Lung Cancer: What Nurse Navigators Need to Know in 2018

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Lung cancer treatment is in flux, with new immunotherapy agents and targeted therapies emerging.
Lung cancer treatment is in flux, with new immunotherapy agents and targeted therapies emerging.
The following article features coverage from the 2018 Oncology Nurse Advisor Navigation Summit. Click here to read more news highlights and expert perspective from the Summit on Oncology Nurse Advisor. 

As nurses working in the oncology field, we should always be aware that change is inevitable. Whether it is a change in patient status, treatment changes, new innovations, or how the diagnosis is made and acted upon — change is constant and continuous. There have been many recent changes in lung cancer and the management of patients with these diagnoses, including updated early detection possibilities and changes in diagnostic procedures, reporting, and treatment options.

There is no known lung cancer prevention. Not smoking, getting exercise, and proper nutrition are all excellent ways to a healthy life style. But we all also know patients who have done all of that, had no family history of lung cancer, and still developed the disease. With that in mind, the focus now is really on early detection through high-risk lung screening programs with/without separate lung nodule follow up programming. In some areas of the country, lung screening and nodule programs dovetail and in others ― especially in areas where numbers of incidentally found nodules exist ― there are separate programs to follow these patients. Either way, it is important to utilize the existing national standards for patient follow up.

The American Joint Committee on Cancer (AJCC) staging has changed in the past year. It impacts not only our patients' diagnosis, but what we need to teach them regarding treatment options and overall survival.

Treatment options are changing by the minute. In addition to adding known immunotherapy agents to existing chemotherapy regimens, almost daily we add new targeted therapies to the armamentarium. Even radiation changes, adding new more refined treatment modalities to the mix. 

We should also remember that some patients do not receive the care that they might receive in other circumstances. Health care disparities exist and oncology navigators must recognize this and take steps to overcome these disparities. Whether it is identifying populations that are underserved or finding patients who appear to “fall through the cracks,” as nurse navigators and oncology caregivers, it is important to bring these issues to the forefront of program administrators with ways to manage the issues.

Lastly, survivorship is also an important topic. Getting patients to this end goal is only part of the overall responsibility of the oncology navigator. We also need to give our patients the resources to move beyond ourselves to return to the “normal” world. Survivorship letters with copies for their primary care physician practices that document follow up needs is the ways to go. Sometimes, this is difficult to accomplish, certainly time consuming, but incredibly important.

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