nursing research topics oncology

Oncology Nursing Research Paper Topics

The realm of oncology nursing research paper topics is crucial and multifaceted. This area delves into a range of issues from cancer pathophysiology, treatment modalities, palliative care, and the psychosocial aspects of cancer, among others. Given the rising prevalence of cancer worldwide, oncology nursing continues to evolve, necessitating ongoing research to optimize patient care, enhance nursing practice, and contribute to the better understanding of this complex disease. This article will provide a comprehensive list of topics for research papers, a detailed article discussing the significance and range of topics oncology nursing offers, and an introduction to iResearchNet’s writing services to aid in the preparation of high-quality research papers.

100 Oncology Nursing Research Paper Topics

Oncology nursing plays a pivotal role in the management of cancer patients, encompassing care during diagnosis, treatment, survivorship, and end-of-life stages. The practice involves not only the physical aspects of care but also the psychological, social, and spiritual dimensions, making it a deeply multidimensional and complex field. As a result, the range of oncology nursing research paper topics is vast, encompassing everything from the pathophysiology of cancer to ethical and legal issues in oncology nursing. This comprehensive list of topics aims to inspire and guide students and researchers in exploring the various dimensions of oncology nursing, ultimately contributing to the body of knowledge that informs practice and improves patient outcomes.

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Cancer Pathophysiology and Staging

• The role of oncology nurses in cancer staging.
• Understanding the genetic basis of cancer.
• The impact of tumor microenvironment on cancer progression.
• The role of inflammation in cancer development.
• The significance of tumor markers in cancer diagnosis.
• Understanding the metastatic process.
• The role of immune system in cancer development.
• The impact of hormonal imbalances on cancer development.
• The significance of angiogenesis in tumor growth.
• Understanding the role of oncogenes and tumor suppressor genes.

Cancer Treatment Modalities

• The role of oncology nurses in administering chemotherapy.
• Understanding the mechanisms of action of targeted therapies.
• The role of immunotherapy in cancer treatment.
• The impact of radiation therapy on patient well-being.
• The significance of surgical interventions in cancer treatment.
• Understanding the role of hormonal therapy in cancer treatment.
• The role of stem cell transplantation in cancer treatment.
• The impact of alternative therapies in cancer treatment.
• Understanding the side effects of cancer treatment modalities.
• The role of oncology nurses in managing side effects of cancer treatment.

Palliative and End-of-life Care

• The role of oncology nurses in providing palliative care.
• Understanding the principles of palliative care in oncology nursing.
• The significance of pain management in end-of-life care.
• The role of oncology nurses in providing spiritual care at the end of life.
• The impact of family involvement in end-of-life care.
• Understanding the psychological challenges faced by patients at the end of life.
• The role of advance care planning in end-of-life care.
• The impact of hospice care on the quality of life of cancer patients.
• Understanding the ethical dilemmas faced by oncology nurses in end-of-life care.
• The role of oncology nurses in bereavement support.

Pediatric Oncology Nursing

• The challenges faced by pediatric oncology nurses.
• Understanding the unique needs of pediatric cancer patients.
• The impact of cancer on the developmental stages of children.
• The role of oncology nurses in providing family-centered care to pediatric cancer patients.
• The significance of pain management in pediatric oncology nursing.
• Understanding the psychosocial challenges faced by children with cancer.
• The role of oncology nurses in supporting the siblings of children with cancer.
• The impact of school reintegration on children with cancer.
• Understanding the ethical dilemmas faced by pediatric oncology nurses.
• The role of oncology nurses in palliative care for children with cancer.

Geriatric Oncology Nursing

• The challenges faced by geriatric oncology nurses.
• Understanding the unique needs of older adults with cancer.
• The impact of comorbidities on cancer treatment in older adults.
• The role of oncology nurses in providing individualized care to older adults with cancer.
• The significance of palliative care in geriatric oncology nursing.
• Understanding the psychological challenges faced by older adults with cancer.
• The role of oncology nurses in supporting the caregivers of older adults with cancer.
• The impact of geriatric assessment on cancer treatment planning.
• Understanding the ethical dilemmas faced by geriatric oncology nurses.
• The role of oncology nurses in end-of-life care for older adults with cancer.

Psychosocial Aspects of Cancer

• The impact of cancer diagnosis on mental health.
• Understanding the role of oncology nurses in providing psychosocial support.
• The significance of social support in cancer treatment.
• The role of oncology nurses in supporting patients with body image issues related to cancer treatment.
• The impact of cancer on relationships.
• Understanding the challenges faced by cancer survivors.
• The role of oncology nurses in supporting cancer patients with depression and anxiety.
• The impact of cancer on the quality of life.
• Understanding the psychosocial needs of patients with advanced cancer.
• The role of oncology nurses in providing support to patients with cancer-related fatigue.

Patient Education and Support

• The role of oncology nurses in providing patient education.
• Understanding the principles of patient education in oncology nursing.
• The significance of health literacy in cancer treatment.
• The role of oncology nurses in providing support to patients undergoing genetic testing.
• The impact of patient education on treatment adherence.
• Understanding the challenges faced by patients in making informed decisions about cancer treatment.
• The role of oncology nurses in supporting patients with treatment-related decision-making.
• The impact of patient education on the quality of life of cancer patients.
• Understanding the information needs of cancer patients.
• The role of oncology nurses in providing support to patients during clinical trials.

Oncology Nursing Practice and Care Models

• The impact of evidence-based practice on oncology nursing.
• Understanding the role of oncology nurses in multidisciplinary teams.
• The significance of care coordination in oncology nursing.
• The role of oncology nurses in developing care plans for cancer patients.
• The impact of nurse-led clinics on the quality of care for cancer patients.
• Understanding the challenges faced by oncology nurses in resource-limited settings.
• The role of oncology nurses in providing culturally sensitive care.
• The impact of telemedicine on oncology nursing practice.
• Understanding the role of oncology nurses in clinical trials.
• The role of oncology nurses in quality improvement initiatives.

Ethical and Legal Issues in Oncology Nursing

• Understanding the ethical dilemmas faced by oncology nurses.
• The role of oncology nurses in obtaining informed consent.
• The significance of patient autonomy in oncology nursing.
• The role of oncology nurses in ethical decision-making.
• The impact of legal issues on oncology nursing practice.
• Understanding the challenges faced by oncology nurses in addressing end-of-life issues.
• The role of oncology nurses in protecting patient privacy.
• The impact of ethical dilemmas on the quality of care provided by oncology nurses.
• Understanding the role of ethics committees in oncology nursing practice.
• The role of oncology nurses in advocating for patients’ rights.

Emerging Trends in Oncology Nursing

• The impact of technological advancements on oncology nursing practice.
• Understanding the role of oncology nurses in precision medicine.
• The significance of immunotherapy in cancer treatment.
• The role of oncology nurses in the management of cancer-related fatigue.
• The impact of mobile applications on cancer care.
• Understanding the role of oncology nurses in the management of side effects of immunotherapy.
• The role of oncology nurses in supporting patients undergoing CAR-T cell therapy.
• The impact of artificial intelligence on oncology nursing practice.
• Understanding the future directions of oncology nursing research.
• The role of oncology nurses in promoting health equity in cancer care.

The importance of research in oncology nursing cannot be overstated. It is through research that we can better understand the needs of cancer patients, develop more effective interventions, and ultimately improve the quality of care provided. This list of oncology nursing research paper topics is by no means exhaustive, but it should serve as a starting point for students and researchers looking to explore this vital field. We encourage you to delve into these topics, contribute to the body of knowledge, and play a part in shaping the future of oncology nursing.

The Range of Oncology Nursing Research Paper Topics

Oncology nursing is a specialized field of nursing that focuses on the care of individuals with cancer and their families. It is a profession that requires a comprehensive understanding of the cancer disease process, strong clinical skills, and the ability to handle emotionally charged situations. The significance of oncology nursing cannot be overstated, as nurses play a critical role in the cancer care continuum, from prevention and early detection to treatment, survivorship, and end-of-life care. This article will discuss the importance of oncology nursing and examine various aspects of the profession, including cancer treatment modalities, palliative and end-of-life care, and the psychosocial aspects of cancer. It will also highlight a range of oncology nursing research paper topics that are pertinent to the field.

Significance of Oncology Nursing

Oncology nurses are integral members of the cancer care team, providing comprehensive care to patients and their families. They play a key role in administering treatments, managing side effects, providing education and support, and coordinating care. Nurses are often the first point of contact for patients, and they play a critical role in helping patients navigate the complex world of cancer care. They also serve as advocates for patients, ensuring that their needs and preferences are communicated to the rest of the healthcare team.

Cancer treatment is complex and multifaceted, often involving a combination of surgery, radiation therapy, chemotherapy, immunotherapy, and targeted therapies. Oncology nurses play a key role in administering these treatments and managing their side effects. For example, chemotherapy, a common cancer treatment, is often administered intravenously by oncology nurses. They must have a thorough understanding of the drugs being administered, their potential side effects, and any contraindications. Moreover, oncology nurses need to be skilled in assessing patients for any adverse reactions during and after treatment. This aspect of oncology nursing is critical as it helps in ensuring the safety and well-being of the patients.

Palliative and End-of-Life Care

Palliative care is an essential component of cancer care that focuses on relieving pain and other symptoms associated with cancer and its treatment. It is not only reserved for patients at the end of life but is an integral part of comprehensive cancer care from the time of diagnosis. Oncology nurses play a crucial role in providing palliative care by managing symptoms, providing psychosocial support, and coordinating care with other healthcare providers. End-of-life care, a subset of palliative care, focuses on providing comfort and support to patients in the final stages of life. Oncology nurses play a key role in providing compassionate end-of-life care, managing symptoms, and supporting patients and their families during this challenging time.

A cancer diagnosis can be incredibly stressful for patients and their families, leading to a range of psychosocial issues such as anxiety, depression, and fear. Oncology nurses play a crucial role in addressing these issues by providing emotional support, counseling, and education. They also play a key role in assessing patients for psychosocial distress and referring them to appropriate resources, such as social workers or psychologists. Addressing the psychosocial aspects of cancer is essential for ensuring the overall well-being of patients and their families.

Research is a fundamental aspect of oncology nursing, as it contributes to the development of evidence-based practices that improve patient outcomes. There are a wide range of oncology nursing research paper topics that can be explored, from the effectiveness of different treatment modalities to the psychosocial needs of cancer patients and their families. Here are a few examples of oncology nursing research paper topics:

• The effectiveness of nurse-led interventions in managing chemotherapy-induced nausea and vomiting.
• The impact of psychosocial interventions on the quality of life of cancer patients.
• The role of oncology nurses in providing palliative care to patients with advanced cancer.
• The effectiveness of patient education interventions in improving treatment adherence in cancer patients.
• The impact of nurse-led survivorship programs on the quality of life of cancer survivors.

These are just a few examples of the many oncology nursing research paper topics that can be explored. Research in this area is essential for developing interventions and strategies that improve the quality of care provided to cancer patients and their families.

Oncology nursing is a critical aspect of cancer care that involves providing comprehensive care to patients and their families throughout the cancer care continuum. It encompasses a wide range of responsibilities, from administering treatments and managing side effects to providing palliative and end-of-life care and addressing the psychosocial aspects of cancer. Research in oncology nursing is essential for developing evidence-based practices that improve patient outcomes. There are a wide range of oncology nursing research paper topics that can be explored, contributing to the body of knowledge in this vital field.

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Priorities for oncology nursing research: the 2013 national survey

Affiliations.

• 1 School of Nursing, University of Texas Health Science Center-Houston.
• 2 New York University in New York.
• 3 Acute Care and Health Systems Division, Yale University School of Nursing, New Haven, CT.
• 4 Virginia Commonwealth University in Richmond.
• 5 Oncology Nursing Society, Pittsburgh, PA.
• 6 Outcomes Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD.
• 7 Department of Science of Nursing Care in the School of Nursing, Indiana University in Indianapolis.
• 8 School of Nursing, University of Pittsburgh.
• 9 Department of Biostatistics, University of Texas M.D. Anderson Cancer Center in Houston.
• PMID: 24368240
• DOI: 10.1188/14.ONF.67-76

Purpose/objectives: To advance the goals of evidence-based care and prioritize the knowledge generation that addresses contemporary challenges in oncology nursing. Results are used to inform the development of the Oncology Nursing Society (ONS) Research Agenda and by the ONS Foundation to develop strategic research initiatives.

Design: Descriptive, cross-sectional survey.

Setting: Web-based survey.

Sample: 8,554 ONS members from all levels of education. All doctorally prepared members were invited to participate. A random stratified sample was obtained from the remainder of the membership.

Methods: The ONS Research Priorities Survey project team created the survey and analyzed and interpreted the results. Members received an email invitation and follow-up reminders for survey completion.

Main research variables: Oncology nursing research and evidence-based practice topic questions.

Findings: The response rate was 11%, which is comparable to previous surveys. Topics ranked included descriptive research on patient adherence; intervention studies to optimize adherence, achieve concordance with cancer screening guidelines in minority populations, manage neurologic and cardiovascular late effects, and manage symptoms and symptom clusters; and studies to identify optimal delivery models for survivorship care. These findings have direct implications for translating existing evidence into practice and underscore the need for intervention research focused on improving patient-centered outcomes.

Conclusions: Results provide a broad assessment of member views regarding oncology research priorities. Given the response rate, additional strategies to encourage member participation will be considered.

Implications for nursing: The results, together with the updates of the ONS Research Agenda, can guide ONS and ONS Foundation research and evidence-based practice initiatives.

Keywords: clinical practice; evidence-based practice.

• Cross-Sectional Studies
• Data Collection
• Educational Status
• Evidence-Based Nursing
• Fatigue / etiology
• Fatigue / nursing
• Needs Assessment
• Neoplasms / complications
• Neoplasms / nursing*
• Neoplasms / psychology
• Nursing Research*
• Oncology Nursing* / organization & administration
• Paraneoplastic Polyneuropathy / etiology
• Paraneoplastic Polyneuropathy / nursing
• Practice Guidelines as Topic
• Societies, Nursing
• Stress, Psychological / etiology
• Stress, Psychological / nursing
• Symptom Assessment
• United States

Grants and funding

• T32 NR011972/NR/NINR NIH HHS/United States

• Latest Articles
• Clinical Practice
• ONS Leadership
• Get Involved

Oncology nurse researcher

Oncology Nurses Drive Discovery in Cancer Clinical Research

In 2023, more than 15 novel drugs were approved by the U.S. Food and Drug Administration for oncology indications. They all underwent rigorous testing via a series of clinical trials to demonstrate their safety and effectiveness. As a nurse, you’re familiar with clinical research and may have even cared for patients on clinical trials. But do you know that you could build a career in clinical research?

The Power of Peer Review

If you’ve read an awe-inspiring professional nursing or healthcare article, textbook chapter, or book that hit the mark on quality, accuracy, and readability and found yourself opining, “How did the author do that ? I could never write something that great”—stop that thinking!

Current AI Studies in Oncology Nursing Lack Evidence of Ethics and Efficacy

Published evidence suggests that artificial intelligence (AI) technologies have promising potential for oncology nursing, but evidence gaps remain regarding ethical considerations and efficacy in clinical practice, researchers reported in Cancer Nursing . 

NIH Awards Nearly $5 Million for Research Grants to Advance Precision Medicine

The National Institutes of Health, through its All of Us Research Program, announced in January 2023 research funding opportunities to expand the use of the program’s data to advance precision medicine. NIH allocated up to $4.75 million in fiscal year 2023 for the research grants.

NINR Promotes Nursing Research to Achieve Health Equity

To address and achieve equity in health care , in fall 2022 the National Institute of Nursing Research (NINR) began offering new  funding opportunities for research studies aligned with the scientific framework outlined in the institute’s 2022–2026 strategic plan . The grants are available cyclically with three application periods per year.

Diverse Nursing Research Tackles Current Medical Challenges and Looks Toward Future

The National Institute of Nursing Research, an National Institutes of Health agency, released its 2022–2026 strategic plan in summer 2022 to support its mission of leading “nursing research to solve pressing health challenges and inform practice and policy—optimizing health and advancing health equity into the future.”

Healthcare Organizations Advocate for Clinical Trial Diversity in Letter to Congress

Healthcare organizations advocated to improve diversity among clinical trials in a letter sent to U.S. Congress in May encouraging the government to take steps as the reauthorization of the Prescription Drug User Fee Act (PDUFA) approaches . The PDUFA allows the U.S. Food and Drug Administration to review and approve drugs, but the authorization is set to expire in September of 2022.

NCI Hosts Virtual Roundtable Discussion on Expanding Clinical Trial Accrual

Driven by the reignited Cancer Moonshot, the National Cancer Institute (NCI) hosted a virtual roundtable discussion on the possibilities and challenges of increasing clinical trial accrual in May 2022.  

NCI Proposes Budget for Fiscal Year 2023

Driving “cancer research that spans the continuum from basic science to survivorship” and taking advantage of the “incredible opportunity to greatly reduce the impact of cancer on people’s lives and end cancer as we know it” takes an investment, the National Cancer Institute (NCI) acknowledged in its proposed budget for the 2023 fiscal year. However, fully funding “cutting-edge research, infrastructure, and training needed to harness these opportunities allows researchers better understand how to prevent and treat cancer.”

NCI Recognizes Three ONS Members as Champions and Changemakers

Where there’s cancer, there are oncology nurses. It’s been that way even before 1971, when President Richard Nixon established and signed into law the National Cancer Act to fight the “war on cancer,” which had just become the second leading cause of death in the United States. Born from the act, the National Cancer Institute (NCI) celebrates its 50th anniversary in 2021. As part of the celebration, it named three oncology nurses and ONS members on its champions and changemakers list— Betty Ferrell , PhD, FAAN, FPCN, CHPN, Deborah Watkins Bruner , RN, PhD, FAAN, and Christine Miaskowski , RN, PhD, FAAN—in recognition of their contributions to cancer prevention, early detection, and symptom science.

Nurse Researcher AIMS to Increase Screening for Malnutrition and Reduce Bowel Dysfunction

Research has identified an association between malnutrition and functional deficits in patients with cancer, regardless of age, and other studies confirm that malnutrition affects treatment tolerability, outcomes, and quality of life for patients with cancer. However, studies have also found that oncology clinicians do not consistently assess for malnutrition and functional deficits in clinical settings. 

NCI Uses Federal Funds to Increase Grant Paylines for Emerging Nurse Researchers

When the U.S. Congress passed the FY 2021 funding bill at the end of 2020, it recommitted its dedication to cancer research by increasing the National Institutes of Health’s National Cancer Institute’s (NCI’s) budget by $120 million.

NCI Gives a Midpoint Progress Update on the Cancer Moonshot

During his final State of the Union address in January 2016, former President Barack Obama appointed Joe Biden the lead on a new initiative: the National Cancer Moonshot. The goal was to find treatments, cures, and more understanding about cancer—a decade’s worth of progress in just five years. 

We Know Oncology Nurse Navigators Improve Patient Experience, but Measurement Is Difficult

In February 2019, my colleagues and I published a retrospective analysis of patient-reported satisfaction comparing those who had contact with an oncology nurse navigator (ONN) and those who did not. We analyzed surveys from patients with outpatient oncology infusion or radiation oncology visits in a 24-month period. First, we sorted the surveys into two groups—self-reported ONN contact (n = 315) and self-reported no contact with an ONN (n = 172)—and compared satisfaction.

NINR Asks Nurses for Meaning of Research

What does the future of nursing research mean to you? How can nurse scientist-led studies provide information you can use in your daily practice? What gaps do you see in evidence to support nursing care?

Nurses Are Central to Lung Cancer Screening Conversations

Participation in clinician and patient conversations about lung cancer screening—as well as the actual screening itself—is relatively low. According to one study, only 3.9% of screening- eligible patients had undergone lung cancer screening. Because the screening recommendations are newer, most patients are unaware that they exist, and research highlights that only 10%–12% of the patient population has had conversations with their clinicians about it.

Nurses Must Understand Health Disparities to Provide Effective Patient Education

Issues pertaining to geography, socioeconomic status, or racial or ethnic background can prohibit patients from accessing the treatment and care they need to successfully navigate their cancer diagnosis. Connecting patients to healthcare professionals and tailored interventions that educate, motivate, and reduce barriers can be a tremendous boon for their care and ultimately their outcomes.

Nurses Need Resources, Data to Support Patients Transitioning to Survivorship

Since the National Academies of Medicine (formerly the Institute of Medicine) issued Cancer Patient to Cancer Survivor: Lost in Transition in 2005, the oncology field has made small strides to implement successful survivorship resources to support patients after their treatment. Because of the vast differences in patient populations, disease types, study locations, and institutional resources, best practices to support patients transitioning from treatment to survivorship care are often unclear. This poses an issue for providers, and patients hear mixed messaging or little information for follow-up care. With many patients receiving treatment in outpatient settings, ambulatory oncology nurses must understand how to provide support for patients during their transition.

Ruth McCorkle Leaves Legacy of Innovation, Advancement in Oncology Nursing

ONS member Ruth McCorkle, PhD, RN, FAPOS, FAAN, had a storied, trailblazing career in oncology nursing, leading the way to advance nursing research, patient-centered care, and educational excellence. McCorkle passed away on August 17, 2019, surrounded by her close family, leaving behind an indelible legacy to the oncology nursing profession.        

Telehealth Programs Improve Symptom Management at Home

Beta Data Browser Puts Precision Medicine Cohort at Researchers’ Fingertips

The future of cancer care is here: precision medicine has led to many of today’s newest cancer treatments and has made incredible progress since former President Barak Obama first announced the U.S. Precision Medicine Initiative (PMI) in 2015.

Nurses Are Crucial to Developing Tools, Best Practices for Novel Therapies

Advanced practice RNs (APRNs), especially those with Doctorate of Nursing Practice degrees, in clinics across the country must not only focus on managing care for patients on novel therapies like immunotherapy but must also look at toxicities and adverse events from a population perspective. APRNs should look across all patients and disease types receiving the same novel treatments and recognize toxicity patterns to determine best practices for patient management. 

Cancer Moonshot Moves to Research Phase

Still a popular program throughout the government, the Cancer Moonshot Initiative challenged the United States to meet goals to accelerate cancer research progress , encourage collaboration in finding treatments and cures, and to improve data sharing to make a decade’s progress in half the time. Through NIH’s Moonshot Blue Ribbon Panel and the 2016 passage of the 21st Century Cures Act—allocating $1.8 billion over seven years for Moonshot—the initiative is moving out of planning and into the research phase.

NIH Seeks Research Proposals Through HEAL Initiative Funding

Recognizing the national opioid epidemic in the United States, the National Institutes of Health (NIH) has allocated a new funding stream for new research to address public health issues like prescription drug abuse and overdose. Through the Helping to End Addiction Long-Term (HEAL) Initiative, the NIH is offering 30 funding opportunities for researchers, awarding $850 million in support.

Oncology Nurses Are Vital to Tobacco Control and Smoking Cessation Efforts Worldwide

 The World Health Organization indicated that tobacco use is the most preventable cause of cancer worldwide. Globally, more than 7 million people die each year from causes associated with tobacco use and tobacco-related diseases. Despite recent trends that show falling rates for U.S.-based smokers, much work still must be done. Oncology nurses around the world can make a difference by engaging in prevention and treatment tactics, working with policymakers, and educating their communities and patients about tobacco control. 

Research Shows That Telephone Triage Is a Vital Part of Patient Experience

The field of telehealth encompasses many efforts in oncology practice and research. When focusing specifically on telephone triage, we examine patient-initiated requests, such as speaking directly with their nurses on the phone, reporting side effects, or seeking answers to questions about plan of care and treatment. This provides oncology nurses with an opportunity for assessment and intervention. Although many current research efforts focus on proactive phone calls nurses make to their patients, it is also important to understand the impact of incoming calls on patient care and workflow.

Emory University Appoints Oncology Nurse as Senior Vice President of Research

Building on a long career as a pioneer in oncology nursing research and cancer clinical trials, ONS member Deborah Watkins Bruner, RN, PhD, FAAN, has been named the senior vice president of research at Emory University in Atlanta, GA, a newly created position that serves on the Emory president’s leadership team. Effective October 1, 2018, Bruner’s leadership, expertise, and research experience will guide Emory’s interprofessional research efforts and promote education and training for future researchers, including nurse scientists.

What the Research Says About Supporting Cancer Survivors in Non-Oncology Settings

In 2016, the American Cancer Society (ACS) reported that the number of currently living cancer survivors is estimated at 15.5 million Americans. For 2018, ACS is projecting another 1.7 million new cases of cancer diagnoses. On one hand, the growing number of survivors indicates that early diagnosis, new technologies, targeted interventions, treatment options, and access to care are making a huge difference for patients. 

Longstanding NINR Director Retires After Two Decades of Developing Nursing Science

Patricia Grady, RN, PhD, FAAN, has defined a generation of nurse science and patient-centered research, serving as the National Institute of Nursing Research (NINR) director for more than 23 years. Under her charge, NINR has grown into one of the foremost federal agencies supporting the scope of the nursing research community, driving groundbreaking initiatives and furthering clinical practice.

NINR Study Identifies Genes for Fatigue in Cancer Treatment

Radiation therapy can be an incredibly draining form of treatment for patients with cancer. Side effects such as fatigue can be debilitating for many before, during, and after treatment. Because symptom management is a crucial component to cancer care and central role of oncology nursing, ensuring that patients are able to mitigate their symptoms and side effects can help improve their quality of life. Recently, a team at the National Institute of Nursing Research (NINR) identified certain genes associated with fatigue in men being treated for prostate cancer.

Meneses Left Legacy of Contributions to Cancer Survivorship and Quality of Life

Long-time ONS member and oncology nurse scientist Karen Meneses, PhD, RN, FAAN, Professor and Associate Dean for Research at the School of Nursing at the University of Alabama at Birmingham (UAB) passed away unexpectedly on August 1, 2018.

Consider a Role in Clinical Trials Research as an Evolution of Your Nursing Career

Nurses can do it all. After all, the often-unsung heroes of health care use their unique skills to positively impact patients and their families in more ways than most people can ever imagine. Unfortunately, role confusion and a lack of awareness of a vital specialty have led to a dire need of nurses in clinical trials.

Nurses Are Advancing Research in Data-Powered Science

Nurses can foster data-powered health through getting involved in research and ensuring that data collection is in patients’ best interest and accessible to all. Patricia Brennan, PhD, RN, director of the National Library of Medicine, and Suzanne Bakken, PhD, RN, FAAN, a professor at Columbia University, discussed how data can empower health and what nurses can do to advance research during a session at the 43rd Annual Congress in Washington, DC.

ONS Scholar-in-Residence Will Drive Nursing Research, Highlight Scientists

Whether being called on to inform the National Cancer Moonshot Initiative, develop novel resources for patients with prostate cancer, or create programs for smoking cessation, nurse scientists are continually advancing patient-centered oncology care. Nurse researcher contributions have led to improved patient outcomes, better symptom management interventions, and overall quality of care. As part of its commitment to future nursing research, ONS created a new scholar-in-residence position to drive and inform the Society’s research agenda and highlight the integral work of ONS member nurse scientists who are moving the needle for patients with cancer.

Motivational Interviewing Nursing Interventions Help Reduce Chemotherapy Symptom Burden

Nursing interventions such as coaching, telephone follow-up, and home care have been reported with inconsistent results. In their article in the January 2018 issue of the Oncology Nursing Forum, Coolbrandt et al. discussed the evaluation of a nursing intervention focused on patient education and self-management to reduce symptom distress in outpatients with cancer.

Oncology Nurses Champion Tobacco Cessation Programs

Twenty-five years ago, you could be flying at 39,000 feet and still be inhaling cigarette smoke. Smoking’s pervasiveness in U.S. culture was far and wide, and it wasn’t until cancer research findings—coupled with public policy and healthcare education—that the dangers of smoking caught on with the general public. Since then, smoking rates have declined.

Governors Push Senators for 2018 ACA Funding; NCI Requests Input on Bioethics in Cancer Research; Congress Braces for Full September Agenda

Summer 2017 saw several attempts to repeal and replace the Affordable Care Act (ACA), none of which were successful. Now that the dust has started to settle—and Congress is slowly moving on to other issues—many are still dealing with the uncertainty left in the wake of the nation’s healthcare debate. This includes many concerned governors who are lobbying for funds to address their states’ current needs.

How NCI Is Training the Future Cancer Research Workforce

To ensure that future cancer research is of the highest quality, the National Cancer Institute (NCI) is committed to developing the best scientific minds. NCI training and funding opportunities cover a broad spectrum of disciplines for individuals at various stages in their careers, ranging from high school and graduate students to scientists, clinicians, and healthcare professionals. 

How One Institution Improved Accrual to Cancer Clinical Trials

One of the key factors to a cancer clinical trial’s success is the ability to enroll an adequate number of patients in an appropriate timeframe. Identifying barriers to slow accrual and ways to address them can help researchers and nurse scientists make big steps in the fight against cancer in the era of the National Cancer Moonshot Initiative.

Navigating Medical Marijuana Laws and Use in Treatment

Medical marijuana laws still vary across the United States, and barriers persist for patients and providers, including fear of addiction and side effects as well as safety, financial, and legal concerns. Carey Clark, PhD, RN, AHN-BC, of the University of Maine at Augusta, Jacquelyn Bainbridge, PharmD, FCCP, from the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and Lisa Kennedy Sheldon, PhD, APRN-BC, AOCNP ® , FAAN, chief clinical officer at the Oncology Nursing Society, discussed the latest in medical marijuana laws and usage during a session at the 42nd Annual Congress in Denver, CO.

NINR Sets Strategic Plan for Nursing Research

40+ Oncology Nursing Research Topics for Nursing Scholars

• Carla Johnson
• August 24, 2023
• Samples for MSN students

Oncology nursing stands as a distinct realm within the healthcare domain, serving as a vital conduit in the holistic care journey of cancer patients. Within this compassionate and multifaceted nursing arena, professionals cater to patients from diagnosis through treatment, survivorship, and even end-of-life care . For nursing students harboring aspirations of effecting positive change in the lives of cancer patients, gaining comprehensive insights into the nuances of oncology nursing becomes paramount. This article plunges into oncology nursing research topics, dissecting key research inquiries and furnishing many tailored projects and concepts for aspiring nursing scholars.

Navigating Oncology Nursing Terrain

The oncology nurses emerge as the beating heart within the intricate tapestry of cancer care teams. Not only do they offer medical assistance, but they also provide unwavering emotional support to patients and their families during the most arduous junctures. Operating in diverse settings like hospitals, clinics, and hospices, these specialized caregivers collaborate with physicians, pharmacists, social workers, and other healthcare stalwarts to orchestrate comprehensive patient care .

PICOT Questions in Oncology Nursing

• P: Adults undergoing chemotherapy; I: Mindfulness meditation intervention; C: Standard supportive measures; O: Decreased chemotherapy-induced anxiety; T: 8 weeks. Can mindfulness meditation interventions mitigate chemotherapy-induced anxiety among adult patients undergoing treatment?
• P: Individuals in palliative care settings; I: Early integration of advanced care planning; C: Conventional palliative care protocols; O: Augmented end-of-life decision-making; T: 1 year. How does early integration of advanced care planning impact end-of-life decision-making for individuals in palliative care settings?
• P: Oncology nursing practitioners; I: Training in effective communication; C: Absence of communication training; O: Enhanced patient-nurse interactions; T: 6 months. How does training in effective communication for oncology nurses influence patient-centered interactions and satisfaction?
• P: Survivors of breast cancer; I: Virtual support group participation; C: Physical attendance in support groups; O: Elevated quality of life; T: 3 months. Are virtual support groups as efficacious as physical support groups in ameliorating the quality of life for breast cancer survivors?
• P: Terminal cancer patients; I: Integration of music therapy; C: Usual supportive care; O: Reduced pain and enhanced emotional states; T: 4 weeks. Can music therapy effectively alleviate pain and uplift emotional well-being among terminal cancer patients under hospice care?
• P: Workforce in oncology nursing; I: Resilience training initiative; C: Absence of resilience training; O: Elevated job satisfaction and diminished burnout; T: 1 year. What is the influence of a resilience training initiative on job satisfaction and burnout rates among professionals in oncology nursing?
• P: Pediatric oncology patients; I: Integration of art therapy ; C: No utilization of art therapy; O: Reduced emotional distress; T: Throughout treatment duration. How does art therapy’s integration correlate with diminished emotional distress among pediatric oncology patients undergoing treatment?
• P: Family caregivers of cancer patients; I: Online caregiver education modules; C: Conventional in-person education methods; O: Enhanced caregiving skills and reduced stress levels; T: 6 months. How do online caregiver education modules fare in comparison to traditional in-person methods in enhancing caregiving skills and reducing stress among family caregivers of cancer patients?
• P: Cancer survivors; I: Adoption of survivorship care plans; C: Absence of structured survivorship care; O: Fostering prolonged wellness and compliance with follow-up regimens; T: 2 years. How do survivorship care plans contribute to long-term wellness and adherence to follow-up care among cancer survivors?
• P: Nursing staff in oncology; I: Implementation of evidence-based pain management protocols; C: Utilization of non-standardized pain management strategies; O: Elevated pain control and heightened patient satisfaction; T: 1 year. What implications arise from implementing evidence-based pain management protocols on pain control and patient satisfaction within oncology nursing settings?

Evidence-Based Practice (EBP) Project Concepts

• Crafting personalized symptom management strategies for cancer patients.
• Elevating patient education methodologies for autonomous chemotherapy care .
• Evaluating the potency of complementary therapies in cancer care realms.
• Infusing tailored pain assessment tools for patients in oncology.
• Framing survivorship care initiatives targeting young adult cancer survivors.
• Formulating culturally attuned guidelines for end-of-life care across diverse populations.
• Investigating the ramifications of exercise interventions on cancer-induced fatigue.
• Probing the role of oncology nurses as enablers in clinical trial facilitation.
• Delving into the advantages of pet therapy in pediatric oncology environments.
• Pioneering strategies to enhance medication adherence among cancer patients.

Concepts for Nursing Capstone Projects

• Sculpting an encompassing support regimen for families of pediatric cancer patients.
• Scrutinizing ethical quandaries in end-of-life care verdicts for oncology patients.
• Investigating the dynamics of telehealth adoption in oncology follow-up care.
• Fabricating guidelines for seamless communication among interdisciplinary oncology collectives.
• Analyzing the financial burden’s repercussions on treatment compliance among cancer patients.
• Engineering a pain management blueprint for advanced-stage cancer patients.
• Untangling the psychological aftermath of survivorship among long-standing cancer survivors.
• Analyzing the stumbling blocks to early cancer detection within underserved communities.
• Assessing the efficiency of mindfulness-based interventions in mitigating oncology nurse burnout.
• Developing a training framework to tackle cultural competence in oncology caregiving.

Notions for Nursing Research Paper Themes

• Unveiling genetic counseling’s role in cancer risk comprehension.
• Evaluating the ripple effect of social support on cancer treatment outcomes.
• Tackling ethical conundrums in pain management for terminally ill cancer patients.
• Unpacking the psychosocial needs of adolescents grappling with cancer.
• Assessing the quality of life among cancer survivors over extended spans.
• Pondering the nutritional influence on chemotherapy tolerance and effectiveness.
• Navigating diverse cultural viewpoints on end-of-life care decisions for cancer patients.
• Proposing innovative strategies for countering chemotherapy-induced nausea and vomiting.
• Grappling with communication challenges amid pediatric oncology nurse-patient interactions.
• Sketching effective palliative care frameworks for those afflicted by rare and aggressive cancers.

Oncology Nursing Research Questions

• How does oncology nursing education factor into patient outcomes?
• What psychological battles confront oncology nurses in end-of-life caregiving?
• In what ways can oncology nurses adeptly address patient apprehensions about treatment side effects?
• What techniques amplify the efficacy of patient-nurse communication in oncology?
• What hinders compliance with pain management protocols among cancer patients?
• How does the presence of psychosocial bolster influence cancer treatment verdicts?
• What avenues exist to augment coping mechanisms for family caregivers within oncology?
• What deters cancer patients from actively engaging in clinical trials?
• How can oncology nurses tailor their approach to accommodate LGBTQ+ cancer patients’ unique needs?
• What facets underlie oncology nurses’ role as advocates in the healthcare system?

Notions & Examples for Essay Topics in Oncology Nursing

• Navigating the psychological aftermath of a cancer diagnosis on patients.
• The moral tightrope in end-of-life care choices for cancer patients.
• Pioneering family caregiver support for pediatric oncology patients.
• Innovations in pain alleviation for actively treated cancer patients.
• Bridging cultural chasms in oncology nursing: Challenges and remedies.
• Survivorship care plans: Charting the odyssey beyond cancer treatment.
• Delving into the unmet needs of adolescent cancer patients: A blind spot?
• Telehealth’s horizons in oncology: Prospects and hurdles in post-treatment care.
• The psychological toll of financial burden on cancer patients’ mental well-being.
• Patient-centered communication: The cornerstone of effective oncology nursing.
• Unveiling the efficacy and safety of complementary therapies in cancer care.
• Confluences of spirituality and cancer patient care: An exploration.
• Disseminating difficult news: Navigating communication for oncology nurses.
• The trajectory of survivorship care: Pivoting from diagnosis to long-term monitoring.
• Initiatives for cancer prevention and education in marginalized communities: A rallying call.
• Articulating the science of symptom management: Oncology nurses as patient champions.
• The synergy of resilience in confronting challenges within oncology nursing.
• Addressing the emotional toll in oncology nursing: Burnout and the self-care narrative.
• Patient agency and decision-making in oncology: A precarious equilibrium.
• Infusing cultural humility within the matrix of oncology nursing practice.

Oncology nursing, a dynamic realm, melds profound medical insights with emotional acumen for the welfare of cancer patients. By immersing into the matrix of PICOT questions, project concepts, and research topics unveiled above, aspiring nursing scholars step onto a path brimming with the potential to impact this indispensable facet of healthcare profoundly. Remember that seeking supplementary support, such as our professional writing services , can catalyze growth as your nursing journey advances. If you need aid with crafting assignments, research papers, or capstone projects connected to oncology nursing, don’t hesitate to explore the resources tailored for your benefit. Your dedication to learning and amplifying the influence of oncology nursing stands as a testament to your unwavering commitment to evidence-based and compassionate patient care.

FAQs About Oncology Nursing for Nursing Students

Q: What are the objectives of oncology nursing students?

A: Oncology nursing students aim to develop a comprehensive understanding of cancer care, including disease processes, treatment modalities, patient communication, and supportive care, to provide holistic and evidence-based care to cancer patients.

Q: What are the competencies of oncology nursing?

A: Competencies in oncology nursing encompass proficient knowledge of cancer types, treatment options, symptom management, emotional support, patient advocacy, and effective communication with patients, families, and interdisciplinary teams .

Q: What is a career objective for a nursing student?

A: A career objective for a nursing student might be to secure a position in a healthcare institution, where I can apply my nursing skills, compassion, and dedication to provide high-quality patient care and contribute to positive health outcomes.

Q: What are three goals as a nursing student?

A: Three goals as a nursing student could include achieving academic excellence, actively participating in clinical experiences to enhance practical skills, and cultivating effective communication and teamwork abilities for collaborative patient care.

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Research team tests intervention to reduce financial burden on cancer patients and caregivers

by Hayden Gooding, University of Kentucky

Researchers at the University of Kentucky College of Nursing and DanceBlue Kentucky Children's Hospital Hematology/Oncology Clinic found that receiving financial and legal navigation services improves levels of financial toxicity and quality of life for patients and caregivers.

Financial toxicity refers to the burden and stress a patient or caregiver has related to the cost of medical care. Patients undergoing cancer treatment and their caregivers often experience high levels of financial toxicity. Currently, very few evidence-based oncology financial and legal navigation programs exist to address this.

The research team's work to evaluate the impact of such services was published in March in the journal JNCI Cancer Spectrum .

"One way to help lessen this burden is to offer social, financial and legal navigation services and resources at the point of care or at the clinic they receive care in," said Jean Edward, Ph.D., associate professor in the College of Nursing.

Edward is a principal investigator on this interdisciplinary study with co-investigators John D'Orazio, M.D., Ph.D., chief of the Division of Hematology/Oncology at UK HealthCare and Kimberly Northrip, M.D., associate professor of pediatrics in the College of Medicine.

While investigating the best way to lessen financial toxicity, researchers at the DanceBlue Clinic decided to test a new interdisciplinary financial and legal navigation intervention for pediatric oncology patients and caregivers called FINassist (Financial and Insurance Navigation Assistance).

Using FINassist, clinic team members were trained in identifying financial and legal issues facing their patients and having conversations about the costs of care.

Utilizing financial navigators and lawyers, through a medical-legal partnership with the clinic's social worker team, the clinic provided financial and legal navigation assistance to support pediatric, adolescent and young adult cancer patients and caregivers.

"The results show that there are resources available to help manage the costs of cancer treatment and overcome barriers to accessing care," said Edward.

As a result of receiving these services, patients and caregivers experienced significant reductions in financial toxicity and improvements in health-related quality of life. The participants who tested FINassist rated the intervention highly for feasibility, acceptability and appropriateness. They found the intervention to be helpful and would highly recommend it to others.

FINassist also helped save roughly $335,323 in financial benefits for participants.

"The DanceBlue Clinic has one of the most robust psychosocial teams at UK HealthCare and continues to provide programs that address cancer-related financial toxicity ," said D'Orazio. "This adds to our well-rounded approach to care for our patients on a variety of levels."

Patients and caregivers who access services at DanceBlue also have access to comprehensive health care services that include financial navigation among other services.

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Researchers identify ‘switch’ to activate cancer cell death

A research team from the UC Davis Comprehensive Cancer Center has identified a crucial epitope (a protein section that can activate the larger protein) on the CD95 receptor that can cause cells to die. This new ability to trigger programmed cell death could open the door for improved cancer treatments. The findings were published Oct. 14 in the Nature journal Cell Death & Differentiation .

CD95 receptors, also known as Fas, are called death receptors. These protein receptors reside on cell membranes. When activated, they release a signal that causes the cells to self-destruct.

Modulating Fas may also extend the benefits of chimeric antigen receptor (CAR) T-cell therapy to solid tumors like ovarian cancer.

“We have found the most critical epitope for cytotoxic Fas signaling, as well as CAR T-cell bystander anti-tumor function,” said Jogender Tushir-Singh , an associate professor in the Department of Medical Microbiology and Immunology and senior author of the study. 

“Previous efforts to target this receptor have been unsuccessful. But now that we’ve identified this epitope, there could be a therapeutic path forward to target Fas in tumors,” Tushir-Singh said.

Finding better cancer therapies

Cancer is generally managed with surgery, chemotherapy and radiotherapy. These treatments may work initially, but in some cases, therapy-resistant cancers often return. Immunotherapies, such as CAR T-cell-based immune therapies and immune checkpoint receptor molecule activating antibodies, have shown tremendous promise to break this cycle. But they only help an extremely small number of patients, especially in solid tumors such as ovarian, triple-negative breast cancer, lung and pancreas.

T cells are a type of immune cells. CAR T-cell therapies involve engineering patient T cells by grafting them with a specific tumor-targeting antibody to attack tumors. These engineered T cells have shown efficacy in leukemia and other blood cancers but have failed repeatedly to provide success against solid tumors. The reason is that tumor microenvironments are good at keeping T cells and other immune cells at bay.

“These are often called cold tumors because immune cells simply cannot penetrate the microenvironments to provide a therapeutic effect,” said Tushir-Singh. “It doesn’t matter how well we engineer the immune receptor activating antibodies and T cells if they cannot get close to the tumor cells. Hence, we need to create spaces so T cells can infiltrate.”

Death receptors do precisely what their name implies — when targeted, they trigger programmed cell death of tumor cells. They offer a potential workaround that could simultaneously kill tumor cells and pave the way for more effective immunotherapies and CAR T-cell therapy.

Developing drugs that boost death receptor activity could provide an important weapon against tumors. However, though drug companies have had some success targeting the Death Receptor-5, no Fas agonists have made it into clinical trials. These findings could potentially change that.

This is a definitive marker for bystander treatment efficacy of CAR T therapy. But most importantly, this sets the stage to develop antibodies that activate Fas, selectively kill tumor cells, and potentially support CAR T-cell therapy in solid tumors.” — Jogender Tushir-Singh, associate professor, Department of Medical Microbiology and Immunology

The right target

While Fas plays an essential role in regulating immune cells, Tushir-Singh and his colleagues knew they might be able to target cancer cells selectively if they found the right epitope. Having identified this specific epitope, he and other researchers can now design a new class of antibodies to selectively bind to and activate Fas to potentially destroy tumor cells specifically.

Other research in animal models and human clinical trials has shown that Fas signaling is fundamental to CAR T success, particularly in tumors that are genetically heterogeneous . Genetically heterogeneous tumors have a mix of different cell types, which can respond differently to treatment.

A Fas agonist could generate a CAR-T bystander effect , in which the treatment destroys cancer cells that lack the molecule the tumor-targeting antibody is designed to hit. In other words, activating Fas may destroy cancer cells and improve CAR T efficacy, a potential one-two punch against tumors.

In fact, the study showed tumors with a mutated version of the epitope of Fas receptors will not respond to CAR T at all. This finding could lead to new tests to identify which patients will benefit most from CAR T-cell immunotherapy.

“We should know a patient’s Fas status — particularly the mutations around the discovered epitope — before even considering giving them CAR T,” Tushir-Singh said. “This is a definitive marker for bystander treatment efficacy of CAR T therapy. But most importantly, this sets the stage to develop antibodies that activate Fas, selectively kill tumor cells, and potentially support CAR T-cell therapy in solid tumors.”

Additional authors include Tanmoy Mondal, Himanshu Gaur, Brice E. N. Wamba, Abby Grace Michalak, Camryn Stout, Matthew R. Watson, Sophia L. Aleixo, Arjun Singh, Roland Faller, Gary Scott Leiserowitz and Sanchita Bhatnagar from UC Davis and Salvatore Condello from Indiana University School of Medicine.

• Read the study
• Jogender Tushir-Singh
• Additional research (PubMed)

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Nursing Support for Pain in Patients With Cancer: A Scoping Review

Miharu morikawa.

1 Graduate School of Medicine, Kyoto University, Kyoto, JPN

Kohei Kajiwara

2 Faculty of Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, JPN

Masamitsu Kobayashi

3 Graduate School of Nursing Science, St. Luke’s International University, Tokyo, JPN

Kanno Yusuke

4 Department of Home Health and Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, JPN

Kimiko Nakano

5 Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, JPN

Yoshinobu Matsuda

6 Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, JPN

Yoichi Shimizu

7 Department of Adult Nursing, National College of Nursing, Japan, Tokyo, JPN

Taichi Shimazu

8 Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, National Cancer Center, Tokyo, JPN

9 Graduate School of Medicine, Mie University, Tsu, JPN

Pain is subjective, warranting tailored responses in pharmacotherapy and nursing support. Despite this, the evidence for suitable nursing support for pain is not well established in terminally ill patients such as those with cancer; therefore, it is necessary to provide support in consideration of changes in physical symptoms and quality of life. However, interventional studies for such patients are often difficult. There have been no comprehensive studies to date on non-pharmacological support that can be implemented by nurses. Therefore, with the aim of examining nursing support applicable at the end of life, this scoping review comprehensively mapped nursing support for pain in cancer patients at all stages of the disease. This study complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Arksey and O’Malley framework. All available published articles from the time of database establishment to January 31, 2022, were systematically searched for in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), CENTRAL, and the Ichushi Web database of the Japanese Society of Medical Abstracts. Overall, 10,385 articles were screened, and 72 were finally included. Both randomized controlled trials (RCTs) (n = 62) and non-RCTs (n = 10) were included. Twenty-two types of nursing support were identified. Eighteen of them showed positive results; five of them were provided only to terminally ill patients, three of which were effective, namely, comfort care, foot bath, and combined therapy. It is important to examine the applicability of types of nursing support in clinical practice in the future.

Introduction and background

Most cancer patients experience pain [ 1 ]; in particular, more than half of patients with advanced, metastatic, or terminal cancer experience pain [ 2 ]. In addition, cancer pain is a subjective experience and a complex symptom with varying factors (e.g., tumor or treatment-related and non-cancer-related), nature (e.g., nociceptive and neuropathic), and duration (e.g., persistent pain, sudden pain, and chronic pain), and its management requires an individualized approach. Therefore, in parallel with pharmacological therapy, nurses provide education on pain management and care to increase pain threshold through various activities such as foot bathing, positioning, and massage [ 3 ].

The National Comprehensive Cancer Network (NCCN) [ 4 ] and American Society of Clinical Oncology (ASCO) [ 5 ] guidelines for patients with pain at any stage of disease recommend a combination of pharmacological and non-pharmacological pain management strategies according to patient preferences. In terms of non-pharmacological therapy, the NCCN guidelines recommend physical interventions such as conditioning exercise, massage, heating and cooling, acupressure, and cognitive-behavioral interventions such as mindfulness, breathing techniques, and relaxation, as well as psychosocial support and spiritual care [ 4 ]. The ASCO guidelines recommend moderate acupuncture for joint pain due to the use of aromatase inhibitors and reflexology, massage, acupressure, yoga, and muscle relaxation therapy for general and musculoskeletal pain [ 5 ]. Only moderate massage is also recommended for patients with cancer receiving palliative care. However, evidence of suitable nursing support for specifically terminally ill patients is still insufficient.

In the case of terminally ill cancer patients with a prognosis of weeks until death, the increased distress of physical symptoms, decline in physical and cognitive functions, and psychological changes warrant special attention to the needs of the patient [ 6 ]. However, guidelines for nursing support for cancer pain and consensus on nursing support for terminally ill patients are lacking. The purpose of this scoping review was to map nursing support for pain in cancer patients at all phases of the disease before examining the potential of pain care for terminally ill cancer patients.

Objective and methodology

In this study, nursing support for pain is defined as any non-pharmacological treatment for pain relief that can be provided by a nurse. This study was conducted in accordance with a previously published protocol [ 6 ]. The protocol article states that information would be collected using the Delphi method to examine the feasibility of providing support to terminally ill cancer patients, although, in this study, we continued to map the results of the scoping review. We applied Arksey and O’Malley’s five-step scoping review framework [ 7 ] and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extended version for scoping reviews (PRISMA-ScR) reporting guidelines [ 8 ].

Step 1: Identification of research questions

A systematic literature search was conducted on nursing support for cancer pain. The research question for this study was “What types of nursing support are provided to reduce cancer pain?”

Step 2: Identification of relevant research

PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials in the Cochrane Library, and the Japanese Ichushi Web database of the Japanese Society of Medical Abstracts were searched from the time of database establishment to January 31, 2022. Relevant studies were evaluated from the list of articles, and major journals were manually searched. Search queries were first created in PubMed for an initial search, and then, search formulas were created to match other databases (refer to the protocol study) [ 6 ]. Two researchers (MM and JK) conducted this initial search in consultation with a librarian. Eligibility criteria were determined by physicians and nurses specializing in symptom management for patients with cancer. The inclusion criteria were studies that reported (a) patient age as 18 years or above, (b) interventions aimed at relieving pain, (c) nursing support, and (d) quantitative assessment of pain using a scale. The exclusion criteria were (a) studies that reported at least 20% non-cancer participants, (b) secondary analyses, and (c) those in languages other than Japanese and English. The details are described in the protocol article [ 6 ].

Step 3: Study selection process

Two investigators (MM and JK) independently evaluated the titles and abstracts of all studies and then screened the complete studies against the eligibility criteria. Discrepancies in study selection were resolved through discussion. The study selection process is summarized in Figure ​ Figure1 1 .

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PICO: population, intervention, comparison, and outcomes

Step 4: Data charting

A form was developed to extract study characteristics, including the name of the first author, year of publication, country of publication, design of the study, size of the sample, eligible patients, type of nursing support, outcome measurement tools, and intervention effect. The same two researchers independently extracted the data. Studies that did not meet the eligibility criteria were excluded at this stage.

Step 5: Consolidation, summarization, and reporting of results

Nursing support reported in the articles extracted from the literature review was categorized by element of care using qualitative thematic analysis. First, the nursing support data described in the subject study were extracted into Microsoft Excel (Microsoft Corp., Redmond, WA) as raw data and analyzed for possible patterns, and notes were made as initial codes leading to the classification of the nursing support elements. Second, initial codes were created based on the intent and content of care provided. Third, patterns were searched, and potential nursing support components were grouped. Fourth, the initial codes were reviewed to find common nursing support components. Finally, each component was identified and clearly named. Several nursing support terms defined in the included studies were used as references. The analysis validated the classification by one author (MM) through discussion with another researcher (JK) and the entire study group.

Our initial literature search listed 11,348 studies. After the removal of 963 duplicate studies, the titles and abstracts of 10,385 studies were screened, following which 10,177 studies were excluded. A total of 208 full-text studies were assessed for study eligibility and relevance, of which 72 were judged to satisfy the eligibility criteria (Figure ​ (Figure1). 1 ). The interventions in the 72 studies were qualitatively categorized into 22 types of nursing support. Each intervention was divided according to the stage of the participant’s illness (all phases, treatment phase, terminal phase, and no notation); the number of tabulated studies is shown in Table ​ Table1. 1 . The details of the identified studies are presented in Table ​ Table2 2 .

BPI § : Brief Pain Inventory, MPQ † : McGill Pain Questionnaire, NRS € : numerical rating scale, VAS ¶ : visual analog scale, EORTC-QLQ-C30 Θ : European Organization for Research and Treatment of Cancer QLQ-C30, RCT Δ : randomized controlled trial, POS: pre- and post-test, N/A: not applicable/available, VR: virtual reality

Of these studies, 62 were randomized controlled trials (RCTs), five were non-RCTs, and five were prospective observational studies. The United States accounted for the largest number of these studies (26 studies), followed by Taiwan (seven studies), China (six studies), Turkey (five studies), and other countries (28 studies). A total of six studies had been published in the 1990s, 25 in the 2000s, 36 in the 2010s, and 13 in the 2020s. In terms of pain assessment tools, the Brief Pain Inventory (BPI) was the most commonly used (24 studies), followed by a numerical rating scale (NRS) (23 studies), and the visual analog scale (VAS) (22 studies). These scales convert pain into a numerical value. Associated factors such as beliefs, barriers, and concerns about analgesics and pain management, which may have an influence on perception of pain, were not identified in this study.

The largest number of studies were related to education and were categorized into four types based on the characteristics of the educational programs. Studies focused on providing knowledge and information, self-care management, using coaching skills, and emphasizing education and psychological care. In total, 10 and 11 studies focused on providing knowledge and information [ 9 - 18 ] and self-care management [ 19 - 29 ], respectively, and four and six studies used coaching skills [ 30 - 33 ] and educational and psychological care interventions [ 34 - 39 ], respectively. A total of 31 studies on education of all types were extracted, 29 of which were RCTs, one a non-RCT, and one a prospective observational study. All studies included a treatment phase. Although only one study each for specific cancers such as that of the lung, breast, and head and neck was extracted, most of the studies involved patients with various cancer types.

For nursing support to promote physical activity, two cases each of exercise [ 40 , 41 ] and progressive muscle relaxation therapy [ 42 , 43 ] were identified. One study on exercise and muscle relaxation therapy was reported for all disease stages and one for the treatment stage, both of which were RCTs.

For nursing support of perception of pain, three guided imagery therapies [ 42 , 44 , 45 ] (two RCTs), four cognitive-behavioral interventions [ 44 , 46 - 48 ] (three RCTs), and two narrative approaches [ 49 , 50 ] (two RCTs) were identified. Four studies (all RCTs) of combined therapies [ 51 - 54 ] that considered both physical function and cognition were extracted. One study of combined therapy involved only terminally ill cancer patients [ 53 ].

The types of nursing support expected to promote comfort and relieve local tension included relaxation therapy using virtual reality (VR) in two studies [ 55 , 56 ] (one RCT), massage therapy in eight studies [ 57 - 65 ] (four RCTs), aromatherapy massage in one RCT [ 60 ], music therapy in six studies [ 44 , 66 - 70 ] (five RCTs), reflexology in five RCTs [ 43 , 65 , 71 - 73 ], poetry appreciation in one RCT [ 68 ], and foot bathing in one RCT [ 74 ].

Two studies on massage therapy [ 60 , 63 ] and one study each on aromatherapy massage therapy [ 60 ], reflexology [ 71 ], and foot bathing [ 74 ] were conducted only in the terminal phase, whereas the others were conducted in the treatment phase or all phases of the disease.

One study each of self-administered acupressure [ 75 ], auricular point acupressure [ 76 ], and Reiki [ 45 ] were identified as considering nursing support related to Eastern medicine. The studies of self-acupressure and auricular acupressure used RCT designs, whereas the study of Reiki used a non-RCT design. In addition, two comfort care (environmental adjustment/mental healthcare/oral care) [ 77 , 78 ] and two adjustments to home care programs [ 79 , 80 ] were identified, all of which were RCTs.

Of the 72 studies, 48 showed a statistically significant reduction in pain. These included 15 studies of education (five focused on the provision of knowledge and information, five on self-management, and five on education and psychological care), six of music therapy, four each of massage and reflexology, three of combination therapy, and two each of exercise, progressive muscle relaxation therapy, comfort care, and adjustments to home care programs. There was one study each of acupressure, poetry appreciation, cognitive-behavioral intervention, relaxation, foot bathing, and Reiki.

This study is the first to comprehensively map nursing research on non-pharmacological therapies for cancer pain. We reviewed nursing support for patients from the treatment phase to the end of life and identified 72 types of nursing support. Only six studies were conducted exclusively on terminally ill patients.

Patient education was identified as a form of nursing support for cancer pain. Pain management education focused on providing knowledge and information, including the introduction of videos, slides, booklets, and online applications to the patients. Education focused on self-care comprised several support packages, including the PRO-SELF Plus pain control program (a pain education intervention program that frames Orem’s self-care theory), which provides information and pillboxes to correct misconceptions about opioids and enable effective medication and communication with healthcare providers. It has been reported that a patient’s ability to effectively self-manage cancer pain can be negatively affected by inadequate knowledge and negative attitudes. Therefore, it is expected that these interventions will be useful to ensure that patients have the correct knowledge and demonstrate appropriate self-care skills [ 81 ]. Oldenmenge et al. [ 82 ] reported that education of patients with cancer pain not only improved their knowledge about cancer pain but also alleviated pain in 31% of the studies. In their review, Koller et al. [ 83 ] divided the content of the educational intervention into four components: cognitive, behavioral, goal setting, and direct contact between research staff and clinicians. They reported that interventions could not be clearly categorized by the educational component; although the present study also focused on the characteristics of educational interventions and categorized them, the components were not clearly separated. Nevertheless, as the purpose of the current study was to comprehensively map nursing support, the objective was achieved. Many of the studies identified in this study were educational for various cancer types and all disease phases, suggesting that the support is adaptable to many cancer patients. In contrast, many studies reported long-term interventions that included follow-up and should be scrutinized when considering their application to terminally ill patients.

Exercise was identified as an aid in promoting physical activity. Meta-analyses on exercise therapy for cancer pain management have shown that it is effective in reducing pain, although the effect size is small [ 84 ]. It has been suggested that exercise be tailored to the patient, as generalized exercise may be ineffective or lead to worsening of pain depending on the patient’s situation [ 84 , 85 ]. Similarly, muscle relaxation therapy has been shown to be effective, but the level of evidence is low [ 86 ], and evidence building is important before considering it as nursing support. The muscle relaxation and guided imagery therapies extracted in this study have been examined using recorded data, and such interventions would be easier for nurses to introduce in clinical practice. In this study, nursing support that can provide comfort and relieve local tension included relaxation using VR, combination therapy (progressive muscle relaxation/guided imagery therapy/cognitive therapy), massage, reflexology, foot bathing, music therapy, and poetry appreciation. Notably, many types of support were identified that address the diverse needs of patients and play a complementary role in pain management. Although a systematic review conducted on the effects of massage on cancer patient symptoms suggests that it has a beneficial effect on pain [ 87 ], only two of the six studies reported pain relief. This may partly be attributed to the fact that this study excluded treatments performed by qualified therapists and included those that could be performed by nurses and other medical personnel. It should also be noted that while differences in techniques used between practitioners are generally noted [ 88 ], it is more difficult to standardize techniques when they are performed by nurses than therapists. More effective comfort care interventions to raise patient pain threshold [ 3 ] should be studied, and relevant evidence should be built in the future.

Reiki, auricular acupressure, and self-acupressure instructions were also identified as other types of nursing support based on Eastern medicine, which are also referred to in the ASCO guidelines [ 5 ] as non-pharmacological therapies. In this study, these nursing support items were extracted in a format that nurses could easily incorporate into their clinical practice, such as auricular point acupressure, in which seeds are applied to the ear, and self-administered acupressure. Further study is needed to determine whether these can be implemented in clinical practice and the effectiveness of their implementation by nurses.

In addition, it was suggested that preparing the patient’s living and recuperation environment, including adjustments to comfort care and home care programs, is a fundamental element of nursing, and these are also important types of support in cancer pain management [ 77 - 80 ].

This scoping review has some limitations. First, because the search was limited to studies published in Japanese and English, this review may have excluded relevant studies published in other languages. Second, this scoping review was not designed to assess methodological quality, as its purpose was to map nursing support. Thus, this conclusion is primarily based on the extraction of nursing support investigated in studies rather than on the effectiveness of nursing support for cancer pain.

Conclusions

In this study, we comprehensively mapped the non-pharmacological support provided by nurses for cancer pain and identified 22 types of nursing support from 72 studies. Of these, six studies were exclusively of terminally ill cancer patients, and only five types of nursing support were identified. The most common nursing support for cancer pain was related to education. Other types of support included those pertaining to the patient’s perception of pain, promoting patient comfort (believed to raise pain threshold), and adjusting the patient’s care environment. Further research on and consideration of the possible support for terminally ill patients are needed in the future.

Acknowledgments

We thank Editage (www.editage.jp) for English language editing. This study received guidance from the National Center Consortium in Implementation Science for Health Equity (N-EQUITY) funded by the Japan Health Research Promotion Bureau (JH) Research Fund (2019-(1)-4) and JH Project fund (JHP2022-J-02). The data are stored as de-identified participant data, which are available on request to the corresponding author ([email protected]).

Table ​ Table3 3 presents the PRISMA-ScR checklist.

JBI: Joanna Briggs Institute, PRISMA-ScR: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews

*Where sources of evidence (see second footnote) are compiled from, such as bibliographic databases, social media platforms, and Web sites.

†A more inclusive/heterogeneous term used to account for the different types of evidence or data sources (e.g., quantitative and/or qualitative research, expert opinion, and policy documents) that may be eligible in a scoping review as opposed to only studies. This is not to be confused with information sources (see first footnote).

‡The framework by Arksey and O’Malley (6) and Levac and colleagues (7) and the JBI guidance (4 and 5) refer to the process of data extraction in a scoping review as data charting.

§The process of systematically examining research evidence to assess its validity, results, and relevance before using it to inform a decision. This term is used for items 12 and 19 instead of “risk of bias” (which is more applicable to systematic reviews of interventions) to include and acknowledge the various sources of evidence that may be used in a scoping review (e.g., quantitative and/or qualitative research, expert opinion, and policy document).

The authors have declared that no competing interests exist.

Author Contributions

Concept and design:   Miharu Morikawa, Kohei Kajiwara, Kanno Yusuke, Kimiko Nakano, Yoshinobu Matsuda, Yoichi Shimizu, Taichi Shimazu, Jun Kako, Masamitsu Kobayashi

Acquisition, analysis, or interpretation of data:   Miharu Morikawa, Jun Kako

Drafting of the manuscript:   Miharu Morikawa

Critical review of the manuscript for important intellectual content:   Miharu Morikawa, Kohei Kajiwara, Kanno Yusuke, Kimiko Nakano, Yoshinobu Matsuda, Yoichi Shimizu, Taichi Shimazu, Jun Kako, Masamitsu Kobayashi

Supervision:   Jun Kako