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Christine Amoroso Coordinates Treatment-Optimizing, Dedicated Intravesical Clinic

In May 2022, Christine L. Amoroso, BSN, RN, OCN, will celebrate 35 years of nursing at the Fox Chase Cancer Center. Amoroso is currently a member of Fox Chase’s Urologic Oncology team, where she helps to run a dedicated intravesical clinic and spends the rest of her week as urology procedure nurse. 

Christine Amoroso, BSN, RN, OCN

“Chris is an agent of change,” said Alexander Kutikov, MD, FACS, Chief of the Division of Urology and Urologic Oncology. “She brings incredible energy to our team and improves patient care with everything she touches. Her humanity and competence make the Fox Chase Urologic Oncology team the best it can be.”

Team Player

Amoroso started her career at Fox Chase working on the surgical floor—the only one at Fox Chase at that time. In the years since, she has worked in the outpatient clinic, minor procedures, the same-day surgery unit, and phone triage before coming to the urology team in 2017. 

It was at that time that members of the urology team tapped Amoroso to help lead the creation of its dedicated intravesical clinic. 

“The idea for the clinic was conceived by two nurses that worked with urologists,” Amoroso explained. “They found that nurses who were working side-by-side with doctors would have to break away from that work to do intravesical treatments.”

As the number of patients requiring intravesical treatment increased, the decision was made to start a dedicated clinic where patients could go for these treatments. Initially, Amoroso was the sole provider in the clinic. Now Amoroso—together with two other nurses—is responsible for scheduling the patients, administering the treatments, and following up with the treating physician for further management. The intravesical clinic is available for a half day Tuesday, a half day Wednesday, and a full day on Thursday. 

The creation of this dedicated clinic is unique and has benefited both patients and doctors. For example, the clinic is part of what has allowed Fox Chase to continue to successfully offer Bacillus Calmette-Guerin (BCG) a standard treatment option for patients with non-muscle-invasive bladder cancer. 

In 2019, the only maker of BCG announced a global shortage of BCG due to increasing demand. 

“We had to immediately start to rethink how we offered this treatment,” Amoroso said. 

Among the recommended options for conserving BCG is use in only high-risk patients and providing maintenance treatments with the drug at one-third of the dose, if feasible. 

“From a nursing perspective, that means we have to be careful about how we schedule our patients,” Amoroso said. “One vial has to be divided between three patients, which means these patient appointments have to be grouped together.”

BCG has to be used within two hours after it is reconstituted. 

“All the nurses work hard to educate our patients about this so they understand why they have to come in on certain days at certain times,” Amoroso said. 

Fox Chase has also been testing intravesical instillation of percutaneous BCG as an alternative conservation approach.

Amoroso said that this nurse-led coordination together with the dedication of the pharmacy team to acquire the treatment has allowed Fox Chase to continue to offer this treatment when many other providers ceased offering it years ago. 

Building Relationships

Although Amoroso admitted that when she was young she dreamed of being a gym teacher and not a nurse, three decades later, she couldn’t imagine doing anything else. 

“Nursing in oncology is so different than other disciplines. These patients are going through some of the hardest, most stressful times in life, and we share that journey with them,” Amoroso said.

Knowing that she may have made a patient’s day a bit easier is very gratifying, she said. After all, having been at Fox Chase for almost 35 years means that she has been on this journey with some of her patients for more than a decade. 

“I know their wives or husbands. I know their kids. Sometimes I even see their grandkids,” she said. “Urology affords you the ability to build a relationship between patient and nurse.”