Adapting to Change: A Thoracic Oncology Team's Perspective.

With targeted therapies, outcomes for patients with NSCLC are improving, but better monitoring for AEs is needed.

Management of Patients With Chemotherapy-Induced Nausea and Vomiting.

Despite advances in the management of chemotherapy-induced nausea and vomiting (CINV), clinical management remains a challenge and CINV continues to be a side effect that patients fear most. Advanced practitioners can play a major role in evidence-based interventions for prevention and management of these side effects of treatment.

Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits.

PURPOSE: With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties-certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. METHODS: Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. RESULTS: By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. CONCLUSION: BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits.

Corticosteroids in the treatment of chemotherapy-induced nausea and vomiting.

Chemotherapy-induced nausea and vomiting (CINV) is one of the most feared side effects of cancer treatment, despite the advances over the past decades. Corticosteroids have been shown to be effective in the management of CINV. These agents are usually used in combination with serotonin antagonists and neurokinin-1 antagonists for highly or moderately emetogenic chemotherapy or as monotherapy for low-emetogenic chemotherapy. Consensus guidelines provide guidance regarding the scenarios in which corticosteroids are recommended. This article reviews the mechanism of action, role, and safety of corticosteroids in the management of CINV.

Role of oncology clinical pharmacists in light of the oncology workforce study.

To date, the information published regarding workforce implications has focused on physicians, nurse practitioners, and physician assistants. But oncology clinical pharmacists also can assist with direct patient care and patient education activities.

Caring for the treatment-experienced breast cancer patient: the pharmacist's role.

PURPOSE: The number of options for the management of metastatic breast cancer has expanded considerably during the past few years and are discussed here. SUMMARY: New treatments have helped to palliate cancer symptoms and improve quality of life for many patients, but they also are associated with several clinically significant adverse events, including myelosuppression, nausea and vomiting, and neuropathy. Neutropenia often develops within a few days of the onset of chemotherapy and is associated with an increased risk of serious infection, hospitalization, treatment delays, and increased treatment costs. Anemia affects many patients with metastatic breast cancer and may result in significantly diminished quality of life. Chemotherapy-induced nausea and vomiting (CINV) is consistently rated by patients as among the most distressing symptoms associated with cancer treatment. The risk of nausea and vomiting varies considerably among different chemotherapy regimens, and guidelines for the prevention of CINV emphasize the importance of developing an antiemesis regimen that is based on the emetogenic potential of the chemotherapy regimen. Peripheral neuropathy is often the dose-limiting adverse event with many cancer therapies. Neuropathy may affect the sensory or motor nerves and produces a broad range of symptoms. Due to the increase in the number of oral medications used in cancer therapy in recent years, patient adherence to treatment has become increasingly important. CONCLUSION: Pharmacists have several important roles in helping patients with breast cancer to attain the best possible treatment outcomes and reducing the impact of adverse events. Some of these roles include patient education, participating in the development of institutional guidelines for the management of adverse effects, ensuring the appropriate laboratory tests have been performed, reconciliation of medications for patients who are hospitalized, and helping to improve treatment adherence for patients who are using oral therapies.