Extreme Heat Impacts Cancer Care: What Oncology Nurses Need to Know

As global temperatures continue to rise, a new study reveals that extreme heat is no longer just an environmental concern — it is a significant clinical barrier for patients undergoing cancer treatment.

Research published in Environmental Research: Climate indicates that extreme heat is already dictating how patients manage daily routines, access medical facilities, and adhere to treatment plans. For oncology nurses, who are often the primary point of contact for patient education and care coordination, these findings suggest a critical need to integrate environmental risk assessments into standard oncology nursing practice.

The qualitative study, conducted by researchers at the Sylvester Comprehensive Cancer Center, interviewed 20 adults in South Florida, a region currently experiencing rapid warming that serves as a bellwether for future global health system challenges. The findings illustrate a "thermal burden" that complicates every facet of the cancer journey.

Heat as a barrier to adherence

One of the most concerning findings for nursing staff is the impact of heat on medical adherence. Patients reported delaying or entirely skipping medical visits to avoid heat exposure. For those managing the cumulative fatigue of chemotherapy or radiation, the physical exertion of traveling in high temperatures can become an insurmountable obstacle.

“What we heard was that heat touches nearly every part of people’s routines,” said Kilan C. Ashad-Bishop, Ph.D., lead author of the study, in a news release. “It affects when people go outside, whether they adhere to medical advice, how connected they feel and how much they spend just to stay safe and comfortable.”

The "incremental" strain

Nurses should be aware that heat stress rarely manifests as a sudden medical crisis in these populations. Instead, it operates through a series of "small compromises" that erode a patient's long-term well-being. Participants described reducing physical activity, limiting social interactions, and staying indoors to manage the heat, often at the expense of their quality of life and independence.

Ashad-Bishop noted in the news release that patients are constantly “weighing comfort against care, safety against necessity,” and that these daily calculations eventually "add up." For a patient already facing financial toxicity, the increased cost of air conditioning to stay safe during treatment can further narrow their choices.

Nursing implications for care planning

The study emphasizes that climate experts expect 2027 to potentially be the planet's warmest year on record, making proactive nursing intervention essential. Sophia George, Ph.D., senior author of the study, stressed that providers must move beyond simple weather advisories.

“It’s about recognizing heat as a health stressor and helping patients plan for it as part of everyday care,” she stated in the news release.

To mitigate these risks, oncology nurses can:

• Incorporate Environmental Screenings: Ask patients about their access to reliable cooling and transportation during peak heat hours.
• Coordinate Appointments: Whenever possible, schedule treatments and labs during cooler morning hours for patients sensitive to heat.
• Provide Targeted Guidance: Offer specific advice for "heat adaptation," such as planning essential errands during lower-temperature windows and monitoring for increased fatigue during heat waves.

By recognizing extreme heat as a clinical factor, oncology nurses can better support patients in navigating the complex intersection of environmental stress and cancer recovery.

Reference

Ashad-Bishop KC, et al. "When it comes to heat, I retreat": heat impacts and adaptation practices among people with cancer. Environ. Res.: Climate. 2024;3(4). doi:10.1088/2752-5295/ae70d3.