By Amos Azure, Oncology Nurse Specialist, Tamale Teaching Hospital, Ghana | Overall Best Graduating Participant, ONLEP Cohort II

Joining the Oncology Nursing Leadership Programme (ONLEP) in Africa has been one of the most meaningful experiences of my nursing career. As an Oncology Nurse Specialist at Tamale Teaching Hospital in northern Ghana, I have always been passionate about improving cancer care. However, ONLEP challenged me to look beyond my daily clinical responsibilities and recognise my potential to influence change within the wider healthcare system. Through lessons in leadership, networking and collaboration, psycho-oncology, health systems administration, research and evidence-based practice, and policy and advocacy, I gained valuable knowledge and skills and, more importantly, the confidence to apply them. Serving as Course Representative for 60 oncology nurses from 17 African countries was another rewarding part of my journey. It gave me the opportunity to learn from colleagues with diverse experiences, build lasting friendships, and appreciate the value of professional relationships across borders. Above all, I learned that leadership is not about standing above others, but about lifting others, recognising needs, and having the courage to take actionable steps to make a meaningful difference.

One of the most fulfilling aspects of ONLEP was the opportunity to turn learning into action. At Tamale Teaching Hospital, I identified a gap in the early recognition of chemotherapy-induced toxicities, particularly among nurses working outside specialist oncology units. Through my quality improvement project, 45 frontline nurses across six clinical units received training in recognising and escalating these toxicities. Their average knowledge scores improved significantly from 4.64 to 8.20 out of 10. A practical decision-support algorithm was also introduced to guide early recognition and timely escalation. For me, this demonstrated the real value of ONLEP: moving beyond acquiring knowledge and certificates to address real challenges in patient care.

On 30 October 2026, I was deeply humbled and honoured to receive the Overall Best Graduating Participant Award for ONLEP Cohort II. While this recognition means a great deal to me, I see it not as a destination, but as a renewed responsibility to serve, inspire others, and contribute to better cancer care. My heartfelt gratitude goes to Professor Lydia Aziato, Vice-Chancellor of the University of Health and Allied Sciences (UHAS) and ONLEP Programme Lead, UHAS, the International Society of Nurses in Cancer Care (ISNCC), City Cancer Challenge (C/Can), Amgen (the funder), our dedicated facilitators and ONLEP administrative team, my wonderful fellow participants, and the Management of Tamale Teaching Hospital for their invaluable support throughout this journey. Through the ONLEP Community of Practice, I look forward to developing new initiatives and collaborating with colleagues across Africa to strengthen oncology nursing practice, education and research. At Tamale Teaching Hospital, I hope to work with the hospital leadership and ONLEP Alumni and future participants to sustain the progress made and further strengthen chemotherapy safety across the cancer care continuum, from safe handling and preparation to administration, early recognition of toxicities, and appropriate and timely management.

ONLEP has taught me that leadership does not end with graduation. Rather, that is where the real work begins.

In this issue of the ISNCC Academic Express column, we highlight a study exploring spousal communication barriers and their relationship with psychological distress among young adults with cancer. This research draws attention to the unique emotional and interpersonal challenges faced by patients navigating cancer during a critical stage of family and personal development.

Based on a study involving 202 married young adults with cancer, the researchers identified key communication difficulties related to body image changes, disease progression, treatment concerns, and sexual experiences. The findings revealed a significant association between spousal communication barriers and depressive symptoms, but not anxiety. This study provides valuable insights into the importance of assessing communication needs and integrating spouse-focused interventions into psychosocial oncology care. It also highlights opportunities for oncology nurses to strengthen emotional support, promote open communication, and deliver more holistic, patient-centred cancer care.

Why We Chose This Research Topic 

Young adult (YA) patients with cancer, diagnosed between the ages of 20 and 39 years, are at a critical life stage of family development. There communication with spouses is vital as it is not only a source of emotional support but also a key pathway to help patients rebuild self-worth and cope with negative emotions. Previous studies mainly utilized qualitative research to explore the communication experiences between patients with cancer and their spouses. The target population mainly focused on breast cancer. The perceived communication barriers with spouses among YA patients with cancer remain unclear. We would like to explore these barriers and their association with psychological distress, which were expected to inform interventions to improve spousal communication.

What We Discovered 

The analysis included 202 married young adult patients with cancer (mean age = 34.69 years; 77.2% female). Participants completed the Cancer-Related Communication Problems Scale, GAD-7 and PHQ-9. The data demonstrate a mild level of overall communication barriers. Item-level analysis indicates the most prominent communication barriers were difficulty with partner understanding of body image changes, discussing worsening conditions, sharing worries about treatment effectiveness, avoidance of discussing sexual experience, and selective disclosure to protect the spouse. The lowest barrier score was observed for not knowing when the partner wants to talk about cancer. Hierarchical linear regression analyses showed that after adjusting for sex and unemployment status, communication barriers remained independently associated with depressive symptoms. No statistical association was observed between communication barriers and anxiety levels. 

Implications for Cancer Care

These findings have implications for optimizing communication and psychosocial support for YA patients with cancer. 

1. Routine assessment of spousal communication using brief screening tools is suggested for YA patients with cancer.

2. Interventions are warranted to be designed to guide YA patients in communicating with their spouses, particularly regarding understanding of body image changes, discussing worsening conditions, sharing worries about treatment effectiveness, avoidance of discussing sexual experience, and selective disclosure to protect the spouse.

3. Psychosocial interventions require stratification according to the patient's dominant psychological symptoms. Spouse-based communication interventions are suggested to incorporated into interventions for relieving depressive symptoms.

Corresponding Author: Qinqin Cheng

The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University / Hunan Cancer Hospital, Changsha, China

Yao, Y., Chen, J., Duan, Y., Xie, J., Chen, X., & Cheng, Q. (2026). Perceived communication barriers with spouses among young adult patients with cancer and their association with psychological distress. Asia-Pacific Journal of Oncology Nursing, 13, 100989. https://doi.org/10.1016/j.apjon.2026.100989

Read ICN’s letter to WHO Director-General candidates

Miss Jyoti Somabhai Patel, Nurse Manager in Oncology at Tata Memorial Hospital in Parel, Mumbai, India, has recognized the tremendous potential nurses have in creating awareness and bringing positive change in the community, especially in the area of breast cancer awareness. If nurses are empowered  with the right knowledge and skills regarding breast cancer awareness, early detection, and timely referral, they can create a significant impact and help reduce the burden of cancer worldwide.

With this vision, Jyoti Somabhai Patel initiated a Training of Trainers (TOT) Programme on Breast Cancer Awareness in Maharashtra. To implement this programme at the state level, she approached the Maharashtra Nursing Directorate and sought the necessary support and permission from the state government. With the encouragement and approval of the Maharashtra authorities, including Commissioner and IAS Officer Mr. Anil Bhandari, this important initiative was successfully organized.

The TOT programme was conducted on 4 April 2026. Two nurse leaders from each participating state government hospital were invited. The programme included a one-day intensive workshop consisting of both theoretical and practical sessions. During the workshop, participants received training on breast cancer awareness, early detection, breast health education, and the practical methods required to conduct awareness sessions in their own hospitals and communities.They also clearly explained how the programme should be implemented after the training. The trained nurse leaders became responsible for transferring their knowledge and skills to other nursing staff in their respective hospitals.

To ensure proper coordination and monitoring, a WhatsApp group was created for all the trained leaders. Before conducting awareness sessions, participants were required to complete a Pre-test, download and use the Dear You app, and conduct a Post-test after the session. Proper documentation was also maintained. Photographs of the training sessions were taken using a GPS-enabled camera, and signatures of all participants were collected.This structured approach helped monitor the programme and measure its impact. Within only five months, 7,043 nurses were trained through this initiative.

This achievement has strengthened the belief that nurses can become powerful ambassadors of cancer awareness. When one nurse leader is trained, that knowledge can be transferred to many other nurses, patients, families, and members of the community. This creates a multiplier effect that can reach thousands of people.

The goal is to expand this Training of Trainers model to every state in India. By empowering nurses across the country with standardized knowledge, practical skills, and digital health tools, breast cancer awareness can be strengthened, early detection promoted, and people encouraged to seek medical care at the right time.

As Jyoti Somabhai Patel emphasizes, empowering nurses is not only an investment in the nursing profession it is an investment in healthier communities. Together, a strong network of informed and empowered nurses can be built, taking breast cancer awareness from hospitals to homes and communities across India.

 

In September 2026, a community-based cancer screening program was implemented in Phong Điền, Phong Dinh and Phong Phú Wards in Hue City, Vietnam. The program was supported by The DOVE Fund, USA, and provided cancer screening services completely free of charge to local residents.

The program was conducted on September 12, 19 and 26, reaching more than 1,000 people, particularly residents affected by Agent Orange and individuals identified as being at high risk of cancer.

The screening package included clinical examinations and investigations for common cancers and cancer-related conditions. For men, services included physical examination, thyroid and abdominal ultrasound, chest X-ray, complete blood count and AFP testing. Women additionally received breast examination and ultrasound, gynecological examination and Pap testing.

The program brought together healthcare professionals from Hue Central Hospital and local health services, creating an opportunity to connect hospital-based oncology care with community health services. Beyond early detection, the activity provided health education and encouraged people at increased risk to seek timely medical evaluation and follow-up.

This initiative demonstrates the value of bringing cancer prevention and early detection services closer to underserved and high-risk communities. It also highlights the important role of nurses and multidisciplinary healthcare teams in community cancer control, from identifying high-risk individuals and coordinating screening to providing education, communication and follow-up support.

By taking cancer screening directly into the community, the program contributed to improving access to early detection and strengthening collaboration between oncology services and local healthcare systems in Hue, Vietnam.

The International Society of Nurses in Cancer Care (ISNCC) and Hue Central Hospital have jointly rolled out the highly anticipated 2nd cohort of the Foundation Course in Oncology Nursing in Vietnam, running from June 25 to July 9, 2026. Tailored for nurses without prior professional oncology training, this flagship program is designed to build standardized core competencies, elevate clinical service quality, and ensure safe, holistic care for cancer patients and their families across the country.

Marking a remarkable scale-up of professional oncology nursing education, the second cohort saw 255 participating nurses from 15 Vietnamese provinces and cities — a substantial growth compared to 70 nurses enrolled in the program’s first cohort. The high-caliber training was further empowered by 30 distinguished local and international guest speakers, bringing together global expertise and local clinical experience to deliver authoritative, practice-oriented education.

Co-developed by ISNCC and Hue Central Hospital oncology nursing and medical specialists, the course adopts a hybrid teaching model combining live interactive sessions and pre-recorded professional lectures. Its comprehensive curriculum covers the full cancer care continuum, including cancer prevention and early screening, disease diagnosis and staging, core treatment principles, and targeted nursing interventions for various cancer types. Key practical modules also span patient and occupational safety standards, cancer symptom management, oncology emergency response, specialized treatment device operation, nutritional care, patient communication and bad news delivery, cancer rehabilitation, survivorship care, palliative care, medical ethics, and oncology nursing research. Throughout the training, the critical role of specialized oncology nurses and the value of multidisciplinary medical collaboration were strongly emphasized to shape standardized, team-based clinical practices.

The two consecutive cohorts of training have delivered transformative impacts on frontline Vietnamese oncology nurses, significantly upgrading their professional knowledge and clinical confidence. A palliative care nurse noted the training equipped them with actionable professional skills and a deeper humanistic understanding of cancer care, enabling more compassionate, patient-centered holistic services for advanced cancer patients. Another nurse transitioning from intensive care to oncology departments reported greatly improved capabilities in patient assessment, early risk warning identification, emergency disposal, patient health education, and cross-team multidisciplinary communication.

Beyond individual professional growth, the program has driven widespread clinical practice improvement and knowledge sharing across medical institutions. Leading nursing colleagues have actively translated course learnings into daily work, collaborating with teams to develop localized patient education materials and cascade standardized oncology nursing knowledge to institutional colleagues. As a former head nurse of Hue Central Hospital’s Oncology Center emphasized, professional knowledge gains true value only through internal sharing, practical implementation, and tangible improvements to patient and family care outcomes.

All participating Vietnamese nursing professionals expressed sincere gratitude to ISNCC and Hue Central Hospital for the rigorous curriculum development, high-quality teaching resources, recorded lecture materials, and in-depth clinical experience sharing. This cross-regional, international collaborative program has built a standardized professional learning platform and facilitated high-level academic exchanges among nurses from diverse hospitals and provinces in Vietnam.

Looking ahead, local nursing practitioners hope to sustain this valuable partnership, secure continuous advanced oncology nursing education opportunities, and further popularize standardized oncology care practices nationwide — ultimately elevating the overall standard of Vietnam’s oncology nursing industry and delivering better care outcomes for cancer patients and their families.

Facebook page of the Hue Central Hospital.

Congratulations to the Oncology Nurses Society of Kenya (ONS-K), a Full Member of ISNCC, on successfully hosting its 12th Annual Scientific Conference and Annual General Meeting from 16–18 September 2026 at Weston Hotel, Nairobi, under the theme “Advancing Evidence-Informed Cancer Care".
The three-day gathering brought together oncology nurses, healthcare professionals, researchers, educators, students, partners and other stakeholders with a shared commitment to strengthening cancer care and advancing the oncology nursing profession.
Throughout the conference, participants engaged in meaningful conversations and knowledge exchange on some of the key issues shaping cancer care today, including innovations in healthcare training and research, cancer prevention and early detection, advances in cancer treatment and radiotherapy, genomics, palliative care, mental health and wellbeing, geriatric oncology, patient-centred care, research and evidence generation, leadership, and the future of oncology nursing.
The conference created an important space for learning, professional exchange, collaboration and reflection, bringing together diverse experiences and perspectives from across the cancer care landscape. It also highlighted the importance of translating evidence and research into clinical practice while strengthening the capacity of oncology nurses to provide quality, comprehensive and patient-centred care.
The 12th Annual General Meeting was an integral part of the gathering, providing members with an opportunity to reflect on the Society’s progress, participate in its governance processes and elect the incoming leadership to guide ONS-K into its next chapter.
ONS-K sincerely appreciates all the speakers, moderators, delegates, partners, exhibitors, members and the organising team whose expertise, participation and commitment contributed to the success of the conference.

In this issue of ISNCC Academic Express, we highlight a qualitative study published in Cancer Nursing by a research team in Türkiye, exploring the ethical dilemmas experienced by pediatric oncology nurses during end-of-life (EOL) care. The study brings nurses’ voices to the forefront, examining how they navigate complex tensions among medical decisions, children’s dignity, family needs, and organizational constraints.

The findings highlight challenges including uncertainty around potentially futile treatment, limited nursing authority in decision-making, ethical silence, and the emotional burden of EOL care. This study provides valuable insights for the global cancer nursing community and underscores the importance of clear EOL care standards, interdisciplinary shared decision-making, ethics support, and emotional preparation for nurses. Strengthening these areas can help advance compassionate, patient- and family-centred pediatric cancer care across diverse health systems.

Why We Chose This Research Topic?

Despite remarkable progress in pediatric cancer survival, many children still progress to end-of-life care, one of the most emotionally and ethically demanding areas of pediatric oncology nursing. While ethics in adult oncology and palliative care are well documented, qualitative evidence capturing pediatric nurses' own voices remained limited. We wanted to understand, from nurses themselves, how they navigate the tension between medical necessity, children's dignity, and family needs when difficult decisions must be made.

What We Discovered?

We conducted three online focus groups with 13 pediatric oncology nurses across Türkiye, most with five or more years of experience in university hospitals. Using Braun and Clarke's thematic analysis, three overarching themes emerged. The first, Ethical Issues in End-of-Life Clinical Care, captured nurses' uncertainty about continuing interventions perceived as futile, decisions about place of care and quality of life, tension between honesty and preserving hope, and system-imposed constraints such as bed shortages and the absence of dedicated palliative spaces. The second, Lack of Authority in Decision-Making Mechanisms and Ethical Silence, revealed that although nurses hold rich, continuous knowledge of children and families, physician-centered hierarchies and unclear institutional or legal frameworks often leave them unable to voice their concerns. The third, The Emotional and Professional Cost of Ethical Conflicts, described the cumulative helplessness, guilt, and exhaustion nurses carry, often far beyond working hours.

What struck me most was how consistently nurses described feeling caught between conscience and institutional rules, with no structured way to consult about what they believed was ethically right.

Implications for Cancer Care

1. Strengthen Institutional EOL Standards: Most participating nurses reported no clear end-of-life protocol. Standardized, child-centered EOL guidelines and expanded pediatric palliative care services can reduce the uncertainty falling on individual nurses.

2. Create Space for Nursing Voice: Because nurses' day-to-day knowledge of children and families is rarely integrated into formal decisions, embedding ethics consultation and shared decision-making structures into EOL care could translate nursing insight into actionable care planning.

3. Invest in Ethical and Emotional Preparedness: Structured training on truth-telling, moral distress, and complex EOL communication may strengthen nurses' confidence in difficult moments, while organizational psychosocial support can help sustain compassionate care and protect against burnout.

Ultimately, ethical dilemmas in pediatric oncology EOL care are shaped by relational, organizational, and institutional contexts together, not isolated clinical events. Listening to nurses, and giving them a genuine role in ethical decision-making, is essential to sustaining dignity-oriented care for children and families facing the end of life.

Source：

Şahin, R. S., Sümengen, A. A., Ercan-Koyuncu, İ., Tekinyildiz, E., Güneş, E., Savaş, E. H., . . . Ay, A. (2025). Under the shadow of ethical dilemmas: A qualitative study of pediatric oncology nurses’ end-of-life care experiences. Cancer Nursing. Advance online publication. https://doi.org/10.1097/NCC.0000000000001599

Author:

By Remziye Semerci Şahin, RN, MSN, PhD, School of Nursing, Department of Pediatric Nursing, Koç University, Istanbul, Türkiye

From August 20 to 23, the Oncology Nursing Academic Conference, hosted by the Chinese Nursing Association (CNA), was successfully held in Jinan, Shandong Province, China. Under the theme “Professional Leadership, Multidimensional Empowerment, and Advancing Together,” the conference brought together nearly 1,000 experts, scholars, and nurses specializing in oncology nursing from 31 provinces, municipalities, and autonomous regions across China. Participants engaged in in-depth discussions and exchanges on the current landscape and future development of oncology nursing.

Prof. Xinjuan Wu, President of the Chinese Nursing Association, and Academician Jinming Yu of Shandong Cancer Hospital delivered keynote presentations focusing respectively on the development strategy for the nursing discipline over the next five years and the high-quality development of hospitals in the new era.

Prof. Winnie So, Past-President of the International Society of Nurses in Cancer Care (ISNCC), and Prof. Catherine Johnson, the Secretary/Treasurer of ISNCC, were also invited to attend the conference, contributing international expertise and perspectives to the advancement of oncology nursing in China.

Prof. Yuhan Lu, Chair of the Oncology Nursing Professional Committee of the Chinese Nursing Association, and Chunyan Li , Executive Vice President of the Beijing Nursing Association, presented updates on the latest advances in oncology nursing.

The parallel sessions focused on empowering nurses through six dimensions, including digital and intelligent technologies, evidence-based practice, professional development, management, and humanistic care. A wide range of new concepts, knowledge, skills, and models in oncology nursing were presented and discussed. The conference also featured various forms of academic exchange and research dissemination, including oral paper presentations and poster sessions. The sessions were rich in content, with a strong emphasis on practical relevance and clinical applicability.

In this issue of ISNCC Academic Express, we highlight a study by Charlotte T. Lee and colleagues exploring Canadian ambulatory oncology nurses’ experiences with virtual care and interprofessional collaboration. As virtual and hybrid models become increasingly embedded in cancer services, the study draws attention to an often less visible dimension of nursing practice: the coordination work required to deliver safe, continuous, and person-centred care across virtual and in-person settings.

Using a mixed-methods sequential explanatory design, the research highlights strong collaboration and role clarity alongside challenges in preparedness and support for virtual nursing practice. Importantly, the findings illuminate oncology nurses’ evolving role as “coordination architects”—connecting patients, providers, information, and care settings while supporting assessment, escalation, communication, and follow-up. This study provides valuable insights into how competency-based preparation, effective communication and documentation systems, and recognition of coordination as clinical labour can strengthen virtual oncology nursing practice and evidence-based cancer care.

Virtual and hybrid care are now routine in many oncology programs. Virtual and hybrid care are now routine in many oncology programs. What has received less attention is how this shift has changed the coordination work underlying safe cancer care. In our study of Canadian ambulatory oncology nurses, a clear message emerged. Oncology nurses are not simply delivering care through a screen; they are increasingly acting as coordination architects who design, maintain, and repair the connections that make safe cancer care possible.

Using a mixed-methods sequential explanatory design, we first surveyed ambulatory oncology nurses across Canada, then conducted follow-up interviews to explain survey patterns. Nurses perceived high levels of interprofessional collaboration and strong understanding of their role within the team. Ratings were lower, however, for perceived ability to enact virtual nursing practice, and nurses expressed neutrality about how adequately prepared they felt for virtual care. Notably, nurses who reported receiving training did not differ significantly from those who did not, suggesting that “training” is inconsistent in content, depth, and relevance to real practice demands.

Interviews clarified why. Nurses described uneven onboarding and variable guidance, particularly for virtual assessment and escalation. Virtual encounters often require more deliberate planning and follow-up to compensate for limited physical assessment cues and fragmented information across platforms. Beyond the clinical interaction itself, nurses described expanding coordination work: aligning schedules and care plans, bridging communication between providers and settings, troubleshooting technology, ensuring documentation continuity, and proactively identifying when a virtual pathway is no longer appropriate and must shift to in-person care.

When nurses are expected to function as coordination architects without adequate scaffolding, the system relies heavily on individual workarounds. Our integrated findings suggest that strong role clarity and collaborative values are necessary but not sufficient. Virtual oncology care requires system-level supports commensurate with the complexity of coordination work, including standardized, competency-based preparation; clear expectations for virtual assessment, triage, and escalation; reliable documentation and communication pathways; and workload models that recognize coordination as clinical labour.

In Canada, the Canadian Association of Nurses in Ontario practice standards are explicit: coordination across providers and throughout the cancer continuum is a core nursing responsibility. Standards 4 and 5 explicitly describe the nurse’s role in navigating patients through the health system, ensuring seamless referral, and communicating across teams. In ambulatory virtual care, these standards are enacted through the supportive care functions nurses perform at every contact: symptom monitoring, patient education, psychosocial check-ins, and follow-up after medical visits. They are the mechanism through which ongoing supportive care needs are identified, communicated, and met. When coordination infrastructure is inadequate, it is precisely these functions that fall through the gaps. What this study reveals is a system gap. The standards exist, but the infrastructure to enact them in virtual environments does not consistently follow. If virtual care is here to stay, the coordination nurses are already performing must be recognized as clinical labour, not absorbed silently into individual workload. Oncology nurses are already performing this coordination work. Recognizing and supporting it is fundamental to safe, continuous, and person-centred cancer care.

Author:    Charlotte T. Lee,

RN, CON(C), PhD,Toronto Metropolitan University, Canada

Source：

 Lee CT, Ng F, Mirzadeh P, Borycki EM, Buick C, Newton L, Lounsbury J, Wong J, Moura S, Kweon A, Marcelo K, Fitch M. Understanding oncology nurses' experiences with virtual care and interprofessional collaboration in Canada: A mixed-method study. Eur J Oncol Nurs. 2026 Jun;82:103170. doi: 10.1016/j.ejon.2026.103170. Epub 2026 Mar 23. PMID: 41926834.