AJN State of the Science on Cancer Survivorship

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All Issues of AJN
April 2007 Update



State of the Science on Nursing Approaches to Managing Late & Long-Term Sequelae of Cancer and Cancer Treatment
Carol P. Curtiss, MSN, RN-C and Pamela J. Haylock, MA, RN, guest editors and project directors.

The report is from a collaborative project of the American Journal of Nursing, the University of Pennsylvania School of Nursing Center for Professional Development, National Coalition for Cancer Survivorship and the American Cancer Society.

The invitational symposium and this report were supported in part through a conference grant from the Agency for Healthcare Research and Quality (AHRQ #1 R13 HS 16072-01) and unrestricted grants from:

Gold Level
American Cancer Society
Silver Level
Novartis Pharmaceuticals
Bronze Level
Endo Pharmaceuticals
Lance Armstrong Foundation
MGI Pharma, Inc.
Ortho Biotech Products, L.P.

pg. 3 —   SPECIAL CONTENT ARTICLES: Foreword**
By Noreen M. Aziz MD, PhD, MPH, senior program director
The recommendations of this symposium are an important step in delineating ways to add to the growing knowledge on cancer survivorship.
pg. 4-5 —  SPECIAL CONTENT ARTICLES: Editorial: Survivor-Centered Care: Millions live for years after cancer treatment. It's time to address their needs** 
By Carol P. Curtiss MSN, RN-C and Pamela J. Haylock MA, RN
Nurses should assess for long-term sequelae whenever they evaluate cancer survivors.
pg. 6-11 —  SPECIAL CONTENT ARTICLES: Executive Summary: The State of the Science on Nursing Approaches to Managing Late and Long-Term Sequelae of Cancer and Cancer Treatment** 
By Arlene Houldin PhD, APRN, BC, Carol P. Curtiss MSN, RN-C, and Pamela J. Haylock MA, RN
A symposium's goals in nursing care for survivors of cancer.
pg. 12-14 — Cancer Survivorship: A First-Person Perspective: A nurse recounts her journey as patient, survivor, and advocate
By Susan Leigh BSN, RN
A nurse's journey into the world of cancer began in 1971.
pg. 14 — Connecting Online
By Linda Goettina Zame DMH
An email discussion group has created a community of cancer survivors.
pg. 15 — On the Cover
By David Belcher
pg. 16-19 — SPECIAL CONTENT ARTICLES: The Shifting Paradigm of Cancer Care: The many needs of cancer survivors are starting to attract attention**
By Pamela J. Haylock MA, RN
Not so long ago, cancer was synonymous with death. But today, more than 60% of adults diagnosed with cancer can expect to be alive in five years.
pg. 20-25 — The Effects of Cancer Survivorship on Families and Caregivers: More research is needed on long-term survivors 
By Frances Marcus Lewis PhD, RN, FAAN
Cancer affects not just those who have the disease but also their caregivers and families.  Few studies have examined the effects.
pg. 22-23 — Racial and Ethnic Disparities in Cancer Care and Survivorship
By Patricia K. Bradley PhD, RN
A research and education effort focuses on African American breast cancer survivors.
pg. 26-31 — Psychosocial Distress and Coping After Cancer Treatment: How clinicians can assess distress and which interventions are appropriate-what we know and what we don't 
By Mary Vachon PhD, RN
As people live longer after diagnosis and treatment of cancer, attention has turned to the quality of their lives.
pg. 32-38 — Sexuality and Body Image: Research on breast cancer survivors documents altered body image and sexuality
By Jody Pelusi PhD, FNP, AOCN
The effects of cancer and its treatment on sexuality are not usually included in assessments and plans of care for patients.
pg. 39-47 — Pain and Neuropathy in Cancer Survivors: Surgery, radiation, and chemotherapy can cause pain; research could improve its detection and treatment
By Rosemary C. Polomano PhD, RN, FAAN and John T. Farrar MD, PhD
The research on pain and neuropathy conducted on cancer survivors is of varying quality.
pg. 48-54 —  Cognitive Changes in Cancer Survivors: Cancer and cancer treatment often cause cognitive deficits, but no guidelines exist for screening or treatment
By Lillian M. Nail PhD, RN, FAAN
Cognitive changes in people with cancer can stem from the disease, the treatment or its complications, comorbid conditions, adverse effects of drugs, aging, and psychological responses to the diagnosis.
pg. 55-59 —  Cardiorespiratory Effects in Cancer Survivors: Cardiac and pulmonary toxicities may occur as late or long-term sequelae of cancer treatment
By Dawn Camp-Sorrell MSN, FNP, AOCN
Long-term cardiorespiratory effects occur in survivors of all types of cancer.
pg. 60-65 —  Reproductive and Hormonal Sequelae of Chemotherapy in Women: Premature menopause and impaired fertility can result, effects that are especially disturbing to young women
By M. Tish Knobf PhD, RN, AOCN, FAAN
Reproductive and hormonal sequelae of cancer treatment are associated with significant distress, especially in younger women.
pg. 66-71 —  Endocrine and Fertility Effects in Male Cancer Survivors: Changes related to androgen-deprivation therapy and other treatments require timely intervention
By Debra Thaler-DeMers BSN, RN, OCN, PRN-C
Men who survive cancer face many long-term consequences that often are neglected at the time of diagnosis and during initial treatment.
pg. 72-77 —  Cancer-Related Fatigue and Sleep Disturbances: Further research on the prevalence of these two symptoms in long-term cancer survivors can inform education, policy, and clinical practice
By Margaret Barton-Burke PhD, RN
Cancer-related fatigue is the most frequent complaint of people with cancer.
pg. 78-82 —  Osteoporosis: Cancer survivors are at increased risk for osteoporosis, but how their management differs from that of the general population remains unclear
By Rebecca Hawkins MSN, ANP, AOCN
Lifestyle factors and primary causes of osteoporosis combine with cancer and its treatment to increase the likelihood of osteoporosis.
pg. 83-85 —  The American Cancer Society's Studies of Cancer Survivors: The largest, most diverse investigation of long-term cancer survivors so far
By Kevin Stein PhD, Tenbroeck Smith MA, Youngmee Kim PhD, C. Christina Bahn Mehta MSPH, Jeremy Stafford MA, Rachel L. Spillers BA, and Frank Baker PhD
Researchers are beginning to study the distinct issues that long-term survivors face, but studies to date have been limited by several weaknesses in design and methodology.
pg. 86-90 — Round Table: Survivor-Focused Practice Models
By Laurie Lewis
Four nurses discuss their cancer survivorship programs.
pg. 91-95 —  SPECIAL CONTENT ARTICLES: Discussion and Recommendations: Addressing Barriers in the Management of Cancer Survivors**
By Laurie Lewis
An invitational symposium identifies obstacles and ways to overcome them.

Links to Additional Resources 

  Cancer Survivorship in the Adult: An Annotated Bibliography
    By Sandra A. Mitchell MScN, CRNP, AOCN

   A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies.

  From Cancer Patient to Cancer Survivor: Lost in Transition.
    Washington, DC: National Academies Press; 2005.

  Quality Care for Cancer Survivors: The Case for Comprehensive Cancer Care: A White Paper of the National Coalition for Cancer Survivorship.

  Cancer Survivorship: Pathways to Health After Treatment: Conference Overview.

  Cancer Survivorship: Pathways to Health After Treatment: Summary of Conference Evaluation.

  Post Treatment Resources.

  Cancer Survivorship: Improving Treatment Outcomes and Quality of Life.

  President’s Cancer Panel: Annual Report for 2004–2005.
Translating Research into Cancer Care: Delivering on the Promise.

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