As health care continues to evolve in the United States, team-based care has become an essential approach to managing complex patient needs, particularly in oncology. Advanced practice providers (APPs), including nurse practitioners (NPs) and physician associates (PAs), play a pivotal role in oncology care teams; however, limited research has examined the dynamics of leadership and psychological safety (PS) within these teams. This study explored the relationship between team leadership factors, leader inclusiveness (LI) and leader–member exchange (LMX), and PS among oncology APPs. Using a national cross-sectional survey of 84 APPs, findings demonstrated that LI and LMX were positively associated with PS, whereas demographic and professional characteristics were not significant predictors. These results highlight the importance of fostering inclusive leadership and strong leader–member relationships to enhance PS and, ultimately, team effectiveness in oncology care. Implications for practice, education, and future research are discussed.
Classical Hodgkin lymphoma (cHL) is a rare cancer, usually affecting young adults and those over 55 years. A subset of patients experiences relapsed or refractory disease, which remains a treatment challenge. Understanding molecular biomarkers, especially programmed cell death protein 1 (PD-1), is increasingly important for developing new therapies. PD-1 is an immune checkpoint that controls T-cell activation, and its overexpression in cHL enables tumors to evade immune detection. Immune checkpoint inhibitors, such as nivolumab, have shown promise in treating relapsed or refractory cHL by blocking PD-1 and restoring immune responses. This developing landscape requires oncology advanced practitioners to be aware of PD-1 as both a therapeutic target and a predictive biomarker, allowing for personalized treatment plans. Additionally, ensuring equitable access to these innovations remains a major concern, particularly for underserved populations. Oncology advanced practitioners play a critical role in closing care gaps, advocating for broader access, and maintaining ethical standards.
Advanced practitioners (APs) play a critical role in cancer care, but many encounter workforce challenges that contribute to rising burnout rates. These challenges include increased documentation requirements, prior authorization or insurance appeals, staffing shortages, and the overall increasing complexity of cancer care. Advanced practitioners working in academic centers face institutional expectations, such as meeting publication and presentation metrics for merit raises. Those working in community settings must remain current on rapid scientific advances in many different disease states, further increasing their workload. Regardless of workplace setting, many APs are likely experiencing some level of burnout.
With the incidence of testicular cancer (TC) rising, understanding implications for long-term survivorship is essential. Advances in surgery, radiotherapy, and chemotherapy have turned this once deadly disease into a highly curable one. Advanced practice providers (APPs) must be well versed in the evaluation and management of long-term health consequences from multimodal therapy. This article provides an overview of TC, available treatments, and the role APPs play in the evaluation and management of late and long-term health consequences of the disease.
Multiple myeloma (MM) is a plasma cell malignancy that impairs immune regulation, leading to increased infection risk and disease-related complications. While advances in therapy have improved survival, MM remains incurable, with most patients eventually relapsing. T-cell–based immunotherapies, such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies (bsAbs), have emerged as powerful treatment options for relapsed/refractory MM (RRMM). CAR T-cell therapy involves complex manufacturing and requires administration in specialized centers due to the risk of severe toxicities such as cytokine release syndrome (CRS) and immune effector cell–associated neurotoxicity syndrome (ICANS). These therapies demand trained personnel, hemodynamic monitoring, and access to intensive care. Bispecific antibodies, in contrast, are off-the-shelf agents that redirect T cells to malignant plasma cells and offer more flexible, outpatient-friendly administration. While bsAbs can also cause CRS and neurotoxicity, these events are typically milder and more manageable. Despite their promise, bsAb therapies still require infrastructure for toxicity management, monitoring of prolonged cytopenias, and infection prevention. Prophylactic strategies, such as early tocilizumab use, may facilitate safer outpatient delivery. Expanding access to bsAbs, especially in community settings, requires 24/7 clinical support, caregiver engagement, and training for local providers. Advanced practice providers, with their advanced clinical skills and holistic patient care approach, are well-positioned to lead in patient education, early identification, and care coordination. Their involvement is essential to promoting equitable access to novel therapies and improving outcomes. Broader implementation of bsAbs will require investment in infrastructure, education, and interprofessional collaboration to ensure safe, equitable, and effective MM treatment.
