Cancer Genetics

special interest group newsletter

Volume 19, Issue 1, May 2015  
 


What's Inside . . .

Pandoraís Box: Genetic Testing Beyond BRCA1/BRCA2

Share, Like, Tweet, Follow: Connect Patients With Hereditary Cancer Syndromes Using Social Media

Coordinatorís Message: Invest in You!

PMS2 Mutations in Lynch Syndrome: Updating the Risk Factors

Advanced Genetics Nursing Certification

Check Out These Online Cancer Education Resources

Celebrate Nursesí Week With Quality Oncology Nursing Publications

Celebrate Nursesí Week With 25% Off ONSís Perpetual Calendar Created for Nurses Just Like You

Make Sure Youíre Current on the Core Skills of Oncology Nursing Practice

Oncology Nursing Certification Corporation is Pilot-Testing Employer Discount Program

Exclusive Articles Available Before Print

Check Out the ONS Connect Blog

Five-Minute In-Service

Ask a Team Member

Membership Benefits

SIG Officers

Click here to print this issue of the newsletter!


   
Pandoraís Box:
Genetic Testing Beyond
BRCA1/BRCA2

Susan Montgomery, BSN, RN, OCN®, GCN
Philadelphia, PA
susan.montgomery@fccc.edu

Multigene panel testing was a hot topic of discussion at the recent International Society of Nurses in Genetics and National Society of Genetic Counselors conferences. We no longer are bound by single-gene testing for high-risk patients. We now have a variety of panels to offer. However, with these opportunities come the following challenges.

  • How can we convey the value of genomic tests to patients?
  • What is the best way to explain the implications of a multigene panel in the timeframe of a genetic counseling session?
  • How can we select the most appropriate panel for patients?
  • If gene-specific testing is ordered first, will insurance restrictions preclude additional (panel) testing?
  • How can we explain moderate-risk gene mutations and variants of uncertain significance?
  • How can we assess and interpret data generated by multigene panel tests and use that information to make clinical decisions (Hall, Forman, Montgomery, Rainey, & Daly, 2015)?

Case Study

The following case study exemplifies the challenges and rewards of multigene panel testing.

Danielle (a pseudonym) is a 38-year-old woman who came to our hospital for a consultation following bilateral breast biopsies at an out-of-state facility. The right-breast biopsy report was negative with no atypia or malignancy. However, the left-breast biopsy report indicated invasive ductal carcinoma.

Danielle came in for genetic counseling on the same day as her oncology consultation. She was accompanied by a maternal aunt who lived locally. Danielle reported good health until this recent breast cancer diagnosis. Her mother died in her 40s without any reported cancer. A maternal grandmother, who was diagnosed with breast cancer at age 42, died at 44. A maternal great-grandfather was reported to have been diagnosed with either colon or stomach cancer. Danielle’s father was 67 and alive and well. Her paternal grandmother was diagnosed with breast cancer in her 70s.

We discussed genetic testing options, and Danielle decided on a multigene cancer panel that included testing for six high-risk hereditary breast cancer genes: BRCA1, BRCA2, CDH1, PTEN, TP53, and STK11. Because she lived out of state, I planned to phone Danielle with her results. Danielle returned to her home and elected to have a left-breast lumpectomy.

At Danielle’s request, our pathologists reviewed the breast pathology slides from the hospital in her home state. The left-breast pathology report revealed in situ and invasive mammary carcinoma, and the right-breast pathology report revealed in situ and invasive lobular carcinomas.

Danielle’s genetic test results arrived. She had a pathogenic mutation in the CDH1 gene, a mutation associated with hereditary diffuse gastric cancer (HDGC) syndrome. Danielle returned to our hospital for a bilateral mastectomy. Prior to her mastectomy, she received gastric screening studies, including an endoscopic ultrasound (EUS) with random biopsies and a computed tomography (CT) scan of her chest, abdomen, and pelvis. All of these tests produced negative results.

Once this rare mutation was identified in the family, other family members pursued genetic testing. Danielle’s maternal aunt underwent testing and was found to carry the same CDH1 mutation, confirming its inheritance through maternal lineage. That same aunt’s daughter also tested positive for the mutation. Danielle’s siblings were tested, and one brother was found to carry the CDH1 mutation. Our genetics team offered extensive counseling about disclosing genetic test results to family members.

Once the mutation was identified, carriers were offered appropriate screening per National Comprehensive Cancer Network ([NCCN], 2015) guidelines. Danielle’s maternal aunt had a screening breast magnetic resonance imaging (MRI) scan. Because of abnormal results, she had a breast biopsy that showed lobular carcinoma in situ pathology. Her EUS and abdominal CT scans produced negative results, and she was asymptomatic. However, she was concerned about her lifetime risk of gastric cancer. Benusiglio et al. (2013) cited a family with this CDH1 mutation whose members developed gastric cancer at ages 24, 24, and 43. Danielle’s aunt decided to have a prophylactic gastrectomy. Pathology revealed early-stage diffuse gastric cancer. Because of this surprising finding, Danielle and her maternal cousin are pursuing prophylactic gastrectomies.

CDH1 Gene Mutation

CDH1 is a tumor-suppressor gene that encodes the E-cadherin protein, which plays a role in cell-to-cell adhesion. The loss of E-cadherin leads to the typical phenotype of diffuse gastric cancer, which initially spreads through the mucosa and only later invades the gastric wall. Lobular breast cancer similarly spreads within the lobules of the breast and is difficult to detect with mammographic imaging (Klujit et al., 2012). As of 2010, only 100 families have been identified and confirmed to be CDH1 mutation carriers. This number will most likely increase with multigene panel testing (Guilford, Humar, & Blair, 2010). The average age at onset of diffuse gastric cancer in CDH1 mutation carriers is 37, and NCCN (2015) guidelines include recommendations for risk-reduction gastrectomies in carriers ages 18-40.

Prior to surgery, surveillance with esophagogastroduodenoscopy and random biopsies should be performed every 6-12 months (Fitzgerald et al., 2010). Given the significant burden associated with surveillance and surgery, patients should be referred to a center with a multidisciplinary team specializing in HDGC. This team should include a surgeon specializing in upper gastrointestinal cancer, a gastroenterologist, a clinical genetics specialist, a nutritionist, and a counselor (Fitzgerald et al., 2010). Breast screening should mirror the recommendations for BRCA1/BRCA2 carriers, including annual MRI scans beginning at age 25, with the addition of a mammogram at age 30. Screenings should alternate between MRI scans and mammographies at six-month intervals, and a clinical breast examinations are recommended every six months (NCCN, 2014, 2015).

Although many people in the genetics community debate the relative merits of multigene panel testing, this gene panel provided valuable and potentially life-saving information for Danielle’s family. As our team reviewed this case, we noted that this mutation could easily have been missed. Danielle’s initial pathology report did not show lobular breast cancer, and her family history was only vaguely suggestive of gastrointestinal cancer in a maternal great-grandfather. Had Danielle undergone traditional BRCA1/BRCA2 testing when she was first diagnosed, the test results would have been negative. She may not have pursued further testing because of insurance restrictions or because she did not have a “strong” family history of gastric cancer. While casting a wide net in the genetic pool may yield challenging results, this case report shows the value of offering appropriate, comprehensive testing based on personal and familial risk factors.

References
Benusiglio, P.R., Malka, D., Rouleau, E., De Pauw, A., Buecher, B., Nogues, C., . . . Caron, O. (2013). CDH1 germline mutations and the hereditary diffuse gastric and lobular breast cancer syndrome: A multicenter study. Journal of Medical Genetics, 50, 486-489. doi:10.1136/jmedgenet-2012-101472

Fitzgerald, R.C., Hardwick, R., Huntsman, D., Carniero, F., Guilford, P., Blair, V., . . . Caldas, C. (2010). Hereditary diffuse gastric cancer: Updated consensus guidelines for clinical management and directions for future research. Journal of Medical Genetics, 47, 436-444. doi:0.1136/jmg.2009.074237

Guilford, P., Humar, B., & Blair, V. (2010). Hereditary diffuse gastric cancer: Translation of CDH1 germline mutations into clinical practice. Gastric Cancer, 13(1), 1-10. doi:10.1007/s10120-009-0531-x

Hall, M.J., Forman, A.D., Montgomery, S.V., Rainey, K.L., & Daly, M.B. (2015). Understanding patient and provider perceptions and expectations of genomic medicine. Journal of Surgical Oncology, 111(1), 9-17. doi:org/10.1002/jso.23712

Klujit, I., Sijmons, R.H., Hoogerbrugge, N., Plukker, J.T., deJong, D., van Krieken, J.H., . . . Cats, A. (2012). Familial gastric cancer: Guidelines for diagnosis, treatment and periodic surveillance. Familial Cancer, 11, 363-369. doi:10.1007/s10689-012-9521-y

National Comprehensive Cancer Network. (2014). NCCN Clinical Practice Guidelines in Oncology: Genetic/familial high-risk assessment: Breast and ovarian [v.1.2015]. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/genetics_screening.pdf

National Comprehensive Cancer Network. (2015). NCCN Clinical Practice Guidelines: Gastric cancer [v.3.2015]. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/gastric.pdf

Additional Resource
Forman, A.D., Rainey, K., Montgomery, S., Rybak, C., Masny, A., Obeid, E., . . . Hall, M.J. (2014, September). 200 days of multi-gene testing: The clinical experience. Abstract presented at the meeting of the National Society of Genetic Counselors, New Orleans, LA.


 

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

Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Share, Like, Tweet, Follow:
Connect Patients With Hereditary Cancer
Syndromes Using Social Media


Heather Fecteau, MS, CGC
Dallas, TX
Heatherfecteau@texashealth.org

Everywhere you look, there are new ways to communicate with others via social media. In one way or another, we all use this new tool, which consists of consumer-generated media designed to engage others in online communities. Roughly 58% of Americans have smartphones (Pew Research Center, 2014). This means that most of our patients have the ability to go online, look things up, and share information. As we know, this is a blessing and a curse. How many times have you heard the phrase “I Googled?” The key is pointing patients toward credible sources of accurate information online. Patients who have hereditary cancer syndromes often are searching for others who have similar syndromes. There are amazing social networking opportunities for patients. I will highlight a few.

Facebook: When looking for social networking opportunities for families, the easiest place to start is Facebook. Facebook (2015) is the world’s largest social network with more than 1.39 billion users, 890 million of whom log in daily. There are many Facebook support groups such as the Cancer Legal Resource Center, Young Previvors, Facing Our Risk of Cancer Empowered (FORCE), Bright Pink, and the Colon Cancer Foundation. Encourage patients to reach out, but warn them that this is not a place to receive reliable medical advice.

Blogs: Not everyone has a Facebook account, but the majority of patients have access to the Internet. There are blogs like I Have Lynch Syndrome, where patients and family members can read the experiences of others. Another excellent resource that connects people with hereditary breast cancer syndromes is the ABOUT registry through FORCE.

Kintalk is an online resource that allows patients to share their test results with family members on a secure storage site built by the University of California, San Francisco. When a person signs up to be a member of Kintalk, he or she can interact with the Kintalk community by reading what people are posting on the Kintalk chat feed and by sharing comments or questions. Patients can learn about the latest research in hereditary cancer and keep up with current screening recommendations for specific hereditary cancer syndromes. But most importantly, members can privately upload genetic information and invite relatives to view this potentially life-saving information.

I encourage you to begin researching online resources and social media sites to compile a list for your patients. Online resources offer patients and family members opportunities to connect with others and share their personal stories. The following are a few suggestions to help you begin (this is not a comprehensive list).

Hereditary Colon Cancer Support

Hereditary Breast and Ovarian Cancer

Other Cancer Support

References
Facebook. (2015). Stats. Retrieved from http://newsroom.fb.com/company-info/

Pew Research Center. (2014). Device ownership over time. Retrieved from http://www.pewinternet.org/data-trend/mobile/device-ownership/

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Coordinatorís Message:
Invest in You!

Catherine M. Belt, MSN, RN, AOCN®
Hatfield, PA
cathy.belt@uphs.upenn.edu

With many hospitals reducing financial support for educational opportunities like ONS’s Annual Congress, I am concerned that attendance at this year’s premier oncology nursing conference will suffer. I have listened to many debates about the obligation of professional development weighing whether it is the responsibility of the employer or of the nurse. Standard number eight of the American Nurses Association’s (ANA’s) “Standards of Professional Nursing Practice” specifies that the registered nurse attains knowledge and competence that reflects current nursing practice” (2010, p. 12). The ANA’s position statement on professional competence asserts that the registered nurse is individually responsible and accountable for maintaining professional competence” (ANA, 2010, p. 49). Many state boards of nursing require continuing education for licensure renewal. ONS and ANA nursing certifications require continued nursing education for recertification. The challenges of accomplishing this goal often are financial.

ONS recognized this limitation and converted many educational materials into online, self-paced learning opportunities. The cancer genetics and radiation therapy courses were the first to be converted into electronic formats. In addition, the chemotherapy and biotherapy certification course became available online last year. For many nurses, these transitions offer an affordable, acceptable learning opportunity. As a trained educator for all of these courses, I was disappointed when these transitions occurred because I believe there is so much more that can be gained from the interactive, face-to-face opportunities afforded by a conference such as ONS Congress. I admittedly am of the generation that finds electronic learning a challenge. I thrive on the interactive networking opportunities provided at a conference.

Whatever your foundational nursing education, you likely put forward a significant financial investment to ensure its completion. This investment may have come from parents, scholarship foundations, personal loans, or employer tuition reimbursements. Your return on that investment was the realization of your personal goal of becoming a nurse. As Florence Nightingale wrote more than a century ago, “Let us never consider ourselves finished nurses . . . we must be learning all of our lives.” This commitment to ongoing professional development is even more crucial now with the rapid evolution of science. In 2014 alone, there were 17 new chemotherapeutic agents approved for a variety of cancer treatments, the majority of which were based on newly discovered epigenetic pathways that lead to the creation of targeted therapies. In addition, advancements in technology have expanded the scope of genetic testing panels for germline mutations as well as tumor-specific molecular markers.

Professional development is about continuous learning and education so you can provide the very best healthcare services to your patients. Your learning should not be random. It should be planned and managed so you have the knowledge and skills necessary to provide safe, caring, effective health care. Just as a financial investment was necessary to attain your diploma and license, your ongoing development also requires a planned investment. Invest in you—the rewards for yourself and your patients will be immeasurable. Now is a good time to make a plan for next year’s Congress funding. Work with your colleagues, discuss it with your manager, and think outside the box to identify alternative funding sources. One potential source is the ONS Foundation, which annually awards conference scholarships as well as academic scholarships. View this list of the Foundation’s offerings as well as application deadlines. Put your professional development on your priority list and budget the time and resources to make a better you. You are worth it. Your patients deserve it.

Reference
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

PMS2 Mutations in Lynch Syndrome:
Updating the Risk Factors

Cathleen M. Goetsch, MSN, ARNP, AOCNP®
Seattle, WA
cathleen.goetsch@vmmc.org

Originally, clinicians only associated diagnoses of Lynch syndrome (LS) with patients who inherited an extreme risk of developing colon cancer because of a significant family history. As additional mutations were linked to LS, clinicians also noted that colon cancer survivors were being diagnosed with a second primary noncolonic cancers. The spectrum of acknowledged LS-associated cancers now includes colon, endometrial, stomach, small bowel, hepatobiliary, upper urologic tract, ovarian, gliomas, pancreatic, breast, prostate, and (rarely) adrenocortical cancers (Lynch, Snyder, Shaw, Heine, & Hitchins, 2015).

In 1993, researchers sequenced the original mutation associated with LS: MSH2. Other scientists identified LS mutations in the MLH1 and PMS2 genes in 1994 and the MSH6 gene in 1997. In 2009, the LS-associated EPCAM deletions were identified by other researchers. Commercial laboratory testing for the LS-associated mutations MLHI and MSH2 became available in 2000 (Cohen & Leininger, 2014). Testing for mutations in MSH6 became commercially available in 2008, but EPCAM mutation testing only became available within the past few years. Accurate testing for PMS2 mutations was technically difficult, delaying its addition to the list of commercial tests for LS (Kohlman & Gruber, 2014). Prior to 2012, clinicians predicted individuals’ cancer risk with LS-related mutations and recommended screening only in individual cases or for families with MLH1, MSH2, and MSH6 mutations.

Clinical experts updated the National Comprehensive Cancer Network’s (NCCN’s) consensus guidelines in 2014 using data from the Senter et al. (2008) study of 99 probandswith positive PMS2 mutations. Data from the report suggested that carriers of this mutation have an excessive risk of colorectal and endometrial cancers compared to the general population, but they have a lower risk than MSH2, MLH1, and MSH6 mutation carriers. The researchers also found a greater breadth of LS-associated cancers than was seen with other mismatch repair genes including cancers of the breast, lung, prostate, skin, pharynx, liver, pituitary gland, testis, pancreas, medulloblastoma, and thyroid as well as lymphoma and leukemia. Almost half of the cancers were diagnosed after age 50, and the mean age-at-onset of gastrointestinal cancers was almost 60 years. Nongastrointestinal cancers, however, were associated with younger ages at onset, similar to mutations on the other LS-associated genes. Colon cancer risk for these individuals was calculated at 15%-20% by age 70 compared to 40%-80% in MLH1 and MSH2 mutation carriers. Endometrial cancer risk also was lower in this group of patients who had a 15% lifetime risk by age 70 compared to a 25%-60% risk in MLH1 and MSH2 mutation carriers and a 16%-26% risk in MSH6 mutation carriers (NCCN, 2014; Senter et al., 2008).

More recently, ten Broeke et al. (2015) published data abstracted from a study of 377 PMS2 mutation carriers. Their observations supported and expanded earlier findings by Senter et al. (2008). Based on data from these sources, ten Broeke et al. (2015) recommended beginning screening for colon cancer at age 30 despite the 1.6% of probands who developed colon cancer before age 30. The 2014 NCCN guideline for PSM2 mutation carriers stated that this population should undergo a “colonoscopy at age 25-30 years of age or 2-5 years prior to the earliest colon cancer if it is diagnosed before age 30 years and repeat every 1-2 years.” The initiation of colonic screening at a younger age may be considered as there is limited evidence on age-of-onset and penetrance among PMS2 carriers (NCCN, 2014).

Although ten Broeke et al. (2015) noted the limitations of current screening techniques for early endometrial and ovarian cancer detection, they did not recommend prophylactic hysterectomy and oophorectomy for PMS2 mutation carriers because these cancer types are associated with a later age at onset and a better prognosis. Several limitations of the data were identified, including (a) white northern Europeans may have a different risk than other populations, (b) family-specific patterns of cancer types and ages at onset must be considered when counseling mutation carriers about predicted risk, (c) the number of mutation carriers that was studied was small, and (d) more data are needed (ten Broeke et al., 2015).

The role of the oncology nurse in interpreting inherited cancer risk for patients and families includes keeping up-to-date with advancements in technology and the knowledge of risk and risk management. Nurses with current, evidence-based knowledge can help clients interpret the quality of data and can provide skillful guidance about accurate, reliable information sources.

References
Cohen, S., & Leininger, A. (2014). The genetic basis of Lynch syndrome and its implications for clinical practice and management. Application of Clinical Genetics, 7, 147-158. doi:10.2147/TACG.S51483

Kohlman, W., & Gruber, S. (2014). Lynch syndrome. In R.A. Pagon, M.P. Adam, H.H. Ardinger, S.E. Wallace, A. Amemiya, L.J.H. Bean, T.D. Bird, C.R. Dolan, C.T. Fong, R.J.H. Smith, & K. Stephens (Eds.), GeneReviews. Seattle, WA: University of Washington, Seattle. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK1211/

Lynch, H., Snyder, C., Shaw, T., Heine, C., & Hitchins, M. (2015). Milestones of Lynch syndrome. Nature Reviews Cancer, 15, 181–194. doi:10.1038/nrc3878

National Comprehensive Cancer Network. (2014). NCCN Clinical Practice Guidelines in Oncology: Genetics/familial high-risk assessment: Colorectal [v.2.2014]. Retrieved from http://www.nccn.org/professionals/physician_gls/pdf/genetics_colon.pdf

Senter, L., Clendenning, M., Sotamaa, K., Hampel, H., Green, J., Potter, J., . . . de la Chapelle, A. (2008). The clinical phenotype of Lynch syndrome due to germline PMS2 mutations. Gastroenterology, 135, 419-428. doi:10.1053/j.gastro.2008.04.026

ten Broeke, S.W., Brohet, R.M., Tops, C.M., van der Klift, H.M., Velthuizen, M.E., Bernstein, I.,. . . Wijnen, J.T. (2015). Lynch syndrome caused by germline PMS2 mutations: Delineating the cancer risk. Journal of Clinical Oncology, 33, 319-325. doi:10.1200/JCO.2014.57.8088

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Advanced Genetics Nursing Certification

The American Nurses Credentialing Center (ANCC) and the International Society of Nurses in Genetics recently announced the launch of the Advanced Genetics Nursing certification through portfolio assessment. Information about eligibility criteria and portfolio requirements are available on the ANCC’s website.
 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Check Out These Online Cancer Education
Resources

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Celebrate Nursesí Week With Quality Oncology Nursing Publications

May 6–12, 2015, marks the celebration of National Nurses Week. During this week, ONS will make all journal content open access so nonmembers can take advantage of their quality content. This is an opportunity for everyone to check out the great articles being published in the ONS journals, Clinical Journal of Oncology Nursing and Oncology Nursing Forum.

Read more!

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Celebrate Nursesí Week With 25% Off ONSís
Perpetual Calendar Created for Nurses Just
Like You

You deserve it, and so do your favorite nurse colleagues! Order using the code PNUR25 any time before the end of Nurses’ Week on May 12, 2015, and receive 25% off “Nurturance for Nurses: Reflections for Compassionate Healers,” ONS's perpetual flip-calendar full of inspiring quotes and daily reflections for nurses.

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Make Sure Youíre Current on the Core
Skills of Oncology Nursing Practice

The first update of this essential resource in 10 years, the fifth edition of Elsevier’s Core Curriculum for Oncology Nursing and its companion study guide are now available to ONS members at a special 10% discount.

Reduce errors in your practice thanks to the emphasis on Quality and Safety Education for Nurses (QSEN) competencies, which have a focus on safety and evidence-based practice including a Safety Alert icon and a High-Alert Medications icon for cancer chemotherapy drugs.

Provide the best care to your patients with more than 150 summary tables and nearly 60 colorful illustrations that explain complex concepts in oncology nursing including up-to-date cancer staging information.

Ensure that you apply what you learn by using the companion study guide, which includes more than 1,200 questions and rationales for each answer as well as an all-new emphasis on application-level questions.

Cover all your patient care bases with pharmacologic and nonpharmacologic interventions that include traditional and alternative therapies.

Add this essential book to your medical library today.

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Oncology Nursing Certification Corporation is
Pilot-Testing Employer Discount Program


Many employers recognize the benefits of having certified nursing staff on their team, but not all realize the positive impact that employer support can have on individual nurses. Reimbursing nurses who pass a certification test is a much-appreciated first step, but savvy employers realize doing more to support and recognize certified nurses can go a long way toward helping nurses overcome barriers to certification.

The Oncology Nursing Certification Corporation (ONCC) is encouraging employers of all sizes to take a broader view of certification support and is pilot-testing an Employer Discount Program in 2015. Through the program, employers will earn points for the ways in which they encourage, support or recognize certification of oncology nurses. The points will translate into discounts on certification fees. The more an employer does to encourage, support, or recognize certification of oncology nurses, the greater the discount that can be earned.

For example, providing nurses with on-site programs to prepare for certification or certification renewal, offering paid time off to take a test, linking certification to the career ladder, and educating patients on the value of certified nurses are a few of the ways employers can earn points.

Employers must meet minimum levels of support to participate in the program; the discount incentives are intended to encourage and reward them for doing more. For example, employers must agree to pay for certification at the time the candidate applies, rather than as a reimbursement. ONCC Executive Director Cyndi Miller Murphy said that “candidates have told us they’re hesitant to pay the certification fee themselves. The concept of being reimbursed upon passing can make some candidates more anxious about testing. When employers pay for certification in advance, it removes another barrier for the individual nurse.”

Employers who meet specific benchmarks for candidate volume will receive additional discounts. This two-prong approach enables employers of all sizes to participate.

ONCC will pilot test the program in 2015 with a small group of employers of different sizes, according to Murphy. If all goes well, the program will be available to more employers in 2016.

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Exclusive Articles Available Before Print

The Oncology Nursing Forum (ONF) and the Clinical Journal of Oncology Nursing (CJON) have unveiled advanced print exclusive articles to give our readers access to important, cutting-edge content ahead of print. Articles from the journals are available on the main ONF and CJON pages. These articles are open access, meaning they are available to members and non-members alike, until they appear in print at a later date. At that time, the content will become password-protected like other articles that appear in print as online exclusives in the journals.

The latest article to receive the advanced print exclusive designation is “A Pilot Study Comparing the Neutropenic Diet to a Non-Neutropenic Diet in the Allogenic Hematatopoietic Stem Cell Transplantation Population” by Martha Lassiter and Susan M. Schneider. Check out this timely and informative article today.

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Check Out the ONS Connect Blog

The official blog of ONS is written by oncology nurses for oncology nurses on a variety of topics of interest, 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, you’ll find the following new discussions.
Exceptional Frontline Nurses Practice at the Bedside and Beyond
Advanced Practice Nurses Evolve Healthcare Solutions
Online Programs Offer Busy Nurses Additional Educational Options

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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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Five-Minute In-Service

The latest Five-Minute In-Service explains how Exercise Improves Quality of Life Throughout Cancer Treatment.

 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Ask a Team Member

The latest Ask a Team Member column answers the question, “How Can Providers Prevent and Manage Dermatologic Toxicities From EGFR Targeted Therapies?
 
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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Membership Information

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Cancer Genetics

Special Interest Group Newsletter  May 2015  
   

Cancer Genetics SIG Officers

Coordinator (2014-2016)
Catherine Belt, RN, MSN, AOCN®
Hatfield, PA
cathy.belt@uphs.upenn.edu

Ex-Officio (2014-2015)
Jacqueline Hale, RN, APN-C, AOCN®, APNG
Flemington, NJ
Hale.jacqueline@hunterdonhealthcare.org

Editor
Patricia Kelly, DNP, APRN, CNS, AOCN®
Dallas, TX
Pakelly1027@sbcglobal.net

 

Web Administrator
Lisa Aiello, RN, MSN, APN-C, AOCNS®
North Cape May, NJ
lba34@drexel.edu

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

ONS Copy Editor
Samantha Hungerford
Pittsburgh, PA
shungerford@ons.org

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ONS Membership & Component Relations Department Contact Information

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

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

Carol DeMarco, Membership Specialist—SIGs
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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