 This activity is provided free of charge.

This CE article is designed to serve as an update on cancer detection and prevention and to facilitate clinical awareness of current and new research regarding state-of-the-art care for those with or at risk for cancer.

Advanced practice nurses, registered nurses, and other healthcare professionals who care for cancer patients may participate in this CE activity.

Upon completion, participants should be able to:

Describe new preventive options and treatments for patients with cancer

Identify options for individualizing the treatment for patients with cancer

Assess new evidence to facilitate survivorship and supportive care for patients with cancer

ACCREDITATION/CREDIT DESIGNATION STATEMENT

Physicians' Education Resource®, LLC is approved by the California Board of Registered Nursing, Provider #16669 for 1.0 Contact Hour.

It is the policy of Physicians' Education Resource®, LLC (PER®) to ensure the fair balance, independence, objectivity, and scientific objectivity in all of our CE activities. Everyone who is in a position to control the content of an educational activity is required to disclose all relevant financial relationships with any commercial interest as part of the activity planning process. PER® has implemented mechanisms to identify and resolve all conflicts of interest prior to release of this activity.

The planners and authors of this CE activity have disclosed no relevant financial relationships with any commercial interests pertaining to this activity.

1. Read the articles in this section in their entirety.

3. Complete and submit the CE posttest and activity evaluation.

This CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CE activity is for continuing medical nursing purposes only and is not meant to substitute for the independent medical judgment of a nurse or other health care provider relative to diagnostic, treatment, or management options for a specific patient's medical condition.

The opinions expressed in the content are solely those of the individual authors and do not reflect those of PER®

Mutations, irAEs May Help PredictImmunotherapy Response in NSCLC

Patients with non–small cell lung cancer (NSCLC) who experience immune-related adverse events (irAEs) may have better survival outcomes than those without irAEs, according to research presented at the IASLC 2020 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer, held January 28 to 31, 2021.

Overall, 30 Hispanic and 97 non-Hispanic patients were involved. Neither 

 mutations nor irAEs were found to occur at significantly different rates between these 2 patient groups.

 gene mutation had shorter median overall survival (OS) than those with wild-type 

 double mutation was also correlated with a lower 12-month OS rate compared with doubly wild-type tumors.

The investigators retrospectively analyzed the outcomes of patients with stage IIIB/IV NSCLC who were tested for mutations in the 

 genes and who were treated with immune checkpoint inhibitors between July 2014 and November 2019. In addition to examining the role of 

 mutations and irAEs in predicting immunotherapy response, the research team sought to compare the incidence of 

 mutations and irAEs between Hispanic and non-Hispanic patients.

The study population included 96 patients with 

 mutation. Both groups had a median age at diagnosis of 65 years. Forty-eight patients experienced an irAE (median 70 years old at diagnosis), and 77 patients were irAE negative (median 66 years old at diagnosis). Overall, 30 Hispanic patients were involved: 8 harbored an 

Median OS was significantly longer in patients who were 

-mutant group (12.1 vs 8.6 months, respectively; HR, 1.7; 95% CI, 1.0-3.6; 

= .03). The wild-type group also had a higher 12-month OS rate (73% vs 55%; 

 wild-type cancer had slightly better median progression-free survival (PFS) (6.3 vs 5.6 months; HR, 1.35; 95% CI, 0.76-2.1; 

-mutant group, though the differences were not statistically significant.

 had a significantly higher 12-month OS rate compared with patients harboring both mutations (70% vs 40%, respectively; 

However, median OS did not differ significantly between the 2 groups (11.4 vs 5.3 months; HR, 1.8; 95% CI, 0.69-4.62; 

= .13), nor did median PFS, at 5.1 months in the fully wild-type group and 3.0 months in the double-mutant group (HR, 1.2; 95% CI, 0.58-2.54; 

 mutations did not differ significantly between Hispanic and non-Hispanic patients (26.7% vs 23.7%, respectively; OR, 1.2; 95% CI, 0.46-3.0; 

Effects of irAE Status on Survival Outcomes

Patients who experienced an irAE had significantly better PFS and OS outcomes.

Median PFS was 9.5 months in patients who had an irAE compared with 4.4 months in those who did not (HR, 0.54; 95% CI, 0.35-0.82; 

 = .005). Twelve-month PFS was also significantly better in irAE-positive patients than in irAE-negative ones (60% vs 33%, respectively; 

Median OS was 14.2 vs 7.3 months in the irAE-positive and -negative groups, respectively (HR, 0.35; 95% CI, 0.20-0.61; 

 < .001). Twelve-month OS was also significantly higher in patients who had an irAE compared with those who did not (85% vs 60%; 

The rate of irAE positivity did not differ significantly between Hispanic and non-Hispanic patients (46.7% vs 35.8%, respectively; OR, 1.6; 95% CI, 0.68-3.5; 

 = .29). Similarly, the irAE-positive patients in the 2 groups did not have significantly different rates of the most common irAEs: hypothyroidism (35.7% vs 14.7%; 

This study’s findings provide additional support for the use of irAE and 

 mutation status to better identify patients who may respond to immune checkpoint inhibitors. The investigators also suggested further evaluation of their findings in larger studies in the future.

Raez LE, Uba R, North A, et al. STK11/LKB1, KRAS mutations and immune-related adverse events as predictors of response to immunotherapy in lung cancer. Presented at: IASLC 2020World Conference on Lung Cancer; January 28-31, 2021; Virtual. Poster P33.14. Accessed January 31, 2021.

Virtual Prehabilitation Is Efficacious Before Lung Cancer Surgery 

Virtual prehabilitation may improve patients’ physical activity level and exercise capacity before they undergo lung cancer surgery, according to recent research presented at the IASLC 2020 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer, held January 28 to 31, 2021.

“Prehabilitation is the practice of enhancing a patient’s functional capacity before surgery, with the aim of improving postoperative outcomes,” explained lead study author Stephanie Wynne, BSc, psychical therapist at Guy’s and St. Thomas’ NJH Foundation Trust in London, England while presenting the data. “In lung cancer surgery, [prehabilitation] is associated with improved functional capacity and quality of life and reduced hospital length of stay, postoperative complications, and readmission.”

Wynne explained that lung resection is the most common radical treatment for lung cancer, yet only 10% to 30% of individuals referred are actual candidates for the procedure “due to their disease stage and a number of surgical risk factors, including advanced age, performance status, high comorbidities, and reduced cardiopulmonary reserve.” Prehabilitation may help increase patients’ presurgical physical fitness.

Although prehabilitation typically occurs in a face-to-face setting, an at-home option is particularly attractive during the COVID-19 pandemic.

A study was conducted during the summer of 2020 that included 20 patients who were about to undergo lung surgery at a National Health Service Trust in London, England. They were all given a personalized home-based exercise program and a diary to monitor compliance. Patients also received written advice and counseling for symptom management and participated in virtual follow-ups every 1 or 2 weeks via telephone or video.

The majority (65%) of participants were female, and the average age was 68 years. The preintervention assessment revealed that 45% of patients had 5 or more comorbidities, 70% had a history of smoking, and 15% were classified as “vulnerable-mildly frail” per the Rockwood Clinical Frailty Score.

Participants were assessed before and after the intervention on the following outcomes:

Articles

CE lesson worth 1 contact hour that is intended to advanced practice nurses, registered nurses, and other healthcare professionals who care for patients with cancer.

Continuing Education: April 2021

Astudy by the Urban Institute, a nonprofit health policy center, found that more than one-third of adults between the ages of 18 and 64 have forgone or delayed medical care because of the coronavirus disease 2019 (COVID-19) pandemic.

 According to the report, as of September 2020, 36% of adults reported delaying or forgoing health care because they were worried about becoming infected with COVID-19 or because their providers offered limited services because of the pandemic.

Among respondents with 1 or more chronic condition, 40.7% reported they have delayed or forgone care, whereas 56.3% of respondents with both a physical and a mental health condition have done the same, the report says. Black adults were more likely (39.7%) to report forgoing or delaying care than Hispanic/Latinx (35.5%) or White (34.3%) adults and more likely to report forgoing or delaying multiple types of care, at 28.5% compared with 22.3% and 21.1% respectively, according to the report.

The most common type of medical care delayed or forgone was dental at 25.3%, followed by visiting a primary care physician or specialist at 20.6%, and receiving preventive health screenings or medical tests at 15.5%, the report says. 

Respondents with 1 or more chronic health conditions such as cancer, hypertension, diabetes, respiratory illness, heart disease, kidney disease, and mental health disorders made up the majority (76%) of those who have delayed or forgone health care. Delaying and forgoing care is not without its dangers; 32.6% of respondents say that doing so has worsened 1 or more of their health conditions or limited their ability to work or do other daily activities, according to the report.

Medical Economics

More than one-third of adults report delaying or forgoing health care either because of fear of infection or their physicians offering limited services.

 COVID-19 Pandemic Led to Delays in Medical Care

Receiving a diagnosis of either cancer or diabetes can be life changing, but for patients with both diseases, it can prove especially challenging. Research shows that 8% to 18% of individuals living with cancer also have diabetes

 and that treating both simultaneously makes the process more complicated for nurses and their patients. The American Diabetes Association states, “Cancer and diabetes are diagnosed within the same individual more frequently than would be expected by chance.”

“As our population ages and people are living longer, we can expect to see the number of patients receiving diagnoses of both cancer and diabetes increase,” said Jill Olausson, PhD, RN, CDE, an assistant professor and assistant chair, Master’s of Nursing in Healthcare Administration, at Azusa Pacific University in California. Olausson is part of the Glycemic Control for Patients with Cancer Nursing Task Force, a group of nurses committed with improving health-related outcomes and the care of oncology patients with diabetes.


People with diabetes (primarily type 2) are at a higher risk of developing certain cancers than those without diabetes, as the diseases share risk factors such as aging, obesity, poor nutrition, and physical inactivity.

 Olausson notes that predni- sone and other steroids used to treat or prevent nausea, or as a component of cancer treatment, can also cause a spike in blood sugars and compound the management of diabetes. Patients who receive steroids should be closely monitored with premeal glucose testing and additional testing 2 hours after a meal.

Caring for Patients With Diabetes and Cancer


“Cancer patients with diabetes are at an increased risk for developing infections, being hospitalized, and requiring chemotherapy reductions or stoppages,” says Denise Hershey, PhD, RN, FNPBC, an associate professor at Michigan State University’s College of Nursing in East Lansing. Unfortunately, Hershey says there is not sufficient evidence on the best way to manage diabetes in patients with cancer. She believes in looking at each patient’s overall health rather than focusing solely on their cancer.

“It’s important for oncology nurses to work with diabetes educators, nutritionists, and others to form a comprehensive care plan for patients,” Hershey says. “Nurses can assess how well a patient’s diabetes is being controlled by looking at the patient’s A1C [glycated hemoglobin] at the time of their initial cancer diagnosis and seeing if they now appear to [have] hyperglycemia.”

Care plans can help patients balance their glucose levels with their cancer treatment after discharge. “It’s important to look at barriers patients may be facing, such as not being able to afford the high cost of diabetic test strips,” Hershey says. “Rather than just advising them to exercise, letting them know that regular exercise can help stabilize blood sugar levels while also lowering the chances of cancer adverse events [AEs] such as fatigue and neuropathy.”

Recent research shows that blood glucose above 180 increases the risk of complications in hospitalized patients.

 Hershey says oncology patients sometimes make the mistake of prioritizing their cancer diagnosis over their diabetes.

“We know glycemic control plays a role in the overall health quality of life for oncology patients, level of symptom severity, and can also affect overall survival,” Hershey says. “Educating patients about how to self-manage their glycemic control is just as important as treating their cancer, in order to achieve the best outcomes.”

Oncology nurses also need to be aware of changes in a patient’s condition; many
cancer symptoms are also signs of diabetes. Uncontrolled high blood sugar can lead to dehydration, but extreme thirst can also be an AE of chemotherapy. Both diabetes and cancer complications can cause or worsen neuropathy. “We need to look at cancer survivorship and ensure these patients receive optimal diabetes care and achieve their glycemic targets,” Hershey says.

Feature Story

Nurses need to know these key concepts when treating patients who have diagnoses of both cancer and diabetes.

Dual Diagnosis: Nurses Face Challenges in Caring for Patients With Both Cancer and Diabetes

Older age is a significant risk factor for many types of cancer. It is estimated that by 2030, 70% of patients with new cancer diagnoses will be 65 and older.

 It is imperative that nurses caring for geriatric patients understand the unique challenges their patients face to ensure that the care provided meets those needs.

®, Leana Cabrera Chien, MSN, RN, GNP-BC, and Jeanine Moreno, MS, APRN, AGNP-C, shared their insights on geriatric oncology nursing. Chien and Moreno, along with Carolina Uranga, MSN, RN, GNP, and Peggy Burhenn, MS, CNS, RN-BC, AOCNS, compose the Aging Wellness APN team at City of Hope Aging Wellness Clinic in Duarte, California, recently recognized by the Institute for Healthcare Improvement as an Age-Friendly Health System. 

As a board-certified geriatric nurse prac-titioner (NP), Chien has worked with older adults with cancer and participated in studies about such patients in various settings with the goal of improving their model of care. Whereas oncologists focus on treatment, the role of the NP goes further, focusing on the whole patient.

“The biggest difference in older patients is they come with a whole history obtained over a longer period of time,” Chien said. “Look at the whole person, their comorbidities, nutritional deficits, functional and/or cognitive decline, falls, depression, and concerns such as fatigue, which may be associated with other issues.” 

Conducting a comprehensive geriatric assessment will help clinicians evaluate and address age-related concerns and improve the quality of care they provide, individualized to meet the patient’s unique need. The American Society for Clinical Oncology (ASCO) Guidelines for Geriatric Oncology provide recommendations on the use of validated, standardized clinical assessment tools

Moreno, who is also a gerontological NP, heartily agrees. Before going to City of Hope, she had no experience working with patients with cancer, but merging her expertise in geriatrics with oncology has made her an invaluable asset.

“That first meeting to discuss a cancer diag-nosis is always overwhelming. It turns your world upside down, no matter your age or health,” Moreno said, adding, “Older adults, however, tend to face obstacles not typically experienced by younger patients.”

Comorbidities can also be affected by treatment, and vice versa. Patients with arthritis, for example, may experience flare-ups in pain from chemotherapeutic drugs. Education is key in helping patients understand that their existing conditions may change or be exacerbated in response to treatments. These conversations are ongoing and meant to help prevent additional problems from occurring. 

Moreno encourages nurses to look at everything going on with a patient and how it relates to their status and safety. “If a patient’s knees hurt too much to stand and cook, they will not eat as much. If their blood pressure is too low, they may pass out and hit their head.” Thorough assessment will identify these issues before a problem develops or an incident occurs.

Polypharmacy is another obstacle common with older adults. Chien shared a story about a patient with cardiac issues who experienced dizziness and frequent falls: “A medication review revealed the patient was taking amiodarone and an antidepressant, which was curious because this patient was always happy, cheerful, and upbeat. When asked about the antidepressant, she said it had been prescribed to her years ago after her husband passed away and no one had told her to stop taking it. Once the medication was discontinued, the dizziness improved and the falls stopped.”

It is not enough to know which medications a patient is taking and why; nurses also need to know how medications may interact and what effects those interactions may have. What may seem minor can make a big difference. 

Medication review includes both prescription and OTC drugs, looking at appropriateness, dosages, frequencies, effectiveness, and adverse events (AEs). Medications may need adjustments during treatment because of drug-drug interactions or patient status. Communication between members of the multidisciplinary team (primary care physician, pharmacist, oncologist, cardiologist, nursing, therapy, nutrition) when updating medication regimens or changes in condition helps ensure consistency and safety.

Cancer treatments are not easy, even for the young patient. Since Moreno began working in oncology, she has been shocked by how much a person can physically endure. Sometimes the decision is based on the wishes of their family. “Even when the prognosis is not great, some patients consent because it’s what their loved one wants,” she stated. Other patients may choose a different course, or one that the health care team may not think is best. Nurses need to honor whatever choice the patient makes, provided education about all the options available including risk and benefit has been given to the patient to make an informed choice. Sometimes the choice may be to forgo treatment. Patients may be unaware that declining treatment is also an option. 

Discussions on toxicity are important with patients considering chemotherapy. A validated chemo-toxicity calculator (along with a geriatric assessment tool) is available from the Cancer and Aging Research Group at www. mycarg.org. The toxicity calculator captures socio-demographics, tumor/treatment variables, lab results, and geriatric assessment items to predict the risk of severe AEs of chemotherapy in older adults that can guide decision-making. 

When looking at patients, consider their functional age, not merely chronological age. Two 90-year-old patients can differ greatly in their functional ability. “This is a huge teaching point for nursing staff,” says Moreno. “Some 90-year-olds are highly functioning, whereas some 65-year-olds are not.” Part of treatment includes preventing functional loss. Balancing rest with activity can be challenging, especially for patients over 85. They may be more afraid of moving or falling, which can be addressed through physical and/or occupational therapy. A key teaching point for both patients and family members is the importance of mobility to prevent loss of muscle mass. 

A recent pilot study conducted at Duke University testing the effectiveness and feasibility of academic-practice partnership for caregiver training and support demonstrated favorable outcomes for caregivers and older patients.

 The program included training on medical tasks in the home as well as follow-up phone calls to caregivers. Programs like this may be helpful prototypes for oncology nurses to consider for adaptation to the special needs of older patients and their families.

Older adults may have struggles with communication because of hearing deficits or cognitive decline, but what about technology? Are older adults less tech savvy than younger adults? Perhaps, but Moreno and Chien have found that most older adults can and do use computers. Research suggests the challenge is related more to resource limitations than ability or reluctance.

Resource limitations may apply to patients of any age, not just older adults. Since the COVID-19 pandemic, however, families have had to adjust to social restrictions, and have learned to use video platforms such as Zoom to visit and communicate with their loved ones. What may be a bigger hindrance to digital communication than technical savvy is poor internet service, especially in areas that are more rural. 

Face-to-face communication is always best, but telehealth has become a valuable tool for health care providers, patients, and their family members. Televideo allows providers to conduct geriatric assessments remotely, to see patients’ home environments, check their medicine cabinet, talk with multiple family members, and can ease the challenges of transportation for the older adult, especially when multiple appointments are needed. Physical and occupational therapy sessions may also be conducted via telehealth to increase strength and mobility.

For patients less adept with using technology, nurses should take the time to walk a patient through the app/resource/program they will be using. Some patients may not have a computer or a smartphone, and accommodations could be made with family members to bring a laptop to the patient’s home and assisting with its use. 

Multiple phone calls between provider and patient are commonplace in oncology. For older adults, they may need encouragement from family to make a call with a question or concern. More than 1 call may be necessary to change a routine or reiterate important information. Nurses find family input helpful, as they add to the conversation and provide information from a different perspective. 

Symptom monitoring technologies may also be helpful for older patients with cancer. A recently published study demonstrated that older adults had the same level of adherence as younger adults, and received similar benefits, using a telephone-based intervention, which did not require smartphones, computers, or Wi-Fi.

 The keys to effective, responsive communication are ensuring that methods used fit the patients’ needs and that messages are communicated clearly and received and understood as intended.

Oncology nurses will be best prepared to provide high-quality, individualized care to their older adult patients by becoming familiar with geriatric guidelines and assessment and learning more about age-related concerns of geriatric patients. Information and education is available from Nurses Improving Care for Healthsystem Elders at www.nicheprogram.org, the National Comprehensive Cancer Network at www.nccn. org and for providers at American Geriatrics Society at www.americangeriatrics.org.

1. Presley CJ, Krok-Schoen JL, Wall SA, et al. Implementing a multidisciplinary approach for older adults with cancer: geriatric oncology in practice. 

. 2020;20(1):231. doi:10.1186/s12877-020-01625-5

2. Mohile SG, Dale W, Somerfield MR, et al. Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology. 

2018;36(22):2326-2347. doi:10.1200/JCO.2018.78.8687

3. Hendrix CC, Matters D, Griffin T, et al. Academic-practice partnership for caregiver training and support: the Duke Elder Family/Caregiver Training (DEFT) Center. 

. 2020;81(4):221-227. doi:10.18043/ncm.81.4.221

4. Coombs LA, Ellington L, Fagerlin A, Mooney K. Age is not a barrier: older adults with cancer derive similar benefit in a randomized controlled trial of a remote symptom monitoring intervention compared with younger adults. 

. 2020;27(1):1073274820968878. doi:10.1177/1073274820968878

Oncology nurses must consider many factors when treating geriatric patients,  from drug-drug interactions to treatment education and functional age. 

Caring for the Geriatric Patient: What Oncology Nurses Need to Know

Long before COVID-19, health care digital technology was here to stay. The pandemic has accelerated the need for and use of this technology, particularly in remote care settings.

More than 4.57 billion people now use the internet—that is close to 60% of the world’s population, with many going online via mobile technology, like smartphones. As of July 2020, there were 5.15 billion unique mobile phone users in the world, and that number is growing at a rate of 2.4% per year worldwide. Smartphone use is growing with an average of more than 1 million new such devices activating every day.

 We need to tap into this large resource with thoughtful, evidence-based approaches to cancer care.

A study in the United States showed that the pandemic caused a massive acceleration in the use of telehealth. Prior to COVID-19, only 11% of US patients used telehealth. Then, when fear of infection and stay-at-home orders canceled many clinician visits, the use of telehealth leaped to 46%.

 This is a great opportunity for nurses to jump on the telehealth movement.

The other advancement pushing the digital revolution in health care is the wearables. The use of Fitbit, Apple Watch, and other devices has grown immensely popular. The number of connected wearables will continue to rise to 1.1 billion, up from 216 million reported in 2016.

 What a great opportunity for health tracking and healthy interventions around the world.

Digital health technology should be of special interest to oncology nurses because monitoring and interventions for symptoms are the pillar of cancer care. Using digital health technology would allow for timely assessment and planning by the patient’s health care team. Managing symptoms effectively allows the patient to continue treatment and have good quality of life. A review of 66 studies found that digital health benefits patients regarding symptom reporting, management, reduction in symptom distress, decrease in unplanned hospitalizations, improved quality of life, and survival.

 Another study found that patients with cancer think that telemedicine is convenient and acceptable.

Investigators recently reviewed several patient in-home monitoring digital tools. The first tool reviewed was the Symptom Care at Home system, which tracks 11 common symptoms in patients undergoing chemotherapy. The tool provides immediate feedback for self-management and notifies providers of symptoms that exceed preset thresholds. This system showed a 43% reduction in symptom burden severity over usual symptom care.

The second in-home monitoring system reviewed was the Symptom Tracking and Reporting tool. The tool gathers information from 12 commonly experienced cancer symptoms and alerts nurses when symptoms worsen by 1 to 2 points or reach grade 3 or higher. The tool has been shown to improve health-related quality of life and reduced emergency department visits by oncology patients undergoing treatment.

The third tool was the Advanced Symptom Monitoring System (ASyMS). The tool was developed in Europe and has international use. ASyMS is a mobile phone–based tool that can monitor toxicities from chemotherapy during the treatment phase of care. The testing of ASyMS found a decrease in severity of fatigue and will be further studied in 5 European clinical trials.

In addition to these tools that track and address symptom management during treatment for cancer, other tools have been developed that address end-of-life (EOL) care. Tools are available that can monitor and track patient symptoms, caregiver distress, and overall EOL care for patients and families.

Moving forward with implementation of digital oncology tools should be done with careful consideration and with oncology nursing care standards as a basis for an effective tool, but let us not miss this opportunity. Digital health has unlimited possibilities in cancer care, and oncology nurses are at the forefront to assure this initiative is successful for patients and health care workers. Oncology nurses, this is a great opportunity. Let’s jump on it.

1. Kaye R, Rosen-Zvi M, Ron R. Digitally-enabled remote care for cancer patients: here to stay. 

. 2020;36(6):151091. doi:10.1016/j.soncn.2020.151091

2. Bestsennyy O, Gilbert G, Harris A, Rost J. Telehealth: a quarter-trillion-dollar post-COVID-19 reality? McKinsey & Company. May 29, 2020. Accessed March 12, 2021. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/telehealth-a-quarter-trillion-dollar-post-covid-19-reality

3. Holst A. Wearable technology—statistics & facts. Statista. March 9, 2020. 

https://www.statista.com/topics/1556/wearable-technology Accessed March 15

4. Aapro M, Bossi P, Dasari A, et al. Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives. 

. 2020;28(10):4589-4612. doi:10.1007/s00520-020-05539-1

5. Liptrott S, Bee P, Lovell K. Acceptability of telephone support as perceived by patients with cancer: a systematic review. 

6. Wilson CM, Mooney K. Advancing oncology nursing practice through the adoption of patient monitoring digital tools. 

2020:36(6):151087. doi:10.1016/j.soncn.2020.151087

7. Basch E, Deal AM, Kris MG, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial

 2016;34(6):557-565. doi:10.1200/JCO.2015.63.0830

Nurse's Notes

Digital health should be of special interest to oncology nurses, as monitoring and interventions for symptoms are the pillar of cancer care.

April 2021

Continuing Education: April 2021

COVID-19 Pandemic Led to Delays in Medical Care

Dual Diagnosis: Nurses Face Challenges in Caring for Patients With Both Cancer and Diabetes

Caring for the Geriatric Patient: What Oncology Nurses Need to Know

Using Digital Technology to Care for Patients