Clinical Journal of Oncology Nursing

Rural Cancer Disparities: Understanding Implications for Breast and Cervical Cancer Diagnoses

Rural populations experience several disparities, influenced by structural-, community-, and individual-level barriers, across the breast and cervical cancer continuum. This study seeks to identify structural-, community-, and individual-level barriers that affect rural populations across the cancer continuum, understand the role of nurses serving rural populations in breast and cervical cancer screening and diagnostics, and provide recommendations for working with rural patients. This is a secondary analysis of qualitative interviews conducted with public health nurses serving rural populations. Emergent themes indicate that rural populations experience barriers that affect disparities across the breast and cervical cancer continuum, including a changing healthcare landscape, access to cancer-focused care, access to insurance, collective poverty, and demographic factors. Nurses working with rural communities can address these disparities as they fulfill multiple roles and responsibilities.

Updating the Carboplatin Hypersensitivity Protocol: Two Case Studies

Gestational Trophoblastic Disease: A Clinical Review and Case Study Presentation for the Advanced Practice Nurse

Gestational trophoblastic (GT) disease is a continuum of gynecologic disorders that begins with a hydatidiform mole and may progress to GT neoplasia. The purpose of this article is to review the pathophysiology and clinical manifestations associated with GT disease and provide the advanced practice RN with evidence-based management strategies to use when caring for patients. A case study details a woman aged 42 years with a hydatidiform mole who underwent multiple uterine curettage procedures. The disease progressed to GT neoplasia, characterized by elevated human chorionic gonadotropin (hCG) levels. The patient completed a 10-week course of IV methotrexate, and hCG levels returned to normal range. Serial monitoring of hCG levels is paramount when caring for a patient with GT disease. The advanced practice RN should recognize the pathologic significance of rising hCG levels, report these trends to the treating physician, and aim to improve health outcomes.

Symptom Distress and Quality of Life in Women With Newly Diagnosed Ovarian Cancer Undergoing Chemotherapy: A Longitudinal Approach

Women with newly diagnosed ovarian cancer who receive chemotherapy experience distressing symptoms and reduced quality of life (QOL). Previous study results identifying changes in symptom distress and QOL over time are limited. This study examined the trajectory of symptom distress and QOL among women with newly diagnosed ovarian cancer from before their first chemotherapy appointment to two weeks after completing six cycles of chemotherapy. A longitudinal design was used to examine symptom distress and QOL in 36 participants across eight time points. Generalized estimating equation analyses identified how participants' symptom distress and QOL changed over time. Psychological symptom distress was highest at baseline and then decreased. Physical symptom distress increased at the second chemotherapy cycle. Similar results were found for QOL, with the lowest QOL reported after the fifth cycle.

Ovarian Cancer Symptom Clusters: Use of the NIH Symptom Science Model for Precision in Symptom Recognition and Management

In the United States, ovarian cancer remains the deadliest gynecologic cancer because most women are diagnosed with advanced disease. Although early-stage ovarian tumors are considered asymptomatic, women experience symptoms throughout disease. This review identifies ovarian cancer symptom clusters and explores the applicability of the National Institutes of Health Symptom Science Model (NIH-SSM) for prompt symptom recognition and clinical intervention. A focused CINAHL® and PubMed® database search was conducted for studies published from January 2000 to May 2022 using combinations of key terms. The NIH-SSM can guide the delivery of precision-focused interventions that address racial disparities and foster equity in symptom- focused care. Enhanced understanding of symptom biology can support clinical oncology nurses in ambulatory and inpatient settings.

Administration of Goserelin at Alternative Injection Sites for Premenopausal Breast Cancer

Prophylactic Protocol for Carboplatin Hypersensitivity in High-Risk Patients With Gynecologic Cancer

Patients with gynecologic cancer may receive multiple lines of carboplatin therapies. Risk of a hypersensitivity reaction (HSR) increases after more than six doses and when resuming treatment after a platinum-based treatment break. This can lead to the discontinuation of therapy or to a complicated and time-consuming desensitization protocol for future cycles. Premedications or extended infusion times have shown varied results in reducing HSRs. An increased incidence and severity of carboplatin-related HSRs led to the implementation of a prophylactic protocol to reduce the incidence and severity of HSRs. Across a six-month period, infusion nurses administered 144 carboplatin infusions using the prevention protocol, which included oral steroid preparation, premedication prior to infusion, and a titrated rate of administration. There were no carboplatin-related HSRs among patients in the pilot program compared to 21 HSRs (8%) among patients who received standard treatment.

Addressing Inequalities in Cervical Cancer Screening: Nursing Strategies to Overcome Barriers and Improve Health Outcomes

Cervical cancer incidence rates have significantly declined mainly because of widespread adoption of screening tests. However, significant disparities remain, leading to higher mortality rates among a range of minority groups.

The Role of Nursing in Preventing HPV-Related Cancers

Human papillomavirus (HPV) is commonly found on the cervix. However, new sites of the virus have emerged during the past 10 years, including the oropharynx in both sexes and the anus in men. According to Senkomago et al. (2019), 34,800 cancers reported annually in the United States from 2012 to 2016 were attributable to HPV. Of these cases, 92% were attributable to types of HPV that are targeted by the 9-valent vaccine (Senkomago et al., 2019). The role of the oncology nurse in HPV prevention begins with the education of patients and their family members regarding updated vaccination information.

Addressing Domestic Abuse Among Couples Experiencing Breast or Gynecologic Cancer in Africa

This article discusses the intersection of domestic abuse and cancer, particularly in couples experiencing breast and gynecologic cancers, and its impact on patients in Africa. It aims to uncover the challenges faced in this.