Last Modified: June 10, 2007
Dear OncoLink "Ask The Experts,"
I am an APRN working in palliative care - inpatient and some homecare. I also have a special interest in lung cancer. I was wondering if there exist any "best practice guidelines" for advanced lung cancer? I am already aware of the NCCN guidelines.
Beth Eaby, MSN, CRNP, OCN, Bboard certified nurse practitioner and nationally certified oncology nurse, responds:
There are 3 major organizations that put forth evidence-based practice guidelines for care. One is National Comprehensive Care Network (NCCN), of course. The others are ASCO (American Society of Clinical Oncology) and MASCC (Multinational Association of Supportive Care in Cancer). The NCCN and ASCO put out practice guidelines on multiple topics, including treatment guidelines and supportive care topics. The MASCC guidelines are primarily on supportive care issues, including chemotherapy-induced nausea and vomiting, neutropenia, mucositis, etc. All three groups have their guidelines available on their websites. The NCCN and ASCO also have patient versions of some of their guidelines and both of these have some information related to advanced lung cancer, although it is not extensive. It may be that you could utilize some of the supportive care guidelines for particular symptoms you see in this group of patients.
As far as "best practice guidelines", these are often found in peer-reviewed publications. For example, I was part of an upcoming publication in "The Oncologist" regarding rash management of EGFR TKI's which was based on a "best practice" model. This was developed utilizing the knowledge of experts in the area, as well as information available in the literature. It is based on a "best practice" model because of the difficulty in conducting randomized clinical trials to evaluate treatments for this particular rash. So, you may be able to find similar types of articles by performing a literature search.