The National Institute of Nursing Research (NINR) is a branch of the National Institutes for Health (NIH). Its strategic plan to guide nurse scientists includes these five priorities: Health Equity, Social Determinants of Health, Population and Community Health, Prevention and Health Promotion, and Systems and Models of Care. Nursing research takes place in communities, schools, hospitals, ambulatory settings, and long-term care facilities. Nursing research, like medical research, is required to have Institutional Review Board (IRB) approval. IRB review ensures protection of human subjects. The IRB safeguards the rights, welfare, and well-being of human subjects involved in research studies, helping to ensure that research is conducted ethically and responsibly.
Cancer is a leading cause of death around the world and rates of new cases and cancer-related deaths are projected to reach nearly 29 million and 16 million, respectively, by 2040. As the global incidence of cancer increases, much of this burden continues to be shouldered by low- and middle-income countries that lack the basic prevention methods, diagnostic tools, and cost-effective treatments routine in high-income countries. Efforts to improve cancer care around the world focus largely on delivering known interventions to these countries in ways that are practical and sustainable for those environments. Opportunities for global cancer research include implementing tobacco cessation strategies, improving access to vaccination, training health care workers to better diagnose and treat cancer, establishing portable cancer screening and treatment clinics, studying indigenous plants or products for anticancer properties, developing anti-cancer products that do not require refrigeration, and more.
Oligometastatic breast cancer is a rare variety of breast cancer that occurs in about 1% to 10% of newly diagnosed patients. The term “oligometastatic” is used to describe disease that has spread beyond the primary tumor site but is limited in its extent of metastasis; most experts would consider oligometastatic disease to include 5 or fewer metastatic lesions. Oligometastatic cancer is thought to have a less aggressive tumor biology than widespread metastatic disease and is associated with an overall better prognosis. Furthermore, de novo oligometastatic breast cancer may be uniquely responsive to treatment. Thus, unlike the typical metastatic state, treatment of oligometastatic cancer can often be approached with curative intent by using multimodal therapies similar to early-stage disease. Based on multidisciplinary discussion with surgical, radiation, and medical oncologists, it may be feasible to administer neoadjuvant systemic therapy and conduct resection of the primary tumor with ablation of metastatic sites before proceeding to maintenance treatment.
Clinical trials have long been associated with large academic institutions, but there has been a push in recent years to introduce more clinical trials into the community setting. Given that most cancer care occurs in the community setting, it is important to ensure that access to research is equitable for all patients regardless of their geographical location. Running clinical trials in the community setting, however, is not a walk in the park. Interviews with community oncologists have identified many perceived barriers to trial participation, from system and trial challenges to physician and patient barriers.
Pancreatic cancer is one of the deadliest solid tumors, with only 12.5% of patients estimated to survive 5 years. The ambiguous symptomatology and lack of extensive treatment options make pancreatic cancer an especially challenging disease to manage. Research efforts in this disease state are vital to learning more about its biology and developing better therapies. Patients and families also need more information to guide them through the pancreatic cancer journey that is often too fast and too shocking. Seven years ago, the desire for a “one-stop-shop” community in pancreatic cancer led to the creation of an advocacy organization called Let’s Win Pancreatic Cancer, founded by Dr. Allyson Ocean, her patient Anne Glauber (public relations executive), Kerry Kaplan (CEO of the Lustgarten Foundation), Willa Shalit (entrepreneur and philanthropist), and Cindy Price Gavin (Founding Executive Director).
Less than 15% of US oncologists participate in clinical research, and of these, very few are community-based providers, even though most cancer care in this country is provided in community settings. Moreover, 8 out of 10 trial participants learn about clinical trials through their provider, so if the majority of community providers are not involved in research, and the majority of cancer patients are treated in the community, then it would stand to reason that the majority of cancer patients across the country are not consistently being offered clinical trial options.