Congress Abstracts 2003

67

ADVANCED CANCERS OF THE ORAL CAVITY: THE ROLE OF THE AMBULATORY CARE NURSE. Jill Solan, RN, MS, ANP, OCN^®, Memorial Sloan-Kettering Cancer Center, New York, NY.

Advanced cancers of the oral cavity can be very aggressive and debilitating, involving a primary site within the oral cavity (e.g., tongue, floor of mouth, palate, buccal mucosa, tonsil) and can invade soft tissue, bone, muscle, and nerves, and metastasize to regional lymph nodes of the neck. Individuals with these cancers of the oral cavity may have interference with performing activities of daily living, eating, and communicating. Cancers in this site can be foul smelling and painful causing social isolation and depression. There can be alterations in physical appearance as well as functional status. The quality of life for individuals with oral cavity cancers can be compromised physically, psychologically, socially, and economically. The ambulatory care nurse/patient relationship begins at initial consultation and continues throughout the whole spectrum of illness, treatment, and recovery. The ambulatory care nurses’ major roles throughout these phases are educator, patient care provider, advocate, and facilitator. The ambulatory care nurse educates patients and families about the disease, treatment, side effects, symptom management, patient self-care measures (range of motion shoulder exercises, prevention of trismus), risk prevention (smoking and alcohol cessation), and available resources in the institution and the community. Patient and family education offers a didactic approach as well as written educational materials. The educational materials that will be discussed are specific for this disease site. (Mandibulectomy: Immediate mandible reconstruction with fibula free flap, glossectomy, tracheostomy care, tube feeding). The treatment and care of individuals with advanced cancers of the oral cavity is multimodality and multidisciplinary. The ambulatory care nurse collaborates and communicates with other members of the healthcare team (plastic and reconstructive surgery, radiation oncology, medical oncology, dental service, nutrition, social work, pain service, inpatient nurses, case managers, insurance companies, visiting nurses) to assure that the care is cohesive and patient needs are met. It is imperative that all members of the healthcare team work toward the ultimate goal of returning the patient to maximum functioning. This presentation will provide an overview of the complex care and unique needs of patients with advanced cancers of the oral cavity and the role of the ambulatory care nurse working with this patient population.