Patients Taking Tamoxifen

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

Read More

Pharmaceutical Clinical Educators: A Resource for Advanced Practice Providers

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

Read More

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

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

Read More

Tender Nodules of the Foot

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

Read More

Thank You to Our Peer Reviewers!

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

JL505. Coping Strategies of Hematology/Oncology Nurse Practitioners

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

JL515. Intra-Professional Collaboration for Safe Chemotherapy Administration

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

JL518. Mistaken Identity: The Soft Tissue Sarcoma Conundrum

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

Read More

---

Meeting Abstract

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

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

View the poster.

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

JL526. Rituximab and Melanoma: A Case Report

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Meeting Abstract

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

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

Read More

---

Innovations in Cancer Therapies and Rising Costs

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

Read More

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

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

Read More

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

Integrating Biosimilars Into Oncology Practice: Implications for the Advanced Practitioner  A continuing education activity for nurse practitioners, PAs, clinical nurse specialists, advanced degree nurses, oncology and hematology nurses, pharmacists, and physicians. Release date: November 16, 2...

Read More

---

Review Article

Integrating Biosimilars Into Oncology Practice: Implications for the Advanced Practitioner

Christopher J. Campen, PharmD, BCOP

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

Read More

---

Review Article

Managing Tumor Lysis Syndrome in the Era of Novel Cancer Therapies

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

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

Read More

---

Grand Rounds

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

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

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

Read More

---

Grand Rounds

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

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

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

Read More

---

Practice Matters

Li-Fraumeni Syndrome

Wendy H. Vogel, MSN, FNP, AOCNP®

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

Read More

---

Practice Matters

Immunotherapy Through the Years

Jessica Eno, MS, PA-C

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

Read More

---

Prescriber's Corner

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

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

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

Read More

---

Tools and Technology

Hepatitis C Virus in the Hematology/Oncology Patient

Wendy H. Vogel, MSN, FNP, AOCNP®

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

Read More

---

Editorial

Oral Cancer Therapy: The Importance of Adherence

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

Read More

---

Editorial

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

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

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

Read More

---

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

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

Read More

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

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

Read More

Cancer Pain Management: Opioid Analgesics, Part 2

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

Read More

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

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

Read More

Brentuximab Vedotin Infusion Reaction Management: A Case Study

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

Read More

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

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

Read More

Advice About Screening for Prostate Cancer With Prostate-Specific Antigen

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

Read More

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

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

Read More

The Oncology Care Model for Advanced Practitioners

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

Read More

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

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

Read More

The Wounded Healer

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

Cancer Care: Supporting Underserved and Financially Burdened Family Caregivers

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

Read More

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

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

Read More

---

Grand Rounds

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

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

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

Read More

---

Grand Rounds

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

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

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

Read More

---

Practice Matters

Instruments That Predict Oncology Treatment Risk in the Senior Population

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

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

Read More

---

Prescriber's Corner

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

Kayla Faith Moore, PharmD

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

Read More

---

Tools and Technology

Starting an Advanced Practice Provider Professional Writing Group

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

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

Read More

---

The System Is All Holes and No Cheese

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

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

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

Read More

---

Grand Rounds

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

Sandra Kurtin, PhDc, ANP-C, AOCN®

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

Read More

---

Grand Rounds

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

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

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

Read More

---

Translating Research Into Practice

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

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

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

Read More

---

Practice Matters

Atypical Femoral Fractures: Implications for the Advanced Practitioner in Oncology

Kathy Sharp, MSN, FNP-BC, AOCNP®, CCD

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

Read More

---

Prescriber's Corner

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

Krista G. Ramirez, PharmD, BCPS

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

Read More

---

Tools and Technology

Establishing an Individual Writing Practice

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

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

Read More

---

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

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 ...

Read More

Advances in the Use of Immunotherapy in Oncology

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...

Read More

CAR T-Cell Therapy: On the Verge of Breakthrough in Many Hematologic Malignancies

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 refra...

Read More

Optimal Collaborative Management of Patients With Esophagogastric Cancers

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 M...

Read More

Management of Patients With Skin Cancers: Basal Cell Carcinoma and Melanoma

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...

Read More

Collaborative Management of Patients With Estrogen Receptor–Positive Breast Cancer

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...

Read More

What Advanced Practitioners Need to Know About the Diagnosis and Treatment of Patients With Pancreatic Cancer

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...

Read More

Advances in Collaborative Practice for Patients With Head and Neck Cancers

"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...

Read More

Diagnosis and Treatment of Adenocarcinomas and Squamous Cell Carcinomas of the Lung

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...

Read More

New Treatment Paradigms Defined for Chronic Lymphocytic Leukemia

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...

Read More

Nuances in the Management of Aggressive Lymphomas

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...

Read More

New Treatment Strategies Making an Impact in Multiple Myeloma

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, ...

Read More

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

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...

Read More

Management of Venous Thromboembolism for Patients With Hematologic Malignancies

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...

Read More

Management of Patients With Chemotherapy-Induced Nausea and Vomiting

Despite advances in the management of chemotherapy-induced nausea and vomiting (CINV), clinical management remains a challenge, 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 ...

Read More

Protecting Against Sun Exposure: Which SPF Will You Recommend?

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...

Read More

Advanced Care Provider and Nursing Approach to Assessment and Management of Immunotherapy-Related Dermatologic Adverse Events

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...

Read More

Managing Constipation in Adults With Cancer

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...

Read More

Current and Emerging Therapies for HER2-Positive Women With Metastatic Breast Cancer

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...

Read More

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 ...

Read More

---

Grand Rounds

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

Beth Eaby-Sandy, MSN, CRNP, OCN®

Interpreting pathology reports as well as routine imaging studies is one of the many roles of the advanced practitioner (AP) in oncology. With recent advancements in the management of patients with non–small cell lung cancer (NSCLC)—in particular, the advent of molecular targeted agents and immun...

Read More

---

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...

Read More

---

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, & ...

Read More

---

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...

Read More

---

Vitamin D and Breast Cancer: Should Our Patients Be Taking a Supplement?

Breast cancer remains a formidable disease in women. In 2017, the American Cancer Society notes that the estimated number of new female invasive breast cancer cases is 252,710, with an estimated 40,610 women dying of the disease (American Cancer Society, 2017). Previously published studies have r...

Read More

Anisocoria and an Array of Neurologic Symptoms in an Adult With Ewing Sarcoma

Ewing sarcoma (ES) is a rare mesenchymal malignancy that most commonly presents in adolescence as a primary bone cancer and less often as extraskeletal Ewing sarcoma (EES). Both ES and EES are part of a larger family of tumors that include small round blue cell tumors and Askin’s tumor of the che...

Read More

Practical Guide to Bone Marrow Sampling for Suspected Myelodysplastic Syndromes

Characterized by ineffective hematopoiesis and progressive bone marrow failure, myelodysplastic syndromes (MDS) comprise a group of diverse clonal hematopoietic stem cell malignancies (Brunning et al., 2008; Zeidan, Faltas, Douglas Smith, & Gore, 2013). Deficiencies in hematopoiesis result in...

Read More

Immunotherapy for High-Risk Neuroblastoma: Management of Side Effects and Complications

Neuroblastoma is the most common extracranial solid tumor in children. Approximately 800 children are diagnosed with neuroblastoma each year in the United States (Ward, DeSantis, Robbins, Kohler, & Jemal, 2014). Risk stratification in children with neuroblastoma is not only based on disease s...

Read More

Understanding and Managing Immune-Related Adverse Events Associated With Immune Checkpoint Inhibitors in Patients With Advanced Melanoma

The projected incidence of melanoma within the United States is about 87,110 new cases for 2017, with an estimated 9,730 deaths from the disease in the same year (American Cancer Society, 2017). The lifetime risk of developing melanoma is 2.1%, or 1 out of every 50 men and women (National Cancer ...

Read More

Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus

In 1965, in answer to the growing demand for primary care, nursing pioneer Loretta Ford, along with Dr. Henry Silver, created the first certificate program that provided nurses with the skills to provide primary care to underserved populations. Since the inception of that first program, the field...

Read More

Daratumumab: Dawn of a New Paradigm in Multiple Myeloma?

Multiple myeloma is a neoplasm of the terminally differentiated B-lymphocyte, or plasma cell (Rollig, Knop, & Bornhauser, 2015). The second most common hematologic malignancy in the United States, multiple myeloma accounts for approximately 18% of all hematologic malignancies and 2% of all ne...

Read More

JL401. A Regional Cancer Center’s Experience With Lung Cancer Screening Using Low Dose CT

Read More

JL402. A Retrospective Study of the Incidence of Vitamin D Insufficiency in BRCA Mutation Carriers in a Community Cancer Center

Read More

JL403. Advanced Practice and Improved Outcomes for Infusion Therapy Patients Experiencing ADRs

Read More

JL404. An Academic Cancer Center’s Approach to Observation Management Services

Read More

JL405. An Interdisciplinary Educational Checklist for Allogeneic Stem Transplant Patients

Read More

JL406. BMDACC Breast Cancer Program Clinical Rotation for Nurse Practitioner Students

Read More

JL407. Burden of Phlebotomy in Patients With Polycythemia Vera in the United States: A Preliminary Analysis of Baseline Data from the REVEAL Study

Read More

---

Meeting Abstract

JL408. Decreasing Venous Thromboembolism in Patients With Hematologic Malignancy Through Implementation of Clinical Practice Guidelines – A Quality Improvement Project

Karley M. Trautman, DNP, ANP-BC, and Chelsey Boggs, MS, AGNP-BC; Blood Cancer and Bone Marrow Transplant Program, University of Colorado Anschutz Medical Campus, Aurora, CO

Read More

---

Meeting Abstract

JL409. Development of An Evidence-Based Scorecard to Assess Provider Adherence to Gastrointestinal Toxicity Management

Read More

---

Meeting Abstract

JL410. Identification of Continued Educational Gaps Among Oncology Nurses Treating Patients With Pancreatic Cancer: A Case for Further Education

Nina N. Grenon, DNP, AOCN®, Dana-Farber Cancer Institute, Boston, MA, and Patricia M. Repetto, M.Ed, CHCP, Medscape Oncology, New York, NY

Read More

---

Meeting Abstract

JL411. Implementation and Evaluation of an Influenza Adherence Toolkit in Allogeneic Bone Marrow Transplant Recipients

Tracy Krimmel, DNP, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, Susan M. Schneider, PhD, RN, AOCN®, FAAN, Duke University School of Nursing, Durham, NC, Rajat Bannerji, MD, PhD, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, and Maribel Borysyuk, PharmD, Walgreens, Dallas, TX

Read More

---

Meeting Abstract

JL412. Management of Endocrinopathies Associated With Nivolumab and Ipilimumab Combination Therapy in Solid Tumors

Read More

---

Meeting Abstract

JL413. Management of Gastrointestinal Adverse Events (AEs) Associated With Nivolumab and Ipilimumab Combination Therapy in Solid Tumors

Read More

---

Meeting Abstract

JL414. Multidisciplinary Management of Hepatocellular Carcinoma: The Role of Systemic Chemotherapy and Chemoembolization in Converting Patients With Large Unresectable Liver Tumors to Surgical Resectability

Jenilette D. Velasco, MPAS, PA-C, and Steven H. Wei, MS, MPH, PA-C; MD Anderson Cancer Center, Houston, TX

Read More

---

Meeting Abstract

JL415. Nurses Championing Exercise in Survivorship Care Clinic Visits

Bernadette Labriola, MSN, FNP-C, Duke University, Durham, NC, and Kathy Trotter, DNP, FAANP, Duke School of Nursing, Durham, NC

Read More

---

Meeting Abstract

JL416. Parathyroid Carcinoma Overview: A Case Study

Elizabeth Sanders-Schacht, PA-C, and Rae Brana Reynolds, MS, RN, ANP; MD Anderson Cancer Center, Houston, TX

Read More

---

Meeting Abstract

JL417. Performance Improvement Continuing Medical Education (CME) for the Advanced Practice Provider in Oncology

Kelly R. Maldonado, MPAS, PA-C, Maura Polansky, MS, MHPE, PA-C, Jessica Eno, MS, PA-C, Leah Theriot, MPAS, PA-C, Carolyn Zawislak, MPAS, PA-C, and Steven H. Wei, MS, MPH, PA-C; University of Texas MD Anderson Cancer Center, Houston, TX

Read More

---

Meeting Abstract

JL418. Primary Polycythemia Vera: Advances in Diagnosis and Treatment

Kathy Leonard, MA, ACNP-B, ANP-B, ANP-BC, AOCNP®, New York University Clinical Cancer Center, New York, NY

Read More

---

Meeting Abstract

JL419. Recognizing the Contributions of Advanced Practice Providers to Oncology Care: Are Current Metrics Enough?

Amanda W. Yopp, MSN, AGNP-BC, Holly Wall, RN, MSN, ACNP-BC, and Kena Miller, RN, MSN, ARNP-BC; Takeda Oncology, Cambridge, MA

Read More

---

Meeting Abstract

JL420. Redesigning How We Communicate Important Safety Information (ISI) Using the Universal Patient Language

Elizabeth M. Chebli, PharmD, CMPP, Bristol-Myers Squibb, New York, NY

Read More

---

Meeting Abstract

JL421. Review of a Genetic Risk Assessment Delivery Model in a Private Community Oncology Practice

Doreen Grzelak, NP-C, CBCN, MSN, AOCN®, Virginia Cancer Specialists, Washington, DC

Read More

---

Meeting Abstract

JL422. Screening for and Managing Distress in Patients With Metastatic Lung Cancer

Victoria Sherry, DNP, CRNP, ANP-BC, AOCNP®, Hospital of the University of Pennsylvania, Philadelphia, PA, Susan M. Schneider, PhD, RN, AOCN®, FAAN, Duke University School of Nursing, Durham, NC, Ranganathan Anjana, MD, Hospital of the University of Pennsylvania, Philadelphia, PA, and Carmen Guerra, MD, MSCE, FACP, Hospital of the University of Pennsylvania, Philadelphia, PA

Read More

---

Meeting Abstract

JL423. Soft Tissue Sarcoma: A Case Study and Multidisciplinary Management

Allison L. Lock, MPAS, PA-C, MD Anderson Cancer Center, Houston, TX

View the poster.

Read More

---

Meeting Abstract

JL424. The Interrelationship of Polypharmacy on Functional Status and Quality of Life in the Elderly Chronic Lymphocytic Leukemia Patient

Patricia Karwan, DNP, APRN-BC, Care New England/Women and Infant Hospital, Providence, RI

Read More

---

Meeting Abstract

JL425. Tumor Lysis Syndrome: An Electrolyte Emergency

Jan Garza-Dennis, RN, MSN, ANP-C, AOCNP®, University of Texas at Houston, MD Anderson Cancer Center, Houston, TX

Read More

---

Meeting Abstract

JL426. The Impact of the ONc-PoWER Course on the Professional Development of Nurse Practitioners

Margaret Quinn Rosenzweig, PhD, FNP-BC, AOCNP®, FAAN, Sara Jo Klein, MS, BSN, RN, Mary Connolly, BSN, RN, and Rose Hoffmann, PhD, RN, University of Pittsburgh School of Nursing, Pittsburgh, PA

Read More

---

Meeting Abstract

JL427. The Effect of Prophylactic Naproxen, Prophylactic Loratadine, or No Prophylaxis on Bone Pain in Patients With Breast Cancer Receiving Chemotherapy and Pegfilgrastim

Read More

---

Meeting Abstract

JL428. Symptoms and Management of Cerebral Progression in Patients With Anaplastic Lymphoma Kinase-Positive (ALK+) Non-Small Cell Lung Cancer (NSCLC): A Clinical and Nursing Perspective

Rachael Pollina, MS, MSN, FNP-BC, Memorial Sloan Kettering Cancer Center, New York, NY, Wendi Stone, RN, NP-C, University of Texas MD Anderson Cancer Center, Houston, TX, Kate Kegg, MPAS, PA-C, University of Texas MD Anderson Cancer Center, Houston, TX, and Anne S. Tsao, MD, University of Texas MD Anderson Cancer Center, Houston, TX

Read More

---

Meeting Abstract

JL429. Transfusion Practice Patterns in Patients Receiving Myelosuppressive Chemotherapy for Nonmyeloid Cancer: Results From a Prospective Observational Study

Read More

---

The Passage of CARA: Implications for Patients With Cancer Pain

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...

Read More

Superhuman Strength in Cancer

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...

Read More

Idelalisib: Practical Tools for Identifying and Managing Adverse Events in Clinical Practice

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...

Read More

Clinical Management of Bowel Dysfunction After Low Anterior Resection for Rectal Cancer

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...

Read More

Case Study of a Young Adult With Ewing Sarcoma

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...

Read More

A Descriptive, Longitudinal Study of Quality of Life and Perceived Health Needs in Patients With Head and Neck Cancer

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...

Read More

Appraising Travelbee’s Human-to-Human Relationship Model

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...

Read More

Understanding Biomarkers in Early-Stage Invasive Breast Cancer: Tools From the ASCO Clinical Guideline

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...

Read More

Information for Contributors

Read More

Upcoming Meetings

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.on...

Read More

Thank You to Our Peer Reviewers!

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 ...

Read More

Statement of Ownership: 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)...

Read More

Cancer Care in 2016: The ASCO State of Cancer Care Report and the Role of Advanced Practitioners

The American Society of Clinical Oncology published their annual State of Cancer Care in America: 2016 report in March of this year (ASCO, 2016). As expected, the report detailed the many improvements in care as well as the challenges and problems that remain in cancer care in the United States t...

Read More

Continuing Education Information: Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients

Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hematology nurses. Release date: July 15, 2016 Expiration date: July 15, 2017 Expected...

Read More

Experiences of Nurse Practitioners in Communicating Bad News to Cancer Patients

In 1995, Breaking Bad News Consensus Guidelines were published (Girgis & Sanson-Fisher, 1995). They called for improved medical provider communication with patients outlining there was a lack of research in the specific steps in delivering bad news and recommending research be undertaken both...

Read More

How Checkpoint Inhibitors Are Changing the Treatment Paradigm in Solid Tumors: What Advanced Practitioners in Oncology Need to Know

Continuing Education Information How Checkpoint Inhibitors Are Changing the Treatment Paradigm in Solid Tumors: What Advanced Practitioners in Oncology Need to Know A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hemat...

Read More

Biomarkers/Molecular Targets, Immunotherapy, and Treatments for Non–Small Cell Lung Cancer

Molecular targets, biomarkers, their treatments, and immunotherapy have changed the treatment paradigm for non–small cell lung cancer (NSCLC) from chemotherapy (“one-size-fits-all”) approach to specific recommendations for patients based on the presence or absence of gene mutations (“personalized...

Read More

A Missed Opportunity: Understanding the Value of Documenting Occupational Exposure to Carcinogens in Adults With Acute Leukemia

Individuals with occupational exposures to carcinogens are at increased risk for leukemia (Mills, Dodge, & Yang, 2009). Blair et al. (2001) found an increased risk of leukemia for those working in particular industries or occupations and used prior studies to illuminate suspected carcinogens ...

Read More

Elotuzumab: The First Monoclonal Antibody for the Treatment of Multiple Myeloma

Multiple myeloma (MM) is a hematologic cancer in which malignant plasma cells are formed. Plasma cells are mainly found in bone marrow and function within the body to attack and destroy antigens. Multiple myeloma occurs when malignant plasma cells accumulate in the bone marrow, leading to marrow ...

Read More

Palbociclib Plus Letrozole for the Treatment of Metastatic Breast Cancer: An Illustrative Case Scenario

In 2007, Betty was one of 26% of women who were diagnosed with breast cancer in the United States, at a time when breast cancer accounted for 15% of cancer deaths (American Cancer Society [ACS], 2007). Similarly, in 2016, estimates predict that 29% of new cancer diagnoses in women are expected to...

Read More

Review of the New American Cancer Society Guidelines for Breast Cancer Screening for Women at Average Risk

Breast cancer is the most common cancer in women worldwide (Torre et al., 2015). In the United States, an estimated 231,840 women were diagnosed with breast cancer in 2015 (Siegel, Miller, & Jemal, 2015). After lung cancer, breast cancer continues to rank second as a cause of cancer death in ...

Read More

When Should I Have a Mammogram? Recent Changes in ACS Mammography Guidelines: Implications for Practice

In the United States, breast cancer is the most common female cancer and the second leading cause of female cancer death (American Cancer Society [ACS], 2015). Breast cancer significantly contributes to morbidity and premature mortality among American women (ACS, 2015). Early detection with mammo...

Read More

Advanced Practitioners’ Favorite Books: Part III

What to Expect When…Saying Goodbye to Your Prostate: How to Beat Prostate Cancer, Ease Your Mind, and Laugh While Doing It Jamie MacKenzie & Lisa  Schwartz (CreateSpace Publishing, 2013) There is nothing funny about prostate cancer, but this book presents prostate cancer diagnosis and ...

Read More

Value and Financial Toxicity of New Cancer Drugs

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 ...

Read More

Beyond BRCA: A Pilot Program to Assess and Improve Knowledge of Pharmacogenomic Testing Among Advanced Practitioners in a Breast Cancer Treatment Setting

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...

Read More

Continuing Education Information: Multigene Panel Testing for Hereditary Cancer Risk

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: 0.7...

Read More

Multigene Panel Testing for Hereditary Cancer Risk

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...

Read More

Effectiveness of Granulocyte Transfusions in Neutropenic Adult Oncology Patients: A Comprehensive Review of the Literature

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...

Read More

Optimizing the Teachable Moment for Health Promotion for Cancer Survivors and Their Families

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...

Read More

Ruxolitinib in Myelofibrosis and Polycythemia Vera

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...

Read More

Trifluridine/Tipiracil: Old Drug, New Tricks

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...

Read More

Assessment of Constipation in Patients With Cancer

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...

Read More

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...

Read More

---

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 ...

Read More

---

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, in...

Read More

---

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 ...

Read More

---

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...

Read More

---

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, ...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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 ...

Read More

---

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 Medicin...

Read More

---

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 diagn...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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 ...

Read More

---

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...

Read More

---

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...

Read More

---

Participation in Cancer Clinical Trials: Researching the Causes of Low Accrual

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...

Read More

Nurse Communication About Goals of Care

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,...

Read More

Bosutinib Therapy in Patients With Chronic Myeloid Leukemia: Practical Considerations for Management of Side Effects

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...

Read More

Novel Uses for Lipid-Lowering Agents

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, ...

Read More

Continuing Education Information: Applying Metrics to Outpatient Oncology Advanced Practice Providers

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 Expira...

Read More

Applying Metrics to Outpatient Oncology Advanced Practice Providers

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...

Read More

Continuing Education Information: Belinostat for Relapsed or Refractory Peripheral T-Cell Lymphoma

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 Expirati...

Read More

Belinostat for Relapsed or Refractory Peripheral T-Cell Lymphoma

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...

Read More

Nivolumab in Metastatic Non–Small Cell Lung Cancer

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...

Read More

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

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 ...

Read More

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 ...

Read More

---

The American Cancer Society Guidelines on Screening for Breast Cancer: What’s New?

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...

Read More

The Advanced Practitioner and Collaborative Practice in Oncology

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...

Read More

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...

Read More

---

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...

Read More

---

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 ...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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 ...

Read More

---

The Cost of New Therapies: Can You Spare $300,000?

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...

Read More

Multidisciplinary Specialty Teams: A Self-Management Program for Patients With Advanced Cancer

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...

Read More

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...

Read More

---

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...

Read More

---

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 ...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

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...

Read More

---

Editorial

Information for Contributors

The focus of JADPRO is to provide relevant clinical information aimed at broadening the knowledge base of the advanced practitioner (AP) in oncology, including nurse practitioners, PAs, pharmacists and other advanced oncology professionals. Therefore, language should be inclusive of the advanced ...

Read More

---

Going Gentle Into That Good Night

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...

Read More

Top Information Need Priorities of Older Adults Newly Diagnosed With Active Myeloma

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...

Read More

Romidepsin for the Treatment of Peripheral T-Cell Lymphoma

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...

Read More

Pain Prevention Using Head and Neck Cancer as a Model

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 ...

Read More

Cognitive Behavior Therapy for Patients With Cancer

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...

Read More

Health-Care Metrics in Oncology

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...

Read More

The Role of the Advanced Practice Nurse in Survivorship Care Planning

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...

Read More

Ramucirumab: A New Therapy for Advanced Gastric Cancer

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...

Read More

Plagiarism’s Poison: Avoiding Scientific Misconduct

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...

Read More

Titling the NP: Challenges and Misconceptions

Nurse practitioners (NPs) have been practicing for nearly 50 years (American Association of Nurse Practitioners [AANP], 2014). So why is there still confusion over who we are and what we do? Why do we consistently get questions from patients such as “Are you my nurse?” or “Are you my doctor?” o...

Read More

Managing Side Effects of Vemurafenib Therapy for Advanced Melanoma

The incidence of melanoma has been rising over the past 30 years. In 2014, it is estimated that 76,100 new cases will be diagnosed and 9,710 individuals will die of melanoma in the United States (Siegel et al., 2014). The prognosis for patients with advanced melanoma has been grim, with a 1-year ...

Read More

Immune Checkpoint Blockade: A New Paradigm in Treating Advanced Cancer

The ability of the immune system to detect and eliminate cancer was first proposed over 100 years ago (Cann, van Netten, & van Netten, 2003). Since then, T cells reactive against tumor-associated antigens have been detected in the blood of patients with many different types of cancers, sugges...

Read More

The Role of the Advanced Practitioner in a Comprehensive Lung Cancer Screening and Pulmonary Nodule Program

The focus of many cancer centers has been primarily on the diagnosis and treatment of disease. While advancing treatments is important, prevention and early detection of disease needs to be formally integrated into comprehensive cancer cancers. It is the mission of the American Cancer Society to ...

Read More

Spiritual Assessment in a Patient With Lung Cancer

Lung cancer is the leading cause of cancer death for both men and women. Those diagnosed with localized lung cancer (~15%) have a 5-year survival rate of 54% (American Cancer Society, 2014). For patients with small cell lung cancer, the 5-year survival rate is 6%, and for those with non–small cel...

Read More

Idelalisib: The First-in-Class Phosphatidylinositol 3-Kinase Inhibitor for Relapsed CLL, SLL, and Indolent NHL

Chronic lymphocytic leukemia (CLL) is a malignancy arising from a monoclonal population of mature B cells (Chiorazzi, Rai, & Ferrarini, 2005). Chronic lymphocytic leukemia is typically considered a disease of the elderly with a median age at diagnosis of approximately 70 years and is the most...

Read More

The Evolving Treatment Landscape for Metastatic Differentiated Thyroid Cancer

Review of "Sorafenib in metastatic thyroid cancer: A systematic review" by Thomas et al. (2014), The Oncologist, 19, 251–258. For a discussion of meta-analysis and forest plots used in oncology research, please see the related article by Joanne Lester here. Nearly 63,000 new cases of thyroid can...

Read More

The Use of Meta-Analysis and Forest Plots to Examine and Display Data in Oncology Research

In the article authored by Thomas et al. (2014) discussed by Carolyn Grande and Marcia Brose on page 461, there are several statistical tools used to understand the data. The data are presented in a quantitative fashion, e.g., numerical measures of outcomes. The statistical tool of meta-analysis...

Read More

What You Need to Know About the Ebola Virus

Although the Journal of the Advanced Practitioner in Oncology (JADPRO) is focused on publishing issues and content specific to oncology, we recognize that the current outbreak of the Ebola virus is a critical issue and one that readers should be aware of. The Ebola virus was first noted in 1976,...

Read More

Thank You to Our Peer Reviewers!

In this issue of the Journal of the Advanced Practitioner in Oncology (JADPRO), we are publishing, with our heartfelt thanks, the names of all of the esteemed professionals who completed peer reviews for JADPRO in 2014. As a group, they represent a staggering depth and breadth of experience in sp...

Read More

JL202. PD-1 Pathway Immune Checkpoint Inhibitors: The Next Wave in Immunotherapy for Melanoma

Read More

JL203. Clinical Practice: Hypercalcemia of Malignancy

Read More

JL204. Efficacy of a Transdermal Granisetron Patch in Controlling Chemotherapy-Induced Nausea and Vomiting (CINV) in Head and Neck Cancer Patients

Read More

JL205. Differences in Metabolite Activity of the Selective Estrogen Receptor Modulators Tamoxifen and Toremifene: Clinical Implications for Patients with Hormone Receptor Positive Breast Cancer

Read More

JL206. ONc-PoWER: Oncology Nurse Practitioner Web Education Resource

Read More

JL207. Decision Making Factors and Outcomes: Cancer Clinical Trials

Read More

JL208. Medical Orders for Life Sustaining Treatment: Making the Most Out of the MOLSTs

Read More

JL209. Vaccinations Post Hematopoietic Stem Cell Transplantation

Read More

JL210. Acupuncture for the Management of Hot Flashes in Breast Cancer Survivors

Read More

JL211. PD-1 Immune Checkpoint Inhibitors: An Exciting New Approach for the Treatment of Non-Small Cell Lung Cancer

Read More

Modifiable Risk Factors Affecting Outcomes: The Truth About Obesity

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...

Read More

Treatment Considerations for the Management of Patients With Hormone Receptor–Positive Metastatic Breast Cancer

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 (...

Read More

Improving Palliative Cancer Care

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...

Read More

Using Technology to Advance Cancer Survivorship Programs

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...

Read More

Ibrutinib in Relapsed or Refractory Mantle Cell Lymphoma and Chronic Lymphocytic Leukemia

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...

Read More

Clinical Management of Pancreatic Cancer

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...

Read More

Use of Radiographic Criteria to Predict Outcomes Following Surgery for Pancreatic Cancer

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...

Read More

Human Herpesvirus-6 Encephalitis After Hematopoietic Stem Cell Transplantation

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...

Read More

Cancer Prediction Nomograms for Advanced Practitioners in Oncology

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...

Read More

How Do You Triage Abdominal Pain in a Patient With Ovarian Cancer?

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...

Read More

Transparency in Medicare Reimbursement: Help or Hindrance?

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 ...

Read More

Targeted Therapies in Breast Cancer: Implications for Advanced Oncology Practice

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...

Read More

The History and Physical in Cancer Care: A Primer for the Oncology Advanced Practitioner

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...

Read More

Approaches to Managing Safety With Lenalidomide in Hematologic Malignancies

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...

Read More

Management of Malignant Pericardial Effusion

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; ...

Read More

The Case for Early Palliative Care in the Treatment of Ovarian Cancer

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...

Read More

Vismodegib: First-in-Class Hedgehog Pathway Inhibitor for Metastatic or Locally Advanced Basal Cell Carcinoma

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...

Read More

Healthy Weight Loss for the Cancer Survivor

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...

Read More

Lessons Learned in Cancer Care Communication

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...

Read More

Diagnostic Snapshot: Aggressive Malignancy or Benign Lesion?

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...

Read More

Thank You for NOT Smoking

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...

Read More

A Tailored Nurse Coaching Intervention for Oral Chemotherapy Adherence

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...

Read More

Functional Morbidity Following Latissimus Dorsi Flap Breast Reconstruction

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...

Read More

Innovative Agents in Multiple Myeloma

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...

Read More

Delayed Presentation of DPD Deficiency in Colorectal Cancer

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). ...

Read More

Dabrafenib: A New Therapy for Use in BRAF-Mutated Metastatic Melanoma

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...

Read More

Simulation as a Learning Tool in the Oncology Setting

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 ...

Read More

Lung Cancer Screening: Are You Ready?

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...

Read More

Can you Identify This Malignancy?

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...

Read More

The Launch of the Advanced Practitioner Society for Hematology and Oncology (APSHO)

Report from JADPRO Live We are pleased to announce the formation of our new organization, the Advanced Practitioner Society for Hematology and Oncology (APSHO). The Journal of the Advanced Practitioner in Oncology (JADPRO) will be the Society’s official journal and will continue to offer relevan...

Read More

What is the Etiology of Dysarthria and Ataxia in a Woman With Cancer?

History R. J. is a 56-year-old woman with recurrent stage 1a, grade 3 endometrial carcinoma who was first diagnosed in 2011. She underwent hysterectomy and bilateral salpingo-oophorectomy with lymph node dissection. No adjuvant therapy was recommended, and she was followed every 3 months. Recurr...

Read More

Celebrities and Medicine: A Potent Combination

When it comes to health-related concerns, celebrity commercials and endorsements have always made me a little nervous. The direct-to-consumer advertisements with known personalities such as Bob Dole for erectile dysfunction or Sally Field for bone health often made me cringe. I couldn’t help but ...

Read More

Improving Surgical Outcomes in Pancreatic Surgery With Preoperative Nutrition

Pancreatic cancer is the fourth leading cause of cancer-associated death. Peak incidence is in the seventh and eighth decades of life, with a slightly higher incidence in African Americans vs. Caucasians. The incidence and mortality for pancreatic cancer has not changed over the past 2 decades (N...

Read More

Ado-Trastuzumab Emtansine in Metastatic HER2-Positive Breast Cancer

Breast cancer is the most common cancer in US women, affecting approximately 1 in 8 women over the course of a lifetime. Nearly 40,000 women die of breast cancer every year (Siegel, Naishadham, & Jemal, 2013). In the past decade, we have come to understand that breast cancer is a heterogeneou...

Read More

Calculating Your Worth: Understanding Productivity and Value

While health-care dollars shrink and the focus on delivering more care with less grows, it is imperative that nurse practitioners (NPs) and physician assistants (PAs) understand the key concepts of productivity and value. Furthermore, with a growing shortage of oncology physicians, the role of th...

Read More

Advanced Practitioners in Oncology: Diverse Experiences, Shared Challenges

Report from JADPRO Live The professional paths of advanced practitioners (APs) in oncology are as varied as the locations in which they work. At the first annual JADPRO Live educational symposium held this past January in St. Petersburg, Florida, a distinguished panel was assembled to discuss th...

Read More

Leaders of ASCO, ASH, ASTRO, and NCCN Embrace Collaboration With Advanced Practitioners

Report from JADPRO Live This past January, nearly 250 advanced practitioners assembled at the first annual JADPRO Live educational symposium in St. Petersburg, Florida, hosted by the Journal of the Advanced Practitioner in Oncology (JADPRO). Leaders from four prominent oncology organizations cha...

Read More

Distress Screening in Chronic Disease: Essential for Cancer Survivors

Distress can be defined as a psychological state exacerbated by physical symptoms, interpersonal challenges, psychological symptoms, social issues, and/or existential concerns. It is a common problem in patients with cancer and other chronic diseases, although screening, assessment, and intervent...

Read More

Information Needs Priorities in Patients Diagnosed With Cancer: A Systematic Review

Research studies on information needs and information-sharing in patients with cancer have been increasing steadily in the past 3 decades. These studies relating to patient information-sharing were aimed at improving patient education and ultimately increasing patient participation in health-care...

Read More

Advanced Practitioners’ Favorite Books: The Sequel

Several issues ago, we published a list of advanced practitioners’ favorite books. We received so much positive feedback about that list that we thought we’d do it again. The holidays are over, and the frenetic pace of those hectic months is hopefully lessening. Now might be the time to find a ne...

Read More

JL01. The Role of the Multidisciplinary Tumor Board in the Management of Patient with Gastrointestinal Malignancy

Read More

JL02. Virtual Reality as an Adjunct Method to Alleviate Pain and Anxiety in Patients Undergoing Bone Marrow Procedures

Read More

JL03. Adding to Your Tool Box: Holistic Modalities

Read More

JL04. Adjuvant Treatment With Toremifene in Hormone Receptor–Positive Breast Cancer: A Systematic Review of the Literature

Read More

JL05. Efficacy and Safety of the Granisetron Transdermal System (GTS) in Elderly Patients Receiving Multiday Chemotherapy Regimens

Read More

JL06. Hereditary Hemochromatosis: What the Nurse Practitioner Needs to Know

Read More

JL07. Intravenous Thiotepa for Meningeal Relapse of Breast Cancer: A Case Study

Read More

JL08. Merkel Cell Carcinoma: Is It on Your Differential?

Read More

JL09. Personalized Medicine for Breast Cancer

Read More

JL10. Subcutaneous Administration of Bortezomib: A Pilot Survey of Oncology Nurses

Read More