Submitted by Scarlott K Mueller, MPH, RN, FAAN, ISNCC Board Member
As the world
watches the challenges and suffering of the people of Ukraine, I want to share how
the American Cancer Society, along with the American Society of Clinical
Oncologists and the Sidney Kimmel Cancer Center-Jefferson Health, are
partnering to assist the Ukrainian cancer patients and their families. With
over 179,000 newly diagnosed cancer patients in Ukraine, displacement from
their homes and lack of medical resources may lead to significant disruption in
care and treatment and may negatively impact their cancer survival. This
collaborative healthcare group is making available valuable cancer information
in languages that include English, Ukrainian, Polish, and Russian and can be accessed
at www.cancer.net/ukraine.
In addition, these partners are supporting the American Cancer Society Clinician Volunteer Corps comprised of oncologists and oncology nurses. These volunteer resource individuals will be available to answer inquiries from Ukrainian patients and families through connection with the American Cancer Society’s National Cancer Information Center at +1-800-227-2345 and can be reached 24 hours a day. Oncology nurses and physicians who are interested in participating in this humanitarian effort should complete a volunteer form online at www.cancer.org/ukrainevolunteer. Members of the American Society of Clinical Oncologists should use the website international@asco.org.
The American Cancer Society and these partners stand in solidarity to support Ukrainian cancer patients and their families. As global oncology nurses, our support can also have influence.
Author: Dion Smyth, Senior Lecturer (Cancer and Palliative care), Birmingham City University, Birmingham, UK
The global Covid-19 pandemic has profoundly disturbed and continues to disrupt, cancer care and management. Despite professionals and cancer services responding rapidly to the challenges posed by the pandemic with a range of changes to their service delivery, we know that delayed or decreased access to screening, early diagnosis, and treatment has been a typical finding across the globe.
For example, research into the impact of Covid-19 has recounted that breast cancer screening declined in communities of color and populations of income deprivation in the US (Feweda et al, 2021); whilst, in the UK, Cancer Research UK estimates 3 million fewer people were screened, compared to pre-pandemic levels of activity (CRUK, 2021). Englum et al (2021) found that there was a significant reduction in the number of cancer diagnostic procedures, such as colonoscopies or prostate biopsies undertaken. Waiting lists and times for treatment of cancer are at record levels in the UK (NHS England, 2021), all of which clearly impact the mental health and well-being of patients waiting and worried about their diagnosis and, potentially, treatment outcomes.
So, what can nurses do?
Obviously, the various government and population and individual responses vary, and so practitioners will work within the political and practical frameworks of their nation-states; however, there is still much that can be done. For example, we might lobby for more resources, whether that is local or a broader societal issue.
Nurses can advise, inform or advocate for the vaccination program so that the impact of incidence in a population can be mitigated, just as the vaccination against oncogenic viruses, such as HPV is known to lessen the burden of cervical cancer.
We might also look at how we can share our experiences, examples of good practice, and practice development so that our colleagues across the globe can gain insights into new ways of working. To that end, writing a blog piece for the ISNCC site is a good and commendable place to start.
The ISNCC is excited to announce the International Conference on Cancer Nursing 2022 (ICCN2022) to be held virtually from February 23rd through February 25th, 2022. The conference will include plenaries, instructional sessions, at least one educational workshop, and industry-supported educational sessions. A virtual library of oral and poster abstracts will also be included.
Theme and Objectives
The conference theme is “Building Sustainability & Resilience: Global Perspectives on Cancer Nursing,” with the following objectives:
Define the evolving challenges facing oncology nurses as they provide care across diverse cultures
Examine the emerging evidence demonstrating the impact of cancer nursing on equitable cancer control worldwide
Describe innovative approaches to nursing education, practice, research, and policy
Evaluate the current status, barriers and solutions of the health sector’s impact on the environment
Identify the influence oncology nursing practices have on the global burden of cancer
ICCN2022 Website
The ICCN2022 website, ICCN2022.com, is currently under development and will be available in early to mid-October. An announcement will be sent once it is available.
Abstract/Instructional Sessions
The abstract submission process will begin in mid-October and remain open for approximately 6 weeks, ending in early December. Oral and poster abstract submissions will be accepted for the virtual library and instructional session abstracts for the virtual conference.
Abstract Categories
Administration/Management/Leadership
Advanced Practice
Education
General Practice
Health Policy & Advocacy
Research
Abstract Topics
Cancer across the Lifespan
Cancer Continuum
Disparities/Equity/Culture
Environmental Issues
Family & Caregivers
Health Care Crises
Health Systems/Models of Care/Workforce
Innovations in Practice, Education & Technology
Palliative Care
Professional Issues
Psychosocial/QOL
Research Issues/ Methods
Survivorship
Symptom Management
Watch our website for more details as we launch the ICCN2022.org website and announce the call for abstract submissions!
Author: Karen Kane McDonnell PhD, RN, Associate Professor, Co-Director, Cancer Survivorship Center, College of Nursing, University of South California, United States
Survivors of cancer should avoid inactivity and be as physically active as possible (Campbell et al., 2019); however, exercise remains underutilized in cancer care programs.
Physical activity (PA) is an important behavior for the prevention and management of numerous acute and chronic diseases (Courneya & Friedenreich, 2010). The number of cancer survivors is rising worldwide, propelled by advances in early detection and treatment and the aging of the population. The predicted global cancer burden is expected to exceed 27 million new cancer cases per year by 2040, a 50% increase in the estimated number of new cancer cases in 2018 (Wild, Weiderpass, & Stewart, 2020). Many cancer survivors are motivated to seek information and advice about PA to improve their response to treatment, facilitate recovery, reduce their risk of recurrence, and improve their quality of life (QOL) (Rock et al., 2012).
Exercise is defined as “a physical activity causing an increase in energy expenditure and involving a planned or structured movement of the body performed in a systematic manner in terms of frequency, intensity, and duration, and designed to maintain or enhance health-related outcomes” (Campbell et al., 2019). For over five decades, PA has been tested as an intervention strategy to help survivors with cancer prepare for, manage side effects of, and recover after treatments. The field that considers PA and cancer survivorship together—exercise oncology—has exploded. The literature now contains thousands of studies about the effects of PA in survivors of cancer; these studies have, in turn, generated dozens of systematic reviews, several sets of international guidelines, and calls for the integration of PA programs into clinical and community cancer care (Courneya, 2017).
PA recommendations vary across the cancer continuum and remain an important area of research. PA interventions have been shown effective in treating both the physical and psychological impairments associated with some cancers and their treatments, with potential for improving overall outcomes. Despite mounting evidence of its benefits, PA is still underutilized due to lack of awareness and knowledge among health-care providers, survivors of cancer, and survivors’ family members (who are often also caregivers) (Maddocks, 2020).
International Guidelines on Exercise and Cancer
Several organizations have put forth guidelines that include specific PA recommendations for cancer survivors; these guidelines include the American College of Sports Medicine’s (ACSM) International Multidisciplinary Roundtable on Exercise and Cancer (Campbell et al, 2019); Exercise and Sports Science Australia’s (ESSA) exercise and cancer position statement (Hayes, Newton, Spence, & Galvão, 2019); and the American Cancer Society’s (ACS) Nutrition and Physical Activity Guidelines for Cancer Survivors, (Rock et al., 2012). See Table 1.
In 2018, the second
ACSM Roundtable on Exercise and Cancer was assembled to advance their previous recommendations
beyond public health guidelines and progress toward prescriptive programs
specific to cancer type, treatment, and outcomes (Campbell et al., 2019). The
Roundtable reaffirmed that PA, exercise testing, and training are generally
safe for survivors of cancer and that every survivor should avoid inactivity.
Also, the group determined that adequate evidence exists that specific doses of
aerobic, resistance, or combined aerobic-plus-resistance training could improve
common cancer-related health challenges, including anxiety, depression,
fatigue, reduced physical functioning, and health-related QOL.
ESSA incorporated
current scientific evidence, coupled with clinical experience and exercise
science principles, to update its position statement on cancer-specific
exercise prescriptions in 2019 (Hayes et al., 2019). ESSA recommends a process for
developing targeted exercise prescriptions. The ESSA framework includes patient
assessment, determination of coexisting health issues, identification of
patient capacity and intervention suitability, creation of an exercise
prescription according to survivor-driven exercise-related goals, and
reassessment.
The ACS’s guidelines address both PA and nutrition for the full continuum of cancer survivors, including those in treatment and recovery, long-term disease-fee living, living with stable disease, and living with advanced disease (Rock et al., 2012). The ACS notes that it is important to remember that survivors across the entire cancer survivorship continuum have different PA needs and challenges, including unique motives, barriers, and preferences.
Summary: The Evidence and Implications for Practice
Overall, evidence exists supporting the implementation of an exercise prescription for survivors of cancer due to its role in reducing morbidity, improving day-to-day physical function and QOL, and improving the potential for survival—all with a low risk of harm. However, the strength of the evidence in relation to exercise safety, feasibility, and benefit depends on cancer type and outcome of interest. While for some survivors, multimodal, moderate- to high-intensity exercise will be appropriate, others will not be able to tolerate such PA levels. Because of the wide-ranging variances across the cancer continuum, there is no set prescription and total weekly dosage of PA that is considered evidence-based for all survivors. Consequently, PA prescriptions need to be targeted and individualized according to survivor- and cancer-specific considerations (Campbell et all., 2019; Hayes et al., 2019; Rock et al., 2012).
For survivors to maintain or improve physical function and possibly reduce cancer-related toxicities, oncology nurses must be prepared to discuss the short- and long-term benefits of PA (Mustian, Lin, Cole, Loh, & Magnuson, 2020). Ideally, oncology providers should partner closely with exercise professionals (like physical therapists or certified cancer exercise trainers) to help identify risks and contraindications that may affect exercise safety and tolerance, and to create individualized exercise prescriptions to meet the unique needs of survivors with various cancer types and disease stages. Lack of knowledge, resource funding, facilities, programs, qualified staff, and exercise specialists in cancer care may be barriers in many settings.
With international guidelines as a springboard, we urge oncology nurses to initiate discussion of PA recommendations for survivors with their colleagues and regularly incorporate those recommendations into their care plans. In addition, more exercise intervention studies with diverse groups of survivors in various settings, including the home, community, and hospital, are needed to grow the evidence base and gain widespread acceptance among professional and the lay communities.
References
Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., . . . Schmitz, K. H. (2019). Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Medicine and Science in Sports and Exercise, 51(11), 2375–2390.
Courneya, K. S. (2017). Exercise guidelines for cancer survivors: Are fitness and quality-of-life benefits enough to change practice? Current Oncology, 24(1), 8.
Courneya, K. S., & Friedenreich, C. M. (2010). Physical activity and cancer: An introduction. In K. S. Courneya & C. M. Friedenreich (Eds.), Physical Activity and Cancer (pp. 1–10). Berlin, Germany: Springer.
Hayes, S. C., Newton, R. U., Spence, R. R., & Galvão, D. A. (2019). The Exercise and Sports Science Australia position statement: Exercise medicine in cancer management. Journal of Science and Medicine in Sport, 22(11), 1175–1199.
Maddocks, M. (2020). Physical activity and exercise training in cancer patients. Clinical Nutrition ESPEN, 40, 1–6.
Mustian K., Lin, P. J., Cole, C., Loh, K. P., & Magnuson, A. (2020). Exercise and the older cancer survivor. In M. Extermann (Ed.), Geriatric Oncology (pp. 917–938). Berlin, Germany: Springer.
Rock, C. L., Doyle, C., Demark‐Wahnefried, W., Meyerhardt, J., Courneya, K. S., Schwartz, A. L., . . . Gansler, T. (2012). Nutrition and physical activity guidelines for cancer survivors. CA: A Cancer Journal for Clinicians, 62(4), 242–274.
Wild, C. P., Weiderpass, E., & Stewart, B. W. (2020). World cancer report: Cancer research for cancer prevention. Lyon, France: International Agency for Research on Cancer [IARC]. Retrieved from the IARC website: http://publications.iarc.fr/586.
Disclosure: Karen Kane McDonnell is supported by the American Cancer Society
under award number MRSG-17-152-01 and the Bristol Myers Squibb Foundation. The
content is solely the responsibility of the author and does not represent the
official views of the American Cancer Society or the Bristol Myers Squibb
Foundation.
Monthly online lectures from leading global experts in Cancer Care Nursing
ISNCC, in collaboration with Continulus, is making world-expert lectures accessible and convenient for all Cancer Care Nurses globally. Access at a time, pace and place that suits you, without the time, cost, hassle or environmental impact of travel. Plus, each lectures comes with a certificate and 1 CPD point or 1 CEU.
Watch live or recorded; take notes; ask questions; download the slides; discuss in the forums.
Plus, each lecture comes with a certificate and 1 CPD point or 1 CEU (USA).
