Nurse-Specific Presentations Set to Expand Knowledge Across Entire Care Team

The nurse-specific track returns to the Miami Breast Cancer Conference® agenda for a second year in 2022. The half-day presentations will cover a range of topics spanning new agent updates and precision medicine to fertility concerns for younger patients with breast cancer.

Sarah Donahue, MPH, AOCNP, of the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, and cochair of the nursing track, recently spoke with Oncology Nursing News®, a sister publication of OncLive®, to discussthe upcoming presentations and key takeaways from this year’s track.

Nursing Track at a Glance

Sarah Donahue, MPH, AOCNP

As part of the program, Donahue will present an update on new therapeutic agents in breast cancer—both in early-stage and metastatic disease. Her session, “New Agent Update,” on Friday, March 4 at 2:25 pm, will cover most recent developments of the past 2 years. Some new agents Donahue plans to highlight include abemaciclib (Verzenio), for the treatment of hormone receptor–positive, HER2-negative, node-positive breast cancer in the adjuvant setting, and pembrolizumab (Keytruda), for patients with triple-negative breast cancer in the neoadjuvant setting.

The new agent update will tie into a presentation on precision medicine. “We are also going to have Antonio C. Wolff, MD, FACP, FASCO, come and speak about precision medicine,” Donahue said, adding that Wolff will cover the basics of using biomarkers. “What those biomarkers [mean] in terms of early-stage or metastatic breast cancer treatment [may] sound kind of dry, but it’s actually really interesting to learn how genetics play a role,” she noted. Wolff, a professor of oncology at Johns Hopkins University and director of breast cancer trials in the Women’s Malignancies Program at Johns Hopkins Kimmel Comprehensive Cancer Center in Baltimore, Maryland, will kick off the nursing track with his presentation “Precision Medicine: What Nurses Need to Know,” at 1:45 pm.

Biomarkers extend beyond hereditary or germline mutations and include mutations that occur within the cells during life, or somatic mutations, Donahue explained, noting that targeting these specific biomarkers is the future of breast cancer therapies. “Everything that I’m going to be [covering] in my talk [will be focused on] therapies that are targeted at [specific biomarkers]. We don’t [really] develop new-generation chemotherapy. It doesn’t happen anymore. It is biotherapy now.”

The nursing track will also include a presentation on managing immunotherapy-related adverse events (AEs). Donahue thinks that understanding AE management with immunotherapies—particularly pembrolizumab— is especially important for nurses and nurse practitioners who work in oncology. “It is both so interesting and complicated,” she noted. “We need more education on that.” La-Urshalar Brock, MSN, FNP-BC, CNM, RNFA, a family nurse practitioner at Winship Cancer Institute of Emory University in Atlanta, Georgia, will present “Immunotherapy-Related Adverse Events” at 2:05 pm.

Fertility remains a hot topic in the breast cancer space and is also scheduled to be addressed at this year’s conference. “Fertility has been coming up a lot with my younger patients,” Donahue said. As prognoses continue to improve, concerns about treatment-associated risks, egg retrieval, and hormone-related treatments are becoming more prevalent and are often a topic of discussion between patients and their nurses or nurse practitioners. Lindsay L. Kroener, MD, a reproductive endocrinology and infertility specialist and assistant clinical professor at UCLA, will cover these topics in her session, “Answering Your Patients’ Questions About Fertility Preservation,” at 3:40 pm.

This year’s nurse track will conclude with a presentation on self-care presented by Erin Kropp, DNP, ACNP-BC, BMTCN, an acute care nurse practitioner at City of Hope in Duarte, California. Donahue is looking forward to the discussion and believes self-care is very important for her and her colleagues.

“It is going to be more ‘for us’ and for our soul, [to guide us through] this career,” she said.

A Different Perspective on Pain Management

Patricia Jakel, MN, RN, AOCN

The track’s other cochair, Patricia Jakel, MN, RN, AOCN, a clinical nurse specialist in the Solid Tumor Program at UCLA Santa Monica Medical Center, and editor in chief of Oncology Nursing News®, will be presenting on pain management.

Jakel plans to provide a case study about a young woman who had received treatment for breast cancer and is now facing a recurrence in the form of liver and bone metastases. She will address the visceral pain and bone pain that often go hand in hand, briefly review steps for pain management, and discuss the different types of supplements that can be added to adjuvant treatments to help alleviate pain.

“I’m really going to emphasize something that I saw in the acute care setting very often, which is the psychological suffering that patients undergo,” noted Jakel. She added that although addressing patients’ physical discomfort may be obvious, it can be easy to neglect the psychological pain they are simultaneously experiencing.

“This is [an individual who] is leaving behind small children. She cannot work at this point so, financially, she is concerned for both her children and her husband. She is starting to question her religious beliefs—[wondering] why this is happening…. [She may be thinking,] ‘I went through the treatments, I had a response, I’ve done everything I’m supposed to do, and now this cancer is coming back.’”

This phenomenon is often described as “total pain,” explained Jakel, noting that this approach to cancer care is familiar to nurses but remains to be further explored. “I think oncology nurses, as a whole, understand what they need to do for patients in pain,” she said. “However, oftentimes, unless you’re a palliative care physician or a palliative care specialist, you often don’t think about the total pain…. There’s a lot more to suffering than [just] physical pain.”

Donahue echoed the importance of addressing the entire pain of the patient. “We chose this topic because of all the issues with the opioid crisis—we really wanted to address that. [We want to present] ways that we can approach pain in patients with metastatic and early-stage breast cancer in a way that’s…therapeutic but also safe,” she said. “I am really excited about that talk as well.”

Jakel’s presentation, “Case Studies in Pain Management Along the Continuum of Care,” will take place at 2:05 pm.

The Value of a Nurse-Specific Track

Nurse-specific tracks at oncology conferences seek to expand the knowledge of the entire care team, which Donahue believes is an important addition to meetings such as the Miami Breast Cancer Conference®. “I think part of the importance is welcoming nurses [and creating] a place where they feel like they’re part of our team,” she said. “Registered nurses, nurse practitioners, and doctors are all part of this team designed to care for patients. Even if doctors understand everything, we have to support them and support the patients through that journey and [therefore] our knowledge is just as important.”

“[Nurses should] feel welcome and feel like their knowledge of these things really does make everything work…. You cannot just have half of a group that is informed and the other half that is not. It just does not work,” she concluded.