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Episode 343: Cancer Cachexia Considerations for Nurses and Patients

Release Date: 12/27/2024

Episode 353: ONS 50th Anniversary: Evolution of Oncology Nursing Certification

The ONS Podcast

“The response was, in my opinion, sort of overwhelmingly positive. I think all of us old-timers who were at ONS Congress® in 1986 remember those 1,600 nurses waiting in line to enter the ballroom to take that inaugural exam. It takes a while to check in 1,600 people. They kind of all filled up the lobby outside of the ballroom, and then they spilled over down into the escalator, and the escalators had to be turned off,” Cyndi Miller-Murphy, MSN, FAAN, CAE, first executive director of the Oncology Nursing Certification Corporation (ONCC), told Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, ONS...

Episode 352: Pharmacology 101: Epigenetics

The ONS Podcast

“Now, what we found is that epigenetics is actually heritable and it’s actually reversible. And we can now manipulate these principles with pharmacotherapy drugs,” Eric Zack, RN, OCN®, BMTCN®, clinical assistant professor at Loyola College Chicago Marcella Niehoff School of Nursing in Chicago, IL, and RN3 at Rush University Medical Center in Chicago, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the epigenetics drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by...

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“It is very much a collaborative group process. There are group meetings where we come to consensus on our different ratings. There’s so much support from ONS staff, even amongst our different groups, even when you’re assigned to one peer reviewer. Let’s say you go on vacation, sometimes we’re paired with other people, too. So there is some flexibility in the opportunity as well,” Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®, lecturer at Old Dominion University in Norfolk, VA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...

Episode 350: Breast Cancer Treatment Considerations for Nurses

The ONS Podcast

“This is what totally drives the treatment decisions, and that’s why having that pathology report when the nurse is educating the patient is so important, because you can say, well, you have this kind of breast cancer, and this kind of breast cancer is generally treated this way,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment. Music Credit:...

Episode 349: ONS 50th Anniversary: Evolution of Safe Handling and ONS’s Legacy in Developing Safe Handling Guidelines

The ONS Podcast

“What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, there were a lot of nurses who were skeptical about the need for self-protection. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors,” ONS member Martha Polovich, PhD, RN, AOCN®-Emeritus, adjunct professor in the School of Medicine at the University of Maryland, told Liz Rodriguez, DNP, RN, OCN®, CENP, ONS member and 50th anniversary...

Episode 348: Breast Cancer Diagnostic Considerations for Nurses

The ONS Podcast

“We know that some women are going to get called back. And it’s just because usually they can’t see something clearly enough. And so in most cases, those women are going to get cleared with one or two images, and they’re going to say, ‘Oh, we compressed that better, we checked it with an ultrasound, we’re fine.’ That woman can go ahead and go. But we don’t want to miss those early breast cancers,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing...

Episode 347: Care Considerations for Radiopharmaceuticals and Theranostics in Patients With Cancer

The ONS Podcast

"If you take your normal radiation oncology experience, as we know in radiation oncology, radiations are done by the machines, you know, externally. Nurses deal with the side effects and everything like that, whereas radiopharmaceuticals are given kind of on the internal basis, they’re systemic,” ONS member John Hollman, BSN, RN, OCN®, radiation nurse educator for Texas Oncology, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about caring for patients receiving radiopharmaceuticals and theranostics. Music Credit:...

Episode 346: Pharmacology 101: BTK Inhibitors

The ONS Podcast

"In B cell malignancies, BTKi inhibits that BTK enzyme which is very upstream. It tells NF-κB to stop signaling into the nucleus and then inhibits proliferation and survival of B cells," Puja Patel, PharmD, BCOP, clinical oncology pharmacist at Northwestern Medicine Cancer Center at Delnor Hospital in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about BTK inhibitors. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.0 contact hours of...

Episode 345: Breast Cancer Screening, Detection, and Disparities

The ONS Podcast

“The statistic you always kind of want to keep in the back of your brain is that over a lifetime, one in eight women will be diagnosed with breast cancer. So that means for an individual assigned female at birth, there’s a 13% chance that if that individual lives to age 85, that they will be diagnosed with breast cancer. So, it’s the most common cancer diagnosed in this group,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in St. Louis, MO, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...

Episode 344: ONS 50th Anniversary: Founding Leaders’ Vision and Challenges, Then and Now

The ONS Podcast

“Who would think that we would be here 50 years later? And with the excitement that I think will build even more, I’m so humbled and honored to talk to young nurses. And their excitement—the same excitement that we had in the very beginning—is inherent. I hope that our legacy will be that we are able to pass on this tremendous gift of our careers to new nurses,” Cindi Cantril, MPH, RN, OCN®-Emeritus, founding ONS member and first vice president, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about the history of...

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“There’s actually quite a bit of debate about what the clinical definition of cancer cachexia is, but in its simplest definition of cachexia in this case is cancer-induced body weight loss. You can have cachexia in other diseases, for heart failure or renal failure, but it's basically tumor-induced metabolic derangement that leads to inflammation and often anorexia, which produces body weight loss,” Teresa Zimmers, PhD, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about cancer cachexia.

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 December 27, 2026. 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 cancer cachexia.

Episode Notes

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 [email protected].

Highlights From This Episode

“Anorexia is often a component of cancer cachexia. In fact, some people call it cancer-induced anorexia, cachexia syndrome, because the tumors produce factors that act on the hypothalamus and hindbrain to produce, among other things, anorexia, but not just anorexia, you know, feelings of misery, anhedonia, wanting to withdraw from social interactions, but definitely altered desire to eat and altered taste of food.” TS 5:32

“Cachexia is most common, you know, where it’s been examined, in patients with upper GI cancers. You could think of those as risk factors for cachexia. So that includes, of course, head and neck cancer, esophageal, gastric, pancreatic, liver and biliary cancers. It’s also found to be very prevalent among patients with any kind of metastatic cancer and very frequent in patients who are hospitalized for their cancer. But beyond that, about half of patients with non-small cell lung cancer also experience cachexia.” TS 8:21

“I’ve been told by oncologists that cachexia is frequent in patients with certain rare cancers like ocular melanoma, small cell lung cancers, but generally speaking, cachexia is underrecognized. Most people have in their minds this picture of someone who’s sort of end-stage cachexia, that’s emaciated. And in fact, most patients, or many patients in the U.S. at least, arrive with a cachexia diagnosis and may be overweight or even indeed obese, but that does not mean that they don’t have cachexia.” TS 8:54

“I have tremendous respect for our nurses who take care of patients, and all of them have their preferred screening tools. There is no single accepted or mandated approach to diagnosing or treating someone with cancer cachexia. And I should say that I didn’t mention a widely accepted definition for cancer cachexia in the field, a diagnostic criterion, is weight loss of greater than 5% in the prior six months—and this is unintentional weight loss. TS 11:05

“I hear from family members all the time about how this was actually the most distressing part of their loved one’s cancer journey because it’s something so visible. And also, so much of our relationships happen over meals. And what I’ve heard time and time again is that telling someone that there is a word for this, cachexia, and explaining that it is the tumor—right, it’s the cancer that’s causing this appetite loss—would have helped because there tends to be a lot of conflict over meals, you know, a lot of guilt on sides when it comes to eating and trying to prepare meals that are appetizing for the person with cancer.” TS 22:24

“I think that we don’t often think about how much the cachexia itself affects the cancer treatment outcomes. The presence of weight loss correlates with treatment toxicity. Chemotherapy is often dosed on body surface area. Patients who have very low muscle, for example, experience greater toxicities, and maybe we should be dosing based on lean muscle mass. Patients with cachexia have poor outcomes after surgery. And actually, patients with cachexia don’t respond to immunotherapy, which of course has been transformative for cancer care. So, treating cachexia may actually enable patients to respond better to all of their cancer interventions.” TS 28:45

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