Care Of Oncology Patients Research Articles

The UC san diego health suspicion of cancer clinic.

e18528 Background: Physicians at UC San Diego Moores Cancer Center (MCC), like at many major cancer centers in the United States, are subspecialized by tumor type. Patients with symptoms concerning for cancer, but without a diagnosis, often face challenges in establishing care with an oncologist, which can potentially lead to delays in diagnosis and treatment. Methods: At our institution, we created a Suspicion of Cancer (SOC) clinic for referral of patients who have symptoms concerning for cancer, but without a definitive diagnosis of malignancy. The purpose of the clinic is to facilitate establishment of a diagnosis and access to an oncologist in a timely manner. We created an order for referral in our electronic medical record system that enables any provider to refer to patients to the SOC clinic. Once a referral is placed, a hematologist-oncologist or medical oncologist reviews the case and approves the patient for an appointment with the SOC clinic. Results: Between January 2022 and November 2022, we received 107 unique referrals to the SOC clinic. The average age of referred patients was 64 years, with 50 (46.7%) females and 57 (53.3%) males. Thirty-four (31.2%) referrals were from primary care doctors, 23 (21.5%) from hospital medicine, 22 (20.6%) from emergency medicine, 15 (14.0%) from medical subspecialties or neurology, 11 (10.3%) from surgery or surgical subspecialties, and 1 (0.93%) that was self-referred. Thirty (28.0%) patients already had definitive diagnosis of malignancy from either our institution or an outside institution, while 77 (72.0%) did not have a diagnosis at time of referral. Of the 107 referrals, 21 (19.6%) did not follow up with a medical oncologist or hematologist-oncologist within our health system. Reasons for not following up included insurance status, establishing care elsewhere, failed attempts to contact patients, or no shows to established clinic appointments. One patient was already established with a hematologist-oncologist within the MCC prior to referral. Eighty-six (80.4%) patients were seen in new consultation by a medical oncologist or hematologist-oncologist at our institution. After referral, the average time to consultation with a medical oncologist or a hematologist-oncologist was 15.3 days. In the 77 cases without diagnosis at time of referral, 39 (50.6%) underwent biopsy, while 38 (49.4%) were deemed to not require biopsy or declined biopsy. Twenty-five (32.5%) patients were diagnosed with cancer and 52 (67.5%) either did not have biopsy or had a negative biopsy. Ninety-two (86.0%) of the 107 referred patients were alive at time of analysis, while 15 (14.0%) were deceased. Conclusions: The MCC SOC clinic offers a referral pathway to expedite diagnosis and access to care for new oncology patients. In continuing to collect data related to the above outcomes, we hope to identify barriers to the delivery of oncologic care and improve patient outcomes.

HSD31 Real-World Pediatric Oncologist Utilization and Perceptions of Next Generation Sequencing

While integration of next-generation sequencing (NGS) techniques has the potential to improve care and outcomes for certain pediatric oncology patients, data are sparse assessing utilization in routine clinical practice. This survey-based study aimed to examine physician perceptions of NGS-based testing utilization among practicing pediatric oncologists in the U.S.

Attitudes and Perceptions of the REFLECT Communication Curriculum for Clinical Oncology Graduate Medical Education

Background Communication and interpersonal skills are important medical components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel communication to improve and refine physician/patient interactions for oncology graduate medical trainees. Each year, this comprehensive course consisted of quarterly (four-hour) workshops comprised of assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient (SP) simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. We sought to evaluate the attitudes and perceptions of the communication curriculum in oncology trainees. Methods Surveys were developed to obtain perceptions of the REFLECT curriculum from trainee (Radiation Oncology and Medical Oncology) participants and faculty mentors. A 9-question and 11-question Likert scale surveys (1 = not beneficial, 5 = beneficial) was distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainee and faculty opinions about perception of improvement in communication, handling of stressful situations, value of curriculum, and overall impression of the curriculum. Surveys were distributed through Qualtrics, and were anonymous, voluntary, and non-incentivized. Results Twelve resident/fellow participants completed the participant survey. Five (41.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the survey. Nine faculty members, 8 radiation oncologists and 1 medical oncologist, completed the faculty survey. In general, trainees felt that the curriculum improved their communication skills (mean = 3.5, range 1-5). Additionally, most also felt the workshop was beneficial in being able to handle certain topics (69.2%). Seven participants (54%) felt that the curriculum enhanced their communication. However, only 28.4% of trainees felt it was beneficial to their training. The overall impression was positive, with 77% of participants rating the curriculum as beneficial. Meanwhile, faculty members felt the curriculum was beneficial with average responses ranging from 4.5-5. There was a significantly more positive perception of the REFLECT curriculum among faculty members compared to trainees (p <0.05). Discussion While the REFLECT curriculum was perceived to enhance communication skills, trainees did not find the curriculum beneficial. On the other hand, faculty physicians and staff felt the curriculum was beneficial. As interactive skills and communication is critical to build positive interaction with patients, further work is needed to improve trainee's perception of the REFLECT curriculum. Communication and interpersonal skills are important medical components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel communication to improve and refine physician/patient interactions for oncology graduate medical trainees. Each year, this comprehensive course consisted of quarterly (four-hour) workshops comprised of assigned reading, knowledge assessments, didactic lectures, expert guest lecturers, standardized patient (SP) simulations, role-playing, patient/expert panels, coaching, reflective writing, and debriefing/feedback sessions. We sought to evaluate the attitudes and perceptions of the communication curriculum in oncology trainees. Surveys were developed to obtain perceptions of the REFLECT curriculum from trainee (Radiation Oncology and Medical Oncology) participants and faculty mentors. A 9-question and 11-question Likert scale surveys (1 = not beneficial, 5 = beneficial) was distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainee and faculty opinions about perception of improvement in communication, handling of stressful situations, value of curriculum, and overall impression of the curriculum. Surveys were distributed through Qualtrics, and were anonymous, voluntary, and non-incentivized. Twelve resident/fellow participants completed the participant survey. Five (41.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the survey. Nine faculty members, 8 radiation oncologists and 1 medical oncologist, completed the faculty survey. In general, trainees felt that the curriculum improved their communication skills (mean = 3.5, range 1-5). Additionally, most also felt the workshop was beneficial in being able to handle certain topics (69.2%). Seven participants (54%) felt that the curriculum enhanced their communication. However, only 28.4% of trainees felt it was beneficial to their training. The overall impression was positive, with 77% of participants rating the curriculum as beneficial. Meanwhile, faculty members felt the curriculum was beneficial with average responses ranging from 4.5-5. There was a significantly more positive perception of the REFLECT curriculum among faculty members compared to trainees (p <0.05). While the REFLECT curriculum was perceived to enhance communication skills, trainees did not find the curriculum beneficial. On the other hand, faculty physicians and staff felt the curriculum was beneficial. As interactive skills and communication is critical to build positive interaction with patients, further work is needed to improve trainee's perception of the REFLECT curriculum.

Rapid detection of EGFR mutation in CTCs based on a double spiral microfluidic chip and the real-time RPA method.

Circulating tumor cells (CTCs) are cells shed from primary or metastatic tumors and spread into the peripheral bloodstream. Mutation detection in CTCs can reveal vital genetic information about the tumors and can be used for "liquid biopsy" to indicate cancer treatment and targeted medication. However, current methods to measure the mutations in CTCs are based on PCR or DNA sequencing which are cumbersome and time-consuming and require sophisticated equipment. These largely limited their applications especially in areas with poor healthcare infrastructure. Here we report a simple, convenient, and rapid method for mutation detection in CTCs, including an example of a deletion at exon 19 (Del19) of the epidermal growth factor receptor (EGFR). CTCs in the peripheral blood of NSCLC patients were first sorted by a double spiral microfluidic chip with high sorting efficiency and purity. The sorted cells were then lysed by proteinase K, and the E19del mutation was detected via real-time recombinase polymerase amplification (RPA). Combining the advantages of microfluidic sorting and real-time RPA, an accurate mutation determination was realized within 2h without professional operation or complex data interpretation. The method detected as few as 3 cells and 1% target variants under a strongly interfering background, thus, indicating its great potential in the non-invasive diagnosis of E19del mutation for NSCLC patients. The method can be further extended by redesigning the primers and probes to detect other deletion mutations, insertion mutations, and fusion genes. It is expected to be a universal molecular diagnostic tool for real-time assessment of relevant mutations and precise adjustments in the care of oncology patients.

Effect of Perioperative Palliative Care on Health-Related Quality of Life Among Patients Undergoing Surgery for Cancer

Involvement of palliative care specialists in the care of medical oncology patients has been repeatedly observed to improve patient-reported outcomes, but there is no analogous research in surgical oncology populations. To determine whether surgeon-palliative care team comanagement, compared with surgeon team alone management, improves patient-reported perioperative outcomes among patients pursuing curative-intent surgery for high morbidity and mortality upper gastrointestinal (GI) cancers. From October 20, 2018, to March 31, 2022, a patient-randomized clinical trial was conducted with patients and clinicians nonblinded but the analysis team blinded to allocation. The trial was conducted in 5 geographically diverse academic medical centers in the US. Individuals pursuing curative-intent surgery for an upper GI cancer who had received no previous specialist palliative care were eligible. Surgeons were encouraged to offer participation to all eligible patients. Surgeon-palliative care comanagement patients met with palliative care either in person or via telephone before surgery, 1 week after surgery, and 1, 2, and 3 months after surgery. For patients in the surgeon-alone group, surgeons were encouraged to follow National Comprehensive Cancer Network-recommended triggers for palliative care consultation. The primary outcome of the trial was patient-reported health-related quality of life at 3 months following the operation. Secondary outcomes were patient-reported mental and physical distress. Intention-to-treat analysis was performed. In total, 359 patients (175 [48.7%] men; mean [SD] age, 64.6 [10.7] years) were randomized to surgeon-alone (n = 177) or surgeon-palliative care comanagement (n = 182), with most patients (206 [57.4%]) undergoing pancreatic cancer surgery. No adverse events were associated with the intervention, and 11% of patients in the surgeon-alone and 90% in the surgeon-palliative care comanagement groups received palliative care consultation. There was no significant difference between study arms in outcomes at 3 months following the operation in patient-reported health-related quality of life (mean [SD], 138.54 [28.28] vs 136.90 [28.96]; P = .62), mental health (mean [SD], -0.07 [0.87] vs -0.07 [0.84]; P = .98), or overall number of deaths (6 [3.7%] vs 7 [4.1%]; P > .99). To date, this is the first multisite randomized clinical trial to evaluate perioperative palliative care and the earliest integration of palliative care into cancer care. Unlike in medical oncology practice, the data from this trial do not suggest palliative care-associated improvements in patient-reported outcomes among patients pursuing curative-intent surgeries for upper GI cancers. ClinicalTrials.gov Identifier: NCT03611309.

Prognostic Factors for Cardiotoxicity among Children with Cancer: Definition, Causes, and Diagnosis with Omics Technologies.

Improvements in the treatment of childhood cancer have considerably enhanced survival rates over the last decades to over 80% as of today. However, this great achievement has been accompanied by the occurrence of several early and long-term treatment-related complications major of which is cardiotoxicity. This article reviews the contemporary definition of cardiotoxicity, older and newer chemotherapeutic agents that are mainly involved in cardiotoxicity, routine process diagnoses, and methods using omics technology for early and preventive diagnosis. Chemotherapeutic agents and radiation therapies have been implicated as a cause of cardiotoxicity. In response, the area of cardio-oncology has developed into a crucial element of oncologic patient care, committed to the early diagnosis and treatment of adverse cardiac events. However, routine diagnosis and the monitoring of cardiotoxicity rely on electrocardiography and echocardiography. For the early detection of cardiotoxicity, in recent years, major studies have been conducted using biomarkers such as troponin, N-terminal pro b-natriuretic peptide, etc. Despite the refinements in diagnostics, severe limitations still exist due to the increase in the above-mentioned biomarkers only after significant cardiac damage has occurred. Lately, the research has expanded by introducing new technologies and finding new markers using the omics approach. These new markers could be used not only for early detection but also for the early prevention of cardiotoxicity. Omics science, which includes genomics, transcriptomics, proteomics, and metabolomics, offers new opportunities for biomarker discovery in cardiotoxicity and may provide an understanding of the mechanisms of cardiotoxicity beyond traditional technologies.

Psychological distress in patients with cancer at the Kenyatta National Hospital in Nairobi, Kenya, during the COVID-19 pandemic

Abstract Background: Psychosocial care for oncology patients is now recognized as a critical aspect of care because it has a positive impact on patient outcomes. Various screening tools have been validated to objectively measure the levels of distress, such as the National Comprehensive Cancer Network distress thermometer. However, there is little evidence of its use in sub-Saharan Africa, where the cancer burden continues to increase. This study sought to evaluate the levels of psychological distress in patients with cancer and the impact of the COVID-19 pandemic. Methods: This was a single-center cross-sectional study among patients with a histological diagnosis of cancer attending the hemato-oncology and radio-oncology units at the Kenyatta National Hospital, a referral tertiary center. We used the National Comprehensive Cancer Network Distress Thermometer and Problem Checklist to define psychological distress, fear of COVID-19 scale, and Corona Anxiety Score to determine the level of fear and anxiety caused by COVID-19 given the study happened during the pandemic, and the Eastern Cooperative Oncology Group (ECOG) to assess the performance status. Results: Of the 361 patients, the median age was 54 years (interquartile range, 43–63), and most were female (70%). The leading cancer diagnosis was breast cancer (26%), followed by cervical cancer (24%), with most of the patients having advanced disease and 28% having ECOG 3. Most (80%) patients were able to continue with their treatment despite the COVID-19 pandemic; however, 71% had a high level of fear of COVID-19 but minimal anxiety symptoms based on Corona Anxiety Score. The mean distress thermometer score was 2.7 (SD, 2.6), with 30% having a high level of distress (4 or above). ECOG status was the only variable significantly associated with high levels of distress, with the strongest association observed in the highest ECOG status (ECOG 4: OR, 6.8 [95% CI, 2.8–16.6] P &lt; .001). Transportation was the main problem in the practical domain (62%) while fears and worries in the emotional domain (46% and 49%, respectively), and pain (65%) were the main physical problems. Conclusions: One-third of patients experienced high levels of distress. These patients reported significant concerns, such as transportation, fears, worry, and pain, in the problem checklist. There is a need to incorporate screening for distress into our patient population to help identify these patients and institute appropriate interventions.

National Survey On The Nutritional And Exercise Therapy Care Of Oncological Patients In German Hospitals And Oncological Specialized Practices

National Survey On The Nutritional And Exercise Therapy Care Of Oncological Patients In German Hospitals And Oncological Specialized Practices

A qualitative analysis of cancer-related patient care in the emergency department.

Due to an increasing incidence of new cancer diagnoses in the United States and longer survivorship, a growing number of patients with cancer receive care in emergency departments (EDs). This trend places an increasing burden on already crowded EDs, and experts are concerned these patients do not receive optimal care. The purpose of this study was to describe the experiences of ED physicians and nurses who care for patients with cancer. This information can inform strategies to improve oncology care for patients in ED settings. We used a qualitative descriptive design to summarize to the experiences of ED physicians and nurses (n= 23) caring for patients with cancer. We conducted individual, semistructured interviews to query participants about their perspectives on care for oncology patients in the ED. Physician and nurse participants identified 11 challenges and suggested three potential strategies to improve care. The challenges included the following: risk of infection, poor communication between ED staff and other providers, poor communication between oncology or primary care providers and patients, poor communication between ED providers and patients, difficult disposition decisions, new cancer diagnoses, complex pain management, allocation of limited resources, lack of cancer-specific skills among providers, poor care coordination, and evolving end-of-life decisions. The solutions included the following: patient education, education for ED providers, and improved care coordination. Physicians and nurses experience challenges stemming from three overarching types of factors: illness factors, communication factors, and system-level factors. Solutions for the challenges of providing oncology care in the ED call for new strategies at the levels of the patient, provider, institution, and health care system.

Interdisciplinary care of pediatric oncology patients: A survey of clinicians in Central America and the Caribbean.

Quality cancer care depends on interdisciplinary communication. This study explored the communication practices of interdisciplinary clinicians, the types of healthcare services for which they engage in interdisciplinary collaboration, and the association between interdisciplinary care and perceived quality of care, as well as job satisfaction. We conducted a survey of interdisciplinary clinicians from cancer centers in Guatemala, Honduras, Panama, El Salvador, and Haiti. The survey included 68 items including previously validated tools and novel questions. Total 174 interdisciplinary clinicians completed the survey: nurses (n=60), medical subspecialists (n=35), oncologists (n=22), psychosocial providers (n=20), surgeons (n=12), pathologists (n=9), radiologists (n=9), and radiation oncologists (n=5). Oncologists reported daily communication with nurses (95%) and other oncologists (91%). While 90% of nurses reported daily communication with other nurses, only 66% reported daily communication with oncologists, and more than 50% of nurses reported never talking to pathologists, radiologists, radiation oncologists, or surgeons. Most clinicians described interdisciplinary establishment of cancer treatment goals and prognosis (84%), patient preferences (81%), and determination of first treatment modality (80%). Clinicians who described more interdisciplinary collaboration had higher job satisfaction (p=.04) and perceived a higher level of overall quality of care (p=.004). Clinicians in these limited resource settings describe strong interdisciplinary collaboration contributing to higher job satisfaction and perceived quality of care. However, nurses in these settings reported more limited interdisciplinary communication and care. Additional studies are necessary to further define clinical roles on interdisciplinary care teams and their associations with patient outcomes.

Burnout among oncologists, nurses, and radiographers working in oncology patient care during the COVID-19 pandemic

IntroductionOncology care professionals are exposed to high levels of stress that can lead to burnout. The aim of this study was to investigate the prevalence of burnout among nurses, oncologists and radiographers working in oncology patient care during the COVID -19 pandemic. MethodsOur electronic questionnaire was sent to e-mail contacts registered in the system of the Hungarian Society of Oncologists and to all oncology staff via an internal information system in each cancer center. Burnout was measured using the Maslach Burnout Inventory, which measures depersonalization (DP), emotional exhaustion (EE), and personal accomplishment (PA). Demographic and work-related characteristics were collected in our self-designed questionnaire. Descriptive statistics, chi-square tests, two-sample t-tests, analyzes of variance, Mann–Whitney and Kruskal–Wallis tests were performed. ResultsA total of 205 oncology care workers' responses were analyzed. Oncologists (n = 75) were found to be significantly more committed to DP and EE (p = 0.001; p = 0.001). Working more than 50 h per week and being on-call had a negative effect on the EE dimension (p = 0.001; p = 0.003). Coming up with the idea of working abroad had a negative effect on all three dimensions of burnout (p ≤ 0.05). Respondents who did not leave their job due to their current life situation had significantly higher DE, EE, and lower PA (p ≤ 0.05). Intention to leave current profession was specific in (n = 24/78; 30.8%) of nurses (p = 0.012). ConclusionOur results suggest that male gender, being an oncologist, working more than 50 h per week and taking on call duties have a negative impact on individual burnout. Future measures to prevent burnout should be integrated into the professionals' work environment, regardless of the impact of the current pandemic. Implications for practicePrevention and oncopsychological training should be developed gradually at the organisational or personal level to avoid early burnout of professionals.

COVID-19: Collateral damage in head and neck oncology and preventive measures for future pandemics

The start of the COVID-19 pandemic led to enormous challenges for global healthcare, as capacities and resources had to be made available quickly for the treatment of COVID-19 patients. As a result, restrictions had to be accepted, especially in the care of oncological patients. The collateral damage of these limitations inevitably also affects patients with head and neck cancer. This review article summarizes the development of tumor incidences during the pandemic, internationally developed guidelines for the care of patients with head and neck cancer and studies on the delay in oncological therapies and mortality. In addition, the effects on the mental health of the patients, the psychosocial consequences and ethical issues are examined. In perspective, preventive measures for such negative collateral effects in future pandemics are discussed using the example of a concept for application software (app)-based digital care for patients with head and neck cancer.

A Proactive Approach to Prevent Hematopoietic Exhaustion During Cancer Chemotherapy in Older Patients: Temporary Cell-Cycle Arrest.

Age is associated with the decline of multiple organ systems. In older patients, hematological toxicities associated with chemotherapy are often dose limiting, impairing dose intensity and treatment efficacy. Contrary to the classical path using growth factors to activate tissue regeneration, a novel strategy is emerging to prevent chemotherapy toxicity that involves temporary cell-cycle arrest of normal cells, such as hematopoietic or epithelial precursors. This proactive approach may allow the sparing of the stem cell reserve of these tissues. Two molecules are included in this new category, trilaciclib and ALRN-6924, which induce cell-cycle arrest by two different pathways. Previous approaches, such as the use of myelopoietic growth factors, were reactive and they might even have accelerated the depletion of stem cells by enhancing the commitment of these elements. Trilaciclib causes cell-cycle arrest by CDK 4/6 inhibition and ALRN-6924 by p53 activation. In a pooled analysis of three randomized phase II studies of patients with small cell lung cancer, trilaciclib prevented neutropenia, thrombocytopenia, and anemia. Similar chemoprotective results were observed with ALRN-6924 in an open-label phase Ib study of patients with p53-mutated small cell lung cancer. Trilaciclib is now approved as a myelopreservation agent in patients with extensive-stage small cell lung cancer. ALRN-6924 is currently in phase Ib clinical development in patients with p53-mutated cancer. In addition to preserving the normal hemopoietic pool, these drugs promise to preserve the stem cell reserve of other normal tissues with high turnover, preventing potentially other dose-limiting toxicities, such as mucositis and diarrhea. An "ex vivo" study provided early evidence that ALRN-6924 may prevent chemotherapy-induced alopecia. By affording protection from multiple toxicities with a single drug, trilaciclib and ALRN-6924 have the potential to transform the current standards of supportive care for oncology patients and may prevent the depletion of tissue stem cells already compromised with age.

Quality improvements in radiation oncology clinical trials.

Clinical trials have become the primary mechanism to validate process improvements in oncology clinical practice. Over the past two decades there have been considerable process improvements in the practice of radiation oncology within the structure of a modern department using advanced technology for patient care. Treatment planning is accomplished with volume definition including fusion of multiple series of diagnostic images into volumetric planning studies to optimize the definition of tumor and define the relationship of tumor to normal tissue. Daily treatment is validated by multiple tools of image guidance. Computer planning has been optimized and supported by the increasing use of artificial intelligence in treatment planning. Informatics technology has improved, and departments have become geographically transparent integrated through informatics bridges creating an economy of scale for the planning and execution of advanced technology radiation therapy. This serves to provide consistency in department habits and improve quality of patient care. Improvements in normal tissue sparing have further improved tolerance of treatment and allowed radiation oncologists to increase both daily and total dose to target. Radiation oncologists need to define a priori dose volume constraints to normal tissue as well as define how image guidance will be applied to each radiation treatment. These process improvements have enhanced the utility of radiation therapy in patient care and have made radiation therapy an attractive option for care in multiple primary disease settings. In this chapter we review how these changes have been applied to clinical practice and incorporated into clinical trials. We will discuss how the changes in clinical practice have improved the quality of clinical trials in radiation therapy. We will also identify what gaps remain and need to be addressed to offer further improvements in radiation oncology clinical trials and patient care.

Needs of cancer patients during the period of treatment of late complications of cancer

Cancer is the most common cause of death worldwide. Nursing services provided in the late stage of cancer complications improve the quality of life of patients, accelerate the recovery process or help them find inner spiritual peace. The ability of nurses to express empathy and apply motivational interviews has an impact on patients becoming stronger psychologically and physically. The psychological need is effective when a teamwork model is used.&#x0D; The aim of the research – to analyze scientific literature on the needs of patients in the stage of late complications of cancer treatment.&#x0D; Methods of research. Systematic research of the scientific literature was conducted using PubMed, BMJ, Elsevier, The Lancet oncology, IMJ, Google Scholar, World Health Organisation electronic databases. The results showed that the side effects of treatment can last for years in cancer patients in the late stage of complications. The nursing needs are directed to the continuous care of oncological patients, assessment of health status. Teamwork helps to involve the patient in the services provided, to motivate the patient's actions, feedback is important too. Educational activities of the nursing staff are aimed at promoting a healthy lifestyle, planning daily activities that help reduce fatigue, pain, and maintain muscle mass.

Total Pelvic Exenteration surgery - Considerations for healthcare professionals.

Associated with considerable risk of morbidity, Total Pelvic Exenteration (TPE) is a life-altering procedure involving a significant prolonged recovery. As a result, and with the view of achieving the best outcomes and lessen short and long-term morbidities, a well-thought-out and coordinated multidisciplinary team approach, is crucial to the provision of safe and high-quality care. Using a nominal group technique and qualitative methodology, this article explores the current practices in the care of oncology patients who undergo TPE surgery, in a tertiary cancer centre, by highlighting considerations of a collaboratively multi-disciplinary team. This article provides guidance on the multi-disciplinary team approach, relating to TPE surgery, with discussion of clinical concerns, and with the goal of high patient satisfaction, provision of effective care and the lessening of short and long-term morbidities. Oncology patients that undergo TPE surgery benefit from the contribution of a diversified multidisciplinary team as skilled and competent care that meets patient's health and social care needs is provided in a holistic, comprehensive, and timely care manner. Improving patient's care, pathway and postoperative outcomes, with the use of clinical expertise and support from professionals in the multidisciplinary team, can maximise care.

Components of ageism in oncologic patient care: A necessary reflection

Components of ageism in oncologic patient care: A necessary reflection

Advanced Practice Provider Model for Urgent Oncology Care.

Inherent to the cancer disease trajectory are heightened risks for a plethora of comorbid diagnoses. As the treatment landscape for oncology therapeutics continues to rapidly advance, patients are living longer and potentially experiencing more symptoms requiring rapid assessment. Prompt assessment and intervention for cancer or cancer treatment-related symptoms is imperative to achieve patient comfort and obtain the best overall patient outcomes. Traditionally, these patients were frequently referred to the emergency department (ED) when same-day clinic appointments were not obtainable. In order to decrease ED utilization and provide same-day urgent care for oncology patients, the Abramson Cancer Center established an advanced practice provider-led Oncology Evaluation Center where cancer patients are able to receive same-day assessment, symptom relief, and ultimately prevent unnecessary ED visits.

Nurses' Existential Spirituality, Nursing Oncological Patients

The phenomenon of nurses' spirituality is relevant in the holistic nursing of oncological patients, providing spiritual care. Its basis is the phenomenon of spirituality, i. e. the aspect of spirituality is felt, experienced. The nurse, providing spiritual care, shall know and reflect the phenomenon of spirituality herself/himself, in her/his own life.&#x0D; The aim of the research is to reveal the existential spirituality of nurses, taking care of oncological patients.&#x0D; The research issue (problem) includes the following main questions: How do nurses, taking care of oncological patients, reflect spirituality in their own practical activities? How do nurses reflect on the nurse‘s and the patient‘s spiritual relationship, providing care for oncological patients?&#x0D; A qualitative research was conducted at National Cancer Institute, Unit X, using an interview method.&#x0D; The existential spirituality of nurses is revealed, performing their favourite work, in which they do realize themselves and have the opportunity to improve themselves, to communicate with patients, and create an empathetic relationship with them.&#x0D; The internal strength for nurses is provided by knowledge, experience at work, character-hardening and positive real-life experiences, thoughts about the transience of life, the desire to give hope and kindness to the patient. Nurses' personal experiences of crises and losses lead to empathy and compassion for their patients. Nurses reveal the nobility of patients by looking at each patient as a full-fledged person with the hope of recovery; and own nobility through professionalism, creating an empathetic relation with patients.

Exploration of current pharmacy practice in cardio-oncology: Experiences & perspectives.

Cardiovascular complications can occur in oncology patients secondary to certain cancer therapies. Pharmacists are involved in the care of oncology patients who are at risk of or experiencing cardiotoxicity related to their cancer therapy. Our study aimed to understand how pharmacists in Canada care to these patients and to explore their experiences, perceptions, and challenges. Canadian pharmacists currently involved in the care of patients receiving cancer treatments and at risk of or experiencing cardiotoxicity were invited to participate in a 30-min telephone interview using an interview guide. A combination of inductive and deductive reasoning was applied using two coders who independently reviewed the transcribed interviews and identified key concepts and themes. Eight pharmacists were interviewed. Perceived benefits included sharing specialized knowledge and conducting safety assessments. Perceived challenges were the lack of role recognition and resources and fractured continuity of care. Proposed future directions were to play a more substantial role in direct medication management, creation of specific guidance and tools to support the clinical decision-making process, and to understand how pharmacists at other sites were providing care through the creation of a community of practice. As patient-focused medication specialists, pharmacists help guide clinical decision-making, assess cardiac risk factors, and offer individualized education to meet the holistic needs of oncology patients at risk of or experiencing cardiotoxicities. The creation of a cardio-oncology community of practice may allow pharmacists with a common interest to connect, share learnings, and collaborate on how to continue to advance the delivery of care.