Managing Your Symptoms and Treatment Side Effects - presented by: Kristen Fessele, MSN, RN, ANP-BC, AOCN Research Associate - Oncology Nursing Society

1. Welcome!
Managing Your Symptoms and
Treatment Side Effects
Part of Fight Colorectal Cancer’s Monthly Patient Webinar Series
Our webinar will begin shortly
www.FightColorectalCancer.org
877-427-2111

2. 1. Tonight’s speaker: Kristen Fessele, RN, MSN, ANP-BC, AOCN
2. Archived webinars: Link.FightCRC.org/Webinars
3. Follow up survey to come via email. Get a free Blue Star of
Hope pin when you tell us how we did tonight
4. Ask a question in the panel on the right side of your screen
5. Or call the Fight Colorectal Cancer Answer Line at
877-427-2111

3. Kristen Fessele, MSN, RN, ANP-BC, AOCN
Research Associate
Oncology Nursing Society

4. Managing Your Symptoms and
Treatment Side Effects
Kristen Fessele, RN
May 16, 2012

5. About ONS
• The Oncology Nursing Society is a professional
association of more than 35,000 members
committed to promoting excellence in oncology
nursing and the transformation of cancer care.
• Since 1975, ONS has provided a professional
community for oncology nurses, developed
evidence-based education programs and
treatment information, and advocated for patient
care, all in an effort to improve quality of life and
outcomes for patients with cancer and their
families.

6. ONS Congress 2012
• 37th annual meeting, held in New Orleans,
LA on May 2-6, 2012
• Over 3000 oncology nurses attended to
share knowledge
• Selected topics for tonight:
– Complementary and Alternative Medicine
– Caregiver Issues
– Personalized Medicine

7. Complementary and Alternative
Medicine
• Judith Fouladbakhsh, PhD, APRN, AHN-BC
– Wayne State University, Detroit MI
• Lynda Balneaves, RN, PhD
– UBC School of Nursing, Vancouver BC
• Cecile Lengacher, RN, PhD
– USF College of Nursing, Tampa FL

8. Complementary and Alternative
Medicine
• “… a group of diverse medical and health
care systems, practices, and products that
are not considered to be part of
conventional medicine…”
- National Center for Complementary and
Alternative Medicine (NCCAM)

9. Talk about CAM use with your
oncology team!
• Gain potential benefits
• Keep open lines of communication
between you and your healthcare team
• Avoid safety issues

10. CAM use is widespread
• According to Fouladbakhsh
– Almost 1 in 2 people with cancer use some
form of CAM
• CAM
– Providers
– Practices
– Products

11. CAM Providers
• Chiropractors
• Acupuncturists
• Homeopathic practitioners
• Ayurvedic physician
• Massage therapists
• Energy healers
• and more…
Fouladbakhsh & Stommel, 2007

12. Tips to Find a Good
CAM Provider
• Accredited school
• Board certified/licensed
• Ask other professionals you trust for
referrals
• Find a local integrative medicine program
• Willing to talk by phone to establish
rapport
Fouladbakhsh & Stommel, 2007

13. CAM Practices
• Acupuncture/acupressure
• Ayurvedic therapy
• Energy therapy
– Healing touch, Reiki, Therapeutic Touch
• Massage
• Yoga
• Tai Chi

14. CAM Products
• Vitamins
• Herbs
• Supplements
• Production and claims of effectiveness not
regulated
• Treat like a regular medication
– Risks, benefits and potential to interact with
other medicines
– Just because it’s natural, doesn’t mean it’s
risk-free…

15. Stress Reducing
Complementary Therapies
• What we think affects how our bodies work
– Mind-body connection
• Prolonged stress negatively affects health
• Practices to relieve stress may help
physical and emotional coping with the
cancer experience for patients and
caregivers

16. “Fight or Flight”
Stress Response
• Short term stress is meant to be protective

17. Effect of prolonged stress
• Elevated stress hormones
• Suppressed immunity
• May lead to new or worsening health
issues
– Physical
– Emotional

18. Stress Reduction Practices
• Meditation
• Mindfulness-Based Stress Reduction
• Tai Chi
• Qi Gong
• Yoga
• and more…

19. Caring for Caregivers
• Laurel Northouse, RN, PhD, FAAN
– University of Michigan School of Nursing,
Ann Arbor MI
• Jane Meier Hamilton, MSN, RN
– Partners on the Path, Gwynedd Valley PA
• Joanne Hambleton, RN, MSN, NE-BC
– Fox Chase Cancer Center, Philadelphia PA

20. Many Caregivers in Oncology
• Professionals
– Nurses, Physicians, Social Workers,
Pharmacists, etc.
• Family Caregivers
• Volunteers

21. Each group faces challenges
• Caregiver Stress
• Sleep Deprivation
• Compassion Fatigue
• Burnout

22. Special challenges for the
Family Caregiver
• Caregivers face many demands
• Few resources to learn how to be a
caregiver
• The situation affects both the caregiver
and patient physically and emotionally

23. More attention to come
• Researchers are studying ways to support
family and informal caregivers of people
with cancer
– Best ways to educate, prepare and support
caregivers
– To ease strain and burden
– To promote physical and emotional health in
the caregiver over the course of the patient’s
experience

24. Personalized Healthcare
• “Patient/Person-centered Care”
– Making the patient the focus of the health
care system
– A “Hot Topic” in healthcare reform
• Treatment planning that considers:
– How your body “digests” medicines
– Features about your particular tumor cells that
can guide the best treatment choices

25. How your body
“digests” medicines
• When you take a medicine, your body:
– Changes it into an “active” form before use
– “Metabolizes” it out of your body, often
through the liver or kidneys
• Chemical process
– Some people’s chemicals work at different
rates than others
– Some people lack needed chemicals to
“digest” certain medicines

26. What if I “digest” differently?
• Researchers are interested to study these
digestion/metabolism systems
• Medication choices might change based
on knowledge of how a particular person
metabolizes
– Too fast = might need a higher dose
– Too slow = might need a lower dose, and/or
be careful with other medicines that need to
use the same “digestion” system
– Missing = Choose a different medicine

29. Examples
• Thymidylate Synthase (TS)
– 5-FU works by inhibiting TS
– High TS levels may mean 5-FU doesn’t work
as well
• Dihydropyrimidine Dehydrogenase (DPD)
– Deficiency associated with 5-FU side effects
• UGT1A1
– A polymorphism (normal difference) in this
enzyme may decrease ability to metabolism
irinotecan = increased side effects

30. Treating the Tumor’s
Characteristics
• What’s sticking out of the surface of the
cancer cell?
• What pathways are active between the cell
surface and the nucleus?
• What changes are there in the cancer
cell’s genetic material?

32. Nucleus

34. Tailoring
medicine
choices to the
specific genes
found in a
tumor cell may
make
treatments
more effective

35. If you would like to view the full
presentations:
• Visit http://congress.ons.org
–Click on Education
–Select Congress Sessions

36. Questions?

37. UPCOMING WEBINARS
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