Genetics and Genomics in Oncology Nursing Practice

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Preface: Genetics and Genomics: The Evolution of Oncology Nursing xiii
Where We Have Been xiii
Genetics and Genomics in Oncology xiv
Genetic and Genomic Advances Affect Oncology Nursing xvii
New Discoveries, New Technology, New Content xvii
Where We Are Going xx
Summary xxxii
References xxiii
Section I. Genetic and genomic fundamental principles for oncology Nursing 1
Chapter 1. The Scope of Cancer Genetics and Genomics Nursing Practice 3
Introduction 3
What Influences Scope of Nursing Practice? 4
Interfacing the Oncology and the Genetic and Genomic Scopes of Nursing Practice 5
Dimensions of Cancer Genetic and Genomic Nursing Practice 5
Incorporation of Cancer Genetics and Genomics in Various Practice Settings 7
Scope of Oncology Nursing Practice in Genetics and Genomics 7
Summary 11
References 11
Chapter 2. Biology of Cancer 13
Introduction 13
Models of Cancer Development 13
DNA and Chromosomes: Structure and Function 14
Gene Expression 18
Causes of Mutations 23
Types of Mutations Associated With Cancer and Other Disorders 23
Gene Transmission in Cancers 26
Cancer and Genetics 29
Types of Genetic Alterations in Cancer Cells 36
Types of DNA Repair Mechanisms 38
The Cell Cycle 40
Summary 43
References 43
Section II. Genetics and Genomics Identification and Risk Reduction 47
Chapter 3. How to Perform a Cancer Genetic Risk Assessment 49
Introduction 49
Cancer Genetic Assessment 50
Purpose of a Cancer Genetic Risk Assessment 50
Familial Cancer Susceptibility Syndromes 52
Components of a Cancer Genetic Assessment 55
Family History 64
Psychosocial Assessment 68
Physical Examination 69
The Assessment Process 70
Common Problems of Genetic Evaluation 71
Sample Assessments 72
Summary 74
References 75
Chapter 4. Common Risk Prediction Models and Cancer Risk Communication 79
Introduction 79
Common Terms in Risk Assessment and Risk Communication 80
Quantifying Risks 84
Specific Models Quantifying Cancer Risk or Mutation Probability 86
Case Study 88
Cancer Risk Communication 92
The Media’s Role in Risk Information 98
The Long-Term Impact of Risk Communication 99
Summary 99
References 100
Chapter 5. Delivering Genetic Education and Counseling Services 103
Introduction 103
The Role of Nurses in Genetic Counseling 104
Elements of Cancer Risk Assessment, Education, and Counseling 108
Issues Related to Cancer Genetic Testing 109
Informed Decision Making Related to Cancer Genetic Testing 110
Preparing for Genetic Testing 114
Pretest Education Regarding Potential Test Results 116
Results Disclosure and Post-Test Counseling 119
Cancer Screening, Risk Reduction, and Follow-Up 123
Summary 124
References 124
Chapter 6. Establishment of a Cancer Genetic Risk Assessment Program  
Introduction 129
Needs Assessment and Planning 130
Institutional Policy Considerations 138
Choosing a Type of Cancer Genetic Risk Assessment Program 141
What a Cancer Genetic Risk Assessment Program Looks Like 143
Quality Assurance 147
Summary 148
References 149
Chapter 7. Genome-Wide Association Studies and Cancer 151
Introduction 151
The Road to Genome-Wide Scans 152
Anatomy of a Genome-Wide Association Study 159
Identifying Promising Genomic Regions 160
Replication in Independent Studies 164
Fine Mapping and Beyond: Hints at Biologic Function 166
Challenges for Genome-Wide Association Studies: Present and Future 166
Clinical Implications and Future Directions 167
Summary 168
Resources 169
References 171
Section III. Genomics and Cancer Care 175
Chapter 8. Tumor Profiling 177
Introduction 177
The Need for Tumor Profiling 177
Beginnings of Tumor Profiling 178
Advances in Tumor Profiling: Molecular Profiling 180
Current Work 190
Fast Forward into the Future 192
Coordination of Efforts 193
Summary 194
References 195
Chapter 9. Pharmacogenomics 199
Introduction 199
History 199
Pharmacogenetics and Pharmacogenomics 200
Polymorphisms in Drug-Metabolizing Enzymes 206
Polymorphisms in Drug Transporters 208
Polymorphisms in Drug Targets 209
Technologic Advances Applicable to Pharmacogenomics 212
Summary 213
References 213
Chapter 10. Targeted Therapies 217
Introduction 217
Rationale for Targeted Therapies 217
History of Targeted Therapy 218
Mechanisms for Targeted Intervention 223
Applying Targeted Therapies to Signaling Pathways in Cancer 226
Toxicities of Targeted Therapies 231
Future Direction of Targeted Therapies 236
Summary 237
References 237
Section IV. Ethical, Legal, and Social Issues of Genetics and Genomics 241
Chapter 11. Handling Genetic and Genomic Information Responsibly 243
Introduction 243
Ethical Considerations of Genetic and Genomic Information 244
Facilitating Autonomous Decision Making 249
Principles of Beneficence and Nonmaleficence 250
Recognition of Ethnocultural Differences 251
Privacy and Confidentiality 252
Client Advocacy 254
Emerging Ethical Issues for Oncology Nurses 256
Maintaining a Current Knowledge Base in Genetic and Genomic Developments 260
Summary 263
References 263
Chapter 12. Multicultural Considerations in Providing Genetic and Genomic Cancer Care 267
Introduction 267
Multicultural Considerations in the Delivery of Genetic and Genomic Cancer Nursing Care 268
Why Are Multicultural Considerations Important for Oncology Nurses? 270
Ethnicity and Sociopolitical Factors 271
Multicultural Aspects of Delivery of Genetic and Genomic Services 274
Education 277
Consent 277
Community Healing Models 278
Steps Toward Multicultural Competence 279
Research Implications 279
Summary 281
References 281
Section V. Professional Practice Issues 285
Chapter 13. Genetic/Genomic Competencies and Recommendations for Education 287
Introduction 287
What Do Nurses Already Know about Genetics and Genomics? 287
Are All Nurses the Target for Education? 288
Education Recommendations for Oncology Nurses 289
Exemplars 293
Summary 294
References 295
Chapter 14. Ensuring Competence: Nursing Credentialing in Cancer Genetics 297
Introduction 297
The Significance of Credentialing to Clinical Practice 298
Establishment of Competence 300
Certification of Nurses in Oncology 301
Certification of Nurses in Genetics 301
Future Directions in Licensure and Certification 303
Summary 303
References 304
Chapter 15. Research: Making a Difference in Practice 305
Introduction 305
Translational Research: Necessary to Make a Difference in Practice 305
Molecular Genomic Tumor Profiling for Breast Cancer as an Example of Moving Basic Research Toward Clinical Utility 308
RNA Interference as an Example of Cutting-Edge Technologies Expected to Affect Practice 309
Highlights of Select Research Initiatives 310
Additional Tips to Stay Current with Genomic Research 312
Incorporating Genetics and Genomics into Oncology Nursing Research 313
Summary 313
References 316
Section VI. Resources 317
Chapter 16. Identifying Appropriate Referrals and Resources 319
Introduction 319
Professional Organizations: Resources for Networking and Genetic and Genomic Information 319
Physician Groups 326
Resources for Continuing Education 327
Clinical Resources: Sources for Patient Information and Referrals 329
Family History and Other Client Resources 331
Resources for Information Regarding Genetics Education 332
Genetics Legislation, Guidelines, and Policies 333
Research Opportunities 335
Summary 337
References 337
   
Glossary 339
Index 347
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