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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...
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“I think we really need to push more of our oncology nurses to get into elected and appointed positions. So often we’re looking at health positions to get involved in, and those are wonderful. We need nurses as secretaries of health, but there are others. We as nurses understand higher education. We understand environment. We understand energy. So I think we look broadly at, what are positions we can get in? Let’s have more nurses run for state legislative offices, for our House of Representatives, for the U.S. Senate,” ONS member Barbara Damron, PhD, LHD, RN, FAAN, told Ryne Wilson,...
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“[When] a lot of men think about prostate exams, they immediately think of the glove going on the hand of the physician, and they immediately clench. But really try to talk with them and discuss with them what some of the benefits are of understanding early detection. Even just having those conversations with their providers so that they understand what the risk and benefits are of having screening. And then educate patients on what a prostate-specific antigen (PSA) and digital rectal exam (DRE) actually are—how it happens, what it shows, and what the necessary benefits of those are,”...
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“This was a panel of subject matter experts of various nurses and pharmacists. We often found common ground but also discovered new ideas, different touchpoints, and key junctures along that oral anticancer medication journey. For example, the pharmacists were able to share their insights into their unique workflows within their practice setting. What resulted is a resource that truly reflects that collaborative effort between the disciplines,” ONS member Mary Anderson, BSN, RN, OCN®, senior manager of nursing membership and professional development at the Network for Collaborative...
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“It started out by doing a kind of a white paper that we called Imperatives for Quality Cancer Care. Ellen Stovall, our CEO [of the National Coalition for Cancer Survivorship] at the time, gave this report to Dr. Richard Klausner, who was the head of National Cancer Institute at the time. He called Ellen immediately and said, ‘Why are we not doing something about this?’ Within one year, we had the Office of Cancer Survivorship at NCI,” ONS member Susan Leigh, BSN, RN, told ONS member Ruth Van Gerpen, MS, RN-BC, APRN-CNS, AOCNS®, PMGT-BC, member of the ONS 50th anniversary...
info_outline“Next-generation sequencing, or NGS, can be used to help us determine if the patient has specific biomarkers we can identify and use to target for treatment. Certain findings can tell us if a particular treatment might work for that patient, and we can see if there are any genetic variants we might have a biomarker targeted agent to use to treat them with,” ONS member Jackie Peterson, MSN, RN, OCN®, NE-BC, MBA, ambulatory nurse manager at the University of Chicago Medical Center in Illinois, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about prostate cancer and biomarker testing.
This podcast is sponsored by AstraZeneca and is not eligible for NCPD contact hours. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.
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 articles:
- An Oncology Nurse's Guide to Cascade Testing
- Genetic Disorder Reference Sheet: BRCA1 and BRCA2 Hereditary Disorders
- Genetic Disorder Reference Sheet: Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)
- Germline and Somatic Variants: What Is the Difference?
- Help Patients Understand Genomic Variants of Unknown Significance
- Prostate Cancer Clinical Trials Don't Reflect Racial Diversity—And It's Getting Worse Over Time
- Prostate Cancer Disparities Disappear With Equal Access to Care
- Prostate Cancer Prevention, Screening, Treatment, and Survivorship Recommendations
- The Case of the Genomics-Guided Care for Prostate Cancer
- ONS book: Understanding Genomic and Hereditary Cancer Risk: A Handbook for Oncology Nurses
- ONS course: Genomic Foundations for Precision Oncology
- Clinical Journal of Oncology Nursing articles:
- Oncology Nursing Forum article: Identification of Symptom Profiles in Prostate Cancer Survivors
- Other ONS Resources:
- Biomarker Database (refine by prostate cancer or specific biomarkers)
- Clinical tool/case study: Biomarker Testing in Prostate Cancer: The Role of the Oncology Nurse
- Genomics and Precision Oncology Learning Library
- Huddle Card: Genomic Biomarkers
- Infographic: Talking to Your Patient About a Germline Variant of Uncertain Significance (VUS)
- American Cancer Society - Genetic Testing and Counseling for Prostate Cancer Risk
- American Cancer Society - Prostate Cancer
- Clinicaltrials.gov
- National Cancer Institute - Prostate Cancer
- National Comprehensive Cancer Network
- ZERO Prostate Cancer
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
“Some of the risk factors for developing prostate cancer include age, race, family history, and certain genetic changes or variants. Prostate cancer has some hereditary components, but most prostate cancer occurs in men without any significant family history of it.” TS 1:31
“Key biomarkers include PSA and prostate cancer gene 3, which is PCA3, and prostate-specific membrane antigen, or PSMA. Other biomarkers that are important for us to test include BRCA1, BRCA2, and Lynch syndrome–associated genes, which are MLH1, MSH2, MSH6, PMS2, and EPCAM. Biomarkers can be collected via your blood, urine, saliva, or tissue samples, so these are different ways that we can test and look for biomarkers in our patients.” TS 3:24
“It does matter how advanced the disease is. Usually, for our castrate-sensitive patients, they respond better to androgen deprivation therapy because that really is slowing down the growth of the cancer by reducing the available testosterone that the cancer needs to grow. Whereas our patients that are more advanced and have castrate-resistant prostate cancer, that cancer will continue to grow despite having the lowered testosterone levels, so they might need additional layers of treatment to really get their cancer under control.” TS 7:50
“When I talk to [patients] about biomarker testing, I tell them it’s another tool in our toolbox that we can use to help us determine if they might benefit from other therapy options now or in the future. I tell them that sometimes we’ll get a report back with a variant of unknown significance, and basically that means that we don’t really know whether or not this has an impact on their health or risk factors for the disease. That can sometimes be a little bit of a concern for these patients, so we just have to reassure them that we’re continually doing research around biomarker testing. The science is always advancing, so if there’s something that [researchers] find in the future, we’ll make them aware of that.” TS 9:08
“One of the biggest topics I think about is the inequity that exists in biomarker testing and research, especially surrounding the African American population. When these tests were developed, that population really wasn’t studied as much, so there’s not a lot of good data yet to make a decision or impact on those patients and that population.” TS: 12:30