Burbage Provides Nursing Perspective on 2022 ASCO Meeting

Darcy Burbage, DNP, RN, AOCN, CBCN

Interdisciplinary collaboration across the oncology care team is key to improving patient outcomes, according to Darcy Burbage, DNP, RN, AOCN, CBCN.

Burbage, who is also the director-at-large of the Oncology Nursing Society, was selected as one of the featured voices of the 2022 ASCO Annual Meeting and many oncology nurses followed her tweets to track the trending presentations from this year’s meeting. As the only nurse to be selected for this year’s meeting, she helped channel content specific to the oncology nursing community, highlighting practice-changing content surrounding patient-reported outcomes, survivorship, and other aspects of supportive oncology care.

In an interview with Oncology Nursing News®, Burbage discussed her virtual experience with the 2022 Annual Conference and important nurse takeaways from the meeting.

Oncology Nursing News®: Which presentations /data to come out of ASCO do you feel will have the largest effect on oncology nursing practice?

Burbage: There were so many great presentations, and many will have a huge impact on patient care. For example, the results of the Destiny-04 trial [NCT03734029] are going to be practice changing for a subpopulation of individuals living with metastatic breast cancer. Watching this presentation online and hearing the cheers from those in the audience, gave me chills.

I was also glad to see the voice of the patient being included in presentations on how to expand clinical trial eligibility so that they are more reflective of the populations that we treat, such as expanding the age criteria as well as allowing individuals that may have other health conditions to be included in clinical trials. Without this expansion, we really don’t know how new treatments will benefit as many individuals as possible.

Additionally, I don’t think that we can [underestimate] the impact of the ongoing COVID-19 pandemic on oncology care and on oncology clinicians [and this was clear at this year’s meeting].

From the start of the pandemic, patients with cancer were designated as a particularly vulnerable subgroup of the population. The oncology community adapted quickly, pivoting to telehealth to maintain patient continuity, embracing extended-interval dosing strategies, abbreviating radiotherapy schedules, and switching from intravenous to oral chemotherapy regimens. However, we are only beginning to understand the multifaceted impact of the COVID-19 pandemic on cancer incidence, treatment outcomes, and side effects. The conference highlighted the number of oncology clinicians that reduced their hours or left practice and mentioned the large number of nurses that have left the workforce as well. Unless meaningful, system-based changes occur, the shortage will only worsen.

There were some great presentations on cultural humility. What values or applications do you think providers should be taking away from these educational sessions? How does cultural humility play a role in providing quality care?

Cultural humility is essential to provide holistic quality care to all individuals affected by cancer as it values learning from and with our patients. Cultural humility encourages an appreciation and understanding of our unique journeys as its goal is to build a mutually beneficial relationship rather than a provider/patient dynamic. To summarize, cultural humility is a clinical skill requiring curiosity and respect; applying the skill of cultural humility is necessary for culturally competent care, and both are key to providing high quality care.

There has been a lot of conversation surrounding the rising cost of cancer care and financial toxicity following various ASCO presentations. Is financial toxicity a growing problem? What can providers and nurses do to help their patients navigate this toxicity and try to prevent it from becoming worse?

Yes, financial toxicity is a growing concern for our patients. The cost of care itself along with rising deductibles and out of pocket expenses impacts a patient’s quality of life. With newer medications, such as immunotherapy agents, the monthly costs can be thousands of dollars.

All oncology clinicians, nurses, physicians, as well as our administrative staff can help address this by normalizing the financial conversation. For example, some of my patients have questions about the cost of this medication. Because of this, our social worker meets with everyone to review what resources are available. On a federal level, it’s important that oncology nurses continue to advocate for lower insurance premiums and oral parity legislation.

This year’s symptoms and survivorship track showcased data on a variety of topics. Which presentations from this track did you find interesting? How has the focus on symptoms and survivorship grown over the years? Where are their current gaps and where do you think research should continue to focus?

I was glad to see the number of abstracts presented in this category as oncology nurses spend a great deal of time helping individuals manage the long term and late effects of cancer treatment. In particular, I was pleased to see fear of recurrence being addressed.

Individuals living with cancer face a myriad of psychosocial distress throughout the cancer continuum; however, fear of recurrence is one of the most common unmet needs expressed by all of our patients, including those with early-stage cancers and those living with metastatic cancer. Fear of recurrence is associated with increased anxiety which may affect quality of life, and not just that of the individual, but their entire support system. As discussed, we need to assess individuals throughout the cancer continuum, including at the end of active treatment and at all follow-up visits to validate their feelings and provide them with the necessary support.

As the number of individuals living with cancer continues to increase, for example, childhood cancer survivors living well into adulthood, along with the number of individuals diagnosed with cancer that are greater than 65 [years old], there is a need to address comorbidities and how they impact cancer treatment and ongoing effects. For example, how does treatment impact [adverse] effects in individuals with both diabetes and cancer?

In addition, the number of abstract presentations focusing on digital health and patient reported outcomes is another area that continues to increase and where additional collaborative research is needed with our behavioral health colleagues.