Pathology of genitourinary malignancies: implications for clinical management.

OBJECTIVES: To describe the pathologic and molecular characteristics of genitourinary malignancies relevant to the implications for the practice of oncology nurses. DATA SOURCES: Actual cases from the author's clinical experience, original scientific papers, review articles, and pathology books. CONCLUSION: Accurate pathologic diagnosis and identification of serum and molecular markers are critical for the accurate classification, staging, and choice of appropriate treatment for patients with genitourinary malignancies. IMPLICATIONS FOR NURSING PRACTICE: Because decisions of treatment initiation, discontinuation, and prognosis are in large part based on pathologic diagnosis and staging, oncology nurses should be knowledgeable about the process of pathologic tissue review and understand the importance of appropriate tumor acquisition.

Restoring and maintaining urinary function.

OBJECTIVES: To describe surgical urinary diversion methods, nursing management, and survivorship issues in urologic cancer survivors. DATA SOURCES: PubMed, Scopus, Cochran Reviews, Core 25 online texts. CONCLUSION: Options exist for patients that require urinary diversion, although long-term symptoms may persist. IMPLICATIONS FOR NURSING PRACTICE: Nurses must be knowledgeable about obstructive uropathy and understand the surgical options for urinary diversion following a cystectomy; pre- and post-operative needs exist for the cancer patient, family, and caregiver. Following completion of active treatment, a survivorship care plan summarizes active treatment and complications, plans long-term health outcomes and surveillance, and communicates with the primary care provider.

Inherited urologic malignant disorders: nursing implications.

Cancer of the urologic system accounts for substantial morbidity and mortality in the United States each year. A subset of individuals with urologic malignancies has cancer due to alterations in a major predisposing gene. While several heritable renal cancer syndromes are well characterized, the hereditary nature and genetic basis of other urologic malignancies is not yet clarified. Nursing roles are increasingly affected by the rapid influx of genetic knowledge. Current advances in the genetic basis of genitourinary cancer and the implications of these advances for urologic nursing practice are addressed.

Quality of final care for terminal cancer patients in a comprehensive cancer centre from the point of view of patients' families.

The aim of this study was to evaluate the quality of care for terminal cancer patients at our institution, as assessed by families in a questionnaire sent 6 months after the death of the patient. We evaluated the quality of information given to the patients and to their families, the patients' "comfort" at the end of their lives (nursing, pain, psychological support) and the families' opinions about the practical conditions at the time of death (in our institution or at home). A total of 105 consecutive patients who died in our institution between January and June 1989 were included in the study; the vast majority had breast or head and neck cancers. We obtained a total of 48 answers from the 105 families that received the questionnaire. Of these, 87.5% were satisfied with the terminal nursing care, 77% were satisfied with the information given to patients and 60% with the information given to families. The treatment for pain was considered to be inefficient or incomplete by 21% of the families; 32 families (67%) considered that the death of terminal cancer patients should occur in the hospital where the patient had been treated and 12% felt that it should occur at home. This study led us to examine various means for improving the quality of care for our terminal cancer patients.

Return-to-work experiences of people with cancer.

Maintaining employment after a cancer diagnosis and even during therapy is becoming a major challenge for an increasing number of individuals. The purpose of this study was to further understanding of the experience of returning to work after a cancer diagnosis by discovering the nature and processes of the experience's dimensions. This exploratory, longitudinal study systematically analyzed the dimensions of the return-to-work experience that were evident in data from 19 unstructured interviews. Grounded theory methods of study design and constant comparative analysis guided the interviews and data analysis. The core social process suggested by the data is one of mobilizing social support in the work environment. The inceptive theory explains and delineates steps in a process that ultimately facilitates a person's reintegration of normal activities after a cancer diagnosis. The added understanding available in these results can guide nurses to focus not only on related dimensions of the return-to-work experience, such as time off for treatment, but on central concerns, such as the social benefits of returning to work.