I remember so well the first professional conference for pediatric hematology/oncology nurses I attended in 2006. I was in awe of the amazing nursing leaders walking around the conference, giving back to our profession by giving sessions, but still actively learning and helping to drive pediatric hematology/oncology forward.
Now, 13 years later, I continue to be in awe of the nursing leaders that attend the Association of Pediatric Hematology/Oncology Nurses (APHON) annual conference, but also am in awe to see how far pediatric hematology/oncology nursing has come since then.
One of the trends causing a lot of excitement is personalized medicine. Personalized medicine is the customizing of medical treatment to the individual characteristics of each patient. It relies on our understanding of how a person’s unique molecular and genetic profile makes them susceptible to certain diseases.
In the world of pediatric oncology nursing, a specific form of personalized medicine — biotherapy — is generating quite a bit of excitement and optimism.
Biotherapy is based on understanding how the immune system works, how cells communicate with each other, and how cancer cells interact with each other and with the immune system. In general, there are two types of biotherapy: immunotherapy, in which the host’s immune system is restored in order to control the cancer cells, and targeted therapy, which acts directly on a specific process that the cancer cell depends on for growth.
Why are we so interested in biotherapy when chemotherapy and other treatments have generated a childhood cancer survival rate that has improved greatly over the past 50 years? One reason is the relative lack of side effects from biotherapy.
Chemotherapy does not discriminate between regular cells and cancer cells; it kills all cells equally, with long term effects. Biotherapy is more discriminate; it searches for cancer cells and prevents their proliferation.
While there are side effects to biotherapy, they are related to the stimulation of the immune system, not the destruction or suppression of normal cells. There are typically fewer side effects to normal cells and less of a chance of drug resistance.
Treating children with cancer takes a big team — families, physicians, social workers, and nurses. The nursing role in the cancer experience is a unique one. More than any other group of healthcare professionals, nurses work alongside patients and families to provide care, support, and education throughout the cancer experience.
In the world of interprofessional practice, nurses are using relationship and organizational skills to coordinate care across disciplines, departments, and institutions, and serving as expert navigators for patients and families
In this changing healthcare environment, nurses will be faced with many challenges. Innovative therapies, like biotherapy, will have to be combined with innovative approaches to support oncology nurses in this emotionally taxing work, in order to minimize compassion fatigue and to retain highly skilled nurses.
Funding support for nursing research that emphasizes caregiving research, and team- and self-management will be needed to build even more effective nursing teams in pediatric hematology/oncology nursing. The most wonderful future challenge, however, will be changing our scope of nursing work because childhood cancer will be cured or prevented altogether.
Joan O’Hanlon Curry, M.S., RN, CPNP, CPON®, President, Association of Pediatric Hematology/Oncology Nurses (APHON), [email protected]