Clinical journal of oncology nursing
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Pharmacogenomics is the fastest growing field in precision medicine. Based on current use, oncology encompasses the largest share of the precision medicine market, necessitating that oncology nurses understand the principles of pharmacogenomics and how it affects clinical practice. . ⋯ The knowledge surrounding precision medicine and pharmacogenomics will position oncology nurses to engage in current research, improve practice, and educate patients. As the focus of health care remains on reducing costs and improving morbidity and mortality, the reduction in adverse drug reactions will continue to be highlighted. Tailoring medications based on individual responses will not only help improve patient outcomes but also potentially affect the cost of health care as these genetic tests become a standard of care.
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Ipilimumab (Yervoy®) therapy improves outcomes in patients with resected stage III melanoma, and ipilimumab alone or combined with nivolumab (Opdivo®) does so in those with unresectable or metastatic melanoma. These immunotherapies are associated with immune-related adverse events (irAEs). With prompt recognition and appropriate management, serious sequelae or unnecessary treatment discontinuation can be prevented. . ⋯ The care step pathways provided represent a proactive, evidence-based, and comprehensive plan to support optimal patient outcomes.
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Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice. . ⋯ The ERAS guidelines were feasible and safely implemented with no change in LOS, readmission, morbidity, and mortality rates.
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Hair loss (alopecia) from chemotherapy is one of the most feared side effects of many patients, particularly women. Many patients and their healthcare providers believe that cryotherapy can help prevent or mitigate these changes. Scalp cooling has been used for more than 30 years to prevent alopecia caused by chemotherapy, particularly taxanes and anthracyclines. This article presents an overview of the evidence for this strategy, as well as its impact on nursing care provision.
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Case Reports
Palliative Care and Phase 1 Trials: Intervention to Improve Quality of Life and Provide Education .
Patients in phase 1 clinical trials often have significant symptom burdens and quality-of-life concerns that increase as they progress along the cancer trajectory and experience drug toxicities from the clinical trial. . ⋯ The initial experience with the palliative care intervention suggests a need for support for this population, as well as potential benefits from integrating palliative care for patients enrolled in phase 1 clinical trials.