With so many of today’s cancer treatments administered orally, ensuring that patients adhere to their regimen as prescribed is essential to optimal outcomes. According to the World Health Organization, medication adherence is the single most important modifiable factor that affects treatment outcomes.

Responses to pandemic-related screening and treatment delays have created new opportunities for oncology advanced practice RNs (APRNs), too. In both their institutions and communities, APRNs are guiding patients and providers to reverse the increases in late cancer diagnoses, morbidity, and mortality—ultimately improving outcomes.

Jeff is a 60-year-old patient with myeloproliferative disease. After his care team secured a 9/10 match, he received an allogeneic hematopoietic stem cell transplantation with a conditioning regimen of fludarabine and melphalan. Neutrophil engraftment occurred at day 20, and he was discharged to home shortly after engraftment. One month later, he presented to the clinic with abdominal pain and a new diffuse erythematous rash, which his care team initially treated with corticosteroids. However, his abdominal pain persisted, and Jeff was admitted to the hospital a few days later for further workup for suspected acute graft-versus-host disease (GVHD). A computed tomography scan of his abdomen demonstrated worsening enterocolitis because of Yersinia enterocolitica. What would you do?

Tepotinib (Tepmetko®) was granted accelerated approval in February 2021 for mesenchymalepithelial transition (MET)-altered metastatic non-small cell lung cancer (NSCLC) based on overall response rate and duration. The drug is still under long-term evaluation and healthcare providers should report all serious adverse events that may be associated to FDA’s MedWatch Reporting System.

On February 12, 2021, the U.S. Food and Drug Administration approved trilaciclib (Cosela^TM), a parenteral inhibitor of cyclin-dependent kinase, to prevent myelosuppression when administered prior to chemotherapy administration. The approval is currently limited to the use of trilaciclib before treatment with platinum- and etoposide-containing regimens and topotecan-containing regimens for treatment of extensive-stage small cell lung cancer.

Delaying initiation of cancer treatment by just four weeks is associated with increased mortality rates for patients with seven types of cancers, regardless of treatment type, researchers reported in BMJ.

Every nurse has been in a situation where he or she is staring at a discharge document, thinking, “This patient will need an immense amount of outside support to adhere to this treatment plan.”

Patients who miss two or more regularly scheduled radiation therapy sessions may be at increased risk of recurrence even if they eventually complete their course of treatment, researchers reported after a recent study.

Administration of chemotherapy drugs has shifted dramatically in the past 15 years from parenteral to oral administration. This change requires patients to self-manage their chemotherapy. Patients need to understand important medication administration tasks: right dose, right time, right route, and right drug.

Oral chemotherapy, like IV chemotherapy, effectively helps patients fight cancer and may have similar side effects to its IV counterparts. Self-administration of oral chemotherapy may be convenient, but it is still chemotherapy and requires extra caution.

Adherence to oral agents for cancer (OACs) is an important issue in the oncology setting. Unlike IV agents, which are typically administered in a controlled environment by oncology nurses, OACs are self-administered at home with little professional oversight. The potential for medication error or nonadherence cannot be underestimated, but oncology nurses are in a key position to spearhead initiatives aimed at improving patient education and adherence for OACs.

Gina is filling in for the triage nurse at her facility’s outpatient solid tumor department. She receives a call from a patient who reports severe swelling in her left arm after returning from a trip on the opposite side of the United States. She says the skin in her arm and hand is quite tight, and that her hand was throbbing when she woke up this morning. What would you do?

Bob, a 61-year-old man with multiple myeloma, calls his hematologist’s office complaining of worsening constipation despite increasing his fiber and liquid intake. Yesterday, he stopped taking his ondansetron because he remembered that it can cause constipation, but now he’s nauseated in addition to being constipated. What would you do?