CANCER BUZZ

The science of oncology is rapidly evolving, as cancer programs and practices around the US continue to make cutting-edge discoveries in the diagnosis and treatment of cancer. In addition, there is an increased spotlight on the effects social drivers of health have on cancer care delivery, as health equity initiatives continue to permeate the oncology landscape.

Building on these successes, NCI released the National Cancer Plan on April 3, 2023. The plan outlines goals designed to support the objectives of Cancer Moonshot. In support of this effort, the President’s Cancer Panel held its first National Cancer Plan Stakeholder meeting September 7, 2023.

ACCC was invited to share the association’s key priorities for impacting cancer care in the US. ACCC president Olalekan Ajayi, PharmD, MBA, and chief operating officer at Highlands Oncology Group, PA, discusses the meeting and these initiatives.

Guest:

Olalekan Ajayi, PharmD, MBA

President, ACCC

Chief Operating Officer,

Highlands Oncology Group, PA

Fayetteville, AR

Resources:

●      President’s Cancer Panel

●      National Cancer Plan

Live this week from the ACCC 40th National Oncology Conference (NOC), CANCER BUZZ interviews Debbie Rimmele, Nurse Retention Specialist at the Loyola University Medical Center, about recruiting strategies and her session at the NOC: Looking Under the Hood of the Employment Process.

Once candidates are in the hiring queue, there are many internal processes that need to go smoothly to offer potential employees the best experience. These steps in the employment process are critical to making a positive first impression. Many candidates are shopping places so to retain a competitive edge, learn how to put your best foot forward to show off your workplace culture.

Guest:

Debbie Rimmele, BSN, RN, OCN, CPC

Nurse Retention Specialist

Loyola University Medical Center

Resources:

Turning Off Turnover

A Perfect Fit: Mentoring Experienced RNs to Meet Oncology Clinic Demand

Onboarding Experienced Non-Oncology Nurses to Address Staffing Shortages: Development of a Transitional Oncology Training Academy

Making the Business Case for New Staff

Live this week from the ACCC 40th National Oncology Conference (NOC), CANCER BUZZ interviews Steve Kennedy, Senior Vice President of Human Resources at Tennessee Oncology, about his session: Leadership Engagement and Sustainment During Challenging Times.

The Tennessee Oncology Leadership Academy launched in July 2020 with the purpose of building a culture of collaborative and agile leaders. Since its launch, the academy has enrolled 157 team members, with 88 leaders graduating from the program. The practice has seen a 96% retention rate of these graduates, and 13 graduates have been promoted to new positions. Currently, 69 high-potential team members and/or leaders are enrolled in the academy. Built around a cohort structure and a blended instructional format, the academy offers 4 pathways based on readiness that guide participants through 3 leadership domains: self, other, and organization. The key to the academy's success is the transition of its instructors into coaches for those who graduate from the program.

Guest:

Steve Kennedy

Senior Vice President, Human Resources

Tennessee Oncology

Resources:

Strengthening Your Oncology Workforce: How to Approach Leadership and Team Building

Healthy Leadership Strategies: Take a Time Out to Walk

How to Lead Effective Meetings

Effective Leadership Strategies: Defining + Helping Others with Their Purpose

Combatting Healthcare Workforce Issues with Proven Leadership Skills

Tips for Building a Resilient Oncology Team

Billing and Coding Fundamentals for Leaders in Oncology

Live this week from the ACCC 40th National Oncology Conference, CANCER BUZZ interviews Dr. Michael Gieske about best practices to increase lung cancer screenings and ACCC's Rural Appalachian Lung Screening Initiative.

ACCC launched the Appalachian Community Cancer Alliance (the Alliance) in partnership with several state oncology societies representing the Appalachian region. The focus is on improving patient and operational cancer outcomes by identifying effective evidence-based practices that can be replicated throughout the region. One of the major initiatives under the Alliance is to increase lung cancer screenings in Appalachia where the cancer mortality rate is 10 percent higher than the national rate.

Guest:

Dr. Michael Gieske

St. Elizabeth

Edgewood, KY

CANCER BUZZ previews the sessions, people and topics of this week's ACCC 40th National Oncology Conference. We interview Kathy Oubre, MS, CEO of the Pontchartrain Canter Center, about helping patients overcome access barriers to biomarker testing.

Guest:

Kathy W. Oubre, MS

Chief Executive Officer

Pontchartrain Cancer Center

Hammond, Louisiana

Resources:

Access to Biomarker Testing - American Cancer Society Cancer Action Network

The Road to Comprehensive Biomarker Testing for All – ACCC Buzz Blog

Precision Medicine in Rural and Underserved Areas – ACCC Buzz Blog

Patient Perceptions of Biomarker Testing – Oncology Issues

Cancer Diagnostics - Biomarkers

Eliminating Precision Medicine Disparities

CANCER BUZZ previews the sessions, people and topics of this week's ACCC 40th National Oncology Conference. We interview Dr. Margaret Liang, about ACCC's Financial Advocacy Network (FAN), and the Financial Advocacy Services guidelines.

Guest:

Margaret Liang, MD, MSHPM

Associate Director, Gynecologic Oncology Fellowship

Cedars-Sinai Cancer Center

Los Angeles, CA

Resources:

ACCC Financial Advocacy Network

ACCC Financial Advocacy Services Guidelines

Financial Advocacy Playbook

Financial Advocacy Boot Camp

Financial Advocacy Toolkit

Bladder cancer cases continue to rise regardless of treatment advances. In addition, disparities in bladder cancer persist, especially with respect to race. There is a documented connection between patient demographics and the impact on health outcomes. ACCC launched the Addressing Disparities in Bladder Cancer Care project to help cancer centers apply evidence-based health literacy and shared decision-making principles and strategies to reduce disparities in bladder cancer care.

CANCER BUZZ spoke to Mary W. Dunn, MSN, RN, OCN, NP-C, Adult Nurse Practitioner of Urology and Medical Oncology at the UNC Lineberger Comprehensive Cancer Center in Chapel Hill, North Carolina, and Samuel L. Washington III, MD, MAS, Assistant Professor of Urology at the University of California in San Francisco, California. Listen as we discuss best practices in health literacy, shared decision-making for bladder cancer care, disparities experienced by female patients, and educational resources being developed through the Addressing Disparities in Bladder Cancer Care initiative.

"Phase 1 analysis of the Bladder Cancer Care Initiative found major gaps in guideline concordant care of all bladder cancer patients, particularly populations that are already facing disparities."

Samuel L. Washington III

"I think when you're dealing with something that is as delicate and difficult and potentially traumatic as a cancer diagnosis and cancer treatment, ensuring that the patient knows that their voice matters in the treatment decision making process is huge, and incorporating their goals of care…"

Mary W. Dunn

"When it comes to effective health literacy practices, the first step is really understanding the difference between literacy (how comfortable people are at reading and their reading level) and health literacy, which is almost a separate language of medical jargon and terms. These terms do not correlate or aren't a 1 to 1 equivalent comparison."

Samuel L. Washington III

Mary W. Dunn, MSN, RN, OCN, NP-C

Adult Nurse Practitioner, Urology and Medical Oncology

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, NC

Samuel L. Washington III, MD, MAS

Assistant Professor of Urology

University of California

San Francisco, CA

Resources:

CancerCare's shared decision making tool - "What Matters to Me"

Bladder Cancer Advocacy Network's (BCAN) - Treatment Matrix

Cancer Support Community

ACCC Health Literacy and Clear Communication eCourse

AHRQ Health Literacy Universal Precautions Toolkit

This project is supported by EMD Serono and Pfizer.

It is important for the cancer team to be able to recognize what a small cell might look like— such as central location of the tumor, bulky adenopathy generally. Sometimes patients present with unexplained weight loss and/or hemoptysis because of the central location of the tumor. It is important to be able to pick up on risk factors and understand the importance from symptoms to diagnosis and diagnosis to treatment. CANCER BUZZ spoke to Adam Fox, MD, Pulmonologist, Medical University of South Carolina in Charleston, South Carolina. Listen as Dr Fox discusses the importance of recognizing and diagnosing small cell lung cancer (SCLC).

"In most patients, while small cell only accounts for 10% to 15% of all lung cancers, almost all patients with small cell lung cancer have a smoking history…"

"Fundamentals for anyone with lung cancer is to pick that biopsy site that is going to provide the diagnosis, at least some stage information, and any tissue needed for extra stains (to confirm the diagnosis), or mostly the case for non-small cell lung cancer, biomarker testing for making treatment decisions."

Adam Fox, MD

Pulmonologist

Medical University of South Carolina

Charleston, SC

ACCC's SCLC program is supported by AstraZeneca and G1 Therapeutics.

Resources:

Cancer Support Community

Go2 for Lung Cancer

LUNGEVITY

Lung Cancer Research Foundation

This cancer program used a business intelligence-enabled dashboard to collect and analyze data on emergency department (ED) visits, admits, and discharges. These data were then used to improve patient triage and evaluation through development of an Express Symptom Management program. After targeted in-service training and education to clinical teams and patients on utilization of the new program, only 2% of patients needed to be seen in the ED, with the rest receiving symptom management by phone, participating in a virtual clinic visit, and/or coming into the infusion suite for in-person assessment and treatment. Improvement efforts around patient self-management and triage to the Express Symptom Management program also included development of a pre- and post-initial infusion visit via Epic MyChart.

Guest:

Dana Salcedo, MSN, APRN, NP-C

Oncology Nurse Practitioner, Express Symptom Management & Outpatient Infusion

Orlando Health Cancer Institute

Orlando, Florida

"Ultimately our role was to prevent ED admissions, but also to help reduce stress, manage common side effects, and to let patients know they had a resource available to them at a moment's notice."

This podcast is part of a special series with the 2023 ACCC Innovator Award winners. For a deeper dive into this and other content that will help your team reimagine how care is delivered at your cancer program or practice, register today for the ACCC 40th National Oncology Conference, Oct. 4-6, in Austin Texas.

Resources:

Deploying Technology Across an Interdisciplinary Team to Improve Oral Oncolytic Compliance

Expediting Cancer Treatment Through a Rapid Access APP-Led Diagnostic Clinic

An APP-Physician Model Improves Risk Stratification and Palliative Care

Reducing ED Visits and Hospital Admissions after Chemotherapy with Predictive Modeling of Risk Factors

Utilizing Technology to Identify Patient Co-Morbidities and Reduce Hospital and ED Admissions

Right Place, Right Provider, Right Time: Implementing Our 24-Hour Cancer Clinic

As geography and regional differences can play a major role in disparities in cancer care, learn how cancer programs can collaborate with local community outreach organizations to improve access to care and support underserved populations. In this episode, CANCER BUZZ speaks with Farrukh T. Awan, MD, MS, professor of Internal Medicine and director of Lymphoid Malignancies at the Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, about their approach to addressing regional barriers to improve care for patients with chronic lymphocytic leukemia.

"Time to get to appointments, the driving distance, the traffic issues, the cost of travel, housing/lodging, food—I think those are some of the biggest challenges we see in our patients, especially in our part of the country, where distances are huge and traffic can be an issue in major cities…" – Farrukh Awan, MD, MS

Guest: Farrukh T. Awan, MD, MS

Professor of Internal Medicine

Director of Lymphoid Malignancies Program

Harold C. Simmons Comprehensive Cancer Center

University of Texas Southwestern Medical Center

Dallas, TX

This podcast was created in connection with the education program A Regional Approach to Advancing Care for Patients with Chronic Lymphocytic Leukemia. This episode was made possible with support by AstraZeneca, Janssen Oncology, and Pharmacyclics.

Additional Reading/Sources

· Chronic Lymphocytic Leukemia (CLL) Resources

· Multidisciplinary Chronic Lymphocytic Leukemia Care (accc-cancer.org)

· Quality Improvement Case Studies

· CLL: Models of Effective Care Delivery

· Podcast EP 104: Addressing Regional Challenges to Equitable Care for Patients with CLL

· Podcast EP 105: Best Practices in Caring for Patients with CLL in a Post-COVID Era

· Podcast EP 57: COVID-19 Challenges: Managing Patients with CLL

· Chronic Lymphocytic Leukemia (CLL) (cancer.org)

· Addressing Racial Disparities in CLL Care - Patient Empowerment Network (powerfulpatients.org)

· CLL Resources - CLL Society