As an advanced practice nurse (APN) in oncology, one of the most fulfilling aspects of my job is the chance to follow patients throughout treatment and manage their symptoms in such a way that hopefully they avoid extreme toxicity, have minimal breaks in therapy, and go on to recover well post-treatment.
Patients with head and neck cancer are especially vulnerable to side effects from therapy, whether they are receiving radiation (RT) alone or concurrent chemotherapy/radiation (CRT). Potential toxicities often include fatigue, nausea, thickened oral secretions, mucositis, pain, difficulty swallowing, all leading to potential extreme decline in weight and the aftermath this brings. The APN can play a vital role in managing these patients along their treatment trajectory. The results of a recent study entitled, “Frequent post-treatment follow-up by advance practice nurses improves care for high-risk head and neck cancer patients,” confirms this.
The American Society for Radiation Oncology (ASTRO) recently published a study comparing the incidence of adverse events in 25 high-risk head and neck cancer patients followed closely by an APN post-treatment versus 24 head and neck cancer patients receiving standard follow-up care. Approximately half of the patients received RT alone versus the other half receiving CRT. Those patients receiving RT alone had the most obvious benefit from follow-up with an APN, with just 16.7% having complications versus 60% of the standard-of-care group.
The full details of this study were just presented at ASTRO’s 57th Annual Meeting, held October 18-21, 2015, in San Antonio by lead study author Bridgett Harr, CNP, with the Department of Radiation Oncology at Cleveland Clinic.
Though this is just one small study, I think we can all agree that close management of our most critical patients can lead to better tolerance to therapy, decreased triage visits, and improved patient outcomes in the end. I would argue, too, that a study looking at close APN follow-up during treatment of certain high-risk patients would also prove beneficial for overall outcomes.
What sort of follow-up do you see in your institution for head and neck patients or other high-risk groups? Do you think we could do a better job of managing these patients?