Pearls From the Exemplars in Melanoma Live Meetings

From H. Lee Moffitt Cancer Center (March 20, 2007)

Many patients have heard about interferon’s side effects from the community, and they may be scared. Explain to patients that everyone responds differently to interferon therapy. Tell patients the range of side effects that they may experience, but help them understand that the effects are individualized. And stress to them that there is something we can do to manage these side effects.
Angie Paniagua, RN

It’s important to get a social worker involved when patients are deciding on treatment approaches in melanoma. Is the patient the breadwinner? Does he or she have small children? What are his/her goals? These factors affect how these patients think about therapy and may impact outcome.
H. Lee Moffitt Nursing Group

In counseling patients about the benefit of improvements in relapse-free survival with adjuvant therapy, I emphasize the benefit of delaying the disease. I tell them we have treatments today that we didn’t have 2 years ago, so by delaying disease for 2 years, they may be able to take advantage of new therapies that will be available 2 years from now. This puts the benefit in perspective.
Vernon K. Sondak, MD

Patients often confuse Clark level with stage of disease, since they are both written in roman numerals. This often leads to undue anxiety. Help educate patients about how we stage melanoma and what the pathology report means.
Darcelle Welker, RN

Patients tend to think they are “out of the woods” when they find out that their lymph node is negative. They see things as all or nothing. It is essential to pull them back to center and emphasize the risk of recurrence and stress the importance of follow-up and sun protection. They are at increased risk.
Rita Meitzner, RN

From Morton Plant Mease Hospital (March 21, 2007)

If you are at a center that does not have a great deal of experience with a melanoma therapy, try to seek out an untapped internal staff resource. Such people may have had more extensive experience at other institutions and can be a good source of referral information or for setting up the systems to get the therapy incorporated into your treatment regimen.
Rosemary Giuliano, ARNP, MSN

Don’t forget to consult your pharmacist when initiating patients on a new oncology therapy. These individuals can be key to recognizing the potential for drug interactions, appropriate dosing, and in anticipating the potential side effects of therapy. These can be critical components to keeping patients on effective therapies.
Rosemary Giuliano, ARNP, MSN

From Lakeland Regional Cancer Center (April 13, 2007)

The role of the registered nurse or oncology nurse in the patient recently diagnosed with melanoma is education, support, and patient care. Education and support need to be given to ensure the patient is getting accurate information from outside sources such as the Internet, other people, and other patients. Since the initial treatment is surgical, “what to expect” discussions are important for the patient and their families. Prognostic information may also be discussed in conjunction with the other members of the health care team.
Lakeland Regional Cancer Center Nursing Group
(led by Douglas Reintgen, MD)

As the patient progresses in his/her clinical course, education and support for various adjuvant therapy approaches may be indicated. For patients undergoing active therapy, the nurse may find herself responsible for the supportive care of the patient and plays a significant role in getting the patient through adjuvant high-dose interferon therapy.
Lakeland Regional Cancer Center Nursing Group
(led by Douglas Reintgen, MD)