Online Ahead of Print

Side-Effect Management

Workshop Addresses Significant Cancer Treatment Issue

American Cancer Society (ACS) program teaches patients with cancer how to repair their physical image when faced with the changes in their appearance brought on by cancer treatments.

Navigator Notes

Improving Patient-Centered, Cohesive Cancer Care

Cancer centers and hospital networks are finding both utility and value in clinical care pathways to help standardize diagnosis, treatment, and management of the most common disease presentations.

Navigator Notes

Text Messages Ensure Survivorship Care for AYA Survivors

An interactive system connects adolescent and young adult survivors of childhood cancers with their health care team to ensure they establish and adhere to recommended survivorship care plans.

General Oncology

Rare Cancers Challenge Patients, Clinicians

A diagnosis of a rare cancer is compounded by a greater sense of isolation because patients often struggle to find "someone like me." Support measures need to provide a sense of inclusion as well as meet unique needs.

Breast Cancer

Why Women Opt for Mastectomy vs BCT

Canadian investigators sought to understand the factors that influence the treatment choices of women with early-stage breast cancer.

Oncology Nursing

Minimizing a Cancer Diagnosis

Seeing another patient's situation as worse may be a coping mechanism for some patients with cancer, but those patients need to be reminded not to diminish their own disease and treatment.

Side-Effect Management

Managing Pain in a Changing Climate

Patient expectations, clinician perception, and institutional objectives create a perfect storm of conflicting interests regarding pain management, especially given the current trend to control opioid use.

Side-Effect Management

Rolapitant Effective in Relieving Delayed CINV

Long-acting NK-1 receptor antagonist rolapitant demonstrates significant efficacy in managing CINV in patients receiving HEC or MEC for cancer.

Side-Effect Management

Distress Management Tool Updated

A review of the updated NCCN Guidelines is presented with a look at the newly published Guideline for Patients.

Breast Cancer

Physical Activity Improves Outcomes in Breast Cancer

Physical activity is proven to improve both physical and mental effects of cancer diagnosis and treatment, even if the activity needs to be modified to fit the patient's current abilities.

Multiple Myeloma

Managing Myeloma With Bortezomib

In this review of the role of bortezomib in the treatment of multiple myeloma, the researchers explain what nurses need to watch for in patients taking this drug.

Navigator Notes

Navigation and the Development of Cancer Screening Programs

A review of the importance of cancer screening programs and the important role of the oncology nurse navigator/care coordinator in developing them.

Side-Effect Management

ASTRO Updates Guideline for Palliative RT of Bone Mets

Palliative radiotherapy for bone metastases is safe, effective — but controversy persists for single-fraction treatment.

Side-Effect Management

Cannabis in Oncology Care

Despite recent new legislation, medical marijuana as an adjunct to palliative and end-of-life care remains controversial. But a greater acceptance within both the medical community and the lay public is prompting research on how it can be integrated into standard care.


Second Cancers in Hodgkin Lymphoma Survivors

Hodgkin lymphoma survivors are at higher risk of second cancers, and that risk is even higher in those with a first-degree relative with cancer.

Navigator Notes

Dance/Movement Therapy Supports Children with Cancer

Dr Lori Baudino, a clinical psychologist and dance/movement therapist, discusses a program that helps children with cancer cope with their disease and treatment, and learn to be children again.

Oncology Nursing

Transference of Cancer Patients’ Suffering

A challenging patient case illustrates how caring for each other enables oncology nurses to provide better patient care.


Kinase Inhibitor-Related Adverse Effects in Metastatic Melanoma

Despite their efficacy in metastatic melanoma, KIs include risk of serious side effects in patients. This overview explains the effects and management recommendations for 4 agents used to treat metastatic melanoma.

Navigator Notes

Support for Cancer Patients at EOL

NODA and V3 are volunteer programs that provide a compassionate presence for patients who are alone in their final hours.

Hematologic Cancers

Oral Kinase Inhibitor Adverse Effect Management in Patients with Hematologic Cancers

Ibrutinib, idelalisib, ponatinib, and ruxolitinib are each associated with a variety of potential adverse effects and oncology nurses must be aware of these to successfully monitor for them.

General Oncology

Precision Radiation Therapy for Cancer

A new tool may enable oncologists to deliver radiation therapy targeted to a tumor's biology and radiosensitivity, similar to how anticancer agents target specific tumor mutation-affected gene pathways.

General Oncology

Therapeutic Writing For Patients With Cancer

Journaling can offer patients with cancer a safe space to express and process emotions without fear of judgment or risk of burdening loved ones.


AYA Cancer Support Organization

Following the lead of a British cancer support organization, Teen Cancer America sponsors age-appropriate cancer center environments as well as peer and community support for adolescents and young adults with cancer.

Navigator Notes

A More Expansive Role for ONNs

Oncology Nursing Society conducted a role delineation survey (RDS) on oncology nurse navigators (ONNs) to determine how the role has evolved since the previous RDS and to determine if an ONN certification is needed.

Oncology Nursing

Finding a Cause for Patient Noncompliance

The patient seemed to demonstrate typical noncompliance behaviors. Until one day her appearance suggested another explanation, prompting an investigation that revealed a surprising cause.

General Oncology

Hypnosis in Cancer Treatment

A cursory look at hypnosis and where it may be used to offer an alternative and side-effect-free management of several aspects of care that can be beneficial to patients with cancer.

SABCS 2016

Drug Prices Influence Value of Cancer Treatment

In his plenary lecture at 2016 SABCS, Peter P. Bach, MD, MAPP, reviewed the factors contributing to escalating drug prices and the significance of drug prices in the value of a cancer treatment regimen.

Breast Cancer

Considering Follow-up Care for a Growing Population of Breast Cancer Survivors

Women with a history of breast cancer face a wide variety of challenges as they transition from the role of "patient" to "survivor".

Prostate Cancer

Second Opinions Rarely Change Prostate Cancer Treatment Choice

Although many men obtain a second opinion regarding their prostate cancer care options, they seldom deviate from the original course of action.

General Oncology

Shared Decision Making Will Require New Tools, Paradigms

A recent paper on the future of radiation oncology reports on the trend toward a greater role for shared decision making and patient-reported outcomes, such as the interrelated benchmarks of patient satisfaction, engagement, and treatment-plan adherence.

General Oncology

Palliative Care Provides Benefits, But Does Not Extend Life

A new meta-analysis examines the impact of palliative care services on patients' and caregivers' quality of life and outcomes.

Side-Effect Management

Cold Caps Minimize Chemotherapy-Induced Alopecia

Inducing vasoconstriction in the scalp of patients with breast cancer undergoing chemotherapy effectively reduces the amount of drug that reaches the hair follicles and hair-cell metabolism, minimizing one of the most dreaded side effects of treatment.

Oncology Nursing

Tips for Culturally Sensitive Communications With Hispanic Patients and Caregivers

Culturally sensitive communications with Hispanic patients can help them understand their cancer diagnosis and treatment options.

General Oncology

Resistance Training Improves Posttreatment Outcomes for Breast Cancer Survivors

Loss of bone density related to chemotherapy and adjuvant therapy for breast cancer can lead to debilitating hip and vertebral fractures. This discussion discusses the impact of resistance training for these patients.

Genitourinary Cancer

How We Developed a New Protocol for Urethral Carcinoma

Faced with a harsh treatment option, a patient with genitourinary cancer helps create a treatment plan that preserves his self-image.

Navigator Notes

Making EOL Discussions Easier

A new card game helps patients and caregivers broach the difficult subject of end-of-life wishes and prioritize what's most important in their planning.

General Oncology

Gero-Oncology: Preparing for the Coming Wave of Elderly Cancer Patients

A growing proportion of cancer patients are elderly—creating a demographic shift with important implications for cancer care, including radiotherapy. Integrating geriatric care into oncology nursing has never been more important.

General Oncology

Giving Voice to the Voiceless

A nurse develops a tablet app that helps intubated patients communicate with their nurses, caregivers, and families.

Oncology Nursing

The Bounty of Failure

How long were you a nurse before you felt competent? Reflections on creating an atmosphere of learning and growing from our own mistakes.


Pseudohyperkalemia: When Too Much Isn’t Really Too Much

The patient's history and current blood work results indicated a dangerously high potassium level. But a meticulously handled redraw proved it false.

Breast Cancer

How Physical Changes From Breast Cancer Affect Self-Image

Cancers that cause more readily noticeable physical changes can produce self-image challenges for patients. This discussion reviews what interventions can help validate patients' self-image concerns.

Side-Effect Management

Chemotherapy Side Effects: Expectations vs Outcomes

Recent studies indicate that adverse side effects can result from factors unrelated to the pharmacologic agent, but rather from other factors.

Gastrointestinal Cancer

Managing TKI Side Effects in GI Cancers

A review of adverse effects and recommended management for 3 kinase inhibitors indicated for the treatment of gastrointestinal cancers.

Navigator Notes

New CRC Screening Option Opens the Door for New Conversations

A new colorectal cancer (CRC) screening test that can be done in the privacy of patients' homes, at their convenience, and with no prep needed may help patients overcome their reticence.

Navigator Notes

Patients' and Caregivers' Misperceptions Continue to Stigmatize Palliative Care

Oncology nurses face a difficult challenge in getting patients to consider palliative care because despite knowing that palliative care is comfort care, many patients and caregivers still equate it with end of life.

Colorectal Cancer

Increasing Dietary Omega-3 Intake After Colorectal Cancer Diagnosis Improves Survival

Lifestyle and dietary measures for preventing colorectal cancer are extensively studied; however, in this study, researchers looked at a dietary measure that improved survival for patients after diagnosis.

Breast Cancer

PMPS: A Common Late Effect

Postmastectomy pain syndrome (PMPS) is a debilitating late effect of surgery and radiation therapy for breast cancer.

Navigator Notes

Help Patients Overcome the Challenges of Dating

The decision to resume or begin dating after a cancer diagnosis can be particularly stressful.

Navigator Notes

Cancer Patients Rely on Social Media

Social media has become a mainstay of day-to-day life. For patients with cancer, it can be a lifeline to unprecedented support that is unique to their needs.

Navigator Notes

Keeping Your Patient Communications Consistent

At what point is attentiveness being too nice? Ann Brady discusses how her words followed the patient's wishes, but her actions prompted an unexpected question.

General Oncology

Administering Mannitol With Hydration and Premeds

At my current clinic, hydration and mannitol are administered before premedications on a cisplatin regimen; at previous clinic, premeds and hydration were administered before mannitol. Does it make a difference?

Navigator Notes

Using Cognitive-Behavioral Therapy Principles in Daily Patient Interactions

Cognitive-behavioral therapy techniques can help patients with cancer turn their negative thoughts into positive attitudes, as well as find meaning and purpose to their life.

Navigator Notes

Cancer Cure Moonshot Is Short of Fuel

Cancer research relies of patients with cancer to participate in clinical trials. However, many patients cite various fears and misconceptions — some supported by physicians - as reasons for why they decline to participate in clinical trials.

Oncology Nursing

Accepting Where Cancer Patients and Their Families Are Emotionally

Reflecting on the 2 meanings of this simple word helps explain the nuances of communicating with cancer patients and their families at pivotal points of care.

Side-Effect Management

Pain Management and Sedation Monitoring for Patients With Cancer

Managing pain with opioids and keeping a close eye on adverse effects is an important part of cancer care. But there is room for improvement in pain management tools, and nurses play a key role in their evolution.

Side-Effect Management

Sleep Is an Important Consideration for Cancer Patients

Sleep patterns and habits should be a part of oncology nurses' routine patient assessment, as sleep disorders can be a significant challenge for cancer patients undergoing radiation therapy.

General Oncology

Treating Patients With Cancer and Mental Health Disorders

Serious mental illness can both challenge and compromise cancer care. To ensure these patients receive optimal cancer care, the oncology team should include the patient's mental health care team.

Gastrointestinal Cancer

Aspirin Use Found to Prevent Bile Duct Cancer

Aspirin's anti-inflammatory action is protective against another aggressive cancer: cholangiocarcinoma. Furthermore, it is beneficial regardless of daily use or dose.

General Oncology

50,000th Flight: CAN Marks a Milestone in Service for Patients With Cancer

A mostly volunteer organization arranges flights for patients with cancer who need to travel to distant treatment centers on corporate jets with empty seats that are flying the same route.

General Oncology

Implementing a Distress Screening Process for Cancer Patients

Highest points of distress experienced by patients with cancer at 1 institution are identified in this study to better implement distress screening.

General Oncology

Socioeconomic Benefits of Marriage Improve Survival Among Married Patients

A recent study confirms the benefits of marriage on patients with cancer, including socioeconomic status, psychosocial support, and a higher regard for health-related self care.

General Oncology

The First Call: The Importance of an Initial Assessment

Accepting the need for counseling or support services may be difficult for many patients. Clinicians need to be attuned to specific clues during a first contact to make an accurate initial assessment.

General Oncology

Initiating Palliative Care in the ED

Despite the benefits of early palliative care intervention, palliative care is less frequently employed at the emergency department. Researchers sought to evaluate patient outcomes related to ED palliative care.

Oncology Nursing

To What End: A Perspective on Perspective

Are the difficult questions easier to answer when the patient still has treatment options available? Ann Brady talks about helping patients and families navigate the changes in disease and care.

General Oncology

Using Olanzapine as an Antiemetic for Patients Undergoing Moderate or High-Emetic Risk Chemotherapy

Some of our patients receive olanzapine (Zyprexa) as an antiemetic. Is this a typical use of this drug?

General Oncology

Managing Radiotherapy-Induced Breakthrough Cancer Pain

Nasal spray effectively relieves intense breakthrough pain associated with radiotherapy planning and treatment.

Chronic Myeloid Leukemia‎

Travel With Oral Chemotherapy Meds

During the summer, many patients with CML who are taking oral chemotherapy drugs have questions about taking their drugs while traveling. What advice can we give them regarding this?

Navigator Notes

The Samfund: Helping Young Adult Patients Navigate the Financial Impact of Cancer Care

The Samfund is a not-for-profit organization dedicated to easing the lasting financial effects of cancer treatments for young adults with the disease.

General Oncology

Helping Families Cope With Cancer-related Anorexia and Cachexia

Loss of appetite and not eating are difficult aspects of cancer for patients' loved ones to understand. Continued and diligent nurse education can help both patients and families cope with this disturbing effect.

General Oncology

Coloring to Relax

The simple childhood pleasure of a coloring book and crayons—or colored pencils, as in this case—provide the foundation of a unique support group for patients with cancer and their families.


Reprogramming the Immune System to Target Cancer: Chimeric Antigen Receptor T-Cell Therapy

An emerging immunotherapy technique uses patients' own T-cells to develop a personalized, targeted anticancer treatment. This review discusses the CAR T-cell process, and the nurses' role in recognizing and managing its toxicities.


ASTRO Develops a Template to Facilitate Radiotherapy-Specific Cancer Survivorship Care Plans

As the American College of Surgeons' Commision on Cancer milestones approach, ASTRO publishes a template to ensure consistent, comprehensive survivorship care plans can be developed for cancer survivors whose treatment involved radiotherapy.

Brain Cancer

Hypnosedation: An Alternative Sedation for Glioma Resection

This technique, which does not use pharmaceutical sedatives, can ease the perioperative discomfort and anxiety experienced by some patients undergoing fully awake craniotomy to remove glioma.


Drug-induced Bone Pain

How is loratadine used to treat bone pain in patients receiving white blood cell growth factors?

General Oncology

Meditation Serves as a Coping Tool for Both Patients and Clinicians

After experiencing the benefits of meditation to help himself cope with the stress of caring for patients with cancer, this oncologist leads classes teaching those patients to use the tool to better cope with their disease and its effects.

Lung Cancer

Inconclusive: The Pulmonary Nodules You Need to Follow

A program in a multifacility health care system is designed to enhance early detection of lung cancer through follow-up of nodules seen on thoracic imaging studies.


Understanding Drug Naming Nomenclature

Why do the antibody drugs have such long names?

Oncology Nursing

Experiences, Dreams, and Visions: Easing the Patient With Cancer Toward End of Life

Cancer patients in their last weeks of life may have end-of-life experiences, including dreams and visions. A study from researchers at a hospice found that these events are an important part of a patient's dying process.

Oncology Nursing

Spirituality and One’s Spiritual Identity

Attending to a patient's spiritual needs is an important aspect of oncology care, but this can also be a challenging topic to broach. This guide helps nurses chart a course for this essential conversation.


Tumor Location and Duration of Therapy Influence Palliative Effects of Radiation Therapy for Painful Bone Metastases

In a review of the Dutch Bone Metastasis Study results, stratified for primary tumor location, palliative radiation therapy was found to reduce pain and improve quality of life for some patients.


Novel Radiotherapy Controls Late Effects in Pediatric and AYA HL

Radiotherapy is the most effective single modality for local control of Hodgkin lymphoma. Involved site radiotherapy is a recent innovation intended to reduce the risk of late effects—an urgent goal, particularly for adolescent and young adult patients.

Oncology Nursing

Pain Management: Listen to Your Patient

Providing your patient with the opportunity to tell his or her story helps to ensure that the goals of treatment are defined and met.

Issues in Cancer Survivorship

Therapy Dogs in Pediatric Practice

Researchers hope to prove the positive effects of the use of therapy dogs in pediatric oncology.

Oncology Nursing

Cancer Prehabilitation and Rehabilitation: What Will It Take for These Services to Catch On?

Two of our ONA Navigation Summit advisors discuss the emerging role of prehabilitation and rehabilitation in the continuum of cancer care.

General Oncology

Yoga Provides Mental, Emotional, and Physical Benefits for Patients With Cancer

Yoga is becoming an increasingly popular practice among patients with cancer, and for good reason. The practice helps patients cope with their disease and its treatment on many levels.


Surviving Cancer Does Not Encourage Healthier Diets In Patients

Dietary habits have a profound impact on cancer survivorship. A recent study found that unfortunately many survivors do not adhere to healthy dietary guidelines, and those who smoke are even less likely to follow the guidelines.


Seizures in Pediatric Brain Tumor Survivors

Researchers at Dana-Farber/Boston Children's Cancer and Blood Disorders Center sought to assess the effects of treatment for brain tumors in children over 10 years of follow-up.

From CancerCare

Understanding the Triple Negative Breast Cancer Patient

Although treatment options are different and recurrence rates higher for triple negative breast cancer, patients with this subtype of the disease can be hopeful for good treatment outcomes.

Ask a Pharmacist

Data Lacks Support for Anticancer Activity of Cannabis

Patients periodically ask about the use of marijuana in cancer treatment. Is there any data about this?

The Total Patient

Adolescent Stem Cell Donors: Benefits, Burdens, and Risks of Being a Lifeline for a Sibling

Psychosocial support for donor siblings of bone marrow transplant patients is a significant part of the care provided by the transplant team.

Oncology Nursing

Windows 10: Microsoft's Apology to PC Users

The software giant's latest software package offers a mea culpa to users left on the wayside of its previous major system upgrade. This article offers an overview of the program's returning favorites and new features for nurses.


Initial Safety Report Finds Acceptable Safety With Ibrutinib for Asymptomatic, High-Risk CLL

ONA presents an exclusive report on the initial findings on the safety profile of ibrutinib in asymptomatic patients with CLL, as presented at the International Workshop on Chronic Lymphocytic Leukemia.

Communication Challenges

Conversations at the Bedside

Patients' constant proximity to nurses gives them opportunities and the ease of familiarity to ask difficult questions. When answering, nurses should remember that part of the answer is the patient's choice of who to ask.

The Patient's Voice

Dedicated Discovery

After undergoing seven cancer-related surgeries, this survivor used her experience to develop a product that makes acute postsurgical period easier for patients.

Radiation and Your Patient

Radiotherapy and Oral Mucositis

Guidelines and novel approaches are helping clinicians to more effectively manage this debilitating side effect of radiation treatment for cancer.

From CancerCare

Health literacy and older adults

Age-related decline in older patients further complicates their ability to maintain an adequate health literacy level. This discussion presents key points to help nurses improve the health literacy of their older patients.

Oncology Nursing

Nurses' duty to reduce risks and ensure workplace safety

Compliance with safety protocols can minimize risks from occupational exposure to antineoplastic drugs. Are you doing all you can do?


Tell me about your prostate cancer symptoms ... Will most men talk or walk?

Approximately 97% of men with advanced prostate cancer report being comfortable discussing their symptoms with their health care team. But the number of men who actually do so is significantly lower.

Issues in Cancer Survivorship

Counseling cancer survivors on family building options

A leading cancer institute developed an online course that teaches oncology nurses about cancer survivors' fertility options and prospects for adoption.

The Total Patient

Clinicians are rallied to view emotional harm as the new 'human' error in health care

Following the call to arms of the Institute of Medicine's landmark report on the impact of medical errors, a multidisciplinary team of health care providers turn the focus toward emotional harms to patients.

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