Episode 324: Pharmacology 101: LHRH Antagonists and Agonists
Release Date: 08/09/2024
Episode 424: Radiation Site-Specific Side Effects: Cancers of the Pelvis
The ONS Podcast
“Think about what organs lie in the radiation field, and anything that lies in that radiation field is likely going to have some potential temporary—hopefully temporary—side effects. If you think about the pelvis, the things that live in there are the bladder, urethra, some bowel, rectum, reproductive organs, skin, some lymph nodes. And so, all of those things could potentially have associated side effects,” ONS member Kayla Kafka-Peterson, BSN, RN, ROCN™, nurse navigator and leader in the brachytherapy and peri-anesthesia programs at UCLA Health, in Los Angeles, CA, told Lenise...
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Episode 423: Pharmacology 101: Interaction Pathways
The ONS Podcast
“When we think of drug interactions, specifically, the National Cancer Institute actually defines this as a change in the way a drug acts in the body when taken with certain other drugs, herbals, or foods or when taken with certain medical conditions. Drug interactions may cause the drug to either be more or less effective or cause effects on the body that are not expected,” Carissa Ganihong, PharmD, BCOP, oncology and bone marrow transplantation clinical pharmacist at Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology...
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Episode 422: An Overview of Chronic Lymphocytic Leukemia for Oncology Nurses
The ONS Podcast
“What I appreciate about our patients with chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia is the consideration that they receive a cancer diagnosis, and the best thing for them to do is actually nothing. There is a large population of patients that we don’t recommend any type of treatment. We recommend that they establish care with an oncologist and that they have a relationship with those care teams,” ONS member Caitilin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®,...
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Episode 421: Medical Trauma in Oncology
The ONS Podcast
“There are a huge array of medical dynamics that people endure, and when they leave a lasting impact, a word that we don’t use widely enough is the word ‘trauma.’ There’s an entire category of phenomena in the medical arena that are, in fact, traumatic. One way we know that these experiences are traumatic is that we know that huge portions of people who experience things like cancer do indeed develop problems like [post-traumatic stress disorder],” James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Jaime Weimer, MSN, RN,...
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Episode 420: Long-Term Myelodysplastic Syndrome Considerations for Oncology Nurses
The ONS Podcast
“We typically think of the disease progressing for our higher-risk patients because many of them already start with increased blasts or a lot of dysplasia. And they have these chromosomal variants that make them prone to evolving into acute myeloid leukemia (AML). With them, we can anticipate that they are going to progress to AML. And that’s what we’re trying to prevent. It’s kind of like a biologic evolution and not a switch,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise...
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Episode 419: Pharmacology 101: Immunomodulators
The ONS Podcast
“Until immunomodulators, patients [with myeloma] did not have a great overall survival rate. But when we introduced lenalidomide, we started seeing our patients have life expectancies between five and seven years—which was unheard of prior to these immunomodulators going forward. I think it’s promising and allows patients to have quality of life versus therapy of life,” ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist...
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Episode 418: Radiation Site-Specific Side Effects: Colorectal Cancer
The ONS Podcast
“Radiation therapy is often extremely well tolerated in colorectal cancer. Technology has really changed things. But location of the tumor can affect side effects, such as radiation dermatitis. If a patient has a low-lying tumor, if it’s less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It’s good to be proactive if that’s the case,” ONS member Lorraine Drapek, DNP, FNP-BC, AOCNP®, nurse practitioner in the Department of Radiation Oncology at Massachusetts General Hospital in Boston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®,...
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Episode 417: Pharmacology 101: Oncolytic Viral Therapy
The ONS Podcast
“There are a lot of specifics that nurses need to keep in mind as they are administering this herpes simplex modified virus to patients because accidental exposure is of concern both to the patient, to their family members, as well as to healthcare workers. I always recommend nurses wear personal protective equipment, such as a gown, safety glasses, gloves, and/or a face shield,” Heidi Finnes, PharmD, RPh, BCOP, director of clinical ambulatory practice at Mayo Clinic and assistant professor of pharmacy at Mayo Clinic Alix School of Medicine in Rochester, MN, told Jaime...
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Episode 416: Cancer Treatments for Noncancer Indications: Radiation
The ONS Podcast
“When you have benign conditions, we’re actually treating 3 gray, so a significant difference [versus doses of 60 gray for brain cancer]. Typically, when you treat at a high dose, the goal is to destroy tissue, like cancer tissue or cancer cells. But when we give a low dose, the goal is actually to modulate inflammation. And what it does is it slows down those inflammatory cells or those cells that release the chemicals that cause pain and inflammation,” Amanda Meyer, DNP, APRN, CNP, family nurse practitioner in the Department of Radiation Oncology at the Mayo Clinic in Rochester, MN,...
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Episode 415: Myelodysplastic Syndrome Treatment Considerations for Oncology Nurses
The ONS Podcast
“We want to make sure that we discuss the details of the treatment and what treatments there are, whether it’s an oral drug, whether it’s a subcutaneous injection or an IV injection, [the patient’s] potential for responding, whether this treatment is curative or supportive, and what the number of visits are. All of those different pieces of information that go into the decision-making process are really important,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN,...
info_outline“A lot of the efforts have been made to improve the patient experience for these treatments, as they can be given for years at a time. For example, when leuprolide debuted way back in 1985, it was a daily injection. But four years later, they developed the monthly depo formulation. Now we have formulations that are approved for administration once only every three, four, and even six months,” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the luteinizing hormone–releasing hormone (LHRH) antagonist and agonist drug classes.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 9, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
Learning outcome: Learners will report an increase in knowledge related to LHRH antagonists and agonists.
- Episode Notes
- The NCPD activity for this episode has expired, but you can still earn NCPD through many other Oncology Nursing Podcast episodes. Find a full list of opportunities.
- Oncology Nursing Podcast episodes:
- Pharmacology 101 series
- Episode 321: Pharmacology 101: CYP17 Inhibitors
- Episode 242: Oncology Pharmacology 2023: Today’s Treatments and Tomorrow’s Breakthroughs
- Episode 154: New Drug Approvals for Metastatic Castration-Sensitive Prostate Cancer
- Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™
- ONS Voice article: Oncology Drug Reference Sheet: Relugolix
- ONS books:
- ONS course: Safe Handling Basics
- ONS Guidelines™ and Symptom Interventions
- ONS Huddle Card: Hormone Therapy
- ONS Learning Libraries:
- Oral Chemotherapy Education Sheets
- National Comprehensive Cancer Network
- On the Treatment of Inoperable Cases of Carcinoma of the Mamma: Suggestions for a New Method of Treatment, With Illustrative Cases (by George T. Beatson)
To discuss the information in this episode with other oncology nurses, visit the ONS Communities.
To find resources for creating an Oncology Nursing Podcast™ Club in your chapter or nursing community, visit the Oncology Nursing Podcast Library.
To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
Highlights From This Episode
“Between all of these agonists and antagonists, there’s a broad spectrum of applications, including hormone-positive breast cancer, androgen-deprivation therapy for prostate cancer, uterine cancer, and then other non-cancer uses like uterine fibroids, and assisted reproduction fertility treatments, and other things too.” TS 3:24
“In the education of my female patients, I basically use the analogy that it is functionally inducing menopause in that person, so there can be changes to mood and cognition, energy level fatigue, body morphology, and shifts in fat distribution metabolism, which can unfortunately increase the risk of cardiovascular disease. One that almost everyone’s familiar with is hot flashes, but also changes to bone mineral density, libido and physically to atrophy and dryness of vaginal mucosa, which can make sex for our patients more difficult as well.” TS 10:33
“A concept that’s familiar to all professionals in the care of prostate cancer is that because LHRH agonists cause an initial increase in testosterone, which can, in essence, feed the cancer, some patients can experience worsening symptoms of their cancer, such as difficulty voiding their bladder pain, or even vertebral collapse or spinal cord compression when bone metastases are present. This is a really serious issue that should be considered ahead of starting an agonist in these patients.” TS 12:39
“I don’t think we’ll see any dramatic changes in treating breast cancer, since the role of these agents is a lot more limited and simply really exist to suppress estrogen and premenopausal patients. But as a referral center that routinely sees patients with breast cancer and their 40s and 30s and even their 20s, it’s crucial to consider these agents in their role for not only actively treating certain types of breast cancer, but also in preserving fertility for patients who desire to have children and they are receiving gonadotoxic chemotherapy.” TS 25:32