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Terri Pollack, DNP, APRN, FNP-C, PMHNP-BC, discusses key data that may affect clinical practice for nurses from the 2023 GI Cancers Symposium.

Pollack Discusses Ongoing Research for Patients With Refractory mCRC and Other Hard-to-Treat GI Malignancies 

In this episode of "The Vitals," Terri Pollack, DNP, APRN, FNP-C, PMHNP-BC, underscores potentially practice-changing data which were presented during the 2023 GI Cancers Symposium.

Pollack Offers Perspective on 2023 ASCO GI Cancers Symposium 

Nivolumab/Cabozantinib continued to outperform sunitinib in an updated analysis of the phase 3 CheckMate 9ER trial.

Nivolumab/Cabozantinib Shows Continued Benefit In Frontline Treatment of RCC

Karyn A. Goodman, MD, MS, provides perspective on the potential advantages of stereotactic body radiation therapy in locally advanced pancreatic cancer.

Goodman Highlights Potential Benefit of SBRT in Locally Advanced Pancreatic Cancer

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The state-of-the-art facility represents the organization’s vision of global cancer care

Cleveland Clinic Opens New Cancer Center in Abu Dhabi

In the United States, only 27 institutions have been awarded the Gold level “Center of Excellence” by the International Cardio-Oncology Society (IC-OS).  The Cardio-Oncology Program at the Georgia Cancer Center is proud to be one of those 27 institutions.

Georgia Cancer Center’s Cardio-Oncology program gets the gold

A television commercial produced by Florida Cancer Specialists & Research Institute, LLC (FCS) has been recognized with a Silver ADDY® by the American Advertising Awards, which honors excellence in advertising as judged by creative industry professionals around the world.

Florida Cancer Specialists & Research Institute Television Commercial Recognized with Silver ADDY® Award

The gift is from the estate of Tom and Catherine Culley, longtime residents of the East Coast and worldwide travelers.

Cancer Center gets $1.1M gift for holistic cancer care

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Two studies suggest that treatment during pregnancy does not appear to negatively impact neurologic or cardiac fetal development. 

In Utero Exposure to Cancer Treatment

Despite the proven benefits of SBRT for patients with inoperable stage I NSCLC, whether such patients are offered it depends on their race, insurance status, and the type of facility where they are being treated.

For Patients With Inoperable Stage I NSCLC, Race, Hospital, and Insurance Status Matter

Despite a recent decline in utilization, consolidated radiation therapy (RT) has been shown to improve 10-year survival rates for patients with stage I/II Hodgkin's lymphoma following treatment with chemotherapy. 

Radiation Therapy Improves Survival in Hodgkin's Lymphoma

A new study has found that standardizing prescribing practices for single-fraction radiation therapy (SFRT) for palliation of bone metastases may result in cost savings and an improvement in patients' quality of life.

Fewer Side Effects, Cost Savings, With Single-Fraction Radiotherapy for Bone Metastases

Findings from a phase 2/3 trial found better disease-free and overall survival outcomes with radiation plus docetaxel vs radiation alone in head and neck squamous cell carcinoma.

Adding Docetaxel to Radiation Boosts Survival in Cisplatin-Ineligible HNSCC

Reanne Booker, MN, NP, shares how nurses can increase patient understanding on the role of palliative care in oncology. 

 Discussions Around Palliative Radiation Are Key To Improving Both Patient and Provider Understanding 

Ellen Miller, MSN, FNP-BC, a nurse practitioner who specializes in survivorship care, underscores what conversations surrounding fertility and pregnancy may look like after radiation. 

Survivorship Clinic Visits Hold Answer to Questions About Post-Cancer Pregnancies 

The rate of severe radiation dermatitis was reduced with the use of Mepital Film in patients with breast cancer undergoing mastectomy.

Mepitel Film Reduces Severe Radiation Dermatitis in Patients Undergoing Mastectomy 

Avasopasem was associated with a significant reduction in severe oral mucositis in patients with locally nonmetastatic head and neck cancer undergoing chemoradiotherapy. 

Avasopasem Represents Potential Mitigation Strategy for Radiotherapy-Induced Oral Mucositis in Head and Neck Cancer

Stereotactic body radiation therapy (SBRT) may present a more tolerable option for patients with locally advanced pancreatic cancer than intensity-modulated radiation therapy (IMRT), according to Karyn A. Goodman, MD, MS, who added that the 2 have similar efficacy profiles.

“For patients with pancreatic cancer, SBRT is a really nice option,” Goodman, professor and vice chair for research and quality in the Department of Radiation Oncology at the Icahn School of Medicine at Mount Sinai, and associate director for Clinical Research at The Tisch Cancer Institute at Mount Sinai told 

. “It minimizes the amount of time patients have to be in the hospital for their radiation—it’s only 5 treatments, usually, given over [approximately] 2 weeks. It’s a very focal radiation delivery process; we’re only treating the primary tumor and maybe some adjacent nodes that are enlarged, rather than [the] larger field that we use for the standard chemoradiation.”

“It is very well tolerated and patients have minimal toxicity from the treatment,” she noted.

Goodman is one of the authors on the phase 3 TIGeR-PaC trial (NCT03257033), which is investigating the efficacy of intra-arterial chemotherapy administered via a dual-balloon catheter vs current standard of care. As part of the trial design, patients undergo radiation therapy during the indication phase. Data from this phase allowed investigators to assess the toxicity and efficacy rates between the 2 radiotherapy methods.

Although the study was not designed as a head-to-head comparison of SBRT compared with IMRT, the data suggest that SBRT may be a more tolerable treatment strategy and elicits similar efficacy outcomes as IMRT. The findings showed that no significant differences in local tumors responses were recorded between SBRT and IMRT. At the same time, fewer patients needed to withdraw from the study because of a serious adverse event (SAE) with SBRT than with IMRT.

The trial included 134 patients from 22 different sites, 75 of whom received IMRT and 59 of whom underwent SBRT. The rates of any adverse event (AE) with IMRT or SBRT, respectively, were 65.3% vs 44.1% (

 = .015). The rates of gastrointestinal AEs were 44.0% vs 16.9% (

 = .001) and the rates of grade 3 or worse AEs were 26.7% vs 10.2% (

 = .026). Moreover, 10 SAEs (13.3%) were reported in the IMRT arm, as opposed to 2 in the SBRT arm (3.4%). During the study there was 1 death with IMRT and none with SBRT. Ultimately, 9 patients (12.0%) on IMRT withdrew from the study vs 1 on the SBRT arm (1.7%; 

Moreover, the mean CA 19-9 change was not significantly different between IMRT and SBRT recipients (

 = .262). In terms of tumor size, the mean change was –11.7% with IMRT and –12.6% with SBRT (

Locally advanced pancreatic cancer is a deadly cancer for which radiotherapy is considered standard management.

 Despite this, the optimal RT technique has yet to be determined. Both SBRT and IMRT represent common treatment approaches. Although the study authors concluded that further prospective studies are needed to address the optimal radiation modality, the findings from this research suggest that SBRT may be the best radiation backbone for novel therapies, such as intra-arterial chemotherapy.

“This was a nice opportunity to evaluate 2 different ways of delivering radiation for patients with locally advanced pancreatic cancer,” Goodman concluded.

Goodman KA, Pishvaian, Lopez CD, et al. Toxicity and efficacy of stereotactic body radiation therapy vs intensity-modulated radiation therapy for the treatment of locally advanced pancreatic cancer in a phase 3 trial. 

 2023;40(suppl 4):713. doi:10.1200/JCO.2023.41.4_suppl.713

National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology. Pancreatic adenocarcinoma, version 2.2022. Accessed February 23, 2023. 

https://www.nccn.org/professionals/physician_gls/pdf/pancreatic.pdf

There are a variety of factors to consider when discussing palliative radiation with a patient with cancer, explains Reanne Booker, MN, NP.

“It’s really important that we consider a patient’s goals and wishes and to make sure that our treatment aligns,” she said in an interview with 

Booker is a nurse practitioner with the palliative and end-of-life care services program at the Foothills Medical Centre at Alberta Health Services in Calgary, is a PhD candidate at the University of Victoria in British Columbia. She recently performed a literature review on palliative radiation, the findings of which were published in the 

In the discussion, Booker broke down some key factors to consider when helping a patient decide if palliative radiation would be beneficial for them. She outlined some potential reasons a patient might not need or benefit from this therapy, as well as some of the symptoms that may be alleviated with this this therapy.

Booker noted that it can take approximately 4 weeks for patients to realize the benefits of palliative radiation, so for patients who have a shorter prognosis (days or weeks), this may not be the best treatment. In addition, patients considering this treatment must be able to tolerate laying still on a hardtop table for at least 15 minutes. Some patients may have conditions which would make this intolerable, in which case, palliative radiation would not be appropriate.

Moreover, depending on the treatment site, it may be necessary to place a mask over the patient’s face, which can cause anxiety and claustrophobia for some. Patients and providers should also consider the logistics of traveling to and from the cancer center for palliative treatments. Depending on where a patient lives, and the amount of time they want to spend in transit, this can also represent a barrier to care.

There are many different symptoms and conditions which can be improved with palliative radiation, Booker noted. For example, patients with brain tumors may be able to better manage headaches, seizures, and neurologic dysfunction, and for patients with head and neck tumors, palliative radiation can help with pain or bleeding, difficulty swallowing, and shortness of breath.

Patients with lung tumors may experience improved pain, coughing, or bleeding symptoms. Palliative radiation may also help with obstructive pneumonia or superior vena cava syndrome. This treatment is also favored for patients with gynecological and genital urinary cancers, as it can help with pain, bleeding, reduce blood in the urine, and urinary outlet obstruction, and it has been known to improve these symptoms in patients with rectal cancers as well.

Booker R. Palliative radiation therapy: the role of radiation therapy in palliative and end-of-life care. 

. 2022;26(6):628-635. doi:10.1188/22.CJON.628-635

Reanne Booker, MN, NP, highlights factors that make a patient a good candidate for palliative radiation. 

Reanne Booker on Factors to Consider When Discussing Palliative Radiation

Patients who undergo radiation therapy may experience a host of long-term side effects that their radiation team would be best equipped to deal with, explains Kate Sandstrom MSN, APRN-BC, AOCN.

Sandstrom currently works as a full-time nurse practitioner in the Department of Radiation Oncology at Seidman Cancer Center, University Hospitals Case Comprehensive Cancer Center, and recently gave a presentation on late side effects at the 47th Annual Oncology Nursing Society Congress.

In an interview ahead of her presentation with 

®, Sandstrom discusses resources available to patients who have undergone radiation therapy, and the importance of emphasizing to the patient that they continue to follow up with the radiation oncology team.

Kate Sandstrom, MSN, APRN-BC, AOCN, discusses the importance of including the radiation oncology team in a patient’s long-term care plan.

Kate Sandstrom on Ensuring Patient Follow-Up With Radiation Oncology Teams

A new kind of dressing may be able to help prevent and reduce the symptoms of radiation dermatitis in patients being treated for head and neck cancer, according to Raymond Chan, PhD, RN, BN, MAppSc, professor of cancer nursing at Queensland University of Technology in Brisbane, Australia.

Chan and his team tested a non-steroidal, silicone-based clear gel that is applied to the radiation site. The product forms a dressing that prevents transdermal water loss and reduces inflammation. And while there was no statistically significant patient-reported outcomes regarding pain and itch, the product may be able to mitigate the severity of radiation dermatitis, thereby improving patients' quality of life.

Radiation dermatitis is a common adverse event for patients with head and neck cancer undergoing radiation therapy, but a new kind of dressing may help.

Preventing Radiation Dermatitis

Molly Freeman, CNP, Cleveland Clinic Cancer Center, discusses the importance of providers being familiar with SBRT and what the effects look like.

If a provider is unaware of what the effects of stereotactic body radiation therapy (SBRT) look like on a scan, it can cause alarm. This can sometimes lead to unnecessary biopsy or other treatment. To combat this, Freeman suggests more education for both patients and providers and sending copies of scans to the radiation oncologist for review.

Molly Freeman explains why it is necessary for providers to be educated on stereotactic body radiation therapy.

Molly Freeman on the Need for Provider Education about SBRT

Molly Freeman, CNP, from Cleveland Clinic Cancer Center, discusses the aftercare that goes into treating patients with lung cancer who have undergone stereotactic body radiation therapy (SBRT).

SBRT is a treatment option for patients with lung cancer. It is a very well-tolerated therapy with minor adverse events -- such as fatigue, chest wall aching and the low possibility of radiation pneumonitis.

Molly Freeman, CNP, discusses the aftercare that goes into treating patients with lung cancer who have undergone stereotactic body radiation therapy (SBRT).

Molly Freeman on SBRT Aftercare for Patients with Lung Cancer

Puneeth Iyengar, MD, PhD, assistant professor of Radiation Oncology at UT Southwestern Medical Center, discusses the use of a hypofractionated course of radiation therapy for patients with stage 3 NSCLC.

The current standard therapy for stage 3 NSCLC is a combination of chemotherapy and radiation. Some patients are unable to tolerate chemotherapy for a variety of reasons and receive 6 weeks of radiation therapy instead. Iyengar's study compared that conventional schedule with a hypofractionated course, for just 3 weeks.

Dr. Puneeth Iyengar discusses the use of a hypofractioned course of radiation therapy for patients with stage 3 NSCLC instead of a combination of chemotherapy and radiation.

Radiation Oncology

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