Frequent communication between patients and providers is key in getting ahead of adverse events that can occur during breast cancer treatment, explained Madeline Kuiper, MSN, RN, OCN, an oncology nurse practitioner at UCLA.
I like to have my patients come back and see me when I start them on a new therapy every week or every 2 weeks, just so that the patient feels that they've got a point of contact where they can come and discuss that with us. Definitely what we talk about additional lung disease is stopping therapy and doing the workup with CTs and steroids as needed. Adding to that, I'd also automatically refer to my patients to a pulmonologist that we work closely with so that we can both co-manage and maximize this patient and their therapy.
For something like niraparib (Zejula) and decatinib, then addressing diarrhea early is important. [as is] making sure that patients do not dehydrate and lose electrolytes. So we talk about preventative drugs and using those upfront. Again, I would have regular contact with my patient, making sure that if I need to bring them in, I can give them some fluids.
The earlier you intervene, the more compliance you can get with your patients. So monitoring those sorts of things [is important]. Management of fatigue, getting my patients to be as active as possible, continuing to do their exercise, those sorts of things.