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Biomedical subjects

Pamela Hallquist Viale

Publications and source records attributed to Pamela Hallquist Viale.

At least 19 recordsLinked to original sources
PubMed2006

Expanded treatment options in the adjuvant therapy of colon cancer: implications for oncology nurses.

PURPOSE/OBJECTIVES: To review the role of adjuvant therapy in the treatment of patients with colon cancer. DATA SOURCES: Published articles, Internet sources, and books. DATA SYNTHESIS: Colon cancer is a very common cancer in men and women. Chemotherapy, consisting primarily of 5-fluorouracil, has been used to treat colon cancer since the 1950s, but additional effective agents against metastatic disease now are available. The options for adjuvant chemotherapy have increased dramatically. Ongoing studies are evaluating the role of biologics in adjuvant therapy of colon cancer. CONCLUSIONS: Use of oxaliplatin in the adjuvant setting has further defined exciting new therapy options for patients with colon cancer. IMPLICATIONS FOR NURSING: Oncology nurses caring for patients with colon cancer should be aware of new changes in therapy options. Although the addition of new therapies increases the tools in the drug arsenal for the common disease, management of toxicities of therapy is crucial as well. This article reviews changes in therapy options and toxicity management, including discussion of key issues for oncology nurses in the care of patients with colon cancer.

Chemotherapy, Adjuvant↗
PubMed2006

Chemotherapy and cutaneous toxicities: implications for oncology nurses.

OBJECTIVE: To review common cutaneous effects and dermatologic or cutaneous toxicities related to the administration of chemotherapy. These range from mostly cosmetic, such as hyperpigmentation or alopecia, to dose-limiting toxicities such as palmar-plantar erythrodysesthesia or hand-foot syndrome. DATA SOURCES: Current research, published literature, and internet resources. CONCLUSION: Assessment and grading of associated toxicities of therapy is an integral part of caring for this patient population. Early intervention may reduce toxicities associated with therapies for this patient population IMPLICATIONS FOR NURSING PRACTICE: As more patients receive chemotherapy, dermatologic effects are becoming more common. Oncology nurses must be skilled in managing these side effects.

Alopecia↗
PubMed2005

The clinical use of tumor makers in select cancers: are you confident enough to discuss them with your patients?

PURPOSE/OBJECTIVES: To review the clinical use of tumor markers in select cancers and highlight future directions in tumor marker development. DATA SOURCES: Guidelines from national and international societies, scientific literature, and Internet resources. DATA SYNTHESIS: Tumor markers are important tools in the management of cancer. Sequencing of the human genome has led to new tumor marker development in the fields of proteomics and DNA microarray technologies. CONCLUSIONS: Tumor marker technology is expanding rapidly; almost a dozen tumor markers currently are being used in the oncology arena, with many more in development. The use of tumor markers can be controversial, particularly because guidelines have not been established for all of the markers. IMPLICATIONS FOR NURSING: Oncology nurses need to be well versed in the use of tumor markers to educate and counsel patients with cancer.

Biomarkers, Tumor↗
PubMed2005

Cancer treatment-induced bone loss in patients with breast or prostate cancer.

PURPOSE/OBJECTIVES: To review the prevalence, consequences, pathophysiology, diagnosis, and treatment of cancer treatment-induced bone loss (CTIBL) in patients with breast or prostate cancer. DATA SOURCES: Published articles, abstracts, book chapters, electronic resources, and manufacturer information. DATA SYNTHESIS: CTIBL is a long-term complication associated with cancer therapies that cause hypogonadism in patients with breast or prostate cancer. Early diagnosis and treatment of CTIBL is essential to prevent bone fractures. CTIBL treatment includes modification of lifestyles that increase the risk of developing bone loss and fractures and includes the use of bone loss therapies (e.g., bisphosphonates, selective estrogen receptor modifiers, calcitonin). CONCLUSIONS: CTIBL is becoming more common as patients with breast or prostate cancer survive longer. Identifying and treating CTIBL early are important because once bone is lost, damaged bone becomes more difficult to repair; early diagnosis and treatment also may prevent fractures. IMPLICATIONS FOR NURSING: Nurses must be knowledgeable about CTIBL to identify high-risk patients and educate patients and their families about CTIBL, bone loss therapies, and lifestyle modifications.

Bone Resorption↗
PubMed2005

Aromatase inhibitor agents in breast cancer: evolving practices in hormonal therapy treatment.

PURPOSE/OBJECTIVES: To review the role of aromatase inhibitor agents with regard to current treatment strategies with hormonal therapy for women with breast cancer. DATA SOURCES: Published articles and books. DATA SYNTHESIS: Hormonal therapy is an essential component of the treatment of most women with breast cancer. Aromatase inhibitor agents are becoming an integral part of treatment for women with metastatic breast cancer and recently have become much more prominent in the treatment of women with early-stage breast cancer. The exact role of these agents in adjuvant therapy of breast cancer, either sequentially with the "gold standard" tamoxifen or for the duration of therapy, has yet to be determined. CONCLUSIONS: Recent studies with aromatase inhibitor agents are intriguing and suggest an improved side-effect profile and efficacy. The approval of these agents for the adjuvant treatment of breast cancer has led to a significant change in practice. IMPLICATIONS FOR NURSING: Breast cancer is an extremely common cancer in women, and oncology nurses take care of large numbers of patients with this disease. Oncology nurses need the most recent information so they can discuss aromatase inhibitor agents and therapy with their patients.

Aromatase Inhibitors↗
PubMed2005

Abnormal clotting in cancer: an overview of pathophysiology and etiology.

OBJECTIVE: To help oncology nurses become more cognizant of the increased risk cancer patients have for venous thromboembolism due to such factors as chemotherapy and hypercoagulability stemming from the neoplasm itself. DATA SOURCES: Primary and tertiary literature and the author's clinical experience. CONCLUSION: Establishing the optimal treatment of cancer-associated thrombosis in the future will depend in part on a better understanding of clotting aberrations. Oncology nurses must be cognizant of the various risk factors for thrombosis and bleeding and how they relate to cancer treatments and interventions. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses are in a unique position to recognize conditions that predispose cancer patients to the development of venous thromboembolism as well as its signs and symptoms. This enhanced understanding will ensure that patients receive appropriate and timely intervention.

Blood Coagulation Disorders↗
PubMed2005

Advanced colorectal cancer: current treatment and nursing management with economic considerations.

Colorectal cancer is one of the most common cancers affecting men and women in the United States. In 2005, 10% of all new cancer cases in men will be colorectal; for women, 11% of new cases will be colorectal. The disease is the third most frequent cancer occurring in both sexes. Colorectal cancer also is the third most frequent cause of death for men and women, and more than 56,000 cancer deaths in 2005 will be attributed to colorectal cancer. Chemotherapy options for treatment of the disease remained relatively stagnant until the approval of irinotecan in 1996 followed by capecitabine, oxaliplatin, and the new targeted agents. The new agents have improved efficacy of treatment for colorectal cancer and the lives of patients with advanced disease. With the new options for treatment come increased nursing and patient-teaching responsibilities, as well as increased costs associated with the newer drugs in the armamentarium of chemotherapy agents. Formulary budgets are seeing dramatic rises in expenditures for the new, targeted therapy treatments; discussion of the most appropriate therapies may be considered. This article will discuss epidemiology of colorectal cancer, treatment options in advanced colorectal cancer, and nursing care crucial to patients undergoing chemotherapy. Discussion of economic impact also will be presented.

Antibodies, Monoclonal↗
PubMed2005

Integrating aprepitant and palonosetron into clinical practice: a role for the new antiemetics.

Chemotherapy-induced nausea and vomiting (CINV) are among the most feared side effects of cancer treatment. With increasingly more complex chemotherapy treatments, CINV plays an important role in determining patients' quality of life, as well as when to halt potentially lifesaving therapy. Although significant progress has been made in the treatment of CINV, patients undergoing chemotherapy continue to report that this side effect is persistent and distressing. In 2003, two new agents were added to the armamentarium of antiemetic therapy. The U.S. Food and Drug Administration approved palonosetron, a longer-acting serotonin antagonist, and aprepitant, a neurokinin-1 antagonist and the first in a new class of antiemetics, for the treatment of CINV. Although the indications for both agents are similar, they have distinct differences. Decisions regarding placement of these agents into existing antiemetic protocols can be based on national guidelines, review of the literature, and clinical experience. This article will review current antiemetic therapy with an emphasis on the new additions to the treatment of CINV. Aprepitant and palonosetron represent significant changes in the treatment of CINV. Oncology nurses need to know current approaches to maximize effective antiemetic therapy.

Antiemetics↗
PubMed2004

The attitudes and beliefs of oncology nurse practitioners regarding direct-to-consumer advertising of prescription medications.

PURPOSE/OBJECTIVES: To obtain information about the knowledge and attitudes of oncology nurse practitioners (ONPs) concerning the effect of direct-to-consumer (DTC) advertising of prescription medications on prescribing patterns. DESIGN: Exploratory survey. SETTING: Oncology Nursing Society Nurse Practitioner Special Interest Group members in the United States. SAMPLE: 221 of 376 ONPs completed the survey (58%). METHODS: Researcher-developed 12-question postal survey. MAIN RESEARCH VARIABLES: Knowledge and attitudes of ONPs on DTC advertising effects on prescribing patterns. FINDINGS: The findings were similar to those of previous studies of physicians regarding the number of visits when patients requested DTC-advertised medications. Major differences were the positive attitudes of ONPs toward potentially longer patient visits to explain and educate patients regarding medication requests based on DTC advertising and smaller percentages of ONPs who felt "pressured" to prescribe requested medications. CONCLUSIONS: ONPs have mixed opinions regarding the practice of DTC advertising but do not believe that they are influenced heavily by advertising with regard to prescriptive practices. ONPs consider patient encounters for education purposes as appropriate and include information about requested DTC-advertised medications in their approach to patient care. IMPLICATIONS FOR NURSING: This is an exploratory survey of a specialty group of ONPs. More research is needed to further explore the practice of DTC advertising and potential influences on the prescribing patterns of ONPs. DTC advertising of prescription medications is increasing; ONPs need to increase their knowledge base about the potential for influences of prescriptive practices.

Adult↗
PubMed2004

Venous thromboembolism in patients with cancer. Part I. Survey of oncology nurses' attitudes and treatment practices for ambulatory settings.

Patients with cancer have a higher incidence of venous thromboembolism (VTE). Little information currently exists on VTE and the understanding and beliefs of oncology nurses. Therefore, the attitudes and treatment practices of ambulatory oncology nurses were surveyed to determine the current knowledge base of VTE in patients with cancer. Survey results are presented along with a thorough literature review of thromboembolism and the unique risk factors for this frequent complication in patients with cancer. The causes of VTE in this patient population often are multifactorial and include hypercoagulability, stasis, and vascular endothelial damage from procedures or the neoplastic process itself. In particular, chemotherapy administration can increase the risk of thrombosis considerably. New therapies, including thalidomide, require oncology nurses caring for these patients to have heightened awareness of the potential for thrombogenic complications. This is the first of two articles that address the problem of thromboembolism in patients with cancer, including the survey results. (See part II on page 465.) Oncology nurses are essential in the care of VTE in patients with cancer and can help with patient identification, treatment, and compliance for improved patient outcomes.

Ambulatory Care↗
PubMed2004

Venous thromboembolism in patients with cancer. Part II. Current treatment strategies.

Patients with cancer have an increased risk of thromboembolism. This complication is connected to a variety of different factors and is influenced by the conditions described in Virchow's triad: stasis, vascular endothelial damage, and hypercoagulability. Once thromboembolism is diagnosed, treatment in patients with cancer usually involves anticoagulation with unfractionated or low-molecular-weight heparin and progression to oral anticoagulant therapy. Duration of treatment is usually three to six months, with most patients receiving six months of anticoagulation. Patients with cancer may be at risk for recurrent thrombosis as well, despite optimal use of oral anticoagulant therapy, and some of these patients may require lifelong heparin therapy. This article describes the current treatment regimens to provide anticoagulation therapy to patients with cancer, including a discussion of the low-molecular-weight heparins and dosing parameters. Nursing interventions to help provide these treatments safely are discussed. Patients with cancer have a high rate of thromboembolism; oncology nurses should heighten their awareness of this important complication, treatment options, and appropriate nursing interventions.

Anticoagulants↗
PubMed2003

What nurse practitioners should know about direct-to-consumer advertising of prescription medications.

PURPOSE: To describe the marketing strategies of direct-to-consumer (DTC) advertising and the risks, benefits, and potential influence on the prescribing practices of nurse practitioners (NPs). DATA SOURCES: Journal articles, media sources, and clinical experience. CONCLUSIONS: The effect of DTC advertising of prescription medications on NPs has not been well studied. Although there are studies that examine the effects of DTC advertising on physician prescribing as well as the effects of this practice on the consumer, opinions on the benefits of DTC advertising are varied. IMPLICATIONS FOR PRACTICE: NPs need to recognize the potential influence of DTC advertising and to be prepared to guide patients toward appropriate medication choices by participating in a partnership with patients. Health care providers, including NPs, need to work with the pharmaceutical industry to encourage accountability of DTC advertising, thus improving dissemination of correct information and promoting positive outcomes for health consumers and patients.

Advertising↗
PubMed2002

Direct-to-consumer advertising of prescription medications: implications for patients with cancer.

PURPOSE/OBJECTIVES: To review the phenomenon of direct-to-consumer (DTC) advertising of prescription medications in the media, with an overview of pertinent studies in the literature regarding patients' and healthcare professionals' perspectives on DTC advertising. DATA SOURCES: Journal articles, media, and clinical experience. DATA SYNTHESIS: DTC advertising of prescription medications is extremely prevalent in U.S. society. Advertising of medications is an expensive business; yearly spending is expected to reach $7.5 billion by 2005. Although opinions vary regarding DTC advertising, healthcare professionals, including oncology nurses, must be prepared to discuss DTC-advertised medications and treatments with their patients. CONCLUSIONS: Communication is the key to helping patients decipher the deluge of DTC advertisements in the media and determine the accuracy of this ever-increasing source of medical information. IMPLICATIONS FOR NURSING: Oncology nurses need to be aware of the increases in DTC advertising of prescription medications and the importance of guiding patients through appropriate medication choices by education.

Advertising↗
PubMedDate not supplied

Complications associated with implantable vascular access devices in the patient with cancer.

Implantable vascular access devices (IVADs), or implantable ports, have been used for patients with cancer for more than 20 years. Although these devices have greatly improved infusion access for this population of patients, complications may still occur. Nurses working with oncology patients who have IVADs must be aware of possible problems for these patients, as well as the importance of early assessment and intervention. The diagnosis of cancer and potential treatments for this disease may make these patients at higher risk for complications associated with the use of IVADS.

Bacteremia↗
PubMedDate not supplied

Update on the management of chemotherapy-induced nausea and vomiting.

Chemotherapy is associated with a variety of side effects, and many of these can be dose-limiting. One of the most dreaded side effects for patients receiving chemotherapy is nausea and vomiting, however. Although in the last 2 decades there have been several advances in the development of new therapies for prevention of chemotherapy-induced nausea and vomiting (CINV), recent pharmacologic advances have significantly improved control of this feared side effect. Antiemetic guidelines help clinicians manage CINV and are updated frequently. Ongoing studies further define appropriate management of patients with CINV; of particular interest is delayed nausea and vomiting. With the addition of the long-acting serotonin antagonist, palonosetron, and the unique neurokinin-1 antagonist, aprepitant, control of CINV has improved considerably for those patients receiving chemotherapy. This article discusses CINV and recent pharmacologic advances in controlling this side effect. Guidelines for the management of CINV are reviewed.

Antiemetics↗