North Carolina Triangle Oncology Nursing Society. TONS of NEWS

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1 North Carolina Triangle Oncology Nursing Society TONS of NEWS 2011 Volume 1, No. 1 SPRING What s new in 2011? April 2011 Welcome to the new and improved TONS Newsletter. Now available in electronic form, and printer friendly. Check out imbedded hyperlinks for websites and . Upcoming Events May 25 June 11 Celebrate Nurses Month!! The Art of Exceptional Professional Performance: Making a Difference in Your Patient s Lives Race for the Cure Komen Breast Cancer Race TONS Team Team: Triangle Oncology Nursing Society

2 President Rita s Corner A Leader is best when People barely know he exists Lao-Tsu Leadership Quotes My year as President of the 2011 TONS board has pretty much made me an invisible leader. The gifts and talents of our Board have made me lead a pretty sedentary life. I started my year out with the great honor of our Chapter winning the 2011 National ONS Chapter Excellence Award.This award was based on the volumes (literally) of achievements that our TONS members acquired through awards, published articles, accomplishments, etc Wow, I get to be the front-woman of such great talent!!!!! So I ask myself, though, How do I lead a Board and Chapter of Leaders? My answer came from one of my wise oncology patients: God gave us two ears for a reason-so we listen more than talk. So my goal as your President is to listen to our Board of Leaders, to you the Leaders of our TONS community, and always to the needs of our Oncology patients as we continue to be their voice. The leadership instinct you are born with is the Backbone. You develop the funny bone and the wishbone that go with it. Elaine Agather First Annual Regional Conference TONS Presents: Triangle Cancer Symposium 2011 Saturday October 8th

3 Oncology Nursing Society State-of-the-Science Lecture LOS ANGELES, CA February 11, 2011 Donald Bailey, Jr., PhD, RN, presented the 2011 Oncology Nursing Society (ONS) State-of-the-Science Lecture, Illness Uncertainty in Adult Cancer Patients, today during the ONS 11th National Conference on Cancer Nursing Research in Los Angeles. Bailey is an associate professor at the Duke University School of Nursing in Durham, NC. Chip Bailey, PhD, RN Assistant Professor Senior Fellow, Center for the Study of Aging New discoveries in oncology nursing science are critical to improving patient and family outcomes, said Bailey. The findings from this award represent one step in that process that I hope will lead to new interventions and their translation to practice. In his presentation, Bailey synthesized the research literature on illness uncertainty in the cancer experience, categorized these data by cancer care continuum phase, and suggested directions for future research and the use of research to advance practice in oncology nursing. Bailey received his bachelor of science in nursing degree from Barton College in Wilson, NC, his master of science in (Continue on next page ) ONS 36TH ANNUAL CONGRESS APRIL 28 MAY 1, 2011 BOSTON, MASSACHUSETTS (electronic version view hyperlink below) Advanced Practice Nursing Conference November 3 5, 2011 Salt Lake City, Utah 12 th Annual Institutes of Learning November 4 6, 2011 Salt Lake City, Utah Registration info not yet available. Central/Conferences

4 2 nursing degree from Emory University in Atlanta, GA, and his doctorate from the University of North Carolina, Chapel Hill. He is an active member of the North Carolina Triangle Chapter of ONS, the ONS Advanced Nursing Research Special Interest Group, and Sigma Theta Tau International Honor Society of Nursing. The Oncology Nursing Society (ONS) is a professional organization of more than 35,000 registered nurses and other Treasurer s Report healthcare professionals committed to excellence in oncology nursing and to leading Kim Camp Treasurer Checking Savings and actively supporting educational, legislative, Money Market TOTAL: the transformation of cancer care by initiating $27, and public awareness efforts to improve the 8, care of people with cancer. ONS provides $36, nurses and healthcare professionals with access to the highest quality educational programs, cancer care resources, research opportunities, and networks for peer support. Program Report Learn more at Kerri Richards Program Chair UPCOMING MEETINGS 1. th MAY 25 Celebrate Nurses Month!! Motivational speaker Imperial 6:00pm 2. st JUNE 21 Partnering with HPNA, TONS Business Meeting. Duke School of Nursing SEPTEMBER TBA Rey Garcia President ex-officio, Kerri Dalton Program Chair, & Joan Cahill appointed board member OCTOBER 8th Regional Conference William & Ida Friday Center 4

5 TONS of Literati! I M TOO YOUNG FOR THIS! - by Luke Holland I2y is a 501(c)(3) Nonprofit Organization Registered in New York. I2y like many Adolescent & Young Adult (AYA) advocacy/support organizations was founded by AYA survivors. Since 1996, there has been a growing upsurge of AYA advocacy directed at the unique needs of those aged Unfortunately, 13 years later, despite living in an age of unbridled global communications, most AYAs affected by cancer (and their care providers) are not aware of the myriad of resources created specifically for AYAs. I2y favors a collaborative and noncompetitive approach by serving as a communications umbrella and socially relevant brand that is finally connecting the dots between socially isolated AYA patients, their providers, and > 400 international AYA resources. In doing so, i2y is innovating cancer advocacy by ending isolation and engendering the first international click-and-mortar social community of young adults affected by cancer. Nearly 70,000 Americans (approximately 6% of new cancers) between are diagnosed with cancer each year, numbers 7x greater than those in pediatrics but still a small minority in the overall cancer population. Unlike the childhood cancer population though, the AYA cancer cohort has largely not been realized as a unique population biologically, economically, and psychosocially. Until relatively recently in the war on cancer, the only thing speaking for the AYA cancer minority has too quietly been our decade s long lack of surviving cancer. In North Carolina we hope our small but growing local chapter of I2y volunteers can assist the growing grassroots voice of the AYA cancer advocacy minority while advocating side by side with and for the other 94%. THE CAUSE: Young Adult Cancer THE VISION: No Survivor Alone THE MISSION: Empower Young Adults THE GOAL: Save More Lives ch?v=sm3kcfc1if0&feature=p layer_embedded

6 Healthcare is Too Important to Leave Up to Congress U.S. Senator Kay Hagan of NC Jennifer Stewart RN, OCN nursing legislation and was a member of the Nursing Caucus; I didn t have to ask for his Last month, I was fortunate to spend four days in Washington, D.C. on Capitol Hill learning how to become an effective health care advocate through the Nurse in Washington Internship (NIWI). The goal of this program is to prepare nurses (all levels of education) to become involved and influence policy at all levels of government. support. So I simply asked the Congressman what is truly going on in Washington and how is it going to affect my nursing colleagues and myself. Congressman Price explained very frankly that currently Congress is arguing over a budget for 2011 that is half over according to their fiscal year. He went on to explain that he, and other members of Congress, needed to hear from their constituents regarding issues important to them. As a representative of ONS and the state of North Carolina, I had the opportunity to meet with the health policy staffers for Senators Richard Burr and Kay Hagan, as well as Congressman David Price and his staffer. NIWI and ONS provided me with my request or asks. The asks included: increase funding for the Nursing Workforce Development programs at HRSA, provide additional resources to the National Institute of Nursing Research (NINR), and the Improving Cancer Treatment Education Act of They want to hear the personal stories about how additional funding for Cancer Treatment Education will help me explain to my patient and their family how chemotherapy will truly effect them and how they can best care for themselves. In Washington, it s true that the squeaky wheel gets the oil, especially during the current financial crisis. As I stood to shake Congressman Price s hand at the conclusion of our meeting, I asked him to attend one of our TONS Chapter meetings so he can learn what great things oncology nurses are doing in his district, he agreed. The most candid of my meetings was with Congressman Price. The meeting was scheduled at 4:30pm. He joined the meeting about ten minutes late with his sleeves rolled up and ready to get down to business. I walked away from my day on Capitol Hill feeling inspired and motivated to truly start the advocacy work which has to begin at home. If you have additional questions regarding NIWI, ONS health policy initiatives, or health advocacy in general please contact me at Jennifer.ramstack@duke.edu. From my research on Congressman Price s voting record and history of support in his district (NC 4th District), I knew he supported most health and After all, you are all excellent patient advocates now you just need to let Congress know you mean business. U.S. Congressman th David Price of NC 4 District 6

7 We Want to Give You Money - Joan Cahill TONS is committed to promoting oncology certification within our Chapter. Last year TONS received a generous grant of $1000 from ONCC to support this goal. TONS will match this grant by adding an additional $1000 of our Chapter funds to encourage certification. If you are a member of ONS and TONS, you could be eligible to receive a $100 bursary. You need to have certified for the first time as an OCN, CPHON, AOCNS, AOCNP or CBCN since July of To receive this bursary, you should send a copy of your certification to Joan Cahill or any TONS board member. If you are thinking about certification this year, TONS can match you with a member to mentor you in reaching your certification goal. Oncology certification is an important part of professional development. Over the next two years, our TONS chapter aims to increase the number of newly certified nurses by at least 20 individuals. Approximately 60% of our current membership is certified, so if you are planning to take a certification exam, remember that there is a wealth of experience available to you in our TONS members. Contact Joan Cahill to have a mentor from TONS to help you through the process. You can do it! CORNUCOPIA SUPPORT PROGRAM New Member Spotlight - Rosie Smith At Cornucopia Cancer Support Center, we believe that all people touched by cancer benefit when they are part of a caring community that offers support, compassion, and hope as they navigate that difficult path. We promise to be a place where anyone touched by cancer can find the support and resources they need to live life to the fullest. Whether you have cancer, are a survivor, family member, caregiver, or close friend, we are here for you. Our integrative programs include yoga, therapeutic massage, Polarity, Reiki, and more. We host SPONIC, Metastatic, I'm Too Young for This (i2y) and brain cancer support groups. We also offer Peer Connect - a one-on-one support for those who would like to talk with someone who has had a similar journey. Participants are matched with a Guide that has been trained and is volunteering to offer their support and guidance. We provide all our services free of charge at our facility in Durham and in-home when individuals are unable to leave their homes. More information is available online at or by calling 919/

8 ! New Drug Alert! Cabazitaxel (Javtana): Treatment for Advanced Prostate Cancer by Christina M. Davis, Duke University Graduate Nursing Student The American Cancer Society estimates that 217,730 new cases of prostate cancer were expected in 2010, and approximately 32, 050 deaths. There are more than 2 million men living with a diagnosis of prostate cancer in the U.S. Many men never receive treatment for prostate cancer due to the slow growing nature of the disease. Prostate cancer is routinely monitored with regular PSA testing, rectal exams and ultrasound. Treatments include surgery, radiation therapy, androgen deprivation therapy and chemotherapy. Surgery is used to cure prostate cancer if metastasis is not apparent. Hormone therapy is also a treatment choice for the disease. Prostate cancer cell growth is stimulated by androgens. The purpose of hormone therapy is to reduce androgen levels in the body. If hormone therapy is not effective and prostate cancer has metastasized, chemotherapy is the optimal treatment choice. An improvement in overall survival rate and reduction of symptoms in advanced prostate cancer can be attributed to the use of the chemotherapy drug docetaxel (Taxotere) and prednisone. Although docetaxel has been an efficacious treatment, some men become chemotherapy resistant. Cabazitaxel (Jevtana) has been developed to treat advanced prostate cancer in men not responding to docetaxel and hormone therapy (Prostate Cancer, 2010). Cabazitaxel is a Taxane chemotherapeutic agent. It is a microtubule inhibitor with a chemical structure very similar to docetaxel. It binds to and stabilizes tubulin, which inhibits microtubule depolymerization and cell division (Williamson, 2011). Cabazitaxel leads to cell cycle arrest and cell death (Bilusic & Dahut, 2010). Predominately metabolized by CYP3A4/5 isoenzyme in the liver, seventy-six percent of cabazitaxel is excreted in the feces. Approximately 4% is excreted in urine (2.3% is unchanged drug in the urine). Half-life of Cabazitaxel is 95 hours (Jevtana, 2011). The final solution must be administered within 8 hours if it remains at room temperature. If refrigerated, it must be used within 24 hours. The solution should be clear and free of crystallized particles. Cabazitaxel is administered intravenously over one hour. Administration is preferred immediately after preparation. A 0.22-micrometer in-line filter is required for use (Highlights of Prescribing Information, 2010). (Continued on next page.)

9 Neutropenia was the most prevalent adverse reaction. Five patients in the clinical trial experienced sepsis or septic shock. Hypersensitivity reactions such as rash/erythema, hypotension and bronchospasm, were found during the administration. Neutropenia was the most prevalent adverse reaction. Five patients in the clinical trial experienced sepsis or septic shock. Hypersensitivity reactions such as rash/erythema, hypotension and bronchospasm, were found during the administration. Severe electrolyte imbalances were noted in patients with severe diarrhea. Other GI symptoms included nausea and vomiting. Adverse reactions include anemia, leukopenia, thrombocytopenia, fatigue, constipation, asthenia, abdominal pain, hematuria, back pain, anorexia, peripheral neuropathy, pyrexia, dyspnea, dysgeusia, cough, arthralgia, and alopecia (Highlights of Prescribing Information, 2010). According to some prostate cancer patients, the additional three months cabazitaxel provides may not be worth enduring if the side effects decrease quality of life within that time frame. Patient advocacy is a paramount component within the nursing profession. The healthcare provider must ensure that the patient has the proper information regarding cabazitaxel. Neutropenic patients should not receive cabazitaxel therefore monitoring lab values prior to initiation of therapy is important. Prior to administration, premedicating the patient to prevent hypersensitivity reactions is keen. After administration the provider must guarantee that the patient understands the side effects to treatment. Monitoring temperature, frequency of stools and changes in elimination are topics that must be heavily emphasized in patient teaching (Highlights of Prescribing Information, 2010). Docetaxel has been a primary treatment choice for men with advanced prostate cancer but the development of cabazitaxel overs new hope for many patients. Cabazitaxel provides patients with an increase overall survival rate and a decrease in the progression of the prostate cancer. Cabazitaxel is currently being studied in various clinical trials with a possibility of becoming an influential weapon in the fight against advanced prostate cancer. For references please contact TONS Newsletter administrator or article author.

10 WANT TO JOIN? NEED TO RENEW? DOWNLOAD THE TONS MEMBERSHIP APPLICATION: nnnstp7 Please print a copy, complete the form, then either bring to our next scheduled meeting, or Mail to: TONS P.O. Box Durham, NC TONS Virtual Community w Calendar of posted TONS events, as well as various oncology community events. w Automatic s notifying you of job opportunities, oncology-related community events, and educational activities. w View TONS board & membership meeting activities. w See photos of you and your fellow TONS members! (All at your fingertips, really click the hyperlink above) T.O.N.S. of Accomplishments Our chapter was awarded the Chapter Excellence Award for 2010!! We have an amazingly vibrant and intellectual group of Oncology Nurses in the Triangle. What s even more amazing is that we only reported accomplishments for roughly 25% of our membership. We know you are out there making a difference. Please do not hesitate to let us know if you are doing something proactive, or if you know of someone else who is! Let us know about your presentations, publishing, community activism, participation in ONS sponsored events, etc. We want to continue to prove that we are an Excellent chapter because we know we are. Please send accomplishments to any of the TONS officers listed below. Just click the , or copy/paste the address into your browser bar. Hats off to you and all the hard work you do!!

11 Communicate with your TONS Officers! President: Rita Steinbauer President-Elect: Faye McNaull Secretary: Kristi Wiggins Treasurer: Kim Camp Membership Chair: Jamie Banwell Program Chair: Kerri Richard Political Liaison: Portia Mitchell Appointed Members: Joan Cahill President Ex-Officio: Rey Garcia Bonnie Toaso Sherri Moroni Nominating Chair: Mary Dunn Jennifer Stewart NC Triangle Oncology Nursing Society P.O. Box Durham, NC TONS Recipient Address line 1 Address line 2 Address line 3 Newsletter Administrator: Kristi Wiggins Newsletter Editor: Faye McNaull