2013 Health Care Crystal-Ball-Gazing

by Nursetopia on January 23, 2013

Go ahead – pick up the crystal ball. Take a look at what 2013 holds or may hold for health care.

Two organizations have already laid out their thoughts on the next year in healthcare. Medscape’s slideshow is quick and easy to follow, and Modern Healthcare reporters present several videos highlighting topics.

Do you agree? What do you think will happen in your healthcare neck ‘o the woods this year?

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The November 2012 special issue of the National Cancer Institute Cancer BulletinThe Science behind Cancer Screening, has a great infographic and accompanying article about the benefits and harms of PSA screening for prostate cancer. Currently, routine PSA screening for prostate cancer is not recommended, and the infographic helps show why. Various cancer screening remain controversial among many. The entire special issue is quite interesting and sheds light on several topics.

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You Are Safe with Me

by Nursetopia on May 10, 2012

Thousands of people place their lives in the hands of pilots and flight crews daily; the large majority arrive safely and soundly at their destinations. When an airplane crashes, it is breaking news and numerous organizations get involved to learn from the crash-causing errors to ensure they are prevented in the future. With nearly 100,000 people dying annually from preventable medical errors – the equivalent of one, full aircraft crashing every single day – hundreds of health care systems are turning to the airline industry’s safety methods and processes.

This collision of aviation and health care safety met an ironic twist last week as I traveled to New Orleans to attend the Oncology Nursing Society‘s 37th Annual Congress. I sat down in my window seat, still listening to my audio book, and an off-shift pilot sat right next to me, a cup of coffee and newspaper in hand. I planned to listen to my audio book, and I thought my nestled ear buds might be a clue to others, but my pilot seat-mate had other plans.

[Smiles largely] Business or pleasure?

[Removes ear buds.] A little of both. I’m an oncology nurse, and I’m on my way to a conference in New Orleans.

Ah! New Orleans! [Pauses; leans closer] So, oncology. That’s…what?…

[Quickly.] Cancer. I’m a cancer nurse.

Right. That’s what I thought. Do you want to read part of the paper? I’m finished with this section. [Offers a folded paper to me.]

No thanks. I’m good. [Puts up iPad and ear buds as the flight crew requests. Looks out window.]

So, when are you supposed to start having that colonoscopy thing? I’ll be 56 in a few months.

Before we left the tarmac I explained screening recommendations, debunked a few myths, and relieved concerns about embarrassment. Less than 30 minutes later we landed at our connection city. Our parting words included my strong encouragement for him to see his provider for a colonoscopy and his thanks and promise to do so.

Within one minute of him finding out I am an oncology nurse, we were discussing colonoscopies. I certainly didn’t mind; I was glad I could share. It’s my job and my passion, and the conversation reiterated how much people trust nurses – even those not in uniform. I am glad he felt safe with me. It’s a responsibility and honor I cherish.

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Coffee + Cervical Cancer Screening = Volunteerism

by Nursetopia on September 14, 2011

"coffee beans" by via Flickr

Looking for a way to give back and see the world at the same time? You need to volunteer for my friends at Grounds for Health, a global nonprofit bringing women’s health to coffee-growing communities in Mexico, Tanzania, and Nicaragua. They use cervical cancer screening technologies such as VIAA to save lives in these resource-limited areas. Cervical cancer is a global threat, and you can make a difference.

Volunteering with Grounds for Health is sure to be an amazing experience. And if you can’t globe-trot, there are absolutely other ways to volunteer with this great organization. Get involved today.

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You Might Really Have Junk in Your Trunk

by Nursetopia on March 1, 2011

Hiney. Tail. Rear-end. A$$. Tush. Badonkadonk. There is an ever-growing list of euphemisms for the gluteus maximus. Not too many for the colon, though. It’s not sexy.

What is even less sexier? Colon, or colorectal, cancer. Yet, according to the American Cancer Society, colorectal cancer is the third most common cancer among both men and women, and “91% of cases are diagnosed in individuals aged 50 and older.” Early stage colorectal cancer typically has no symptoms, which is why screening is so important. Starting at age 50, men and women should both begin routine colorectal cancer screenings. Those at increased risk such as people with certain genetic disorders (FAP and HNPCC), personal or family history of colorectal cancer or colon polyps, or history of chronic inflammatory bowel disease should talk to their physicians about beginning screening earlier than age 50. Advanced signs of colorectal cancer include changes in bowel movements such as the color (i.e. bloody) and shape (i.e. thinner), stomach pains that do not go away, and unexplainable weight loss. If  any one has these symptoms, no matter the age, colorectal cancer should be considered in the differential diagnosis.

Current evidence-based colorectal cancer screening options include fecal occult blood test (FOBT), fecal immunochemical test (FIT), flexible sigmoidoscopy, and colonoscopy. I know I am an oncology nurse, I am completely biased, and have a weird sense of the world, but cancer screening is hot. Living longer is sexy. Bottom line: you might really have junk in your trunk. So go ahead – if you’re age 50 or older (or are at an increased risk), get your derriere to the doctor. And make sure those in your life do, too.

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Cervical Cancer Survivors: In Their Own Words

by Nursetopia on January 27, 2011

I love hearing from cancer survivors. I enjoy getting to know them and listening to their unique stories. A beautiful organization and website I adore is Voices of Survivors, which explores what “survivorship” means to individual “survivors.” In honor of cervical cancer awareness month, take a look at some cervical cancer survivors’ voices and stories. Some of the things that stand out the most to me are ages, careers, families, and healthcare professionals overlooking what is now obvious.

Aalia’s Voice

Angela’s Voice 

Lisa’s Voice

Jennifer’s Voice

Alissa’s Voice

Katie’s Voice

These ladies and their stories represent a much larger group of women. What from their voices stands out the most to you?

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If MacGyver was a nurse and needed to do a cervical cancer screening in the wilderness, this is the one he would use – visual inspection with acetic acid, or VIA*. I think he was more into wires and bomb diffusions, but whatever…

I had never heard about VIA in my sweet little nursing bubble until two years ago when I met some African nurses who were actually utilizing it to save their neighbors’ lives. I was amazed as they told me about their work, and I was shocked at how differently similar our clinical experiences were in comparison. According to Jhpiego, cervical cancer is the second most common cancer in females globally killing more than 250,000 women annually. This from a cancer that is largely, what we call, “controlled” in the U.S. 80% of the world’s cervical cancer burden occurs in developing countries where as many as 95% of women have never had a Pap test.

VIA is particularly useful in developing countries in which financial and technical constraints serve as tremendous barriers to screening. A healthcare professional or lay worker is trained to swab a female’s cervix with acetic acid, otherwise known as vinegar, and then view or photograph the cervix under a bright (halogen) light, looking for clearly defined white neoplasms, or abnormal cells, that appear as a result of the chemical reaction.Very cool. And to make it even cooler, there are now examples of VIA practiced in telemedicine as explained in this poster-love video.

*VIA is also known as cervicoscopy or direct visual inspection (DVI).

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If you have ever had sexual intercourse or plan on having sex in the future, there’s a pretty good chance you either currently have HPV, have had HPV in the past, or will have HPV in the future. According to the American Cancer Society, some physicians believe HPV infection may be as common as the cold. Between 50% to 75% of sexually active people will have HPV in their lifetime.

HPV, or human papillomavirus, is a group of over 150 viruses. More than 40 of those viruses are sexually transmitted causing genital warts, oral viruses, and even cancers of the cervix, vulva, penis, anus, rectum, and throat. HPV infections can last from one to several years and may have no symptoms at all or may develop papillomas, which are warts or noncancerous tumors, lesions, and cancerous changes. In most cases, the body’s immune system will kill the virus in about a year. Still, according to the National Cancer Institute, “persistent HPV infections are now recognized as the cause of essentially all cervical cancers.” A monogamous relationship and condom use are both associated with lower HPV-infection rates; the addition of Gardasil and Cervarix have also shown protection against several high-risk strains of HPV.

Because it is difficult to know if someone has HPV, women should follow the recommended screening guidelines and receive routine Pap tests. You may not be able to prevent HPV infection entirely, but you can certainly help prevent cervical cancer by detecting HPV-induced pre-cancerous cervical changes via a Pap test.

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Ladies, Say it With Me: Papanicolaou

by Nursetopia on January 24, 2011


You may know it more fondly as Pap – like Pap test or Pap smear. Okay, so maybe “fondly” is not the first word that comes to mind when thinking about stirrups, speculums, and cervical scrapings. Unless maybe it has saved your own or a loved one’s life. If so, you have largely one man to thank. That’s right – Dr. Papanicolaou.

Dr. George Nicholas Papanicolaou spent his entire medical career studying uterine* cytology, or cell-structure and processes, of both animals and women.  He developed one of the greatest cancer screening methods of all time upon realizing a simple uterine fluid smear (e.g. take some fluid and smear it on a microscope slide) viewed under the microscope reveals cancerous and pre-cancerous cells. According to the American Cancer Society, most of the 67% reduction in cervical cancer incidence and mortality over the last thirty years is directly attributed to Dr. Papanicolaou’s discovery. [cue the female Hallelujah! Choir]

"Anatomy:The Cervix and Nearby Organs" by Don Bliss (NCI Visuals Online)

Unfortunately, more than 12,000 women were newly diagnosed with cervical cancer last year. Well, that would mean, Ladies, you’d actually have to get your Pap test to receive its awesome benefits. January is Cervical Cancer Awareness Month, and I’m devoting Nursetopia to cervical cancer awareness and education the entire week. Until tomorrow, thank you, Dr. Papanicolaou. Thank you!

For my non-healthcare professional friends who may be wondering why I keep saying uterine or uterus rather than cervical or cervix: the cervix is part of the uterus and separates the vagina and the larger part of the uterus commonly referred to as the womb.

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I Hope I Am the One & You Are the Two

by Nursetopia on January 19, 2011

While reading through The New Your Times Picture Your Life After Cancer site, I came upon Tyler’s picture and post. Tyler points out that, according to the American Cancer Society, 1 in 2 men and 1 in 3 women will be diagnosed with cancer in their respective lifetimes. Those are pretty high statistics for all of us, but it was Tyler’s closing sentence that struck me.

I hope I am the one and you are the two.

It’s not fair. The odds are stacked against us, it seems, in regards to carcinogenesis. It’s inevitable. No, no it’s not. The American Cancer Society also reports that nearly two-thirds of all cancers can be prevented – stopped entirely before they occur – via tobacco cessation and changes in nutrition and physical activity (to reach a healthy BMI). For perspective, approximately 1.5 million new cancer cases will be diagnosed in the U.S. alone this year. 1.5 million people will hear, “You have cancer,” for the first time. 1.5 million lives and families’ lives will be changed forever. Yet, if all two-thirds of those cancers could be prevented by doing what we know works, close to 990,000 people this year would likely never experience cancer related to lifestyle behaviors. In addition, numerous cancers have high survival rates if detected at early stages, and it seems like we are still pulling, pushing, and persuading people to complete routine cancer screenings.

While I don’t know the specifics of Tyler’s diagnosis, I doubt the cancer was related to lifestyle behaviors or even screenable per today’s various cancer screening guidelines. Still, Tyler’s picture and post remind me of my lifetime relative risk of cancer which then leads me to think about prevention and early detection. I want to do everything I can so that I am “one of the two,” and I want to do everything I can so that there are no more “ones” like Tyler.

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