CCR Nurses: Collaborative, Committed, and
Caring Amidst Complexity
A welcoming presence at the door and a familiar face going forward—in addition to the best chances for treatment, this is also what cancer patients seek when they enroll in one of CCR’s many clinical trials. As consistent points of contact during treatment, CCR nurses Mary Ann Yancey, Megan Mackey, Melissa Walker, and Marcia Mulquin meet that obligation, even as they tend to the administrative details of managing research. As caregivers, CCR nurses provide a reassuring presence for patients. And as liaisons among patients, physicians, and pharmaceutical companies, they manage the critically important flow of clinical information from the bedside to the research database.
Mary Ann Yancey, R.N., C. Ola Landgren, M.D., Ph.D., and Marcia Mulquin, R.N. (Photo: R. Baer)
As in other medical settings, cancer treatment at CCR is a collaborative effort directed by a team of doctors and nurses who oversee a patient’s daily care—but working in a research environment adds even more responsibility: to aid in the development of safe, potentially better cancer therapies. As highly trained professionals in oncology, CCR nurses aim to make a patient’s cancer journey as successful as possible. During cancer treatment, patients experience side effects and anxiety, which contribute to a reduced quality of life. CCR nurses work tirelessly to address these complicating factors using the most advanced techniques available.
The Nurse Practitioners
As highly trained professionals in oncology, CCR nurses aim to make a patient’s cancer journey as successful as possible.
Some nurses have “hands-on” jobs that tend to the clinical aspects of patient care, while others have administrative responsibilities ensuring that the many clinical trial protocols are carried out seamlessly. Mary Ann Yancey’s job is among the former. A former Peace Corps volunteer, Yancey came to CCR’s Medical Oncology Branch Multiple Myeloma Section, headed by Ola Landgren, M.D., Ph.D., in 2007 after finishing her master’s degree in oncology nursing at George Mason University. She compares the workings of various research teams at CCR to the parts of a bicycle. “The principle investigators are like the bike frame,” she said. “They bring us the science, the hypotheses, and the protocols. The research nurses are the hub of the bicycle wheels. They connect the needs of the protocol with the rest of CCR to make sure the protocol is followed as written and keep the whole thing running.” Her greatest pleasure is seeing how new treatments developed through CCR’s clinical trial programs can really help patients, not just physically, but also by giving them hope. She recalls one patient, a 26-year-old woman with cutaneous T cell lymphoma, a type of non-Hodgkin’s lymphoma that manifests in the skin. Nothing had worked until the patient was enrolled in a Phase 1 clinical trial with intravenous fenretinide, a drug related to vitamin A. “That was four years ago, and as of today she continues to be free of disease and able to care for her two children,” Yancey said. “This type of experience makes my job very rewarding.”
“The principal investigators are like the bike frame... The research nurses are the hub of the bicycle wheels.”
Yancey said that most CCR patients arrive fearful and confused, and what she has learned over time is how listening to what patients say often helps to calm their fears. “I try to be as communicative as possible; I try my best to listen to their concerns and answer their questions as quickly and as best as I can. When I don’t have the answer, I will look to other sources to help them better understand their disease as well as what we are trying to accomplish here,” she said. The entire research collaboration is focused on the patient, Yancey added. “Everyone at CCR tries their best to make this as easy an experience as possible for the patient. Without the patient and their time and commitment, there would be no research,” she said.
As a research nurse, Yancey also participates in administrative duties: she schedules labs and clinical procedures, and helps to guide patients in their journey through the clinical trial protocol. Yancey acknowledges the hardships that come with her job. One patient—a 56-year-old male truck driver who was treated six years earlier for breast cancer—arrived in the clinic with his family and with a new diagnosis of pancreatic cancer. “He enrolled in a Phase 1 trial of gemcitabine, cisplatin, and an experimental drug and responded well initially. It was very gratifying to see the treatment work, at least for a while,” Yancey said. “But sadly, after six months, his disease progressed. Talking about this with him and his family was extremely difficult.”
“We work together with our patients in every way that we can, from diagnosis until they leave the program.”
Megan Mackey, a nurse practitioner in CCR’s Neuro-Oncology Branch, headed by Howard Fine, M.D., also describes her work as highly rewarding because it occurs in an environment where new treatments are constantly evolving. Mackey came to the NIH in 1999 for an internship after graduating from nursing school at the University of Rochester and decided to stay on full-time—working first in a stem cell transplant unit, and then in the Oncology Day Hospital. After earning a Master’s Degree in Nursing (MSN) in 2006 from the University of Maryland, she was offered the position she holds today, tending to patients with primary brain tumors and tumors of the spinal cord. “These are such terrible illnesses with such a great need for new therapies,” she said. “And that makes it a great field for research and a huge part of why I enjoy being part of that process.”