Episode 360: An Overview of Brain Malignancies for Oncology Nurses
The ONS Podcast
“Everyone’s brain is extremely heterogenic, so it’s different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They’re highly aggressive biologically. It’s a small area in a hard shell. So trying to get through the blood–brain barrier is different. There’s a lot of areas of hypoxia in the brain. There’s a lot of pressure there. The microbiology is very different—it’s a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C,...
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Episode 359: Lung Cancer Screening, Early Detection, and Disparities
The ONS Podcast
Episode 359: Lung Cancer Screening, Early Detection, and Disparities “I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don’t want to do it.’ And I said, ‘Do you remind them that lung cancer is curable?’ Because everybody thinks it is a death sentence. But when you’re talking about screening a patient, I think it’s really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60%...
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Episode 358: Pharmacology 101: KRAS Inhibitors
The ONS Podcast
“It’s been known for quite a while that [KRAS] is a mutation that leads to cancer development, but for really over four decades, researchers couldn’t figure out a way to target it. And so, it was often considered something that was undruggable. But all of this changed recently. So about four years ago, in 2021, we had the approval of the first KRAS inhibitor. So it’s specifically a KRAS G12C inhibitor known as sotorasib,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN,...
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Episode 357: ONS 50th Anniversary: The Evolution of Cancer Treatment: Stories From the Front Lines
The ONS Podcast
“There have been many changes since the ’70s that have shaped the nurse’s role in administering chemo, and in supporting patients. The major change early on was the transition from that of nurses mixing chemo to that of pharmacists. Regulatory agencies like NIOSH and OSHA defined chemotherapy as hazardous drugs, and professional organizations became involved, leading to the publication of the joint ASCO and ONS Standards of Safe Handling,” ONS member Scarlott Mueller, MPH, RN, FAAN, secretary of the American Cancer Society Cancer Action Network Board and member of the Oncology Nursing...
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Episode 356: A Nurse’s Guide to the 2024 NIOSH List of Hazardous Drugs
The ONS Podcast
“And so you have different kinds of hazards with the drugs that you’re using. That means that in the past, when a lot of oncology drugs, antineoplastic drugs used to treat cancer would have been added, you may see that a lot of oncology drugs either weren’t added or they’re added in a different place on the list than they were in the past. That’s due to some of the restructuring of the list we’ll probably talk about later,” Jerald L. Ovesen, PhD, pharmacologist at the National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention,...
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Episode 355: Pharmacology 101: Hedgehog Pathway Inhibitors
The ONS Podcast
“I genuinely think nurses and pharmacists need to know why these medicines are called hedgehog inhibitors so that we can, in fact, effectively educate our patients. Just because to date, this class has the weirdest name I’ve encountered, and I almost expect at this point that my patients are going to ask me about it. I think that we need to be informed that, just on, where do these names come from, why is it called this, and does it matter to my patient?” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN,...
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Episode 354: Breast Cancer Survivorship Considerations for Nurses
The ONS Podcast
“You can give someone a survivorship care plan, but just giving them doesn’t mean that it’s going to happen. Maybe there’s no information about family history. Or maybe there’s information and there’s quite a bit of family history, but there’s nothing that says, ‘Oh, they were ever had genetic testing,’ or ‘Oh, they were ever referred.’ So the intent is so good because it’s to really take that time out when they’re through with active treatment and, you know, try to help give the patient some guidance as to what to expect down the line,” Suzanne Mahon, DNS, RN,...
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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...
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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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Episode 351: What It’s Like to Develop Symptom Intervention Resources
The ONS Podcast
“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...
info_outline“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: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.75 contact hours (including 40 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 28, 2027. 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 the epigenetics drug class.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ Pharmacology 101 series
- ONS Voice articles:
- ONS book: Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (Fourth Edition)
- ONS Biomarker Database
- ONS course: Genomic Foundations for Precision Oncology
- ONS Huddle Card: Financial Toxicity
- ONS Learning Libraries:
- American Cancer Society: Patient Programs and Services
- Centers for Disease Control and Prevention: Epigenetics, Health, and Disease
- Leukemia & Lymphoma Society: Financial Support
- National Institutes of Health: Epigenetics
- University of Pennsylvania: Epigenetics Institute
- University of Utah: Genetic Science Learning Center
To discuss the information in this episode with other oncology nurses, visit the ONS Communities.
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To provide feedback or otherwise reach ONS about the podcast, email [email protected].
Highlights From This Episode
“Epigenetics is influenced by several factors. Right now, there’s about seven of them that we’ve identified, and we can only manipulate right now about two of those seven. So the first one is DNA methylation. When you methylate DNA, that’s adding or subtracting a methyl group, which is CH3, chemically. The addition of methyl to DNA tightens the DNA around the chromatin, which then can block some genes from being expressed.” TS 7:21
“Histones basically package DNA into the chromatin, which is a mixture of DNA and proteins, and they spool around this structure like the DNA is coiled around that. And again, it has to do with how tight or loose that is coiled. That determines if the genes are expressed or not. And again, we found that histones also play a role in DNA repair as well as regulating the cell cycle.” TS 8:21
“When we’re dealing with the azacitidine and decitabine, these drugs cause pancytopenia. Pancytopenia is neutropenia, thrombocytopenia, and anemia. So it affects the complete blood count. We see GI toxicity, nausea, vomiting, diarrhea, constipation, sometimes mouth sores, and urticaria—hives.” TS 15:34
“It’s really, really important to take these drugs exactly as they are prescribed. They have to follow the doctor’s orders carefully, which requires taking them properly, doing the proper follow up. There’s a lot of blood tests and appointments that we have to do to make sure that everything is okay. And again, because we know when there is nonadherence, the disease progresses and becomes resistant, so that’s a really, really important teaching point. We have to monitor the patient for expected side effects and unexpected side effects.” TS 23:58
“Now, we expect the landscape to change dramatically over the next few years. And again, it’s just an explosion of science information. As we learn more about the science, it’s going to translate into practice. We’re always identifying new biomarkers. These biomarkers are essentially DNA mutations or variations. There’s so many variants of unknown significance.” TS 30:02
“Every patient deserves biomarker testing. Very important, whether it’s through IHC, polymerase chain reactions, or the most common next-gen sequencing. Again, there’s several companies out there that have standard kits available.” TS 31:33
“This is a precision medicine. This is what we’ve always dreamed about—tailoring the treatment to the specific patient. We’ve gone away from treating standard diseases, like lung cancer and breast cancer, the way they’re supposed to be treated to now looking at these biomarkers and using epigenetic drugs and other medications tailored to those variants that that patient is having, not necessarily based on their disease type.” TS 33:59