Your FREE OCN Flashcards 2026 – 250+ Cards

Facial/upper-body swelling, distended neck veins, dyspnea — often from a mediastinal/lung tumor.

Actions that reduce cancer risk before disease occurs — e.g., smoking cessation, HPV vaccine, sun protection, healthy diet.

Early detection of cancer through screening so disease is found at a treatable stage (mammography, colonoscopy, Pap test).

Care after a cancer diagnosis to limit complications and disability and improve quality of life (rehab, surveillance).

USPSTF recommends biennial screening mammography for average-risk women ages 40–74.

Average-risk adults begin screening at age 45 (colonoscopy every 10 years or stool-based tests).

Cervical cytology (Pap) with HPV co-testing detects precancerous cervical changes; HPV is the main cause of cervical cancer.

Annual low-dose CT for adults 50–80 with a 20 pack-year history who currently smoke or quit within 15 years.

Prostate-specific antigen is used to screen for prostate cancer; shared decision-making is recommended due to overdiagnosis risk.

T = primary tumor size/extent, N = regional lymph node involvement, M = distant metastasis.

Describes how abnormal cancer cells look vs normal cells; higher grade = poorly differentiated and more aggressive.

Abnormal cells confined to the layer where they began with no invasion through the basement membrane.

Liver, lungs, bone, and brain are the most frequent sites of distant metastasis.

Inherited mutations greatly increasing breast and ovarian cancer risk; guide enhanced screening and risk-reducing surgery.

Hereditary nonpolyposis colorectal cancer; mismatch-repair gene mutations raising colorectal, endometrial, and other cancer risk.

Required before/after hereditary cancer testing to assess risk, ensure informed consent, and interpret results.

An agent (chemical, radiation, virus) that promotes cancer development; e.g., tobacco, asbestos, UV, HPV, hepatitis B/C.

Leading preventable cause of cancer, linked to lung, head/neck, bladder, pancreatic, and many other cancers.

Prevents infection with high-risk HPV types that cause cervical, anal, oropharyngeal, and other cancers.

A document summarizing treatment received plus a follow-up plan for surveillance, late effects, and health maintenance.

Care focused on relieving symptoms and improving quality of life; can be given alongside curative treatment at any stage.

Comfort-focused care for terminal illness, generally a prognosis of 6 months or less, with no curative treatment.

Typically a physician-certified prognosis of 6 months or less if the disease follows its usual course.

Legal document stating a patient's care wishes if they cannot speak for themselves (living will, durable power of attorney).

Names a surrogate (health care proxy) to make medical decisions when the patient is incapacitated.

Do-not-resuscitate order directing that CPR not be performed if the heart or breathing stops.

First-in-human study evaluating safety, toxicity, and the maximum tolerated dose in a small group.

Evaluates efficacy and further assesses safety of a treatment for a specific cancer type.

Compares the new treatment to standard therapy in large randomized groups to confirm efficacy.

Post-marketing surveillance gathering long-term safety and effectiveness data after approval.

Voluntary agreement after disclosure of purpose, risks, benefits, alternatives, and the right to withdraw.

Patient navigation removes barriers and coordinates the cancer-care continuum across providers and settings.

Percent of patients alive 5 years after diagnosis; a common benchmark, not a cure guarantee.

Incidence = new cases in a period; prevalence = all existing cases at a point in time.

Breast cancer is the most commonly diagnosed cancer in women; lung cancer causes the most cancer deaths.

Prostate cancer is most commonly diagnosed in men; lung cancer causes the most cancer deaths.

Substances (e.g., CA-125, CEA, PSA, AFP, CA 19-9) used to aid diagnosis, prognosis, and monitor treatment response.

Sampling the first node(s) draining a tumor to assess regional spread while sparing extensive dissection.

Metastatic cancer found without an identifiable original site after workup; managed by tissue type and immunohistochemistry.

Conversations clarifying patient values to align treatment with comfort, dignity, and quality of life near death.

Systematic approach: assessment, diagnosis, planning, implementation, and evaluation applied to cancer care.

Integrating best research evidence with clinical expertise and patient values to guide care decisions.

Oncology Nursing Society defines the professional scope, competencies, and standards of oncology nursing practice.

Sets handling requirements for hazardous drugs to protect personnel, patients, and the environment.

Double chemo-rated gloves, gown, eye/face protection, and respirator as indicated when handling cytotoxic agents.

Device that prevents escape of hazardous drug or vapor during preparation and administration.

Contains absorbent pads, chemo gloves/gown, goggles, respirator, and waste bags to manage cytotoxic spills.

Body fluids of patients on hazardous drugs are treated as contaminated for 48 hours (longer for some agents).

0 = fully active to 4 = completely disabled/bedridden; guides treatment tolerance and eligibility.

Scale from 100 (normal) to 0 (death) rating functional ability and self-care.

Assess readiness/literacy, use plain language and teach-back, and reinforce with written/visual materials.

Having the patient restate information in their own words to confirm understanding.

A patient's ability to obtain, understand, and use health information to make decisions.

Delivering care responsive to patients' cultural beliefs, language, and health practices.

The ethical principle respecting a competent patient's right to make their own treatment decisions.

Acting in the patient's best interest (beneficence) and avoiding harm (nonmaleficence).

Fair, equitable distribution of resources and access to cancer care.

Truth-telling (veracity) and keeping commitments/maintaining trust (fidelity) in the nurse-patient relationship.

Two qualified practitioners independently verify drug, dose, route, rate, and patient before administration.

Confirm right patient, drug, dose, route, time, and informed consent prior to administration.

Comprehensive evaluation of disease, treatment effects, symptoms, function, nutrition, and psychosocial needs.

Guiding patients through the health system, addressing barriers to timely, coordinated cancer care.

Accurate records of drug administration, vital signs, reactions, education, and patient response are legally required.

Most chemotherapy doses are calculated per m² of BSA using height and weight.

Only specially trained/credentialed nurses should administer vesicant chemotherapy.

Confirm patency and blood return before and during IV chemo to prevent extravasation.

Strict hand hygiene is the single most effective measure to prevent infection in immunocompromised patients.

Ongoing process to measure and improve patient outcomes and safety in oncology care.

Symptom and quality-of-life data reported directly by patients to guide and evaluate care.

Collaborative process where clinician and patient choose treatment based on evidence and patient values.

Remote monitoring and visits expanding access to oncology care, symptom management, and survivorship follow-up.

Patient self-administration requires education on schedule, storage, handling, and missed-dose management.

Cytotoxic waste is segregated into designated yellow hazardous-drug containers, never regular trash.

Record site, drug, volume, symptoms, interventions, photos, and notification per policy.

e.g., Risk for infection related to neutropenia; guides individualized interventions.

Oncology care involves physicians, nurses, pharmacists, dietitians, social workers, and chaplains.

Pre-built, evidence-based order templates reduce dosing errors and improve safety.

Generally prohibited except in emergencies; chemotherapy orders should be written/electronic and double-checked.

Use at least two identifiers (name and date of birth) before any treatment administration.

Protected health information must be safeguarded and disclosed only as legally permitted.

The oncology nurse advocates for patient wishes, informed choice, and access to needed resources.

Maintaining oncology competency through certification, ONS resources, and ongoing professional development.

Pregnant or breastfeeding staff should minimize/avoid handling hazardous drugs per policy.

Provides surveillance, late-effect management, and health promotion for cancer survivors.

Evaluating language, beliefs, support, and resources to individualize and improve adherence.

Damage DNA by adding alkyl groups, causing cross-links; cell-cycle nonspecific (e.g., cyclophosphamide, cisplatin).

Can cause hemorrhagic cystitis; mesna and hydration are used as uroprotection.

Nephrotoxic and ototoxic; requires aggressive hydration; highly emetogenic.

Mimic normal metabolites to disrupt DNA/RNA synthesis; cell-cycle (S-phase) specific (e.g., methotrexate, 5-FU).

Leucovorin (folinic acid) rescue limits methotrexate toxicity to normal cells after high-dose therapy.

Interfere with DNA (e.g., doxorubicin); generally cell-cycle nonspecific.

Anthracycline with cumulative dose-related cardiotoxicity; monitor cardiac (ejection) function.

Inhibit microtubule formation, arresting mitosis (M-phase); e.g., vincristine, vinblastine.

Major dose-limiting toxicity is peripheral neuropathy; vincristine is a potent vesicant.

Vincristine is fatal if given intrathecally — it must ONLY be given IV.

Stabilize microtubules to block mitosis (M-phase); e.g., paclitaxel, docetaxel; risk of hypersensitivity.

Corticosteroids, H1 and H2 blockers are given to prevent hypersensitivity reactions.

Block topoisomerase enzymes to prevent DNA repair; e.g., irinotecan, etoposide, topotecan.

Causes early (cholinergic, treated with atropine) and late (severe, treated with loperamide) diarrhea.

Act on cells in a particular phase; given by continuous infusion or divided doses (e.g., antimetabolites).

Act on cells in any phase, including resting; effective against large tumors (e.g., alkylators, anthracyclines).

A drug that causes severe tissue damage/necrosis if it leaks into surrounding tissue (e.g., anthracyclines, vinca alkaloids).

A drug that causes inflammation or pain at the site without necrosis if it extravasates.

Stop the infusion, leave the catheter, aspirate residual drug, and follow the drug-specific antidote protocol.

Antidote for anthracycline extravasation and a cardioprotectant against anthracycline cardiotoxicity.

Antidote for vinca alkaloid extravasation; promotes drug dispersion and absorption.

Cold for most vesicants; warm compress for vinca alkaloids and oxaliplatin extravasation.

Target specific antigens on cancer cells; e.g., rituximab (CD20), trastuzumab (HER2), cetuximab (EGFR).

HER2-targeted antibody for HER2-positive breast cancer; can cause cardiotoxicity (monitor cardiac function).

Anti-CD20 antibody for B-cell lymphomas; risk of infusion reactions, especially with the first dose.

Oral targeted drugs blocking signaling pathways; e.g., imatinib, erlotinib, sorafenib.

TKI targeting BCR-ABL in chronic myeloid leukemia; a landmark targeted therapy.

Block PD-1, PD-L1, or CTLA-4 to unleash T cells against cancer (e.g., nivolumab, pembrolizumab, ipilimumab).

Autoimmune toxicities from checkpoint inhibitors — colitis, dermatitis, pneumonitis, endocrinopathies; often treated with steroids.

Patient's T cells are engineered to express a chimeric antigen receptor targeting cancer (e.g., CD19 in leukemia/lymphoma).

Systemic inflammatory response after CAR-T/immunotherapy: fever, hypotension, hypoxia; may need tocilizumab.

IL-6 receptor blocker used to treat severe cytokine release syndrome.

Selective estrogen receptor modulator for hormone-receptor-positive breast cancer; increases thromboembolism and uterine cancer risk.

Block estrogen synthesis in postmenopausal women (anastrozole, letrozole); cause arthralgia and bone loss.

Blocks hormones that drive growth of hormone-sensitive cancers (breast, prostate).

Lowers testosterone to treat prostate cancer (e.g., leuprolide); side effects include hot flashes and bone loss.

Delivers radiation from an outside machine to the tumor; the most common radiation form.

Internal radiation placing a sealed radioactive source in or near the tumor.

Minimize time near the source, maximize distance, and use shielding to reduce exposure.

Limit visitor/staff time, keep distance, use a lead shield, and never touch a dislodged source with bare hands.

Use gentle, fragrance-free care; avoid sun, heat, friction, adhesive tape, and metallic deodorant on the field.

Do not wash off radiation field markings; they guide precise daily treatment.

Body fluids are radioactive; isolate, increase fluids/voiding, and follow distance precautions per policy.

Dividing total radiation dose into smaller daily fractions to spare normal tissue while killing tumor.

Stem cells are collected from the patient, then reinfused after high-dose therapy.

Stem cells come from a matched donor; carries graft-versus-host disease risk but adds graft-versus-tumor effect.

Human leukocyte antigen matching between donor and recipient reduces rejection and GVHD risk in allogeneic transplant.

Donor/autologous stem cells begin producing blood cells, shown by a rising ANC, typically 2–4 weeks post-transplant.

Donor immune cells attack recipient tissues — classically skin (rash), gut (diarrhea), and liver (jaundice).

Beneficial donor immune attack on residual cancer cells after allogeneic transplant.

Used for diagnosis, staging, cure, debulking, palliation, prevention, and reconstruction.

Drug given into cerebrospinal fluid (via lumbar puncture or Ommaya reservoir) to treat CNS disease.

Drug instilled into the peritoneal cavity, often for ovarian cancer, for high local concentration.

Access with a noncoring (Huber) needle using sterile technique; flush with saline/heparin per protocol.

The lowest blood-cell count after chemotherapy, usually 7–14 days post-treatment, when infection risk peaks.

Treatment using biologic agents (interferons, interleukins, monoclonal antibodies) to modify the immune response.

Treatment given before primary therapy (often surgery) to shrink the tumor.

Treatment after primary therapy to eliminate residual micrometastatic disease and reduce recurrence.

Chemotherapy-induced nausea/vomiting occurring within 24 hours of treatment.

Nausea/vomiting occurring more than 24 hours after chemotherapy (peaks 2–3 days), common with cisplatin.

Conditioned nausea/vomiting before treatment triggered by prior experiences; managed with anxiolytics and behavioral techniques.

Antiemetics like ondansetron, granisetron; first-line for acute CINV (watch QT prolongation, constipation).

Aprepitant/fosaprepitant added to prevent delayed CINV from highly emetogenic chemo.

Corticosteroid used with 5-HT3 and NK1 antagonists to enhance antiemetic control.

Examples include cisplatin and anthracycline/cyclophosphamide; require triple-agent antiemetic prophylaxis.

Painful inflammation/ulceration of the oral and GI mucosa from chemo/radiation; impairs intake and risks infection.

Use a soft toothbrush and frequent saline or sodium bicarbonate rinses; avoid alcohol-based and irritating products.

Inspect the oral cavity regularly; grade severity and screen for candidiasis or herpes infection.

Manage with loperamide, hydration, and a low-fiber diet; severe cases risk dehydration and electrolyte loss.

Common from opioids and vinca alkaloids; prevent with stimulant laxatives plus stool softeners and hydration.

Anticipate with every opioid order; treat prophylactically with a stimulant laxative (e.g., senna), not fiber alone.

The most common cancer symptom; manage with exercise, energy conservation, and treating anemia/sleep/mood issues.

Step 1 nonopioids, step 2 weak opioids, step 3 strong opioids, each plus adjuvants, escalating with pain severity.

Persistent cancer pain is best controlled with scheduled long-acting analgesics, not as-needed only.

Transient flare of pain over baseline; treated with a short-acting opioid (about 10–20% of the 24-hour dose).

Burning/tingling nerve pain treated with adjuvants such as gabapentin, pregabalin, or duloxetine.

Constipation (does not resolve), sedation, nausea, and respiratory depression; constipation needs ongoing prophylaxis.

Opioid antagonist that reverses opioid-induced respiratory depression.

Converting between opioids using equivalent doses; reduce the dose ~25–50% for incomplete cross-tolerance when switching.

Bone marrow suppression lowering WBCs, RBCs, and platelets — the most common dose-limiting chemo toxicity.

Absolute neutrophil count below 1,500; severe neutropenia is ANC < 500 cells/mm³ with high infection risk.

ANC = WBC × (% segs + % bands) ÷ 100, expressed in cells/mm³.

Strict hand hygiene, avoid sick contacts, no fresh flowers/raw produce per policy, and prompt fever reporting.

Filgrastim/pegfilgrastim stimulate neutrophil production to shorten neutropenia; bone pain is a common side effect.

Manage with iron evaluation, transfusion if symptomatic, and ESAs in select cases; assess fatigue and dyspnea.

Epoetin/darbepoetin raise hemoglobin in chemo-induced anemia; carry thrombosis and tumor-progression cautions.

Low platelets increasing bleeding risk; serious bleeding risk rises as platelets fall below 20,000–50,000/mm³.

Use a soft toothbrush, electric razor, avoid IM injections/NSAIDs/aspirin, and prevent falls; monitor for bleeding.

Prophylactic platelets are often given when counts fall below 10,000/mm³ or for active bleeding.

Numbness, tingling, and weakness from agents like vinca alkaloids, taxanes, and platinums; assess safety/falls.

Protect hands/feet from heat and injury, inspect skin daily, and use caution due to impaired sensation.

Hair loss is usually temporary; reassure that regrowth typically begins 1–3 months after treatment ends.

Palmar-plantar erythrodysesthesia from agents like capecitabine; redness, pain, peeling of palms/soles.

Loss of appetite with muscle/weight wasting; manage with small frequent meals, appetite stimulants, and dietitian referral.

Limb swelling from impaired lymph drainage after node removal/radiation; managed with compression and manual lymph drainage.

Protect the at-risk limb from injury, infection, and constriction (no BP, blood draws, or tight items).

Common from treatment, hormones, fatigue, and body image; address openly and offer counseling/resources.

Discuss before gonadotoxic therapy; options include sperm banking, egg/embryo cryopreservation, and ovarian protection.

Hand hygiene, avoiding crowds and live vaccines, oral/skin care, and reporting any fever immediately.

Maintain protein-calorie intake; manage taste changes, early satiety, and consider enteral support if oral intake fails.

Treat the cause; use oxygen, positioning, fans, and opioids/anxiolytics for refractory breathlessness.

Dry mouth from radiation/medications; manage with frequent sips, saliva substitutes, and good oral hygiene.

Altered taste from chemo/radiation; manage with flavor changes, oral care, and zinc as indicated.

Cumulative fatigue during/after radiation; manage with rest, exercise, and addressing anemia.

Persistent hiccups in cancer can be distressing; treated with agents such as chlorpromazine or baclofen.

Itching from disease, drugs, or cholestasis; manage with skin moisturizers, antihistamines, and treating the cause.

Used as adjuvants for localized neuropathic pain in some patients.

Prophylactic scheduled antiemetics are preferred for emetogenic chemo; PRN agents cover breakthrough nausea.

Topical anesthetics, mucosal coating agents, and systemic analgesics for severe oral pain affecting intake.

Start a stimulant laxative when opioids begin and titrate to keep bowels moving.

Aggressive IV hydration supports renal clearance and reduces metabolic complications during high-cell-kill therapy.

Reduces chemo blood flow to hair follicles to limit alopecia with some regimens.

Common in cancer; address pain, anxiety, steroids, and sleep hygiene; limit late stimulants.

From endocrine therapy/menopause; options include SSRIs/SNRIs, gabapentin, and lifestyle measures.

Fluid accumulation in the peritoneal cavity (e.g., ovarian cancer); managed with paracentesis and symptom control.

Fluid around the lung causing dyspnea; managed with thoracentesis, pleurodesis, or indwelling catheter.

Reposition, manage moisture/nutrition, and protect skin in debilitated cancer patients.

Manage odor, exudate, and bleeding with appropriate dressings and metronidazole for odor control.

Severe diarrhea causes dehydration and loss of potassium/magnesium; replace fluids and electrolytes.

Benzodiazepines (e.g., lorazepam) plus behavioral techniques help anticipatory CINV.

A 5-HT3 patch provides multi-day antiemetic coverage for moderately/highly emetogenic chemo.

Added to antiemetic regimens to prevent nausea, especially delayed and breakthrough CINV.

Bowel inflammation from pelvic/abdominal radiation causing cramping/diarrhea; managed with diet and antidiarrheals.

Lung inflammation weeks to months after thoracic radiation; cough and dyspnea, treated with corticosteroids.

Painful swallowing during chest radiation; managed with topical/systemic analgesia and soft diet.

Bladder irritation causing urgency/dysuria; manage hydration and symptomatic relief.

Bisphosphonates/denosumab reduce skeletal events in bone metastases; monitor for jaw osteonecrosis and hypocalcemia.

Integrate non-pharmacologic comfort (relaxation, music, presence) into supportive symptom care.

Dronabinol/nabilone may help refractory nausea and appetite when standard antiemetics fail.

Evidence supports acupuncture and similar therapies as adjuncts for nausea, pain, and hot flashes.

Single oral temp ≥ 38.3°C (101°F) or ≥ 38.0°C for 1 hour with ANC < 500 cells/mm³ — a medical emergency.

Obtain blood/site cultures and start broad-spectrum IV antibiotics within 1 hour — do not delay for results.

Report fever immediately; avoid masking it before evaluation, and never give rectal meds/temps in neutropenia.

Massive tumor cell breakdown releasing intracellular contents, causing metabolic and renal emergency.

↑K⁺, ↑PO₄, ↑uric acid, and ↓Ca²⁺ from rapid cell lysis.

Aggressive IV hydration plus allopurinol or rasburicase to lower uric acid; monitor electrolytes and renal function.

Recombinant urate oxidase that rapidly lowers uric acid in tumor lysis syndrome.

Bulky, rapidly proliferating tumors (acute leukemias, high-grade lymphomas) at treatment initiation.

Obstruction of the SVC causing facial/upper-extremity edema, distended veins, and dyspnea; often lung cancer/lymphoma.

Elevate the head of bed, give oxygen, avoid upper-extremity venipuncture/BP, and prepare for radiation or stenting.

Tumor pressing on the cord; back pain (earliest sign), then weakness, sensory loss, and bowel/bladder dysfunction.

Recognize early back pain, give corticosteroids (dexamethasone), and arrange urgent imaging/radiation or surgery.

Most common metabolic emergency in cancer; from bone metastases or PTH-related protein.

Fatigue, confusion, constipation, polyuria, nausea — 'stones, bones, groans, and psychiatric overtones.'

Aggressive IV normal saline hydration plus bisphosphonates (and calcitonin); monitor cardiac and neuro status.

Syndrome of inappropriate ADH causing water retention, dilutional hyponatremia, and low serum osmolality (e.g., small cell lung cancer).

Fluid restriction; hypertonic saline for severe symptomatic hyponatremia; correct sodium slowly to avoid CPM.

Disseminated intravascular coagulation: widespread clotting consumes factors, then causes bleeding (e.g., APL, sepsis).

Low platelets and fibrinogen, prolonged PT/PTT, and elevated D-dimer; treat the underlying cause and support.

Life-threatening response to infection; recognize fever, tachycardia, hypotension, and altered mentation early.

Cultures, broad-spectrum antibiotics within 1 hour, IV fluid resuscitation, and lactate measurement.

Fluid in the pericardial sac compressing the heart; from malignant effusion.

Hypotension, muffled heart sounds, and jugular venous distension; pulsus paradoxus may be present.

Emergency pericardiocentesis to relieve pressure; monitor hemodynamics closely.

From brain metastases/edema; headache, vomiting, altered consciousness, and pupillary changes.

Corticosteroids (dexamethasone) for edema, head elevation, and seizure precautions; avoid maneuvers that raise ICP.

Late sign of dangerously high ICP: hypertension (widened pulse pressure), bradycardia, and irregular respirations.

Tumor blocking the GI tract; nausea, vomiting, distension, pain; managed with decompression and symptom control.

Bleeding from tumor erosion, thrombocytopenia, or DIC; apply pressure, support volume, and replace blood products.

Rapid allergic reaction to chemo/biologics: flushing, dyspnea, hypotension, urticaria — stop the drug immediately.

Stop the infusion, maintain the airway, give epinephrine, oxygen, IV fluids, and antihistamines/steroids.

Platinums (carboplatin/oxaliplatin), taxanes, asparaginase, and monoclonal antibodies are frequent culprits.

Vesicant leakage requires immediate stop, aspiration, antidote, and documentation to prevent tissue necrosis.

Life-threatening cecal inflammation in neutropenic patients: fever, RLQ pain, diarrhea; managed with antibiotics and bowel rest.

Cancer is hypercoagulable; sudden dyspnea, chest pain, tachycardia — give oxygen and anticoagulation.

APL is strongly associated with DIC at diagnosis; treated with ATRA and aggressive blood-product support.

Very high blast counts cause sludging in vessels (dyspnea, neuro changes); managed urgently with leukapheresis/cytoreduction.

Pad rails, suction at bedside, and protect the patient in those with brain metastases or metabolic derangements.

Dyspnea, chest fullness, and tachycardia; can progress to tamponade — monitor closely.

Mild infusion reactions may allow rate adjustment/premedication; true anaphylaxis requires stopping and emergency care.

Surgical emergency presenting with sudden severe abdominal pain, rigidity, and signs of peritonitis/sepsis.

Head/neck or mediastinal tumors can obstruct the airway — stridor and dyspnea require emergent management.

Tachycardia, hypotension, and pallor; restore volume with fluids/blood and control the bleeding source.

Low albumin lowers total calcium; assess ionized calcium when interpreting levels in cancer patients.

Frequent monitoring of K⁺, Ca²⁺, PO₄, and renal function is essential during high cell-kill therapy.

Severe high-dose methotrexate toxicity is treated with leucovorin and, if needed, glucarpidase.

Patients use varied strategies to manage the cancer experience; assess and support adaptive coping.

Common with diagnosis, treatment, and surveillance; screen routinely and offer counseling and anxiolytics as needed.

Underrecognized and treatable; screen for persistent low mood, hopelessness, and suicidal ideation.

Routine screening (e.g., a distress thermometer) identifies psychosocial needs across the cancer continuum.

Surgery, alopecia, and weight changes affect self-image; provide support, prostheses, and counseling resources.

Normal response to loss; support anticipatory grief and provide bereavement resources to families.

Grieving that begins before an expected loss; allow expression and provide support.

Prolonged, intense grief impairing function; refer for specialized mental-health support.

Address meaning, hope, and faith needs; involve chaplaincy and respect diverse beliefs.

Caregivers face burden and burnout; assess needs and connect them to respite and support resources.

Framework for breaking bad news: Setting, Perception, Invitation, Knowledge, Empathy, Strategy/Summary.

Active listening, open-ended questions, silence, and empathy to support patient expression.

Economic burden of cancer care harming well-being and adherence; refer to social work and assistance programs.

Cancer and treatment affect sexual health; initiate open, nonjudgmental discussion and offer resources.

Fear of recurrence, identity changes, and reintegration challenges require ongoing support.

A common, persistent survivor concern; validate feelings and provide coping strategies and follow-up plans.

Respect cultural views on illness, disclosure, decision-making, and death to deliver patient-centered care.

Honor diverse rituals and preferences around dying, the body, and mourning.

Connect patients to support groups, peer mentoring, counseling, and community organizations.

Foster realistic hope and help patients find meaning; this supports coping and quality of life.

Teach caregivers symptom monitoring, medication management, and when to seek help.

Mild denial may be protective early on; assess whether it interferes with necessary care decisions.

Screen distressed patients directly; ensure safety and refer urgently when ideation is present.

Differentiate acute fluctuating confusion (delirium) from sustained low mood (depression) for correct treatment.

A central oncology outcome encompassing physical, psychological, social, and spiritual well-being.

Ongoing self-reflection and respect for patients' cultural identities, not assuming expertise about any group.

Structured discussions to share information, clarify goals of care, and support shared decisions.

Integrate emotional, social, and spiritual care alongside symptom management throughout illness.

Provide age-appropriate communication and support for children of patients facing serious illness.