Posted by Sandy Powell on September 18, 2009
The death of Patrick Swayze this week will bring some much needed attention to Pancreatic cancer. He fought galiantly, but the awful statistics about survival. Very little research is underway. We must give props to the PanCAN (Pancreatic Cancer Action Network) and support them in the efforts to increase awareness and funding for clinical trials.
Posted by Joni Watson on September 2, 2009
Senator Kennedy used his voice, power, and prestige to change the health of millions. Check out the recent ONS Connect to learn about others bringing attention to cancer.
I just couldn't resist linking to Kathy LaTour's blog post, "The Cancer Community Will Miss You, Teddy." Kathy LaTour is the Editor-at-Large of CURE Magaine, and she's right. Indeed, we will miss you, Teddy.
Posted by Joni Watson on September 1, 2009
...a busy month! It's actually National Prostate Awareness Month, Gynecological Cancer Awareness Month, Ovarian Cancer Awareness Month, Leukemia & Lymphoma Awareness Month, Childhood Cancer Awareness Month, Thyroid Cancer Awareness Month aaaaand Pain Awareness Month. Yep. I think that covers it. Soooo that just about captures all of us in the nursing profession. Here are a few of my favorite (perhaps lesser known) orgs that bring awareness to some of these important issues. Check 'em out:
Pints for Prostates - uses the international language of beer to raise awareness of prostate cancer
Teal Toes - raising ovarian cancer awareness via toenail polish
Tamika and Friends, Inc.- raising awareness about HPV's link to cervical cancer
SuperSibs! - supporting siblings of children with cancer
The Max Foundation - serving the worldwide leukemia community
CureSearch - Children's Oncology Group and the National Childhood Cancer Foundation joining forces
Pain & Policy Study Group (PPSG) - find out your state's "pain grade" and what you can do to help
These great organizations are just a drop in the bucket of who's working in these areas. What are some of your favorite organizations bringing these issues to the forefront of people's attention?
Posted by Sandy Powell on July 16, 2009
Recently, SWOG released some data indicating that genetics may pay a larger role in the disparities that exist in Afrrican-American patients with Breast, Ovarian, and Prostate carcinomas. As access to healthcare has been on a more even keel in the last few years, SWOG has gone back to the 1970's to draw conclusions indicating more than healthcare access and cultural norms, that there may be biologic/genetic factors involved. The article can be found at www.swog.org. The press release is here:
Why Do African-Americans Fare Worse With Cancer? Access and Economics Are Only Part of the Story
An analysis of clinical trial data implicates biological factors behind worse outcomes for African-Americans with breast, ovarian, or prostate cancer.
ANN ARBOR, Mich., July 7 /PRNewswire-USNewswire/ -- An analysis of almost 20,000 patient records from the Southwest Oncology Group's database of clinical trials finds, for the first time, that African-American breast, ovarian, and prostate cancer patients tend to die earlier than patients of other races even when they get identical medical treatment and other confounding socioeconomic factors are controlled for. The finding points to biological or host genetic factors as the potential source of the survival gap.
"When you look at the dialogue about the issue of race and cancer survival that's gone on over the years," says the paper's lead author, Kathy Albain, M.D., a breast and lung cancer specialist at Loyola University's Cardinal Bernardin Cancer Center, "it always seems to come down to general conclusions that African-Americans may in part have poorer access to quality treatment, may be diagnosed in later stages, and may not have the same standard of care delivered as Caucasian patients, leading to a disparity in survival."
The study, which will be published online by the Journal of the National Cancer Institute (JNCI) on July 7, found that when treatment was uniform and differences in tumor prognostic factors, demographics, and socioeconomic status were controlled, there was in fact no statistically significant difference in survival based on race for a number of other cancers -- lung, colon, lymphoma, leukemia, and multiple myeloma.
"The good news is that for most common cancers," Albain says, "if you get good treatment, your survival is the same regardless of race. But this is not the case for breast, ovarian, and prostate cancers."
Even with good treatment by the same doctors, African-American patients with one of these three cancers faced a significantly higher risk of death than did other patients, ranging from a 21% higher risk for those with prostate cancer to a 61% higher risk for ovarian cancer patients.
The elimination of treatment and socioeconomic factors as the cause of this higher mortality "implicates biology," says study co-author Dawn L. Hershman, M.D., of the Columbia University College of Physicians and Surgeons.
"There may be differences in genetic factors by race that alter the metabolism of chemotherapy drugs or that make cancers more resistant or more aggressive," she adds.
Hershman published a smaller study last month that found that, at least with breast cancer, disparities in survival based on race persist even after adjusting for differences in treatment. That study, published in the Journal of Clinical Oncology, analyzed data on 634 breast cancer patients.
"Our study of multiple cancers is distinguished from others that have looked at race-based disparities by its size and by the source of its data," says Joseph Unger of the Southwest Oncology Group's Statistical Center, who was statistician and co-author on the new JNCI study.
The study analyzed records from 35 clinical trials - going back as far as 1974 - that had been conducted by the Southwest Oncology Group, an NCI-sponsored cooperative group headquartered at the University of Michigan. Using data from clinical trials, which are already controlled for a range of potentially confounding factors such as differences in diagnosis, treatment, and follow-up, helps throw the remaining factors into sharper relief, according to Frank L. Meyskens, Jr., M.D.
"It's because of the similar way that people are treated on clinical trials that these differences are even detectable," he says. Meyskens is associate chair for Cancer Control and Prevention for the Southwest Oncology Group and director of the University of California-Irvine's Chao Family Comprehensive Cancer Center.
The urgency of addressing the reasons for racial disparities in outcomes - both sociological and biological - is amplified by another recent study in the Journal of Clinical Oncology. It predicts the cancer incidence among minorities will nearly double in the coming decades, increasing 99% by 2030 compared to an expected 31% increase among whites.
And the American Society of Clinical Oncology, the field's premier professional organization, recently issued a "Disparities in Cancer Care" policy statement that recommends a set of strategies for improving outcomes for minority cancer patients.
"The elimination of socioeconomic and healthcare access disparities must be a priority in the United States," says Lisa Newman, M.D., director of the Breast Care Center at the University of Michigan Comprehensive Cancer Center. "However, Dr. Albain's landmark study demonstrates that further investigation of race- or ethnicity-associated differences in primary tumor biology is also important."
John Crowley, Ph.D., of the Southwest Oncology Group Statistical Center and Charles A. Coltman, M.D., of the University of Texas Health Science Center were also coauthors of the study, which was funded by the National Cancer Institute.
The Southwest Oncology Group (swog.org) is one of the largest cancer clinical trials cooperative groups, with a network of almost 5,000 physician-researchers practicing at more than 500 institutions, including 19 of the National Cancer Institute-designated cancer centers. The Group is headquartered at the University of Michigan in Ann Arbor, Mich. (734-998-7140). The Group has an operations office in San Antonio, Texas and a statistical center in Seattle, Wash
Posted by Joni Watson on July 15, 2009
Dr. Regina Benjamin, a rural family physician, is President Obama's nominee for the next U.S Surgeon General. With a stunning professional background, accolades upon accolades, truly altruistic care and a family history of just about every major chronic disease, including cancer, she definitely understands the challenges of rural care in America.
The Office of the Surgeon General is a part of the Office of Public Health and Science within the U.S. Department of Health and Human Services, and the Surgeon General serves as "America's chief health educator," addressing topics from childhood obesity, cancer, and tobacco cessation to deep vein thrombosis, pulmonary embolism, and mental health. The National Call to Action on Cancer Prevention and Survivorship is one of my favorite publications and is a collaboration of the previous four U.S. Surgeons General.
With so many healthcare issues needing attention, Dr. Benjamin already has more than enough to accomplish. Once confirmed by the Senate, what do you think Dr. Benjamin should focus on first?
Posted by Erin Elphee on July 15, 2009
Being from Canada, I've heard a lot in the news in the past few months about the shut down of the Chalk River Reactor, the shortgae of radio isotopes for nuclear imaging, and the impact it is having world-wide on the healthcare system. Working in oncology, I thought I would have heard more about this issue and that it would have a more powerful impact on my daily practice, but surprisingly it seems to be a non-issue. The only people I hear about it from are the patients who see the story on the news.
The Chalk River reactor is one of five nuclear reactors in the world and supplies approximately 1/3 supply of radio isotopes used for diagnostic tests to diagnose and reassess htreatment response in heart disease and cancer. This shortage has been called the 'biggest crisis ever for nuclear imaging.' Last week it was reported that the Chalk River reactor will now be down for the remainder of 2009 and that we will begin to feel the shortage more in August.
For the assessment and imaging of cancer patients a PET scan (Positron emission tomography) scan is an alternate test that can be ordered in place of bone scans and other imaging that requires radio-isotopes. At our center, we are lucky to have acccess to a PET scanning machine for our cancer patient populations but I understand there may be an issue in the United Sattes in that the FDA has approved the use of PET scanning but in some instances a PET scan is not covered by Medicare. This poses the question of what to do? The principles of cancer treatment rely on specific timing of cycles to maximize cell kill, what happens if we are unable to perform staging tests 'on-time' because of the isotope shortage? How will this affect clinical trials who rely heavily on nuclear imaging to determine if new treatments are more benefical than our current standards of care? Will insurance companies pay for a more expensive test if we are physically unable to provide the test that has been approved for use?
In a perfect world, the world-wide shortage of radio-isotopes will remain a non-issue' but I suspect this isn't the case.
Posted by Jeanine Gordon on July 3, 2009
http://well.blogs.nytimes.com/2009/07/01/nurses-helpers-angels-or-something-more/
A colleague sent me the above link to read and it infuriated me so I wanted to get some other opinions on it. Personally I'm getting annoyed with all the negative stereotypes about our profession in the media lately with the addition of the new nurse shows (if they're worthy of being called that). It's interesting what people think of us until they're in that hospital bed pushing the call button praying that we appear to assist them with any nursing or non-nursing need that they might have.
What stereotype about nursing bothers you the most?
Posted by Kimberly George on June 29, 2009
Erin previously posted about Nurse Jackie, and I must say "I agree!" I have not seen the show as I do not subscribe to that channel, BUT, I don't think I would enjoy it after reading the description.
Several non-nurse friends of mine are divided on the topic as well. Some say that nursing is a highly-respected profession and that TV shows like this leave a bad impression of real nursing. Another friend said we shouldn't take it personally; that people know it is fiction and is intended only to pull-in viewers.
I have spent many years of my nursing career explaining what exactly a nurse is. This has been especially true since becoming a CNS. It takes years to earn the respect of our co-workers, physicians, administrators, and, most importantly, out patients. So does a TV show like this one damage nursings reputation? Do you take it personally?
Another new TV show focuses on nursing as well. Have you seen HawthoRNe? Like Erin, I think highly of the actress playing the lead nursing character, Jada Pinkett-Smith. My question for those of you who have seen this show: Have you ever seen a CNO do these things? No offense to CNOs, but no CNO can be in so many places at one time, performing tasks meant for other disciplines all the while knowing every detail of all of the staff members personal lives. Hmmmmm. Lesser of 2 evils. At least she is a patient advocate and not a druggie who hides her next fix in the ER nurses prosthetic leg.
But I digress.........
Posted by Erin Elphee on June 17, 2009
I was recently alerted about a new television show premiering this month on ShowTime with a nurse as the lead character. I'm usually 'in-the-know' about new shows especially medical ones but with the arrival of summer I have to admit that this one took me by surprise. By the time the snow melts, I've usually had enough of being a winter couch potato and am ready to engage in hobbies that include more than the mind-numbing tedium that winter on the prairies brings with it.
So I googled "Nurse Jackie" and learned that it is a new medical comedy starring Edie Falco. This intrigued me more. She is a respected and skilled actor, just the person to accurately show the world just how great it is to be a nurse. My opinion of this show in no way is a criticism of the actress. In fact, I haven't even seen it yet. Nurse Jackie is described as "a wife, mother, and highly competent ER nurse who knows more than the doctors. She talks tough, is quiet and mean but when no one is looking she's good with kids and the elderly. She's a rule breaker." Sounds good doesn't it? BUT she's also a highly functioning drug addict who gets her supply from her lover, a co-worker, a pharmacist in the hospital. Ugh! You just lost me. Maybe to non-nurses this sounds great but why oh why can't being an ER nurse, mother, and wife be enough of a storyline? We does the image of nursing have to be tarnished? I don't know about you but none of my friends and coworkers are addicted to drugs or having affairs with co-workers. Granted you hear rumors of 'hospital hookups' but they are the exception not the rule. TV portrayal of nurses and health care professionals sways the general public. If you think it doesn't then you are being naive. My best friend thinks thaT I work at "Grey's Anatomy" despite ongoing reassurance that I actually get my work done without a quickie in the clean supply closet!
Nurses are viewed as sex objects, or cold and heartless. Nursing may not be that glamorous, that is, sex, infidelity and drugs but most days I can go home and tell my boyfriend a good story or two about an interesting case, making a difference and helping someone or a ridiculous mishap that had us in stitches (pun intended). If the people who decide what to put on TV can put 10 'famous for simply being pretty celebrities' on a desert island for the summer so we can watch them do nothing, why can't Nurse Jackie just be Nurse Jackie? I know nurses and I'd tune in. What do you think?
Posted by Erin Elphee on May 20, 2009
Social networking sites such as Facebook, MySpace, Twitter, and blogging have quickly established themselves as acceptable means of communication in our current society. Technology is advancing at an alarming pace and for new nurses and those part of the Generation Y, life as they know it has always included technology and computers. A fellow blogger commented on the benefits of blogging and instant communication/social networking at the recent ONS Congress and while I agree wholeheartedly, as the devil's advocate I must raise the question of how much is too much? I am a thirty something nurse who is technologically capable who can navigate the internet, send a text message, and blog but even I admit that the whole Twitter experience boggles my mind. So much so that I choose not to try to understand it all. Perhaps my close mindedness will also close opportunities for me but that is the risk I will have to take.
I read with interest the "Ask a Practice Consultant" column in my professional nursing journal last month where a staff nurse voiced concerns over a colleagues posting on Facebook about comments and frustrations about their unit manager and some patients on the unit. She asked whether or not this posting posed a professional problem? I really related to this question because it is such a timely and topical issue. The information in the response letter serves as a reminder for all nurses and included a reminder that information posted on the web while often considered private is not. Identiying information may breach an individual's right to privacy. It is important to bear in mind that while some may feel 'safe' to post information on their 'private profiles', once posted it is part of the public forum and network security settings may not stop others from viewing it. The article gave a general rule of thumb that when posting: do not post anything on the Web that you wouldn't feel comfortable posting in the lunch room at work.
As I sit here at my desk and blog, I can't discount or devalue the benefits and importance of social networking sites, cell phones, and technology but I post this article as some food for thought.
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