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Greg,
No we don’t keep track of our infusion patients here at SSCBC using scalp cooling. I do know that AC has the worse outcome with only 20% of the patients able to keep 50% of their hair after 4 cycles of Adriamycin and Cytoxan. The patients who are trying to work fulltime while undergoing chemotherapy seem to be the most interested in scalp cooling so that they’re able to maintain amenity during their treatment.Mindy- I think my patients have purchased cooling gloves from Amazon
Some nurses have expressed concern when our patients are icing their hands and feet because there is no way to control how cold they are making their extremities. They also voice concern that some taxanes can infuse for long periods of time a 3 hour taxol titration can be up to 4 hours long or more.
1. What was the knowledge gained from the article?
I chose these articles because it seems to me that more and more breast cancer patients receiving taxanes are interested in cryotherapy in the prevention of peripheral neuropathy (PN). These articles reminded me of those patient who have existing peripheral vascular disease and diabetes are at increased risk. I’ll use this information when assessing my patients prior to their chemotherapy. I wasn’t aware that 50% of patients receiving a taxane experience nail changes and peripheral neuropathy. I had never given much thought in the use of cryotherapy in prevention of nail changes but it seems to be a simple intervention.2. Will the research/information in this article change or influence your practice? If so how? I’m more inclined to recommend cryotherapy in those patients experiencing nail changes.
3. What other questions does the article raise about current practice? I would like to see larger studies done so that we can have more substantial evidence in support this intervention.
4. Do you agree/disagree with the conclusions of the author, why?
I disagree I think that cryotherapy works to prevent peripheral neuropathy.
Pauley- I too worry about our patients and whether or not they’ll be penalized for positive genetic testing. I had a 80 year old male patient today who has breast cancer and PMH of prostate cancer and was voicing worry about the results of his genetic testing which was still pending. He stated the reason why he received genetic testing was for his grandchildren.
Hopefully, there will always be laws in place to protect our patients from discrimination.Herrington- Foundation One is still one of the outside PMI’s used and just recently I saw one of the medonc physicians treating breast cancer patient include the findings from Foundation One in their progress note. Unfortunately, the information found from Foundation One did not impact the current treatment plan but who knows if this information will help in the future. I greatly appreciated the additional information https://www.cancer.gov/research/areas/treatment/pmi-oncology I shared it with several of my coworkers.
What was the knowledge gained from this article?
The article Implementing Precision Medicine in Community-Based Oncology Programs: Three Models, I particularly appreciated the details on how the three models implemented this data into their daily practice. I know I’ve personally witnessed medical oncologist struggle with how useful this data is when deciding on a treatment regimen especially information from commercial NGS. I also appreciated the acknowledgement that oncologists are generally not aware of the performance characteristics of available tests and may not be directly involved in ordering tests because it often falls to hospital pathology departments.
Vorderstrausse, Hammer, & Dungan I appreciated the reminder of the role of the nurse as a educator and advocator for our patients when it comes to precision medicine.Will the research/knowledge gain from this change or influence your practice? why? Yes I’m definitely going to seek out education opportunities as well so that I can strength my knowledge when it comes to precision medicine. I also will take the advice of Vorderstrausse, Hammer, & Dungan and suggest Health/national human genome research institute and National cancer institute as online resources for additional information on genetic and genomic testing and pharmacogenomics in oncology.
What other questions does the article raise about current practice? Tomorrow brings new treatments and new genetic and genomic testing we must stay current on latest practice because our patient rely on our guidance so much.
Do you agree/disagree with the conclusions of the author, why?
I agree with the generalize message of both of these articles that cancer care is moving forward to personalized medicine will become at the center of the treatment plan and as a oncology nurse evolve with this change by educating myself on current practice.
Levit, L. A., Schenkel, C., Schilsky, R. L., Kim, E. S., McAneny, B. L., Nadauld, L. D., & Levit, K. (2019). Implementing Precision Medicine in Community-Based Oncology Programs: Three Models. Journal of Oncology Practice, 15(6), 325–329. https://doi.org/10.1200/JOP.18.00661
Vorderstrasse, A.A., Hammer, M.J., & Dungan, J. R. (2014). Nursing Implications of Personalized and Precision Medicine. Seminars in Oncology Nursing, 30(2), 130-136. https://doi.org/10.1016/j.soncn.2014.03.007I feel like sometimes I underestimate the power of therapeutic touch. This journal discussion has reminded me how much CT can help patients. Thanks again for selecting such great articles.
I’m definitely going to suggest Complementary therapy to my patients because I find many need help increasing their ability to cope. I also think it takes the CT specialists and the entire medical team to help the patient cope through their oncology journey.
Today, I was able to witness a patient receiving Reiki and I felt like one of the benefits from this therapy was the therapist actively listens for 30-60 minutes and the therapist quickly develops a therapeutic relationship with the patient.
I feel like the patients just greatly benefit from someone spending so much time listening to all their cancer journey.Thank you for initiating a journal club that all of the James Nursing staff can participate in.
Great articles it appears that this is a growing interest of our patients.
1.What was the knowledge gained from the article? After reading Oncology Pain and Complementary Therapy (CT): A Review of the Literature, I was provided a great description of the different complementary therapy modalities. I struggle at times defining these therapies I feel after reading this article I am better equipped to educate my patients. This article also reminded of how many patient experience pain especially the metastatic patient.
I specifically liked the Reiki definition for this is a therapy that is available to the breast cancer patients here at SSCBC and my patients are always inquiring about it. We also have Dr Borja one of the Complementary Therapy providers running a clinic out of the SSCBC so I’m aware of the increase interest in CT by my patients.
The other article Assessing the impact of Acupuncture on Pain, Nausea, Anxiety, and Coping in Women Undergoing a Mastectomy provided data on a study of 30 women with half of those women receiving acupuncture postoperatively. The finding were reduction in pain, nausea, and anxiety as well as an increase in ability to cope. This was a small study but the results are hopeful that in combination with western medicine acupuncture could be helpful in decreasing the side effects our patients are experiencing for the treatment modalities that they receive for their cancer.2.Will the research/information in this article change or influence your practice? If so how? I will use the information gained by these articles to support the use of CT to reduce pain, nausea and anxiety ect. I will provide this information to my patients as well as request5 referrals from the providers.
3.What other questions does the article raise about current practice? Will Western Medicine get on board with the possibility of promoting CT. Insurance coverage definitely is an obstacle. The Reiki is provided to patients at SSCBC at no cost because I think it’s funded by a grant. There is also a grant for massage for our survivorship clinic at SSCBC which I’ve heard from patients how much they look forward to those visits.
4.Do you agree/disagree with the conclusions of the author, why? I agree with the authors of these articles that CT can help with many side effects from cancer treatments. CT can reduce the side effects of cancer treatments. I think the emphasis is reduce these side effects. I find a lot of my patients welcome the idea of eliminating the side effects of cancer and cancer treatments especially pain but the reality is that our goal is to make it tolerable.
