Volume 11, Issue 3, October 2007
     


Message From the Coordinator
Cancer Genetics Changes Landscape of Drug Applications

Jennifer T. Loud, RN, MSN, CRNP
Derwood, MD
loudj@mail.nih.gov

Summer was a time for taking trips and seeing new sights. Genetics and cancer research didn’t take time off for summer trips, but the future of genetics is definitely creating new sights and possibilities not only for prevention and early diagnosis but also for appropriate treatment of cancer based on our genetic differences. This issue of the Cancer Genetics SIG newsletter focuses on pharmacogenetics, pharmacogenomics, pharmacodynamics, and pharmacokinetics. This issue contains information about current and future applications of genetics to disease management and drug selection.

A synopsis of the article “Influence of Pharmacogenomics on Disease and Symptom Management” offers a brief overview of a publication by Linda Howe, PhD, APRN-BC, CNE, and Cancer Genetics SIG member Julie Eggert, PhD, APRN-BC, GNP, AOCN®.

Continuing with the theme of pharmacogenetics and pharmacogenomics, co-editor Pat Kelly, RN, MS, AOCN®, has provided the article “Genes and Codeine: What’s the Connection?” Editor Millie Arnold, RN, OCN®, CCRC, further discusses genotyping and cancer therapy in the article “Oncopharmacogenetics: 21st-Century Cancer Care.”

The News to Use section provides an up-to-date resource for information pertaining to the Nurse in Washington Internship Program. Additionally, we trust you will benefit from hearing more about H.R. 493, the Genetic Information Nondiscrimination Act of 2007 submitted by Lisa Aiello-Laws, coordinator-elect.

Finally, we offer our heartfelt thanks to Pat Herman, MSN, RN, AOCN®, who has been an outstanding contributor as a co-editor for the Cancer Genetics SIG newsletter. Pat’s input for the newsletter is deeply appreciated.

The Cancer Genetics SIG leaders hope this issue will provide new insights into cancer genetics that are useful in your nursing practice.

 

 
The Cancer Genetics SIG Newsletter is produced by members of the
Cancer Genetics SIG and ONS staff and is not a peer-reviewed publication.

Special Interest Group Newsletter  October 2007
 
   

Cancer Genetic SIG Feature Article
Breakthroughs in Genetic Knowledge Transform Pharmacogenomics

Millie Arnold, RN, OCN®, CCRC
Mesquite, TX
mildreda@baylorhealth.edu


The following is a review prepared by Millie Arnold, RN, OCN®, CCRC, and approved by the original authors: Linda A. Howe, PhD, APRN-BC, CNE, and Julie Eggert, PhD, APRN-BC, GNP, AOCN®, “Influence of Pharmacogenomics on Disease and Symptom Management,” International Journal of Nursing in Intellectual and Developmental Disabilities, 2007, 3(2), 2. Web site: http://journal.hsmc.org/ijnidd

This published article points out how the study of genetic inheritance and drug response are on the verge of transforming pharmacology. The authors discuss that the utilization of genetic analyses such as Microarray technology will identify a more precise evaluation of disease and differences in drug response and metabolism. It also provides at-a-glance definitions of key genetic terms.

The authors identify how the future of pharmacogenomics will allow the prescription of drugs in a manner with the greatest efficacy and the lowest risk of side effects based on individual genetic make-up.

For instance, genetic differences can alter the rate of drug metabolism through the enzyme system known as cytochrome P-450 (CYP-450). Dr. Howe and Dr. Eggert offer an excellent explanation of how this superfamily of enzymes catalyzes the rate-limiting step in the overall metabolism and elimination of many drugs.

Since the completion of the Human Genome Project (HGP) in 2000, the discovery of the influence that genetic inheritance has on disease and drug therapy response has opened new fields of research such as pharmacogenomics. The article discusses in detail how polymorphisms can affect pharmacokinetics and pharmacodynamics at the drug target sites.

Variations in DNA sequence that occur in a single nucleotide or SNPs (pronounced “snips”) in a target protein can reduce drug efficacy. Dr. Howe and Dr. Eggert discuss how SNPs can be useful in determining individual response to a drug. The authors also indicate that ongoing research is making progress to catalog as many of the genetic variations found within the human genome as possible.

This paper discusses that an individual’s DNA must be sequenced for the presence of specific SNPs and how this technology remains a lengthy and expensive process. The current process and expense for DNA sequencing unfortunately prevents the widespread use of SNPs as a diagnostic tool for prescribing medication. However, the article points out that as technology advances in the future, it most likely will be possible to genotype drug-metabolizing enzymes in a physician’s office prior to prescribing a drug. In the meantime, the authors encourage an awareness of individual reactions to identified drugs and having knowledge of the CYP-450 system.

The publication provides two excellent tables and a brief review of several diseases and disorders that have genetic links when considering pharmacotherapy. The conclusion provides a Web site with information about genetic influences and drug responses: “Defining Genetic Influences on Pharmacologic Responses: Drug Interactions,” by the University of Indiana, updated February 26, 2007. Available from http://medicine.iupui.edu/flockhart/.

Corresponding Author: Linda Howe, PhD, APRN-BC, CNE, is an associate professor at Clemson University School of Nursing in Clemson, South Carolina. E-mail: lhowe@clemson.edu

Julie Eggert, PhD, APRN-BC, GNP, AOCN®, is an associate professor at Clemson University School of Nursing in Clemson, South Carolina. Julie is also a member of the ONS Cancer Genetics SIG. E-mail: jaegger@clemson.edu

 
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Special Interest Group Newsletter  October 2007
 
   

Genes and Codeine: What’s the Connection?

Patricia Kelly, RN, MS, AOCN®
Dallas, TX
patriciakelly@texashealth.org


Have you ever cared for a patient who did not respond to a “usual” dose of codeine? Or have you had a patient exhibit toxicities with “normal” codeine dosing? We know that age, renal and liver function, drug interactions, body mass index, and lifestyle influence drug metabolism. Did you know that genetic variants also can significantly affect drug metabolism? This article presents an example of how genetics can impact the usefulness of codeine medications for pain management.

Drug Metabolism Enzymes

The cytochrome P-450 (CYP) enzymes are a class of 30-50 liver enzymes that are responsible for drug metabolism. The cytochrome CYP2D6 enzyme is a CYP enzyme responsible for converting codeine (a nonfunctioning prodrug) to morphine (an active metabolite). Some individuals inherit mutant CYP2D6 gene alleles that result in too little or no CYP2D6 enzyme production. Patients who inherit two CYP2D6 enzyme-deficient alleles do not convert codeine to morphine and are poor codeine metabolizers (PMs). Approximately 5%-10% of patients are PMs and receive no pain relief from codeine or codeine-derivative medications (e.g., hydrocodone, oxycodone, ethylmorphine, dihydrocodeine). PMs should benefit from morphine and morphine-derivative analgesics (Meyer, 2000; Prows, 2004).

Other individuals inherit additional CYP2D6 gene copies and have too much CYO2D6 enzyme. These patients are extensive codeine metabolizers (EMs) and may experience exaggerated codeine toxicities with respiratory, pupillary, gastrointestinal, and psychomotor side effects. Individuals of Ethiopian and Hispanic heritage are more likely to be EMs. Certain medications, such as quinidine or rifampin, are CYP2D6 enzyme inhibitors. EMs may have blocked analgesia if they receive a potent CYP2D6 inhibitor medication (Fishbain et al., 2004; Meyer, 2000; Prows, 2004).

Clinical Relevance

So what does this information mean in the clinical setting? Is it possible to identify PMs and EMs? Genotype testing can profile some inherited CYP enzyme alleles and is being used selectively in the clinical setting. In the future, individuals will carry a DNA genotype computer chip, and medications will be ordered based upon this personalized genomic information. Until that day, nurses should remember that genetic variability can significantly influence analgesia and adverse reactions, and “one size fits all” dosing is inappropriate for many medications, such as codeine and codeine derivatives.

Challenges to Nurses

Refrain from judging patients who are not responding to standard codeine analgesics. They may be PMs. Remember that genotypes do not change. A patient who has a poor response to codeine or codeine-derivative medications will not receive analgesia with subsequent administration. Patients with exaggerated codeine responses (EMs) need careful monitoring and should be changed to an unrelated analgesic.

Teach patients and families about genetics and variable responses to codeine medications. Patients may be reluctant to report or may not understand having no pain relief after receiving a codeine medication. Instruct patients to report codeine sensitivities to their healthcare provider.

Seek information about new developments in pharmacogenomics. The CYP2D6 enzyme is only one of many clinical pharmacogenomic examples. This is a dynamic and rapidly changing field. The nurse of today needs to be knowledgeable about genetics and the multiple clinical practice applications.

References

Fishbain, D.A., Fishbain, D., Lewis, J., Cutler, R.B., Cole, B., Rosomoff, H.L., et al. (2004). Genetic testing for enzymes of drug metabolism: Does it have clinical utility for pain medicine at the present time? A structured review. American Academy of Pain Medicine, 5(1), 81-93.

Meyer, U.A. (2000). Pharmacogenetics and adverse drug reactions. Lancet, 356(b), 1667-1671.

Prows, C.A. (2004). Medication selection by genotype. American Journal of Nursing, 104(5), 60-70.

For additional information, visit these genomic Web sites.

 
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Special Interest Group Newsletter  October 2007
 
   

Oncopharmacogenetics: 21st-Century Cancer Care

Millie Arnold, RN, OCN®, CCRC
Mesquite, TX
mildreda@baylorhealth.edu

 

Simply defined, oncopharmacogenetics is individualized cancer treatment based on genetic make-up. Prescribing cancer drugs based on large clinical trials results in protocols that help one patient but not necessarily another. Also, one patient may experience tolerable side effects while another experiences potentially lethal side effects. Specifically, cancer treatments in the future will be personalized to deliver therapeutic benefit while at the same time reducing potential side effects.

Currently, postmenopausal women diagnosed with estrogen receptor–positive breast cancer are prescribed standard doses of serum estrogen receptor blockers (known as SERMs). It has been suggested that a variation in individual response may be the result of genetic variants or polymorphisms. The cytochrome P-450 (CYP-450) genotype is a superfamily of liver enzymes involved in the metabolism of 25% of all therapeutic drugs, as well as some over-the-counter drugs (Kalow, 2006).

One cancer application for P-450 is CYP2D6, responsible for the metabolic activation of tamoxifen to endoxifen. Endoxifen is the predominant antiestrogenic metabolite of tamoxifen. If the enzyme is missing or present in lower levels, it affects the efficacy of the drug and increases the risk of potential side effects. Many women report intolerable hot flashes while taking tamoxifen. Some antidepressant medications that reduce hot flashes also block production of CYP2D6, thereby reducing the efficacy of tamoxifen (Rae, 2007).

Another example of oncopharmacogenetics and cancer is sequencing the DPYD TYMS genes (Myriad Genetic Laboratories, Inc., n.d.). Through a multistep process, the enzyme dihydropyrimidine dehydrogenase metabolizes 5-fluorouracil (5-FU) or capecitabine. The 5-FU/capecitabine target enzyme thymidylate synthetase is encoded by the gene TYMS. Patients with DPYD or TYMS deficiencies are unable to adequately metabolize 5-FU or capecitabine and may experience severe side effects with even the smallest dose. It has been reported that as many as 1 in 3 patients receiving 5-FU-based treatments may experience avoidable, potentially severe side effects. Identifying deficiencies prior to 5-FU-based regimens can identify patients who are at greater risk for potential severe side effects.

CYP2D6 and DYPD gene sequencing and TYMS gene analysis are examples of how pretreatment genotyping may improve drug selection in appropriate candidates. These specific genetic tests are commercially available, but the evidence of benefit to patients has yet to be demonstrated. However, in the future, chemotherapeutic agents will no longer be prescribed based on standard protocols, body surface area, and tumor markers. Individual genotyping will become a necessary pretreatment step prior to any drug administration. Although oncopharmacogenetics is not ready for daily primetime applications today, in the future, oncopharmacogenetics will identify not only the right drug and the right dose, but also the right tumor treatment for the right patient.

References

Kalow, D. (2006). Pharmacogenetics and pharmacogenomics: origin, status, and the hope for personalized medicine. Pharmacogenomics Journal, 6, 162-165.

Myriad Genetic Laboratories, Inc. (n.d.). TheraGuide 5-FU. Retrieved from http://www.myriadtests.com

Rae, J.M. (2007, May). Pharmacogenetics. Session presented at Cancer Genetics and Genomics: A Workshop for Oncology Nurses, Bethesda, MD.

For additional information on commercially available genetic tests available, go to www.genetests.org.

 
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Special Interest Group Newsletter  October 2007
 
   

News to Use

Jennifer Loud, RN, MSN, CRNP
Derwood, MD
loudj@mail.nih.gov

BRCA2 and Fanconi Anemia (FANC-D1)

Dr. Blanche Alter, a pediatric hematologist/oncologist in the Clinical Genetics Branch of the National Cancer Institute, recently published an article that reviewed the association between inheritance of mutations in BRCA2 and the occurrence of a disorder called Fanconi anemia (FA) (Alter, Rosenberg, & Brody, 2007). According to the study, 27 individuals with the clinical diagnosis of FA have been found to carry mutations in both of their two copies of the BRCA2 gene, which we now know also can be an FA gene.

FA is a rare genetic disease that affects children and adults. It is characterized by short stature, skeletal abnormalities, bone marrow failure that leads to anemia, and a predisposition to cancer. Mutations in 12 different genes are known to cause FA; the type of FA related to BRCA2 is called FANC-D1. The genetic mechanism is very different when one compares HBOC with FANC-D1, the form of FA related to BRCA2. HBOC is an autosomal dominant disorder; to be at risk, a child needs to inherit a BRCA2 mutation from one of his or her parents. At birth, these patients have one abnormal and one normal copy of BRCA2. FANC-D1 is an autosomal recessive disorder; a child needs to inherit a BRCA2 mutation from both parents in order to be at risk. At birth, these patients have two abnormal copies of BRCA2. People with two BRCA2 mutations are at higher risk for developing leukemia, brain tumors, and Wilms’ tumor (a type of kidney cancer), rather than breast or ovarian cancer. The Clinical Genetics Branch has an ongoing clinical research study to learn more about FA (see http://marrowfailure.cancer.gov).

The chance of someone inheriting two BRCA2 mutations (one from each parent) is extremely rare. However, individuals with BRCA2 mutations may wish to consider additional genetic counseling to evaluate their spouse’s risk under specific clinical circumstances in which the spouse might be more likely to have a BRCA2 mutation, for example, (a) a strong family history of HBOC-related cancers on the spouse’s side of the family; (b) the spouse being of Ashkenazi Jewish descent; or (c) in the rare circumstance when it is already known that their partner’s family also carries a BRCA2 mutation.

This unexpected overlap in genetic risk for two disorders, which at first glance appear to be quite different from one another, offers an unusual opportunity to learn more about each disorder.

Reference

Alter, B.P., Rosenberg, P.S., Brody, L.C. (2007). Clinical and molecular features associated with biallelic mutations in FANCD1/BRCA2. Journal of Medical Genetics, 44, 1-9.

Genetic Insurance Nondiscrimination Act to Become Law

It has taken 12 years, but it appears that Congress is about to pass, and President Bush will sign into law, the Genetic Information Nondiscrimination Act (GINA) [H.R. 493, S. 358]. GINA is a bill designed to protect individuals from discrimination in health insurance and employment on the basis of genetic information discrimination. It was introduced to establish basic legal protections that will allow individuals to take advantage of genetic screening, counseling, testing, and new therapies that are resulting from the scientific advances in the field of genetics. It prevents health insurers from denying coverage or adjusting premiums based on an individual’s predisposition to a genetic condition and prohibits employers from discriminating on the basis of predictive genetic information. The legislation makes it illegal for employers and insurers to require applicants to submit to genetic tests, creates strict use and disclosure requirements for genetic test information, and imposes penalties against employers and insurers who violate these provisions.

Establishing these protections should eliminate concerns about the potential for discrimination and encourage individuals to participate in genetic research and to take advantage of genetic testing, new technologies, and new therapies. It provides substantial protections to individuals who experience actual genetic discrimination now and in the future. These steps are essential to fulfilling the promise of the Human Genome Project.

The Employee Retirement and Security Act (known as ERISA) currently prohibits a group health plan or health insurance issuer offering coverage from discriminating against an individual in the group in setting eligibility or premium or contribution amounts based on the individual’s genetic information. The new legislation:

  • Applies to employer-sponsored group health plans, health insurance issuers in the group and individual markets, Medigap insurance, and state and local non-federal governmental plans
  • Prohibits healthcare professionals from requiring that an individual undergo a genetic test.
  • Specifically bans the use or disclosure of genetic information for purposes of deciding whether to issue insurance to an individual (“underwriting”)
  • Bans health plans and insurance issuers from requesting or requiring genetic information from people seeking insurance
  • Protects the privacy of genetic information by prohibiting plans and insurance issuers from requesting, requiring, or purchasing genetic information prior to an individual’s enrollment into the plan.

It has long been the view among cancer genetics professionals that many individuals chose not to know their mutation status out of fear regarding genetic discrimination. In practice, this has not seemed to be a real problem over the past 10 years, but high-risk individuals have been concerned anyway. GINA solves this problem and should permit anyone who is a candidate for genetic testing to have the test without fear of genetic discrimination.

 

 
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Special Interest Group Newsletter  October 2007
 
   

Nurses Find Leadership Role in Washington Internship Program

The Nurse in Washington Internship (NIWI) Program is an annual event sponsored by the Nursing Organizations Alliance (the Alliance). With 55 member organizations, ONS among them, the Alliance represents approximately 500,000 nurses. The Alliance sponsors the internship to promote the interests of its member groups through education, research, and health policy activities. Over the years, more than 1,000 nurses have attended NIWI, many of whom have become influential participants in the political process at state and federal levels.

The purpose of the NIWI Program is to provide nurses the opportunity to learn how to influence health care through legislative and regulatory processes. Participants learn from health policy experts and government officials and network with other nurses.

One of NIWI’s objectives is to prepare participants to be responsible nurse-citizens and to educate them about how they can affect legislative and regulatory processes. This is accomplished by an outstanding faculty who come from nursing, education, advocacy, and government.

The next NIWI is scheduled to be held March 9-11, 2008, in Washington, DC. The internship includes spending a day on Capitol Hill visiting legislators. It is hoped that the dialogue begun during the internship will continue after the interns return home.

This year, ONS is offering a limited number of grants for nurses to attend NIWI. The deadline to apply for the grant is November 1, 2007. Recipients of the grants will receive full registration for NIWI, expenses for travel and hotel, and a per diem.

Applicants must:

  • Have current membership in ONS with a minimum of two years as a member
  • Provide evidence of current activity in the legislative arena on the local, state, and/or national levels
  • Describe all past ONS activities
  • Describe how the internship experience will help his or her current professional role and role within ONS
  • Be willing to serve as a chapter or SIG legislative liaison or state health policy liaison
  • Demonstrate strong communication skills
  • Demonstrate willingness to participate in NIWI by meeting the time requirements for preparation.
A review panel will select the most qualified applicants. To apply, members should submit a letter stating that they are applying for a NIWI grant, including three copies of all accompanying information listed above, and current curriculum vitae to:

Executive Team
Oncology Nursing Society
125 Enterprise Drive
Pittsburgh, PA 15275
Phone: 866-257-4ONS
E-mail:
government.relations@ons.org

 
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Special Interest Group Newsletter  October 2007
 
   

Help GINA Progress Through the Senate: Tell the Senate to Take Action on GINA!

Prepared by Lisa Aiello-Laws, RN, MSN, APN, C, APNG, AOCNS®
Cape May, NJ
laiello@shorememorial.org

The Genetic Information Nondiscrimination Act, or GINA, (S. 358) is on the verge of passing, after 12 long years. The House bill (H.R. 493) passed 420-3 on April 25, and the Senate bill has been reported out of committee. We just need the full Senate to vote on the bill to get it to the president’s desk.

Tell your senators to push for GINA to come to the floor for a vote. A list of senators and their contact information is below. Please take a few minutes to tailor the sample letter below on your letterhead, and fax it to the Senate. Feel free to insert personal reasons for your support of the bill.

There is power in numbers. Tell your friends, family, coworkers, and other members of your organization to take action now. We must make a big impact on this issue, and if every senator is contacted multiple times, we can make it happen!

Sample Letter

Dear Senator ____,

I support the Genetic Information Nondiscrimination Act, or GINA, (S.358). I am writing to ask for your support for this legislation to come to the floor and pass.

It is astounding that this bill, which the Senate has passed unanimously in the 108th and 109th Congresses, has not passed in the 110th yet. The House passed it 420-3 on April 25, 2007. This bill protects all Americans from the misuse of genetic information in employment and health insurance decisions. With these protections in place, Americans will be able to use genetics in medicine without fear of misuse of their genetic information.

More than 140 national patient groups, academic institutions, research centers, companies, women’s organizations, labor organizations, and the millions of Americans endorse this legislation. We represent every sector of society in this nation, and we urge passage of GINA.

Thank you for your time.

Best,

____


This information was obtained from the Genetic Alliance Web site. Go to this link for the contact information, a list of senators, and their contact information: http://www.geneticalliance.org/ws_display.asp?filter=policy.gina.senate

 
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Special Interest Group Newsletter  October 2007
 
   

The SIGs Virtual Community Keeps You Connected

Jenny Shinsky
Pittsburgh, PA
jshinsky@ons.org

The SIGs Virtual Community was developed to improve communication among SIG leaders and members. Visiting your SIG’s Web page on the Virtual Community keeps you updated about SIG activities by providing you with important information and resources.

To navigate to your SIG’s page, visit the SIGs Virtual Community at http://sig.vc.ons.org and select “Find a SIG” from the top navigation.

Many features in the SIGs Virtual Community are useful to all members. Below is an outline of the information that can be found on your SIG’s page.

From your SIG’s main page, you can subscribe to SIG announcements, calendar events, and the discussion forum. Once you are subscribed to the areas, an e-mail will be sent to you every time an announcement, event, or discussion has been posted.

Announcements are added frequently with important information pertaining to your SIG, such as scholarship, leadership, and meeting information.

SIG events on the SIG calendar are showcased on the main page for your convenience. Simply click on an event for detailed information.

About Us
The About Us area features information about your SIG leaders.

News
The News section provides important information, such as minutes from past meetings and newsletters. Educational news and photos also can be found here.

Discussions
The Discussions area is very similar to the ONS List Serve, which can be found at http://listserv.vc.ons.org. Click the Discussions button at the top of your SIG’s page to access the area. You can post a message, thought, or questions, and fellow SIG members can read your message and respond.

ONS National Announcements
Check this section every month for updated information from ONS such as continuing nursing education offerings, events, and important information.
If you have questions or problems navigating the SIGs Virtual Community, contact me at jshinsky@ons.org.

 
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Special Interest Group Newsletter  October 2007
 
   

Article of Interest
Cancer Genetics SIG Members May Enjoy This Recently Published Article

Check out the Oncology Nursing Forum (ONF) for interesting articles about the Cancer Genetics SIG’s focus.

For access to the full-text versions of this and other ONF articles, visit the Publications area of the ONS Web site.

 
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Special Interest Group Newsletter  October 2007
 
   

Membership Information

SIG Membership Benefits
  • Network with colleagues in an identified subspecialty area around the country.
  • Contribute articles for your SIG's newsletter.
  • Participate in discussions with other SIG members.
  • Contribute to the future path of the SIG.
  • Share your expertise.
  • Support and/or mentor a colleague.
  • Receive information about the latest advancements in treatments, clinical trials, etc.
  • Participate in ONS leadership by running for SIG coordinator-elect or join SIG work groups.
  • Acquire information with a click of a mouse at http://sig.vc.ons.org/, including
    • Educational opportunities for your subspecialty
    • Education material on practice
    • Calls to action
    • News impacting or affecting your specific SIG
    • Newsletters
    • Communiqués
    • Meeting minutes.

Join a Virtual Community
A great way to stay connected to your SIG is to join its Virtual Community. It's easy to do so. All you will need to do is

  • Log on to the ONS Web site (www.ons.org).
  • Select "Membership" from the tabs above.
  • Then, click on "Chapters, SIGs & Virtual Communities."
  • Scroll down to "Special Interest Groups (SIG) Virtual Community" and click.
  • Now, select "Find a SIG."
  • Locate and click on the name of your SIG from the list of all ONS SIGs displayed.
  • Once the front page of your SIG's Virtual Community appears on screen, select "New User" from the top left. (This allows you to create log-in credentials.)
  • Type the required information into the text fields as prompted.
  • Click "Join Group" (at the bottom right of the text fields) when done.
Special Notices
  • If you already have log-in credentials generated from the ONS Web site, use this information instead of attempting to generate new information.
  • If you created log-in credentials for the ONS Web site and wish to have different log-in information, you will not be able to use the same e-mail address to generate your new credentials. Instead, use an alternate e-mail address.

Subscribe to Your SIG's Virtual Community Discussion Forum
All members are encouraged to participate in their SIG's discussion forum. This area affords the opportunity for exchange of information between members and nonmembers on topics specific to all oncology subspecialties. Once you have your log-in credentials, you are ready to subscribe to your SIG's Virtual Community discussion forum. To do so,

  • Select "Log In," located next to "New User," and enter your information.
  • Next, click on the "Discussion" tab on the top right of the title bar.
  • Now, select "Featured Discussion" from the left drop-down menu.
  • Locate and select "Subscribe to Discussion" inside the "Featured Discussion" section.
  • Go to "Subscription Options" and select "Options."
  • When you have selected and entered all required criteria, you will receive a confirmation message.
  • Click "Finish."
  • You are now ready to begin participating in your SIG's discussion forum.
Participate in Your SIG's Virtual Community Discussion Forum
  • First, log in. (This allows others to identify you and enables you to receive notification [via e-mail] each time a response or new topic is posted.)
  • Click on "Discussion" from the top title bar.
  • Select "Featured Discussion" from the left drop-down menu.
  • Click on any posted topic to view contents and post responses.

Sign Up to Receive Your SIG's Virtual Community Announcements
As an added feature, members also are able to register to receive their SIG's announcements by e-mail.

  • From your SIG's Virtual Community page, locate the "Sign Up Here to Receive Your SIG's Announcements" section. This appears above the posted announcements section.
  • Select the "Click Here" feature, which will take you to a link to subscribe.
  • Once the "For Announcement Subscription Only" page appears on screen, select how you wish to receive your announcements.
    • As individual e-mails each time a new announcement is posted
    • One e-mail per day comprised of all new daily announcements posted
    • Opt-out, indicating that you will frequently browse your SIG's Virtual Community page for new postings
  • Enter your e-mail address.
  • Click on "Next Page."
  • Because you have already joined your SIG's Virtual Community, you will receive a security prompt with your registered user name already listed. Enter your password at this prompt and click "Finish."
  • This will bring up a listing of your SIG's posted announcements. Click on "My SIG's Page" to view all postings in their entirety or to conclude the registration process and begin browsing.
 
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Special Interest Group Newsletter  October 2007
 
   

Cancer Genetics SIG Officers

Coordinator (2006-2008)
Jennifer Loud, RN, MSN, CRNP
Derwood, MD
loudj@mail.nih.gov

Coordinator-Elect (2007-2008)
Lisa Aiello-Laws, RN, MSN, APN, C, APNG, AOCNS®
Cape May, NJ
laiello@shorememorial.org

Editor
Millie Arnold, RN, OCN®, CCRC
Mesquite, TX
mildreda@baylorhealth.edu

 

Co-Editor
Patricia Herman, MSN, RN, AOCN®
Bethlehem, PA
hermanp@slhn.org

Co-Editor
Patricia Kelly, RN, MS, AOCN®
Dallas, TX
patriciakelly@texashealth.org

ONS Publishing Division Staff
Amy Nicoletti, BA
Staff Editor
anicoletti@ons.org

Know someone who would like to receive a print copy of this newsletter?
To print a copy of this newsletter from your home or office computer, click here or on the printer icon located on the SIG Newsletter front page. Print copies of each online SIG newsletter also are available through the ONS National Office. To have a copy mailed to you or another SIG member, contact Membership/Leadership Administrative Assistant Carol DeMarco at cdemarco@ons.org or 866-257-4ONS, ext. 6230.

To view past newsletters, click here.

ONS Membership/Leadership Team Contact Information

Angie Stengel, MS, CAE, Director of Membership/Leadership
astengel@ons.org
412-859-6244

Diane Scheuring, MBA, CMP, Manager of Member Services
dscheuring@ons.org
412-859-6256

Carol DeMarco, Membership/Leadership Administrative Assistant
cdemarco@ons.org
412-859-6230

The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability.

Oncology Nursing Society
125 Enterprise Dr.
Pittsburgh, PA 15275-1214
866-257-4ONS
412-859-6100
www.ons.org

 
 
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