Survivorship research

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Every other year, the leading cancer survivorship researchers gather to share information on the needs of those who have gone through cancer and are working to live the remainder of their lives with health and joy. Supported by the ACS, NCI, LIVESTRONG, and the CDC, the 2014 meeting has brought attendees from some 30 foreign countries in addition to leading researchers in the United States. Since its beginning in 2002, in addition to almost doubling the attendees, the meeting has added a patient advocate component that shows active survivors how to advance their causes. The subtitle of the meeting is Advancing Survivorship through Multilevel Collaborations and includes researchers who provide the critical evidence to drive change, the health care providers who care for the patients, and the patients themselves. Changing how patients are treated, particularly when there is no component involved that will make someone money, is like trying to turn the Titanic in the middle of the iceberg field. Or as one presenter said, "We don't have a health care system, we have a payer system."But the ongoing research gives validity and power to those who fight for us, whether we are living past treatment, have chronic cancer or live with metastatic cancer. The discussions ranged from the challenge of smoking, financial burden, employment issues, older Americans, underserved populations, and caregiver issues, among others. I am particularly interested in the caregiver issues. In the past decades, as cancer has become an outpatient disease, it is possible to be diagnosed, treated, live or die without ever being in the hospital. But who said the caregiver wants to be in the role of nurse and who said they are competent? And what if the caregiver does not understand or cannot comprehend the role of caring for someone? A study I read recently talked about caregivers having severe depression and today a speaker from the Institute for the Study of Cancer Caregivers at Memorial Sloan Kettering Cancer Center touched on the subject. Studies from the Institute have shown a number of outcomes. For example, we now know that during survivorship, caregivers are more prone to distress than patients. There will be lots more on this meeting in the upcoming issues of CURE.

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
Yuliya P.L Linhares, MD, an expert on CLL
Yuliya P.L Linhares, MD, and Josie Montegaard, MSN, AGPCNP-BC, experts on CLL
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