<IMER - Colorectal Cancer 2008: Progress and Prospects
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Colorectal Cancer 2008: Progress and Prospects

This program was originally presented as an educational symposium during the ONS 33rd Annual Congress.

Friday, May 16, 2008
6:00 am – 8:00 am (EST)

Pennsylvania Convention Center
Ballroom A
Philadelphia, Pennsylvania

Release Date: June 2008
Expiration Date: June 2009
Estimated Time to Complete Activity: 90 minutes (Adobe Flash Player and Adobe Acrobat Reader required)

Posttest

I have read and understand the information presented on this page and agree to proceed with the educational activity.

Target Audience

This activity has been designed to meet the educational needs of patient care oncology nurses and related healthcare professionals attending.

Purpose

To educate nurses on new and emerging therapeutic options for the treatment of colorectal cancer (CRC).

Program Overview

As we enter 2008, oncology nurses have witnessed remarkable progress in the treatment of CRC. In this 2-hour symposium, a physician CRC thought leader will reflect on recent progress and discuss the clinical implications of emerging research data in the neoadjuvant, adjuvant, and metastatic settings. A similar presentation, led by an oncology nurse expert, will highlight developments in symptom management and supportive care strategies.

Learning Objectives

Upon completion of this program, participants should be better able to:

  • Describe recent clinical trial data on the use of cytotoxic and biologic agents in patients with CRC in the neoadjuvant, adjuvant, and metastatic settings
  • Explain current understanding of biologic markers/genetic profiling as they relate to identifying treatment efficacy and toxicity
  • Outline toxicity profiles of neoadjuvant, adjuvant, and metastatic CRC treatment regimens
  • Discuss emerging research data when determining patient symptom management and supportive care strategies
  • Choose appropriate counsel for patients and families regarding prognosis and treatment strategies based on emerging clinical data

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the U.S. Food and Drug Administration. The Institute for Medical Education and Research (IMER), Genentech BioOncology, and sanofi-aventis U.S. do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of IMER, Genentech BioOncology, and sanofi-aventis U.S. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclosure of Conflicts of Interest

IMER requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by IMER for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this educational activity:

Please refer to the individual faculty bios for statements.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this educational activity:

Madelyn T. Herzfeld, RN, BSN, OCN®, reported no areas of conflict.

Michael Bramwell reported no areas of conflict.

Dorothy Dulko, PhD, RN, AOCNP®, reported no areas of conflict.

Davecia Ragoonath, MS, reported no areas of conflict.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

 

 

 

Sponsored by:

IMER
  

This activity is supported by independent educational grants from Genentech BioOncology and sanofi-aventis U.S.
 

Faculty

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP® (Chairperson)
University of California, San Francisco
  • Bio
  • Abstract

Ms. Viale is an assistant clinical professor in the Department of Physiological Nursing at the University of California, San Francisco, where she also received her master’s degree in oncology nursing. She has lectured nationally and written journal articles on various oncology nursing topics. She is also a member of the editorial advisory board for the ONCOLOGY Nurse Edition publication, and is an expert panel member for the ManageCRC.com Web site, which provides information on colorectal cancer for nursing professionals.

Pamela Hallquist Viale, RN, MS, CS, ANP, AOCNP®, reported a financial interest/relationship or affiliation in the form of: Consultant, Institute for Medical Education & Research, Meniscus Educational Institute, and Bristol-Myers Squibb Company; Speakers’ Bureau, Institute for Medical Education & Research, Meniscus Educational Institute, Bristol-Myers Squibb Company, Novartis Pharmaceuticals Corporation, Amgen, Inc., and Merck & Co., Inc.

Symtom Management

The treatment of colorectal cancer has changed dramatically in the last decade, from a single therapy (used for the last four decades), expanding to include six new agents used in various combinations. These innovations have led to increased survival. Patients with colorectal cancer can expect to live 2 years or longer with metastatic disease; those receiving adjuvant treatment also survive for longer periods. Patients receiving some of these therapeutic agents may experience toxicities that are sustained. Oncology professionals often struggle with symptom management of adverse events associated with colorectal cancer therapies. This is a critical issue especially as patients are living longer with the disease. This presentation will highlight symptom management issues in the care of patients with colorectal cancer, including pertinent studies, selected toxicities of therapy and management strategies, and the use of treatment holidays or sequencing of therapies to improve quality of life without sacrificing efficacy of therapy. Specific postmarketing toxicities will also be discussed with an emphasis on the role of the oncology nurse in their identification. Patients with colorectal cancer are surviving longer than ever before and healthcare professionals should be cognizant of the issues relevant to the care of patients with this common malignancy.

Daniel G. Haller, MD
Abramson Cancer Center of the University of Pennsylvania
  • Bio
  • Abstract

Dr. Haller is a professor of medicine at the University of Pennsylvania School of Medicine, Philadelphia. He received his doctor of medicine from the University of Pittsburgh, Pennsylvania, and completed his fellowship in medical oncology at the Georgetown University Hospital, Washington, DC. His research interests include both pancreatic and gastrointestinal oncology. Dr. Haller has been published in numerous journals, including Cancer, Annals of Internal Medicine, American Journal of Clinical Oncology, and The New England Journal of Medicine. He is also an active member of the American Joint Commission on Cancer and National Institutes of Health.

Daniel G. Haller, MD, reported a financial interest/relationship or affiliation in the form of: Consultant, Genentech BioOncology and sanofi-aventis U.S.; Contracted Research, Bristol-Myers Squibb Company and Roche Laboratories, Inc.

Adjuvant Therapy/Metastatic Disease

Throughout the past several years, significant strides have been made in the number of therapeutic options available to patients with colorectal cancer (CRC) along with a concomitant increase in overall survival times. However, controversy continues to surround the management of patients with high-risk stage II disease, specifically, factors that may increase risk of recurrence. This presentation will highlight data from recent clinical trials such as the Combined Oxaliplatin Neurotoxicity Prevention Trial (CONCEPT) and the Multicenter International Study of Oxaliplain/5-FU/LV in the Adjuvant Treatment of Colon Cancer (MOSAIC) Trial. A practicechanging discovery—the identification of the KRAS mutation that may allow clinicians to identify which patients will not benefit from treatment with cetuximab and panitumumab—will be presented, in addition to treatment options and the future goals of adjuvant therapy.

Margaret F. Bishop, MS, ARNP
Dartmouth-Hitchcock Medical Center
  • Bio
  • Abstract

Ms. Bishop is a nurse practitioner at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. She received her master’s degree in nursing from Virginia Commonwealth University in Richmond. Her primary research interest is in the use of bone marrow transplant for the treatment of patients with cancer. In addition to her clinical responsibilities, Ms. Bishop regularly teaches the Oncology Nursing Society chemotherapy/biotherapy course, participates in training sessions of the End of Life Nursing Education Consortium, and presents on a variety of palliative care topics at both the local and national level.

Margaret F. Bishop, MS, ARNP, reported no areas of conflict.

Concepts in Caring: Patient/Family Communications Regarding CRC Progress and Prospects

Patients with colorectal cancer are living longer than ever. As such, they face a multitude of transitions (from changes in the ability to perform activities of daily living to facing difficult decisions following treatment failure) as they move through different stages of illness and treatment. These changes produce a sense of loss and a necessity for the patient to discover ways to adapt to their new circumstances. The goal of effective communication with sensitivity and empathy lies at the heart of nursing interactions with patients during the course of cancer therapy. Patients want and need support during all phases of their illness experience, but especially at transition points. It is the responsibility of the oncology nurse as a compassionate and capable provider to help guide patients emotionally as well as physically. There are numerous tools to help nurses devise appropriate strategies for effectively communicating with patients while maintaining a balance of practicality and hope. One such tool is SPIKES, a six-step protocol for dialogue with patients. This presentation will highlight ways to address the emotional aspects of each patient’s experience and provide insights into areas that need special attention. How can oncology healthcare providers best meet the needs of this patient population? How do healthcare providers inadvertently hinder communication and how can they encourage it? How does the concept of hope play a role as the patient’s disease progresses? How can providing a sense of optimism be balanced with realistic expectations? It is perceived that difficult conversations with patients about prognosis, limited or no treatment options, hospice and end of life care contradict the concept of hope. On the contrary, we will see how having these discussions can maintain a patient’s sense of hope. As a patient’s cancer progresses, it is the personal side of their relationship with their healthcare provider that takes precedence over the medical one. They want to be recognized and respected as unique individuals, they want to be heard, they want to be told the truth, they want time to ask questions and express concerns. These considerations should be taken into account when providing care for the patient with cancer.

 

 

Accreditation Statements

This educational activity for 2.0 contact hours will be provided by the Institute for Medical Education & Research (IMER). IMER is an approved provider of continuing education by the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

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