Mary Mccabe, RN, MA

The increasing national and international attention to October as Breast Cancer Awareness Month brings to mind the tremendous progress made by the women’s rights movement over the last few decades.

Two very different articles in this issue of ONCOLOGY Nurse Edition drive home the lesson that evidence-based practice improves cancer care.

The May 2010 theme of Oncology Nursing Month is “Oncology Nurses: There When You Need Us.”

As a new decade unfolds, we are very fortunate to have an increasing number of new interventions available because of the recent tremendous advances in genetics and genomics.

October marks National Breast Cancer Awareness month, now in its 25th year, a time to contemplate important advances and milestones as well as future research needs.

Formal recommendations for the support and management of cancer patients who are transitioning from active treatment to long-term follow-up are fairly recent, documented notably in the 2006 Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition.

Change is in the air-and I don’t just mean the arrival of spring. The current national focus on health care is clearly evident from many quarters, including policy makers, health care institutions, and clinical staff. In addition to the discussion on health care coverage, there is an increasing emphasis on patient-centered care. As a result, we have before us a unique opportunity to assure the inclusion of survivorship and end-of-life care as formal parts of the health care continuum.

On January 20th, all eyes were on the inauguration in Washington, and most of us felt not only a sense of renewed hope but also some uncertainty about what the future will hold. In many ways, cancer patients also face these dual feelings of hope and uncertainty when treatment ends and they confront the task of finding a “new normal.” Re-establishing routines, relationships, and one’s connection to the world is eagerly wanted, but for some it can be daunting. The impact of cancer on one’s health, daily function, and body image, as well as financial and other concerns, also may present challenges.

Helping cancer patients to recover and heal goes beyond managing physical consequences of treatment. Mental scars from the cancer experience can run deep. Patients often face profound psychological, spiritual, and emotional challenges as they navigate difficult treatments-and then, if all goes well, move into long-term follow-up.

In cancer treatment these days, the immediate-what needs to be done for the patient right now toward achieving long-term survival-is coupled with planning post-treatment surveillance, care, and support for patients who will likely survive their disease.

Increasing attention is now being focused on cancer care as a continuum with expectations for the development and evaluation of a seamless set of medical, psychosocial, and spiritual services that flow from diagnosis through survivorship and end of life care.

As oncology nurses, we know that effective communication, comprehensive patient education, and ongoing identification of patients' needs are key components of excellent patient care.

This issue of ONCOLOGY Nurse Edition represents the full range of the cancer-management spectrum: Anna Schwartz and Laura Zitella, respectively, re-examine standard protocols and prevailing clinical assumptions in their review of evidence-based approaches toward relieving cancer-related fatigue and managing cancer patients' anemia. In contrast, Ellen Giarelli, in her cancer vaccine review, looks over the horizon at novel and promising approaches now under investigation for both treatment and prevention of cancer.

As oncology professionals, we all look forward to seeing our successfully treated patients come in for their follow-up visits. In a busy day filled with making complex medical decisions, delivering bad news, managing symptoms, and dealing with insurance companies, it is a real highlight. These individuals are among the over 10 million cancer survivors in the United States and represent 3.5% of the population. However, along with these optimistic results come new challenges for survivors that require ongoing medical care and psychosocial support. Survivors face lifetime health risks that are dependent on the cancer, treatment exposures, genetic predispositions, comorbid health conditions, and lifestyle behaviors.

One cannot pick up a newspaper, magazine, or even a professional journal without reading about the increasing pace of scientific discoveries and the expanded potential for medical breakthroughs in the postgenomic era. In particular, there is great emphasis placed on the unprecedented opportunity for incredible new tools to address the cancer problem.