ISNCC.ORG Blog

Academic Express:Development and implementation of a supportive care model for cancer patients in the last days of life A hospital-based program

Wed, 11 Mar 2026 02:06:41 GMT

To promote academic exchange and advance oncology nursing practice, the Academic Express column invites ISNCC members to share their latest research achievements with the global cancer nursing community. In this issue, we highlight an important study on improving supportive care for cancer patients in the last days of life. This research, led by Xiaoting Hou and Yuhan Lu from China, explores the development and implementation of a hospital-based supportive care model designed to enhance the quality of end-of-life care for cancer patients.

Why We Chose This Research Topic

This research topic was chosen in response to the urgent clinical challenges in China, where 2.57 million cancer-related deaths occurred in 2022—accounting for 26.4% of the global total—and where terminally ill patients and their families endure significant physical, psychological, and socioeconomic burdens. Driven by national policies such as the Healthy China 2030 strategy, which prioritizes comprehensive, lifelong health services, nurses—as the most frequent caregivers for cancer patients—play a pivotal role in improving end-of-life outcomes. Although growing attention to palliative care in China, the quality of care in the final days of life remains inadequate, highlighting a critical gap: the absence of systematic, evidence-based implementation programs for end-of-life supportive care.

This study adopts a problem-oriented approach to initiate a hospital-based quality improvement program, and seeks to enhance the quality of care for cancer patients in their final stages, and then to improve the quality of death of cancer patients and family satisfaction.

What We Discovered?

Between May 2023 and August 2024, the program was initiated and implemented in five hospitals located in Beijing, Nanjing, and Kunming involving 114 terminally ill cancer patients. The intervention featured 30 bundled supportive care strategies covering recognition of dying, end-of-life communication, patient-centered supportive care, family-centered supportive care, and bereavement support. By developing in-hospital practice standard and related materials, conducting stratified training, offering assistance for nurses and conducting quality supervision, these supportive care strategies have been integrated into clinical practice and implemented.

This study examined the quality of death for patients using the Good Death Inventory (GDI) and family satisfaction using the Family Satisfaction with Advanced Cancer Care-2 (FAMCARE-2) scale. Despite some cultural challenges we encountered during implementation, encouraging research results were achieved. Nurse-rated Good Death Inventory scores reached 299.81±53.70, while family-rated scores were 310.76±49.55—substantially higher than historical controls. Family satisfaction measured by FAMCARE-2 was 80.52±8.75, exceeding previous Chinese studies.

Implications for Cancer Care

The implications are multifaceted. Practically, standardized pathways integrating evidence-based strategies into routine care from recognition of dying to bereavement support can systematically address patients' physical, psychological, social and spiritual needs of both patients and families, providing clear guidance for nurses. Educationally, stratified training with ongoing specialist support ensures homogeneous implementation. Policy-wise, implementation revealed culturally sensitive approaches must balance family protective instincts with patient autonomy.

This program demonstrates that structured, hospital-based supportive care can achieve satisfactory outcomes in improving the quality of death of cancer patients and the satisfaction of their family caregivers, offering a replicable model for advancing palliative care in China and similar contexts.

Source:

Hou X, Guo R, Yu W, Yuan L, Chen G, Ma X, Zhou Y, Zhang X, Liu L, Wang Y, Lu Y. Development and implementation of a supportive care model for cancer patients in the last days of life: a hospital-based program. Asia Pac J Oncol Nurs. 2025;13:100828. doi:10.1016/j.apjon.2025.100828.

Academic Express：“Merging AI into cancer nursing care: what changes, what stays, and what nurses must lead”

Wed, 25 Feb 2026 06:49:14 GMT

We proudly continue our Academic Express section to advance oncology nursing through scholarly exchange.This edition features groundbreaking insights from Dr. Yingchun Zeng (National University of Singapore) on merging AI into cancer nursing. Her analysis reveals nursing’s "sweet spot" where AI enhances prediction, personalization, and patient experience while addressing critical implementation challenges.Discover how nurses can lead meaningful AI integration at the care frontier.

Artificial intelligence (AI), from being a “nice-to-have” technology to being a “need-to-have” technology that can augment nursing practice across the entire continuum of cancer care from early detection through survivorship and palliative care. However, the question is not whether we are going to use this technology; rather, how are we going to integrate this technology safely and meaningfully into nursing practice.

Where AI is already making a difference
In screening and early detection, AI can enhance image interpretation and help expand access in settings where specialist capacity is limited. In treatment planning, AI can support precision (e.g., surgical support, radiation planning, toxicity prediction) and help identify patients at higher risk of complications—creating opportunities for earlier nursing interventions and tailored education.

The nursing “sweet spot”: prediction, personalization, and patient experience
Many high-impact nursing activities depend on timely recognition of risk and early supportive care. AI-enabled prediction models may help identify patients more likely to develop complications (e.g., lymphedema, venous thromboembolism, delirium), allowing nurses to intensify monitoring, education, and preventive strategies earlier. In survivorship and rehabilitation, AI can help tailor symptom management and supportive programs, while emerging approaches (e.g., analysis of large volumes of patient-generated text from forums) can broaden our understanding of patient concerns at scale—complementing, not replacing, human qualitative insights.

What stays hard: validation, bias, and trust
AI is not automatically safe because it is “data-driven.” Models require rigorous clinical validation, careful attention to privacy and consent, and ongoing monitoring for algorithmic bias and unintended harms. A particularly important concern is that some imaging AI systems may infer sensitive attributes (such as race) in ways that are not obvious to clinicians—raising equity risks that oncology nurses must help surface and mitigate.

What nurses must lead next
To ensure AI strengthens—rather than fragments—care, oncology nurses should co-design AI tools around nursing workflows, define implementation outcomes (workload, safety, equity, experience), and advocate for governance that is transparent and patient-centered. The goal is not “AI everywhere,” but AI where it improves outcomes, protects dignity, and supports nursing judgment.

Source:

Wang M, Abu-Odah H, Zeng Y. Merging artificial intelligence into cancer nursing care: Current applications, challenges, and opportunities. Asia Pac J Oncol Nurs. 2025 Dec 30;13:100849. doi: 10.1016/j.apjon.2025.100849. PMID: 41585538; PMCID: PMC12825068.

Dr Yingchun Zeng

Academic Express: Trajectories and related factors of subjective cognitive function in patients living with breast cancer receiving postoperative chemotherapy: a latent class growth model study

Tue, 06 Jan 2026 09:02:51 GMT

We are delighted to continue the Academic Express section, which aims to facilitate academic exchanges and further the development of oncology nursing. In every issue, we present ground-breaking research contributions from esteemed members in the field.

In this issue, we are privileged to feature an innovative longitudinal study led by Dr. Yu Bi and Professor Aihua Zhang from China. Their research, "Trajectories of Subjective Cognitive Function in Breast Cancer Patients: A Latent Class Growth Model Study", uncovers heterogeneous patterns of chemotherapy-induced cognitive impairment through pioneering analytical methods.

Why We Chose this Research Topic?

Chemotherapy-related cognitive impairment was recognized as a common and distressing side effect of breast cancer treatment, with a substantial impact on patients’ quality of life. However, existing studies on cognitive function trajectories in this population were found to yield inconsistent findings and rarely examined heterogeneous patterns of change over time or their associated influencing factors.

To address this gap, the study was designed to:

- Identify distinct trajectories of subjective cognitive function in breast cancer patients undergoing postoperative chemotherapy using a latent class growth model.

- Explore the demographic, clinical, and psycho-behavioral factors associated with these trajectory classes, so that evidence could be provided to inform more personalized clinical interventions.

What We Discovered?

This longitudinal study was conducted with 282 breast cancer patients, who were followed up at five time points: before the first chemotherapy cycle, 1 month, 3 months, 6 months, and 9 months after the first chemotherapy.

Using latent class growth modeling, four heterogeneous trajectories of subjective cognitive function were identified: the “No impairment class”, “Impair-recover class”, “Delayed recovery class”, and “Persistent impaired class”. Distinct patterns of cognitive change over the follow-up period were demonstrated by these four classes, and different recovery processes after chemotherapy were reflected. Several factors closely associated with poorer subjective cognitive function were also identified, including demographic and clinical factors (older age, postmenopausal status, and specific chemotherapy regimens) as well as psycho-behavioral factors (higher levels of anxiety, depression, cancer-related fatigue, and lower physical activity levels).

The psycho-behavioral profiles were found to differ markedly across trajectory classes. For example, the Delayed Recovery Class was observed to have the highest scores for negative emotional states, including anxiety and depression, whereas the Persistent Impairment Class was characterized by continuously high levels of cancer-related fatigue and persistently low physical activity throughout the follow-up period. These results indicated that patients did not follow a uniform cognitive trajectory after chemotherapy and that emotional and behavioral factors played an important role in shaping these patterns.

Implications for Cancer Care

The importance of tailored cognitive care for breast cancer patients undergoing postoperative chemotherapy was emphasized by the findings.

Early screening was recommended for high-risk groups, including older and postmenopausal patients and those with pre-existing or emerging emotional distress (anxiety, depression). Dynamic monitoring of cognitive function was advised across the entire treatment and follow-up period. Interventions were suggested to target modifiable psycho-behavioral factors: emotional support and psychological counseling were proposed to alleviate negative emotions, fatigue management strategies were encouraged, and individualized physical activity programs were advocated. On the basis of different cognitive trajectories, personalized follow-up plans were proposed, with increased monitoring for the Delayed Recovery Class and more intensive, multidisciplinary support for the Persistent Impairment Class.

Source:

Bi Y, Lu Y, Gao X, Shi X, Zhang A. Trajectories and related factors of subjective cognitive function in patients living with breast cancer receiving postoperative chemotherapy: a latent class growth model study. Supportive Care in Cancer. 2025;33:998. doi: 10.1007/s00520-025-10027-5

Yu Bi (First author) Aihua Zhang (Corresponding author)

ANNUAL REVIEW 2025

Wed, 24 Dec 2025 10:22:34 GMT

Dear ISNCC Members, Global Citizens, and Regional/International Partners,

Annual Review 2025

As 2025 draws to a close, we are pleased to share this summary of our achievements on behalf of the International Society of Nurses in Cancer Care (ISNCC). This year has been pivotal in turning our Strategic Plan 2022–2025 into action, strengthening nursing’s impact on cancer control. We deeply appreciate the support of our volunteers on the committees, member organizations, global citizens, and partners worldwide.

Strategic Direction 1: Strengthening the Global Cancer Nursing Workforce

With over 20 million nurses and midwives worldwide, ISNCC has prioritized leadership development and workforce capacity-building to reduce the global cancer burden. In 2025, our outreach across Oceania, Asia, and Africa supported more than 240 cancer nurses from 20 countries.

Highlights include:

Leadership workshops co-hosted with Cancer Nurses Society of Australia (CNSA) and Asian Oncology Nursing Society (AONS) at major international and regional conferences in Adelaide, Australia, and Manila, Philippines.
Completion of the first African Oncology Nursing Leadership Program funded by Amgen, graduating 30 nurses from seven countries in December 2025. This project is a joint effort of University of Health and Allied Sciences (UHAS) in Ghana, City Cancer Challenge (C/Can) and ISNCC.
Launch of the Foundation Course in Oncology Nursing with Hue Central Hospital, Vietnam, ISNCC associate member, training 70 nurses and receiving excellent participant feedback.
Review of the Advanced Training Curriculum for Breast Cancer Nursing with the Indonesian Oncology Nursing Association, ISNCC full member, to enhance national competencies.
Travel scholarships for three nurses from low- and middle-income countries (Vietnam, Kenya, and Indonesia) to attend the CNSA–ICCN Congress 2025, fostering cross-regional learning and collaboration. We deeply appreciate Canadian Association of Nurses in Oncology (CANO), our full member organization, for sponsoring one of the travel scholarships.

These initiatives have collectively strengthened global leadership capacity and provided accessible oncology education, particularly in low- and middle-income countries (LMICs).

Strategic Direction 2: Influencing Global Health Policy

ISNCC continues to advocate for the integration of nursing in global cancer control. In 2025, we developed two new position statements—“Climate Change and Cancer Nursing” and “Children’s Palliative Care”—and updated four key statements:

Cancer Nursing Education
Palliative Care
Cancer Pain Management
Role of Cancer Nurses Around the World

These policy updates reaffirm the essential contribution of nurses across prevention, care, and palliation, guiding advocacy and practice worldwide.

Strategic Direction 3: Advancing and Applying Knowledge

To expand access to continuing education and evidence-based practice, ISNCC collaborated with member organizations (CANO, CNSA) and partners (AONS, C/Can, European Oncology Nursing Society (EONS), International Thoracic Oncology Nursing Forum (ITONF)) to deliver global knowledge exchange webinars, symposia, and workshops.

The CNSA–ICCN Congress 2025 in Adelaide gathered over 1,100 participants from more than 30 countries, showcasing innovation and leadership in cancer nursing.

Knowledge advancement continued through major research initiatives:

The Bristol Myers Squibb Foundation (BMSF)-funded project promoting early gastric cancer detection in rural China completed Phase I needs assessment and progressed to developing training for rural healthcare providers and education materials for local communities.
A CANO-sponsored research grant launched supports LMIC nurses conducting research to improve cancer care outcomes.

Our official journal, Cancer Nursing, remains a leading reference for research and clinical practice innovations. ISNCC continues to support non-English-speaking nurse authors through editorial assistance programs, ensuring global dissemination of nursing science.

Strategic Direction 4: Leveraging Partnerships

In 2025, more than a hundred cancer nurses worldwide engaged in ISNCC activities—serving as directors, committee members, speakers, curriculum reviewer, judges, and project leads. Collaboration with member organizations and international partners was instrumental in advancing our shared mission. A summary of collaborative initiatives is included in the attached report.

Strategic Plan 2026–2029

ISNCC is pleased to announce the launch of our Strategic Plan 2026-2029, which builds on the momentum of the past three years.

Vision:

Leading and empowering the global nursing community in equitable and innovative cancer control and care.

Mission:

To lead and amplify the role of nursing in reducing the global burden of cancer through collaboration, advocacy, education, and the advancement of nursing science.
To promote excellence in quality and standards of cancer care aimed to improve the health and well-being of people at risk for and/or living with cancer.

Strategic Directions:

Build and strengthen global nursing leadership in cancer control and care.
Enhance educational and resources outreach.
Advocate for nursing in cancer prevention, control, and care.
Leverage technology for engagement and communication.
Strengthen global partnerships.
Diversify funding sources and sustain financial stability.

After consultation with member organizations, ISNCC introduced a new membership fee structure (effective 2026). This tiered model balances affordability for lower-income countries with sustainability for the Society, ensuring equitable global participation. We sincerely thank our members for their feedback and support during its development.

Looking Ahead

The accomplishments of 2025 have been extraordinary—highlighted by cross-continental leadership programs, expanded oncology education in LMICs, evidence-informed policy work, global research collaborations, and unprecedented member engagement.

These collective efforts embody ISNCC’s commitment to empowering the nursing community to reduce the cancer burden worldwide. As we enter a new strategic cycle, we look forward to continued collaboration in advancing equitable, innovative, and high-quality cancer care for all.

We wish all a happy, prosperous, and healthy New Year 2026.

With appreciation from the ISNCC Executive Committee,

Winnie So, President
Lena Sharp, President-Elect
Catherine Johnson, Secretary/Treasurer
International Society of Nurses in Cancer Care (ISNCC)

Appendix

2025 activities highlight

Jan	Research grant was launched
Feb	Support non-English-speaking nurse authors through editorial assistance programs
Mar	Review Advanced Training Curriculum for Breast Cancer Nursing developed by Indonesia Oncology Nursing Association (IONA)
Apr	The First Foundation Course of Oncology Nursing was launched in Huer Vietnam
May	Online education portal was developed
Jun	“MASCC Supportive Care 2030 Movement: International Cancer Nursing Organizations collaboration for Advancing Supportive Cancer Care” was presented at ICN Congress in Helsinki, Finland. This presentation is a joint effort of CANO, GPON, ISNCC, MASCC and ONS CNSA-ICCN Congress 2025 including: -₋Joint ISNCC-CNSA pre-conference oncology nursing leadership workshop -ISNCC-ENOS joint session Two new position statements— “Climate Change and Cancer Nursing” and “Children’s Palliative Care”— were developed The 1st cohort of Oncology Nursing Leadership Program in Africa was launched
Jul	“The essential role of oncology nursing professional organizations in advancing supportive care” was presented at MASCC conference 2025. This presentation is a joint effort of CANO, GPON, ISNCC, MASCC and ONS.
Aug	A commentary “Five prerequisites to achieving excellence in supportive cancer care by 2030: oncology nursing in the driver’s seat” was published. This article is a joint effort of CANO, GPON, ISNCC, MASCC and ONS.
Sep	Joint CNSA-ISNCC webinar: Best Nursing Practices for Hazardous Drug Safety webinar
Oct	ISNCC-EONS joint session at EONS18 and EMOS 2025 Invited as an international nursing exert and participated in ASCO-C/Can Multidisciplinary cancer management course in Phnom Penh Cambodia Participated in an international symposium at CANO/ACIO Annual conference
Nov	Joint CANO-ISNCC Global Knowledge Exchange webinar: Exposure assessment and health effects of hazardous drugs for oncology nurses: The unseen hazard and the imperative for change Joint ISNCC-AONS preconference workshop on oncology nursing leadership Formal announcement of AONS-ICCN 2027 in Tokyo Japan at the 7^th AONS conference
Dec	Graduation ceremony of the 1^st cohort of Oncology Nursing Leadership Program in Africa 1^st National Oncology Nursing Conference in Nigeria as a plenary speaker MyGiving Circle was launched

Academic Express：” Bridging the Gap: Family Experiences in Palliative Care Transition and the Call for Oncology Nurses“

Mon, 22 Dec 2025 00:29:41 GMT

In this issue, we are privileged to feature a transformative study led by Associate Professor Bruno Magalhães from the University of Trás-os-Montes and Alto Douro (UTAD), Portugal. His phenomenological research, "Bridging the Care Divide: Family Caregivers' Journeys in Palliative Transition and Imperatives for Oncology Nursing", illuminates the complex realities of transitioning palliative care from hospital to home settings through the lens of family caregivers.

We are deeply honored to contribute to the International Society of Nurses in Cancer Care (ISNCC) website by sharing insights from our recent phenomenological study: "Family perceptions of the transition from hospital to home palliative care." Given that cancer was the predominant diagnosis among the patients whose families participated in our research, our findings hold critical relevance for oncology nursing practice globally.

The study, conducted in Portugal, aimed to explore the profound lived experiences of family caregivers as they navigate the critical shift of palliative care responsibility from the structured hospital environment to the intimacy and complexity of home.

The Essence of the Caregiving Experience

Our analysis revealed that this transition is characterized by a mix of profound moral commitment and systemic fragility. Caring is primarily driven by love, duty, and reciprocity. However, this commitment coexists with intense feelings of helplessness, exhaustion, and deep insecurity due to the inevitability of disease progression.

Three essential themes emerged from the caregivers’ narratives: Emotional and Relational Experience of the Family Member, Family’s Challenges and Adaptation, and Support for the Family.

A particularly salient finding was the tension between the family’s dedication and their profound sense of being unprepared. Caregivers often felt abruptly responsible for complex tasks—such as mobilizing, hygiene, or administering medication—without prior formal training or clear guidance from the institutions. The lack of technical knowledge was a significant source of stress, leading families to resort to "self-directed learning" (trial and error or searching the internet) to manage daily care.

Critical Implications for Oncology Nursing Worldwide

These experiences highlight concrete areas where oncology nurses can act as crucial agents in supporting families during the end-of-life continuum:

1.Mandate Structured Transition Programs: Nurses must implement formalized, practical training programs before hospital discharge. These programs should include supervised sessions on specific technical tasks (e.g., symptom management, mobility techniques) to boost caregiver confidence and reduce anxiety about "doing something wrong".

2. Prioritize Emotional and Psychological Support: Recognizing the high levels of burden, stress, and anticipatory grief reported by caregivers is essential. Oncology nurses must proactively identify signs of exhaustion (burnout) and facilitate timely access to emotional support strategies, such as psychological counseling or support groups.

3. Ensure Seamless Continuity of Care: The contrast between continuous hospital support and limited home resources causes immense insecurity. The presence and responsiveness of community palliative care teams (PCHSTs) emerged as a critical factor for family safety and validation. Nurses must advocate for, and ensure, clear and coordinated referral pathways to strengthen community support structures.

In conclusion, our study confirms the urgent need to recognize the family as the unit of care. By investing in caregiver empowerment, continuous support, and coordinated systems, oncology nurses can ensure that the transition to home palliative care is safe, sustainable, and truly compassionate for both the person with cancer and their devoted family.

References:

Cruz, S., Magalhães, B., & Fernandes, C. (2025). Family perceptions of the transition from hospital to home palliative care: a phenomenological study. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 33(11), 1014. https://doi.org/10.1007/s00520-025-10069-9

Associate Professor Bruno Magalhães

PhD, DNSc, MPH, CMSRN, RN

Academic Express: Exploring the Role of Medication Perceptions in Adherence to Oral Anticancer Agents among Patients with Gastrointestinal Tract Cancer

Mon, 15 Dec 2025 03:22:38 GMT

In this issue, we are privileged to feature an innovative study led by Dr. Yongfeng CHEN from The Chinese University of Hong Kong, in collaboration with Professor Marques Shek Nam NG and Professor Carmen Wing Han CHAN. Their research, titled "Exploring the Role of Medication Perceptions in Adherence to Oral Anticancer Agents among Patients with Gastrointestinal Tract Cancer", unveils critical psychological determinants of treatment adherence through a pioneering mixed-methods approach.

Why We Chose This Research Topic

Oral anticancer agents (OAAs) have transformed cancer care by enabling patients to receive treatments at home. However, this convenience comes with a critical challenge of upkeeping adherence—a global concern across cancer care settings. This challenge is even more pressing in patients with gastrointestinal (GI) tract cancers, who often rely on cytotoxic OAAs administered in long-term, intermittent regimens. Our previous review found a median adherence rate of 68% in this population. Such suboptimal adherence may compromise treatment effectiveness and increases mortality risk.

To address this challenge, we turned to the Common-Sense Model of Self-Regulation (CSM). Unlike traditional frameworks that view patients as passive recipients of care, they are regarded as active problem solvers in the CSM. This model emphasizes that patients’ medication perceptions—both cognitive and emotional responses to medication—shape adherence. While existing studies have focused largely on cognitive responses, our clinical observations revealed that pivotal roles of emotions. Therefore, we conducted a mixed-methods study, integrating quantitative surveys and qualitative interviews, to capture both measurable data and authentic patient voices for building a more comprehensive understanding about how medication perceptions influence adherence.

What We Discovered

Our survey showed that only 58.9% of patients fully adhered to their prescribed OAAs regimens, whereas 25% stopped when they felt worse, 17% forgot doses, and 9% discontinued when they felt better. Patients who fully adhered to OAAs were characterized by significantly lower general harm beliefs and perceived sensitivity to medicine, while significantly higher self-efficacy in managing OAAs. Through patient voices, four major themes emerged:

Emphasizing the effectiveness of OAAs despite their hazardous nature.
Experiencing negative emotions in relation to taking OAAs, including concern and reluctance.
Taking responsibility for routine OAAs management at home.
Encountering multiple barriers to taking OAAs, including adverse effects,polypharmacy, poor memory, unpleasant drug characteristics, and lack of knowledge about managing OAAs.

By integrating quantitative and qualitative data, we found that:

Patients with higher general harm beliefs tended to reinforce the hazardous nature of OAAs, resulting in lower adherence.
Those rated a higher level of sensitivity to medication were more likely to consider sensitivity to the adverse effects of OAAs, thereby presenting lower adherence.
Those reported a higher level of medication self-efficacy might have a higher possibility of overcoming barriers to taking OAAs and showing better adherence.

Implications for Cancer Care

Our findings support the application of the CSM in explaining adherence behaviors and offer new insights into effective management of OAAs among patients with GI tract cancer:

Targeting negative medication perceptions, such as exaggerated harmful or adverse effects of OAAs, to promote adherence.
Enhancing self-management ability to empower patients to take an active role in managing OAAs and overcoming barriers at home.
Integrating emotional management strategies, such as addressing concerns and reluctance, in adherence-enhancing programs.
Screening for negative medication perceptions, such as harm beliefs and perceived sensitivity to medication, may help identify high-risk patients with non-adherence.

We are committed to supporting patients who manage OAAs at home. Building on this study, we are developing and evaluating a program that addresses medication perceptions and promotes adherence. We welcome your continued engagement with our ongoing research.

References

Chen Y, Ng MSN, Dong B, Chan CWH. "These Drugs Are Going to Save Our Lives" A Mixed Methods Study on the Role of Medication Perceptions in Adherence to Oral Anticancer Agents Among Patients With Gastrointestinal Tract Cancer. Psychooncology. 2025;34(7):e70213. doi: 10.1002/pon.70213.

From left to right: the second author and co-supervisor, Professor Marques Shek Nam NG; the first author and principal investigator, Dr. Yongfeng CHEN; and the corresponding author and supervisor, Professor Carmen Wing Han CHAN

Academic Express: Understanding Psychological Distress in AYAs with Gynecological Cancer

Thu, 13 Nov 2025 09:16:30 GMT

In this issue, we’ll continue focus on pioneering oncology research from China, featuring a novel multidimensional assessment of adolescent and young adult gynecological cancer patients. Through synchronized actigraphy, circadian chronotyping, and serum inflammatory marker quantification (including TNF-α), this Cancer Nursing (2025) study establishes an objective framework during active treatment.

Our recent publication, “The Level of Psychological Distress Is Associated with Circadian Rhythm, Sleep Quality, and Inflammatory Markers in Adolescent and Young Adults with Gynecological Cancer,” which published in Cancer Nursing, investigates associations between psychological distress, circadian rhythm, sleep quality, and inflammatory markers in adolescent and young adults with gynecological cancer. As researchers and clinicians working with young cancer patients, we are deeply aware of the unique psychosocial and physiological challenges faced by adolescent and young adult (AYA) women with gynecological cancers. This study aimed to explore the interrelationships among circadian rhythm, sleep quality, inflammatory markers, and psychological distress in this vulnerable population.

Why We Chose This Topic

AYA gynecological cancer patients not only confront a life-threatening diagnosis but also face threats to fertility, body image, and sexual health, which can exacerbate psychological distress.
Previous research has shown that circadian disruption, poor sleep, and systemic inflammation are linked to worse mental health in cancer patients, but few studies have focused specifically on AYAs with gynecological cancers. We believed a deeper understanding of these factors could inform more holistic and effective supportive care strategies.

What We Discovered

Our study included 64 AYA gynecological cancer patients in active treatment. We found that the average psychological distress level (4.23 on the Distress Thermometer) exceeded the clinical cutoff, indicating significant psychological burden. Key findings include:

Patients with high psychological distress were more likely to have evening-type circadian preferences.
Those with high psychological distress had significantly worse sleep quality, including shorter total sleep time (TST), longer sleep onset latency (SOL), and lower sleep efficiency (SE).
Inflammatory markers, particularly TNF-α, were elevated in highly distressed patients and positively correlated with psychological distress levels.
Stepwise regression identified TST, SOL, and TNF-α as significant predictors of psychological distress.

Implications for Cancer Care

Our findings highlight the need for integrated care that addresses both psychological and physiological aspects of health in AYA gynecological cancer patients. Specifically, we recommend:

l Routine screening for circadian preference and sleep quality using validated tools like MEQ and actigraphy.

l Early intervention for sleep disturbances through cognitive-behavioral therapy for insomnia (CBT-I), light therapy, or sleep hygiene education.

l Monitoring inflammatory markers such as TNF-α may help identify patients at risk of severe distress and guide targeted support.

l Multidisciplinary collaboration among oncologists, nurses, psychologists, and rehabilitation specialists to address the complex needs of these patients.

By addressing circadian rhythm disruption, improving sleep quality, and mitigating inflammation, we can better support the mental health and overall well-being of AYA women with gynecological cancer. This holistic approach is essential not only for improving quality of life but also for enhancing treatment adherence and outcomes.

Source:

Luo, Y., Duan, Y., Zhou, Y., Yi, S., Dai, C., Luo, X., Kang, Y., Wan, Z., Qin, N., Zhou, X., Liu, X., Xie, J., & Cheng, A. S. K. (2025). The Level of Psychological Distress Is Associated With Circadian Rhythm, Sleep Quality, and Inflammatory Markers in Adolescent and Young Adults With Gynecological Cancer. Cancer nursing, 48(5), E289–E295. https://doi.org/10.1097/NCC.0000000000001325

Reference:
Linden, W., Vodermaier, A., Mackenzie, R., & Greig, D. (2012). Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. Journal of affective disorders, 141(2-3), 343–351. https://doi.org/10.1016/j.jad.2012.03.025
Manne, S. L., Myers-Virtue, S., Kissane, D., Ozga, M. L., Kashy, D. A., Rubin, S. C., Rosenblum, N. G., & Heckman, C. J. (2017). Group-based trajectory modeling of fear of disease recurrence among women recently diagnosed with gynecological cancers. Psycho-oncology, 26(11), 1799–1809. https://doi.org/10.1002/pon.4223

Li, L., Duan, Y., Sun, Q., Xiao, P., Wang, L., He, S., Liu, X., Zhou, J., Xie, J., & Cheng, A. S. K. (2021). Relationship of Circadian Rhythm and Psychological Health in Adolescents and Young Adults With Cancer. Cancer nursing, 44(6), E659–E669. https://doi.org/10.1097/NCC.0000000000000971

Irwin, M. R., Olmstead, R. E., Ganz, P. A., & Haque, R. (2013). Sleep disturbance, inflammation and depression risk in cancer survivors. Brain, behavior, and immunity, 30 Suppl(Suppl), S58–S67. https://doi.org/10.1016/j.bbi.2012.05.002

Nursing Department, The Third Xiangya Hospital (Jianfei Xie)

Academic Express: Reflecting on Our Experience: Multicomponent self-management intervention for cancer patients with pain: A pilot randomized controlled study.

Mon, 15 Sep 2025 02:15:52 GMT

We are honored to continue the Academic Express initiative, a cornerstone platform for disseminating transformative research that shapes the future of cancer care worldwide. In this issue, we present a reflective commentary by Dr. Dorothy N.S. Chan (Chair, ISNCC Knowledge Development Committee), her doctoral student Ms. Jennifer Zhang and her team on their pioneering study: "Multicomponent Self-Management Intervention for Cancer Patients with Pain". Responding to the universal crisis of unrelieved cancer pain—where patients may view suffering as inevitable or even contemplate suicide—this research delivers a breakthrough multicomponent self-management intervention (MSMI) integrating mHealth technology. The PainManager app achieved remarkable 95.8% retention, demonstrating scalable solutions to bridge critical gaps in outpatient pain management.

We are honored to share reflections on our recent research, "Multicomponent Self-Management Intervention for Cancer Patients with Pain: A Pilot Randomized Controlled Study." Our decision to focus on cancer pain management emerged from firsthand observations of the profound challenges patients endure throughout their cancer journeys. Pain disrupts not only physical comfort but also emotional and psychological well-being. In China, we have encountered cancer patients who endured unrelieved pain, and patients who believe suffering is an inevitable part of cancer. Despite advances in medical treatment, many individuals still experience inadequate pain relief, particularly during the transition to outpatient care. This highlights the urgent need for effective self-management strategies that empower patients and improve their quality of life.

Through this study, we gained valuable insights into the importance of a holistic approach to pain management. A systematic review revealed that while existing self-management interventions offer benefits, they often lack a comprehensive framework addressing the multifaceted nature of pain. Synthesizing data from multiple randomized controlled trials allowed us to develop a novel multicomponent self-management intervention (MSMI) that integrates education, assessment, ongoing support, and lifestyle adjustments—all essential components for improving outcomes in cancer patients experiencing pain.

One of the most rewarding aspects of our research was the incorporation of mHealth technology via the PainManager app. Our findings highlight its potential to bridge the gap between patients and healthcare providers, fostering a collaborative approach to pain management. The app not only improved communication but also promoted engagement and adherence to self-management strategies. Positive participant feedback emphasized its practical value and potential for broader implementation in cancer care.

Our pilot study, which included 23 participants, demonstrated high feasibility with a 95.8% retention rate and strong acceptability. Although preliminary analyses showed modest effects on several outcomes, we observed a moderate positive effect on medication adherence—a key challenge in pain management. Participant interviews provided invaluable feedback, noting the app’s convenience and benefits while also identifying areas for refinement, such as streamlining questionnaires. These findings are not an endpoint but a critical foundation, underscoring the need for a larger-scale study to validate and optimize the intervention’s efficacy.

We believe nursing practice can greatly benefit from these insights. Equipping patients with the tools and knowledge to manage their pain fosters independence and strengthens the nurse-patient relationship. As we continue to explore innovative ways to address the complex needs of cancer patients, we hope our research encourages further exploration in the vital field of self-management interventions.

In conclusion, conducting this study has reaffirmed our commitment to improving cancer care. We invite our colleagues in oncology nursing to embrace the possibilities offered by evidence-based, technology-integrated interventions. Together, we can make meaningful strides toward alleviating cancer pain and enhancing the quality of life for patients worldwide.

Ms Jennifer Zhang (in the middle, first author of the article) and her nursing team

Reference:

Zhang, J., Yu, W., Wu, X., Zhang, S., Yang, M., Luo, M., Jiang, J., Mai, M., Ho, L.L.K., & Chan, D.N.S. (2025). Multicomponent self-management intervention for cancer patients with pain: A Pilot randomized controlled study. European Journal of Oncology Nursing, 78, 102964. doi: 10.1016/j.ejon.2025.102964.Multicomponent self-management intervention for cancer patients with pain: A Pilot randomized controlled study.

CNSA-ICCN Congress 2025

Sat, 19 Jul 2025 14:48:45 GMT

From June 18 to 21, 2025, the International Conference on Cancer Nursing (ICCN) was successfully held in Adelaide, Australia. The conference was jointly held with the Cancer Nurses Society of Australia (CNSA) with the theme of "Global Voice, Local Actions: from inspiration to implementation". Nearly 1,150 oncology nurses from more than 30 countries and regions attended the conference.

Pre-Congress Symposium (June 18, 2025)

Prof Patsy Yates (ISNCC Past President) and Prof Winnie So (ISNCC President) conducted a pre-conference workshop “Future Ready: Working together to build a sustainable and resilient cancer nursing workforce”. The workshop aimed to explore factors impacting the cancer nursing workforce and considerable strategies to build a sustainable and resilient workforce for the future to drive the best possible outcomes for people at risk of or affected by cancer.

Opening ceremony (June 19, 2025)

The Congress began with a Welcome to Country led by Suzanne Bartlett, Chairperson of conference program committee, and a formal opening from the Hon Chris Picton MP, Minister for Health and Wellbeing.

Plenary Sessions

Plenary Session one: the opening plenary brought together national leaders, personal stories, and global perspectives to launch the Congress theme: Global Voices, Local Actions: From Inspiration to Implementation.

Plenary Session Two: Inspiration to Implementation - Genomics and Lung Cancer Screening, explored how emerging science is transforming cancer care--shaping how to prevent, detect, and treat cancer across diverse populations. The expert panel examined lessons learned from global leaders, barriers to implementation, and strategies for equitable access. The panel also discussed early detection, workforce capability, and the critical role of nurses in supporting at-risk population.

After the plenary session 2, Prof. Winnie So, President of ISNCC, presented a distinguished merit award to Prof Annie Young, an Emerita Professor of Nursing at Warwick Medical School, University of Warwick, UK. This award is offered once every two years in recognition of an outstanding contribution to the international advancement of the science and art of cancer nursing.

Plenary Session Three: Leading with Impact - Palliative Care, Survivorship & Advocacy

This plenary session brought together diverse voices to explore compassionate, equitable, and Patient-Centered care across the cancer continuum—from diagnosis to survivorship and end-of-life care. In the panel discussion, panel exerts explored what equity looks like, how nurses and consumers drive advocacy, and nurse-led leadership is key to system-wide change.

Plenary Session Four: Building Capability - Navigation, Education and Workforce Needs. This session focused on Navigation and Education in cancer care—how they can strengthen the cancer nursing workforce while improving outcomes across the care continuum.

Plenary Session Five: Cecilia Peña was recognized as the recipient of the ISNCC Past President's Award, which is honored to recognize outstanding leadership and contributions to cancer care in low- and middle-income countries. Ceceilia shared her experiences at the Congress, and a message of resilience for nurses working in diverse settings around the world. Then, Dr Tabitha Healey brought the Congress to a close, creating space for reflection, renewal, and resilience -honoring global leadership and prioritizing the emotional wellbeing of cancer nurses.

Thematic parallel sessions

The conference featured nine parallel thematic sessions. These themes encompassed the refugee experience and its impact on cancer nursing practice; fostering local perspectives and regional collaborations in cancer care development; exploring equitable cancer care through nurse - led and consumer - informed innovation; amplifying regional voices; promoting greater involvement of cancer nurses in caring for cancer survivors; leveraging global expertise for local impact in children's palliative care; uniting cancer nurse educators; strengthening oncology nursing partnerships; and examining the COVID-19 pandemic's impact on cancer care provision, including lessons learned and future directions, as presented by ISNCC& EONS.

Oral presentation sessions

The oral presentation sessions covered a wide range of topics, such as patient education, the cancer nursing workforce, current challenges and constraints faced by cancer nurses, nurse-led interventions impacting patient outcomes, palliative care, survivorship, nursing education in cancer care, vascular care, supportive care toolkits, Patient-Centered care experiences and support for cancer nurses, as well as patient- centered care research. Scholars, nurse clinicians and leaders worldwide shared their research studies and clinical experiences about the above themes.

Poster presentations: The conference featured hundreds of poster presentations and a lot of themed booths in the exhibition hall, facilitating vibrant academic exchanges among scholars and clinical experts across the world.

Travel grants program

The travel grant program has been established to further the mission and vision of the ISNCC to foster the development of cancer nursing internationally, particularly focuses on supporting nurses from low and middle resource countries. Travel grant recipients are expected to share their experiences and newly acquired knowledge with colleagues following attendance at the International Conference on Cancer Nursing.

Recipients of Travel scholarship

The four-day CNSA-ICCN 2025 Congress successfully concluded, providing a platform for knowledge and experience exchange among cancer nurses globally. Participants gained fruitful insights, enriched knowledge in cancer care, and broadened horizons through the event, which also played a vital role in promoting future global collaboration and professional advancement in cancer nursing.

ISNCC Treasurer Catherine Johnson Recognised in 2025 King’s Birthday Honors

Fri, 13 Jun 2025 03:18:10 GMT

“Catherine is an outstanding international leader with significant contribution to maximize global cancer nurses' potential in cancer control and care. We are very proud of Cath for being awarded the Member of the Order of Australia (AM)” - Prof Winnie So, ISNCC President

The International Society of Nurses in Cancer Care (ISNCC) is proud to congratulate our Secretary/Treasurer,,Ms Catherine Louise Johnson,on being awarded the Member of the Order of Australia (AM) as part of the 2025 King’s Birthday Honours List.

This prestigious national honour recognises Catherine’s significant service to oncology nursing and research. With nearly 30 years of dedicated work as a Clinical Research Nurse in Medical Oncology at Calvary Mater Newcastle, Catherine has made a lasting impact on cancer care in Australia. Since 2010, she has served as the Gastrointestinal Cancer Care Nurse Coordinator for Hunter New England Local Health District.

Catherine is also a passionate leader in nursing professional organisations. In addition to her current role with ISNCC, she was a founding member of the Cancer Nurses Society of Australia (CNSA), contributing to the advancement of cancer nursing nationally and globally.

We are delighted to see Catherine’s outstanding commitment and leadership recognised at the highest level. Congratulations, Catherine!

Ms Catherine Louise Johnson

Reference:

https://www.miragenews.com/aussie-nurses-honored-in-2025-kings-birthday-1474307

ISNCC Member Naomi Oyoe Ohene Oti Wins 2025 Aster Guardians Global Nursing Award

Heather Yip — Fri, 06 Jun 2025 17:10:31 GMT

The International Society of Nurses in Cancer Care (ISNCC) is proud to celebrate the remarkable achievement of Naomi Oyoe Ohene Oti from Ghana, who has been named the winner of the 2025 Aster Guardians Global Nursing Award. Naomi, an Oncology Nurse Specialist and Head of Nursing at the National Radiotherapy Oncology and Nuclear Medicine Centre, Korle-Bu Teaching Hospital, received this prestigious honor during a grand ceremony held in Dubai, UAE, on May 26, 2025.

The Aster Guardians Global Nursing Award is an international accolade that recognizes the extraordinary contributions of nurses worldwide in areas such as leadership, research, innovation, and community service. Naomi was selected from a remarkable pool of over 100,000 applications spanning 199 countries, rising to the top among ten outstanding finalists.

Naomi’s impact on oncology nursing in Ghana has been transformative. She has pioneered specialized nursing training programs, improved patient care pathways, and championed equitable cancer outcomes in her institution and beyond. Her collaboration with international partners, including the Cross Cancer Institute in Canada, has led to the development of advanced oncology nursing education and professional development programs for nurses in Ghana. Naomi serves on the ISNCC Member Development Committee and has contributed to the development of the AORTIC Oncology Nurse Competencies as well as the oncology nursing content in the 2024 IAEA/WHO Guidance on Setting Up a Comprehensive Cancer Centre.

For her groundbreaking work and dedication, Naomi received a $250,000 prize, underscoring the global importance of her contributions to cancer care and nursing leadership.

ISNCC congratulates Naomi on this well-deserved recognition and is honored to have her as a member of our global community of oncology nursing leaders. Her achievements exemplify the mission and vision of ISNCC — advancing global cancer nursing through excellence in practice, education, research, and leadership.

The Oncology Nursing Committee of Chinese Nursing Association Carried Out Evidence-Based Healthy Living for Cancer Prevention Campaigns

Fri, 30 May 2025 03:54:34 GMT

Yingtao Meng, Huiyu Luo

The Oncology Nursing Committee of the Chinese Nursing Association

The China Anti-Cancer Association initiated the 31^st National Cancer Prevention and Control Awareness Week (April 15 to 21, 2025) to promote healthy lifestyles and early screening to the public. The Oncology Nursing Committee of the Chinese Nursing Association and China Anti-Cancer Association Integrated Nursing Committee actively responded to the call and launched "Evidence-Based Healthy Living for Cancer Prevention" campaigns.

Coordinated by the Oncology Nursing Committee, the campaign involved more than 15,000 nurses from 91 institutions across 27 provinces, autonomous regions, and municipalities. A total of 704 face-to-face and online activities were organized successfully, including public lectures/educational seminars and health consultations. The campaign outreached 66 million people, including patients with cancer and their family members, as well as the general public.

During this campaign, oncology nurses actively participated in evidence-based educational seminars and heath consultation sessions to enhance the public’s awareness of cancer prevention and control. Their efforts demonstrated the value of nursing in reducing the burden of cancer in the nation and achieving the goals of cancerprevention and control under the Healthy China initiative.

Nurturing the Art of Caring: Bridging Cultural Gaps in Adolescent Cervical Health Education

Tue, 27 May 2025 09:55:53 GMT

We are honoured to present an innovative educational initiative addressing cervical health equity for multicultural youth: “Developing and Implementing an Educational Program for Cervical Health, Healthy Lifestyles, and HPV Vaccination for Female Chinese and Non-Chinese-Speaking Students", co-authored by Dr. Laurie LK Ho and Dr. Dorothy NS Chan from The Nethersole School of Nursing, Chinese University of Hong Kong.

Adopting a healthy lifestyle and receiving Human Papillomavirus (HPV) vaccination are crucial for preventing HPV infections and cervical cancer, making it essential to initiate these practices during adolescence. In Hong Kong, however, there is a lack of focus on promoting cervical health and preventing HPV infections within the secondary school sex education curriculum. While initiatives have primarily targeted Chinese-speaking students, few address the needs of non-Chinese-speaking students. Given Hong Kong’s multicultural society, it is vital that all students, regardless of their linguistic background, have equal access to health information that protects their well-being. Thus, there is a need for an educational program that effectively targets both Chinese and non-Chinese-speaking students in secondary schools.

Reflecting on a recent educational program developed for female Chinese and non-Chinese-speaking students, we aimed to promote cervical health, healthy lifestyles, and HPV vaccination. Creating an effective program required careful planning and cultural sensitivity. Our initiative included a health talk and a tutorial session designed to enhance students’ understanding of HPV, its associated infections, cervical cancer, and preventive measures. The health talk provided foundational knowledge, while the tutorial session focused on addressing myths and misconceptions.

To support these sessions, we developed a variety of educational materials, including PowerPoint presentations, booklets, matching exercises, and case scenarios. The development process followed a multi-step approach. Initially, an outline of the content was created, followed by the selection of different formats to facilitate effective content presentation. Meetings with a graphic designer ensured that graphics were tailored to the interests and comprehension levels of both Chinese and non-Chinese-speaking secondary school girls. Additionally, project team meetings integrated relevant life skills and positive values regarding cervical health and HPV vaccination into the materials.

Successful implementation of the educational program required considering several factors. First, the literacy levels of the students influenced the scope of the health content. Thus, medical jargon was avoided, using simple language, infographics, and cartoons to clarify complex concepts. Bilingual materials were prepared in both Chinese and English to ensure accessibility. Second, the information had to be engaging to stimulate interest in learning. The sequence of materials was finalized: PowerPoint presentations provided knowledge input; booklets served as reminders; interactive matching exercises addressed myths; and scenario-based discussions encouraged practical application of knowledge. Bilingual facilitators guided these discussions, fostering an inclusive environment.

User experience with the educational materials was also paramount. Before implementation, three secondary school girls reviewed the content, providing valuable feedback, especially on sections addressing myths about HPV vaccines. Their insights led to important modifications. Additionally, cultural practices concerning sensitive topics were respected by conducting the program in a female-only classroom setting.

After the program, feedback from students indicated that the program was engaging and inspiring, with accessible and useful information. They appreciated the clarity of the materials and the supportive atmosphere fostered by bilingual facilitators.

By offering bilingual resources and fostering an inclusive environment, we equip adolescents with the knowledge to make informed health decisions. This program not only promotes individual well-being but also enhances community health awareness.

Author’s organisation: The Nethersole School of Nursing, Faculty of Medicine, the Chinese University of Hong Kong

Email: longkwanho@cuhk.edu.hk dorothycns@cuhk.edu.hk

World No Tobacco Day Special：Smoking Cessation and Cancer, What Can Nurses Do?

Fri, 09 May 2025 09:02:29 GMT

Ahead of World No Tobacco Day, we interviewed Professor William Li,FAAN, to discuss his pioneering work in integrating behavioural science with modern technology to transform smoking cessation support. As a Top 2% Global Scientist (Stanford University) and leader at CUHK’s Nethersole School of Nursing, Professor Li has secured HK$42M+ in grants and published over 200 studies. His team develops innovative interventions—including instant messaging platforms like WhatsApp/WeChat and self-determination theory-based protocols—to empower nurses in delivering personalised cessation guidance. In this interview, he shared how these strategies address challenges in chronic smokers and strengthen nurses’ frontline impact, aligning with global efforts to reduce tobacco-related cancers and healthcare burdens.

Smoking and cancer

Cigarette smoking is the leading preventable cause of premature death and disease, accounting for 8 million deaths annually worldwide, including approximately 1.3 million deaths from exposure to second-hand smoke. Evidence indicates that smoking adversely affects nearly every organ in the body and is linked to various types of cancer. Conversely, quitting smoking can significantly reduce the risks of developing and dying from cancer. For example, the risk of death from lung cancer has been shown to decrease by 30%–50% within 10 years of quitting.

Despite clear evidence that smoking increases mortality, decreases treatment efficacy, and increases the risk of cancer recurrence and the development of new cancers, many cancer patients continue to smoke post-diagnosis. However, quitting smoking after a cancer diagnosis can delay disease progression, decrease treatment side effects, and improve prognosis and quality of life. Therefore, it is crucial for nurses to support cancer patients in quitting smoking to enhance their health.

What are the challenges ahead?

Quitting smoking is extremely difficult, with relapse common due to intolerable withdrawal symptoms. This is especially true among chronic smokers, who often have a long smoking history, high nicotine dependency, and low quit success rates. These individuals are often less responsive to current tobacco control interventions or policies and will ultimately constitute an increasing proportion of remaining smokers in the community. Overcoming this challenge will require innovative and effective smoking cessation strategies, along with tailored advice and support from healthcare professionals.

What can nurses do?

Healthcare professionals have a moral obligation to help smokers quit due to the detrimental effects of smoking on health. Nurses, as frontline clinical staff, spend more time with patients than other healthcare professionals and interact with them across various settings. They play a crucial role in smoking cessation programmes and are uniquely positioned to provide valuable information and encouragement.

However, nursing curricula worldwide often lack comprehensive training on smoking cessation. Additionally, busy schedules can make it difficult for nurses to assist smokers in quitting. Therefore, incorporating smoking cessation training into nursing curricula to empower future nurses to help smokers quit is crucial. Nurse researchers should focus on developing and evaluating effective and cost-efficient smoking cessation interventions.

Technological advancements, such as mobile health apps, web-based platforms, and chatbots, can offer improved solutions to the challenges faced by nurses in promoting smoking cessation. The application of artificial intelligence in healthcare can assist nurses in delivering continuous professional advice and personalised support. By leveraging these strategies, nurses can significantly reduce smoking rates and prevent cancer, ultimately improving public health outcomes globally.

In sum, nurses can play a pivotal role in helping smokers to quit, reducing tobacco-related illnesses and deaths, and improving quality of life. This also protects the public from exposure to second-hand smoke, fostering a healthier environment for future generations. Additionally, it can reduce the economic burden on the healthcare system imposed by smoking and the related diseases, especially cancer. These outcomes will guide smoking cessation policies and boost sustainable development.

The following illustrations depict key components of Prof. Li’s Self-Determination Theory-based interventions, integrating behavioral science to empower nurses in smoking cessation support.

Empowering Nurses, Strengthening Healthcare: An Interview with the Chief Nursing Officer of Slovenia, Lucija Rojko

Shelli Bourne — Fri, 28 Mar 2025 14:43:02 GMT

From her early days as a practical nurse to leading national nursing initiatives, Lucija Rojko has dedicated her career to advancing the nursing profession and improving healthcare systems. Lucija was appointed Chief Nursing Officer of Slovenia in December 2024, bringing a wealth of experience in emergency care, health promotion, and policy development. In this interview, she shares insights into her journey, the evolving role of oncology nursing, and her vision for the future of nursing. She also offers invaluable advice for aspiring healthcare leaders and reflects on the progress—and challenges—of strengthening nursing’s impact on a global scale.

Can you share a bit about your path to becoming Chief Nursing Officer of Slovenia?
My path has been shaped by a variety of roles and experiences that gradually built my knowledge in the field of nursing. I began as a practical nurse, working in nursing homes as a student, and after earning my bachelor’s degree in nursing, I gained invaluable experience in emergency care at the Division of Internal Medicine, University Medical Centre Ljubljana. Later, I decided to focus on health promotion and health education programmes, where I discovered the profound impact nurses can have in primary health care and how influential they can be within local communities.

I pursued a Master’s in Nursing and am currently a PhD student at the University of Ljubljana, Faculty of Public Administration, specialising in Governance and Economics in the Public Sector. This academic path has allowed me to explore the intersection of healthcare policy and nursing practice, further enriching my perspective.

In 2024, I joined the Ministry of Health and immediately became involved in key projects related to nursing and the role of nurses. At the end of 2024, I took the role of Chief Nursing Officer of Slovenia. My primary focus is to create positive working conditions for nurses across the country. My vision is to strengthen nursing’s contribution to healthcare by ensuring patient-centered care, improving accessibility and quality, and supporting nurses in delivering safe and effective care.

A pivotal element in my professional development has been my involvement with the International Society of Nurses in Cancer Care (ISNCC). This opportunity provided me with valuable insights into the global burden of cancer on healthcare systems, the social welfare of populations, and national economies. It also deepened my understanding of the demanding nature of oncology nursing and the critical importance of supporting oncology nurses both professionally and psychologically.

I initially joined ISNCC while working at the National Institute of Public Health in Slovenia, where I coordinated health education initiatives for adults. These efforts included coordination of Slovenia’s health promotion centres, which operate within community healthcare centres at the local level. These centres organise workshops on healthy living, including sessions and counselling on smoking cessation, reducing risky and harmful alcohol consumption, and encouraging participation in Slovenia’s national screening and early detection programme for colorectal cancer. They also run a wide array of health promotion and health education activities for all age groups within local communities. I saw the role of ISNNC as a great opportunity for networking with experts from all around the world and to learn new approaches for cancer prevention and early detection.

From your perspective, is oncology nursing practice and nursing in general different now compared to when you first started?

Particularly from the standpoint of prevention – namely cancer prevention and early detection – I believe there has been a significant shift towards strengthening health and empowering individuals to make healthier lifestyle choices. This is an area where we, as a society, have made a progress. However, we are far from the end goal, and I do not believe that this is a journey that ever truly concludes. New challenges and emerging risks continually arise, which must be continuously addressed to maintain and improve health within our communities.

In general, one of the most notable differences in oncology nursing today is the increased emphasis on cancer prevention and early detection, particularly in low- and middle-income countries where the cancer burden is highest. ISNCC has played a significant role in addressing these global disparities by offering training programmes, resources, and leadership development opportunities for nurses in under-resourced regions. For example, ISNCC’s tobacco cessation workshops, cancer screening modules, and palliative care curriculums have substantially enhanced the capacity of nurses to drive meaningful improvements in care delivery and prevention worldwide.

What advice would you give to your younger self?
I would give myself three pieces of advice. I live by them now, but younger me didn’t, and I wish I had. It would have saved me a lot of time and energy.

First, do not fear standing up for what you believe in. Have the courage to fight for your values and the vision you hold for a better future. Never hesitate to share your ideas and dreams, no matter how ambitious they may seem. Let go of any self-doubt that might hold you back, and trust in your ability to create meaningful change. Even the smallest steps can lead to something bigger, so take that first step.

Second, be patient and persistent.

Lastly, surround yourself with people who support and believe in you, and who share your vision.

Thinking about the future of our profession, what excites you the most or fills you with hope?

I believe that healthcare is at a crucial turning point. While the situation differs from one country to another, the role of nurses and their importance to the healthcare system is being recognised. Though the journey ahead is long, I am confident that we are on the right path to further empowering the nursing profession. Key steps towards progress include providing qualified mentors who support nurses at the start of their careers, preparing them for the challenges of the profession, and investing in those who take on leadership roles. By supporting and educating nurses, encouraging their professional development, and helping them feel secure and valued in their roles, we enable their growth and strengthen the entire healthcare system.

When I see improvements in these areas, I feel hopeful. It fills me with confidence for the future. After all, today we are healthy and active, but tomorrow, it may be us who will need skilled, professional, and compassionate healthcare staff—people who will advocate for us and support us through treatment—and much of this care will be provided by nurses.

Academic Express: Application of Artificial Intelligence in Symptom Monitoring in Adult Cancer Survivorship

Fri, 14 Mar 2025 06:21:07 GMT

In this issue, we are privileged to feature a significant study led by Dr Muna Alkhaifi from Odette Cancer Centre in Toronto, and a multinational team of researchers from the Multinational Association of Supportive Care in Cancer (MASCC) Survivorship Study Group. Their research, titled "Application of Artificial Intelligence in Symptom Monitoring in Adult Cancer Survivorship: A Systematic Review," provides a comprehensive evaluation of the role of artificial intelligence (AI) in monitoring and managing symptoms across the cancer survivorship trajectory.

As the global population ages and the number of cancer survivors continues to rise, the integration of AI technologies, such as machine learning and natural language processing, holds immense promise for transforming patient care. This study systematically reviews the effectiveness, safety, and usability of AI-driven approaches in symptom monitoring, offering valuable insights into their potential to enhance patient outcomes. The authors also provide actionable recommendations for the future integration of AI into clinical practice, emphasizing the need for standardized data collection, system interoperability, and patient-centered customization.

This research underscores the transformative potential of AI in oncology care and highlights critical considerations for its implementation, making it a vital contribution to the ongoing discourse on improving cancer survivorship care. With a growing and aging population, the number of cancer survivors is expected to rise. Artificial intelligence (AI) is becoming increasingly common in health care, with promises to transform patient care and administrative processes. AI technologies, such as machine learning (ML) and natural language processing (NLP) have already been applied to tasks in healthcare, including analyzing clinical documentation, treatment planning, toxicity management and follow-up care. Given the widespread application of AI in healthcare, it is imperative to assess the comprehensiveness, effectiveness and safety of AI in symptom monitoring and management for cancer survivors. There is also a lack of systemic evaluations addressing AI-driven symptom monitoring in cancer survivorship. In light of this gap, my team and I undertook a systematic review to assess the current state of science regarding the integration of AI in symptom monitoring within the adult cancer survivorship trajectory, from diagnosis through the end of life.

Forty-one studies were included in this review. AI prediction models typically performed well, with high precision and accuracy in tasks such as symptom detection. However, a small proportion of studies found limited accuracy, sensitivity and specificity of their AI models. Data was available to determine the effectiveness of AI approaches in monitoring and improving patient symptoms. Several studies found that their AI approach was highly accurate at identifying symptoms. Overall, AI showed utility in symptom prediction, monitoring and outcomes. User acceptance and satisfaction were mixed, with some studies reporting a higher user acceptance rate for their AI approach, while others reported mixed results regarding user acceptance, suggesting the need for tailored AI solutions.

After discussion and consensus among authors, we provided three broad recommendations on the future integration of AI into clinical practice for cancer symptom monitoring:

1. To effectively implement AI into clinical practice, symptom monitoring should be standardized in terms of frequency and method of data collection to achieve consistent data across all healthcare settings. This will allow for strategic use of analytics to detect trends and test interventions to improve patient outcomes.

2.System integration of AI requires significant investment in infrastructure and technology. It is instrumental to ensure electronic health records and analytical tools are interoperable and designed to meet individual needs so relevant and timely information can be collected that better supports decision-making.

3. Enhancing the usability of AI applications is essential for increasing patient engagement. Customizing these applications to accommodate individual patient preferences can foster active participation in symptom monitoring. This can include allowing patients to personalize features such as data input methods and notification settings, which can improve adherence with the system, improving patients’ experience and well-being.

Overall, the findings of this review indicate a promising potential for AI to enhance symptom monitoring in diverse cancer settings by incorporating various data sources, including patient text, patient-reported outcomes, and physiologic measurements. The review underscores the significant role of AI in both symptom monitoring and overall patient care throughout cancer survivorship.

Dr. Muna Alkhaifi (Corresponding author)

Reference:

Tabataba Vakili, S., Haywood, D., Kirk, D., Abdou, A. M., Gopalakrishnan, R., Sadeghi, S., Guedes, H., Tan, C. J., Thamm, C., Bernard, R., Wong, H. C. Y., Kuhn, E. P., Kwan, J. Y. Y., Lee, S. F., Hart, N. H., Paterson, C., Chopra, D. A., Drury, A., Zhang, E., Raeisi Dehkordi, S., … Multinational Association of Supportive Care in Cancer (MASCC) Survivorship Study Group (2024). Application of Artificial Intelligence in Symptom Monitoring in Adult Cancer Survivorship: A Systematic Review. JCO clinical cancer informatics, 8, e2400119. https://doi.org/10.1200/CCI.24.00119. Application of Artificial Intelligence in Symptom Monitoring in Adult Cancer Survivorship: A Systematic Review

Academic Express: Exploring Financial Toxicity and Quality of Life in Chinese Cancer Patients

Sat, 25 Jan 2025 07:01:04 GMT

We are delighted to continue the Academic Express section, which aims to facilitate academic exchanges and further the development of oncology nursing. In every issue, we present groundbreaking research contributions from esteemed members in the field.

In this issue, we are privileged to feature a significant study led by Dr. Binbin Xu from the School of Nursing, Hunan University of Chinese Medicine, and Prof. Winnie KW So from the Nethersole School of Nursing, The Chinese University of Hong Kong. Their research, titled 'Mediating Role of Financial Toxicity in the Relationships Between Health-Related Quality of Life and Its Risk Factors in Chinese Patients with Cancer,' offers an insightful analysis into the financial challenges faced by cancer patients and how these impact their quality of life. This study is a notable addition to the ongoing conversation about improving patient care and outcomes in oncology nursing.

Why We Chose this Research Topic?

As researchers in oncology nursing, we recognize that cancer care extends beyond medical treatments. Financial toxicity (FT)—the financial strain caused by cancer care costs—significantly burdens patients and their families, compromising patients’ health-related quality of life (HRQoL). Many of the factors that influence HRQoL also impact FT, and the strong association between the two suggests that FT may mediate the relationship between HRQoL and its risk factors in patients with cancer. By exploring this mediating role of FT, our goal is to enhance understanding within the healthcare system about the impact of specific risk factors on HRQoL and to advocate for a more comprehensive, patient-centered approach to cancer care that addresses both medical and financial challenges, ultimately enhancing patients’ HRQoL.

What We Discovered?

We examined the mediating role of FT in the relationships between HRQoL and its risk factors in a large sample (N = 1208) of Chinese patients with cancer. Our findings revealed that FT predominantly mediated the relationships between HRQoL and both annual household income and the level of the hospital (secondary and tertiary under hospital classification in Chinese Mainland) where treatment was received. Patients with lower household incomes or those treated in tertiary hospitals (compared with secondary hospitals) experienced greater FT, which in turn led to worse HRQoL outcomes. Additionally, the number of treatment modalities, social support, perceived stress, discussions with healthcare providers about cancer care costs, and social medical insurance influenced HRQoL both directly and indirectly through FT.

Implications for Cancer Care

Our findings highlight the need for a comprehensive approach to cancer care that includes FT as an integral part. A key takeaway from our research is the need for healthcare systems to improve cost discussions with patients. Many patients avoid or delay these conversations out of fear or lack of knowledge, but our study suggests that open, transparent discussions about treatment costs hold the potential to help patients make informed financial decisions and mitigate FT. Furthermore, addressing the challenges posed by FT requires a more holistic approach that focuses not only on a patient’s financial issues but also on other aspects of distress. Comprehensive psychological management is expected to enhance patients’ overall psychological state, enabling them to better cope with FT.

Future healthcare policies and research on HRQoL in cancer populations should prioritize FT management, particularly for individuals with low incomes or inadequate health insurance. Policymakers and healthcare providers should focus on enhancing access to health insurance and financial assistance programs. Further research is needed to explore innovative interventions, such as financial navigation, financial counseling, insurance education, and other strategies, to mitigate FT and reduce its impact on HRQoL.

We hope this study sparks a conversation about the importance of comprehensive cancer care that goes beyond treating the disease itself to also address FT.

Reference:

Xu B, So WKW, Choi KC, Huang Y, Liu M, Qiu L, Tan J, Tao H, Yan K, Yang F. Mediating Role of Financial Toxicity in the Relationships Between Health-Related Quality of Life and Its Risk Factors in Chinese Patients With Cancer. Cancer Nurs. 2024 Dec 10. doi: 10.1097/NCC.0000000000001432. Epub ahead of print. Financial toxicity and its risk factors among patients with cancer in China: A nationwide multisite study — ScienceDirect

Celebrating 40 Years of Global Collaboration: Reflections from the 2024 Virtual Cancer Care Symposium

Sun, 19 Jan 2025 12:12:48 GMT

As the ISNCC proudly marks its 40th anniversary of global collaboration, we recently hosted a transformative three-day virtual symposium from November 4th to 6th, 2024. This landmark event brought together experts and practitioners from around the world to share their insights and experiences in cancer care.

We are thrilled to present reflections from three of our esteemed members who participated in this momentous occasion. Let's hear from them about their experiences and key takeaways from the symposium.

Participant 1: Airong LU, RN, MSN, Cancer Hospital of Chinese Academy of Medical Sciences, China.

The workshop provided a comprehensive overview of quality improvement, covering essential topics such as SMART goal setting, problem identification, solution testing, and data measurement.It was designed to equip participants with practical tools and methods for implementing quality improvements effectively.

A significant takeaway was the emphasis on creating diverse teams. We learned that team composition should include not only professionals but also patients, families, caregivers, and partners, incorporating a variety of skills, backgrounds, cultures, and perspectives. This holistic approach enhances the effectiveness of quality improvement efforts.The workshop also highlighted practical applications, such as using the IAP2 spectrum for public participation and SMART goals to address nursing adverse events. By identifying specific goals and employing model improvement methods, we can uncover root causes and test solutions. Data measurement allows for monitoring progress and adjusting strategies based on feedback.

The interactive nature of the workshop, featuring sharing sessions and activities, demonstrated how rapid testing and improvement cycles can lead to significant advancements in quality improvement. Overall, it was an enlightening experience that provided valuable practical knowledge.

Participant 2: Doris Machaki, RN, MSN, Aga Khan University- School of Nursing and Midwifery / Oncology Nursing Society of Kenya, Kenya.

Participating as an awardee in this year's virtual symposium was an enlightening experience, despite the late-night hours due to the time difference. The event offered profound insights into the role of oncology nursing and emphasized the significance of patient-reported outcomes (PRO). It became clear that unreported symptoms can lead to unnecessary distress for patients, underlining the critical role of therapeutic communication in oncology care.

Key discussions included quality improvement strategies like root cause analysis and innovations in cancer literacy, crucial for enhancing patient outcomes. The second day shed light on ageism in oncology, revealing the necessity for inclusivity in healthcare. This prompted a commitment to advocate for equitable treatment for all patients, irrespective of age.

Moreover, the symposium highlighted Kenya's progress in cancer literacy through communication guidelines and efforts in pediatric palliative care, demonstrating the importance of continuous education and advocacy. This experience reinforced my dedication to improving cancer care and patient inclusivity in our healthcare systems.

Participant 3: Hoang Thu Phuong, RN, General Medical Oncology Department in Hanoi Oncology Hospital, Vietnam.

The 3-day virtual symposium was an inspiring experience, covering key topics such as Quality Improvement, Supporting System Change, and Reducing the Burden of Advanced Disease. The sessions provided valuable insights into the latest advancements in cancer care, demonstrating practical approaches to improve care quality, enhance patients’ quality of life, and develop innovative support strategies.

I was particularly inspired by the global collaboration displayed by nurses around the world, embodying the spirit of “Leave No One Behind.” ISNCC’s efforts to support cancer nurses from LMIC regions to engage in international conferences play a crucial role in fostering health system development.

A standout was the presentation by Professor Winnie So and Associate Professor Dorothy Chan, who introduced evidence-based tools for early cervical cancer detection. Their culturally sensitive communication strategies, including guidebooks, were especially relevant to overcoming barriers in Eastern contexts. I hope to develop similar tools and expand electronic communication systems to promote early cancer detection in my country and beyond.

Annual Review 2024

Tue, 24 Dec 2024 17:41:35 GMT

Dear Colleagues

As 2024 draws to a close, I would like to share our achievements this year on behalf of the International Society of Nurses in Cancer Care (ISNCC). This review reflects on the remarkable achievements and significant milestones we have reached in maximizing the influence of nursing on reducing the global cancer burden. We are deeply grateful to all member organizations and global citizens for their unfailing support and valuable contributions to turning our strategic plan 2022-2025 into action.

Strategic Direction 1: Build and strengthen the cancer nursing workforce across the world

Over half of global cancer cases occur in low- and middle-income countries (LMICs). Our priority in 2024 was to continue to strengthen cancer nursing leadership and workforces worldwide, particularly in LMICs, to reduce the global cancer burden. In 2024, we worked collaboratively with the University of Health and Allied Sciences (UHAS), Ghana, and City Cancer Challenge (C/Can) to prepare a 5-year project proposal on developing an oncology nursing leadership program for training 240 cancer nurses across African countries. The project was successfully funded by Amgen, and the first cohort will be launched in Spring 2025.

Upholding the standards of training programs for cancer nurses is crucial for strengthening nurses’ provision of cancer care and control. We gathered oncology nursing leaders to review and provide feedback on the chemo-immunotherapy course developed by Hellenic Oncology Nursing Society to enhance the competency of cancer nurses in Europe.

To optimize learning opportunities and build capacity for nurses from LMICs, we offered over 60 scholarships for LMIC nurses to attend the virtual symposium 2024.

Strategic Direction 2: Influence global health policy

Global health policy helps establish national cancer control plans that benefit patients, healthcare organizations, and healthcare systems. Two position statements—one each on “cancer prevention, early detection, screening, and health promotion” and “out-of-hospital care for people living with metastatic breast cancer”—were developed in 2024. These statements highlight the key role played by nurses in cancer prevention, early cancer detection, and ensuring optimal care delivery to people with metastatic breast cancer. ISNCC is committed to optimizing nurses’ contributions to cancer care and control. Let us work together to transform these position statements into action.

As a member of the steering committee of the International Cancer Control Partnership, we supported cancer control planning efforts by reviewing national cancer control plans and enlisting global cancer nursing experts to implement and evaluate these plans.

Strategic Direction 3: Advance and apply knowledge

We have provided global nurses with various educational opportunities for advancing their cancer care knowledge and skills. We conducted global knowledge exchange webinars focusing on the care of people with mesothelioma and emotional distress. We convened a virtual symposium 2024 with the theme “Stronger together – 40 years of global cancer nursing,” covering topics on quality improvement, supporting system change, improving cancer treatment outcomes, and reducing cancer patients’ burden. Using Pfizer’s funding, we developed educational resources for global cancer nurses to support metastatic breast cancer patients receiving oral anti-cancer treatment. The English educational materials have been translated into simplified Chinese and Spanish. We also shared up-to-date research and knowledge with global cancer nurses via scientific meetings and conferences hosted by our member organizations and regional/international partners. All of these educational activities gathered global nurses from more than 40 countries/regions. The nurses’ commitment to equipping themselves to provide the best cancer care is greatly appreciated. The cancer nurses who attended the global knowledge exchange programs and virtual symposium gained actionable insights that they can use to make a difference in their own healthcare settings, from cancer prevention to end-of-life care.

Up to 50% of cancer cases are preventable by engaging in healthy lifestyles and detecting the disease early. We obtained a research grant to promote early gastric cancer detection in rural China by strengthening nurses and healthcare providers’ capacity for the prevention and early detection of gastric cancer, improving access to and uptake of gastric cancer screening, and improving knowledge, attitudes, and behavior regarding the prevention and early detection of gastric cancer among rural residents. We deeply appreciate The Bristol Myers Squibb Foundation for supporting ISNCC’s initiatives to reduce the global cancer burden via early cancer detection.

Cancer Nursing, ISNCC’s official journal, continues to disseminate groundbreaking research findings and their practical applications to address the wide spectrum of problems arising in the care and support of cancer patients worldwide. We continue to support our journal by offering an English editorial assistance program to non-English-speaking nurse authors seeking to publish.

Strategic Direction 4: Leverage partnerships with Members and Global Citizens

ISNCC Members are organizations representing cancer nurses in countries and regions worldwide. Our Global Citizens are individuals in the field of cancer care who support ISNCC’s ethos, objectives, strategy, and philanthropic goals. In 2024, over 130 cancer nurses from 30 countries/regions engaged in various positions and/or strategic activities to achieve ISNCC’s mission, including being directors/committee members/speakers/project team leaders/members and/or engaging in organizing various ISNCC activities. We also worked collaboratively with our member organizations and regional/international partners to achieve our common goals. For example, we organized a joint Global Knowledge Exchange webinar with the Canadian Association of Nurses in Oncology (CANO) and The International Thoracic Oncology Nursing Forum; provided mutual support to promote our activities via members’/partners’ networks and vice versa; worked collaboratively with the Cancer Nurses Society of Australia (CNSA) to organize a joint CNSA–ICCN 2025 Congress in Adelaide, Australia; worked collaboratively with C/Can and UHAS to develop an oncology nursing leadership program for nurses across African countries; used CANO’s funding to establish a research grant for ISNCC members and global citizens from LMICs; and partnered with Asian Oncology Nursing Society and Peter MacCallum Cancer Institute to develop a clinical observership program for Asian cancer nurses. Moreover, ISNCC collaborated with five member organizations and regional/international partners (CANO, Oncology Nursing Society, European Oncology Nursing Society, Multinational Association of Supportive Care in Cancer (MASCC), Global Power of Oncology Nursing) to respond to the recently published MASCC Supportive Care 2030 Ambition Statements that outline the desired global state of supportive care by 2030, articulating the role and contribution of oncology nurses in achieving it.

Incoming and outgoing Board of Directors

We have four new members on the Board of Directors, Lena Sharp (President-elect), Catherine Johnson (Treasurer), Yuhan Lu (Director, communication portfolio), and David Makumi-Kinyanjui (Director), while Suzanne Bishaw (Director, conference management portfolio) and Julia Downing (Director, policy and advocacy portfolio) were re-elected for their second term. We greatly appreciate three outgoing members—Patsy Yates (Past president), Linda Watson (Treasurer), and Yongyi Chen (Director, communication portfolio)—for their dedication and contributions to ISNCC and global cancer nurses during their term of services.

As we look to 2024 and beyond, we are grateful for your support of ISNCC’s mission. Our global accomplishments could not be achieved without your support and commitment. Your engagement in ISNCC’s work creates synergies to maximize global nurses’ efforts to improve the health and well-being of people at risk of or living with cancer. We look forward to continuing to work closely with you to maximize our contributions to cancer control.

We wish you all a happy and healthy New Year 2025!

Regards,

Winnie So
President
International Society for Nurses in Cancer Care

ISNCC Research Grant 2024/2025: Empowering Cancer Nursing Innovation in LMIC Regions

Fri, 06 Dec 2024 18:02:48 GMT

Are you passionate about advancing oncology nursing and making a difference in cancer care? The International Society of Nurses in Cancer Care (ISNCC), in collaboration with the Canadian Association of Nurses in Oncology (CANO), invites you to apply for the 2024/2025 Research/Evidence-Based Project Grant!

Why Apply

This grant offers CAD $5,000 (~USD $3,500) to support impactful projects by cancer nurses in low- and middle-income countries (LMICs). The focus is on generating knowledge and improving cancer care globally through evidence-based initiatives.

Explore These Project Areas

Policy Development: Crafting tools like policy briefs to influence healthcare systems.
Oncology Nursing Processes: Designing or updating care models and guidelines.
Cancer Prevention: Implementing effective screening programs for common cancers.
Palliative & End-of-Life Care: Enhancing symptom management for advanced-stage cancer patients.
Digital Transformation: Leveraging digital tools to optimize care.
Survivorship & Quality of Life: Addressing the physical, emotional, and social impacts of cancer.

For more suggestions please visit the grant information page.

Who Can Apply?

If you’re a cancer nurse from an LMIC with at least three years of oncology experience and a bachelor’s degree in nursing, we want to hear from you! Applicants must be ISNCC Global Citizens or affiliated with a Member Society and have institutional support for their projects.

Key Dates and Submission Guidelines

Grant Amount: CAD $5,000 (~USD $3,500)
Duration: Up to 2 years
Deadline: February 9, 2025

We invite proposals from eligible individuals.

ISNCC Research Grant 2024 / 2025

Stronger Together – 40 Years of Global Cancer Nursing ISNCC Virtual Symposium 2024

Shelli Bourne — Fri, 22 Nov 2024 16:26:51 GMT

To mark 40 years of global collaborations, the ISNCC Virtual Symposium on Cancer Nursing was held from November 4 to 6, 2024. The aim was to connect fellow professionals with one another and foster collaborations that transcend borders. We hope that the oncology nurses who attended the symposiums obtained some actionable insights that they can use to make a difference in their own health care settings, from cancer prevention to end-of-life care.

Virtual Symposium Day 1

Opening Remarks:

The first day of the virtual symposium was kicked off by a warm welcome from Winnie So, President of ISNCC. Prof. So highlighted the importance of improving quality and supporting systems change in cancer nursing and stressed the need for a collaborative approach to addressing the challenges faced by cancer patients. She also introduced the meeting agenda and thanked the speakers.

Session 1.1: Panel Discussion on ISNCC – Forty Years Together: Nurses Addressing the Global Burden of Cancer Together

This panel session was moderated by Distinguished Prof. Patsy Yates and included ISNCC Past Presidents Connie Henke Yarbro, Margaret Fitch, Sanchia Aranda, Greta Cumming and Stella Aguinaga Bialous. They reflected on the nursing journey in cancer control over the past four decades. The aim of the discussion was to build on this history and look ahead to the future of cancer nursing. Participants learned about some of the most important achievements and milestones in cancer nursing and heard from past presidents of the ISNCC about the opportunities and challenges for the future of cancer nursing.

Session 1.2: Workshop – PROcision Care: Using Patient-Reported Outcomes to Personalize Care Delivery

Chaired by Prof. Darryl Somayaji, this session explored the growing trend of incorporating standardized, validated questionnaires into routine care to gather information directly from patients about their symptoms, functioning and well-being. The concept of PROcision Care, which involves the use of patient-reported outcomes (PROs) to inform patient care and management, was emphasized. The aim of the workshop was to build a foundation of knowledge about PROs in practice and to enhance nurses’ ability to use PRO data to guide clinical action, ultimately improving patient outcomes. Case studies were used to guide learning and discussion.

Session 1.3: Workshop – Building Capacity for Quality Improvement in Health Care Settings

The final workshop, “Building Capacity for Quality Improvement in Health Care Settings,” was chaired by Jo Visser, with speakers Joanne Burke-Bajaj, Neil Drimer and Sarah Olver. The session introduced participants to the basics of quality improvement, including understanding the improvement model and how to implement it. Participants learned how to identify problems, root causes and potential solutions, and how to test changes and measure improvement.

Session Close:

The first day of the virtual symposium was a great success. Nurses from all over the world were inspired by the achievements and practical experience of the experts in continuous quality improvement and systems change in cancer nursing.

Virtual Symposium Day 2

Opening Remarks:

Proceedings began with a warm welcome from Suzanne Bishaw, who set the tone for an informative and engaging second day. Suzanne Bishaw acknowledged the importance of the topic and emphasized the need to improve cancer treatment outcomes.

Workshop: Oncology Nurse Advocacy for Age-Friendly Cancer Care

In this workshop, Prof. Mei Krishnasamy addressed the challenges of ageism in cancer care and its negative impact on patient outcomes. She emphasized the need for effective communication with older patients and strategies to prevent elder abuse. The session highlighted the value of co-designing resources with patients and carers to create age-sensitive care.

Symposium: Enhancing Cervical Cancer Screening Equity – A Multilayered Approach

A session led by Prof. Winnie So and Prof. Dorothy Chan discussed strategies to promote equitable access to cervical cancer screening, with a particular focus on underserved communities. They presented topics such as multimedia interventions, the role of community health workers, and decision aids that empower individuals to make informed screening decisions.

Oral Presentation 1: Exploring the Decision-Making Process of Palliative Care among Male Caregivers

Prof. Cindy Wang presented research on the unique challenges faced by male carers in palliative care. Her presentation focused on the emotional and practical hurdles that male carers face in the palliative care decision-making process.

Oral Presentation 2: Early Palliative Care – Integrating an Innovative Nurse-Led Approach in Oncology

Prof. Stephanie Lelond presented a nurse-led model for integrating early palliative care into oncology services to improve patient support and quality of life. Her model demonstrated an innovative approach to improving the accessibility and effectiveness of palliative care through nursing leadership.

Symposium: Models of Patient-Led Survivorship Care

In this session, Makala Castelli shared examples of successful patient-led initiatives in survivorship care, highlighting models that empower survivors to take charge of their ongoing health care needs. She also illustrated how patient-led care can promote autonomy and resilience in survivorship.

Session Close:

The second day of the symposium focused on a global nursing approach to improving cancer care outcomes and provided valuable insights into improving cancer care through patient advocacy, age-sensitive practices, equitable screening initiatives and supportive palliative care models. This part of the study broadened the participants’ horizons and increased their knowledge and skills, which will play a positive role in promoting high-quality care in cancer nursing.

Virtual Symposium Day 3

Opening Remarks:

The third day of the symposium began with a warm welcome from Prof. Dorothy Chan, who set the tone for an informative and engaging day. Acknowledging the importance of the topic, Prof. Chan emphasized the need for a collaborative approach to addressing the burden of patients with advanced disease.

This day of the virtual symposium was chaired by Stavroule Chante and Marisa Durao Portela Lima.

Call for Action: Global Needs for Pediatric Palliative Care

Prof. Julia Downing discussed the definition and importance of pediatric palliative care, highlighting the prevalence of serious illness in children. She addressed the challenges facing the field and shared best practices, case studies and collaborative strategies for improvement. She also provided suggestions for raising awareness and educating others about pediatric palliative care and recommendations for national and international policies to strengthen its implementation.

Symposium: Oncology Nurse Advocacy for Equitable Cancer Care

Prof. Mei Krishnasamy from the University of Melbourne discussed how social determinants of health affect access to care and cancer outcomes, and highlighted cancer nurses’ advocacy for equitable care. This session will have enhanced participants’ understanding of these determinants and introduced the NEAT nursing equity tool for practice.

Symposium: Making the Most of the Contemporary Approaches to Education and Training in Palliative Care

Dr. Heather Richardson emphasized the importance of incorporating innovative, modern methods into palliative care education and training. Participants were thereby equipped with the skills to discover new learning opportunities, understand how technology can transfer knowledge and skills, identify potential partners for education and training efforts, and learn from the successes and challenges faced by palliative care education and training providers.

Symposium: Cancer Prevention Across Europe (PrEvCan), Key Learning Experiences and Impact

Dr. Lena Sharp explored the impact of health literacy, public health campaigns and cancer prevention strategies in various European subgroups. This session emphasized the vital role of cancer nurses in alleviating the burden of cancer and enhancing cancer prevention literacy. Participants gained insights into the importance of effectively communicating cancer prevention information to diverse populations.

Session Close

The third day of the symposium focused on a global nursing approach to cancer prevention and alleviating the burden of patients with advanced illness. It addressed several key topics, including the global need for pediatric palliative care, oncology nurse advocacy for equitable cancer care, effective use of contemporary education and training methods, and cancer prevention across Europe (PrEvCan). We hope that oncology nurses around the world were inspired by these lectures and were empowered to make a greater contribution to reducing the global burden of cancer!

A recording of the symposium is now available for all registered participants. Please access the following link:

1. Direct link: isncc.org/2024-Symposium-On-Demand/ (login required)

2. Website Path: Go to RESOURCES → MY ISNCC → 2024 VIRTUAL SYMPOSIUM ON-DEMAND (login required to see item in menu).

Remarks: This on-demand access is exclusively for registered participants, so feel free to dive back into the content anytime.

Caring for Breast Health, Spreading “Pink Power”: Chinese Nurses in Action - A Report by the Oncology Nursing Committee of the Chinese Nursing Association

Shelli Bourne — Fri, 22 Nov 2024 15:58:52 GMT

October 18 is World Breast Cancer Awareness Day, a globally recognized and highly significant event that is celebrated in diverse ways. The main goal of this day is to raise awareness of breast cancer, a disease that affects millions of women worldwide. Recently, nurses from various medical institutions across China have responded to this initiative by taking actions to promote breast health and facilitate early diagnosis and treatment through education, advocacy and support.

Tianjin Medical University Cancer Institute and Hospital held its 13th Breast Care Theme Event on October 18. The event began with an energetic flash mob performance by medical staff and volunteers on the theme of “Harmony: Born Together in Love.” This lively performance, infused with music and dance, created a warm atmosphere and united its participants in a collective effort to inspire hope and strength in women. In the second part of the program, seven medical and nursing experts from the Breast Cancer Prevention and Research Center gave informative talks on important topics such as breast cancer prevention, treatment options, side-effects of anti-cancer therapy and healthy lifestyle choices. The final segment of the program focused on psychological stress relief, with the theme “Meet the Heart, Walk Toward the Light.” An anti-cancer advocate delivered an inspiring performance that included a solo rendition of “Her Pillow on the Light,” celebrating the beauty of life and sharing a message of love and courage.

In Shandong Province, health professionals at Shandong Cancer Hospital organized a Pink Month health promotion event with the theme “Caring for Breast Health: Cherishing the Women Around You.” The event involved more than 40 breast cancer survivors and their caregivers. Dr Li Yongqing provided advice on breast cancer genetic testing and interpreting the results. Ms. Li, a breast cancer patient, described her experience as follows: “When I learned that the BRCA gene test results were good, I finally felt that a weight had been lifted off my shoulders. We are lucky—our daughter is safe.” Head Nurse Huang Amei and the nursing team gave a presentation on lymphedema prevention and management. Mr Ge, husband of a breast cancer survivor, expressed his gratitude: “We are lucky to have such a dedicated breast care team. My wife received excellent care and her recovery from surgery has been smooth.” The event concluded with a paper rose making activity involving volunteers and breast cancer survivors.

The Nursing Department of Fudan University Affiliated Cancer Hospital held a series of professional academic forums with the theme “Caring with Care and Sharing with Love,” seeking to raise women’s awareness of breast cancer prevention and breast health. This initiative also provided a platform for professional academic exchange among medical staff in breast care and rehabilitation. The hospital organized a course on body management, inviting medical and rehabilitation experts to teach nurses through a combination of theoretical and practical approaches.

In addition, the Nursing Department organized a Breast Reconstruction Nursing Forum to discuss and share knowledge of breast reconstruction and lymphedema, innovatively exploring nursing decisions through situational drama interpretations. The forum featured keynote speeches and sub-forums in which experts from different fields shared their insights and explored new possibilities for breast cancer treatment in the era of precision medicine. This series of academic activities not only enriched nursing staff’s theoretical knowledge but also broadened their clinical practice horizons, as part of a commitment to continuously elevating the academic standards of specialized nursing. The forum received strong support and recognition from colleagues.

In October, diverse efforts were made to raise awareness of breast cancer in major hospitals across the country. Oncology nurses worked with other team members to teach patients and survivors how to look after themselves better and raise awareness of how to prevent breast cancer and diagnose the disease early. It is hoped that these activities will ultimately make a meaningful contribution to cancer control in China.

Nursing as Therapy in Papua New Guinea

Shelli Bourne — Fri, 01 Nov 2024 17:02:37 GMT

Papua New Guinea (PNG) is a low-middle income country (LMIC) of 10.5 million people in the western South Pacific and Australia’s nearest neighbour. Despite increasing cancer incidence, cancer nursing is not recognized as a specialty. Within a resource-limited health system there is limited patient access to scarce cancer treatments, and the majority of patients become palliative. Across the country, however, there are many nurses who use ‘nursing as therapy’, providing care, hope, spiritual and personal interaction as nursing interventions. They often have to overcome ancient traditions and culturett, sorcery, the widespread use of traditional medicines and practices, often limited literacy, and patients’ fears of western medicine.

There had been no cancer nursing education across PNG beyond the undergraduate level. Nurses providing chemotherapy were self-taught. In 2021 we commenced weekly tutorials via ZOOM on cancer nursing to a small group of nurses at Port Moresby General Hospital (POMGEN) in preparation for a new comprehensive cancer centre to include radiation oncology services.

A range of colleagues have become involved with PNG cancer nurses: in 2022 ISNCC provided scholarships to 5 RNs to attend the virtual conference, supported by Suzanne Bishaw: this was their first exposure to the global cancer nursing community, and it ignited a literal ‘fire’ to become engaged. All five RNs wrote a blog on their experience for the ISNCC Newsletter. In June 2023 the Cancer Nurses Society of Australia (CNSA) provided scholarships for 5 RNs to attend the winter congress in Adelaide, followed by 4 RNs travelling to Canberra in the Australian Capital Territory (ACT) to spend one month at Canberra Hospital, supported by the ACT Nursing Directorate and Canberra Hospital. CNSA also supported 2 RNs to attend the Winter Congress in 2024. In 2023 the Papua New Guinea Oncology Nurses Association (PaNGONA) was created by RN Peter Fore to bring together nurses across the country for the first time with the support of ISNCC. In 2023 the International Society of Paediatric Oncology (SIOP) provided a week-long workshop on paediatric oncology to nurses across PNG. Since then, SIOP nurses, mainly CNC Jayne Harrison, deliver a monthly session in the tutorials; they also provided a second workshop in 2024.

In September 2024 I met with the Deans of the University of Papua New Guinea (UPNG) Medical School about the introduction of a post-graduate diploma in oncology nursing in 2025. A further meeting with key stakeholders, sponsored by Merilyn Nicholas, Director of Nursing (DON) POMGEN, created a core group I lead in writing the curriculum with Jayne Harrison (SIOP) and Ben Felmingham (SIOP Pharmacist), supported by Andrew Dimech, DON, Peter MacCallum Institute, Melbourne Australia. This will provide career pathways in clinical expertise, management, education and research. The creation of Nurse Navigator roles across the country within a ‘hub and spoke’ model has the prospect of improving cancer care across PNG. Oncology nursing is now a specialty in PNG!

The next focus is to present a session highlighting the remarkable work of 5 PNG cancer nurses at the next ISNCC/CNSA congress in Adelaide in 2025.

Author: Pauline Rose RN, BN, M(Onc),PhD, Remote volunteer Port Moresby General Hospital, Papua New Guinea

Email: prose@cheerful.com

ISNCC/ITONF Webinar on Mesothelioma: Insights, Challenges, and Support

Shelli Bourne — Fri, 01 Nov 2024 16:43:49 GMT

Unleash the Power of Knowledge at the Global Knowledge Exchange Webinar! The ISNCC co-hosted this Global Knowledge Exchange webinar with the International Thoracic Oncology Nursing Forum (ITONF): A Global Nursing Focus to the Care of the Person with Mesothelioma on 25 September 2024 brought together experts from around the world to discuss mesothelioma, a rare and aggressive form of cancer. The webinar aimed to give participants the latest knowledge and insights. Eighty-five nurses from around the world attended the meeting.

Opening Remarks

The event began with a warm welcome from Caitlin Broderick, ITONF Co-Chair, who set the tone for an informative and engaging session. Ms. Broderick acknowledged the importance of the topic and emphasised the need for a collaborative approach to addressing the challenges faced by those affected by mesothelioma.

Understanding a Diagnosis of Mesothelioma

Kirsten Mooney (Australia) presented an erudite discourse on the diagnosis of mesothelioma. She provided an overview of the disease, its symptoms, and the diagnostic process, emphasising the importance of early detection and accurate diagnosis in improving treatment outcomes.

Treatment Dilemmas

Suzanne Walker (USA) proceeded to elucidate the intricacies of managing mesothelioma. The lecture, entitled "Treatment Dilemmas in Mesothelioma", addressed the array of available treatment modalities, encompassing surgical, chemotherapeutic, radiotherapeutic and immunotherapeutic approaches, in addition to other cutting-edge therapeutic modalities emerging from the most recent clinical trials and guideline updates.

Family and Care Burden

The webinar proceeded to examine the emotional and practical burdens borne by families and caregivers of mesothelioma patients. Sarah A. Hargreaves (United Kingdom) investigated the impact of mesothelioma on families and elucidated a number of coping strategies for providing support.

Sarah Yasuko Nagamatsu (Japan) offered insights on this aspect of the disease. It was emphasised that it is crucial to provide these caregivers with both emotional support and practical assistance, as well as to recognise and address the specific challenges they encounter.

Managing Expectations and Understanding Pathways for Compensation

Leah Taylor (United Kingdom), presented a discourse on the subject of compensation for victims of mesothelioma. She provided an overview of the various avenues for pursuing compensation, including legal and government-sponsored programs. Furthermore, she addressed some of the barriers to compensation, including those posed by institutions, patients, and healthcare professionals. Ms. Taylor furnished the participants with a more comprehensive grasp of the available options and the practicalities of the compensation process.

Session Close

The webinar concluded with closing remarks from Dorothy Chan (ISNCC Board Member, Knowledge Development & Dissemination Committee), who thanked the presenters, sponsor, participants, and organizers for their contributions to the event. Dorothy Chan saidthat each speaker’s sharing was invaluable and the webinar had been useful in understanding and improving care for people with mesothelioma.

The recorded webinar is now available!

https://isncc.org/GKE

Academic Express: Understanding Workforce Challenges for Cancer Nurses

Shelli Bourne — Fri, 01 Nov 2024 16:02:45 GMT

We are launching the Academic Express section to promote academic exchanges and the development of oncology nursing. Each issue will feature the latest research findings from ISNCC members.

In this issue, we are honoured to invite Dr. Natalie Bradford from the Centre for Cancer and Palliative Care, Queensland University of Technology to share her latest research “Cancer Nurses’ Voices and Recommendations to Address Workforce Challenges: A Qualitative Analysis” published in Seminars in Oncology Nursing.

As cancer nurses, our own well-being and job satisfaction are not always heard, yet both are essential to maintaining high-quality patient care. While many cancer nurses are dedicated and resilient, there are increasing challenges to providing safe, equitable care to patients. Understanding workplace issues are key to making improvements, This research aimed to give Australian cancer nurses the platform to share their experiences and propose solutions to enhance both their professional fulfilment and patient outcomes.

What We Discovered

In our study, we analysed the survey responses of 601 cancer nurses to understand the balance between their sense of fulfilment and the numerous obstacles they face in the workplace. The study revealed two main themes.

First, nurses consistently reported finding great personal and professional fulfilment in their roles, even while grappling with overwhelming workloads, burnout, and limited opportunities for career progression. Many felt undervalued, which, coupled with these pressures, added to emotional strain.

Second, the nurses identified solutions to the workforce challenges they encounter, including the need for improved nurse-to-patient ratios, structured career development programs, dedicated time for learning, and better mentorship. Despite these solutions being voiced at the grassroots level, nurses expressed frustration at perceived organisational inertia and resistance to change.

Implications for Cancer Care

The findings of this study carry important implications for cancer nursing globally. Tangible solutions to address workforce challenges include: 1) enhance educational and career and opportunities, 2) invest in the workforce, 3) address compassion fatigue, and 4) strengthen nursing leadership, management and support. To operationalize these solutions collaboration between healthcare institutions, educational providers, professional organizations and the cancer nursing workforce is imperative. Providing nurses with opportunities for professional growth and fostering interdisciplinary teamwork will contribute to a more sustainable workforce. Additionally, ongoing research to understand the changing needs of the cancer nurse would help inform future education agendas and development opportunities, as well as policy reform in the workplace. Addressing these workforce challenges is not only a matter of nurse well-being but also crucial to improving patient care. It is clear that by listening to and acting on the voices of cancer nurses, we can create an environment where both nurses and their patients thrive.

Through this research, we hope to inspire further dialogue and action within the field, ensuring that cancer nurses feel supported, valued, and empowered to provide the best care possible.

Reference:

Bradford, N., Kirk, D., Taylor, K., Williams, N., McErlean, G., Cook, O., ... & Moore, E. (2024, October). Cancer Nurses’ Voices and Recommendations to Address Workforce Challenges: A Qualitative Analysis. In Seminars in Oncology Nursing (Vol. 40, No. 5, p. 151722). WB Saunders. Cancer Nurses’ Voices and Recommendations to Address Workforce Challenges: A Qualitative Analysis - ScienceDirect

Nurturing the Art of Caring: Let’s Take Action on Breast Cancer Awareness Day

Shelli Bourne — Wed, 30 Oct 2024 20:47:57 GMT

October 18 is World Breast Cancer Awareness Day, a globally recognized and highly significant event celebrated in diverse ways. The main goal of this day is to raise awareness of breast cancer, a disease that affects millions of women worldwide. Awareness can be raised by educating the public about risk factors, symptoms and the importance of screening and early detection. World Breast Cancer Awareness Day also provides a platform for breast cancer survivors, their families and advocates to share their experiences, raise funds for research and promote support networks. With this in mind, the ISNCC urges oncology nurses worldwide to take action to promote breast health and facilitate early diagnosis and treatment through education, advocacy and support.

To promote the contributions of nurses to cancer care and control worldwide, we encourage all oncology nurses to submit a short report (no longer than 500 words) about your Breast Cancer Awareness Day activities, such as public education campaigns, Wear it Pink initiatives, fundraising events and media collaborations, along with photos. Outstanding activities will be featured on the ISNCC’s blog and social media accounts to highlight the role and value of nurses in cancer prevention and treatment. Please submit your report and activity photos to the following email address: info@isncc.org (Subject: Breast Cancer Awareness Day activities). The deadline for submissions is October 31, 2024.

Let's make a difference on Breast Cancer Awareness Day! We look forward to seeing your amazing work in different countries and regions across the globe!

Nurturing the Art of Caring: An Innovative Patent for a Single-Use Safety Subcutaneous Injection Kit

Ariesta Milanti — Fri, 27 Sep 2024 13:28:09 GMT

Nurturing the Art of Caring: Unveiling Oncology Nursing Innovation with Specialized Expertise. We are excited to announce a significant advancement in oncology nursing: the clinical patent for "A Single-Use Safety Subcutaneous Injection Kit," developed by Miaoning You RN,MSN from Peking University Cancer Hospital, China.

First Inventor: Miaoning You, RN,MSN

Ms. You has worked in the field of cancer care for over 20 years. Now she is the head nurse of the Breast Oncology Department of Peking University Cancer Hospital. She also serves as vice chairman of the Chinese Aging Well Association’s Committee on Chronic Edema and Wound Treatment and Rehabilitation, and the Lymphedema Subcommittee under the Chinese Microcirculation Society. With rich experience in cancer care, she invented a series of nursing patents these year.which have brought great benefits to the improvement of nursing quality and efficiency

Subcutaneous injection is a common route of administration. Traditionally, the injections dose doesn’t exceed 2ml that can be done with a 2ml syringe,within 2 minutes. However, in recent years, the subcutaneous formulation of antitumor drugs has gradually increased, which brings new challenges to nursing..Some subcutaneous drugs delivery requires larger doses and longer injection times, which can lead to fatigue for nursing staff and discomfort for patients during these extended procedures with traditional syringes.Moreover, the absence of safety features increases the risk of needlestick injuries.

To combat these challenges, Ms. You's team has introduced the "Safety Subcutaneous Injection Kit." This innovative kit includes a specialized subcutaneous injection needle with a safety protection device, along with an extension tube connecting the needle to the syringe. This design enhances usability for nurses and significantly reduces the risk of needlestick injuries. The kit further includes cotton swabs for disinfection, an infusion patch, a sterile gloves pair, and a medical waste bag, streamlining nursing operations.

Sample Diagram of the 'Single-Use Safety Subcutaneous Injection Kit' After Patent Conversion (Patent Number:ZL202221209632.5)

On July 8, 2024, Ms. You's team successfully signed a technology transfer contract with Beijing JiaDeZhongHe Technology Co., Ltd. for their innovative injection kit, achieving a conversion amount of 3 million RMB. This remarkable invention not only showcases the advancements in nursing practice but also exemplifies the vital role of innovation in enhancing patient care and safety.

Stay tuned for more updates on innovations that are transforming the field of oncology nursing!

Call for Expression of Interest

Shelli Bourne — Mon, 09 Sep 2024 14:54:07 GMT

CNSA is excited to partner with ISNCC to deliver a joint Congress in Adelaide next year! Planning is well underway, and our theme of Global Voices, Local Actions: From Inspiration to Implementation will provide a fantastic array of international and national initiatives to inspire change in practice and showcase nurse-developed, evidence-based models of care. With that in mind, we are delighted to open Expressions of Interest for both our Pre-Congress Symposiums and Concurrent Sessions. If you have ideas that you’d like to present, we’d love to hear from you!

Key Dates for CNSA ICCN 2025 Congress
Abstracts Submissions: Open Early September, Close 1 November
Registrations Open: Early November

Pre-Congress Symposiums will take place on Wednesday, June 18, 2025, from 1:00 PM to 5:00 PM, with a 15-minute afternoon tea break. These symposiums offer specialist groups a chance to deliver focused professional development aligned with the Congress theme and CNSA’s strategic direction. We are providing six half-day symposiums, encouraging interactive and practical workshop formats. Organizers should plan for approximately 3.5 hours of content.

Concurrent Sessions are scheduled from Thursday, June 19, to Saturday, June 21, 2025, with each session running for 1.5 hours. These sessions feature specialized, focused presentations that occur simultaneously throughout the Congress. They should be relevant to delegates and align with the Congress themes, typically following a theatre-style format with presentations and Q&A.

The deadline to submit your Expression of Interest is Monday 30th September, 2024. We will get back to you in early October regarding your submission.

For more information and submissions, visit the CNSA website.

Save the Date for ICCN2025 in Adelaide!

Shelli Bourne — Fri, 06 Sep 2024 19:11:32 GMT

We are thrilled to announce the International Conference on Cancer Nursing (ICCN2025), taking place from June 18-21, 2025, in beautiful Adelaide, Australia. This year's conference theme, Global Voices, Local Actions: from Inspiration to Implementation, emphasizes the vital role that cancer nurses play in transforming ideas into impactful actions worldwide.

Event Details:
DATES: June 18-21, 2025
LOCATION: Adelaide Convention Centre, Australia
THEME: Global Voices, Local Actions: from inspiration to Implementation

ICCN2025, co-hosted by the International Society of Nurses in Cancer Care (ISNCC)and the Cancer Nurses Society of Australia (CNSA), is set to be a remarkable event. It will bring together leading experts, practitioners, and researchers from across the globe to share insights, exchange ideas, and discuss innovative approaches to cancer care and nursing.

Stay tuned for upcoming announcements about registration, keynote speakers, and program highlights. We look forward to welcoming you to Adelaide for what promises to be an enriching and collaborative experience.

Mark your calendars and join us for this extraordinary event. Together, we can drive progress in cancer nursing, turning inspiration into meaningful action.

About The International Conference on Cancer Nursing (ICCN)

The International Conference on Cancer Nursing (ICCN) hosted by ISNCC is the longest running international conference for our profession and offers a unique opportunity to meet with international cancer nursing leaders from around the world, in one place, at one time.

This meeting focuses on all aspects of oncology nursing and our ability to impact patients, families, communities and nations through clinical practice, education, health policy, leadership and research. Through scholarly discourse, networking and collaboration among oncology nursing educators, practitioners, researchers, and leaders from across the globe, ICCN showcases the remarkable work and dedication of nurses involved in cancer care.

Announcement: David Makumi Appointed to ISNCC Board of Directors

Shelli Bourne — Wed, 04 Sep 2024 20:16:47 GMT

We are pleased to announce that David Makumi-Kinyanjui has been appointed to the ISNCC Board of Directors. David brings over 15 years of extensive experience in oncology nursing and cancer care advocacy, making him a valuable addition to our leadership team.

As the CEO of Faraja Cancer Support Trust in Kenya, David provides strategic leadership to a multidisciplinary team dedicated to offering free complementary services to both adult and pediatric cancer patients.

David's impressive career includes numerous leadership roles, such as serving on the Board of Trustees for the National Cancer Institute of Kenya and the World Health Organization’s Expert Technical Advisory Group on Cervical Cancer Eradication. He has also been a Goodwill Ambassador for the National Cancer Institute of Kenya, contributing to its mission both locally and internationally.

David's experience and leadership have been instrumental in advancing the oncology nursing field, particularly in Africa, and his appointment to the ISNCC Board of Directors is a testament to his dedication and impact. We are confident that his strategic vision and advocacy will greatly benefit our organization and the global oncology community.

Please join us in congratulating David Makumi-Kinyanjui on his new role!

2024 Election Results and Welcome to New Directors

Fri, 19 Jul 2024 10:54:52 GMT

On behalf of the Nominations and Awards Committee, it is my great pleasure to announce the outcomes of the election for two Executive and three Director Portfolio positions on the ISNCC Board of Directors.

President Elect: Lena Sharp, Head of Department, Regional Cancer Center Stockholm-Gotland, Sweden

Lena Sharp, RN, PhD, is the Head of Department at The Regional Cancer Centre, Stockholm-Gotland, in Sweden. She is the former President of EONS, former chair of EONS advocacy working group and the project leader for the PrEvCan initiative. Lena has been a cancer nurse since 1985. She has long experience in clinical cancer nursing, leadership, teaching and research.

Prior to taking up her post at the Regional Cancer Centre, Lena Sharp was the chief nursing officer and patient safety coordinator at the Department of Oncology at Karolinska University Hospital. Her main focus areas in cancer nursing research are patient safety, communication, leadership, prevention, inequalities and cancer care organisation. She has experience in leading cancer prevention work, regionally, nationally and internationally, with particular focus on cancer related inequalities. Lena and her team received the 1st Health care equality award in Stockholm in 2018. In 2021 Lena was awarded The Robert Tiffany Award in cancer nursing and EONS Life-time Achievement Award.

Secretary / Treasurer: Catherine Johnson, Medical Oncology Clinical Nurse Consultant, Calvary Mater Newcastle, NSW Australia

Catherine Johnson is a clinical nurse and her career in cancer care spans 34 years; specialising in oncology and clinical trials. Catherine is the Clinical Nurse Consultant in Medical Oncology at Calvary Mater Newcastle; where she provides expert clinical advice and consultancy to patients, carers and other health care professionals within cancer services. Catherine is a past board member of the Cancer Nurses Society of Australia (CNSA), the International Society of Nurses in Cancer Care (ISNCC) and the Editorial Board for the Australian Journal of Cancer Nursing. Catherine has a special interest in cancer care in low and middle income countries and has served as the project lead for the ISNCC Cervical and Breast Cancer Prevention and Screening Train the Trainer Project in Latin America and the Breast Aware: A train the trainer programme for nurses in Africa.

She has a strong interest in equity of access to efficient cancer services for patients with cancer. Other key interests include the health and wellbeing of Aboriginal and Torres Strait Islander peoples, supportive care and quality of life issues in cancer care and ensuring nurses and staff are adequately equipped to deliver quality care to meet the needs of their patients. She is also involved with a number of oncology projects on symptom management and supportive care as both principal investigator and co-investigator.

Communications Portfolio: Yuhan Lu, President of Oncology Nursing Committee of Chinese Nursing Association; Director of Nursing Department of Peking University Cancer Hospital

Ms. Yuhan LU, Associate Professor of Nursing, Director of Nursing Dept.,Peking University Cancer Hospital. She has been dedicated to cancer nursing for nearly 30 years and has rich experience in the field of cancer nursing and nursing management. She is also a Board Member of the Asian Oncology Nursing Society, President of Oncology Nursing Committee of the Chinese Nursing Association and the Beijing Nursing Association, Vice Chairperson of Oncology Nursing Committee of the China Anti-Cancer Association. She also serves as an editorial board member and reviewer for many nursing journals. Over the past years, she has made outstanding contributions to promoting the communication and development of oncology nursing on national level in China.

Conference Management Portfolio: Suzanne Bishaw, Lecturer at Curtin University - Unit Coordinator for Undergraduate nursing units located in Perth and Mauritius. Lecturer Post-graduate nursing education in Perth and Singapore.

Suzanne Bishaw is a dedicated educator and leader in nursing education, currently serving as a Lecturer at Curtin University, where she coordinates undergraduate nursing units in Perth and Mauritius and lectures on post-graduate nursing education in Perth and Singapore.

In her role as Chair of the Conference Management Portfolio, Suzanne has successfully led the organization and delivery of both face-to-face and online international conferences in 2021, 2022, and 2023. Her ability to navigate the unique challenges of each year, coupled with her commitment to continuous learning and improvement, underscores her capability to lead a diverse team of volunteers globally. Suzanne's dedication and expertise make her an invaluable asset to the ISNCC Board of Directors.

Policy & Advocacy Portfolio: Julia Downing, CEO, International Children's Palliative Care Network (ICPCN); Professor of Palllative Care, Makarere University, Uganda

Julia Downing is a distinguished leader in cancer and palliative care, with over 30 years of dedicated service to the International Society of Nurses in Cancer Care (ISNCC). She began her journey by presenting her first paper on the role of nurses in radiotherapy at an ISNCC conference and has since been an active participant. Julia's notable achievements include winning the ISNCC Robert Tiffany Lectureship Award in 2014 for her impactful work in Uganda and sub-Saharan Africa.

In her roles within ISNCC, including Chair of the Policy and Advocacy Committee, Julia has significantly influenced the development of key position statements and strategic policy initiatives. Her extensive international policy experience includes contributions to the World Health Assembly resolutions on palliative and cancer care and co-authoring the Lancet Commission report on palliative care and pain relief. Julia’s strong global network and collaborative approach make her an essential link in promoting ISNCC’s goals and fostering international partnerships.

The successful candidates will take up their board positions for a four-year term starting this month. They join other continuing members of the Board, including:

Winnie So, President, China
Lisa Kennedy-Sheldon, Membership Portfolio Director, United States
Dorothy Chan, Knowledge Development & Dissemination Portfolio Director, China
Josephine Visser, Corporate & Philanthropic Portfolio Director, United States

ISNCC wishes to thank and recognize outgoing members Patsy Yates, Linda Watson and Yongyi Chen for their leadership and outstanding contributions to the society over the past four years or more.

On behalf of the Board of Directors, congratulations to all new and continuing board members and we look forward to bringing news and exciting updates in future.

Sharing Of Experiences From ICCN 2023 In Glasgow

Thu, 15 Feb 2024 22:13:17 GMT

Author: Agnes Nonyem Anarado (PhD Nurs; RN, RM, RNE, FWAPCNM, MEMBER, AORTIC), Prof of Nursing (Rtd) Department of Nursing Sciences, University of Nigeria Nsukka, Enugu Campus

The International Society of Nurses in Cancer Care (ISNCC) was established in 1984 with a vision to lead the global nursing community in cancer control and a mission to maximize the influence of nursing to reduce the global burden of cancer. To actualize her vision and achieve her mission to foster the development of cancer nursing internationally, ISNCC established a donor sponsored travel grant scholarship programme. This Travel Grant scholarship enabled me attend the 2023 ICCN conference in Glasgow UK.

What/Who made the conference attendance possible? ”it’s Divine favour with humans as instruments”. First, the ISNCC Executive Board decision that the 2023 ICCN) conference shall be physical after three years virtual conferences. The only action I initiated was a joint abstract written and submitted with my supervisee for oral presentation at the conference. The abstract was accepted which qualifies us to apply for a travel grant. However, my co-author declined to be the abstract presenter and/or apply for the travel grant as she was not disposed to attend. I accepted both, and was awarded the travel grant scholarship. My perceived pencils in God’s hand that effected required actions were: ISNCC executive, abstract co-author, abstract shortlisting and Travel Grant selection committees’, the Travel Grant donor and the International conference Secretariat (ICS) that executed the Grant plan. The scholarship enabled my physical presence/presentation at this conference the accepted co-authored abstract entitled "Nurses Experiences of Compassion Fatigue in a Comprehensive Cancer Centre". I met face-to-face the ISNCC project team members I have been working with virtually, on "Breast Aware: A train the trainer programme for nurses in Africa", led by Catherine Johnson. I was also privileged to present at the conference the successful phase one report of the project with her. I was also privileged to witness the presentation at the conference another collaborative project on development of Africa Oncology Nursing Competencies, involving ISNCC and other national/international nursing associations’ members under AORTIC –Nursing Special Interest Group (SIG) of which I am a member. These Africa focused projects attest ISNCC mission to maximize the influence of nursing to reduce the global cancer burden in Africa.

I also appreciate the wealth of knowledge/experience gained from attending the Travel Grant Awardees’ invited meetings, highly educative Scientific/plenary/break-out sessions and the opening/closing ceremonies social events. The large number of young attendees especially from Asian countries and their presentations highly impressed me.

I thank the ISNCC Executive, Board of Directors, Conference Organizers, Sponsors, especially my Travel Grant sponsor, Attendees and all who assisted in driving forward the oncology nursing leadership worldwide in line with ISNCC vision. I enjoin fellow awardees to shout a loud ‘THANK YOU” The conference activities and travel couldn’t have been that exciting/stress-free without us all.

The way forward: I will:

offer the required nursing leadership support in mentorship, practice, education and research to drive the Breast Aware: TOT in Africa
lobby Boards of Nursing for inclusion of Breast Aware as a mandatory Continuing Professional Development (CPD) programme for nurses.

Thank you

Breast Aware: A Train the Trainer Program for Nurses in Africa

Fri, 08 Dec 2023 16:18:58 GMT

Breast Aware: A Train the Trainer Program for Nurses in Africa

The ISNCC Breast Aware Train-the-Trainer program for nurses in Africa was shortlisted for the Vanessa Moss prize at the Global Cancer Control: Bridging boundaries conference at the Royal College of Physicians London UK in November. This was presented by Vera Samba, project nurse representative from Cameroon.

The ISNCC Breast Aware project aims to design and deliver training on early diagnosis of breast cancer including health awareness messages and clinical breast examinations in Cameroon, Ghana, Nigeria, Tanzania and Uganda. These aims are being accomplished in the following ways:

Holding focus groups in each country to develop content that addresses the specific needs, barriers and available resources for their country.
Facilitate design changes needed for each country to ensure materials are culturally sensitive.
Develop high quality educational materials for training other nurses including a trainer’s guide.
Provide mentorship to nurse leads in each country to deliver training events.

This project seeks to contribute directly to the development of nurse leaders and strengthen their capacity to improve breast cancer control across all facets of the healthcare system. Participants of the program will use their skills, knowledge and acquired resources to train other nurses in their local communities to improve understanding of prevention, early detection, screening, and supportive care for women at risk of breast cancer in resource poor countries.

Integrative Nursing creates a new chapter, focusing on empowerment to create a new future

Ariesta Milanti — Mon, 04 Dec 2023 12:02:45 GMT

On November 17, 2023, the CACA Integrated Nursing Summit, hosted by the Chinese Anti-Cancer Association and organized by Tianjin Medical University Cancer Hospital, Tianjin Anti-Cancer Association, and China Institute for Integrated Medicine Development Strategy, was held in Tianjin, China. The theme of this conference was "Innovation Leadership, Integration for Mutual Benefit".

In 2012, Academician Fan Daiming, the Chairman of the Chinese Anti-Cancer Association, first proposed the concept of integrated medicine, marking the beginning of the era of integrated medicine in cancer prevention and treatment. In 2023, the Chinese Anti-Cancer Association established the Integrated Nursing Professional Committee. Academician Fan Daiming, the Chairman of the Chinese Anti-Cancer Association, was appointed as the Chair of the Integrated Nursing Committee, and Director Qiang Wanmin from the Nursing Department of Tianjin Medical University Cancer Hospital was appointed as the Executive Chair. During this nursing summit, Professor Qiang Wanmin, guided by the concept of integrated medicine, innovatively proposed the concept and connotation of integrated nursing. Director Qiang pointed out that integrated nursing is supported by precision nursing and evidence-based nursing as scientific and technological foundations. It is an extension and expansion of holistic nursing. "Integration" is not simply about stacking resources together, but about appropriately matching them. It requires both a holistic perspective and artistic skill. By leveraging digital and intelligent technologies, integrating multidisciplinary knowledge, techniques, and resources, it aims to provide optimized and personalized integrated care for cancer patients, achieve maximum benefits for patients, and attain the best rehabilitation outcomes.

Professor Patsy, past president of the International Society of Nurses in Cancer Care and executive dean of Queensland University of Technology Centre for Healthcare Transformation, shared a special report on "Advances in Symptom Management". She emphasized that the core strategies of symptom management lie in integrating patient-reported outcomes, applying genomics to cancer symptom management, designing personalized symptom management plans, and implementing chronic disease management service models.

Professor Winnie K.W. So, a professor at the Nethersole School of Nursing, The Chinese University of Hong Kong, a fellow of the American Academy of Nursing, and currently the President of the International Society of Nurses in Cancer Care (ISNCC), delivered a keynote presentation titled "Call to action: build and strengthen global oncology nursing leadership". The presentation emphasized the need for effective leadership in oncology nursing to address the current global burden of cancer, shortage of nursing personnel, and challenges posed by the digital health era. Professor Winnie launched ten initiatives for oncology nursing leadership, aiming to collaborate and achieve mutual success in the future.

New Guideline Reviews Evidence Documenting the Benefits of Integrative Interventions for Patients with Cancer

Ariesta Milanti — Thu, 23 Nov 2023 00:22:17 GMT

Karen Kane McDonnell, PhD, RN, Associate Professor*; Amanda Bennett, MSN, RN, Vera Bratnichenko, MSN, RN, Fattona Umari, BA, BSN, RN, PhD Students; and Ella Weinkle, MSN, RN, Research Associate

Cancer Survivorship Research Center, College of Nursing, University of South Carolina, Columbia, SC 29208, United States

*Corresponding author: Karenkm@mailbox.sc.edu

A lack of management of anxiety and depression are associated with diminished quality of life and increased mortality. Both symptoms are underrecognized and undertreated.1

Integrative oncology is a growing field of cancer care. It is a patient-centered, evidence-based field of supportive cancer care that utilizes integrative therapies such as mind-body practices, acupuncture, massage, music therapy, nutrition, and exercise in collaboration with conventional cancer treatments. Patient interest and utilization has been growing in popularity over several decades. Clinical research has shown the benefits of some of these approaches to improving symptom management and quality of life. The availability of these integrative oncology programs at cancer centers and in communities is also growing, though it is still highly variable from location to location along with program structure and implementation.1

A joint effort between the American Society of Clinical Oncology (ASCO) and the Society for Integrative Oncology (SIO) reviewed the evidence and made recommendations about therapies targeting adults with cancer experiencing symptoms of anxiety and/or depression.1,2 The recommendations were developed based on a comprehensive review and analyses of the research literature.2 The literature search from 1990 to 2023 identified 110 relevant studies (30 systematic reviews and 80 randomized control trials).2 Most importantly, these new recommendations can guide clinicians as to which interventions will be most effective in helping their patients.

The following four questions guided the review:
1. What integrative therapies are recommended for managing symptoms of anxiety experienced after diagnosis or during active treatment in adults with cancer?
2. What integrative therapies are recommended for managing symptoms of anxiety experienced post-treatment in adults with cancer?
3. What integrative therapies are recommended for managing symptoms of depression experienced after diagnosis or during active treatment in adults with cancer?
4. What integrative therapies are recommended for managing symptoms of depression experienced post-treatment in adults with cancer?2
The guideline development process was detailed. An international, multidisciplinary, 18-person expert panel, which included a patient representative, and two doctorly-prepared nurses were responsible for providing critical review and finalizing the guideline. BRIDGE-Wiz software, the GuideLines into Decision Support (GLIDES) methodology, the Cochrane risk-of-bias tool, and the AMSTAR 2 instrument were used to measure the quality of the evidence (rated as High, Intermediate, Low, or Insufficient) and the strength of a recommendation (Strong, Moderate, or Weak).3-5

Twenty-one recommendations regarding therapies are included in the guideline. The following four recommendations were the only ones rated as Strong:
1. Mindfulness-based interventions (MBIs) should be offered to people with cancer to improve anxiety during active treatment.
2. MBIs should be offered to people with cancer to improve anxiety post-treatment.
3. MBIs should be offered to people with cancer to improve depression during active treatment.
4. MBIs should be offered to people with cancer to improve depression post-treatment.

Even though the review of MBIs provided the strongest evidence, other types of interventions provided sufficient evidence to inform the recommendations. Those interventions included aroma therapy, acupuncture, expressive writing, hypnosis, music therapy and music-based interventions, reflexology, relaxation techniques, acupuncture, tai chi, qigong, and yoga.2

Other interventions provided inconclusive evidence for informing recommendations, revealing many gaps in the existing evidence base and demonstrating the need for more research. Studies testing acupressure, dance and movement therapy, dietary supplements, healing touch, therapeutic listening, laughter therapy, light therapy, massage, natural products, nutritional interventions, and psilocybin-assisted therapy were included in this category.2

Survivors with cancer use integrative (sometimes referred to as complementary) therapies to help manage side effects and symptoms.

Guideline Implementation

Guidelines are developed for implementation across health-care settings around the world. However, many barriers can slow dissemination. A team approach—in which clinicians partner with expert mindfulness practitioners and translational researchers in their respective settings—may improve the chances of successful implementation.

Due to the evidence base gaps (i.e., not enough studies conducted that could be considered in the review), the expert panel was not able to make recommendations for many supportive care modalities. The panel specifically recommended that more research be conducted with populations other than women with breast cancer, in contexts other than metastatic disease, and among people from diverse backgrounds.

Read the full joint SIO-ASCO Clinical Practice Guideline for Integrative Oncology Care of Anxiety and Depression in Adults with Cancer at either link below:

SIO website: https://integrativeonc.org/practice-guidelines/guidelines

ASCO website:

www.asco.org/survivorship-guidelines

References

1. Semeniuk, G., Bahadini, B., Ahn, E., Zain, J., Cheng, J., Govindarajan, A., Rose, J., & Lee, R. T. (2023). Integrative oncology and the clinical care network: Challenges and opportunities. Journal of Clinical Medicine, 12(12), 3946. https://doi.org/10.3390/jcm12123946
2. Carlson, L. E., Ismaila, N., Addington, E. L., Asher, G. N., Atreya, C., Balneaves, L. G., Bradt, J., Fuller-Shavel, N., Goodman, J., Hoffman, C. J., Huston, A., Mehta, A., Paller, C. J., Richardson, K., Seely, D., Siwik, C. J., Temel, J. S., & Rowland, J. H. (2023). Integrative oncology care of symptoms of anxiety and depression in adults with cancer: Society for Integrative Oncology–ASCO Guideline. Journal of Clinical Oncology, 41(28), 4562–4591. https://doi.org/10.1200/JCO.23.00857
3. Shiffman, R. N., Michel, G., Rosenfeld, R. M., & Davidson, C. (2012). Building better guidelines with BRIDGE-Wiz: Development and evaluation of a software assistant to promote clarity, transparency, and implementability. Journal of the American Medical Informatics Association, 19(1), 94–101. https://doi.org/10.1136/amiajnl-2011-000172
4. Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savović, J., Schulz, K. F., Weeks, L., & Sterne, J. A. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343, d5928. http://doi.org/10.1136/bmj.d5928
5. Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Moher, D., Tugwell, P., Welch, V., Kristjansson, E., & Henry, D. A. (2017). AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 358, j4008. http://dx.doi.org/10.1136/bmj.j4008

Disclosure: Karen Kane McDonnell is supported by the American Cancer Society under award number MRSG-17-152-01. The content is solely the responsibility of the authors and does not represent the official views of the American Cancer Society.

Book Donation by the Chinese Palliative Care Committee at ICCN 2023

Ariesta Milanti — Wed, 08 Nov 2023 09:23:37 GMT

From September 29 to October 2, 2023, the International Conference on Cancer Nursing (ICCN2023) was held in Glasgow for four days. The theme of the conference was "Building Global Excellence in Nursing, Achieving Excellence in Cancer Care," and it was divided into four main themes and five sub-forums. Leading cancer care experts from the UK, USA, Australia, China, Japan, South Korea, Singapore, and other countries in Africa gathered to discuss the latest developments in cancer care.

During the conference, the Palliative Care Committee of the Chinese Nursing Association and the Palliative Care Committee of the Chinese Anti-Cancer Association donated more than 30 books in Chinese and English, including "Palliative Care: A Technical Guide for the Integrated Diagnosis and Treatment of Cancer in China." These donation provided strong support for and promoted the development of global palliative care.

Through this international Cancer Nursing Conference, the influence of the Palliative Care Committee of the Chinese Nursing Association has been further enhanced. We expect that palliative scholars from around the world will actively participate in the practice and research of palliative care, contributing to the further development of palliative care in our country.

REPORT ON THE INTERNATIONAL CANCER CARE NURSING CONFERENCE 29th September - 2nd October 2023, IN GLASGOW UK

Ariesta Milanti — Tue, 07 Nov 2023 01:54:09 GMT

by: Roselyne Anyango Okumu

ISNCC Travel grant scholarship recipient (2023)

President - Oncology Nurses Chapter- Kenya

The International Society of Nurses in Cancer Care (ISNCC) was founded in 1984 with a vision to lead global nursing communities in cancer control. ISNCC works towards improving the health and well-being of people at risk of living with cancer through leadership development, supporting the development of cancer nurses around the world, and promoting nurses' role in improving cancer care delivery. The Executive committee included Prof Winnie So- President, Patsy Yates -- Past president, and Linda Watson - Secretary/Treasurer.

The ISNCC Nominations and Awards Committee granted me a full travel scholarship to participate in the International Conference on Cancer Nursing 2023 (ICCN 2023) in Glasgow, UK, 29 September– 2 October 2023. The scholarship program was established to further the mission and vision of the ISNCC to foster the development of cancer nursing internationally. The planning process was smooth air travel and accommodation organized by the ISNCC secretariat, my stay in Glasgow was very interesting. I enjoyed the sumptuous dinner themed on Scottish culture and the dance.

The experience at ICCN was unmatched as I followed the proceedings, I learned a lot from the research, best practices, and experiences of nurses across the globe. It was also exciting to learn about progress made in nursing education across the globe as well as to identify gaps and explore possibilities of continuous improvement in cancer care. Indeed, these aligned very well with the conference theme of Building Global Nursing Excellence for Tomorrow’s Cancer Realities. Additionally, the networking with colleagues was very exciting accompanied by meeting some people that we have depended on reading their research papers and articles to inform practice in my home country was very inspiring.

I also attended the ISNCC General meeting where I got great insights, especially on what it takes the leadership to manage operations at such a high-level institution. I was also delighted to know that the Oncology Nurses Chapter Kenya (ONC-K) has now become a member of ISNCC. I also learned a lot about what is happening around the globe and the need to have ISNCC global citizens. We were pleased to meet some of the ISNCC board members and the leadership and to learn from them. As I come back home, I am thrilled to know that we have an organization that we can look up to for mentorship in order to prepare ourselves to better handle future challenges in cancer care across the continuum.

I am very grateful for this opportunity to participate in this year's presentation on the status of cancer in Kenya; and the role of oncology nurse. It pleases me as the ONC-K leader that one of our mem- bers was granted the past president award in line with her contributions to cancer care. We look forward to building the relationship further as we learn and empower the nurses.

It was such a pleasure attending this conference and am continually indebted to ISNCC for this. I will endeavor to share the knowledge gained with my colleagues as we seek to improve the quality of cancer care. I will be willing to take up any role assigned to me by ISNCC in furtherance of its agenda. Please allow me to invite you to come and visit Kenya and see what we are doing at various institutions and at ONC-K as we seek opportunities to collaborate.

Thank you

Palliative Care Remote Multidisciplinary Collaborative Alliance: Promote Quality Palliative Care Resources

Ariesta Milanti — Fri, 17 Mar 2023 01:35:25 GMT

Author: Yongyi Chen, Boyong Shen, Junchen Guo

Affiliations: Hunan Cancer Hospital; Palliative Care Technology Training and Guidance Base of Hunan Province

The inaugural meeting of the Hunan Palliative Care Remote Multidisciplinary Collaborative Alliance was successfully held in Changsha, China on March 10, 2023. More than 300 representatives from 93 medical institutions from within and outside Hunan Province attended this conference.

Professor Yimin Zhu, Deputy Director of the Health Commission of Hunan Province, delivered a keynote speech. He stressed that the development of palliative care in Hunan Province needs the joint efforts of the whole province to achieve common progress and benefit more patients, and hoped that the Hunan Palliative Care Remote Multidisciplinary Collaborative Alliance would spare no effort to promote palliative care with high starting point planning, high standard promotion, high efficiency implementation, and high-quality implementation.

Professor Yazhou Xiao, President of Hunan Cancer Hospital, pointed out that the Hunan Palliative Care Remote Multidisciplinary Collaborative Alliance is in line with the overall development healthy, and is based on the current situation of the ageing population and high incidence of cancer. Hunan Cancer Hospital will shoulder the mission and play a leading role to further comprehensively improve the quality of life of end-stage patients.

Professor Winnie So, President of the International Society of Nurses in Cancer Care, joined the conference online. She said that the establishment of the Hunan Palliative Care Remote Multidisciplinary Collaborative Alliance is a model for the provision of high-quality palliative care. The collaboration of multidisciplinary experts can have a synergistic effect so that more patients in need of palliative care can live the last journey of life in peace, comfort and dignity without regrets.

The conference formally established Hunan Cancer Hospital as the presiding unit of the first Hunan Palliative Care Remote Multidisciplinary Collaboration Alliance; Professor Lihui Zhu, the deputy secretary of Hunan Cancer Hospital, as the chairman of the alliance; and Professor Yongyi Chen as the chief expert. 8 hospitals were included as the vice-chairman institutes, and 84 hospitals were included as the committee institutes.

The establishment of the Hunan Palliative Care Remote Multidisciplinary Collaborative Alliance shows that palliative care work in Hunan has reached a new stage. As a next step, the Alliance will gradually improve the palliative care service system and standardise the industry standards in Hunan.

Exploring The Critical Role of Nursing Leadership In Closing the Cancer Care Gap

Fri, 03 Feb 2023 00:56:43 GMT

World Cancer Day is coming up on February 4th and the ISNCC Board of Directors are pleased to mark the date by releasing a video series and forum on the critical role of nursing leadership in closing the cancer care gap.

These videos explore the role of nurse leaders and examine strategies to accelerate nursing leadership developing. Presentations are delivered by outstanding nursing leaders in cancer control who share examples of how nursing leadership is applied at the system and organizational levels to close the cancer care gap.

Visit the video series page by clicking on the button below and we invite you to share your ideas and ask questions in the public discussion forum.

GO TO VIDEOS AND DISCUSSION FORUM

Behind the Scenes of Donor Search Coordination

Tue, 20 Dec 2022 21:31:27 GMT

Author: Kathryn Ciccolini DNP, AGACNP-BC, OCN, Mount Sinai Hospital

Allogeneic hematopoietic stem cell transplantation (AlloSCT) is potentially a curative treatment for various hematologic malignancies. Patients referred for evaluation for an AlloSCT to the bone marrow transplant (BMT) program at Mount Sinai Hospital (MSH) are immediately evaluated for donor availability. The process of a donor search is multifaceted requiring a specialized and highly unique skillset. At MSH, our group of transplant nurse coordinators and administrative donor coordinators have extensive training and are one of the very few members in the hospital who perform this exceptionally rewarding patient care coordination. Although, identifying a donor is not so straightforward, let’s delve behind-the scenes to learn more.

Basics of HLA and Transplantation

There are many factors that can influence transplantation outcome, one of which is an absolute pre-requisite and a paramount criterion for an alloSCT, donor-recipient histocompatibility (matching of donor and recipient human leukocyte antigen [HLA] protein). In short, HLA proteins are cell-surface inherited proteins found on the major histocompatibility complex (MHC) and play a major role in the immune defense system’s ability to identify self from non-self (NMDP 2021). The most pertinent genes for transplantation belong to MHC Class I (HLA-A, HLA-B, and HLA-C), and MHC Class II (HLA-DR, HLA-DQ, and HLA-DP) (Furst et al, 2019). Detailed HLA typing is used to determine match grade between recipient and donor and donor eligibility. Matched HLA allows for engraftment and reduces the risk of graft-versus-host disease (GVHD) and graft rejection. It is also the most consistent, predictive factor for outcome post HSCT from unrelated donors (Petersdorf, 2016). Donors can be related or unrelated as the source of stem cells resulting in several possible approaches for transplantation. Related donors can either be full match or half match thus siblings, children, parents and even second degree relatives can be considered (NMDP 2022; Sugita, 2019). While an HLA-identical matched sibling donor remains the preferred stem cell source for allogeneic stem cell transplantation, only 30% of patients clinical situation meet this standard leaving the remaining 70% requiring further exploration in other donor sources emphasizing the importance of volunteer donor registries such as National Marrow Donor Program (NMDP) (Ayuk, & Balduzzi, 2019; Petersdorf, 2016; Sugita, 2019). Factors to consider for a successful transplant beyond HLA are donor age, CMV status, cell dose, donor sex, pregnancy history, ABO compatibility, and the presence of donor specific HLA antibodies (DSA) (Ayuk, & Balduzzi, 2019).

Related Donors

At the initial BMT clinic visit, the patient (recipient) is extensively educated on the donor search process for their transplant and is assessed for their initial HLA lab markers by blood test. The recipient completes a family information sheet which is used to arrange initial HLA related donor HLA blood testing. The selection of related donors per recipient can vary with sometimes having over ten options, all of which the interdisciplinary team manages simultaneously. The HLA results of both recipient and donor(s) are compared to assess their match degree. All potentially qualified donors are notified and assessed for willingness to voluntarily donate to share the results with the recipient. The prospective donors are screened for eligibility and suitability by a transplant physician (who is not primary physician of the recipient) and nurse coordinator which includes a comprehensive history and physical evaluation, infectious disease screening and educational session on modes of donation (bone marrow harvest and peripheral blood stem cell), collection process, and medical clearance. Once a donor is identified, and donation stem cell source preference is established by the clinical team and donor, they are brought to the apheresis center for a tour, the nurse coordinator arranges mobilization therapy, addresses central venous catheter requirements, and organizes their collection.

Unrelated Donors

However, when a related donor search is not feasible or did not yield a potential donor, the nurse coordinators initiate a preliminary search through the NMDP, a national resource for facilitating unrelated donor and cord blood stem cell transplants. This is the only organization in the USA that matches unrelated volunteer donors, arranges collections and transportations of stem cells, manages collection and analysis of multi-center data on both donor and cord blood unit (CBU) process, stem cell donation side effects, patient transplant outcomes, and histocompatibility, and maintains a research sample repository (NMDP 2021). Preliminary searches are often proactively done in tandem of conducting related donor searches in the circumstance a suitable related donor is not found. This search identifies potential unrelated stem cell donors and CBU representing a “snap shot’ of potential matches at a given time which can help shape a recipient’s treatment plan. When potential donors are selected from this search after thorough collaborative clinical team discussion, the search is formalized by requesting confirmatory HLA testing on identified potential unrelated donors. The coordinators work closely with NMDP case manager on unrelated donor workup, eligibility and clearance domestically, nationally, and internationally requiring consistent follow up and assurance of donor medical clearance. Once the donor is identified and cleared, the team works with the NMDP case manager on the donor collection, delivery of cells to MSH requiring tremendous logistical coordinator with NMDP, recipient, family, our Cell Therapy Lab, and other members of the BMT program.

Challenges with Donation Coordination

Besides the inherently complex process from donor identification to recipient transfusion, there are many donor-related challenges the coordinators address including physical symptoms and often moral distress. Donors may experience feelings of ambivalence, grief, anguish, fear, pressure in being responsible for the recipient’s outcomes, feeling pressured (Gutierrez-Aguirre et al. 2021). The coordinators are heavily relied upon to demystify the process of what it means to be a donor, address psychosocial concerns, dispel misconceptions of donation, educate on expected adverse events associated with donation, and could be faced with donors with religious conviction or occupational barriers (Garcia et al, 2013; NMDP 2022). Further, the coordinators face challenges with donors living in remote areas with limited access to medical care, communicating with donors who are in different time zones and in different languages, governmental import and export restrictions for international donors, and travel limitations for donors with visa issues. A large majority of the donors registered in the database are of Western European ancestry impeding HLA match access for certain ethnic origins (Tiercy, 2016). Our geographic location and the diversity of New York City complicates finding a well-matched related or unrelated donor resulting in exploration of alternative donors allowing for greater degree of mismatch.

Final Thoughts

It takes up to an estimated ten hours per recipient to perform preliminary searches, formalize donor searches to clear and collect a donor, and coordinate cell delivery to MSH and recipient admission given exquisite and meticulous logistical coordination and attention. Between 2020 and 2021, 469 related donors were typed requiring coordination of HLA testing and counseling on donor matches and process. I hope this article sheds light on the value of a strong donor search coordination program and the highly unique skills needed to provide quality care within our bone marrow transplant and cellular therapy program at Mount Sinai Hospital.

References

Ayuk, F. & Balduzzi, A. (2019). The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies [Internet]. 7th edition. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK554000/

Furst, D., Neuchel, C., Tsamadou, C., Schrezenmeier, H., & Mytilineos, J. (2019). HLA Matching in Unrelated Stem Cell Transplantation up to Date. Transfusion Medicine and Hemotherapy, 46(5), 326-336.

Garcia, M.C, Chapman, J.R., Shaw, P.J., Gottlieb, D.J, Ralph, A., Craig, J.C., & Tong, A. (2013). Motivations, Experiences, and Perspectives of Bone Marrow and Peripheral Blood Stem Cell Donors: Thematic Synthesis of Qualitative Studies. Biology of Blood and Marrow Transplantation, 19(7), 1046-1058.

Gutierrez-Aguirre, C.H., Jaime-Perez, J.C., de la Garza-Salazar, F., Guerrero-Gonzalez, G., Guzman-Lopez, A., Ruiza-Arguelles, G.J., Gomez-Almaguer, D., & Cantu-Rodriguez, O.G. (2021). Moral Distress: Its Manifestations in Healthy Donors during Peripheral Blood Hematopoietic Stem Cell Harvesting. Transplantation and Cellular Therapy, 27(10), 853-858.

National Marrow Donor Program (2021). Manual of Operations Chapter 2: NMDP Search and Matching Process. Retrieved from https://network.bethematchclinical.org/transplant-centers/policies-and-protocols/tc-manual-of-operations/

National Marrow Donor Program (2022). HLA Matching. Retrieved from: https://bethematch.org/

Petersdorf, E.W. (2016). Mismatched Unrelated Donor Transplantation. Semin Hematol, 53(4), 230–236.

Sugita, 2019. Allogeneic hematopoietic stem cell transplantation for hematological malignancies: an algorithm for donor selection. Rinsho Ketsueki, 60(6), 626-634.

Tiercy, J. (2016). How to select the best available related or unrelated donor of hematopoietic stem cells? Haematologica, 101(6), 680-687.

ICCN Scholarship Series

(Past member) — Mon, 28 Nov 2022 20:18:56 GMT

About this ICCN Scholarship Series Blog

In February 2022 ICCN held their second virtual conference, Building Sustainability & Resilience: Global Perspective on Cancer Nursing. ICCN was a three-day event culminating in Plenary 4 simply titled Building Sustainability & Resilience. It was a series of interviews with nursing leaders including ISNCC President Patsy Yates, International Council of Nurses, CEO Howard Caton and European Oncology Nursing Society, President Johan de Munter plus cancer nurses from Afghanistan and Ethiopia discussing the challenges that are facing oncology nurses tasked with providing cancer and palliative care across diverse cultures. This was a highlight of the conference as it showcased the strength and fortitude of nurses who have continued to provide the best possible care during COVID19 pandemic and in some regions war and political challenges. I am pleased to present M. Asif Huassainyar a nurse leader from Afghanistan who was a speaker in plenary 4 and also a recipient of a scholarship from Canadian Oncology Nurses Society [CANO] who writes this blog.

Suzanne Bishaw
ISNCC Chair ICCN Portfolio

Experiences of attending the International Conference in Cancer Nursing (ICCN2022)

Author: Mohammad Asif Hussainyar, Nursing Instructor, Aga Khan University Academic Projects Afghanistan and Board Member Afghanistan Cancer foundation

In Afghanistan, there is not any speciality in nursing including oncology nursing. The nurses who are working in the oncology wards are General Nursing Diploma graduates with few training opportunities in oncology. In Afghanistan there is only one oncology ward in one of the tertiary hospitals with two regional chemotherapy centres in Herat and Mazar Provinces.

The workload caring for oncology patients including those with palliative care needs, is increasing day by day, likely due to borders being closed as a consequence of COVID-19 pandemic and the sudden collapse of government and continuity of care.

The concept of Palliative Care in Afghanistan is new and few nurses have the knowledge and skills to provide palliative care in for people with cancer and other conditions. However, palliative care was added for the first time to the General Nursing Diploma Programme in 2020.

As a BSc Nurse who has the experience of one of the premier hospitals and a renowned university (Aga Khan) and a board member of the Afghanistan Cancer Foundation, I am a great advocate for palliative care for those in need. Moreover, I acknowledge the knowledge and skills of those nurses working in the oncology ward need support.

I appreciate the kind words and fellowship of organisations such as the International Society of Nurses in Cancer Care (ISNCC) in bringing together the International Conference in Cancer Nursing which I found extremely valuable; it is important for nurses to discuss and debate trends in oncology nursing.

This is a call to action to members of the national and international nursing organizations working in health and in particular, in cancer, to support the Afghanistan Nursing Society and also include cancer and palliative care in their curricula as appropriate. This will lead to a cadre of specialist oncology nurses. Find out about your global scholarships, visiting fellowships and shared training - all for nurses in Afghanistan to scale up their knowledge and skills.

Thank you.

Asif

Lung cancer with COPD is a serious health problem of global magnitude

Wed, 23 Nov 2022 22:13:19 GMT

Authors: Karen Kane McDonnell PhD, RN, Associate Professor, Co-Director, Cancer Survivorship Research Center; Amanda R. Bennett MSN, RN, PhD Student; & Vera Bratnichenko MSN, RN, PhD Student; College of Nursing, University of South Carolina, Columbia, SC, United States

November brings awareness to individuals living with lung cancer and their family members and friends. Regardless of the prognosis, a diagnosis of lung cancer creates substantial physical, emotional, and financial challenges on individuals, families, communities, health systems, and countries.¹ Lung cancer continues to be the most common cancer type and the leading cause of cancer death worldwide. Around the globe, the general cancer burden is high and increasing.¹The highest incidence rates of lung cancer are observed in parts of North America, in East Asia, and in parts of central and eastern Europe.¹

There is good news which fosters HOPE! The number of new lung cancer diagnoses is declining steadily in some countries. The American Cancer Society describes trends in cancer death rates as the best measure of progress against cancer. In the United States, lung cancer death rates declined by 56% since 1990 in men and 32% since 2002 in women. These improvements in lung cancer survival are due to declines in cigarette smoking and advances in early detection and treatments, mostly for non-small cell lung cancers (NSCLC) the more common classification of lung cancer (NSCLC; 82%).² In recent years, more individuals with lung cancer are being diagnosed when the cancer is at an early stage and living longer as a result. The rate of localized-stage disease diagnoses increased by 4.5% yearly from 2014 to 2018, while there were steep declines in advanced disease diagnoses. The result was an overall increase in 3-year survival rates (from 21% to 31%).^2.3

It is widely accepted that the major cause of lung cancer is tobacco smoking, which is responsible for 80–85% of lung cancer cases worldwide. The World Health Organization describes tobacco use as a global epidemic.⁴ Tobacco smoke contains more than 7000 chemicals and at least 69 carcinogens, including polycyclic aromatic hydrocarbons, tobacco-specific nitrosamines, and benzene. About 8 out of 10 (81%) deaths from lung cancer are expected to be caused from smoking cigarettes. Both the amount and how long someone smokes increase the risk of dying from lung cancer. People who smoke are about 25 times more likely to develop lung cancer than those who never smoked. Second-hand smoke causes almost 3% of new diagnoses of lung cancer and is expected to cause about 3% of deaths. After smoking, the next leading cause of lung cancer is exposure to radon gas, which is released from soil and can build up indoors. Relative to the hazards of smoking cigarettes and cigars, the full hazard profile presented by electronic nicotine delivery systems (NEDS) and by cannabis smoking are largely unknown at this time.^2,3,4

Chronic obstructive pulmonary disease (COPD) is the most common smoking-related illness in the world and the most common co-morbidity for persons with lung cancer. Even though, it is well established that COPD is associated with the risk of lung cancer it is often under-emphasized as a comorbidity for those with lung cancer.⁵ Clinically, the co-existence of lung cancer and COPD can have a dramatic impact on the patient’s quality of life (QOL) and survival.⁵

Optimal treatment of concurrent lung cancer and COPD is crucial to the success of lung cancer therapy. Oncology and advanced practice nurses can play an essential role in these patients’ care, which requires early and close attention to prevention, assessment, treatment, and surveillance of both diseases, related symptomatology, and lifestyle behaviors. Patients with lung cancer and COPD benefit from a multidisciplinary disease management approach throughout their illnesses to ensure maximum QOL and functional status. In collaboration with a team that includes pulmonologists and oncology physicians, oncology nurses can help improve these patients’ health outcomes using pharmacologic and nonpharmacologic treatments and symptom management. More clinical research is needed to expand our understanding of the management of patients with this twofold disease burden, to increase the use of existing evidence-based interventions, and to develop, and test new QOL-boosting interventions.⁵

The outlook is more promising than ever for individuals with lung cancer at all stages of disease with and without COPD. Around the world, nurses who care for persons with a history or current diagnosis of lung cancer can make a positive impact. The Position Statement on Cancer Nursing’s Potential to Reduce the Growing Burden of Cancer Across the World describes nurses as “essential” to cancer control.6 The Call to Action is clear. It is our role as nurses to reduce the global burden of cancer across the cancer trajectory.

References:
1.    Wild, C. P., Weiderpass, E., & Stewart, B. W. (Eds.) (2020). World Cancer Report: Cancer Research for Cancer Prevention. International Agency for Research on Cancer. http://publications.iarc.fr/586.

2.    Siegel, R. L., Miller, K. D., Fuchs, H. E., & Jemal, A. (2022). Cancer statistics, 2022. CA: A Cancer Journal for Clinicians, 72(1), 7–33. https://doi.org/10.3322/caac.21708

3.    American Cancer Society. (2022). Cancer Treatment & Survivorship Facts & Figures 2022–2024.

4.    World Health Organization. (2021). WHO Report on the Global Tobacco Epidemic, 2021: Addressing new and emerging products. World Health Organization.

5.    Newsome, B. R., McDonnell, K. K., Hucks, J., & Estrada, R. D. (2018). Chronic obstructive pulmonary disease: clinical implications for patients with lung cancer. Clinical Journal of Oncology Nursing, 22(2), 184.

6.    Yates, P., Charalambous, A., Fennimore, L., Nevidjon, B., So, W. K., Suh, E. E., Woodford, E. Young, A. (2020). Position Statement on Cancer Nursing’s Potential to Reduce the Growing Burden of Cancer Across the World. Cancer Nursing, 43(6) 433-435. doi: 10.1097/NCC.0000000000000900

Disclosure: An American Cancer Society (ACS) Mentored Research Scholar Grant support Dr. Karen Kane McDonnell [#MRSG-17-152-01].

Research on the Construction of a Mobile-Health Based Personalized Exercise Management Program for Colorectal Cancer Patients with Fatigue

(Past member) — Mon, 21 Nov 2022 20:17:14 GMT

Authors:
Ya-Ting GAO RN, MN 1,2 ; Yan LOU PhD, Associate Professor 1 ; Ying LIN RN, MN 1 ; Shuai-Ni LI RN, MN 1,3 ; Mei-Rong HONG RN, BN 1 ; Yu-Lu XU RN, BN 1 ; Wei YU RN, BN 1
1. School of Nursing, Department of Medicine, Hangzhou Normal University
2. Sir Run Run Shaw Hospital (SRRSH), School of Medicine, Zhejiang University
3. The Children's Hospital, School of Medicine, Zhejiang University

Cancer-related fatigue is a long-lasting and distressing symptom for CRC patients, and it would exhibit a detrimental effect on their quality of life. Physical activity could relieve fatigue, and aerobic exercise combined with resistance training can maximize the fatigue-relieving effect. Nevertheless, it has been challenging in promoting combined aerobic exercise and resistance training among CRC patients, especially training for improving lower limb flexibility, muscular strength, and endurance.1 Novel strategies are needed to enable these individuals to monitor their physical activity levels, encouraging them to set goals to achieve adequate physical activity levels for themselves. Mobile-health was suggested to be a desirable platform to administer physical activity program for this purpose.2

We conducted a study that aimed to design and implement a combined aerobic exercise and resistance training program for CRC patients with fatigue via a mobile-health platform. Overall, our twelve-week exercise program involved a combination of aerobic exercise and resistance training, and it was supplemented with flexibility exercises. Progressive increase in the frequency, intensity, duration and volume of the exercise have been introduced as the participants progressed through the program. The core elements of personalized intervention included an individualized goal setting, autonomous habit training, staged professional guidance and targeted interactive encouragement. The feasibility and applicability of the mobile-health-based personalized exercise management program for CRC patients with fatigue were also evaluated.

This study was conducted using a multi-step approach.

Step 1: Development of the exercise movement library
Four exercise guidance movement libraries were established . Specific movements included: (i) the dynamic stretching movement library; (ii) the aerobic exercise movement library; (iii) the resistance training movement library (iv) the static stretching movement library. The combination of these movements forms three progressive aerobic exercise and resistance training sets.

Step 2: Digitization of intervention program
We used multi-media technology including audio, video, and motion graphics to present the program and make it adaptable to the mobile-health platform.

Step 3: Evaluation of intervention program
Face-to-face or virtual expert consultation method were used to evaluate the feasibility and applicability of the program. Seven experts with a professional background of human kinesiology or nursing care for CRC patients validated the applicability of the exercise management program, and the suitability of movement library for CRC patients. These experts provided feedback and comments on the ways to improve the program.

Step 4: Design of the mobile-health platform
WeChat Mini Program was selected as the mobile-health platform for the presentation of the exercise management program. An iterative interactive process was used. The research team and the software designers held six rounds of face-to-face interviews, and online communications were also established with them, where the technical aspects of presenting the program via the mobile-health platform were discussed and sorted.

Step 5: Preliminary test
Twenty CRC inpatients and their families were invited using a purposive sampling method to evaluate the WeChat Mini Program. Face-to-face semi-structured interviews were used to collect the qualitative data on the patients’ experience and feedback in using the WeChat Mini program. The thematic analysis method was used to extract themes from the data.

Overall, the development and implementation of the personalized exercise management program for colorectal cancer patients with fatigue appeared to be feasible. CRC patients and their families who participated in this program perceived that the WeChat Mini Program, “Huì Dòng” (Smart Exercise), was easy to use. Program content was suitable and beneficial for them to do exercises, and almost all of participants expressed willingness to continue using it, although two were concerned about the low potential of long-term adherence to the program. The WeChat Mini Program could be improved from the perspective of optimized format design, such as the use of light color background in the video, the incorporation of oral interpretation into the motion graph, and enhancement of cognition education on exercise. Further cohort studies should be conducted to evaluate its effect on the level of physical activity, the relief on CRF, self-efficacy in exercise and quality of life.

Figure: The Resistance Training Program-Beginning Level.

References

1. Nakagawa H, Sasai H, Tanaka K. Physical Fitness Levels among Colon Cancer Survivors with a Stoma: A Preliminary Study. Medicina (Kaunas). 2020 Nov 10;56(11):601. doi: 10.3390/medicina56110601.

2. Cheong IY, An SY, Cha WC, et al. Efficacy of Mobile Health Care Application and Wearable Device in Improvement of Physical Performance in Colorectal Cancer Patients Undergoing Chemotherapy. Clin Colorectal Cancer. Jun 2018;17(2):e353-e362.

Development of an Evidence-based Practice Scheme of Perioperative Oral Care for patients with oral cancer

(Past member) — Mon, 14 Nov 2022 20:14:30 GMT

Haiqin Hu, MMed, Department of Thyroid Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences

Oral cancer is a malignant tumor occurring in the oral cavity. Currently, surgical resection is still the major treatment strategy for oral cancer, but undergoing such treatment may lead to a repertoire of postoperative conditions such as bacterial imbalance, a condition that involves an imbalance of health-promoting and pathogenic bacteria in the gastrointestinal tract. This may have an adverse effect on the prognosis and quality of life of patients after surgery. The perioperative care requirements of oral cancer patients are different from those of patients of other diseases, which demands proficiency of the nurses in their professional practice. At present, there is still a lack of corresponding evidence-based practice of oral care in China. To enhance the quality of life of people with oral cancer, a set of care standards for oral cancer management needs to be developed. To facilitate this, we conducted a review on the evidence-based practice of oral care for oral cancer patients, with the aim to develop, based on the JBI evidence-based health care model, a set of scientific and standardized evidence-based oral care practice program that can guide clinical nursing staff for increasing the efficacy of oral cancer care that they can deliver. This may help provide a more scientific and effective decision-making basis for clinical nursing practice in oral care.

To start off, we first established a research team, consisting of nursing professors, medical specialists in head and neck, clinical psychologist, dietician rehabilitation nurse specialist. The team members conducted a review in order to summarize and evaluate the literature that reports oral care programs currently practiced worldwide. PubMed, Cochrane Library ,Web of Science , the National Comprehensive Cancer Network (NCCN) and the Oncology Nursing Society (ONS) were used in the literature search, using a combination of keywords including oral cancer, oral care and perioperative. In our search, we retrieved four articles for inclusion in this review, including three practice guideline papers and one systematic review paper (Adelstein et al., 2017; Cervenka et al., 2019; Dort et al., 2017; Joo et al., 2019). Upon the retrieval of these articles, we conducted a summary of the evidence presented in these articles, and an evaluation on their suitability in clinical practice. The collected evidence was then summarized narratively in our review, presenting the latest evidence-based practice for perioperative oral care of patients with oral cancer. Recommendations on the care practice were classified into six major themes, including perioperative oral care rehabilitation, behavioral habits, psychology, flap care, nutrition, and pain.

According to the included evidence and the preliminary investigation, the possible obstacles in the implementation of oral care practice were also analyzed. We finally established the final draft of perioperative oral care practice plan for oral cancer patients, including an action plan and a flow chart of this plan (Figure 1).

In order to scientifically and effectively establish an evidence-based practice plan for perioperative oral care for patients with oral cancer, we also carried out a survey among current oral cancer patients. After review of the survey data, we found that current oral care practice does not involve the medical staff to evaluate the oral function of patients before surgery, to guide patients to quit smoking, nor to use skin temperature detectors to monitor the oral flap temperature of patients after surgery.

Overall, our review and survey have highlighted the importance of the evaluation of preoperative and postoperative oral function, nutrition, pain and psychological status among patients, the provision of rehabilitation training to patients, as well as the guidance for them to quit smoking and excessive alcohol consumption.

References
Adelstein D, Gillison ML, Pfister DG, Spencer S, Adkins D, Brizel DM, Burtness B, Busse PM, Caudell JJ, Cmelak AJ, et al. NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2017. J Natl Compr Canc Netw. 2017; 15(6): 761-770.

Cervenka B, Pipkorn P, Fagan J, Zafereo M, Aswani J, Macharia C, Kundiona I, Mashamba V, Zender C, Moore M. Oral cavity cancer management guidelines for low-resource regions. Head Neck. 2019; 41(3): 799-812.

Dort JC, Farwell DG, Findlay M, Huber GF, Kerr P, Shea-Budgell MA, Simon C, Uppington J, Zygun D, Ljungqvist O, et al. Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction: A Consensus Review and Recommendations From the Enhanced Recovery After Surgery Society. JAMA Otolaryngol Head Neck Surg. 2017; 143(3): 292-303.

Joo YH, Cho JK, Koo BS, Kwon M, Kwon SK, Kwon SY, Kim MS, Kim JK, Kim H, Nam I, et al. Guidelines for the Surgical Management of Oral Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clin Exp Otorhinolaryngol. 2019; 12(2): 107-144.

Figure 1. Flowchart of perioperative oral care plan for patients with oral cancer.

Psychological Changes among Breast Cancer Patients having Completed Treatment and Factors Influencing their Returning to Work During their Rehabilitation Period

(Past member) — Mon, 07 Nov 2022 20:10:17 GMT

Author: Huiting Zhang, MSN., RN; Case Manager, Head Nurse, Department of Breast Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China

Breast cancer patients having undergone curative treatment, including surgery, chemotherapy and radiation therapy, often face problems upon returning to work .after completion of such treatments. For example, the function of the affected limbs may not have fully recovered after surgery, while nausea and vomiting caused by chemotherapy may affect the patients’ adaptability to work. In addition, hair loss as a result of chemotherapy may lead to a tendency of the patients to avoid facing their colleagues. These patients would also face a repertoire of psychological issues as a result of the treatment, which may potentially have negative effect on their attitudes towards returning to work. A better understanding on the factors that would hamper and facilitate the patients to return to work after cancer treatment is needed, in order to address the psychological issues that contribute to the patients’ reluctance to return to work. Therefore, we conducted a qualitative study that explores the psychological changes and influencing factors of breast cancer patients having completed their curative treatment and were returning to work during the rehabilitation period. Study findings may provide a basis for constructing individualized interventions that facilitate patients to return to work.

We used a phenomenological approach to conduct this study. Ten breast cancer patients who were either receiving endocrine therapy or having completed all curative treatments, who have returned to work or were planning to return to work, were recruited. Semi-structured interviews were conducted with the patients to explore their views upon returning to work, and the factors that may encourage or hamper them from doing so.

Two themes were generated from the interview data. The first theme pertains to the journey of the breast cancer patients in promoting their mental health when they returned to work. The journey has three phases. First, ‘Avoid and surround themselves’, where the patients showed a low willingness to return to work when they were still at the early stage of treatment. Second, ‘Forget the past, set sail again, when they would try to let go of their pain and illness, accept the reality and resume their work, after a period of recovery at post-treatment. Finally, ‘grasp today and harvest the future’, where the patients who had returned to work, after a period of adjustment, could work as normal, believing that their illness had brought unexpected benefits, while feeling satisfied with their job, and being hopeful and optimistic for their future. The second theme involves the factors affecting breast cancer patients' return to their work after completing their treatment. Economic pressure, work ability and experience, the correct mentality in the face of the illness, the pursuit of social values, and social support were identified to be the stimulating factors for patients to return to work, while work pressure was found to be a hindering factor.

Indeed, the process for patients to return to work is dynamic, where the patients’ feelings would change over the course of rehabilitation from their illness. They will have different attitudes towards returning to work at different times. Returning to work can help to forget the pain of their illness, improve their self-value, and return to a normal life. In the future, medical staff should carry out relevant interventions that address the influencing factors of patients returning to work. For example, rehabilitation volunteer groups may be set up, where the patients can receive social support from the medical staff, enabling the patients to maintain positivity and optimism during their rehabilitation.

Efficacy of compound traditional Chinese medicine oil in alleviating regorafenib-induced hand–foot skin reaction

(Past member) — Mon, 31 Oct 2022 18:58:43 GMT

Authors:

Liyan Zhang (Registered Nurse) 1; Jieyuan Cai (Master Student) 1; Hong Sun (Doctor of Medication) 2; Lin Shen (Doctor of Medication) 1
1 The Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Medical Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China 2 Department of Intergrative Medicine & Geriatric Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China;
*Corresponding author: Hong Sun

Regorafenib is a novel, oral anticancer agent used in cancer treatment. Despite its known benefit in improving survival among cancer patients, it was reported to induce hand–foot skin reaction (HFSR) in patients . HFSR is characterised by numbness, tingling sensation, swelling, desquamation, ulceration, hyperkeratinized or pain in hands and feet. It significantly affects the quality of life (QOL) of patients, even upon dose reductions or treatment discontinuation. Currently, the methods for managing HFSR include moisturization, avoiding friction or chemical injury, or drug dose adjustment, although these treatments have limited efficacy. Traditional Chinese medicine (TCM) is useful in skin-related symptoms by regulating internal imbalance, promoting skin wound healing, relieving pain, anti-inflammatory. However, there is no clinical studies to confirm the effect of TCM in alleviating HSFR.

In view of this, we conducted a study that aimed to investigate whether a compound traditional Chinese medicine (CTCM) oil would alleviate HFSR induced by regorafenib, in order to enhance the physical function and quality of life of cancer patients on a regorafenib treatment regime.

The study involved 85 patients with metastatic colorectal cancer presenting with HFSR. These patients were divided into the control group (n = 42) and the intervention group (n = 43). The HFSR among the control participants was managed as keeping skin moisture, avoiding friction or chemical injury and using pain killers or other medication following doctors’ order. The intervention participants was treated with a CTCM oil comprising five selected herbs which can alleviate skin swelling, pain, injury anti-inflammatory, eventually promoting skin repair and wound healing . This oil generally works by regulating immune functions and the molecular pathways leading to inflammation. The oil was given to the intervention participants for external application twice daily for two weeks. To evaluate the effect of the application of this CTCM oil, we compared the HFSR remission rate and quality of life (QOL) between the two groups of participants at post-intervention (two weeks after the start of intervention).

Our data support that CTCM oil application is effective in the treatment of HSFR and improving the well-being of the patients. Notably, the post-intervention HFSR remission rate was significantly higher among participants in the intervention group than those in the control group (65.1% vs 16.7%; p < 0.01) indicating that the use of the CTCM oil can alleviate the severity of HFSR among the patients. Consistent with this, participants in the intervention group also experienced lower levels of pain caused by the inflammatory events associated with HFSR (p < 0.01). Besides, the oil significantly improved patients’ physical function such as walking and grabbing stuffs, emotional function as depression and the social function as social activities. (p < 0.05). Overall, our data demonstrated that the CTCM oil can effectively alleviate HFSR and improve the QOL of patients using regorafenib.

The findings suggest the CTCM oil can be considered as an optional management of patients undergoing therapy with regorafenib. Future research may explore the efficacy of CTCM oil in reliving other skin conditions.

Before CTCM oil application After CTCM oil application

Figure 1. HRSR before and after intervention
Note: Before treatment, both patients’ feet occur HFSR, presenting as skin hyperkeratinized (as yellow part shown), swelling and severe pain, affect their walking badly. After treatment, the symptoms significantly relieved.

This study was presented at ICCN2022 virtual conference.
Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

Share Your Research at the MASCC/JASCC/ISOO 2023 Annual Meeting

Wed, 26 Oct 2022 21:20:26 GMT

Present your research to an international audience of best-in-class supportive cancer care professionals.

Abstracts on a wide range of supportive care topics are welcome, particularly those relating to our 2023 meeting themes:

Overall Theme: Interdisciplinary Nature of Supportive Cancer Care
Robotics and Digital Medicine
Disparities in the Availability of Supportive Care
When Evidence-Based Medicine Meets Traditional Medicine
Sessions on the Various MASCC/JASCC/ISOO Study Group Topics

We encourage submissions from both new and experienced researchers. A number of awards and scholarships are available to qualifying first authors.

Deadlines:

December 21, 2022 3pm EST (for submissions which include a Conference Scholarship application)

January 11, 2023 3pm EST (for all other submissions, including all other awards and scholarships)

Learn more here: mascc.org/annualmeeting2023/abstracts/

Prevalence of psychological distress and its associated factors among breast cancer patients in China：a systematic review and meta-analysis

(Past member) — Mon, 24 Oct 2022 18:57:13 GMT

Authors: Jia Hui Liu, MS, RN, Hunan Cancer Hospital; Xu Ying Li, PhD, RN, Hunan Cancer Hospital

Background

Breast cancer（BC）is a common cancer type in women, ranking the first in in the incidence, and the fourth in the mortality, among female cancers in China. Treatment of BC was reported to lead to a repertoire of psychological symptoms and health problems, such as depression, anxiety and fatigue (de Ligt et al., 2019; Götze et al., 2020), and the psychological symptoms were suggested to be caused by psychological distress among patients receiving treatment. (Loewenstein 2018). Such psychological distress may hinder treatment compliance, increase the risk of suicide and mortality, and affect the prognosis of the disease. In light of the detrimental effect of cancer treatment on the psychological well-being on patients, a better understanding on the factors that may increase their risk of experiencing psychological distress is needed. Therefore, we conducted a systematic review that aims to provide an overview on the prevalence of psychological distress with breast cancer patients in China, and the factors that may affect their experience of psychological distress. These identified factors may help provide useful clues in the identification of patients at higher risk of psychological distress, where additional psychological interventions may be given to these patients to facilitate personalized care.

Our findings showed that breast cancer patients in China had a high prevalence of psychological distress of 55.4%. We also found that patients with moderate distress, those who were about to receive chemotherapy, those living in western regions in China, and those whose cancer was at the pathological stages Ⅱ to Ⅲ had a higher prevalence of psychological distress.

With our data showing the relatively high prevalence of psychological distress among breast cancer patients in China, more resources should be allocated in the implementation of psychological interventions shown to be effective in alleviating psychological issues, such as training more psychological care professionals, and constructing psychological intervention plans based on the level of psychological distress. Psychological interventions of potential for implementation among the patients include relaxation training, physical activity, and couples therapy. Patients at stages II or III of Cancer who have their chemotherapy scheduled to start and those living in western China are in higher need of these interventions. Meanwhile, there is a great need to further improve the ability of healthcare professionals to screen for or detect psychological distress in cancer patients, where those having psychological distress can be identified for referrals to receive the psychological interventions. The Government may consider the allocation of more resources for training healthcare professionals to implement these interventions.

References:

de Ligt, K. M., Heins, M., Verloop, J., Smorenburg, C. H., Korevaar, J. C., Siesling, S. (2019). Patient-reported health problems and healthcare use after treatment for early-stage breast cancer. Breast, 46, 4-11. doi: 10.1016/j.breast.2019.03.010

Götze, H., Friedrich, M., Taubenheim, S., Dietz, A., Lordick, F., Mehnert, A. (2020). Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis. Support Care Cancer, 28(1), 211-220. doi: 10.1007/s00520-019-04805-1

Loewenstein, K. (2018). Parent Psychological Distress in the Neonatal Intensive Care Unit Within the Context of the Social Ecological Model: A Scoping Review. J Am Psychiatr Nurses Assoc, 24(6), 495-509. doi: 10.1177/1078390318765205

This study was presented at ICCN2022 virtual conference.
Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

ASCO Multidisciplinary Cancer Management Course (MCMC)

Fri, 21 Oct 2022 01:34:06 GMT

Invited by City Cancer Challenge, Prof Patsy Yates, past president of ISNCC, represented ISNCC to be one of the ASCO-C/Can Global External Panel of Experts for the implementation of the ASCO Multidisciplinary Cancer Management Course (MCMC) in Greater Petaling, Malaysia. The course focused on using multidisciplinary team care and guidelines for breast cancer to help healthcare professionals in Greater Petaling to address local gaps in cancer care. The course was successfully conducted on 17th to 19th September 2022.

A Family-based Multimedia Intervention: A Potential Strategy to Promoting Colorectal Cancer Screening Utilisation among South Asian Ethnic Minorities

(Past member) — Mon, 17 Oct 2022 18:56:01 GMT

Authors:

Winnie K.W. So, RN, PhD, FAAN; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
Dorothy N.S. Chan, RN, PhD; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
Bernard M.H. Law, PhD; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Kai Chow Choi, PhD; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Meinir Krishnasamy, RGN, PhD; Peter MacCallum Cancer Centre, Victoria, Australia;
Carmen W.H. Chan, RN, PhD, FAAN; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;

Submission topic:
A Family-based Multimedia Intervention: A Potential Strategy to Promoting Colorectal Cancer Screening Utilisation among South Asian Ethnic Minorities

Colorectal cancer (CRC) is one of the most common cancers in Hong Kong. In view of the benefit of cancer screening utilisation in reducing CRC prevalence, the local government had started implementing a CRC screening programme that enable the public to undergo screening tests (faecal immunohistochemical test – FIT) at a reduced cost. Nevertheless, South Asian (SA) ethnic minorities, one of the disadvantaged populations in Hong Kong, were known to exhibit a low CRC screening rates.1 They face multiple barriers in utilising the available CRC screening services, including the language barrier, and limited knowledge on CRC prevention and screening.2,3 SA older adults are particularly affected by these barriers, yet these individuals are those who require CRC screening most, due to the increased CRC risks among older individuals. These older adults are in need of effective educational interventions to increase their knowledge on CRC screening, its benefits and how screening services can be accessed.

To educate SA effectively, we developed and implemented a family-based multimedia educational intervention, and assessed its effectiveness in promoting FIT utilisation among SA older adults in a cluster-randomised controlled trial. The intervention not only provides education on FIT to the SA older adults, but also highlights the importance of support from younger family members in enhancing cancer screening utilisation among these adults. It involved a multimedia health talk by trained instructors and navigational assistance by site coordinators, where they accompanied the older adults to attend medical appointment with a family doctor for FIT. Dyad participants, comprising an older adult and one of their younger family members, were recruited among SA communities through our partnerships with non-governmental organisations (NGOs).

The intervention appeared effective in enhancing FIT utilisation among SA older adults, as the proportion of intervention participants having undergone FIT was 10 times higher than that among control participants. Among the younger family members, the intervention may have promoted their level of willingness and readiness to encourage and assist their older family members to undergo FIT, where such levels had remained high at post-intervention among the dyads in the intervention group only. Moreover, the participants were satisfied with the intervention, expressing that they would promote it to their peers. Over 80% of our partnering NGOs were impressed with the intervention and would continue implementing it at their centres provided they have the manpower and resources. Overall, our findings demonstrated the acceptability and effectiveness of our family-based multimedia intervention, and the potential feasibility of its implementation in local SA communities.

Given the demonstrated effectiveness of the intervention in promoting CRC screening utilisation among local SA, we suggest that the intervention should be implemented regularly within SA communities worldwide, via NGOs serving local SA. Governments worldwide may allocate more resources for training the staff at these NGOs, enhancing their competence in delivering the intervention to their community peers. With enhanced awareness of SA on the importance of CRC screening and prevention, it is of potential that the CRC prevalence among this disadvantaged population group in regions worldwide can be reduced.

Detailed report of this study can be found in the published article in the International Journal of Nursing Studies.4

References

1.   Choi KC, So WK, Chen JM, Lau GC, Lee PC, Chan CW. Comparison Study of Uptake of Colorectal Cancer Testing between Ethnic Minorities and the General Population in Hong Kong. Asian Pac J Cancer Prev. 2015; 16(17): 7713-7720. http://dx.doi.org/10.7314/apjcp.2015.16.17.7713.

2.   Campbell C, Douglas A, Williams L, Cezard G, Brewster DH, Buchanan D, Robb K, Stanners G, Weller D, Steele RJ, Steiner M, Bhopal R. Are there ethnic and religious variations in uptake of bowel cancer screening? A retrospective cohort study among 1.7 million people in Scotland. BMJ Open. 2020; 10(10): e037011. http://dx.doi.org/10.1136/bmjopen-2020-037011.

3.   Wyatt LC, Patel S, Kranick JA, Raveis VH, Ravenell JE, Yi SS, Kwon SC, Islam NS. Disparities in colorectal cancer screening among South Asians in New York City: a cross-sectional study. J Cancer Educ. 2021: http://dx.doi.org/10.1007/s13187-021-01991-7.

4.   So WKW, Chan DNS, Law BMH, Choi KC, Krishnasamy M, Chan CWH. Effect of a family-based multimedia intervention on the uptake of faecal immunohistochemical test among South Asian older adults: A cluster-randomised controlled trial. Int J Nurs Stud. 2022; 132: 104254. https://doi.org/10.1016/j.ijnurstu.2022.104254

The flow of the family-based multimedia intervention project. In this project, we first recruited a number of South Asian instructors who will take part in delivering the educational intervention to their community peers. They were trained on their presentation skills and educated on various aspects of colorectal cancer and its prevention. They were also given training on how stool sample is collected for faecal immunohistochemical test (FIT). They were given a competence assessment at the end of the training. Upon passing the assessment, they will be engaged in delivering the family-based multimedia intervention. The intervention involved a health talk on colorectal cancer, colorectal cancer screening and how it can be accessed. During the talk, a video clip was shown, with its content highlighting the importance of support from younger family members in modifying cancer screening behaviours of the older participants. A demonstration on how stool sample is collected for FIT was also given by the instructor during the talk. Finally, each participant received a health information booklets at the end of the talk, with the contents aiming to reinforce the knowledge gained by the participants during the educational intervention.

Integrated Care Pathway for Metastatic Spinal Cord Compression: A Quality Improvement Project to Strive for Better Patient Care

(Past member) — Mon, 10 Oct 2022 18:11:53 GMT

Author: LING Wai Man (MScN, RN, FHKAN), Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong

Metastatic spinal cord compression (MSCC) is an oncological emergency which can cause severe debilitation and adverse impacts on patient’s quality of life. A preliminary review conducted between January 2018 and June 2019 in our oncology wards on 6 MSCC patients revealed that there were delayed initiation of multidisciplinary supportive care and a paucity of routine psychosocial assessment. The lack of a systematic and timely multidisciplinary MSCC care plan was evident. Therefore, we decided to initiate a quality improvement project to enhance the MSCC care by establishing and implementing a systematic multidisciplinary care pathway.

Based on the gaps identified from the aforesaid review and current international guidelines like the Christie NHS Guideline and NICE Pathway, a departmental integrated care pathway (ICP) for MSCC was developed. Emphasis was placed on the multidisciplinary input for timely therapeutic interventions, pain management, psychosocial care and supportive measures so as to maximize rehabilitation, prevent complications and aid discharge planning. To facilitate the systematic care delivery, a clinical practice checklist was designed and used since September 2019. A clinical audit was then conducted in late 2020 to evaluate the effectiveness of the project, including the (i) compliance to the ICP, (ii) effectiveness in multidisciplinary communication and service coordination, and (iii) effectiveness of the enhancement in clinical care.

A retrospective approach with the pre and post historical comparison design was adopted. Twenty-one MSCC patients from September 2018 to August 2019 (pre cohort) and 40 from September 2019 to August 2020 (post cohort) were recruited. Their median age was 71 with the range of 41 to 100. Thirty-eight (62.3%) of them were male. The top 5 cancer diseases were lung, prostate, colorectal, breast and lymphoma. The most common site of MSCC was thoracic spine (86.7%), followed by cervical (18.3%) and lumbar (15%). Ratio of single to multiple levels of MSCC was half to half. Radiotherapy (85.2%) was the most common primary treatment for the MSCC, whereas surgery (4.9%) and supportive management (9.8%) were the minority. Their median survival time was 3.2 months only.

The overall compliance to ICP was good. All the post cohort patients were under its care with 85% initiated within 1 day. All had a clear documentation of the spinal stability. Use of anti-embolism stockings rose from 19% to 75% (p<0.001). There was a statistically significant increase in the referral to physiotherapist (81% vs 100%; p<0.5), occupational therapist (72.6% vs 95%; P<0.5) and social worker (42.9% vs 75%; P<0.5). Although it was not statistically significant yet, there was a trend of improvement in pain control, prevention of constipation and discharge planning. The median length of stay was shortened from 13 to 10 days with over three-fourths back to home or elderly home.

Our audit results support the use of ICP, which can promote systematic, timely and holistic MSCC care, and is worthwhile to adopt in routine practice. Improvement actions (like a stepwise remobilization protocol and a more convenient multidisciplinary referral system) have been identified afterwards to strive for a continuous quality enhancement in our MSCC care.

References
Christie Hospital NHS Foundation Trust. (2020a). Overview of the Management of Metastatic Spinal Cord Compression due to Cancer (Version: V6). Retrieved from https://www.christie.nhs.uk/media/9329/overview-of-the-management-of-mscc-due-to-cancer-sept-2020-final.pdf
Christie Hospital NHS Foundation Trust. (2020b). Protocol for Mobilisation and Rehabilitation (Version: V6). Retrieved from https://www.christie.nhs.uk/media/9321/guidelines-on-mobilisation-and-rehabilitation-sept-2020-final.pdf
Laufer, I., Bilsky, M., Schiff, D., & Brown, P. (2021). Treatment and prognosis of neoplastic epidural spinal cord compression (Topic 2820 Version 42.0). Retrieved from https://www.uptodate.com/contents/treatment-and-prognosis-of-neoplastic-epidural-spinal-cord-compression?search=malignant%20spinal%20cord%20compression&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
National Institute for Health and Clinical Excellence. (2008). Metastatic spinal cord compression in adults: risk assessment, diagnosis and management (CG75). Retrieved from https://www.nice.org.uk/guidance/cg75
Vogel, W. (2020). Structural Emergencies. In J. M. Brant, D. G. Cope, & M. G. Saria. (Eds.), Core Curriculum for Oncology Nursing (6th ed.) (pp. 470-486). St. Louis, Missouri: Elsevier.

Oncology nurses are practicing the essential skills in MSCC care: the application of orthotics and log rolling.

Barriers and Facilitators of Cervical Cancer Screening Utilisation among People with Physical Disabilities

(Past member) — Mon, 03 Oct 2022 18:05:42 GMT

Authors

Dorothy N.S. Chan, RN, PhD; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Bernard M.H. Law, PhD; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Winnie K.W. So, RN, PhD, FAAN; The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Ning Fan, MBBS; Yan Chai Hospital, Hospital Authority, Hong Kong SAR, China

Cervical cancer screening utilisation is known to be of benefit to reduce the prevalence of cervical cancer,1 one of the most common cancers among women. However, individuals with physical disabilities, including those having impairments in mobility, vision and hearing, were reported to exhibit low cervical cancer screening utilisation rate.2,3 This renders them more likely to have missed the opportunities to detect any precancerous lesions early for a timely treatment that prevents these lesions to develop into cancer. Therefore, strategies need to be developed to increase the screening rates of individuals with physical disabilities. To do so, we need to have a better understanding on the factors that hamper and facilitate these individuals to undergo cervical cancer screening.

To this end, our team had previously conducted a systematic review exploring the barriers and facilitators of cervical cancer screening utilisation among individuals with mobility, visual and hearing impairments. Based on these identified barriers and facilitators, we aim to make recommendations on the potential strategies that help increase the screening rates of these disadvantaged individuals.

Overall, people with physical disabilities, especially those with mobility disabilities, are hampered to undergo cervical cancer screening by three major factors:
•    They possess limited knowledge, and even misconceptions, on the need for screening – they believe that screening is not needed if they feel healthy or are not sexually active.
•    They perceive that undergoing screening is an unpleasant experience, as they have been informed on the poor screening experience of their peers, potentially due to the lack of knowledge of healthcare professionals to work with people with disabilities.
•    They experience difficulties in accessing screening providers, especially owing to the hassle in making transportation arrangements and the lack of ramps for wheelchairs within the premises of screening providers.

On the other hand, individuals with physical disabilities would be more likely to undergo cervical cancer screening if an attendant is on hand to help these individuals throughout the screening procedures, and that the duration of screening appointments can be lengthened so that they can feel less rushed during the screening process.

The review findings enable the suggestion of several strategies for enhancing the cervical cancer screening utilisation rate of individuals with physical disabilities. First, public education on cervical cancer screening should be enhanced within communities, through the implementation of educational programmes that help clarify certain misconceptions on cervical cancer screening possessed by the public. Second, more resources may be allocated to train healthcare professionals to work with people with disabilities, enabling these healthcare professionals to be more patient with these disabled individuals. This may provide a more pleasant and relaxing experience for these individuals to undergo screening. Third, screening providers may also consider allocating resources to employ helpers assisting individuals with physical disabilities to get into position for the screening procedures, install disability-friendly facilities at their premises and provide transportation services for these individuals, offering them a greater level of convenience for them to attend screening appointments. All these may enhance the intention and capability of these individuals to undergo screening.

The article reporting the methodologies and findings of this review was recently published in Health Policy.4

References

1.    Landy R, Sasieni PD, Mathews C, Wiggins CL, Robertson M, McDonald YJ, Goldberg DW, Scarinci IC, Cuzick J, Wheeler CM; New Mexico HPV Pap Registry Steering Committee. Impact of screening on cervical cancer incidence: A population-based case-control study in the United States. Int J Cancer. 2020; 147(3): 887-896. http://dx.doi.org/10.1002/ijc.32826.

2.    Lofters A, Guilcher S, Glazier RH, Jaglal S, Voth J, Bayoumi AM. Screening for cervical cancer in women with disability and multimorbidity: a retrospective cohort study in Ontario, Canada. CMAJ Open. 2014; 2(4): E240-E247. http://dx.doi.org/10.9778/cmajo.20140003.

3.    Kellen E, Nuyens C, Molleman C, Hoeck S. Uptake of cancer screening among adults with disabilities in Flanders (Belgium). J Med Screen. 2020; 27(1): 48-51. http://dx.doi.org/10.1177/0969141319870221.

4.    Chan DNS, Law BMH, So WKW, Fan N. Factors associated with cervical cancer screening utilisation by people with physical disabilities: A systematic review. Health Policy. 2022: (in press). doi: 10.1016/j.healthpol.2022.08.003.

A schematic diagram depicting the identified barriers and facilitators of cervical cancer screening utilisation among people with physical disabilities.

Breast Cancer Awareness Month

Sat, 01 Oct 2022 13:38:57 GMT

October is Breast Cancer Awareness Month. Breast cancer is the most prevalent cancer globally and the leading cause of cancer death among women. WHO Global Breast Cancer Initiative aims to reduce global breast cancer mortality by 2.5% per year, averting 2.5 million cancer deaths globally by 2040.

Early diagnosis is key to reducing mortality. The International Society for Nurses in Cancer Care (ISNCC) is the proud recipient of a UICC grant for the early detection of breast cancer. ISNCC is using the grant funding to facilitate train-the-trainer initiatives and working with nurse leaders across Africa to educate ground nurses in the region on early diagnosis of breast cancer including health awareness messages and clinical breast examination. The goal is to maximize contributions of nurses, the biggest healthcare provider, to reduce cancer burden and mortality.

Union For International Cancer Control Initiatives

The Union for International Cancer Control (UICC) is raising awareness of Breast Cancer through Pink October this month. Learn more about their initiatives including the launch of a Master Course on “Good practices for planning and implementing breast cancer projects” on the UICC Breast Cancer Awareness Campaign Page.

As a proud member of UICC, ISNCC would like to encourage our community to help raise awareness of breast health and the importance of screening for the early diagnosis of breast cancer. As the largest component of the health workforce, nurses across the world play an important role in breast cancer management, including in the critical area of early diagnosis.

Launch of ISNCC Strategic Plan 2022-2025

Tue, 12 Jul 2022 15:39:17 GMT

The ISNCC Board of Directors is pleased to announce the release of the Society’s 2022-2025 Strategic Plan. The plan continues ISNCC’s long tradition as the global leader in cancer nursing and reconfirms our commitment to the identification, engagement, and development of nurses across the world as essential health care providers in cancer care and control.

The 2022-2025 Strategic Plan includes the following strategic directions:

Build and strengthen the cancer nursing workforce across the world
Influence global health policy
Advance and apply knowledge
Leverage partnerships with members and global citizens

Each direction is associated with a range of key activities that will enable ISNCC to achieve its mission to lead the global nursing community to reduce the burden of cancer.

Open ISNCC 2022-2025 Strategic Plan

Professor Winnie So to commence her Term as President of ISNCC

Fri, 01 Jul 2022 15:36:55 GMT

Professor Winnie So, BN, MHA, Ph.D., FAAN, will commences her four-year term as President of ISNCC from July 1st, 2022. Winne is a Professor at the Nethersole School of Nursing, The Chinese University of Hong Kong, and a Visiting Professor at the School of Nursing, Shandong University of Traditional Chinese Medicine. Winnie’s research interest focuses on cancer and palliative care, especially in relation to cancer prevention and early detection of cancer, supportive care needs, symptom experience, and quality of life of cancer patients. She has published over 170 papers in peer-reviewed journals and delivered more than 110 invited presentations/lectures at national/international conferences, workshops, research institutes, and universities. She is also the Editor-in-Chief of the Asia-Pacific Journal of Oncology Nursing and an Associate Editor of Cancer Nursing.

Outcomes of Elections to the ISNCC Board

Fri, 01 Jul 2022 15:33:08 GMT

The ISNCC Nominations and Awards Committee is pleased to announce outcomes for election to three vacant Board of Director Portfolio positions.

Corporate & Philanthropic Development Portfolio: Josephine Visser RN, BSN, OCN
Joanne is currently Oncology Clinical Territory Manager, Takeda Oncology, USA. She has extensive professional experience in a range of clinical and education roles. She has been an active member of the Oncology Nursing Society in the USA, contributing to a number of projects and committee roles. Joanne has been a member of the Corporate and Philanthropic Committee of ISNCC since 2019. She has been an active member with participation and bringing ideas/suggestions to assist with the goals of the strategic plan of the committee.

Knowledge Development & Dissemination Portfolio: Meinir Krishnasamy, B.A.(Hons), RGN, Master of Advanced Clinical Practice (Cancer Nursing), PhD
Meinir is currently Director, Academic Nursing Unit, Peter MacCallum Cancer Centre, Melbourne, Research and Education Lead - Nursing, Victorian Comprehensive Cancer Centre (VCCC) Alliance, and Professor of Cancer Nursing, University of Melbourne. She has made significant contributions to cancer nursing over the past 30 years including being a long standing and active member of ISNCC, contributing to and participating in the International Conference on Cancer. More recently, Meinir has been a member of ISNCC’s Policy and Advocacy Committee.

Member Development Portfolio: Lisa Kennedy Sheldon, PhD, ANP-BC, AOCNP®, CGNC®, FAAN
Lisa is currently Global Nurse Consultant and Oncology Nurse Practitioner, St. Joseph Hospital. She has more than four decades as a registered oncology nurse and certified nurse practitioner, and experience as a tenured faculty, consultant and author. Lisa is a longtime member of the Oncology Nursing Society (ONS) in the USA and has held positions on ONS research advisory panels. She was the first ONS Chief Clinical Officer. Lisa is also a longtime member of ISNCC and currently serves as an author mentor for Cancer Nursing.

The three successful candidates will take up their Board positions for a four-year term from July 1st, 2022. They join other continuing members of the Board, including:

Winnie So, President (from 1st July 2022)
Linda Watson, Secretary/Treasurer
Patsy Yates, Past President (from 1st July 2022)
Suzanne Bishaw, Conference Management Portfolio
Julia Downing, Policy and Advocacy Portfolio
Yongyi Chen, Communications Portfolio

I would also like to thank outgoing board members, Raymond Chan, Andrew Dimech, and Scarlott Mueller, for their outstanding contribution to the Board over the past four years.

Financial Toxicity: an emerging side effect of cancer

(Past member) — Thu, 16 Jun 2022 07:32:52 GMT

AUTHORS: Margaret I Fitch RN PhD, Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
Christopher J Longo PhD, Health Policy and Management, DeGroote School of Business, MacMaster University, Hamilton, Canada

Cancer and its treatments have many impacts and leave individuals and families coping with a range of challenges. One of the challenges we are understanding more about is financial toxicity. The term reflects both hardship and distress arising from the financial burden experienced during and following cancer treatment.

Initially, exploration of financial impact following a cancer diagnosis only focused on calculating costs of treatments. Investigations then moved on to explore the amount of ‘out-of-pocket’ costs which patients incurred. These are defined as expenses not covered by the healthcare system or reimbursed through health insurance. They can include costs for hospital bills, medications, supplies, counselling, transportation, and parking. These objective measures failed to capture the extent and complexity of the financial impact. More recently, subjective measures concerning distress and impact on quality of living have been explored.

Almost all people diagnosed with cancer will report having added expenses. Cancer patients/survivors report there are often “out-of-pocket” expenses they must pay themselves related to having cancer and being treated. The actual amounts vary from country to country but exist regardless of the type of healthcare system coverage in a country (i.e., public, private. combination).

Many individuals also report a loss of income which they attribute to cancer. Many who are working at the time of diagnosis report not being able to work for a time. This can also apply to family members. Some individuals will be covered by work leave or sick coverage plans, but this will vary from person to person. Those who are self-employed often face significant challenges if they are unable to work, as do those in fixed incomes. Additionally, whether an individual has private insurance coverage will influence the amount of income lost.

Patients use a variety of strategies to deal with the financial demands: using savings, reducing spending, forgoing leisure activities, or setting aside plans for items such as vacations, education, and home renovations. In some instances, they forgo medical care or medications.

The emotional distress engendered by financial burden varies from person to person. The extent of this strain is linked to such factors as financial status at the time of diagnosis, financial acumen, having insurance coverage, and ability to access financial support programs.

It is important that a conversation occur soon after diagnosis about the potential for financial burden. Patients need to be prepared for the financial impact and not taken by surprise. They need to know what resources are available to them. Some will have sufficient resources of their own and be able to manage without additional intervention, but others will benefit from additional assistance. The role of financial navigators has been implemented successfully in some cancer programs.

Screening for distress surrounding financial toxicity should be incorporated into routine practice. Often the financial impact emerges during treatment and may continue long after treatment has finished. It is important to identify those who would benefit from intervention as early as possible so that effects can be mitigated.

Selected References

Fitch MI, Sharp L, Hanly P, Longo CJ. Experiencing financial toxicity associated with cancer in publicly funded healthcare systems: A systematic review of qualitative studies [e-pub ahead of print]. J Cancer Surviv. doi: https://doi.org/10.1007/s11764-021-01025-7.
Fitch MI, Longo CJ, Chan RJ. Cancer patients’ perspectives on financial burden in a universal healthcare system: analysis of qualitative data from participants from 20 provincial cancer centres in Canada. Patient Educ Counsel. 2021;104:903–910. https://doi.org/10.1016/j. pec.2020.08.013.
Longo CJ. Linking Intermediate to Final “Real-World” Outcomes: Is Financial Toxicity a Reliable Predictor of Poorer Outcomes in Cancer? Curr Oncol. 2022; 29: 2483–2489. https://doi.org/10.3390/curroncol29040202
Longo CJ, Fitch MI, Banfield L, Hanly P, Yabroff KR, Sharp L. Financial toxicity associated with a cancer diagnosis in publicly funded healthcare countries: a systematic review. Support Care Cancer. 2020;28(10):4645–65. https://doi.org/10.1007/s00520-020-05620-9 Epub 2020 Jul 11 32653957.

This study was presented at ICCN2022 virtual conference.

Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

Building sustainability and resilience: Growing oncology nursing as a specialty in Rwanda

(Past member) — Thu, 16 Jun 2022 07:31:56 GMT

Authors:
Marie Goretti Uwayezu RN MScN¹Bellancille Nikuze RN MScN¹Emile Munyembaraga RN MScN¹Margaret I Fitch RN PhD^1,2,3

¹Scholl of Nursing and Midwifery, University of Rwanda, Kigali, Rwanda
²Bloomberg Faculty of Nursing, University of Toronto, Toronto Canada
³School of Nursing, New York University, New York, USA

The burden of cancer is increasing around the world with almost three-quarters of this burden expected to occur in middle- and low-income countries. The incidence is expected to double by 2050 in some Sub-Sahara African countries (Fidler et al., 2018). Rwanda lies at the heart of East Africa and has about 12.8 million inhabitants. Eighty-three percent live rurally in nuclear family compounds. The country can be held up as a model for how a resource-limited country can build a strong health care system.

The Rwandan health care system is a decentralized and multilayered system with specialized centres for some diseases. Cancer is one such specialty which is growing in terms of infrastructure and human resources. As of 2021 an estimated 10,704 new cancer cases were diagnosed annually and 7662 deaths occurred. The most frequent female cancer was cervical (12.2%) and for males was prostate (15.6%). Cancer surgery is available in district hospitals while chemotherapy and radiation treatment are available in selected specialty programs. Like other African countries, people face challenges in accessing diagnosis and treatment for cancer including lack of specialty centres close to home; transportation to screening, diagnosis and treatment facilities; financial concerns; and pain and symptom management. As a result many face a late diagnosis (Stage 3 or 4).

Rwanda has shown leadership for cancer control. A national five-year plan for cancer control exists as well as a comprehensive prevention program for HPV vaccination and clearly articulated palliative care policy, guidelines, and standards. The country launched its own morphine production and distribution program to meet the needs for pain management in palliative patients.

Advanced nursing and midwifery education was established in 1996 at the Kigali Health Institute with opportunities for advanced diploma, bachelor and master’s preparation. In 2007, five Schools of Nursing were established which, in 2013, were joined through a Ministry of Health initiative under the University of Rwanda. In 2015, a two-year Masters of Science Program was started with eight specialty tracks including Oncology Nursing. The other tracks were Critical Care and Trauma; Nephrology; Pediatrics; Neonatal; Perioperative; Medical-Surgical; and Education, Leadership and Management.

The Oncology Nursing Stream is a four-semester program and offers education for nurses across cancer screening, diagnosis, treatment and follow-up care of both adults and children. End-of-life care, psychosocial care and cancer rehabilitation topics are incorporated. A thesis is required, and clinical practice components occurs in several hospital, clinic, and home settings.

To date, three cohorts have graduated, and the 4^th and 5^th are enrolled. Graduates are assuming clinical and leadership roles in their respective health care facilities as well as faculty positions in Schools of Nursing. Additionally, they are beginning to publish their research and offer presentations at international conferences. The program is building capacity for oncology nursing in the country.

References

Fidler MM, Bray F, Soerjomataram I. The global cancer burden and human development: A review. Scandinavian Journal of Public Health, 2018; 46: 27–36.
Uwayezu, M.G., Nizure, B., & Fitch, M.I. (2020). Oncology Nursing Education: Looking Back, Looking Forwards and Rwanda’s Perspective. eCancer Journal, 14,1079. https://doi.org/10.3332/ecancer.2020.1079
Uwayezu, M.G., Nikuze, B., Fitch, M.I (2020). A Focus on Cancer Care and the Nursing Role in Rwanda. Canadian Oncology Nursing Journal, 30(3), 223-226.

This study was presented at ICCN2022 virtual conference.

Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

Giving voice to family caregivers of person with comorbid dementia and cancer

(Past member) — Thu, 16 Jun 2022 07:16:35 GMT

Reflection
Author: LING Cheuk Chi Gigi (RN, PhD), The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong

Throwback to a few years ago, a poll in UK revealed that persons over 50 are more terrified of developing dementia or getting cancer than other chronic illnesses (“Older people are more scared of”, 2014). Meanwhile, living and dying with comorbid cancer and dementia becomes increasingly prominent with the ageing population (McWilliams et al., 2018).

Family caregivers often devote a considerable time and effort in providing physical and psychosocial care to their loved ones during the end-of-life. Providing end-of-life care for persons with either dementia or cancer is well-known to be a stressful and burdensome experience (Secinti et al., 2021). The comorbidity of cancer and dementia might further amplify the intricacies of the end-of-life caregiving experience when the person’s physical, cognitive, emotional, and behavioural aspects are affected altogether at the same time by both illnesses. Understanding the unique struggles encountered by this specific group of family caregivers is essential to provide information in the development of nursing interventions to effectively support both the persons with comorbidity and their family caregivers. Nonetheless, limited studies have acknowledged this unique family caregiving experience.

In view of this, an interpretative phenomenological analysis (IPA) was employed to examine the unique end-of-life caregiving experience among family caregivers of persons with comorbid dementia and cancer (PwDnC). Twenty-one family caregivers of deceased PwDnC with diverse backgrounds and characteristics were recruited purposefully from a palliative care unit in Hong Kong. A total of eighteen semi-structured interviews were done as some caregivers in the same family were interviewed together. The audio recordings were then transcribed and analyzed in accord with the principles of IPA. This study yielded a high volume of information. The findings shared below is only part of the data set that mainly focus on the unique internal struggles that encountered by the family caregivers of PwDnC.

A main theme of unconfirmable silent suffering is unveiled with two subthemes that capture family caregivers’ internal conflict and perception towards the pain of their loved ones: (1) uncertain silent of dementia and (2) undoubted suffering of cancer. Family caregivers in this study believed cancer was the origin of noxious and yet their loved ones could not express their cancer pain due to the unexpressive nature of dementia. These two fallacious beliefs collided when dementia met cancer and ascribed to a sense of silent suffering and worries in family caregivers of PwDnC. On one hand, family caregivers worried their loved ones were suffering silently. On the other hand, family caregivers were also suffering from their own uncontrollable worries, which resulted in their immobilization and helplessness in providing care and management symptoms.

These findings give voice to the family caregivers and acknowledge the intricacy of family caregiving in the context of comorbid cancer and dementia. From the findings, we could see that the cancer diagnosis, the grave prognosis, and the possible interactions of all the new and preexisting signs and symptoms might increase family caregivers’ sense of uncertainty and resulting in impertinent worries regarding cancer pain. Taking account of the diversity of family caregivers, careful considerations is needed to develop appropriate assessment and relevant education for this unique group of family caregivers to reduce the ambiguity and uncertainty of caregiving. Further research is suggested to better understand the impact of perceived silent suffering to enable healthcare professionals and family caregivers to provide better care and symptoms management for persons with comorbid cancer and dementia.

All in all, family caregivers suffered not because of the heavy burden of caregiving, but because they loved and cared about their loved ones.

Image: Captured through my lens: Suffered from your Pain. Chinese ink on rice paper

Inspired by the data, I created this Chinese Calligraphy during data analysis in 2020. It represents the interpretation and perception of reciprocal suffering through love and caregiving.

References

Older people are more scared of dementia than cancer, poll finds. (2014, August 4). The Telegraph. https://www.telegraph.co.uk/news/health/elder/11008905/Older-people-are-more-scared-of-dementia-than-cancer-poll-finds.html
McWilliams, L., Farrell, C., Grande, G., Keady, J., Swarbrick, C., & Yorke, J. (2018). A systematic review of the prevalence of comorbid cancer and dementia and its implications for cancer-related care. Aging & Mental Health, 22(10), 1254-1271. https://doi.org/10.1080/13607863.2017.1348476
Secinti, E., Lewson, A. B., Wu, W., Kent, E. E., & Mosher, C. E. (2021). Health-Related Quality of Life: A comparative analysis of caregivers of people with Dementia, Cancer, COPD/Emphysema, and Diabetes and Noncaregivers, 2015–2018 BRFSS. Annals of Behavioral Medicine, 55(11), 1130-1143. https://doi.org/10.1093/abm/kaab007

This study was presented at ICCN2022 virtual conference.

Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

Establishing a Nutrition Rehabilitation Multidisciplinary Team (NRMDT) Led by Nurses: Clinical Outcome Assessments of Postoperative Patients with Head and Neck Cancer (HNC).

(Past member) — Thu, 16 Jun 2022 07:09:34 GMT

Yiyuan Zhao¹ （RN，MSN，NP）, Jingjing Wang¹ （RN，BN）, Yanli Wang²（RD）, Yening Zhang³（MD）, Ying Zhang¹（RN，BN）, Bin Zhang¹（MD，Professor）, Yuhan Lu⁴（RN，MSN，NP, Professor）

1. The Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck, Peking University Cancer Hospital & Institute, Beijing, China

2. The Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Nutrition, Peking University Cancer Hospital & Institute, Beijing, China

3. The Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-oncology, Peking University Cancer Hospital & Institute, Beijing, China

4．The Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Nursing Department, Peking University Cancer Hospital & Institute, Beijing, China

Rehabilitation management is crucial for postoperative inpatients with head and neck cancer (HNC) to reduce treatment related complications such as excessive salivary flow, anastomotic fistula and poor nutritional status. Recently, we conducted a study that aimed to establish a Nutrition-Rehabilitation Multidisciplinary Team (NRMDT) led by nurses and evaluate the effects of adopting this model in rehabilitation management on improving clinical outcomes among patients with HNC.

The NRMDT consists of a group of experts--surgeons, oncology nurse specialists, registered nurses, dietitians, palliative care physicians (Figure). The oncology nurse specialist in this department is also a certified Dysphagia Specified Nurse. The NRMDT is led by the oncology nurses who play essential roles in nutritional and symptom assessment, coordination of and monitoring multidisciplinary perioperative care (Table). They also provide a food-intaking-transition training to patients who have postoperative dysphagia (Picture).

Quasi-experimental design with a sequential sampling method was used in this study. The study was carried out from January 2017 to August 2021. A total of 49 HNC patients recruited were divided into the NRMDT group (n=38) and the control group (n=11). Patients in the control group received usual care from January 2017 to April 2018, whereas those in the NRMDT group were offered nutrition and rehabilitation management during the period of May 2018 to August 2021.Clinical outcomes including rates of weight loss, gastric tube dwelling time, the positive ratio of secretion, the occurrence rates of anatomic fistula, rates of hypoproteinemia, and length of stay were collected. SPSS software V.22.0 was used for data input and statistical analysis. Chi-square and independent-sample t-test were used to evaluate the clinical outcomes between these two groups.

The positive ratio of secretion in the NRMDT group was significantly lowerthan that in the control group（13.16% versus 45.45%, P=0.02). Furthermore, 2.63% of patients underwent anastomotic fistula in the NRMDT group, which was significantly lower than that in the control group (36.36%, P=0.01). The participants in the NRMDT group reported the proportion of weight loss and hypoproteinemia was 43.75% and 15.79% respectively, versus 54.54%(p=0.47) and 36.36% (p=0.29) in the control group. The days of gastric dwelling time and hospital length of stay were 16.87±7.91 and 19.89±6.31 in the NRMDT group compared with 21.18±9.87 (p=0.14) and 23.73±10.53 (p=0.27) in the control group.

This study demonstrated that the model of NRMDT may reduce the positive ratio of secretion and occurrence of anastomotic fistula among patients undergone surgery with HNC. A full‑scale study is warranted to examine its effects on improving other clinical outcomes for these patients.

Appendix

Figure The team members of NRMDT

Picture Assessment of dysphagia

Table Roles of nurses in the NRMDT model

	Oncology nurse specialist	Registered nurse
Preoperative stage	Quality control and management of perioperative and multidisciplinary care	Assessment of symptoms and food/fluid intake and output, coordination of multidisciplinary care, and timely respond to patients’ needs
Early stage of postoperative	Quality control and management of perioperative and multidisciplinary care	Coordination of multidisciplinary care, provide post-operative care, timely respond to patients’ needs
Rehabilitation stage	Assessment of dysphagia, nutritional status, provide food-intaking-transition training to HNC patients	Implementation of oral intake/ nutrition plan designed by oncology nurse specialist / dietitian
Stage of discharge and home-nursing	Follow-up all the discharged cases in the online or face-to-face nursing clinic	Provision of general health education and evaluation (with other team members if needed)

This study was presented at ICCN2022 virtual conference.

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Sailing for a New Chapter of Palliative Care: Parallel session of Palliative Care for 2021 Chinese Conference on Oncology (CCO)

(Past member) — Thu, 16 Jun 2022 02:56:31 GMT

Authors: Yongyi Chen, Yang Liu, Junchen Guo

Affiliations: the Palliative Care Committee of China Anti Cancer Association (CACA)

On April 23, Parallel session of Palliative Care for 2021 Chinese Conference on Oncology (CCO) was held online. A total of nearly70,000 experts and representatives have attended this conference.

Those who share the same aspirations are not far away

Daiming Fan, the chairman of China Anti Cancer Association (CACA), attended the opening ceremony and delivered a speech. He pointed out that palliative care is at a flourishing stage. As the first palliative care conference for annual CCO, more and more health care workers would benefit from this influential conference. The integrated perspective and multi-dimensional strategies would be applied to improve the whole life cycle health.

Yazhou Xiao, the Director of the Palliative Care Committee of CACA, extended a welcome speech. He called on palliative care workers to work together for the better palliative care collaboration, the more refined quality improvement, and the higher level of science and technology innovation. The ultimate goal is to achieve the improvement of the quality of life for end-stage patients.

The video "Journey of Life, Love is always there" filmed by the Association was played at the conference. A book release ceremony for "Love in Peace: narrative stories from the palliative care ward" was held. Prof. Ruixian He, Xiaoxia Xu, Zhangyu Pan, Huiqing Yu, and Yongyi Chen were served as the hosts of the conference.

Those who are in harmony do not regard the region as the boundary

The conference comprised of three modules: The development of palliative care, the practice of palliative care, spiritual comfort and quality management of palliative care.

Concurrent Session 1: The development of palliative care

The topic of Prof. Yazhou Xiao was"Palliative Care: Protecting the dignity of the last mile of life", shared the review and reflections of understanding the development process of palliative care from various angles, the responsibility of promoting the steady development of palliative care from multiple dimensions, the practice of improving the service capacity of palliative care through multiple channels, and the countermeasures and prospects for the all-round development of palliative care with multilevel assistance. He emphasized that the "last mile" of life is a livelihood project and a system project that requires the joint efforts of all medical staff and even the whole society.

In "Palliative Care Development in China: Past, Present and Future", Prof. Jin Gu from Peking University Cancer Hospital elaborated on the development and practice of palliative care in four aspects: the unprecedented changes in a century, the changes in doctor-patient relationship, and the construction of palliative care centers, medical humanities and hospital culture. He introduced how to spread the concept of palliative care and led the behavior of medical care, so as to arouse more attention and investment in palliative care from the society.

Concurrent Session 2: The practice of palliative care

ProfGuijun Lufrom Tsinghua Changgeng Hospital in Beijing elaborated"Palliative Care Discipline Development and Professional Practice Outlook" in three aspects:re-examination of medical model, palliative care discipline development, and thepractice outlook. He reviewed the demand, current situation, and policy evolution of palliative care in China. He also put forward "four assessments": funeral assessment, burial assessment, grief assessment, and growth assessment, as well as the "five satisfaction": the deceased, bereaved families, teamwork, policy integration, and self-satisfaction.

Prof. Wenwu Cheng from Fudan University Cancer Hospital shared his in-depth analysis of the difficult issues of palliative care in clinical practice in "Difficult aspects of palliative care in clinical practice". He offered corresponding countermeasures and suggestions on how to promote the concept of palliative care, popularize knowledge and education, formulate corresponding norms to safeguard the rights and interests of all parties, improve the breadth of coverageand perfect the protection system, build a diversified model for quality services.

Concurrent Session 3:Spiritual comfort and quality management of palliative care

Prof. Yifang Wang shared his plenary address regarding "Spiritual Comfort at the End of Life in Chinese Cultural Perspective". His speech began with traditional Chinese folklore and expanded to physical, psychological, social, and spiritual palliative care, multiple and multidirectional transmission of holistic concepts, philosophical rhetoric and philosophical categories. He also shared the concept and historical of spirit development, the essence of spirit, and spiritual care from the perspective of care, analyzed the concept of death, near-death experience, and near-death image, and emphasized the importance of spiritual comfort at the end of life.

Prof. Yongyi Chen of Hunan Cancer Hospital shared the practice of quality management from the perspective of high-quality development of palliative care. She explained in detail the model, assessment tools and management exploration of palliative care quality management around three aspects: opportunity, practice and prospects. She believed that rigorous and scientific quality management will help to realize the systematization of the quality assessment of palliative care and the homogenization and standardization of the quality assessment of palliative care.

Those who know each other are not thousands of miles away.

The conference set up an "expert connection" session, three experts discussed online and explored the future development of palliative care.

Prof. Ping Zhao of the Cancer Foundation of China reviewed the development history of palliative care. He pointed out that although China moved up from the 71^st to 53^rd in the Death Quality Index released in 2021, there was still significant space for improvement in death quality.

Prof. Duanqi Liu analyzed the palliative home care model in the context of normalized COVID-19 pandemic. He believes that advanced cancer patients are a rather vulnerable group under the COVID-19. He emphasized it was necessary to realize the integration and coordinated development of needs, resources, and professions from the perspective of integration.

Prof. ShiyingYu from Tongji Hospital considered that how to transform the realization of palliative care wishes into concrete actions is a question worthy of in-depth consideration. We can refer to the international document, standards, and guidelines on the core elements of palliative care to retain the dignity of terminal patients,

Prof. Yongyi Chen made a summary of the conference. In the future, the committee will continue to take the responsibility to realize service optimization to get out of the "acceleration" of the high-quality development of palliative care, utilized the ability to press the "fast-forward key" of the high-quality development of palliative care, and carry out popular science education to drive into the "fast lane" of the high-quality development of palliative care.