EONS Magazine Winter/Spring 2019 edition

EONS11 Symposia

A number of symposia with industry sponsors brought even more educational opportunities than ever to our conference participants. EONS would like to thank the sponsors for making these EONS11 sessions possible. Short reports from these sessions are below.

Cancer therapy induced nausea and vomiting: cancer nurses role in this symptom management – a symposium sponsored by Helsinn

Helsinn logo

As we know, cancer therapy induced nausea and vomiting (CINV) remains a significant and unpleasant side effect that, if managed well, contributes to enhanced quality of life during cancer treatment. Cancer nurses are often the first contact with whom patients share their experience. However, a gap in the flow of information about the symptom and treatment options still exists. With up-to-date knowledge about therapy strategies and considerations of patient and caregivers needs, nurses can impact the outcomes of CINV.

The aims of this symposium were set out as follows:

#1 To underpin the important role of cancer nurses in supportive care for CINV within the interprofessional team

#2 To recognise the risks, occurence of CINV and understand the treatment options for CINV

#3 To provide appropriate education and care to patients looking at prevention as well as interventions during therapy

Chair, Patrick Jahn, of University Hospital Halle, Germany, introduced the session. Karin Jordan, of ESMO, then looked at CINV today – examining new findings, new drugs, new dosages and new guidelines – and asked the important question, are we up to date? Next, Cheryl Vidall, of Alcura Health, UK, shared with the audience the result of two surveys carried out by nurses, examining their findings’ consequences for care interventions. Continuing this theme, Sara Torcato Parreira, a Portuguese cancer nurse and EONS’ Young Nurses Rep, looked at patient reported outcomes and left the audience with the inspiring message that ‘nurses can make a difference!’ 

 

Staying ahead of the curve: enhancing care management skills and knowledge of cancer immunotherapies in multi-professional teams – sponsored by BMS

BMS logo

The new class of cancer therapy - immunotherapy, is a rapidly evolving field. For cancer nurses, it is very challenging to stay current on their knowledge and care management skills.  Yet, the nurses remain at the frontline when educating patients and need adequate information for effectively managing and supporting cancer patients receiving this type of treatment. Evidence-based patient education is often lacking.

The aims and objectives of this symposium were identified as:

#1 To increase understanding of the characteristics of immunotherapy and how it works

#2 To identify three side effects of immunotherapy and how to manage them

#3 To characterise evidence-based patient education and supportive care

The session was chaired by Professor Theresa Wiseman of the Royal Marsden Hospital, UK, who is also an EONS Board Member. Dr James Larkin and Nikki Hunter, also of the Royal Marsden, focused respectively on the importance of understanding immunotherapy and how it works and managing side effects and toxicity. Professor Wiseman then spoke about developing supportive care guidance for immunotherapy. The final speaker was Carole Farrell, of the Christie NHS Foundation Trust, Manchester, UK, whose talk was entitled, Staying safe: Patient and family education. 

 

Introducing Biosimilar Therapeutic Products in Oncology: The Critical Need for Nurse Education – sponsored by Amgen and Medicines for Europe

Amgen and Medicines for Europe logos

The new class of cancer therapy – biosimilars – is a rapidly evolving field. This symposium was developed to provide information on where there are gaps in cancer nurses’ knowledge of what are the best practice and skills needed to effectively manage and support cancer patients receiving this type of treatment.

Three key aims and objectives were identified:

#1 To familarise nurses with how biosimilars are regulated in Europe and the characteristics of therapeutic oncology biosimilars

#2 To identify current areas of opportunities and challenges for cancer nurses in this field  

#3 To identify the best ways to improve knowledge and understanding of biosimilars amongst both cancer nurses and oncology patients

Symposium chair, Johan de Munter, of UZ Gent and an EONS Board Member, started by setting out the current state of play regarding cancer nurses’ knowledge about biosimilars. Dr Jane Hippenmeyer, of Amgen, then introduced biosimilar therapeutic products in oncology and explained the critical need for nurse education. Andrew Spiegel of PATH, Germany, then examined patients’ perspectives on biosimilars. A discussion followed in which the audience was able to ask questions to further extend their knowledge in this important area. Finally, the chair rounded up the session with some conclusions that could be drawn and thanked all the participants.

 

Nursing Roles: Aiming for Cancer Nursing Equity Across Europe as a Means to Achieve better Patient Outcomes – J&J

Johnson and Johnson logo

One of the main EONS goals is to highlight the different roles that cancer nurses play in multi-professional teams in different healthcare settings and how this influences various patient-reported outcomes. Findings from the RECaN study highlight an existing lack of standardised education requirements for cancer nurses that can in turn impact the patient-reported outcomes.

The aims and objectives of this symposium were:

#1  To raise awareness about the relationship between specialised cancer nursing roles and patient reported outcomes

#2 To initiate a conversation with cancer society members about the importance of recognising specialised cancer nursing as an indicator in PROs

#3 To highlight and examine the influence that cancer nurses have over resource management as one of their key roles in clinical settings

Symposium chair, Lena Sharp, of Regional Cancer Centre Stockholm-Gotland, Sweden and EONS President, introduced the session and provided an overview of cancer nursing roles. Daniel Kelly, EONS Past-President, then spoke on Why recognising cancer nursing is crucial to improving patient reported outcomes. Maude Andersson, of the Gynaecological Cancer Patients National Coalition, Sweden, and Board Member, ECPC, went on to describe the impact of cancer nursing on PRO’s from a patient’s perspective. This was then followed by a discussion before Lena Sharp concluded the symposium.

 

Teamwork for Nutrition: Improving patient & clinical outcomes by addressing chemotherapy related malnutrition for patients in a multidisciplinary approach – sponsored by Baxter

Baxter logo

Cancer-related malnutrition is highly prevalent in 50% of target cancer patients (EY Report, 31 Jan 2018), which increases the risk of premature death and significantly increases costs of cancer treatment. Regular nutritional screening, continuous nutritional advise and guidance on adequate diet and exercise, and timely initiation of clinical nutrition if needed improves functional and clinical outcomes in oncology, including survival, quality of life for patients and helps them complete their planned anticancer treatment, and reduce cost of cancer care.

The aims and objectives of this symposium were:

  • To raise awareness about the importance adequate nutritional intake and regular screening throughout cancer therapy, to highlight the current lack of information given to cancer patients on nutrition and available clinical nutritional options during cancer treatment and the overall importance of nutrition in contributing to better treatment outcomes and quality of life for patients.
  • To identify the best ways to ensure that patients and their carers are provided information and support to reduce chemotherapy related malnutrition.
  • To amplify the patient led campaign on nutrition for cancer patients and giving them a voice 
  • To outline the key roles of cancer nurses with multi-professional teams related to ensuring evidence based actions are followed to prevent malnutrition in cancer patients
  • To highlight the different options in supportive clinical nutrition and their impact on chemotherapy-related toxicity

The session was chaired by EONS COO Emma Woodford. Speakers included Birgitte Grube of the Danish Cancer Nursing Society, Jacquelin Daly, of the East Galway & Midlands Cancer Support group, Ireland, and Dr Olivier Marschal, a German medical oncologist. They addressed a variety of important aspects of cancer care relating to nutrition and how to improve patient outcomes.

 

Occupational safety for cancer nurses: limiting exposure to hazardous cancer treatments – sponsored by Paxxo, Equashield and Tevadaptor

Paxxo, Equashield and Tevadaptor logos

Most cancer drugs are non-selective in their mechanism of action. Studies continue to show that health care providers continue to be exposed to hazardous cancer treatments despite implementation of safety protection improvements. Occupational safety of cancer nurses is crucial and can be improved by using various self-protective measures, including closed infusion sets.

The aims and objectives of this symposium were:

#1 To increase understanding of possible occupational health risks in cancer setting

#2 To list at least three personal health protective measures

#3 To identify safe chemotherapy handling procedures

The session was chaired by Gabi Knötgen of the German Cancer Nursing Society. The first two speakers, Jane Wall, an independent consultant from Sweden and Ida Virtala, an independent cancer nurse/Paxxo, Sweden, addressed the evidence and practice recommendations for occupational safety for cancer nurses. Seth Eisenberg, of the USA, spoke about US guideline USB800. Then, Lemme-Liis Aruväli, of Tartu University Hospital, Estonia and the Estonian Cancer Nursing Society, went on to talk about occupational safety, focussing on a case study from Estonia. She was followed by session chair Gabi Knötgen who in turn examined a case study from Germany, and then drew together the key learning points from the symposia as a whole.

 

Squaring the Triangle: Meeting the needs of patients, informal carers, cancer nurses and oncologists throughout treatment and care of the patient – sponsored by Merck Serono and Pfizer

Merck and Pfizer logos

This symposium examined the relationships between cancer patients, cancer nurses, medical oncologists and informal carers of people affected by cancer through the eyes of representatives of all four health care professional groups, to optimise cancer care by multi-skilled teams for individual patients. During this session, the policy white paper developed in collaboration of ECPC and Eurocarers was discussed.

The aims and objectives of the symposium were:

#1 To raise awareness of challenges carers face when looking after relatives and friends during cancer care

#2 To initiate a conversation with oncology society members, and broader health stakeholders and policymakers, about the need to support carers in cancer care

#3 To outline types of available support carers themselves may often need

EONS Board Member and Education Working Group Chair Rebecca Verity chaired the symposium. First to speak was Valentina Biagioli who gave an overview of cancer nursing roles and relationships in the patient-carer-nursing-oncologist spectrum. Claire Champiex, of Eurocarers, then spoke on raising awareness and supporting cancer carers, and how the Eurocarers online Toolkit for Cancer Carers could help in this respect. Matti Järvinen, of the Association of Cancer Patients in Finland followed, explaining the importance of good working relationships in the patient’s team. Last to speak was Christoph Thomssen, of Martin Luther University Halle-Wittenberg, Germany, who focused on team roles of the medical oncologist, cancer nurse and carers in patient care; he also highlighted the policy recommendations of the Advanced Breast Cancer (ABC) Global Alliance.

 

“target” 2018: Launch of the Updated Interactive Education Course on Targeted Therapies – sponsored by Bayer

Bayer logo

Targeted therapies and “precision medicine” are moving forward at a breakneck speed. This symposium presented the updated EONS target education initiative designed to give nurses a general understanding of the science of targeted therapies and the care issues involved. Cancer patients are increasingly being treated with these new drugs and this complex knowledge is not often consequently presented in the clinical or in educational settings. Nurses, having the most contact with the patients, must be prepared for this progress to care for these patients and their caregivers. 

The aims and objectives were:

#1 To briefly present each learning module showing the principles of the targeted therapies and the possibilities for knowledge transfer in daily clinical practice

#2 To briefly highlight and reflect on aspects of nursing care with issues  about the drugs, the management of side effects and the increasing need of patient education on various issues

#3 To promote and disseminate the  target 2018 Update education initiative  to conference participants from various cancer nursing  oncology societies and work settings across Europe.

Anita Margulies, a former EONS Board member and Education Working Group Chair and chair of the target initiative, led this session with co-chair former EONS President Erik van Muilekom of the Netherlands Cancer Institute. A range of expert speakers, including Beatrix Kirchhofer of Germany, Ada Kinneally of Ireland, Fedro Peccatori of Italy and Jan Ouwerkerk of The Netherlands, examined the biology of cancer, understanding the ‘targets’ and their clinical application, immunology and immunotherapy, nursing aspects and patient care issues. 

 

The role of cancer nurses in precision oncology – sponsored by Roche

Roche logo

Precision medicine is a rapidly evolving field in oncology and offers improved diagnostic and therapeutic opportunities for patients with cancer. Nurses face increasing challenges in communicating, supporting, and advocating for patients given the availability of advanced testing and treatment in personalised and precision medicine. Their appropriate education is key in enabling nurses to guide their patients. 

The aims and objectives of this symposium were:

#1 To outline family and ethical implications of a precision medicine approach to cancer treatment

#2 To review how to communicate precision medicine to patients

#3 To identify influences of precision medicine to individualised care and how nurses adjust

Session chair, Andreas Charalambous, of Cyprus University of Technology and EONS President-Elect, introduced the symposium. Then, Patrick Crombez of the Jules Bordet Institute/EONS Board member (Belgium) started off by asking, How does personalised/precision medicine work? Michelle Davies, of the Christie NHS Foundation Trust, Manchester, UK, then gave a talk entitled Found in translation: Communicating precision medicine to patients. She was followed by Theresa Wiseman of  the Royal Marsden NHS Foundation Trust/University of Southampton and an EONS Board member, who spoke on patient and family experience: developing supportive care guidance. Jose Kolderhof of University Medical Center Utrecht, the Netherlands, developed this theme with a talk on the role of patient reported outcome measurements in precision medicine. Andreas Charalambous then drew the session to a close.