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R. Thomas
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NU04 - Managing Toxicity (ID 278)
- Event: WCLC 2016
- Type: Nurses Session
- Track: Nurses
- Presentations: 1
- Moderators:M. Hesdorffer, M. Davies
- Coordinates: 12/06/2016, 14:30 - 15:45, Schubert 5
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NU04.02 - Experience of Lung Cancer Patients Receiving Immunotherapy (ID 6479)
14:50 - 15:10 | Author(s): R. Thomas
- Abstract
- Presentation
Abstract:
With the emergence of immunotherapy in lung cancer, patients now have access to treatments that have the potential to improve prognosis. Patients diagnosed with advanced non-small cell lung cancer (NSCLC) (either squamous or non-squamous) have previously had limited treatment options. With the emergence of new drugs, particularly in the immune-oncology setting, this is now changing. Recent clinical trial evidence demonstrates that compared with docetaxel, patients who received Nivolumab or Pembrolizamab had better overall survival and also significantly fewer Grade 3-4 adverse events (AEs). However the nursing experience of caring for lung cancer patients on an immunotherapy remains quite limited. Up to recent times immunotherapy drugs were limited to the clinical trial setting or early patient access schemes. Often patients on clinical trials are managed and monitored by research nurses which can further limit the experience for Lung Cancer Clinical Nurse Specialists caring for patients on immunotherapy. The two main clinical trials for immunotherapy in the UK were CHECKMATE (Nivolumab) and KEYTRUDA (Pembrolizamab). The aim of this presentation is to look at two patient case studies and review their experience of taking an immunotherapy. The presentation will focus on how immunotherapy has impacted on their lung cancer and also on their life. As part of the patient case studies there will be a focus on the nursing role in supporting and caring for patients on immunotherapy in a safe and effective manner. The presentation will examine the main adverse event profiles of immunotherapy and how these differ to chemotherapy. The presentation will open with a brief synopsis of the mode of action of immunotherapy which is a 2 minute film. The main focus of the presentation however, will be on the patient experience and the nurses’ role. Currently in the UK there is a scarcity of information available to oncology nurses on the nursing care of patients on immune-oncology treatments. However, there are many transferable skills which can be utilised when caring and supporting patients and their carers who either about to commence on immune-oncology. According to Reiger (2003) oncology nurses have a better opportunity than any other member of the healthcare team to develop the required rapport for effective educational pre-treatment consultations with both the patient and the carer. With regards to lung cancer clinical nurse specialists this rapport is often developed from the point of meeting the patient and carer at diagnosis and then supporting them through first line treatment and beyond to follow up. Often oncology nurses will build a rapport with patients when they attend to undergo treatment and are often a point of contact for patients to report side effects to. Including the patient’s carer in pre-treatment consultations and at key points in the patient pathway is very important. Often patients will be receive a lot of information about their diagnosis and proposed treatment plans and this can be very overwhelming (Malton 2002). Having the carer present means that they can ask questions about treatment side effects, how long the intended benefit of the treatment is and how the patient will be monitored during treatment. The pre-treatment consultation should be undertaken separately to the consent to treatment appointment to allow both the patient and the carer to digest information and write down any questions about the treatment they may have. In the current setting patient information for Nivolumab is under design meaning there may be limited information available to give the patient. There are patient alert cards which patients can keep in their wallets which detail the main side effects of Nivolumab. However, it is also important the nurse undertaking the pre-treatment consultation has a good understanding of Nivolumab, how it works and the potential side effects to monitor for so that they can counsel the patient and their carer accordingly and be able to answer any questions they may have. A clear and concise approach should be used in the pre-treatment consultation with key communication skills of planning, preparation and delivering the message, listening and questioning skills should also be implemented (Wiffen 2007). References. Malton S (2012) How to counsel cancer patients about their oral chemotherapy. Clinical Pharmacist 4: 171 Wiffen P, Mitchell M, Snelling M, Stoner N (2007) Oxford Handbook of Clinical Pharmacy. 1st edn. Oxford University Press, Oxford Rieger P, Yarbro C (2003) Role of the oncology nurse. In: Cancer Medicine. 6th edn. Kufe DW, Pollock RE, Weichselbaum RR, eds. BC Decker, Hamilton
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