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

The ONS Podcast

Release Date: 01/24/2025

Episode 427: Pharmacology 101: Resistance Pathways show art Episode 427: Pharmacology 101: Resistance Pathways

The ONS Podcast

“A good way of thinking about this is this is the survival of the fittest clone. There could be a portion of a cancer that naturally has some resistance or ability to survive a particular drug. And over time, as the other cells around it are dying off, that particular clone is able to replicate and continue to survive in the face of that drug therapy and eventually take over as being the fittest clone. At that point, we’re often seeing disease progression,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh,...

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Episode 426: Tools to Support Patients and Nurses Through Medical Trauma in Oncology show art Episode 426: Tools to Support Patients and Nurses Through Medical Trauma in Oncology

The ONS Podcast

“When people with PTSD [post-traumatic stress disorder] get quite avoidant—and that can be expressed in so many different ways—the implications can be really profound. I think an important invitation to oncologists and oncology nurses and primary care providers who care for people battling cancer is let’s explore what's underneath these avoidant behaviors. Is it a very practical thing? Or is it that underneath this avoidant behavior is really profound fear?” James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Lenise Taylor, MN,...

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Episode 425:  How AI Can Help Healthcare Organizations Improve the Cancer Experience show art Episode 425: How AI Can Help Healthcare Organizations Improve the Cancer Experience

The ONS Podcast

“In oncology specifically, where care is complex, artificial intelligence (AI) can really synthesize large volumes of clinical information, flag risks such as treatment complications, and support adherence to evidence-based pathways. For nurses specifically, this enables them more time for direct patient care, clinical judgment, and care coordination, and really practice to the top of their license while reducing repetitive time and administrative tasks,” Jenn Frith, DNP, RN, OCN®, NE-BC, associate vice president of clinical operations at Duke Cancer Institute in Durham, NC, told Jaime...

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Episode 424: Radiation Site-Specific Side Effects: Cancers of the Pelvis show art 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 show art 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 show art 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 show art 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 show art 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 show art 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 show art 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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"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: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

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 radiopharmaceuticals and theranostics in cancer care. 

Episode Notes  

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  

To find resources for creating an ONS 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

 
Highlights From This Episode 

"I think most places are now doing the seven days, just to be extra cautious and you know, can't you be around any pregnant women or children, you can’t just be going to Target and stuff like that right after your injection because you are radioactive, and try not to share a bathroom with your family, that can be difficult and that leads into, as we’ve talked about in many talks that we’ve had, the social situation.” TS 8:08

“It’s really up to that nurse to recognize, like a good infusion nurse, to recognize the signs and symptoms of an infusion reaction and then to catch it at the earliest possible moment.” TS 11:42

We’re not really dependent on lab values between treatments, whereas the infusion you have to look at your lab values. These are the game changer.” TS 13:20

“You just hear the term radiation, and you just think of Chernobyl, or you think of like these worst-case, media-blown things and you think, how are you not being dosed with radiation every day? Because they don’t realize that you have this whole radiation safety team that’s required to be overseeing that you’re doing things safely and effectively, that these nurses that are administering these therapies or these therapists that are helping with the therapy are the safest as possible.” TS 18:37

“If it wasn’t safe, we wouldn’t be doing it. You know what I mean? So, there is that implicit bias that I think I can foresee a lot of people trying hard to get over. And if you do have questions, anyone who’s listening, and you’re scared that your center is going to roll this out, please talk to your physicians, please talk to your radiation oncologists, please talk to your radiation safety officers. They can definitely assure and put your fears at rest, hopefully. I 100% trust the radiation safety officers.” TS 19:45

“That’s why the nurses really need to be educated by those radiation safety teams so they can pass those questions, or they can answer those questions, alleviate those fears on consultation—or actually during the week when we’re calling in for questions.” TS 21:07

“I think getting both teams involved, if you’re going to really do this partnership, I find it really rare that it’s ever solely in rad onc. It’s always usually a combination of both. They’re always referred to us from that onc or somewhere. So, you really need that partnership.” TS 23:20

“This is so great to see what the future holds with these. And like I said, now they’re trying to do clinical studies for different diagnoses. So I think it’s just going to explode in the next few years about what we can use these for. It’s really an exciting time to be not only in oncology, but in radiation oncology.” TS 26:54