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December 2007 Issue

As a member of the Nursing Leadership Board, Ginger Love, nurse coordinator in UC's hematology-oncology division, is helping to develop national guidelines for managing multiple myeloma therapy side effects.
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UC Nurse Helps Sets the Standards in Managing Care

By Amanda Harper
Published December 2007

Sometimes conquering the side effects of cancer treatment can be more difficult than the initial diagnosis or fear of recurrence.


That challenge is especially acute for the more than 100,000 Americans living with myeloma, a disease that affects plasma cells (white blood cells) produced by disease- and infection-fighting B lymphocytes in the bone marrow.


Although myeloma is not curable, experts say promising new medical treatments are increasing long-term survival for patients with the disease.  But these new therapies come with side effects that can discourage patients from finishing treatment: drowsiness, weakness, stomach pain, dizziness, constipation and diarrhea are among the most common.


Nurses and the oncologists they work for are faced with the challenging task of helping patients manage these side effects and improve their overall quality of life.


"This is an exciting time in myeloma care because new therapies are working and patients are starting to live longer after diagnosis," says Ginger Love, an oncology nurse who recently joined the UC Barrett Cancer Center at University Hospital. "Taking the patient off a therapy that could save their life because the side effects are too intense should only be the last option."


According to the American Cancer Society, about 20,000 Americans will be diagnosed with multiple myeloma in 2007.


A type of blood cancer, multiple myeloma causes the body to overproduce clusters of abnormal plasma cells that cannot perform their normal duties of fighting off bacteria and viruses. As a result, healthy platelets and red and white blood cells have little or no room to grow.


Serious complications-including increased susceptibility to infections, easy bone breaks and uncontrollable bleeding from minor cuts-can greatly impact a patient's ability to live a full life.


"It's critical that oncology nurses-both in major medical centers and smaller community clinics-understand how to manage those symptoms," Love says.


Love is among an elite group of 20 nurses from across the United States selected in 2006 by the International Myeloma Found-ation (IMF) to participate in its  Nursing Leadership Board.


Board members share their knowledge and experience in an effort to educate other nurses about managing the side effects associated with treating this complicated disease.


"Oncology nurses play a major role in the ongoing care of cancer patients," says Love, who also serves as nurse coordinator in UC's hematology-oncology division.


"Although the physicians make the key decisions about care, it's usually the nurses who actually implement it and help patients manage their symptoms."


As part of the Nursing Leader-ship Board, Love has worked for the past year to help create treatment protocols and therapy side-effect management guidelines that nurses can use day-to-day in caring for myeloma patients.


To tackle this task, board members were split into four teams that concentrated on developing protocols for managing a specific side effect associated with new drug therapies.


Love's team was charged with addressing peripheral neuropathy (PN), a condition that damages the nerves and often results in patients feeling numbness, tingling or discomfort in their hands and feet.


The way PN is managed, however, depends on whether it is induced by myeloma or as a side effect of treatment.


New guidelines developed by Love and her colleagues recommend patients who show early signs of PN receive nutritional supplements including B-complex vitamins, folic acid and certain amino acids prior to treatment. If a patient already has the condition, tricyclic antidepressants might be a better approach. 


Full guidelines developed by the Nursing Leadership Board will be published in an upcoming issue of  Journal of Supportive Oncology. They will also be available through the IMF at


The hematology-oncology division is part of a joint cancer program involving the UC College of Medicine, Cincinnati Children's Hospital Medical Center and University Hospital.


The collaborative initiative brings together interdisciplinary research teams of caring scientists and health professionals to research and develop new cures, while providing a continuum of care for children, adults and families with cancer.

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