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Caring for Cancer Patients

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Presentation on theme: "Caring for Cancer Patients"— Presentation transcript:

1 Caring for Cancer Patients
Vicki Norton, MHA, RN, OCN Clinical Nursing Director, Park Nicollet Methodist Hospital Director-at-Large, ONS Board of Directors

2 Working with Cancer patients: what you need to know
How many cancer patients are there? What healthcare settings will I find oncology patients? What is some basic information to know about cancer? What are my resources to care for cancer patients? How would I know if I’d be a good oncology nurse?

3 Why do all nurses NEED to know about cancer?
# that have been touched by cancer in their families / significant others # that have supported a walk/run/fundraising event for cancer # that have cared for patients with a cancer diagnosis in a nursing clinical experience # that expect to care for patients with cancer

4 The New York Times Best Seller
“This book is a history of cancer. It is a chronicle of an ancient disease – once a clandestine, “whispered-about” illness – that has metamorphosed into a lethal shape-shifting entity imbued with such penetrating metaphorical, medical, scientific, and political potency that cancer is often described as the defining plague of our generation.” Siddhartha Mukherjee (Author’s Note, xiii) Best seller – people are interested

5 2014 Statistics All Sites New Cases = 1,665,540 Deaths = 585,720
Male = 855,220 Female = 810, 320 Deaths = 585,720 Male = 310,010 Female = 275,710 Percent Surviving 5 Years = 66.1%

6 Top four causes of death in U.S.
Heart disease (24.5%) Cancer (23%) Chronic Respiratory Disease (6%) Stroke (4%) Percent Surviving 5 Years

7 Top 4 causes of cancer deaths
Male Female Lung Prostate Colon/rectum pancreas Lung Breast Colon/rectum Pancreas Percent Surviving 5 Years

8 What % of Americans will get cancer?
Lifetime Risk of Developing Cancer: Approximately 40.4 % of men and women will be diagnosed with cancer at some point during their lifetime. Prevalence of cancer: In 2015, there will be an estimated 14.5 million people living with cancer in the United States (~5% of population). Percent Surviving 5 Years

9 Healthcare settings with oncology patients
Primary Care Clinics Women’s Health Centers Cancer Centers Infusion Centers Rural & Metro Hospitals Rehabilitation Facilities Home Care Long-term Care Palliative Care End-of-Life Care Percent Surviving 5 Years

10 Hot Topics in Cancer Care 2015
Genetics New treatment modalities Palliative Care/End of Life Care Assisted Suicide Survivorship Percent Surviving 5 Years Genetics- ethical challenges Oral – compliance at home. Fasttrack by FDA for new drugs? Palliative Care – When to start? Assisted Suicide – dying on your terms

11 Percent Surviving 5 Years
Oncology Nursing: The Application of Cancer Genetics and Genomics Throughout the Oncology Care Continuum “Advances in the understanding and application of cancer genetics (i.e., single gene hereditary disorders) and cancer genomics (i.e., the identification of multiple genes, DNA sequences, and proteins and their interaction with one another) have dramatically changed the practice and implementation of cancer risk assessment, risk reduction, prevention, screening, diagnosis, therapeutics, and options for personalized health care.” Percent Surviving 5 Years

12 End of Life Issues The American Nurses Association, in its position statement Registered Nurses’ Roles and Responsibilities in Providing Expert Care at the End of Life states: “Respect for persons is a fundamental principle of bioethics; ensuring respect for persons includes honoring their wishes regarding treatment decisions.”

13 Percent Surviving 5 Years
Assisted Suicide The Hospice and Palliative Care Nursing Association (HPNA) has a position statement called Legalization of Assisted Suicide: We.. “Affirm the value of end-of-life care, which includes aggressive and comprehensive symptom management; open and honest communication about prognosis, treatment options and the dying process; ongoing discussion about patients’ goals of care; and psychosocial and spiritual support for patients and their families; and bereavement services.” Percent Surviving 5 Years

14 Survivorship Statement
“Many survivors face distinct and serious health care issues. Cancer survivors are at increased risk for long-term morbidity and premature mortality, related directly to the cancer itself, to preexisting comorbidities, and to exposure to therapy.” Percent Surviving 5 Years

15 Percent Surviving 5 Years
Cancer Basics Cancer starts when cells in a part of the body start to grow out of control. In normal cells, when the cell DNA changes for any reason, the cell either repairs or dies In cancer cells, the cell does not repair or die but starts to replicate the damaged cells Grows into a tumor in an organ or multiplies in the blood or lymph systems Cancer cells travel (metastasize) to other parts of the body through the bloodstream or lymph system Cancers are named based on the place that it originates, not necessarily where it is found Percent Surviving 5 Years

16 Percent Surviving 5 Years

17 Percent Surviving 5 Years
Cancer Risks Age Smoking Sun Exposure Previous radiation exposure Diet Genes Infections Other – chemicals Percent Surviving 5 Years No one knows the exact cause of most cases of cancer. Age – 78% age 55 or older Tobacco – lungs, throat , bladder, kidney, and other organs Sun Exposure – in the sun without protection, tanning bed exposure. Melanoma is growing Radiation – exposure to rT for one cancer can cause another cancer years later Diet – healthy diets can prevent some cancers i.e. colon – fruits and vegetables, breast – low fat Genes – 5-10% of cancers have a genetic component Infections – HIV, hepatitis, HPV Other – asbestos, saccharin, preservatives in food

18 7 signs of cancer C-A-U-T-I-O-N
Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge Thickening or lump in the breast, testicles, or elsewhere Indigestion or difficulty swallowing Obvious change in the size, color, shape, or thickness of a wart, mole, or mouth sore Nagging cough or hoarseness Percent Surviving 5 Years

19 Percent Surviving 5 Years
Other Symptoms Persistent headaches Unexplained loss of weight or loss of appetite Chronic pain in bones or any other areas of the body Persistent fatigue, nausea, or vomiting Persistent low-grade fever, either constant or intermittent Repeated infection Percent Surviving 5 Years As cancer grows, it begins to push on nearby organs, blood vessels, and nerves. Many times the symptoms are the result of this growth. Weight loss – Fever – more common when cancer has already spread Fatigue – not better with rest. Sometimes related to blood loss, such as colon or stomach cancer. Pain – early symptom with bone cancer, headaches with brain tumor, or can be a symptom of cancer spreading Skin – moles with melanoma, itching could be pancreas or gall bladder, yellow skin or eyes Lumps – breast lumps, or enlarged lymph nodes

20 Percent Surviving 5 Years
Treatment Prevention Early diagnosis Surgery Radiation Bone Marrow and Stem Cell transplants Chemotherapy/Biotherapy Targeted Therapies Percent Surviving 5 Years Prevention – avoiding the risks as much as possible Early Diagnosis – the earlier cancer is caught , the better chance of cure or survival. Colonoscopies, mammograms/self breast exams, genetic testing , PAP, look at your skin Surgery – remove tumor Radiation – to shrink tumors (prostate, thyroid, cervical, breast) Chemotherapy/Biotherapy – attacks cancerous and healthy cells. Neutropenia, thrombocytopenia Targeted therapies – attack just the cancerous cells

21 ONS Clinical Practice Resources
Clinical Inbox Do you have a hands-on question for the ONS education team? our experts Putting Evidence into Practice Learn which treatments are most effective for patients with cancer—and which aren’t. Visit the PEP webpages to learn about interventions for more than 20 different cancer topics. ASCO/ONS Chemotherapy Safety Administration Standards The gold standard for chemotherapy administration, applied by institutions everywhere to ensure the safest care for nurses and their patients.

22 Putting Evidence into Practice
ONS Resource 20 topics Anorexia Constipation Depression Diarrhea Fatigue 15 more Percent Surviving 5 Years

23 Percent Surviving 5 Years
Survivorship What does that mean for nursing care? All healthcare settings Long term effects of treatment Symptom management Reoccurrence Anxiety for patient Advanced Care Planning Percent Surviving 5 Years Remember million survivors in 2015

24 Palliative and End-of-Life Care
Symptom Management Quality of Life discussions Ethical Issues Family dynamics Comfort Care/Hospice Symptom Management – pain, neuropathy, cardiac issues, Graft vs. Host disease Quality of Life discussions

25 End-of-Life Nursing Education Consortium (ELNEC)
Nursing care at EOL Pain Management Symptom Management Ethical Issues in Palliative Nursing Communication Cultural Considerations in EOL care Loss, Grief, Bereavement Achieving Quality Palliative Care Preparation for and Care at the Time of Death Information about ELNEC Courses:

26 Oncology Nursing as a Profession
What does it take? Knowledge Critical thinking Technical skills Psychosocial skills Compassion Empathy Self care Called Life-long learning Percent Surviving 5 Years Grieving process

27 Oncology Nursing Society
Student discounts on membership Scholarships through the ONS Foundation for education Resources and educational offerings on caring for oncology patients Leadership and volunteer opportunities Percent Surviving 5 Years

28 Free Membership

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