Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer
Release Date: 11/29/2024
The ONS Podcast
“[Multiple myeloma] is very treatable, very manageable, but right now it is still considered an incurable disease. So, patients are on this journey with myeloma for the long term. It’s very important for us to realize that during their journey, we will see them repeatedly. They are going to be part of our work family. They will be with us for a while. I think it’s our job to be their advocate. To be really focused on not just the disease, but periodically assessing that financial burden and psychosocial aspect,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer...
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“Referring patients to audiology early on has shown dramatic reduction in hearing loss or complications because the audiologist can really see where were they at before they started chemotherapy, where were they at during, if they get an audiogram during their treatment. And then after treatment, it’s really important for them to see an audiologist because this is really a survivorship journey for them. And as nurses, the ‘so what’: We are the first line of defense,” ONS member Jennessa Rooker, PhD, RN, OCN®, director of nursing excellence at the Tampa General Hospital Cancer...
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“We proposed a concept to the American Society of Clinical Oncology (ASCO), recognizing that extravasation management requires significant interdisciplinary collaboration and rapid action. There can occasionally be uncertainty or lack of clear guidance when an extravasation event occurs, and our objective was to look at this evidence with the expert panel to create a resource to support oncology teams overall. We hope that the guideline can help mitigate harm and improve patient outcomes,” Caroline Clark, MSN, APRN, AGCNS-BC, OCN®, EBP-C, director of guidelines and quality at ONS, told...
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“They [monoclonal antibodies] are able to cause tumor cell death by binding to and blocking to necessary growth factor signaling pathways for tumor cell survival. That’s going to be dependent on the target of the antibody, but I’ll give an example of epidermal growth factor, or EGFR. This is overexpressed in several different kinds of cancers where activation of this growth factor increases the amount of proliferation and migration of cancer cells. So, if we bind to it and block to it, then that would help halt these pathways and stop cancer cell growth,” Carissa Ganihong, PharmD,...
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“The thought of recurrence is also a psychosocial issue for our patients. They’re being monitored very closely for five years, so there’s always that thought in the back of their head, ‘What if the cancer comes back? What are the next steps? What am I going to do next?’ It’s really important that we have conversations with patients and their families about where they’re at, what we’re looking for, and reassure them that we’ll be with them during this journey and help them through whatever next steps happen,” ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager...
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“I’ll go back to the backpack analogy. When your kids come home with a backpack, all of a sudden their homework is not on the desk where it’s supposed to be. It’s in the kitchen; it kind of spreads all over the place, but it’s still in the house. When we give antibody–drug conjugates (ADCs), the chemotherapy does go in, but then it can kind of permeate out of the cell membrane and something right next to it—another cancer cell that might not look exactly like the cancer cell that the chemotherapy was delivered into—is affected and the chemotherapy goes over to that cancer cell...
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“Working as an oncology infusion nurse, being oncology certified, attending chapter meetings, going to ONS Congress® has really taught me plenty. But being an oncology patient taught me way more. I know firsthand the fears ‘you have cancer’ brings. Then going through further testing, CT scans, MRIs, genetics, the whole preparation for surgery was something I never considered when I treated a breast cancer patient,” ONS member Catherine Parsons, RN, OCN®, told Valerie Burger, MA, MS, RN, OCN®, CPN, member of the ONS 50th anniversary planning committee, during a conversation about...
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“Antibody–drug conjugates (ADCs) have three basic parts: the antibody part, the cytotoxic chemo, and the linker that connects the two. First, the antibody part binds to the target on the surface of the cell. Antibodies can be designed to bind to proteins with a very high level of specificity. That’s what gives it the targeted portion. Then the whole thing gets taken up by the cell and broken down, which releases the chemotherapy part. Some sources will call this the ‘payload’ or the ‘warhead.’ That’s the part that’s attached to the ‘heat-seeking’ part, and that’s...
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“Any time the patient hears the word ‘cancer,’ they shut down a little bit, right? They may not hear everything that the oncologist or urologist, or whoever is talking to them about their treatment options, is saying. The oncology nurse is a great person to sit down with the patient and go over the information with them at a level they can understand a little bit more. To go over all the treatment options presented by the physician, and again, make sure that we understand their goals of care,” ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager of clinical education and...
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“It’s critical to identify those mutations found that are driving the cancer’s growth and guide the personalized treatment based on those results. And important to remember, too, early testing is crucial for patients with non-small cell lung cancer (NSCLC). In studies, it has been found to be associated with improved survival outcomes and reduced mortality,” ONS member Vicki Doctor, MS, BSN, BSW, RN, OCN®, precision medicine director at the City of Hope Atlanta, GA, Chicago, IL, and Phoenix, AZ, locations, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing...
info_outline“The nurse’s role in monitoring the lab values really depends on the clinics you're working at, but really when our patients are receiving treatment, especially in the infusion center, the nurses should be looking at those lab values prior to treatment being started,” Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, clinical nurse specialist at Karmanos Cancer Center in Michigan told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS during a conversation about how to monitor and educate patients with cancer.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 29, 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: The learner will report an increase in knowledge related to monitoring labs and educating patients with cancer.
Episode Notes
- The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast™ episodes. Find a full list of opportunities.
- Oncology Nursing Podcast™ episodes:
- Episode 319: Difficult Conversations About Pregnancy Testing in Cancer Care
- Episode 311: Standardized Pregnancy Testing Processes in Cancer Care
- Episode 183: How Oncology Nurses Find and Use Credible Patient Education Resources
- Episode 179: Learn How to Educate Patients During Immunotherapy
- Episode 87: What Are the Biggest Barriers to Patient Education?
- Episode 43: Sharing Patient, Provider, and Caregiver Resources
- ONS Voice articles:
- ONS Course: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
- Oncology Nursing Forum article: Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards
- Clinical Calculations—ANC Huddle Card
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 ONS Podcast Library.
To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
“Your traditional chemotherapy agents are the ones that we see the most lab abnormalities with, and we can predict those a little bit more with the advent of more of the advanced targeted therapies and immunotherapies, we still see lab values that are altered because of the way that the treatment works, but they may differ a little bit than what we traditionally saw with our normal chemotherapy agents.” TS 2:51
“I talked about the lifespan of all the other cells, and Neutrophils are usually what stop treatment, and part of that is, is that the lifespan of a neutrophil is 48 hours. It is proliferated very frequently in the bone marrow. But that is usually what we see. The cells that we see that stop treatment, and as you mentioned earlier, classic chemotherapy really the types of treatment that historically, we've been given and we have given to patients, and we've seen those blood counts really significantly impacted.” TS 6:21
“Kidney function, or renal function tests, are really determined whether the kidneys are functioning the way they should be. We look at an estimated glomerular filtration rate, or GFR, which is really based on the patient’s protein level, their age, gender, and race. And the test really looks at how efficiently the kidneys are clearing the waste from the body. So that’s really one that we need to look at, especially as we’re giving agents that are excreted through the kidneys.” TS 12:23
“I think it’s important for nurses to start looking at lab results with their patient very early on, you know, even before treatment starts, so they understand what the normals look like. So when they do get those lab results, because now pretty much everybody has patient portals, right? So the labs are reported in there, and they’re seeing the labs before they're talking to their providers. if we can start early on and talk to them about what the normal lab values are, what they mean, and what we're looking at when we're drawing these labs. I think it’s really important for the patient.” TS 27:00