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Volume 15, Issue 3, December 2007
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Coordinator’s Message Thursdays Are for Kindness Ask a nurse why she or he became a nurse and the frequent answer is “to help people.” Among the many worthy characteristics of a good nurse is the ability to treat others with kindness. Kindness is a form of helpfulness without expecting anything in return. Thinking kindly can be challenging at times. Steve Wilson (2003) of the World Laughter Tour suggested wearing a rubber band on your wrist and snapping it whenever you have an unkind thought, in addition to learning to ask yourself, “What could I do to make someone else’s life a little bit easier?” Practicing acts of kindness can be learned, and practicing them anonymously can be great fun. Both bring joy to the giver. Compassionate peopleand most nurses aredesire to make a difference in people’s lives. An act of kindness, large or small, can make a memorable difference. Of all the experiences I had when my son was born some 22 years ago, the one that stands out is the student nurse who insisted on washing my glasses while I was on bed rest. Obviously, I still recall this very simple but meaningful act and try to perform similar small acts of kindness for others in my work and in my life. Serve coffee to your coworker, bring a homemade goodie to work, answer another nurse’s call light, share information with a patient, hold the elevator door, listen to a loved one’s concerns, smile, etc. Remember to be kind to yourself, too. I’m sure you can think of many acts of kindness. Mountain States Health Alliance in Johnson City, TN, offers a STAR card recognition program. When a team member notices another go above and beyond the call of duty, he or she can give that individual a STAR card. STAR cards are redeemable at the end of the year for gift certificates, personal hours, and entry into a drawing for a trip to Walt Disney World®. Other groups have used coins and trinkets to recognize acts of kindness and encourage others to continue the cycle. In the song “The Chain of Love,” country music artist Clay Walker shares the circle of giving, beginning with a young man who stops to change a stranger’s tire. The stranger, in turn, gives a large tip to her waitress, who then shares her good fortune with her husband, who turns out to be the same young man who changed the tire. Kindness, like other positive attributes, is contagious. When you begin to practice kindness, others are likely to respond with kind acts themselves, bonding you together. And you will be rewarded with personal satisfaction.
To read other quotes on kindness, click here. Reference Wilson, S. (2003). Good-hearted living. Columbus, OH: Steve Wilson and Company. |
The Complementary and Integrative Therapies SIG Newsletter is produced by members of the Complementary and Integrative Therapies SIG and ONS staff and is not a peer-reviewed publication. |
Special Interest Group Newsletter December 2007 |
CDR Colleen O. Lee, RN, MS, AOCN® The field of complementary and alternative medicine is emerging daily into the forefront of the media, health care, and wellness. Recently, CBS Evening News aired a segment on an investigational botanical for the treatment of cancer in a better-than-neutral light. The airing of the segment on primetime television further emphasized to me that oncology nurses are in a strategic position to educate themselves and translate research findings into clinical practice at a more accelerated pace than in previous years. The resources are out there, and I hope that we can highlight these resources via our SIG newsletter and virtual community. We invite comments, questions, and suggestions from the SIG membership so that we can meet our needs as well as those of the public. What would you like to see in print or as a resource? Please also begin thinking about developing abstracts for posters and sessions to be presented at the 2008 ONS Institutes of Learning and Advanced Practice Nursing Conference. Now is the time for learning!
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Special Interest Group Newsletter December 2007 |
As oncology nurses, we are interested in providing the best possible care and resources to facilitate the health and well- being of our patients. We are members of the Complementary and Integrative Therapies SIG because we see merit in exploring therapies that may relieve side effects of conventional treatment, support comfort, promote spiritual well-being, and possibly promote cure. Herbal medicine is an arena of both controversy and possibility. Indigenous healing practices such as the use of turmeric by healers in Hawaii and India have led to research on the efficacy of the herb for treating cancer. In this issue, Margaret Anne Bailey, RN, BSN, CCRN, MN-R/ANP©, describes her experience as a nurse studying Hawaiian healing, which prompted her interest in the use of turmeric for cancer prevention and treatment. The use of herbs by people with cancer requires that oncology nurses be informed about the efficacy of herbal supplements as well as their side effects and contraindications. Also in this issue, Coordinator-Elect CDR Colleen O. Lee, RN, MS, AOCN®, and Georgia Decker, MS, RN, CS-ANP, CN®, AOCN®, report on the U.S. Food and Drug Administration’s regulation of herbal supplements and offer informative resources for investigating dietary and herbal supplements. Data collection on complementary therapy modalities is of interest to PNI SIG members. And on the research front, Linda Lillington, RN, DNSc, reports on the ONS Multisite Research Core Data Set/Outcomes Consensus Conference. I hope that you enjoy this issue and will share your comments with me. Happy holidays to all!
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Special Interest Group Newsletter December 2007 |
Margaret Anne Bailey, RN, BSN, CCRN, MN-R/ANP© In sharing my knowledge of turmeric as a traditional ingredient from indigenous Hawaiian plant medicines used for cancer treatment, I would like to preface this article by stating that major differences exist between indigenous Hawaiian healing and Western medicine. The five greatest differences between my Western medicine training and my traditional Hawaiian medicine training can be summed as follows.
Throughout centuries of indigenous Hawaiian medical practices, turmeric (Curcuma longa) has been a constant ingredient in the plant medicines used for all types of cancer treatment. Because turmeric had interested me so greatly during my two-year apprenticeship with Master Healer Papa Henry Auwae, I began to research turmeric in medical journals upon my return to the mainland United States in 1998. Although the ancient and traditional customs in Hawaiian healing are decidedly different than allopathic Western medicine practices, these two very different healing cultures intersect at least at one point: the recognition of turmeric’s anticancer properties. Bharat Aggarwal, PhD, head of experimental cytokine research at the University of Texas M.D. Anderson Cancer Center in Houston, found that cancer rates in India are anywhere from two to eight times lower than the incidence in the United States. More researchers are concluding that curcumin, the chemical found in turmeric, makes the difference, especially considering that cancer rates in south India, where people eat approximately 2.5 g of turmeric daily, are much lower than in northern India, where people consume approximately 0.81.0 g of turmeric daily (Aggarwal, Kumar, & Bharti, 2003). In August 2006, Clinical Gastroenterology and Hepatology published a study conducted by Johns Hopkins (Cruz-Correa et al., 2006). Five patients with an inherited form of precancerous polyps in the lower bowel known as familial adenomatous polyposis were treated for an average of six months with regular doses of curcumin and quercetin, an antioxidant in onions. The average number of polyps dropped 60.4%, and the average polyp size dropped by 50.9%, suggesting turmeric’s efficacy against this genetic cancer. Turmeric also can help patients with cancer have better outcomes by sensitizing cancer cells to certain chemotherapies, including paclitaxel, cisplatin, doxirubicin, and 5-fluorouracil. In addition, turmeric reduces adriamycin-induced cardiotoxicity. To view some fascinating and in-depth cancer research and human clinical trials on turmeric and curcumin, I highly recommend Aggarwal’s presentation, “An Old Spice With New Targets.” Additionally, although a commercial site that sells supplements, turmeric-curcumin.com is a favorite turmeric research site, providing a virtual treasure trove of turmeric journal articles. With its low incidence of side effects and high potential for patient benefits, this healing ginger root might be an incredible functional food recommendation for oncology nurses to consider as a part of their plans of care. References Aggarwal, B.B., Kumar, A, & Bharti, A.C. (2003). Anticancer potential of curcumin: Preclinical and clinical studies. Anticancer Research, 23(1A), 363398. Cruz-Correa, M., Shoskes, D.A., Sanchez, P., Zhao, R., Hylind, L.M., Wexner, S.D., et al. (2006). Combination treatment with curcumin and quercetin of adenomas in familial adenomatous polyposis. Clinical Gastroenterology and Hepatology, 4, 10351038. Bibliography Aggarwal, B.B., Shishodia, S., Takada, Y., Banerjee, S., Newman, R.A., Bueso-Ramos, C.E., et al. (2005). Curcumin suppresses the paclitaxel-induced nuclear factor-kappaB pathway in breast cancer cells and inhibits lung metastasis of human breast cancer in nude mice. Clinical Cancer Research, 11, 74907498. Blumenthal, M. (Ed.) (1998). The complete German commission E monographs: Therapeutic guide to herbal medicines. Austin, TX: American Botanical Council. Fetrow, W., & Avila, J.R. (1999). Professional's handbook of complementary and alternative medicines. Philadelphia: Springhouse. Garcea, G., Berry, D.P., Jones, D.J., Singh, R., Dennison, A.R., Farmer, P.B., et al. (2005). Consumption of the putative chemopreventive agent curcumin by cancer patients: Assessment of curcumin levels in the colorectum and their pharmacodynamic consequences. Cancer Epidemiology Biomarkers and Prevention, 14, 120125. Reader note: Generally speaking, turmeric has a very low incidence of reactions and side effects and has been consumed daily for thousands of years of recorded history by entire populations such as India. M.D. Anderson Cancer Center presents a Natural Standard Monograph on Turmeric that describes efficacy, traditional uses, dosing, safety (interactions with drugs and herbal and dietary supplements), and research. Another side of the turmeric debate, from Scientific American, says that turmeric can interfere with P53 and raises caution against using turmeric for chemoprevention. For more information, click here.
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Special Interest Group Newsletter December 2007 |
CDR Colleen O. Lee, MS, CRNP, AOCN® The use of herbal products in the United States has become increasingly popular, as recent surveys indicate that more than half of the adult population consumes some type of dietary supplement. Herbs are classified as nutritional supplements since passage of the Dietary Supplement Health and Education Act of 1994, and many products sold as supplements contain herbs as tablets, teas, extracts, and essential oils. Herbs are consumed to promote wellness, provide symptomatic relief, or prevent a condition. As long as marketed products do not make claims of treating or curing disease, they remain largely unmonitored. Consequently, without proper guidance, consumers choose from an array of products with variable composition and dosing and sometimes unstated cautions. In June 2007, the U.S. Food and Drug Administration (FDA) issued a final rule that requires good manufacturing practices for dietary supplements. The rule ensures that supplements are produced in a quality manner, do not contain contaminants, and are labeled accurately. Manufacturers are required to evaluate the identity, composition, purity, and strength of the products in addition to establishing quality control procedures. Access to dietary supplements will not be limited. The final rule does not require manufacturers to provide additional information regarding safety or health effects of supplements. As oncology nurses, we routinely conduct medication assessments, often consult with pharmacists for potential herb–cytotoxic interactions, and may counsel patients on herb use before, during, and after cancer care. Many resources are available to assist nurses in achieving a higher level of comfort in counseling patients, such as databases containing graded evidence, text excerpts, and publications by knowledgeable oncology pharmacists, nurses, and nutritionists. Oncology nurses also can acquire the information necessary to properly document an adverse event, such as concurrent medications, dosages, and duration and exact nature of the event, including onset, duration, and tolerance. Then they can report the event via institutional channels and the FDA. With the knowledge available within reach, oncology nurses can positively impact symptom management, safety, and economic nursing-sensitive patient outcomes. Links on FDA Final Rule on Current Good Manufacturing Practices for Dietary Supplements Complete report as printed in the Federal Register Databases North American Institute of Medical Herbalism Publications Decker. G. (2002). How to read a label. Clinical Journal of Oncology Nursing, 6, 370373. Decker, G. (2003). Commonly used vitamin supplements: Implications for clinical practice. Clinical Journal of Oncology Nursing, 7(2 Suppl.), 128 Lee, C. (2005). Herbs and cytotoxic drugs: Recognizing and communicating potentially relevant interactions. Clinical Journal of Oncology Nursing, 9, 481487.
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Special Interest Group Newsletter December 2007 |
Linda Lillington, RN, DNSc ONS has been exploring the role it can play in outcomes measurement and multisite research as part of the Outcomes and Multisite Research Strategic Plans. The Nursing-Sensitive Patient Outcomes White Paper (Given & Sherwood, 2005), published in the Oncology Nursing Forum as a result of the 2003 Outcomes Project Team, provided important background for the examination and evaluation of oncology patient outcomes impacted by nursing interventions. Simultaneously, the interest of ONS research members in identifying ONS’s role in facilitating the use of the same research plan across several sites and pooling data for interpretation and dissemination has led to the development of several initiatives. The outcomes and multisite research initiatives came together at the recent Multisite Research Core Data Set/Outcomes Consensus Conference held August 4[en dash]5, 2007. Several experts were invited to join the Core Data Set Project Team to share and present their expertise in defining outcomes, developing quality indicators, and collecting and storing large data sets. The presenters included Jacqueline Dunbar-Jacob, PhD, RN, FAAN, from the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS) Initiative and the University of Pittsburgh Center for Research in Chronic Disorders; Kristen McNiff, MPH, from the American Society of Clinical Oncology Quality Oncology Practice Initiative; Lori Hoffman-Hogg, RN, MS, AOCN®, from the Veterans Affairs Nursing Outcomes Database; and Dianne M. Reeves, RN, MSN, from the National Cancer Institute’s Cancer Biomedical Informatics Grid. Other invited members included Susie Beck, PhD, ARPN, AOCN®, Deborah Eldredge, PhD, RN, Barb Holmes-Gobel, MS, RN, AOCN®, and Lori A. Williams, RN, DSN, OCN®, AOCN®. The focus of the consensus conference was to identify a set of core data elements that are meaningful to oncology nurses, patients, and stakeholders and to devise a strategy for collection and use in clinical practice, research, and administration. The group came together to brainstorm, reach consensus on nursing-sensitive measures (core data elements, core data set, and outcomes), and generate ideas for strategies to facilitate implementation in various clinical and research settings. Discussion focused on considerations important in planning and implementing an oncology nursing outcomes measurement program, including the role that ONS can contribute as a professional society. ONS Putting Evidence Into Practice (PEP®) resources were considered as the basis for the selection of core data elements. A review of proposed core data elements, their related measures, and criteria for selection, prepared by Christopher Friese, PhD, RN, AOCN®, and Dorothy Dulko, PhD, RN, MS, NP, identified core data elements to be considered for use, including fatigue, pain, oral assessment, performance status, emotional distress, neurotoxicity, neutropenia, sleep, nausea and vomiting, constipation, and demographic characteristics. The consensus conference participants felt that ONS core data elements for common data collection should aim to provide consistency in nursing core measures across local, regional, and national settings. The consensus conference yielded many activities that are consistent with several national and international initiatives related to quality cancer care and quality nursing care. The work of the 2007 Core Data Set/Outcomes Consensus Conference Project Team is just beginning, as this will be a long-term initiative with several intermediate steps, ultimately leading to data that will demonstrate the impact of oncology nursing interventions on quality cancer care. ONS has the potential to be in a unique leadership role in this complex and important quality cancer care initiative. Reference Given, B.A., & Sherwood, P.R. (2005). Nursing sensitive patient outcomesA white paper. Oncology Nursing Forum, 32, 773-784.
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Special Interest Group Newsletter December 2007 |
Margaret is an RN certified in critical care who has worked in a variety of rural and urban hospitals, caring for a diverse patient population in critical care, including patients with cancer and survivors. What makes Margaret’s approach to nursing different is her extensive training and practice in indigenous Hawaiian plant medicines used to treat heart disease, diabetes, and cancer. In 1997, Margaret was chosen to join a class of 30 students for a two-year apprenticeship under the direction of Papa Henry Auwae. Papa Auwae was a renowned Hawaiian healer from Hilo, HI, who at the age of 90 trained two cohorts in the ancient art of indigenous Hawaiian medicine, including cancer treatments using traditional botanical medicines of Hawaii.
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Special Interest Group Newsletter December 2007 |
To address the needs of patients with cancer seeking complementary and alternative medicine (CAM) information, the National Cancer Institute (NCI) and the National Center for Complementary and Alternative Medicine developed a publication to guide a patient’s process in seeking CAM resources. Thinking About Complementary and Alternative Medicine features
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Special Interest Group Newsletter December 2007 |
To navigate to your individual SIG virtual community, visit the Main SIG Virtual Community at http://sig.vc.ons.org and select “Find a SIG” from the top navigation. The following is an outline of what information can be found on your SIG’s virtual community. My SIG’s Page Announcements are posted frequently with important information pertaining to your SIG such as scholarship, leadership, and meeting information. SIG events are posted on the SIG calendar and showcased on the main page for your convenience. Simply click on each event for detailed information. About Us News Discussions ONS National Announcements
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Special Interest Group Newsletter December 2007 |
Check out the Oncology Nursing Forum (ONF) for interesting articles about the Complementary and Integrative Therapies SIG’s focus.
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Special Interest Group Newsletter December 2007 |
Put your knowledge and expertise to work by becoming a reviewer for the Clinical Journal of Oncology Nursing. For more information, click here. Back to SIG Newsletter front page
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Special Interest Group Newsletter December 2007 |
The Oncology Nursing Society (ONS) is hiring a candidate who possesses the following to fill the role of Education project manager. The ideal candidate will be
ONS Education project managers
This position requires a strong degree of accountability for overall success in developing and delivering scientifically rigorous educational programming for the oncology nursing audience. Submit resume and salary history to hrdept@ons.org. Resumes without salary history will not be considered. EOE
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| Special Interest Group Newsletter December 2007 |
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Membership Information SIG Membership Benefits
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
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,
Participate in Your SIG’s Virtual Community Discussion Forum
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.
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| Special Interest Group Newsletter December 2007 |
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Complementary and Integrative Therapies SIG Officers
Know someone who would like to receive a print copy of this newsletter? To view past newsletters, click here. ONS Membership/Leadership Team Contact Information Angie Stengel, MS, CAE, Director of Membership/Leadership Diane Scheuring, MBA, CMP, Manager of Member Services Carol DeMarco, Membership/Leadership Administrative Assistant 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
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