Survivors for whom metastatic cancer has become a chronic illness have complicated issues related to cancer treatment and to living with a limited life expectancy. Although research and guidelines on the specific concerns of this population are lacking, symptom-monitoring and palliative care interventions can improve quality of life and mood for these survivors. Continuing education on this topic will allow nurses to recognize the issues confronting this population and enable them to help survivors with metastatic disease to live out their remaining days with a high quality of life.

Nurses play a critical role in the recognition and management of immune-related adverse events (irAEs). Education and training are needed to manage the needs of the growing patient population treated with these agents, particularly as our understanding of best practices for addressing complex toxicities evolves. The NCCN Guidelines provide helpful recommendations for assessing and managing irAEs in order to support optimal management of potentially life-threatening adverse events.

The decision regarding the best treatment option for cancer patients with anemia is dependent on many factors including the presence of symptoms, etiology of anemia, chemotherapy treatment intent and patient comorbidities. While red blood cell (RBC) transfusion is best for symptomatic patients requiring an immediate boost in hemoglobin levels, consideration of erythropoiesis-stimulating agent (ESA) therapy and/or iron supplementation may be warranted for the long-term management of anemia in high-risk patients or in asymptomatic patients with comorbidities.

Graft versus host disease (GVHD) is a serious complication that increases mortality and significantly impacts quality of life in allogeneic HCT recipients.  A thorough understanding of the various clinical manifestations of acute and chronic GVHD is essential for the early recognition of signs and symptoms. Oncology nurses require ongoing education that provides expert guidance necessary for the optimal management of patients with GVHD.

In order to improve smoking cessation efforts, health care providers need to understand options for smoking cessation therapy as well as the clinical data supporting these interventions. Pharmacists can play a critical role in patient education, therapy recommendations, and therapy management for smoking cessation.

Many new options exist for the treatment of advanced non-small cell lung cancer (NSCLC) in addition to traditional platinum-based chemotherapy. Pharmacists should be aware of the new data and recommendations for immunotherapies and targeted therapies, and how they relate to improvements in clinical efficacy and quality of life. It is also important to be aware of the potential for unique and potentially severe adverse events that can occur with these therapies; therefore, pharmacists should educate patients about the possibility of adverse events and the need to report symptoms to their health care teams to avoid severe complications.