Highlights from Saturday, November 19, 2016

Conference Highlights published on November 19, 2016 in 2016 Annual Conference

Attendees were up bright and early on Saturday morning, ready to enjoy yet another day packed with informational sessions and activities. The day began with a product theater sponsored by Genomic Health, and presented by Mary Van Cleave, BSN, RN, OCN. Her presentation, titled Harnessing the Power of Genomics, began with reminding attendees about the differences between genomics and genetics.

She explained the capabilities of genetic testing, including prognosis and a prediction of treatment benefits. She went on to discuss a test for breast cancer recurrence. She explained that tumor size does not reveal the whole picture of tumor biology—genomic testing can show the likelihood of disease recurrence and whether patients would benefit from chemotherapy or a different therapeutic option.

After the morning product theater sponsored by Genomic Health, Lillie D. Shockney, RN, BS, MAS, Program Director and Co-Founder of AONN+, and Sharon Gentry, RN, MSN, AOCN, CBCN, of the AONN+ Leadership Council, presented a year in review of AONN+ and discussed some of the exciting news and projects that the organization has been working on. For example, the Evidence Into Practice Committee officially launched its Standardized Metrics in Navigation and Survivorship!

They also reviewed some of the highlights from the annual Membership Survey and talked about the Resource Library project, which will offer clinical articles and best practices. Lillie and Sharon concluded by taking a fun and informative survey of the audience.

Genetics, Wellness, and Prevention

After a warm welcome from Lillie D. Shockney, RN, BS, MAS, Program Director and Co-Founder of AONN+, and Sharon Gentry, RN, MSN, AOCN, CBCN, of the AONN+ Leadership Council, an educational session about genetics, wellness, and prevention commenced. This session was presented by Jennifer Klemp, PhD, MPH, MA, Associate Professor of Medicine, Division of Clinical Oncology, University of Kansas Cancer Center, Founder and CEO, Cancer Survivorship Training; Melanie Leepers, RN, MBA, Cancer Program Manager, Clinical Trial Nurse, Tammy Walker Cancer Center at Salina Regional Health Center; and Michelle Weaver Knowles, RNC, BSN, CBCN, FNP, Graduate Student, Gonzaga University, who opened the educational portion of the day.

During her presentation, Jennifer provided a large-picture perspective on the topic and the trends involved. Michelle then took to the stage to talk about her poignant, personal story about her and her sister’s battles with breast cancer and how these experiences continue to inspire her. She stressed the importance of being an advocate for patients in assessing their genetic risk. She used the term “previvors” and offered her hope that genetic testing and educating patients on this topic will result in patients being diagnosed much earlier.

Melanie talked about her cancer center’s ovarian cancer study, in which they aimed to determine if patients with a history of cancer also had hereditary and cancer syndrome. Her presentation focused on genetic testing in rural settings. She talked about the significance of using the registry. Through this study, the organization found that few patients had been tested for a hereditary cancer at initial diagnosis and that there were benefits to re-contacting patients to offer testing, even after they had completed treatment. These findings have led the organization to offer genetic testing to every new patient at intake. “We need to capture people when they are right there,” stated Leepers regarding the importance of genetic testing and counseling at intake.

Jennifer mentioned that it is important for navigators to bring genetic testing data to their own cancer center settings. “Genetics is growing and being pushed out to primary care…and going into every one of our disciplines,” she said.

Navigating Adolescents and Young Adults

Paula M. Sanborn, RN, BSN, CPHON, CPN, Sarcoma Nurse Navigator, Nationwide Children’s Hospital, took the stage next to talk about the National Comprehensive Cancer Network’s guidelines for adolescents and young adults (AYAs; ages 15-39 years) with cancer. She brought humor and valuable insight to an underdiscussed topic.

This patient population is like sandpaper, Paula joked. She stressed having patience with AYAs, and said that many of them have similar concerns. “Am I going to die?” and “Will this affect my fertility?” are the two biggest questions she hears when talking to AYAs. She also said that this population needs education on prevention and early detection, such as how to perform skin and breast self-checks.

In addition to highlighting the social/emotional barriers of this population, she also emphasized the age and transitional care challenges that this population faces. Paula then discussed the diverse survivorship needs of the AYA population, as well as the ways in which providers can address the needs for change in the care that they receive.

Paula’s presentation was followed by breakout sessions.

Morning Breakout Sessions

During her breakout session, Yvonne Ward, RN, MSN, CBCN, OCN, Breast Nurse Navigator, Sarah Canon Cancer Center–Overland Regional Medical Center, focused on the importance of education for patients with breast cancer. She discussed the educational goals of the navigator, the timing of education, as well as the way in which information should be presented to patients. Yvonne also talked about the type of information that should be delivered at each point of care and who should do what at a cancer center. “You do need to know a little bit of everything,” she stated. Nicole Messier, RN, BSN, OCN, Gastrointestinal/Genitourinary Nurse Navigator and Clinical Program Coordinator, University of Vermont Medical Center, engaged participants in a discussion about the differences and challenges associated with navigating patients by cancer type. Nicole reviewed her cancer center and some of its inner dynamics. She received good feedback and conducted an engaging conversation with the audience.

Using several case studies, she highlighted the various barriers to care for patients with gastrointestinal and genitourinary malignancies and demonstrated how different resources could promote patient support and guidance. She talked about how patients were traveling long distances to come to the clinic—it had been weeks since they were diagnosed and had not even been classified. Therefore, her staff meets weekly to discuss gaps in care and other challenges.

Amy Jo Pixley, MSN, RN, OCN, Thoracic Program Coordinator, Penn Medicine–Lancaster General Health, engaged navigators in a discussion about the various aspects of navigation in thoracic oncology. She talked about the navigator’s evolving role and the impact of personalized care and medicine across the continuum. She also touched on ways that navigators can participate in the Moonshot initiative, and closed with a discussion about best practices and challenges with navigating this disease site, citing some of her patients and their end-of-life experiences.

She specifically discussed how to speak to patients about palliative care. She expressed the importance of being realistic in giving their patients their life’s expectations. “There is nothing wrong with hope—but realistic hope,” Amy stated.

Tricia Strusowski, MS, RN, Manager, Oncology Solutions, LLC, led navigators in the early stages of their career through a comprehensive discussion about the various aspects of the field. The presentation began by defining navigation, its goals, and the various models for the profession. It then transitioned into a discussion about the Commission on Cancer guidelines for navigation, the core competencies that navigators should possess, and the navigator’s roles in care transitions and overcoming barriers to patient care.

She showed a patient management algorithm and specifically pointed out when a patient is transitioned to the survivorship program. She pointed out the distress screening component and said that she trained her staff to use a more immediate approach by simply asking the question: “What can I help you with right now?”

Tricia also spoke about building a relationship with patients. “Trust is important,” she said.

In addition, she talked about the new AONN+ nurse navigator certification and the tools and resources available through certification. She closed by talking about ways in which navigators can partner with their community, market their services, and demonstrate their value to the organization.

At the close of the first breakout session, guests moved to the exhibit hall, where they interacted with a wide variety of vendors while enjoying lunch.

A Targeted Approach for NSCLC Patients Who Have Progressed After Initial EGFR-TKI Therapy

Blanca Ledezma, NP, began the product theater by talking about the breakdown of the classifications of patients with NSCLC. She explained that patients want to go into therapy right away; they don’t like the idea of being in limbo and not taking part in therapy.

She provided an overview of the progression of the disease. Blanca then segued into an oral therapy called osimertinib (Tagrisso) for patients who have progressed after initial EGFR-TKI therapy. She provided an overview of two clinical studies, and a majority of patients received a response in both trials. She also covered the dosing indications and the safety profile of the therapy.

Patricia discussed ovarian cancer treatment and pointed out this patient population is usually diagnosed in the late stages of the disease. She touched on the genetic characteristics that are used to classify ovarian cancer. After explaining the genetic mutations that create the environment for ovarian cancer, Patricia explained the genomic mechanism of action for treating ovarian cancer. She discussed a therapy called olaparib (Lynparza), which was indicated for this type of cancer. She talked about the dosing indications, safety profile, and performance in a trial. The trial reported a 34% response rate, which is much higher than the typical 10% to 20% response rates for chemotherapy. “This drug is a game changer,” she said.

The afternoon continued with the second series of breakout sessions.

Afternoon Breakout Sessions

Linda Burhansstipanov, MSPH, DrPH, of the Cherokee Nation of Oklahoma, Founder of the Native American Cancer Research Corporation and President of the Native American Cancer Initiatives, engaged participants in an insightful conversation about cultural awareness in navigation. She used examples from her own work to talk about how an organization that interacts with a unique patient population—Native Americans, for example—can benefit from the assistance of a navigator from within that community. Linda focused on the Native Patient Navigator Program. This program partners Native American patients with Native American navigators, who understand the various cultural barriers and can work in a respectful way to incorporate their customs and beliefs into the cancer care continuum.

In her breakout session, Natalie Chorn BSN, OCN, GYN covered gynecological cancers. She talked about the risk factors of uterine and cervical cancer, their symptoms, patient populations, and ways to reduce patients’ risk. She also discussed the vaccine for human papillomavirus (HPV) and the guidelines.

In her session on multiple-disease navigators, Melissa Shields, RN, BSN, OCN, spoke about building relationships with providers and touting the benefits of this type of navigation. Some of the benefits include increased screening and gaining good outcomes. She also spoke about the emphasis on overall patient care.

Stephanie Merce Boecher, RN, OCN, MSN, BSN, BA, Director of Oncology Services, and Rachel Faustner, BS, Oncology Financial Navigator, both of Advocate Sherman Hospital, focused on the need for financial navigation in an area of healthcare that is confusing and financially crippling. Patients with cancer who are recently diagnosed and insured face more than $16,000 in direct and indirect costs per year for their illness. This underscores the need for financial navigators, according to Advocate Sherman Hospital’s Stephanie Merce Boecher, RN, OCN, MSN, BSN, BA, Director of Oncology Services, and Rachel Faustner, BS, Oncology Financial Navigator. During their presentation, they discussed the financial barriers that patients face and the role of the financial navigator in the oncology environment.

How You Can Be a Champion to LGBT Cancer Patients

From same-sex marriage to the bathroom rights of transgender individuals, there have been a lot of changes in the LGBT community this year. During her insightful presentation, Mandi Pratt-Chapman, MA, Director, Patient-Centered Initiatives & Health Equity, GW Cancer Institute, emphasized the need for change in the way that the LGBT community accesses and receives healthcare. She explored the many considerations and nuances associated with caring for the LGBT community. These include the way that LGBT patients identify themselves and their body parts, the way that transgender individuals are screened, and the way that providers make these patients feel safe and comfortable in their interactions and their environment.

Patient-Centered Medicine: Oncology Medical Homes

Gina shared her experience with her cancer center’s Come Home Project, which focused on patient-centered medicine in a cancer setting. Her project was deemed a success and some of the benefits associated with it included increased patient satisfaction, improved documentation, a streamlined phone triage, and better chemotherapy education. Project challenges included obtaining compliance, achieving staff buy-in, and staffing.

Barbara shared a story about a patient with cancer who had an acute medical event, called her practice first, and demonstrated an optimal outcome. She compared this to the traditional medical care paradigm and how if the patient went directly to the emergency department of a local hospital, the patient would have had a different experience.

Disease Progression and Current Challenges in ALK-Positive NSCLC

Benjamin Creelan, MD, started by reviewing the lung cancer landscape, including its high mortality rate and the issues associated with the disease. He also talked about how patients are often diagnosed in later stages.

He spoke of the patient profile for ALK-positive NSCLC and discussed molecular testing guidelines. He also discussed the challenge of heterogeneity of tumor types and brain metastasis.

Following the product theater and a cocktail reception with exhibitors, guests gathered in the Starvine rooms and Foyer for the second annual Heroes of Hope™ Event.

Heroes of Hope™ Event

Following a day full of presentations, and a cocktail hour with exhibitors and colleagues, guests gathered in the Starvine rooms and Foyer for the second annual Heroes of Hope™ Event. This “old Vegas”–themed evening featured drinks and food, appearances by Vegas show girls, and a performance by Rat Pack impersonators. The highlight of the evening was the announcement of this year’s Hero of Hope Patient Award winner.

After Lillie D. Shockney, RN, BS, MAS, Program Director and Co-Founder of AONN+, provided some background about the Hero of Hope Patient Award, the audience was treated to a moving video montage about the 6 Hero of Hope nominees, their battles with cancer, and the ways in which they are now helping others.

Maryann Wahmann of Long Island, NY, was then announced as the 2016 Hero of Hope recipient. Ms. Wahmann’s ongoing battle with carcinoid cancer, a type of neuroendocrine tumor (NET), led her to found the Neuroendocrine Cancer Awareness Network (NCAN) in 2004. NCAN exists to raise awareness for NET, including carcinoid, to connect patients and providers from around the world with access to NET information, and to fund NET cancer research.

Thank you to all of our sponsors and exhibitors!

Related Items
Highlights from Sunday, November 20, 2016
Conference Highlights published on November 20, 2016 in 2016 Annual Conference
After enjoying a fun-filled Heroes of Hope™ Event the night before, guests of AONN+’s Seventh Annual Navigation & Survivorship Conference were up bright and early for the final day of education and networking.
Highlights from Friday, November 18, 2016
Conference Highlights published on November 18, 2016 in 2016 Annual Conference
The morning began with a breakfast N.E.X.T. Day session sponsored by Bristol-Myers Squibb. Peg Esper, DNP, ANP-BC, AOCN, discussed Opdivo (nivolumab) therapy, which is a fully human monoclonal antibody indicated for previously treated metastatic non–small-cell lung cancer. She reviewed the CheckMate 057 study, which looked at standard-of-care therapy, docetaxel, and Opdivo.
Highlights from Thursday, November 17, 2016
Conference Highlights published on November 15, 2016 in 2016 Annual Conference
More than 900 nurse and patient navigators converged on the Las Vegas Aria today to kick off AONN+’s Seventh Annual Navigation & Survivorship Conference! For participants, the day began with the long-awaited nurse navigation and patient navigation certification exams. These are the industry’s first certifications specifically for navigators, and AONN+ is honored to be setting the standard in this area.