When hope becomes reality

Article

Last week I talked about my friend Karen and her move into that place called hopeful reality as her options for treatment ended and she chose a clinical trial for her advanced endometrial cancer. She began the clinical trial on Monday, July 23, her 56th birthday, with high hopes that the drug would begin to do its magic and slow the growth of what she knew was a very aggressive tumor. But there wasn't even time for the drug to get a good foothold before pain meant a hospitalization and fever of unknown origin that indicated an infection somewhere that the doctors couldn't determine. By Thursday, Karen was on antibiotics and morphine, hoping a few days of each would allow her medical team to analyze and fix the problem. But as often happens with cancer, the problem was the cancer. On Sunday, I spent the night with her and we talked about how hope had changed from months to long enough to say goodbyes. With her pain under control and her fever close to normal, she discussed ways that she might have a week to travel to her favorite city in New Mexico where she had lived for a number of years. She wanted to breathe the air and say goodbye to the mountains she had hiked so often. Then she would return to hospice. Today she finished a week of radiation treatments, and her plan is to leave this weekend for her final trip to say goodbye to friends and places. We worry for her and her health as she takes this final trip, but we honor her need to go.

Related Videos
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
Image of a man with a beard.
Image of a man with gray facial hair and a navy blue suit with a light orange tie.
Image of a woman with black hair.
Related Content