The intersection of oncology and autoimmune disorders presents a unique challenge for healthcare providers. Patients diagnosed with cancer who also suffer from autoimmune diseases often require tailored care plans that address both their needs.

This dual diagnosis increases the complexity of treatment decisions, particularly when immunosuppressive therapies overlap or conflict with cancer therapies. For example, the use of immune checkpoint inhibitors (ICIs) in oncology can trigger or worsen autoimmune flare-ups, making clinical judgment critical.

An NCBI study states that it is also important to keep patients well-informed about such a condition. Patients with both these conditions expressed wanting to learn more about the risks and benefits of treatment plans. Most of them wanted to get information in visual formats so they could learn at their own pace in their homes.

In this article, we will discuss how doctors and nurses can work together to manage oncology patients with comorbid autoimmune disorders.

Managing Symptoms and Side Effects

In patients dealing with both cancer and autoimmune diseases, symptom management becomes more nuanced. Fatigue, joint pain, rashes, fever, and gastrointestinal issues are common in both groups. This makes it difficult to determine whether symptoms are caused by the cancer itself, the autoimmune condition, or a treatment-related side effect.

A comprehensive meta-analysis encompassing 95 studies and 23,897 patients revealed more about this intersection. It was found that 61% of cancer patients with preexisting autoimmune diseases experienced immune-related adverse events (irAEs) when treated with ICIs. Notably, 36% of these patients experienced flares of their existing autoimmune conditions, and 32% required hospitalization due to irAEs.

For these patients, nurses are often the first point of contact. Their ability to gather accurate symptom histories, observe subtle changes, and communicate concerns to physicians can prevent complications. A nurse’s observational skills are particularly important when symptoms arise suddenly or fluctuate in severity.

This kind of clinical complexity underscores the importance of experience, continuing education, and team communication. Nurses who are trained to view patient conditions from multiple angles are better equipped to advocate for treatment adjustments. Their insight can influence whether a therapy continues as planned or is paused to address a flare or adverse reaction.

The Role of Modern Nursing Education

In today’s healthcare environment, nurses are expected to do more than follow care plans. They are vital contributors to treatment decisions, symptom management, and patient education. As the clinical demands of managing patients with complex conditions increase, so does the need for a well-prepared nursing workforce.

However, there is a shortage of nurses in the US. According to the US Chamber of Commerce, there are only nine nurses per 1,000 people in the country. It is estimated that 177,400 nurses will enter the workforce between 2022 and 2032. However, this number is less than the projected openings.

This can be an excellent opportunity for people interested in pursuing a career in nursing. These individuals can become part of an in-demand field and get the satisfaction of helping patients and changing their lives. Those who want to pursue this career can enroll in a Bachelor of Science in Nursing (BSN) program. However, someone with another bachelor’s degree can also switch to this profession.

Accelerated online BSN programs allow individuals with an existing bachelor’s degree to complete a nursing program quickly. Traditionally, it takes four years to get the degree, but with accelerated programs, you can get it before that. Moreover, as these programs are online, you don’t have to make a huge change in your existing life. For instance, you can enroll in this program without having to leave your job.

According to Cleveland State University, these programs help you build real-world competency and get relevant experience. This helps you get acquainted with the nursing field based on the education you gathered in your other bachelor’s degree.

Balancing Treatments and Coordinating Care

Treatment planning in dual-diagnosis cases involves more than choosing the most effective medication. It requires coordination among multiple specialists to ensure therapies do not counteract or compound each other’s effects.

Oncologists may recommend checkpoint inhibitors for a patient’s melanoma, while the patient’s rheumatologist may be concerned about a history of autoimmune arthritis. Each perspective is valid, but a unified plan must be reached.

Steroids, commonly used in autoimmune treatment, may reduce the effectiveness of certain cancer drugs. Similarly, targeted cancer therapies can activate immune responses that worsen autoimmune symptoms. Without regular communication between departments, patients risk experiencing serious side effects or reduced treatment efficacy.

In leading cancer centers, interdisciplinary care teams have become a standard approach to address these challenges. Weekly or biweekly meetings often include oncologists, rheumatologists, pharmacists, nurse practitioners, and nurse case managers. These sessions provide opportunities to review progress, discuss adverse reactions, and adjust treatment plans with everyone on the same page.

In some institutions, dedicated comorbidity clinics have emerged to streamline care for patients with overlapping diagnoses. This level of coordination not only improves clinical outcomes but also reduces stress for patients, who otherwise may receive conflicting information from different providers.

A BMC Journal study found that this quality of communication is essential to improve patient-centered outcomes, especially among seniors. It was found that both verbal and non-verbal communication can be effective. Effective communication can enhance:

• Patient satisfaction
• Physical and mental health
• Quality of life
• Quality of care

Leveraging Technology for Better Outcomes

Technology has made it easier to manage patients with overlapping health issues, but only when it is used thoughtfully. Electronic health records (EHRs) allow providers across departments to view shared patient notes, lab results, and medication histories in real time. Alerts can be set for drug interactions or abnormal lab values, providing an added layer of safety.

However, technology should not replace clinical judgment. It must support the decisions made by knowledgeable providers. Custom templates within EHR systems, for instance, can prompt nurses to ask about autoimmune-specific symptoms during oncology check-ins. Automated reminders can notify providers to monitor labs more frequently when certain drug combinations are in use.

Telehealth also plays a growing role, particularly for patients who need frequent monitoring but have mobility issues or live in remote areas. Virtual check-ins allow nurses and physicians to assess symptoms quickly and make timely adjustments to treatment plans. Still, the effectiveness of these tools depends on proper training and clear workflows.

The COVID-19 pandemic accelerated the adoption of EHR technology in the healthcare industry. EHR adoption increased from 6.6% to 81.2% between 2009 and 2019, which further accelerated after the pandemic. On the other hand, comprehensive systems only increased from 3.6% to 63.2% in the same period.

Frequently Asked Questions

Can cancer treatments trigger new autoimmune conditions in patients without a prior history?

Yes, certain cancer treatments—especially immune checkpoint inhibitors—can activate the immune system in ways that may lead to new-onset autoimmune conditions. These therapy-induced autoimmune responses are known as immune-related adverse events and can involve the skin, gastrointestinal tract, endocrine system, and more. Close monitoring and prompt management are essential to prevent long-term complications.

Are patients with autoimmune disorders more likely to be excluded from clinical trials for cancer treatment?

Historically, many oncology clinical trials excluded patients with preexisting autoimmune diseases due to concerns about adverse events. However, this is changing. More recent trials have started to include these patients with appropriate monitoring protocols, recognizing the need for broader applicability of treatment data.

How do biologic medications for autoimmune conditions impact cancer risk over time?

Biologic agents that suppress specific parts of the immune system, like TNF inhibitors, have raised concerns about long-term cancer risk. Current data suggest that while some biologics may slightly increase the risk of certain cancers, the overall risk is still relatively low. Risk assessments should be personalized and based on the patient’s cancer history, family history, and treatment duration.

Research into safer and more effective therapies for patients with dual diagnoses is ongoing. Biologics that target specific immune pathways are being explored to minimize side effects, and personalized medicine continues to shape how clinicians approach treatment decisions.

In clinical settings, success in managing these patients comes down to collaboration, current knowledge, and careful observation. As more cases of overlapping oncology and autoimmune conditions emerge, the healthcare system must stay adaptable. With the right training and teamwork, clinicians can ensure that patients receive care that is both safe and effective.

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