Sue Zupanec, MN, NP
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Behind every COG clinical trial are nurses who ensure treatments are safe, effective, and child-centered. In this Q&A, COG Nursing Committee Chair Sue Zupanec, MN, NP, explains how nurses shape protocols, educate families, and help deliver game-changing therapies like blinatumomab. She also highlights why donor support is vital to expanding education, innovation, and research — and what’s kept her involved with COG for more than 20 years.
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When Sue Zupanec, MN, NP, applied for her first job as a pediatric oncology nurse, she didn’t know she would fall in love with the field — or how passionate she would become about improving the lives of kids and families touched by pediatric cancer.
“I fell into oncology nursing,” she said. “But I stayed in part because I was so interested in the complexity of care from a medical standpoint. And even more so because I learned that nurses play such a critical role in partnering with these families on this crazy and terrible journey. The relationships I’ve built have been so rewarding.”
Zupanec has now been a pediatric oncology nurse for more than three decades and currently practices at The Hospital for Sick Children (SickKids) in Toronto, Canada. She first got involved with COG when she was invited to give an educational talk on relapsed leukemia nearly 20 years ago. She’s been involved ever since and now leads COG’s Nursing Committee. We caught up with her to learn about COG’s Nursing Committee and the vital role nurses play in pediatric cancer research.
How do nurses help with cancer clinical trials research?
Nurses have so many roles in pediatric cancer clinical trials research! Nurses administer all of the cancer therapies and other necessary medications and follow research protocols to a tee. They draw blood for studies to analyze and monitor patients for important side effects. At COG, nurses often influence protocols, weighing in on what is practical and identifying when an idea that looks great on paper would be difficult to put into action in an actual clinical setting.
Nurses carry out the majority of direct patient care as part of clinical research. Their work is essential and research cannot happen without them.
“I fell into oncology nursing,” she said. “But I stayed in part because I was so interested in the complexity of care from a medical standpoint. And even more so because I learned that nurses play such a critical role in partnering with these families on this crazy and terrible journey. The relationships I’ve built have been so rewarding.”
Zupanec has now been a pediatric oncology nurse for more than three decades and currently practices at The Hospital for Sick Children (SickKids) in Toronto, Canada. She first got involved with COG when she was invited to give an educational talk on relapsed leukemia nearly 20 years ago. She’s been involved ever since and now leads COG’s Nursing Committee. We caught up with her to learn about COG’s Nursing Committee and the vital role nurses play in pediatric cancer research.
How do nurses help with cancer clinical trials research?
Nurses have so many roles in pediatric cancer clinical trials research! Nurses administer all of the cancer therapies and other necessary medications and follow research protocols to a tee. They draw blood for studies to analyze and monitor patients for important side effects. At COG, nurses often influence protocols, weighing in on what is practical and identifying when an idea that looks great on paper would be difficult to put into action in an actual clinical setting.
Nurses carry out the majority of direct patient care as part of clinical research. Their work is essential and research cannot happen without them.
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Tell us more about the COG Nursing Committee. What does your committee do?
The Nursing Committee is COG’s largest committee with more than 3,000 members around the world. Education is a big focus of our committee. We help nurses understand protocols and provide training on how to carry out various protocols that are part of clinical trials. This work helps make it possible for COG to carry out trials across hundreds of centers and bring the latest cancer trials closer to home for many families. Nurses are often the front line for questions and concerns from patients and families, providing important anticipatory guidance to support families to monitor and manage cancer-related symptoms. The nursing committee has led the development of patient and family education materials — we developed COG’s core patient and family education resources, including the COG Family Handbook and New Diagnosis Guide, and the Teen, Adolescent, and Young Adult New Diagnosis Guide. |
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What are some of the most interesting projects your committee has worked on lately?
One exciting project is focused on the implementation of COG-endorsed fatigue guidelines led by COG nurses at their home institutions. Research shows that many kids and teens undergoing cancer treatment experience extreme fatigue and exercise can help mitigate fatigue. But determining how to assess fatigue and to get kids undergoing treatment (who may be hospitalized, attached to medical equipment and generally not feeling well) to exercise is a challenge.
When nurses across 15 COG sites explored different ways to assess fatigue and to incorporate exercise into care, we saw so many creative ideas. One hospital put on a scavenger hunt for kids where they had to do a bit of walking. Another hospital found a donor to donate shoes to every kid who walked a certain number of steps. We were overwhelmed by the enthusiasm at so many institutions.
We also helped develop best practices for an amazing new therapy. Thanks in large part to COG clinical trials, an immunotherapy called blinatumomab can now offer a highly effective treatment for the vast majority of kids who develop acute lymphoblastic leukemia (ALL), which is the most common childhood cancer. It’s also a complex therapy that requires continuous infusion for 28 days per cycle — and it creates many challenges when a child needs to be connected to the infusion for that long.
COG nurses helped develop practice guidance about how to administer the therapy, including managing interruptions, flushing, and supporting the infusion bags in a backpack that goes everywhere with the child. The nurses are really the ones who figured out how to administer this complex therapy and helped the kids and families to get through it.
One exciting project is focused on the implementation of COG-endorsed fatigue guidelines led by COG nurses at their home institutions. Research shows that many kids and teens undergoing cancer treatment experience extreme fatigue and exercise can help mitigate fatigue. But determining how to assess fatigue and to get kids undergoing treatment (who may be hospitalized, attached to medical equipment and generally not feeling well) to exercise is a challenge.
When nurses across 15 COG sites explored different ways to assess fatigue and to incorporate exercise into care, we saw so many creative ideas. One hospital put on a scavenger hunt for kids where they had to do a bit of walking. Another hospital found a donor to donate shoes to every kid who walked a certain number of steps. We were overwhelmed by the enthusiasm at so many institutions.
We also helped develop best practices for an amazing new therapy. Thanks in large part to COG clinical trials, an immunotherapy called blinatumomab can now offer a highly effective treatment for the vast majority of kids who develop acute lymphoblastic leukemia (ALL), which is the most common childhood cancer. It’s also a complex therapy that requires continuous infusion for 28 days per cycle — and it creates many challenges when a child needs to be connected to the infusion for that long.
COG nurses helped develop practice guidance about how to administer the therapy, including managing interruptions, flushing, and supporting the infusion bags in a backpack that goes everywhere with the child. The nurses are really the ones who figured out how to administer this complex therapy and helped the kids and families to get through it.
Sue Zupanec, MN, NP
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What’s on the research horizon for the Nursing Committee? Our committee’s core values are always the same: We’re trying to improve cancer outcomes for kids, teens, and families. But exactly how we do that changes over time as the clinical trials rapidly change. Moving forward, one of our most important efforts is making sure that nurses are involved in developing research protocols across COG. We’re also really invested in collecting more patient-reported outcomes to learn more about patients' experience during and after clinical trials. What role does donor funding play in your work? The support COG receives from the National Cancer Institute is incredible, but it’s limited. The core goal at COG is to improve survival outcomes and NCI funding helps us do that. But donor funding can help us do so much more. |
COG has the scientific expertise and the track record of influencing our standard of care therapies for most pediatric cancers. We are a group of caring individuals driven by passion. We get things done. We have the infrastructure, we have the network, we have the experts, we have everything we need to make the biggest impact. Donor dollars help that work go even further and help more kids and families.
You’ve been working with COG for more than 20 years. What keeps you coming back?
I really enjoy nurse education and seeing nurses be engaged and excited about clinical trials. Being involved in the COG blinatumomab trials has been amazing — no one could have dreamed that this was going to change therapy around the world. Blinatumomab has been the greatest advance in childhood leukemia for decades and the fact that nurses played such a strong role in it is incredible. I’m inspired every day because the Nursing Committee is so passionate about these kids and families. There’s nothing like it — COG is an amazing family.
Learn more about COG’s Committees: Read about the Adolescent and Young Adult Oncology Committee and the Patient Advocacy Committee.
You’ve been working with COG for more than 20 years. What keeps you coming back?
I really enjoy nurse education and seeing nurses be engaged and excited about clinical trials. Being involved in the COG blinatumomab trials has been amazing — no one could have dreamed that this was going to change therapy around the world. Blinatumomab has been the greatest advance in childhood leukemia for decades and the fact that nurses played such a strong role in it is incredible. I’m inspired every day because the Nursing Committee is so passionate about these kids and families. There’s nothing like it — COG is an amazing family.
Learn more about COG’s Committees: Read about the Adolescent and Young Adult Oncology Committee and the Patient Advocacy Committee.