Volume 16, Issue 2, August 2012
 
   
Coordinator's Message:
Looking Forward

Jacqueline Hale, RN, APN-C, AOCN®, APNG
Flemington, NJ
Hale.jacqueline@hunterdon
healthcare.org

I am excited about my role as the Cancer Genetics (CAG) SIG coordinator. The first few weeks have been busy! When I first considered the coordinator position, I knew many networking opportunities would come up—and they have.

During Congress and in its following weeks, I have interacted with SIG members and the SIG leadership team. We have discussed current issues and topics of interest. I encourage all SIG members to share thoughts, concerns, experiences, and opportunities. The CAG SIG Virtual Community is an excellent communication vehicle. We have much to share.

At Congress in New Orleans, LA, the SIG sponsored three great sessions.

  • PARP Is a PERP: Biology of Cancer Update (Julie Eggert, RN, PhD, GNP-C, AOCN®, and Lori Williams, PhD, RN, AOCN®, OCN®)
  • Personalized Health Care: Interpreting What It Means for the Practitioner and the Patient (Karen Roesser, RN, MSN, AOCN®, and Mary Thomas, RN, MS, AOCN®)
  • Demystifying Colon Cancer Genetics (Patricia Kelly, DNP, APRN, CNS, AOCN®, and Bridget LeGrazie, RN, MSN, AOCN®, APNG)

A special instructional session also was held.

  • What Does Genomic Competency Mean for You? (Jean Jenkins, RN, BS, MSN, PhD, FAAN, and Georgia Cusack, RN, MS)

Our SIG meeting included a continuing nursing education opportunity.

  • Interesting Cases in Cancer Risk Assessment (Bridget LeGrazie, RN, MSN, AOCN®, APNG, and Jacqueline Hale, RN, APN-C, AOCN®, APNG)

Looking forward, we face some common concerns. Though this list is not all-inclusive and certainly will become longer, the following are current issues.

  • Do we feel prepared to address the multiple genetic and genomic questions posed by our patients and their family members? What are our resources for patient and family education?
  • How can we stay current in the rapidly changing areas of genetics and genomics?
  • Are standards for accreditation, such as those developed by the American College of Surgeons, the National Accreditation Program for Breast Centers, and other organizations, going to affect employer expectations and role definitions?
  • How can my program meet these standards?
  • What is the genetics "credentialing by portfolio" process really like?

As oncology nurses, we use genetic and genomic information throughout the cancer care continuum—from prevention to survivorship. Our SIG poster for Congress bore the following diagram to illustrate integration of genetics and genomics into this continuum.


(Click to enlarge)

We each have a responsibility to help our patients understand the genetic and genomic information guiding their healthcare management. One of our current SIG projects is updating the ONS position statement on "The Role of the Oncology Nurse in Cancer Genetics and Genomics." I encourage you to share any thoughts or comments you have as we prepare this update.

Finally, I would like to thank Patricia Kelly, DNP, RN, CNS, AOCN®, who has served as the CAG SIG coordinator for the past two years. Her experience, expertise, and guidance have been an encouragement to me. Under her leadership, our SIG received the SIG Excellence Award, sponsored genetic and genomic educational sessions, and completed an online educational needs survey. Thank you, Pat, for a job well done. Thank you, SIG members, for the opportunity to serve as your coordinator.

 
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  August 2012
 
   

NCCN Guidelines Update:
Hereditary Cancer

Karen Heller, MS, CGC
Dallas, TX
kheller@myriad.com

Freely available at the National Comprehensive Cancer Network (NCCN)'s Web site (requires registration), under "NCCN Guidelines for Detection, Prevention, & Risk Reduction," are helpful guidelines for the testing and management of hereditary cancer syndromes. They are updated annually. In this article, we will review some highlights and recent updates. Unless otherwise specified, all recommendations are category 2A ("based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate.")

Colorectal Cancer Screening, Version 2.2012

  • Colonoscopy recommendations based on family history (i.e., no confirmed syndrome) have been revised for 2012, based largely on a population study of more than 2 million individuals (page 12/CSCR-6).
  • Criteria for evaluation of Lynch syndrome, or hereditary nonpolyposis colorectal cancer, have not changed (page 22/LS-1).
    • Revised Bethesda guidelines and Amsterdam criteria (described on pages 27/LS-B and 28/LS-C)
    • Endometrial cancer under age 50
  • Lynch syndrome management guidelines (page 23/LS-2)
    • Management recommendations largely are unchanged from 2011, including colonoscopy every one to two years beginning age 20-25 and consideration of prophylactic hysterectomy with bilateral salpingo-oophorectomy after completion of childbearing for females.
    • Upper gastrointestinal surveillance guidelines include consideration of esophagogastroduodenoscopy and capsule endoscopy with less detail than in 2011, allowing for clinician discretion.
    • Guidelines for annual urothelial and central nervous system cancer screening (urinalysis and physical exam, respectively) now include a starting age of 25-30 years.
  • Tumor testing results (microsatellite instability and immunohistochemistry) and recommended follow-up testing are listed on page 26/LS-A2.
  • Lynch syndrome risk and average age of onset have been revised based on more recent data (page 29/LS-D).
  • The remainder of the guidelines include testing and management of familial adenomatous polyposis (FAP), attenuated FAP, MYH-associated polyposis, Peutz-Jeghers syndrome, juvenile polyposis, and serrated polyposis (previously referred to as hyperplastic polyposis).

Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 1.2012

  • Hereditary breast and ovarian cancer (HBOC) testing criteria are unchanged from 2011, except for a clarification of the ages in the italicized section in the following (page 9/HBOC-1).
    • Breast cancer (invasive or ductal carcinoma in situ) at or under 45 years of age; at or under 50 years of age with limited family structure; at or under 60 years of age if triple negative; at any age if patient is Ashkenazi Jewish, is male, or has family history as described
    • Epithelial ovarian, fallopian tube, or primary peritoneal cancer at any age
    • Pancreatic cancer with family history of breast, ovarian, or pancreatic cancer in at least two relatives
    • Individual without cancer with a first- or second-degree relative meeting criteria
  • The 2012 guidelines state that "comprehensive genetic testing includes full sequencing of BRCA1/BRCA2 and detection of large genomic rearrangements," suggesting that the BRACAnalysis® Rearrangement Test (BART™)* should be requested for any patient being tested for HBOC (page 10/HBOC-2, footnote j).
  • HBOC management recommendations largely are unchanged and include the following (page 11/HBOC-A).
    • Breast magnetic resonance imaging and mammography annually and clinical breast exams every 6-12 months, all beginning at age 25 with the option of mastectomy or chemoprevention
    • Ovarian cancer surveillance beginning at age 30 (previously 35) with salpingo-oophorectomy ages 35-40
    • Guidelines are included for the management of males with HBOC, as well as discussion of reproductive options with appropriate patients.
  • Li-Fraumeni syndrome test criteria were clarified to include breast cancer under age 30 with negative BRCA1/BRCA2 testing (page 13/LIFR-1). Management guidelines are listed on page 15/LIFR-A.
  • Cowden syndrome test criteria and management are included in the last few pages of the guidelines.

Breast Cancer Risk Reduction, Version 1.2012

  • In addition to guidelines for the use of breast cancer risk reduction agents, this document includes a table comparing survival for BRCA1/BRCA2 mutation carriers that opt for risk-reducing salpingo-oophorectomy, mastectomy, or breast surveillance at different ages (page 40/MS-27).

Consider updating your knowledge with a thorough read of these guidelines, including the detailed discussion with references in the text section. Because these guidelines are updated annually, many clinicians depend on them to guide management, and most insurers use them to determine coverage criteria.

*BART™ refers to Myriad Genetic Laboratories, Inc.'s testing for large genomic rearrangements in BRCA1 and BRCA2. BART™ and BRACAnalysis® are either trademarks or registered trademarks of Myriad Genetics, Inc.

 
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Special Interest Group Newsletter  August 2012
 
   

Unusual Case Presentation
Pseudopapillary Pancreatic Tumor in a 13-Year-Old With a BRCA2 Mutation

Robin S. Stevens, ARNP-BC, MSN, OCN®, CBC
Jupiter, FL
robin.stevens@pbcancer.com

Introduction
Jennifer (not her real name), a 21-year-old female, came to the Cancer Risk Assessment and Genetic Counseling office with her mother six months after the death of her father. Jennifer's father died at the age of 48 after being diagnosed with stage IV high grade poorly differentiated adenocarcinoma of the pancreas. Jennifer and her mother were concerned that Jennifer may have a hereditary form of pancreatic cancer. Jennifer—now cancer-free—was diagnosed and treated for pancreatic cancer at age 13.

Case History
The proband, Jennifer, was presented as a slender, active, healthy, nulliparous 21-year-old woman. With the exception of the diagnosis of a pancreatic tumor, her health history was unremarkable. She did not use drugs, alcohol, or tobacco and was physically active. While playing soccer at age 13, Jennifer had uncontrollable vomiting after being hit in the abdomen with a soccer ball. She was sent to the hospital emergency room and had a computed tomography (CT) scan that showed a 7-cm mass that was "consistent with a hematoma." The proband continued having abdominal tenderness and nausea one month later. A second CT scan and subsequent magnetic resonance imaging (MRI) lead to a differential diagnosis of teratoma, leiomyoma, and a connective tissue neoplasm. Two months after her initial symptoms, the proband had an exploratory laparotomy and partial removal of the pancreas, leaving 10% of the pancreas for endocrine function. The pathology report said that the pancreatic tumor was "a low-grade, solid, and pseudopapillary malignant neoplasm of the pancreas." Post-surgery, the proband was followed by a pediatric oncologist. Subsequent CT scans have been negative with no evidence of recurrence since the original diagnosis.

Pseudopapillary Tumors Background
Pseudopapillary tumors of the pancreas are rare pancreatic tumors and represent 0.1%-5% of all pancreatic tumors. These tumors are characterized by low-grade histology with cells of unclear origin. The patients often are young women presenting with an abdominal pain and mass. Surgical resection and removal of the tumor result in an overall survival rate of approximately 95% (Guo et al., 2011).

Family History
I obtained a four-generation family history and constructed a pedigree. The proband has two sisters and one brother—ages 22, 24, and 28. All are alive and well with no health issues. Her father, who had pancreatic cancer at the age of 47, died at the age of 48. Her mother has a history of uterine polyps. Her mother also reports that her mother, the proband's maternal grandmother, died at the age of 29 of an unknown cancer. I asked if she would obtain further information. Her maternal grandfather died of a myocardial infarction at the age of 62. Her paternal grandfather died at the age of 68 from a heart attack, and her paternal grandmother is still living at the age of 74. She has numerous paternal cousins ranging in ages from 6 to 30 years old, and all of these relatives are reported to be healthy. She is of Greek ancestry on the maternal side of the family and Italian ancestry on the paternal side of the family.


(Click to enlarge)

Differential Diagnosis

BRCA2 Mutation

  • BRCA2 mutations account for 7% of moderate and 15% of high-risk pancreatic cancer families.
  • Average age of onset is 62.8 years.
  • No association between BRCA2 mutations and young onset of pancreatic cancer has been observed (Couch et al., 2007).

PALB2

  • Partner and localizer of BRCA2
  • Second most commonly mutated gene for hereditary pancreatic cancer
  • Average age of onset of pancreatic cancer is 66.7 years.
  • Breast cancer also is seen in these families (Jones et al., 2009).

MEN1

  • The pancreas is the second most commonly affected endocrine gland in MEN1.
  • Pancreatic neuroendocrine tumors occur in 30%-80% of patients with MEN1.
  • Slow-growing and seldom metastasize
  • Young age of onset (Kann et al., 2006)

Lynch Syndrome

  • Extracolonic cancers seen with Lynch syndrome include endometrial, ovarian, small bowel, gastric, pancreatic, and brain. (Lynch et al., 2002)
  • Lifetime risk for pancreatic cancer is less than 5%.
  • Age of diagnosis is seen later in life, after age 65 (Watson et al., 2008).

P16 (CDKN2A) Mutation

  • Germline mutations in the p16 tumor suppressor gene have been shown to predispose to pancreatic cancer.
  • Family members with the p16 mutation-associated familial atypical multiple mole melanoma are estimated to have a 22-fold risk for the development of pancreatic cancer.
  • P16 is a rare cause in familial pancreatic cancer without the occurrence of malignant melanomas (Lynch et al., 2002).

Testing and Follow-Up
I decided to start with testing for mutations in BRCA1 and BRCA2 for the following reasons. The only documented cancers in the family were the proband's and her father's. A number of studies have evaluated the prevalence of BRCA mutations in families with pancreatic cancer. In families with two or more first-degree relatives with pancreatic cancer, the prevalence of BRCA2 mutations has been estimated to range from 17%–19% (Hahn et al., 2003). Although the risk for pancreatic cancer associated with BRCA1 mutations appears to be rare, some studies have suggested a two- to three-fold higher risk than the general population (Brose et al., 2002). I felt that testing for BRCA mutation was a good starting point to begin genetic testing, knowing that if the results returned negative, I would need to discuss testing for other syndromes with the proband.

After education, counseling, and informed consent, the proband had full-sequence BRCA1 and BRCA2 testing. The patient's test was positive for a BRCA2 deleterious mutation, 4093del4, a premature truncation of the BRCA2 protein. Several studies have indicated that the BRCA2 lifetime risk of breast cancer ranges from 41%–49%, and the lifetime risk of ovarian cancer ranges from 8.4%–45%. Other cancers associated with BRCA2 mutations include fallopian tube carcinoma, male breast cancer, prostate cancer, and melanomas (Petrucelli, Daly, & Feldman, 1998 [Updated 2011]).

The patient and mother returned to my office for test disclosure. The decision was made at that time to perform single site testing on her mother to rule out her potential carrier status. The mother's test was negative. The plan now is to test the proband's siblings as well as paternal relatives, starting with her oldest sister. To date, none of the siblings have had testing (even though recommended). The proband enrolled in a clinical registry and pancreatic study through a major cancer center. Screening recommendations include monthly self-breast exam, clinical breast exams every six months, annual mammogram, and breast MRI screening starting at age 25. At the age of 30, she should begin concurrent transvaginal ultrasound with CA-125. I discussed reproductive options including pre-implantation genetic diagnosis when she is ready to start a family. I reviewed surgical options as part of hereditary breast and ovarian cancer (HBOC) syndrome management. She is taking oral contraceptives and is encouraged to continue because it is found to reduce the risk of ovarian cancer. I discussed the signs and symptoms of pancreatic cancer as well as referral to the pancreatic cancer registry for the remainder of the family. She was advised to have skin screening due to increased risk of melanoma. All recommendations were based on the current National Comprehensive Cancer Network (NCCN) guidelines (NCCN, 2012).

This case was reviewed by genetics colleagues at a large cancer hereditary institution. They confirmed that no cases of pancreatic cancer in a teenager with a BRCA2 mutation have been reported. Recommendations were made for testing other family members and screening for pancreatic cancer in family members who are BRCA2 mutation carriers. Testing of minors in this family was not recommended. In summary, this was a challenging case with unusual pathology and a limited family history.

References
Brose, M.S., Rebbeck, T.R., Calzone, K.A., Stopfer, J.E., Nathanson, K.L., & Weber, B.L. (2002). Cancer risk estimates for BRCA1 mutation carriers identified in a risk evaluation program. Journal of the National Cancer Institute, 94(18), 1365-1372. doi:10.1093/jnci/94.18.1365

Couch, F.J., Johnson, M.R., Rabe, K.G., Brune, K., de Andrade, M., Goggins, M., . . . Hruban, R.H. (2007). The prevalence of BRCA2 mutations in familial pancreatic cancer. Cancer Epeidemiology, Biomarkers, & Prevention, 16(2), 342-346. doi:10.1158/1055-9965.EPI-06-0783

Guo, N., Zhou, Q.B., Chen, R.F., Zou, S.Q., Li, Z.H., Lin, Q., . . . Chen, J.S. (2011). Diagnosis and surgical treatment of solid pseudopapillary neoplasm of the pancreas: Analysis of 24 cases. Cancer Journal of Surgery, 54(6), 368-374. doi:10.1503/cjs.011810

Hahn, S.A., Greenhalf, B., Ellis, I., Sina-Frey, M., Rieder, H., Korte, B., . . . Bartsch, D.K. (2003). BRCA2 germline mutations in familial pancreatic carcinoma. Journal of the National Cancer Institute, 95(3), 214-221. doi:10.1093/jnci/95.3.214

Jones, S., Hruban, R.H., Kamiyama, M., Borges, M., Zhang, X., Parsons, D.W., . . . Klein, A.P. (2009). Exomic sequencing identifies PALB2 as a pancreatic susceptibility gene. Science, 324(5924), 217. doi:10.1126/science.1171202

Kann, P.H., Balakina, E., Ivan, D., Bartsch, D.K., Meyer, S., Klose, K.J., . . . Langer, P. (2006). Natural course of small, asymptomatic neuroendocrine pancreatic tumours in multiple endocrine neoplasia type 1: An endoscopic ultrasound imaging study. Endocrine-Related Cancer, 13(4), 1195-1202. doi:10.1677/erc.1.01220

Lynch, H.T., Brand, R.E., Hogg, D., Deters, C.A., Fusaro, R.M., Lynch, J.F., . . . Kern, S. (2002). Phenotypic variation in eight extended CDKN2A germline mutation familial atypical multiple mole melanoma-pancreatic carcinoma-prone families: The familial atypical multiple mole melanoma-pancreatic carcinoma syndrome. Cancer, 94(1), 84-96. doi:10.1002/cncr.10159

National Comprehensive Cancer Network. (2012). Hereditary breast and/or ovarian cancer syndrome management. NCCN Guidelines Version 1.2012. Retrieved from http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

Petrucelli, N., Daly, M.B., & Feldman, G.L. (1998 [Updated 2011]). BRCA1 and BRCA2 hereditary breast and ovarian cancer. Gene Reviews. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK1247/

Watson, P., Vasen, H.F., Mecklin, J.P., Bernstein, I., Aarnio, M., Järvinen, H.J., & Lynch, H.T. (2008). The risk of extra-colonic, extra-endometrial cancer in Lynch syndrome. International Journal of Cancer, 123(2), 444-449. doi:10.1002/ijc.23508M

 
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Special Interest Group Newsletter  August 2012
 
   

Cancer Genetics SIG Authors and Researchers

The following is a list of Cancer Genetics SIG members' 2011-2012 publications and research topics. The list is not all-inclusive. If you did not respond to the SIG Virtual Community request for authors and researchers, we have missed your contributions. Please let us know if we can add your name to the list for either publishing or research.

Publications

Beamer, L.C., Grant, M.L., Espenschied, C.R., Blazer, K.R., Hampel, H.L., Weitzel, J.N., & MacDonald, D.J. (2012). Reflex immunohistochemistry and microsatellite instability testing of colorectal tumors for Lynch syndrome among US cancer programs and follow-up of abnormal results. Journal of Clinical Oncology, 30(10), 1058-1063. doi:10.1200/JCO.2011.38.4719

Cummins, A., Eggert, J., Pruitt, R., & Collins, J.S. (2011). Huntington disease: Implications for practice. Nurse Practitioner, 36(2), 41-47. doi:10.1097/01.NPR.0000392796.01760.e2

Eggert, J. (2011). The biology of cancer: What do oncology nurses really need to know. Seminars in Oncology Nursing, (27)1, 3-12. doi:10.1016/j.soncn.2010.11.002

Kelly, P. (2011). Colorectal cancer family history assessment: Documentation, deficiencies, and future directions. Clinical Journal of Oncology Nursing, 15(5). Retrieved from http://ons.metapress.com/content/d01k4u15p2257404/fulltext.pdf

Raudonis, B.M., & Cauble, D.M. (2011). Palliative care in the genomic era. Journal of Hospice & Palliative Nursing, 13(5), 298-308. doi:10.1097/NJH.0b013e31821adafd

Steck, M.B., & Eggert, J.A. (2011). The need to be aware and beware of the Genetic Information Nondiscrimination Act. Clinical Journal of Oncology Nursing, 15(3). Retrieved from http://www.ons.org/Publications/VJC/media/ons/docs/publications/VJC/october2011.pdf

Williams, J., Prows, C., Conley, Y., Eggert, J., & Nichols, F. (2011). Genetics/genomics and nursing education: Strategies to prepare faculty to integrate genetics and genomics into nursing education programs. Journal of Nursing Scholarship, 43(3), 231-238.

Research and Evidence-Based Practice

Clement, R. (2012, in progress). Identifying women at risk for hereditary breast and ovarian cancer syndrome at women's mammography and diagnostic centers utilizing breast care nurse navigation. University of Alabama College of Nursing.

He, R., Eggert, J., Larcom, L., Chen, C., Dye, C., & Moore, D. (2011, in progress). Impact of raspberry intake on chemo brain in women receiving chemotherapy after a diagnosis of breast cancer. Clemson University, Clemson, SC, and Bon Secours St. Francis, Greenville, SC.

 
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Special Interest Group Newsletter  August 2012
 
   

Study Aims to Increase Nurses' Genetics Competency

The National Council of State Boards of Nursing (NCSBN) Center for Regulatory Excellence grant program awarded a West Virginia University School of Nursing faculty member, Laurie Badzek, LLM, JD, RN, FAAN, a two-year $300,000 grant to develop, implement, and evaluate a program to improve genetics knowledge among nurses.

The goals of the study are to establish a program for improving nursing genomic literacy and to determine the success of such a program. Recruited study participants were pairs of nurse administrators and educators from Magnet-designated hospitals. Following evaluation of applications using study criteria, 21 participant hospitals and two control hospitals were accepted to participate in the study. Hospitals were represented related to size and geography. They included a rural hospital, three children's hospitals, and a cancer institute.

The year-long genomics educational program will be designed by Badzek and her co-investigators, Kathleen Calzone, PhD, RN, APNG, FAAN, and Jean Jenkins, PhD, RN, FAAN, from the National Institutes of Health. The study's curriculum is built around an online, interactive case study-based learning experience.

This project will demonstrate the acceptability and effectiveness of a hospital-based champion effort to facilitate genomic nursing integration and competency and will document the range of facilitators and obstacles that are unique to the practice environment. This intervention will be the first genomic champion effort of its kind aimed at the practicing community with empirical outcome measurements.

For more information, visit the project Web site.

 
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Special Interest Group Newsletter  August 2012
 
   

Journals Now Available in Digital Format

Did you know that the Clinical Journal of Oncology Nursing (CJON) and Oncology Nursing Forum (ONF) are now available in digital format? To access the digital editions, click on the journal you wish to view at www.ons.org/Publications and follow the instructions featured prominently in the top center of the page. The digital editions are a members-only benefit, so make sure you have your ONS username and password handy.

 
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Special Interest Group Newsletter  August 2012
 
   

RE:Connect

RE:Connect is a blog written by oncology nurses on a variety of topics of interest to other nurses in the specialty, including facing day-to-day challenges at work, juggling busy lives at home, and keeping up to date with the magnitude of information available for practicing nurses. This month on RE:Connect, you'll find the following new discussions.

As a reader, join in on the conversation and connect with other oncology nurse readers by posting your own stories, tips, ideas, and suggestions in the comments section at the end of each blog post.

 
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Special Interest Group Newsletter  August 2012
 
   

Five-Minute In-Service

In the latest issue of ONS Connect, the Five-Minute In-Service takes a look at how Studies Support Value of Exercise in Patients at Different Stages of Cancer.

 
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Special Interest Group Newsletter  August 2012
 
   

Do You Enjoy Writing?
Become an ONS Blogger

Join Patients and Caregivers on the Cancer Journey!
We're looking for oncology nurses to write for Traveling Companions, ONS's patient- and caregiver-focused blog. If you'd like to share your thoughts and comments to support patients and caregivers on the cancer journey, please e-mail us at socialmedia@ons.org for consideration.

 
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Special Interest Group Newsletter  August 2012
 
   

ONS Podcasts of Interest

ONF Podcasts
What coping strategies do patients use while receiving radiation treatments for head and neck cancer? When are physical side effects most problematic? What coping resources assist patients as they undergo treatment?

During May's podcast, lead author Mary Ellen Haisfield-Wolfe, PhD, RN, OCN®, will answer these questions and discuss strategies to assist patients with head and neck cancer that were presented in her May 2012 ONF article "Perspectives on Coping Among Patients with Head and Neck Cancer Receiving Radiation." Previous research investigating head and neck cancer treatment found that patients' illness experiences include physical symptoms, side effects from treatment, symptom distress, and psychological distress. This qualitative study explores coping strategies and resources utilized by patients with laryngeal or oropharyngeal cancer over four time points during radiation with or without chemotherapy. (Listen to ONF podcasts!)

CJONPlus Podcasts
Older adults constitute the greatest percentage of cancer survivors in the country, with 61% being 65 years and older. Assessing older cancer survivors beyond chronological age to include changes in functional status is essential to help nurses anticipate cancer treatment impact and aide in planning individualized survivorship care.

This CJONPlus podcast features lead author Denice Economou, RN, MN, CNS, CHPN, discussing her June 2012 CJON article titled "Integrating a Cancer-Specific Geriatric Assessment Into Survivorship Care." (Listen to CJON podcasts!)

 
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Special Interest Group Newsletter  August 2012
 
   

Membership Information

SIG Membership Benefits

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  • 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://ons.org/membership including
    • Educational opportunities for your subspecialty
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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

  • Visit the "Find a SIG" page.
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  • Once on your SIG’s main page, click “Join Group,” and log in using your ONS Profile. Don’t have an ONS Profile? Create one today, and then return to your SIG to join.

Subscribe to Your SIG’s Virtual Community Discussion Forum
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.
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  • Locate and select "Subscribe to Discussion"
  • Enter e-mail address.
  • 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.
  • 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.
  • Select the "Click Here" feature, which will take you to a link to subscribe.
  • Once the "For Announcement Subscription Only" page appears 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."
  • Click "Finish"
  • You are now subscribed to receive announcements.
 
 
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Special Interest Group Newsletter  August 2012
 
   

Cancer Genetics SIG Officers

Coordinator (2012-2014)
Jacqueline Hale, RN, APN-C, AOCN®, APNG
Flemington, NJ
Hale.jacqueline@hunterdonhealthcare.org

Ex-Officio (2012-2013)/Co-Editor
Patricia Kelly, DNP, RN, CNS, AOCN®
Dallas, TX
patriciakelly@texashealth.org

Co-Editor
Rose Bell, ARNP-C, MSN, OCN®
Gig Harbor, WA
rbell@nwmsonline.com

 

Web Administrator
Lisa Aiello-Laws, RN, MSN, APNG, AOCNS®
North Cape May, NJ
llaws@eviti.com

Special Projects
Julie Eggert, RN, PhD, GNP-C, AOCN®
Greer, SC
jaegger@exchange.clemson.edu

ONS Copy Editor
Jessica Moore, BA, BS
Pittsburgh, PA
jmoore@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 Specialist Carol DeMarco at cdemarco@ons.org or 866-257-4ONS, ext. 6230.

View past newsletters.

ONS Membership & Component Relations Department Contact Information

Brian K. Theil, CAE, Director of Membership and Component Relations Department
btheil@ons.org
412-859-6244

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dscheuring@ons.org
412-859-6256

Carol DeMarco, Membership Specialist—SIGs
cdemarco@ons.org
412-859-6230

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

 
 
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