Precision symptom science helps clinicians identify specific individuals at risk for symptoms and develop targeted strategies to prevent or mitigate the severity of the symptoms. In March 2024, I was one of eight PhD-prepared nurse scientists selected to participate in a workshop hosted by ONS and supported by the Oncology Nursing Foundation to develop the next generation of precision symptom scientists. 

Do you remember the pride you felt when you first put “RN” after your name? Your credentials represent your hard work and dedication. As you add to your education and training, listing your credentials in a standard order ensures they are as meaningful to others as they are to you.

Nurses who specialize in oncology need specific knowledge and skills to ensure they are prepared to deliver high-quality patient care. That need is particularly pressing in low- and middle-income countries.

If 90% of success is preparation, how can one undergraduate lecture on oncology possibly be enough to prepare nurses to successfully care for the nearly 40% of Americans diagnosed with cancer during their lifetimes?

RNs in the United States will see an average of 193,100 annual job openings from 2020–2030, with a 6% increase in employment—faster than the average for all occupations—the U.S. Bureau of Labor Statistics reported in November 2023. Four years into the timeline for that statistical forecast, we need to take a pulse on continuing to grow not only the profession of nursing but also the oncology speciality.

You’ve accumulated the experience, practice hours, and NCPD, and now you’re ready to take the next step in your oncology nursing career and pursue OCN^® certification from the Oncology Nursing Certification Corporation (ONCC). But what about the test? If the idea of sitting for the exam fills you with fear, you’re not alone—studies show that nurses often experience moderate stress (42.1%) and mild to moderate anxiety (19.4%–25.1%) about taking tests. 

Nurses represent a substantial percentage of healthcare artificial intelligence (AI) end users, yet 70% say they have little to no knowledge of AI technologies or uses. In an article published in the December 2023 issue of the Clinical Journal of Oncology Nursing, ONS members Britney Starr, BSN, RN, OCN^®, and Erin Dickman, DNP, RN, OCN^®, and incoming editor Joni L. Watson, DNP, MBA, RN, OCN^®, gave oncology nurses an educational foundation on AI concepts, overview of AI applications in cancer care, and opportunities to actively participate in AI development.

Pressure injuries, falls, central line–associated bloodstream infections, catheter-associated urinary tract infections, and other hospital-acquired conditions (HACs) develop while a patient is in the hospital being treated for another condition. They not only cause patient harm, but they also contribute to escalating costs of care. For example, in the United States, the annual cost of treating pressure injuries is estimated as high as $22 billion, with expenses for a single pressure injury ranging from $500–$70,000. 

Well before the trauma, stress, and burnout from COVID-19, the nursing profession was facing a national workforce shortage. Decision-makers and the advocacy community—including ONS—have had serious policy discussions on how to blunt the impact on the patient population, including promoting federal investments at the Health Resources and Services Administration for more than a year. In August 2023, the Biden-Harris Administration responded, announcing a $100 million awards program to stem the tide.

Join ONS member Suzanne Mahon, RN, AOCN^®, AGN-BC, FAAN, professor at Saint Louis University in Missouri and member of the St. Louis ONS Chapter, as she demonstrates how to examine and explore somatic biomarker testing reports. Understanding these reports is critical when providing patient education, and Mahon’s tips and tricks when identifying report components and their importance are helpful tools for oncology nurses to consider in their practice.

Among all racial and ethnic groups, indigenous people (Native American and Alaska Natives) had the largest decline in life expectancy from 2020–2021. They also have the lowest overall life expectancy (65.2 years) than any of their Asian, Black, Hispanic, or White counterparts—in some cases, up to 20 years shorter. Indigenous people have disproportionately high rates of suicide, chronic liver disease, cardiac disorders, diabetes, and infant and maternal mortality.

As summer’s heat records finally take a fall break, the Centers for Disease Control and Prevention’s (CDC’s) latest awareness campaign reminds parents about some simple strategies to start now to support their children’s health and lower their risk for cancer later in life.

A critical and often overlooked component of germline biomarker testing, cascade testing involves identifying biologic relatives at risk for inheriting a specific known family pathogenic variant after it’s first found in the family and extending the offer for germline biomarker testing to them.

Transgender individuals often experience poor health outcomes, particularly when it comes to cancer. Compared with cisgender individuals, transgender individuals may be diagnosed with cancer at later stages, be less likely to receive treatment, and have worse survival for many cancer types. The disparities extend to survivorship, where transgender people report significant unmet needs, including lack of coordination between gender-affirming care and cancer care, oncology clinician understanding of transgender patient care needs, and transgender-specific resources.

During an inspirational panel discussion at the 48th Annual ONS Congress® that moved many to tears, ONS wrapped up its Leadership Development Committee 2022–2023 Young Leaders pilot program in late April 2023.

Rates of hate incidents against the Asian American/Pacific Islander community have tripled since the COVID-19 pandemic began, and it’s taking a toll on the population’s mental well-being. Researchers have linked pandemic-related discrimination to increased anxiety, depression, and sleep disturbances among members of the AAPI community, yet they are much less likely to seek or accept mental health services than any other racial group.

Oncology nursing is a hands-on practice, and nurses’ learning must be hands-on, too. Allowing your colleagues to try out what you teach further solidifies their foundational knowledge and new concepts. With the use of oral oncolytic agents exploding in oncology care, we must adapt and learn the ins and outs of these agents. As a unit educator at The University of Kansas Cancer Center in Westwood, I help nursing staff understand my cancer center’s oral agent refill process.

Coming to you from Congress, as our coverage wraps up, we're reminded once more of the strength and compassion oncology nurses demonstrate every day. On Saturday evening, we celebrated all of you during the ONS Congress attendee reception at the Stars at Night Ballroom in the Henry B. Gonzales Convention Center. 

Coming to you from Congress, attendees visited the ONS Poster Pavilion to talk with poster abstract presenters to learn more about key oncology nursing topics, directly from leaders and experts. Take a look at one of this year's poster sessions.

Whether it’s through conferences, podcasts, or journals and other articles, an oncology nurse’s quest for continuing their cancer care learning is ever extensive. Innovative educational methods like gamification can keep training fresh and encourage teamwork.

In 2022 we celebrated the National League for Nursing’s Year of the Nurse Educator, but nursing staff recognize and thank nurse educators for their critical role in training and support year in and year out. Oncology nurses in particular rely on nurse educators to stay updated as treatments and patient care constantly evolve—and that requires a multipronged approach. All aspects are covered when clinical nurse educators and pharmaceutical nurse educators come together to deliver training for today’s cancer therapies.

In the years following their initial licensure, nurses will often pursue certification. Obtaining certification shows a nurse’s commitment to their profession, specialty, and patients. Along with showing their commitment, certifications validate a nurse’s qualification and knowledge of a specific area.

November 7, 2022, is the 155th birthday of Maria Sklodowska, who is better known as Madame Marie Curie, one of the greatest minds of chemistry, physics, and radiation oncology. The day also marks the fifth anniversary of #WomenWhoCurie, a social media campaign from the Society for Women in Radiation Oncology that supports and increases visibility of women in radiation oncology.

An eight-week online symptom self-management program, which can be facilitated by a nurse, significantly improves symptom burden, sense of control, and quality of life among patients with ovarian cancer. Researchers reported the evidence in the Journal of Clinical Oncology.

Natural disasters present unique challenges to patients with cancer and the healthcare systems that must stand ready to keep them healthy. Exposure to floodwater places patients at risk for infectious diseases, chemical hazards, and injury, and anything in the water’s path, including medical equipment, medications, homes, and vehicles, can be severely damaged or destroyed. Patients with cancer who are immunocompromised are a highly vulnerable post-flooding population and need special guidance.

Leita, a 42-year-old patient with locally advanced pancreatic cancer, was treated with 5-fluorouracil, irinotecan, and oxaliplatin followed by capecitabine and radiation therapy. After she completed initial treatment, a computed tomography scan conducted in preparation for a possible surgical resection revealed metastatic liver lesions. Leita’s surgery was cancelled, and she began second-line therapy with gemcitabine and nab-paclitaxel.

Survivors need support to resume a high-quality, healthy “new normal” life after they complete their treatment. The services of a cancer survivorship clinic or program may help them manage the physical and emotional implications involved with ongoing care.

To improve cancer care and lower costs, the Centers for Medicare and Medicaid Services created the Enhancing Oncology Model in June 2022.

PITTSBURGH, PA—August 25, 2022—Seven emerging Oncology Nursing Society member leaders under age 40, representing diverse oncology nursing backgrounds around the world, joined the ONS Leadership Development Committee’s 2022 Young Leaders pilot program.

Sally is a 65-year-old patient with T3N1M0 human papillomavirus–negative cancer of the supraglottic larynx who is beginning treatment with radiation and chemotherapy. She has a history of type 1 diabetes mellitus, diabetic retinopathy, diabetic nephropathy, and hospital admissions for diabetic ketoacidosis. She has been using a continuous glucose monitor and insulin pump to help her effectively manage her diabetes. She is concerned that her chemotherapy regimen will involve taking dexamethasone, which will affect her hard-to-control diabetes. Sally tells you she wants to wear her CGM and IP during treatment.

John is a 58-year-old patient who was diagnosed with glioblastoma two years ago. He initially responded well to radiation, temozolomide, and a tumor-treating fields device. His cancer recurred 18 months after diagnosis, and John underwent a second craniotomy that was complicated by a stroke. He became unable to verbally communicate, but John and his partner had previously discussed his desire to participate in clinical trials to help extend his life. The medical oncologist says that John will not qualify for a clinical trial because John is unable to give an informed consent, and John’s partner is frustrated that she can’t speak for him and respect his wishes.

Clinical decision support systems are tools integrated into electronic health records that include reminders for preventive care, evidence-based clinical practice guidelines, order sets, and alerts for drug prescribing. In health care, artificial intelligence converts data into knowledge to guide clinical decisions. When combined, the two technologies can guide advanced practice RNs and other providers with predictions and suggestions that go beyond human accuracy and specificity.

ONS reaps value and benefits from its many collaborations and teamwork—whether between members and staff the Society’s own partnerships with and memberships in other organizations. You may see the outcomes that ONS achieves from those organizational relationships, but you may not yet realize the direct benefit they have for you as well.

Summer is synonymous with vacations, and vacations require logistical preparation. (What will I pack? What should I plan to do?) But it’s also important to ready yourself mentally for a period of wellness and rejuvenation to reap the full benefits of a well-deserved getaway. Making a checklist can help eliminate the stress of both, before and during your travel.

Whole-person care involves evaluating a patient’s physical, emotional, spiritual, and social health. A conversational assessment can help oncology nurses foster an open dialogue about the patient as a person, not just their physical or health needs.

ONS Bridge™, the Oncology Nursing Society’s (ONS’s) premier annual conference tailored to nurses in direct patient care, returns to your screens in September with topics such as care coordination and the latest information on cancer therapies.

Diarrhea is a distressing condition that significantly affects patients’ quality of life and social functioning. Characterized by passage of more than three unformed stools in 24 hours, in cancer it can be caused by chemotherapy, radiotherapy, laxatives and antibiotics, enteral feeding, malabsorption syndromes, colectomy, or several types of malignant tumors. Diarrhea has also been reported in long-term cancer survivors. Standard treatment options such as opiate agonists and adsorbents are associated with side effects that may increase a patient’s symptom burden.

Symptom and pain assessment tools can measure multiple aspects of a patient’s pain experience in both ambulatory and acute care settings. My interest in symptom assessment began with to my work as an oncology nurse practitioner, when I witnessed how symptom management can make a positive difference in patients’ lives and ability to tolerate cancer treatment.

Emerging evidence has consistently shown that flushing central venous catheters with normal saline is comparable to heparin flushes in the adult care setting, leading to updated guideline recommendations that include saline as an alternative. But to date, only two studies have evaluated the two options in pediatric patients, the older of which found increased complications when used in children with leukemia or lymphoma. Is normal saline an acceptable alternative in that population?

Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant genetic disease affecting about 1 in 30,000 people. Pathogenic variants in the MEN1 gene are associated with benign and malignant tumors in the parathyroid glands, pituitary gland, pancreas, duodenum, and stomach.

Symptom assessment gives oncology nurses a consistent matrix to directly evaluate the significance that symptoms have on patients’ distress, quality of life, and survival. Both symptoms and their impact can evolve throughout a patient’s cancer course, making high-quality and detail-oriented assessments an essential tool for successful treatment and management.

More than a year and a half after a report suggesting a potential racial bias in pulse oximeter technology first surfaced as a letter to the editor in the New England Journal of Medicine (NEJM), on June 21, 2022, the U.S. Food and Drug Administration (FDA) said that it is continuing its investigation into the devices’ accuracy and performance, particularly among people of color.

PITTSBURGH, PA—June 24, 2022—Curated by nurses, for nurses, ONS’s new Biomarker Database connects clinicians to information about therapeutic options for certain cancers and their associated biomarkers. 

Samuel, a 55-year-old patient with a history of T3N1M0 oropharyngeal HPV+ cancer on the base of his tongue, underwent surgery followed by 70 Gy of intensity-modulated radiation over seven weeks with concurrent weekly cisplatin. He responded well and had a positron emission tomography (PET) scan three months post-treatment that showed no cancer. Two months later, Samuel calls the triage line to report swelling on the left side of his neck, the same area where he first noticed a lymph node that led to his initial diagnosis.

Highlighting the most prominent barriers that people accessing care face and the influencers acting on providers, the Centers for Medicare and Medicaid Services (CMS) unveiled in May Chronic Pain Experience Journey Map. The map came out of the work done under the 2019 Chronic Pain Stakeholder Engagement initiative to explore the serious role chronic pain has in patients’ lives.  

Individuals with 10–100+ polyps may have a germline pathogenic variant in the APC gene, placing them at higher risk for developing colorectal, gastrointestinal, and other cancers. The condition is known as familial adenosis polyposis (FAP), and loss of function in the APC gene is the first step in the adenoma-to-carcinoma sequence. Some people have an attenuated form (aFAP), with delayed polyp growth and fewer polyps (see sidebar). As many as 20% are de novo, meaning that they are the first in their family to have an identified pathogenic variant.

Bladder cancer is the sixth most common cancer in the United States, with an estimated 83,730 adult diagnoses in 2021. Smoking is the greatest risk factor (47% of all cases occur in smokers), followed by advancing age and sex (assigned males are four times more likely to develop bladder cancer than those assigned female). The incidence rate in White people is double that of Black people, but Black people are twice as likely to die from the disease.

ONS collaborated with the National Community Oncology Dispensing Association, Hematology/Oncology Pharmacy Association, and Association of Community Cancer Centers to launch the IV Cancer Treatment Education (IVE) online resource. After the success of the highly used Oral Chemotherapy Education (OCE) online resource, the four oncology healthcare organizations expanded their collaboration to launch this new initiative that provides patient and caregiver resources about IV cancer therapies and their side effects.

One of the many lessons we’ve learned since early 2020 is to hope for the best but prepare for the worst. When COVID-19 vaccination rates climbed and infection rates declined in spring 2021, we all confidently looked to September for a return to prepandemic activities. However, the Delta variant’s rapid transmission in July and resulting surge in infection rates paused our plans as the United States reevaluated the safety of a full return without restrictions.