“It can be emotional waiting for testing results before starting treatment”

The role of the oncology nurse in supporting patients and genomic education is a pivotal one, Oncology Clinical Specialist Erin Dickman, MS, RN, OCN tells Danielle Barron

Oncology nurses have a very specific, very important role when it comes to supporting patients through what can be a complex treatment journey. Can you elaborate on this?

Oncology nurses have an essential role on the healthcare team to support their patient through their cancer journey which includes any genomic-informed care. The application of genomics to oncology nursing includes adopting consistent and accurate genomic terminology, educating patients and family members about the biomarker testing process and participating in the process, understanding possible outcomes of biomarker testing and implications for cancer care, translating complex findings through patient and family education, identifying when a patient should be referred to a genetics professional, providing emotional support to patients and family through the testing process, and advocate for a precision medicine approach

Genomics and precision oncology is a relatively new field that is of increasing importance in the oncology community. How has it changed practice?

The utilization of biomarker testing to inform diagnosis, prognosis, treatment decisions, symptom management, and monitoring response to therapy has shifted many parts of cancer care and in response, the workflow and scope of the oncology nurse. For example, in some cases, biomarker testing results are part of the workup for a person newly diagnosed with cancer. It can be emotional waiting for testing results before starting treatment and the nurse is there to guide, educate, and support the patient through that time. Another example is genomic testing technologies, which has led to novel therapy advancements and additional treatment options for patients who are now living longer. Nurses are now supporting people with longer survival times and different symptom profiles.

What are the challenges in educating patients on these developments? What are the opportunities?

Genomics is complex and the rapid advancements and application of this science into practice is evolving by the day. This makes it challenging for nurses to keep up with the correct terminology and integrate the most up to date information into their practice. Many nurses lack confidence and knowledge about genomics concepts because they did not get the content in their educational preparation. ONS is working to fill this practice gap through an extensive Genomics and Precision Oncology Learning Library that includes genomics taxonomy and on-demand education that spans from 5 mins –  one hour depending on the time that you have. We have also developed clinical practice resources to be used at the point-of-care to inform conversations with patients or show them a video to prepare for their genetic counseling appointment. A clinical decision support tool, the ONS Biomarker Database, was just launched to bring precision medicine to the point-of-care for oncology nurses. It will help nurses better understand biomarker testing reports and much more.

Why did the ONS develop the Learning Library? Who is it aimed at and what kind of information does it include?

The Library of resources was created to support the oncology nurse that cares for patients that would benefit from genomic-informed care. It provides ONS developed patient education, clinical practice resources to have at your fingertips for reference in daily practice, learning activities that include bite and snack size videos, podcasts, and a free basics course that takes about one-hour – this course will launch in mid-July. All of the resources provided in the learning library were built through collaboration of nurses from a variety of backgrounds and experiences with expertise in genomics. We have an avid review process to ensure the content is up to date and reflects the current state of the science.

How important is provider-patient communications when it comes to a complex topic such as genomics and precision medicine? How can it help improve access?

Consistent communication of genomic information among healthcare professionals and between the healthcare professional and patient/caregiver is extremely important to build trust and deter misconceptions of the patient. Shared decision-making cannot occur if anyone in the decision-making has different information than another or lacks understanding. It is imperative that time is spent as healthcare providers using the same language and being knowledgeable of precision medicine offerings and then translating that information to the patient so they can make informed decisions about their care. In addition, it may provide them broader access to care and novel treatments through clinical trial eligibility.