Blogs

By Margaret (Peggy) Rosenzweig, PhD, FNP-BC, AOCNP®, FAAN  
ONS Scholar-in-Residence 

As an oncology nursing research scientist, I have witnessed our field evolve in exciting ways. The Oncology Nursing Society’s (ONS’s) 2024–2027 Research Agenda is a testament to that progress. In 2023, ONS conducted a rigorous research prioritization process, gathering insights from key stakeholders, thought leaders, and the latest science. We uncovered five major priority areas: advancing precision symptom science, ensuring safe and sustainable cancer care delivery, understanding environmental influences on outcomes, integrating navigation, and promoting innovative research methodologies. 

What stands out to me as the most unique is the heightened attention to environmental influences on cancer outcomes. This is more than a timely topic; it is a crucial opportunity for nurse scholars to be a voice of change. Although the landscape of environmental impact is broad, the research priority panel narrowed the focus to three pivotal areas that are uniquely suited to the holistic lens of oncology nursing:  

I like these categories because they push us to think beyond traditional boundaries but remain approachable for oncology nursing scholarship. They offer fresh research directions and the chance to inform policy, ensuring that oncology nursing continues to drive meaningful changes for patients, families, and entire communities. 

Place Matters: Neighborhood Deprivation and Cancer Disparities 

In recent years, oncology nursing scholarships devoted more attention to environmental factors within cancer care and oncology nursing. AnnMarie Walton, PhD, MPH, RN, OCN®, CHES, FAAN, of Duke University has emerged as a key figure in this area, leading the publication of a white paper in the Oncology Nursing Forum titled “The Impact of Climate Change Across the Cancer Control Continuum: Key Considerations for Oncology Nurses.” Walton’s research, including her examination of hospital maintenance workers’ exposure to contaminants in chemotherapy units, provides concrete and compelling examples of how environmental risks are unequally distributed, even among our work colleagues. 

At the community level, evidence increasingly demonstrates that individuals living in poverty or in resource-limited neighborhoods experience disproportionate exposure to environmental hazards, resulting in higher cancer risk. But there is more to the story beyond incidence. Cancer disparities across the continuum are exacerbated by a lack of support systems and resources to help individuals navigate cancer treatment and recovery. The disparities also challenge oncology nurses to consider interventions and advocacy that reach beyond the clinical setting, addressing the broader social and environmental determinants of health. 

For oncology nurse scholars, this is not just background context. It is a call to action. Nurses are exceptionally positioned to lead longitudinal symptom trajectory studies that examine how neighborhood-level resources influence symptom distress and management during active treatment. Could the study of epigenetics add the biological, mechanistic lens that presents an even more comprehensive landscape? Through understanding clinical context and holistic assessment, including biologic markers, nurse scientists are equipped to frame those questions. 

Navigation intervention trials embedded within specific area deprivation index (ADI) strata represent another promising avenue. Rather than treating deprivation as a statistical covariate, nurse-led studies can test whether navigation models need to be calibrated differently based on neighborhood context and intensity of support to optimize outcomes for patients living in the most underserved areas. Implementation science approaches can then examine how cancer centers adapt care delivery for those patients and how nurse-driven process improvements like telehealth symptom management, community-based infusion sites, and extended pharmacy hours can be systematically tested and scaled. The research and quality improvement possibilities are endless with potential for real impact. 

A Warming World: Climate Change and Oncology Care 

Climate change has emerged as a defining challenge for global health and oncology care is not immune. Extreme weather events, including hurricanes, wildfires, and floods, can disrupt treatment schedules, exacerbate workforce shortages, threaten supply chains for supplies and medications, and disproportionately burden vulnerable populations. Who knows this better than oncology nurses? Yet oncology nursing has limited evidence to guide care continuity during those crises. 

Nurse scholars, informed in a collaborative manner through clinical colleagues, can begin filling this gap through retrospective analyses of treatment interruptions following disasters using claims or registry data to quantify delays, emergency department use, and downstream outcomes. Prospective registry studies in disaster-prone regions could establish ongoing surveillance systems that capture real-time data on treatment modifications and care gaps during environmental events. Those studies would finally answer two basic questions: Which patients are most vulnerable, and what strategies prevent treatment disruption? 

Truth in a Noisy World: The Information Environment 

The COVID-19 pandemic exposed with painful clarity how misinformation can undermine trust, distort risk perception, and deter patients from evidence-based treatment or clinical trial participation. For patients and families with cancer, the information environment is not merely about access to facts, it is about who delivers information, through what relationships, and within what context of trust.