Episode 357: ONS 50th Anniversary: The Evolution of Cancer Treatment: Stories From the Front Lines
Release Date: 04/04/2025
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“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 “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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“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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“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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“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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“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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“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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“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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“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...
info_outline“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 Foundation Capital Campaign Cabinet, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, ONS member and chair of the ONS 50th Anniversary Committee during a conversation about the evolution of chemotherapy treatment. Along with Mueller, Burbage spoke with John Hillson, DNP, NP, Mary Anderson, BSN, RN, OCN®, and Kathleen Shannon-Dorcy, PhD, RN, FAAN, about the changes in radiation, oral chemotherapy, and cellular therapy treatments they have witnessed during their careers.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Episode Notes
- This episode is not eligible for NCPD.
- ONS Podcast™ episodes:
- ONS Voice article:Safe Handling—We’ve Come a Long Way, Baby!
- ONS books:
- Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
- Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition)
- Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
- Safe Handling of Hazardous Drugs (fourth edition)
- ONS courses:
- Oral Anticancer Medication Toolkit
- Oral Anticancer Medication Care Compass
- Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers:
- Connie Henke Yarbro Oncology Nursing History Center
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 [email protected].
Highlights From This Episode
Hillson: “I remember as a new grad, from back in ’98, walking up to the oncology floor. We had patients with pink labels on the chart and that was the radiation oncology service. I hadn’t heard of such a thing before. … I’d gone through nursing school and hospital orientation and unit orientation without ever hearing of these therapies. At the time, both the management and the union had no interest in specialist nurses, and the really weren’t any books that were targeting the role. And it was very isolating and frightening. I was very glad to find ONS when I moved to the U.S. Right now, the Oncology Nursing Society Manual for Radiation Oncology, Nursing Practice, and Education, it’s in its fifth edition and a sixth is underway. There’s nothing else like it. Most books are very much geared towards other professions.” TS 5:34
Mueller: “We mixed our chemo in a very small medication room on the unit, under a horizontal laminar flow hood, which we later discovered should have been a vertical laminar flow hood. Initially, we did not use any personal protective equipment. I remember mixing drugs like bleomycin and getting a little spray that from the vial onto my face. And to this day, I still have a few facial blemishes from that.” TS 14:28
Anderson: “As the increasing number of these actionable mutations continue to grow, so will the number of oral anticancer medications that patients are going to be taking. And we are already seeing that there's multiple combination regimens and complex schedules that the patients have to take. So this role the oral oncolytic nurse and the nursing role, like you said, it cannot be owned by one individual or discipline. So it’s not a pharmacist; the pharmacies aren’t owning this. The nurses are not owning this. It takes a village.” TS 32:12
Shannon-Dorcy: Then as immunotherapy comes into the picture, we start to learn about [cytokine release syndrome]. All of a sudden, we had no concept that this was a deadly consequence. ONS was on the front lines, convening people across the country together so we could speak to the investigative work with science and find ways that we could intervene, how we can look for signs of it early on with handwriting testing.” TS 39:58