Congress Abstracts 2005

167

THE NURSES ROLE IN SYMPTOM MANAGEMENT AND FOLLOW UP OF PATIENTS WITH HEAD AND NECK CANCER RECEIVING MULITI-MODALITY THERAPY. Amy West, BSN, Memorial Sloan-Kettering Cancer Center, New York, NY.

Cancer of the head and neck account for 3.7% of all cancers. These cancer patients require debilitating surgery, treatment with radiation, chemotherapy or both. Oncology nurses play a significant role in educating, managing and supporting this patient population known to have multi psychosocial needs often attributed to their alcohol and tobacco use.

Our comprehensive cancer center plays a pivotal role in treatment of head and neck cancer patients who are referred locally and nationally. Many of these patients present with complex needs such as poor nutrition, socioeconomic concerns and a high potential for non compliance. In order to address these needs and reduce morbidity, a coordinated effort is made by all members of the nursing team to ensure safe and positive patient outcomes. This presentation will share our experiences in managing patients receiving concomitant therapy and the importance of follow up in maximizing quality of life.

Combined chemotherapy and radiation treatments improve tumor control rates however side effects of radiation are potentiated. Patients are assessed prior to and frequently throughout the course of treatment. Severe symptoms of mucositis, skin irritations, salivary gland dysfunction, nausea, infection, constipation, and pain are often experienced by patients. The oncology nurse provides careful observation and early interventions in the management of these side effects. Comprehensive nutritional assessment is done to address the anticipated dysphasia and potential placement of a percutaneous endoscopic gastrotomy tube. This strategy will minimize dehydration and decrease the possibility of hospitalization. Educational materials are provided to patients addressing potential and expected side effects of treatment as well as symptom management. Oral care, mouth sprays, narcotics and comfort measures are provided routinely to alleviate symptoms.

Nursing interventions and education are integral components in determining patient’s outcomes and potential morbidities. Based on our aggressive assessment, education, follow up and multidisciplinary team approach, problems are addressed early and outcomes improved.

Nurses play an integral role in assessing and educating patients. This presentation will provide strategies for patient education, symptom management, and tools that nurses can use in their own setting to manage the patient with head and neck cancer receiving multi-modality therapy.