Evidence and Practice
Why you should read this article: • To explore how people living with multiple myeloma can be supported to self-manage their condition • To reflect on the need for patient-focused digital tools in oncology and how to design them • To learn about the System Usability Scale, which measures the usability of tools such as healthcare apps Supporting patients to self-manage chronic conditions can reduce the risk of adverse events and improve quality of life. Digital tools such as smartphone apps are increasingly used in oncology to support patient self-management. Multiple myeloma (MM) is often treated as a chronic rather than a terminal condition, and people living with MM need to be empowered to self-manage their condition. This article describes the development of a digital tool designed to support people with relapsed or refractory MM to monitor and manage side effects and symptoms, and reports the findings of a small pilot evaluation conducted to assess the tool’s usefulness and usability for patients. Findings suggest that the tool could potentially assist people living with MM in monitoring side effects and symptoms, but further research in a larger sample is needed to determine whether the tool is useful and usable.
Why you should read this article: • To improve your understanding of the personal meaning of living with cancer beyond the medical focus on disease • To recognise that the process of making sense of life for some people living with cancer may be guided by their relationship with those who have died, God or a higher being • To be aware of the role of spiritual beliefs and practice in the illness experience This is the second of two articles presenting findings from a wider study that aimed to explore and better understand the personal story of cancer beyond the label of ‘patient’ and the healthcare context. Part 1 focused on the importance of relationships with other people with cancer, family members and the healthcare team in the search to make sense of life. This article focuses on the importance of relationships with people who have died, with God or a higher being, and the self in the search to make sense of life. Using an interpretative phenomenological approach, data were gathered through semi-structured interviews with 15 people living with cancer. It was identified that the ability to relate to those who have died, with God or a higher being, and the self was an important component of the sense-making process. For some participants, important relationships continued to exist with people who had died, which provided support and consolation. Their relationship with God or a higher being guided many participants in their sense-making process. Several participants also reported that their relationship with themselves evolved and was redefined through their illness experience. Understanding the importance of these relationships may reveal some of the less visible components of the illness experience. These findings may support the provision of an increasingly person-centred approach to care.
Literature review on enhanced recovery in patients undergoing colorectal surgery
Qualitative research into prostate cancer among black African and Caribbean men in England
First of two articles on the personal experience of cancer, this explores relationships
CIPN is a common side effect of certain cytotoxic regimens characterised by sensory symptoms
Why you should read this article: • To gain knowledge of the mechanism of action of CDK4 and CDK6 inhibitors and how you could explain this to patients • To understand the dosing, administration and potential side effects of abemaciclib in the treatment of metastatic breast cancer, and where to find prescribing information: https://www.lillyoncology.co.uk/assets/pdf/verzenios-api-a4-landscape.pdf • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Many patients with metastatic breast cancer develop resistance to endocrine therapy. Therefore, treatments with novel molecular targets have been developed to overcome endocrine resistance in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) metastatic breast cancer, including cyclin-dependent kinase 4 and 6 (CDK4 and CDK6) inhibitors. CDK4 and CDK6 inhibitors such as abemaciclib offer a new treatment option for patients with metastatic breast cancer. Nurses have an important role in providing guidance, education and support to patients with breast cancer. Since more patients are likely to receive abemaciclib, it will become increasingly important for nurses to understand how it works, how to effectively manage potential side effects and how to support patients with adhering to treatment. This article describes the rationale for the use of CDK4 and CDK6 inhibitors in patients with breast cancer, and provides practical advice on how to manage patients with metastatic breast cancer who have been prescribed abemaciclib.
Oral complications can cause distress, long-term complications and increased morbidity
A systematic approach for nurses at any level or experience to engage with service evaluation
Receiving a new diagnosis of cancer or of its recurrence is distressing and there are increasing numbers of people living with the disease, some taking continuous treatment, as well as others who have been cured. Living with cancer and the possibility of recurrence requires psychological strength to deal with the treatment, effects of the illness and uncertainty about the future. The attributes of self-efficacy and psychological well-being can reduce the effects of chronic stress. Excellent symptom control is essential and fatigue, the most prevalent and often most distressing symptom for those with cancer, requires targeted support. Well-being and psychological resilience may be improved by specific actions and psychological approaches, some of which are encompassed by Foresight Mental Capital and Well-being Project’s (2008) five ways to well-being framework, which can be used to deliver personalised care. This is the second of a two-part article that reviews interventions promoting well-being and resilience in patients living with cancer. It describes the framework and suggests practical ways in which clinicians can integrate it and other interventions into clinical practice. It also offers time out exercises and a multiple choice quiz to aid readers’ learning and test their knowledge.
There is increasing recognition of the importance of making the Recovery Package available to more people affected by cancer. The cancer treatment summary is one of the core components of the Recovery Package and aims to improve communication between secondary and primary care, and help patients manage their care following treatment. The Somerset, Wiltshire, Avon and Gloucestershire Cancer Alliance is developing a suite of best practice treatment summary templates for each cancer site to improve the quality of the information in the documents, and to support cancer teams to begin the process of introducing them to practice.
Oral vinorelbine has been a well-established cytotoxic treatment for non-small cell lung cancer and metastatic breast cancer since 2004. This article summarises the applications of the drug, the advantages and challenges of using an oral agent in palliative oncology settings and how oral vinorelbine has been used to develop nurse-led services and chemotherapy outside traditional hospital environments. The article includes two case studies to place this treatment in a clinical context.