* Implications for practice

The evidence presented here highlights the benefits of nurse-led in- terventions for cancer-related symptoms 
identified a range of diverse interventions, that many of the components are, arguably, al- ready delivered by cancer nurses in their daily practise. For instance, cancer nurses routinely provide education, psychological support, and lifestyle advice to people living with a cancer diagnosis.
These skills are often the result of years of training and clinical experience
However, all of this relies on a well-trained cancer nursing work- force being available To ensure improvements in cancer symptom management and enhance the quality of future symptom-focused interventions, cancer nurses need to be prepared appropriately and highly skilled in terms of undertaking assessment, patient education, behavioural and lifestyle management, as well as psychological support.

* Implications for further research

confirmed that cancer nurse researchers should be recognized for addressing troublesome symptoms for people with can- cer, but that they also need to address weaknesses in trial design and re- porting
Interventions need to be more fully described, including study context (e.g., specialist hospital, home, or outpatient clinic) and per- sonnel involved in delivery (e.g., level of nursing qualification, cancer training, expertise and time available)
, as well as
other non-pharmacological interventions [9] will be particularly rele- vant for future nurse-led intervention studies. Robust economic evalu- ations, will only be possible when suf-ficient details are provided that allow comparisons based on actual or estimated costs.
Most of the ev- idence focusses on common cancers and on the treatment phase [16]
which means that rarer cancers and other phases of the cancer trajec- tory remain open for further research for well-designed research to underpin symptom-focused interventions. 
The challenge for cancer nurses now is to secure funding to under- take large-scale, high quality, international trials. will be required to secure more findings that can be implemented in more than one health system. 
identified in this review –now recommend adopting a broader perspec- tive, and moving beyond the question of ‘does the intervention work’ to deeper understanding of how it works and in what context? [71]

* Implications for policy
Despite the advances outlined here into the effectiveness and devel- opment in nurse-led interventions, cancer nurses continue to lack suffi- cient recognition for the part they play in the design, development and delivery of interventions that may enhance patient experience, reduce cost, and improve outcomes for those living with cancer
The impetus for this project arose out of the European Oncology Nursing Society’s Recognising Cancer Nursing (RECaN) initiative. This had sought to advance recognition of the contribution that an edu- cated and specialist nursing workforce make to enhancing the qual- ity of cancer care ( https://www.cancernurse.eu/research/recan.html ). This study has revealed the contribution that nurse researchers made between 2000–2018 to address symptoms commonly experienced by people with cancer. As demand for cancer treatment grows, there will be a need for even more evidence-based interventions that improve the cancer experience, including innovations designed by nurses
. This pa- per has provided a baseline position from which to consider how best to strengthen the quality of nurse-led intervention reporting, as well as illustrating the role that standardized cancer nursing outcome measures could play in helping to gauge the effectiveness of novel symptom man- agement interventions. The benefit of nursing innovation has long been clear in improving cancer practise. The challenge now is to further im- prove the design and quality of novel interventions that will, in time, make further valuable contributions to improving the lives of those ex- periencing cancer-related symptoms.