Oncology Nurse Navigation 101

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Introduction   

Cancer continues to be the second most common cause of death in the United States. Because of improvements in both diagnostics and awareness, more individuals are getting diagnosed with cancer. Additionally, the advancements in cancer care improve client longevity (1). Between more clients diagnosed and clients living longer, the need for oncology nurses is expected to grow six percent between 2023 and 2033 (2). 

The role of the oncology nurse is both difficult but rewarding. The oncology nurse plays a critical role in supporting the client, the healthcare team, and caregivers through the entirety of the cancer care journey. The cancer journey begins at the time of a client’s diagnosis and continues throughout their lifetime (3). Depending on the specific role of the oncology nurse, the nurse will help support and coordinate administering treatments, management of symptoms, providing emotional support, and educating clients and caregivers on how to best manage the disease. 

Role and Importance of Oncology Nurses 

Oncology nurses are vital in the support of clients with cancer through their fight against cancer. The nurse acts as a primary point of contact for the clients, caregivers, providers, and other key interdisciplinary care team members. There oncology nurse may assist in administering treatments, including delivering chemotherapy, immunotherapy, and other cancer treatments. The oncology nurse aids with symptom management by educating clients about potential and expected side effects associated with cancer and its treatment (4). 

Additional education is provided about disease, the treatment options, and self-care strategies. Another important aspect of the nursing role is to provide emotional support, as the psychosocial dynamics of cancer care are challenging for clients and families to navigate. Finally, the coordination of care is an important portion of the oncology nurse’s role. Many clients become overwhelmed with the various appointments with various providers that the nurse can remove confusion and tracking difficulty (5). 

Scope of Practice 

The scope of practice for oncology nurses is broad and includes clinical practice, education, research, and advocacy. The clinical practice that an oncology nurse is responsible for includes direct client care such as assessments, planning, implementation, and evaluation of care. Education, as part of the oncology nurse role, includes teaching clients, families, and communities about cancer prevention, diagnosis, treatment, and management. Additionally, the oncology nurse may assist in cancer research by conducting clinical trials or other research efforts to improve cancer care and outcomes. Finally, the oncology nurse is responsible for advocacy efforts. Advocating for the client’s needs and rights helps improve access to resources, healthcare policies, and insurance coverage (6). 

Definition 

Oncology is a branch of medicine that focuses on the diagnosis, treatment, and management of cancer. Oncology involves the biology of cancer, including developing treatments to improve the quality of life for clients impacted by a cancer diagnosis. A few key terms used in oncology are cancer, tumor, metastasis, chemotherapy, radiation therapy, immunotherapy, and biopsy. Understanding these commonly used terms is vital for a new oncology nurse to understand (7). 

Cancer is defined as a disease that is developed by the uncontrolled growth and spread of abnormal cells. If these cells are not controlled, cancer can result in death. A tumor is defined as an abnormal mass of tissues that results from excessive cell division. Tumors can be benign (non-cancerous), or malignant (cancerous). Metastasis occurs when cancer cells break off from the primary site and spread to other parts of the body (7). 

Chemotherapy is a type of cancer treatment that uses drugs to destroy cancer cells. This is commonly prescribed as an intravenous (IV) therapy, though oral chemotherapy is also administered. Radiation therapy is another form of cancer treatment that uses high-energy radiation to kill or shrink cancer cells. Immunotherapy is a form of cancer treatment that uses the immune system to target cancer cells. Finally, a biopsy is a common treatment used to either sample the cells that are considered cancerous, or sometimes used to fully remove the cancer cells (8). 

Types of Cancers 

There are a variety of cancers. Understanding the basics of the different types can help prepare a nurse for their role as an oncology nurse. First, carcinoma is a type of cancer that originates in the skin or lining or organs, such as the liver or kidneys. Carcinomas may include breast, lung, or colorectal cancers. Next, sarcomas are cancers found in the bones, cartilage, fat, muscle, blood vessels, or other connective tissues. Leukemias are cancers formed in the bone marrow. This causes an abnormally large number of blood cells to be produced and enter the blood stream. Lastly, central nervous system cancers impact the brain and spinal cord (9).  

Assessment 

Assessing a client with cancer will be slightly varied based on the phase in which the assessment is occurring. An initial assessment for a client with cancer should include an evaluation of the client’s medical history, a physical examination, and symptoms review. The medical history review includes collecting information regarding previous diagnosis and medical procedures, as well as their current medical information surrounding their potential or confirmed cancer diagnosis (10). 

To be referred to an oncologist, a suspected cancer diagnosis must be present. Depending on the type of cancer, there will be specific diagnostics completed. Most commonly, a client will present to the oncologist office with labs (including a completed blood count [CBC] and a completed metabolic panel [CMP] plus a few specific labs related to their cancer diagnosis, i.e. prostate specific antigen [PSA]), diagnostic imaging (such as PET CT, bone marrow biopsy, or MRI), pathology reports, and pertinent medical records (10). 

Beyond this client’s medical history, it is important to assess the client’s family history of cancer, lifestyle choices, and any previous treatments. The nurse should also review with the client any current symptoms they are experiencing. Either the client will be experiencing symptoms related to their cancer or related to their cancer treatment if they have already begun. The nurse should assess the onset of these symptoms, the duration, and severity of these symptoms (10). 

Diagnostic Tools and Techniques 

To obtain a formal cancer diagnosis, certain diagnostics must be completed and evaluated. An accurate diagnosis is essential for appropriate and effective treatment planning. The nurse should be aware of the various diagnostics and their purpose.  

First, several imaging diagnostics may be ordered. Imaging tests may include x-rays, CT scans, MRIs, PET scans, and ultrasounds. These imaging procedures can help visualize tumors and assess their size, locations and spread. Next, laboratory tests including blood, urine and other tests can help analyze certain markers to detect cancer and assess organ function. Additionally, biopsies can assist with cancer diagnosis. The various biopsy procedures include fine-needle aspiration, core needle biopsy, or surgical biopsy to confirm the presence of cancer cells (10). 

Lastly, genetic testing may be ordered for individuals who have a strong family history of certain cancers. Not all cancer types will benefit from genetic testing. However, certain cancers are linked to other cancer types and understanding their family history can help guide practitioners to what other tests, procedures, and even treatments may be necessary. On the other hand, genetic counseling and testing may help the client identify who in their family may be at risk for developing their specific cancer type or others associated with that diagnosis (10). 

Physical and Psychosocial Assessment 

Another important aspect of the nursing assessment for clients with cancer is both the physical and psychosocial assessment. The physical assessment should include vital signs, pain level assessment, nutritional status review, and screening for other physical or medical complications related to their cancer diagnosis (10). The psychosocial assessment should include the client’s current mental and emotional state, assessing specifically for anxiety, depression, or distress. Similarly, the nurse should assess the client’s overall quality of life. Cancer can impact the client in a variety of ways, all of which can reduce or eliminate the client’s quality of life in many aspects. This assessment should include the client’s ability to perform daily activities, social interactions, and enjoyment of their life in its current state (11).  

Epidemiology 

Cancer incidence refers to the number of cases newly diagnosed, typically per year. Cancer prevalence indicates the total number of clients living with a cancer diagnosis (12). Both terms will be helpful when identifying trends, understanding the needs for resource allocation, and supporting and implementing public health strategies.  

Identifying trends include monitoring for changes in cancer rates over time in hopes of uncovering new patterns and potential causes. An example of this is another term called Downwinders. Downwinders refers to individuals who were exposed to radioactive fallout from the nuclear testing done during the cold war. As these tests occurred, the wind would take the radioactive materials to other surrounding locations (13). 

The states impacted include Arizona, Colorado, Idaho, Montana, Nevada, New Mexico and Utah. Individuals living in these areas between 1950 and 1962 are not only compensated for their exposure, but any cancer treatments needed will be covered for those who develop them. Some cancers for downwinders include bile duct, bladder, brain, breast, colon, leukemia, lung, ovarian, pancreatic, rectal, thyroid and several other cancers (13). 

Once trends are identified, the focus can shift towards the needs of clients. Resources to address the client’s needs require planning and distribution based on the higher cancer burdens. Similarly, understanding the trends in the community can help in the development and implementation of prevention and early detection programs (12). 

Risk Factors and Demographics 

Several factors influence a client’s risk for developing cancer. These include genetic, lifestyle, environmental, and demographic influences. Genetics refers to both family history and genetic mutations that can increase the risk for developing cancer. Lifestyle factors, such as smoking, alcohol consumption, diet, and exercise, all impact the overall health and cancer risk of clients. Environmental factors, such as radiation, can also elevate cancer risk. Demographic factors include age, race, gender, and socioeconomic status (14). 

Global and Regional Cancer Statistics 

Cancer statistics vary in regions and populations. The global burden of cancer includes being the leading cause of death worldwide. However, this burden can have significant variations between countries. Some regional differences for cancer include healthcare access, lifestyle, and environmental exposures. For example, certain countries have higher rates of lung cancer as associated with the cultural acceptance of smoking. Some trends and projections of cancer predict that the future cancer burden is increasing in both urban areas and aging populations (15). 

Pathophysiology 

Cancer begins at the cellular level. When the normal regulatory process that stops cell division is disrupted, then cancer is a risk. There are three key points of cell cycle dysregulation. First, the cell cycle regulates growth, division and death. When this regulation is disrupted, uncontrolled cell proliferation occurs. Next, genetic mutations occur when DNA sequence of genes mutates. This mutation occurs through genetic inheritance or due to environmental factors. Lastly, oncogenes promote cell growth and division while tumor suppressor genes inhibit it. When a mutation occurs that activates oncogenes or inactivates tumor suppressor genes, this leads to cancer (16). 

Tumor Growth and Metastasis 

Tumor growth and metastasis occurs when cancer progression is present. Tumor growth, angiogenesis, and metastasis terms used when discussing tumor growth and metastasis. First, tumor growth is present as cancer cells proliferate. The proliferated cells develop a mass known as a tumor. Tumors can be benign (or non-cancerous), or malignant (or cancerous). If malignant, these cells invade surrounding tissues and can spread to other parts of the body (16). 

Angiogenesis is the term used to describe the process in which tumors stimulate the formation of new blood cells. These blood cells bring nutrients and oxygen to the tumor, increasing their growth. Metastasis is a term used to describe when cancer cells spread to a distant site in the body. This process involves fixe steps: invasion, intravasation, circulation, extravasation, and colonization (17). 

Invasion is the first step of metastasis. This step occurs when cancer cells invade the surrounding tissues. Next step, intravasation, is when the cancer cells enter the blood stream or lymphatic system. The third step is circulation, where the cancer cells travel through the body. This is followed by extravasation, where cancer cells exit the bloodstream or lymphatic system and are invading the new tissues. Lastly, colonization is when these cancer cells establish new tumors in the distant organs (17). 

Genetic and Environmental Influences 

Both genetic and environmental factors contribute to cancer development. Some genetic influences include the inherited genetic mutations of certain cancers. An example of this includes the BRCA1 and BRCA2 genes that are linked to higher risks of breast and ovarian cancers (18). 

Environmental influences include exposure to carcinogens, or cancer-causing agents, such as tobacco smoke, radiation, and certain chemicals. Lifestyle factors include diet, physical activity, and alcohol consumption, all of which play a role in cancer development. There are complex interactions between genetic predispositions and environmental exposures. Someone with a genetic predisposition to cancer may be more susceptible to the effect of environmental carcinogens (18). 

Clinical Signs and Symptoms 

Cancer presents a range of signs and symptoms. These can vary based upon the cancer type. Additionally, cancer treatment can also lead to certain symptoms. Recognizing these signs and symptoms can help a nurse properly educate the client on what to look for, what to escalate, and when to seek emergency care (19). 

Common signs and symptoms of various cancers include unexplained weight loss, fatigue, pain, skin changes, persistent cough or hoarseness, and unusual bleeding or discharge. Unexplained weight loss can signify potential cancer diagnosis of pancreas, stomach, esophagus, or lung. Pain, particularly chronic pain in the bones, can indicate cancer. Skin changes may include new growths, poor healing sores, changes in existing moles, can all be signs of skin cancer (19). 

Additional signs and symptoms include changes in bowel or bladder habits, such as changes to bowel movements or urinary symptoms. These can indicate colorectal or bladder cancer. Persistent cough and hoarseness, such as a cough that does goes away, can be signs of lung or throat cancer. Additionally, unusual bleeding or discharge can be a sign of cervical, endometrial, or colorectal cancer (19). 

Early Detection and Screening 

It is important to educate clients about early detection and screening methods. Early detection can significantly improve chances of successful treatment and improve outcomes. These strategies include screening tests, self-examinations, and general awareness and education. Screening tests include regular screening tests even before cancer is a concern. These can include mammograms for breast cancer screening, pap smears for cervical cancer, colonoscopy for colorectal cancer, and low-dose CT scans for lung cancer (19). 

Self-examinations are also an important tool in detecting cancer early. Encouraging clients to perform regular self-examinations, such as breast self-exams or skin checks, can detect changes in the client’s body. Additionally, education about signs and symptoms of cancer and the importance of regular check-ups can further lead to early detection and treatment (19). 

Symptom Management 

Managing symptoms of cancer and cancer care is crucial for improving the quality of life of clients. Strategies for symptom management include pain, and fatigue management, nutritional and psychological support, as well as palliative care. Fatigue management encourages rest, balanced nutrition, and gentle exercise to help manage fatigue (20). 

Nutritional support includes providing dietary advice and support to help clients to maintain their strength. It is also helpful to focus on client strengths when managing clients’ diet. Lastly, this form of management should also address reducing nausea and lack of appetite, a common concern for clients with cancer (20). 

Psychological support includes offering clients with cancer counseling, support groups, and other resources to help the client cope with the psychological and emotional impact of cancer. Palliative care is a supportive service that is often thought of for end-of-life care. Contrary to popular belief, integrating palliative care early in the treatment process can address symptoms and improve overall well-being (20). 

Etiology 

The causes of cancer can be widespread. One of these causes includes genetic predisposition. Genetic predisposition involves genetically inherited gene mutations that increase a client’s risk for developing cancer. Certain mutations in genes, such as BRCA1 and BRCA 2 – the commonly inherited breast cancer genetic mutation, are passed from parents to children. Having these mutations significantly increases the risk of developing the cancer associated with the identified gene mutation (21).  

Because of this, it is important for a client and their healthcare team to identify a family history. A strong family history can indicate that a genetic predisposition is present. Genetic counseling and testing can help clients identify if they are at risk for certain cancers. This is particularly helpful in preventative care and early detection. Genetic syndromes may also be identified with genetic testing. Genetic syndromes, such as Lynch syndrome, are associated with higher risk of various types of cancer (21). 

Environmental and lifestyle factors are also at play when cancer risk is calculated, as both play a significant role in the development of cancer. Various lifestyle choices, such as tobacco use, diet, nutrition, physical activity, alcohol consumption and even sun exposure are considerations when advising a client about possible risk. Tobacco use can increase the risk for lung, mouth, throat, esophagus, and bladder cancers (21). 

A healthy diet and nutrition can reduce the risk of all cancers. Clients should be advised to avoid processed foods, red meats, and increase their fruit and vegetable intake, as these diet choices increase antioxidant consumption which further reduces the risk of cancer. Physical activity goes hand-in-hand with diet and nutrition. Regular exercise reduces the risk of several cancers, most notably breast and colon cancers. Also reducing alcohol consumption can reduce the risk for liver, breast, and colorectal cancer. Finally, sun exposure is most associated with skin cancers such as melanoma, so clients should be advised to use sunscreen, wear UV-protecting clothing, and avoid tanning beds (21). 

Beyond lifestyle choices, the environment in which a client lives can impact their cancer risk as well. Exposure to certain carcinogens and infectious agents means clients are more likely to develop cancer. Some viruses, such as human papillomavirus (HPV), are linked to specific cancers. In this case, HPV leads to cervical and other cancers. Bacteria, such as H. pylori, can also lead to cancer. H. pylori is linked with stomach cancer. Parasites can also be traced to certain cancers, such as schistosomiasis being linked to bladder cancer. Chemical carcinogens and radiation are two other environmental factors that can lead to cancer. Chemical carcinogens include asbestos, benzene, and formaldehyde. Radiation includes exposure to x-rays or radioactive materials (21). 

Treatment  

Once a cancer diagnosis has been confirmed, determining the appropriate treatment would be the next step. There are a variety of treatment modalities, with surgery, chemotherapy, and radiation therapy being the most commonly known forms of treatment (22). Surgery is often the first line of defense against the spread of cancer. Surgery involves removing the tumor. For some clients, surgery will include the surrounding tissue and possibly the lymph nodes in that area. There are three goals of surgery: curative, debulking, and palliative. Curative is meant to remove all cancerous cells, while debulking focuses on removing parts of the tumor when the size is too large to remove it all. Finally, palliative surgery focuses on alleviating symptoms to improve the client’s quality of life rather than seeking to cure the client of cancer (22). 

Chemotherapy is also a commonly prescribed cancer treatment. Chemotherapy uses drugs to kill cancer cells or stop them from dividing. It can be administered orally, intravenously, or via other routes. Chemotherapy can be used alone or in combination with other treatments. Side effects of chemotherapy most commonly include nausea, vomiting, fatigue, weakness, hair loss, and increased risk for infection (22).  

Radiation therapy is a form of treatment used to kill cancer cells through the use of high-energy radiation methods. Radiation therapy can be provided externally (or external beam radiation) or internally (brachytherapy). Radiation therapy is used to shrink tumors before surgery, destroy the remaining cancer after surgery, or used alone as the primary treatment of cancer. Most commonly reported side effects or radiation therapy include skin irritation, fatigue, and localized pain. Depending on where the radiation is provided, localized organs will be negatively impacted, and clients will experience additional symptoms to those areas of radiation (22). 

Less known treatments include targeted therapy and immunotherapy. Target therapy uses drugs that specifically target the cancer cell’s unique characteristics, such as specific proteins or genetic mutations. The purpose of this treatment is to reduce the damage to healthy cells. Some examples of this type of treatment include monoclonal antibodies and tyrosine kinase inhibitors. Monoclonal antibodies bind to specific proteins in the cancer cells, ultimately leading to the destruction of these cells by the immune system. Tyrosine Kinase Inhibitors block the signals that cause cancer cells to grow and divide (22). 

Immunotherapy taps into the body’s natural immune system capabilities to attack and destroy cancer cells. These treatments use checkpoint inhibitors, CAR T-Cell therapy, and cancer vaccines. Checkpoint inhibitors help the immune system to recognize and attack cancer cells that may have been overlooked otherwise. CAR T-Cell therapy involves modifying a client’s T-cells to better target cancer cells. Lastly, cancer vaccines help stimulate the immune system to attack specific cancer cells (22). 

Multidisciplinary Approach to Treatment 

Because of the complexity of cancer, there are often multiple departments contributing to a client’s cancer care plan. To ensure the best outcomes for a client with cancer, a multidisciplinary approach to treatment is necessary. Collaborative care includes a team of healthcare professionals working together to create and implement a comprehensive treatment plan. These individuals may include surgeons, medical oncologists, radiation oncologists, pathologists, oncology nurses, social workers, and other specialists (23). 

Personalized treatment plans help tailor the clients care to their unique needs. To tailor this care, the client’s type and stage of cancer, overall health, and personal preferences are considered. Similarly, the client’s psychosocial needs and support need to be considered. The regular communication among team members ensures the client’s treatment is properly coordinated and adjusted as needed. This collaborative approach helps address the complex needs of the client with cancer and improves their outcomes (23). 

Self-Management 

Beyond the multidisciplinary care team, another important influence on the client’s outcomes is the client themselves. Self-management can be a powerful tool, as an empowered client is more likely to follow their treatment plan, advocate for themselves, and practice appropriate self-care throughout. As an oncology nurse, the best way to empower clients with cancer is through education. Client education should provide a comprehensive review of the client’s diagnosis, treatment options, potential side effects, and self-care strategies. This can be accomplished through written materials, digital resources, workshops or classes, and other client empowerment techniques (24). 

Written materials can include brochures, pamphlets, and booklets that explain cancer, treatment, and resources available. Digital resources can include informational websites, apps, and online forums where clients can be connected to reliable information and connect with other healthcare professionals or clients. Workshops and classes can be provided in-person or virtually. These focus on commonly experienced side effects and concerns of clients with cancer, such as nutrition, fertility preservation, and managing side effects. Empowering clients can also include encouraging clients to ask questions, express concerns, and be an active participant in making decisions surrounding their cancer care. Empowered clients are more likely to adhere to their treatment plans and experience better outcomes, so these additional steps taken can be impactful both short- and long-term (24). 

Coping Strategies and Quality of Life 

Helping clients develop effective coping strategies will be necessary to improve the client’s overall quality of life. Strategies that can be taught to clients include stress management techniques, physical activity, nutritional choices, psychosocial support, and pain or symptom management efforts. Stress management includes techniques such as mindfulness, mediation, and relaxation exercises to reduce stress and anxiety. Regular and moderate physical activity can be tailored to the client’s abilities currently. Exercise improves the client’s physical and emotional well-being.  

Nutrition can improve the client’s overall health and reduce the treatment-related side effects. Psychosocial support includes counseling, support groups, and mental health services to address the emotional challenges of cancer. Pain and symptom management should be a priority in education, as these can be debilitating if not properly managed. Pain and symptom management can be accomplished through the use of medications, complementary therapies, and lifestyle adjustments (24). 

Support Systems and Resources 

A strong support system is a critical part of a client’s overall success during their cancer care journey. This support system can include family, friends, support groups, the healthcare team, and community and online resources. Family and friends can encourage clients on a personal level with emotional and practical assistance. Support groups help connect clients to others who are going through similar experiences (25). 

The healthcare team can provide support through answering questions, addressing concerns, and providing additional support medically. Providing clients with community resources can support the client financially, with transportation, among other forms of support. Providing access to online communities includes online forums and social media to share their experience and receive virtual support (25). 

Research Findings 

As healthcare advances, so does oncology care. Some of the most recent findings include advancements in various treatment techniques. Precision medicine is one of those advances. Advances in genetics and molecular profiling have enabled the ability to personalize treatment plans to the unique makeup of the client’s cancer (26). Advances in immunotherapy also have become readily available. New immunotherapy drugs, such as checkpoint inhibitors and CAR T-cell therapies, are quite successful in treating certain types of cancer that were previously considered untreatable (22).  

Liquid biopsies are non-invasive blood tests that detect cancer-related genetic mutations and biomarkers. These biopsies allow for earlier detection and monitoring of cancer progression (27). Artificial intelligence (AI), while not a treatment itself, is another advancement that can help outcomes for clients with cancer. AI and machine learning are being used to analyze datasets to improve accuracy of cancer diagnosis, predict treatment response, and identify new drug targets (28). 

Clinical Trials and Studies 

In addition to these advancements, there are also advancements occurring in clinical trials. Clinical trials test new ways to find, prevent, or treat cancer (29). Clinical trials include four different phases. Understanding the phase of the clinical trail and their roles can aid in evaluating the safety, efficacy, and long-term effects of new treatments. Client participation is important in clinical trials, as this helps researchers gather critical data to improve future cancer therapies. Additionally, recent studies have led the FDA to approve new cancer treatments including targeted or combination therapies that improve client outcomes.  

Future Directions in Cancer Research 

The future of cancer research is promising, as it holds even more groundbreaking discoveries and innovations. This research will focus on four main components. 

Next-generation sequencing continues to advance with improvements in sequencing technologies. These advancements will lead to the development of even more effective targeted therapies (30). Cancer vaccines aim to stimulate the immune system to recognize and attack cancer cells. While some vaccines are currently available, the current research is offering a potential new avenue for treatment (31).  

Two other advancements include microbiome research and nanotechnology. More and more research is connecting the gut biome to overall health, and cancer is no different. Poor gut biome is linked to the development of cancer, as well as reduced treatment response. Using this information, novel therapeutic strategies could be developed to improve gut biome health and subsequently treat cancer (32). Additionally, the use of nanotechnology is beginning to be explored in the treatment of cancer. Using nanoparticles to deliver target drugs promises to improve the precision and effectiveness of cancer therapies (33). 

Conclusion

Cancer remains the second leading cause of death in the United States. With an increasing number in diagnosis and improved client longevity, the need for oncology nurses is increasing. The demand for oncology nursing is projected to grow by six percent from 2023 to 2033, this role is vital in supporting the growing demand. Oncology nurses serve as a central support system for clients, caregivers, and healthcare teams throughout the cancer care journey.  

They serve as a central support system for clients, caregivers, and healthcare teams throughout the cancer care journey. Beyond providing support, oncology nurses aid in administering treatments, managing symptoms, and empowering clients in their own cancer care journeys the scope of the oncology nurse encompasses clinical care, education, research, and advocacy, allowing nurses to deeply impact a client’s outcomes. By advocating for client’s rights and needs, the oncology nurse can also contribute to better healthcare access and policies to further enhance the quality of cancer care.  

Despite being emotionally challenging, being an oncology nurse is a rewarding career. With proper preparation and dedication, the prepared oncology nurse can significantly impact healthcare for the clients, the department, the healthcare organization, the national healthcare system, and even global oncology care at large.  

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