Nurses caring for patients with primary central nervous system lymphoma (PCNSL) should emphasize education, early recognition, and maximizing quality of life (QOL), according to a review published in the Clinical Journal of Oncology Nursing.
PCNSL is a rare non-Hodgkin lymphoma accounting for 2% to 4% of central nervous system cancers. The disease trajectory of PCNSL is progressive, occurs rapidly, and is associated with a high mortality rate.
The role for the nurse oncologist varies throughout the disease course. Due to the heterogeneous nature of the disease, coordination through the nurse oncologist is essential. Nurses should be prepared to navigate the patient through delivery of care, provide education, facilitate decision-making, and promote advanced care planning.
The nurse must be familiar with brain anatomy such that effective assessment of tumor-associated alterations in neurologic function may be detected in a timely manner. Possible symptoms may include altered mental state, headache, vomiting, visual disturbances, dysrhythmias, blood pressure alterations, seizures, and dyspnea. Nurses should be prepared to refer patients for palliative care, psycho-oncology, social work, and physical or occupation rehabilitation when appropriate.
Education of the patient and caregivers should include descriptions of possible symptom manifestation such that patient and family members are active participants in care.
Due to the progressive, degenerative disease trajectory, nurses should focus on interventions that increase patient QOL. Nurses also should encourage patient and caregivers to plan for advanced care early such that escalation plans for care and arrangements for the patient’s Will and funeral are not made during periods of crisis.
The review authors concluded that oncology nurses caring for patients with PCNSL must utilize knowledge about brain anatomy and oncology to monitor disease progression. Patients and family should be educated about the disease trajectory and be encouraged to plan ahead.
David K, Davis ME. Primary central nervous system lymphoma: treatment and nursing management of immunocompetent patients. Clin J Oncol Nurs. 2021;25(4):439-448. doi:10.1188/21.CJON.439-448