I write at a critical time for our planet and humanity. The midpoint of the 26th UN Climate Change Conference of the Parties (COP26) (https://ukcop26.org) comes a month after global publication of Atwoli and colleagues' editorial by 220 health journals to control global heating to attempt to restore healthy climate.1

At this fraught moment, I turn to you, my cancer nursing colleagues. Too often in the past, my personal interests in climate and sustainability lapsed into quiet observation of all but absent consideration of contingent human and planetary health with consequences for healthcare. I speak now with clear sighted aims and fervent hope that COP26 brings unprecedented international accords and that we will act correspondingly.

Our climate crisis affects every facet of human cancer experience. The editors of The Lancet Oncology recently synthesized connections between cancer and climate, spanning escalating risk of carcinogenesis to cancer survivorship in global heating.2 From clean air, pure water, and healthy diets that improve health and reduce cancer risk to cancer treatment and supportive care delivered with minimal environmental impact, restoring a healthy climate is integral to our vision and mission as cancer nurses. Ask yourselves: What is it to help someone to live with and after cancer if that person's life ways, livelihood, and life itself are at grave risk from global heating?

Robust science on climate and health exists to guide us. Considering that science, we must revisit our perspective on health and cancer. Nursing theory and philosophy hold the environment as integral to health. Cancer nurses know that environment and cancer are inextricably intertwined. Thus, we are distinctively positioned for generating solutions for healthy climate and cancer. Moving forward, let us juxtapose climate science against our nursing perspective to effectively reposition our science and all else we do.

Widely known healthy climate opportunities may call many cancer nurses already. Others will reach farther, defining yet uncharted phenomena. We may partner with farmers and nutrition scientists to study accessing and adapting to local whole food diets to reduce cancer risk. We may advance telehealth, e-health, and m-health, redressing digital divides, to reinterpret self-management and self-care for cancer treatment and supportive care. We may draw on environmental science to model mitigation of poor air quality and UV light exposure for those living after cancer. The possibilities for deriving just, evidence-based solutions are endless. Time is not.

Time is against us. The Global Carbon Budget report warns that we have only 11 years left in which to act to avoid the worst sequelae of our planetary catastrophe.3 All our actions count, both personal and professional, as does urging our national leaders to replace promises with deeds.

Here are some suggestions for action:

* Map research, education, practice, and policy to the United Nations' 17 Sustainable Development Goals (https://sdgs.un.org/goals).

* Analyze healthy climate dimensions of all research, education, practice, and policy initiatives.

* Seek solutions for healthy climate and sustainability in designing any project. Cobenefitting processes, synergies in initiatives, and multiple use devices are among many possibilities.4

* Find new partners including those whose potential contributions are apparent (eg, climate scientists and engineers) and those whose parts in collaboration are less obvious (eg, farmers and artists).

* Expect sustainable solutions from ourselves, our partners, and our suppliers. Disallow responses failing that expectation with decisive changes in partnership.

* Discuss implications for sustainability in all dissemination, sharing findings and implications with local, regional, national, and international leaders.

Join me in acting for our healthy climate. We have no time to spare. Our climate crisis is the very definition of malignancy. Who knows better than we how to help fellow humans respond to the threat malignancy poses?

Sarah Hope Kagan, PhD, RN

University of Pennsylvania, Philadelphia

References