Episode 387: Prostate Cancer Screening, Early Detection, and Disparities
Release Date: 10/31/2025
The ONS Podcast
“You want to try to act quickly and be able to know what the pathways are for appropriate escalating when a patient is having symptoms that are reflective of cytokine release syndrome (CRS) or neurotoxicity. These toxicities are very manageable and treatable when recognized early. To summarize, choosing the right patient, knowing the toxicity profile for each product, and acting early is really what helps to prevent severe outcomes with chimeric antigen receptor (CAR) T-cell therapy,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center at...
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“Our goal of precision oncology has been to shift to tailored therapies that can help to improve treatment efficacy and ultimately improve patient outcomes. Resistance biomarker testing can help the care team to detect these genomic changes that the tumor may have acquired during therapy that makes the cells resistant to therapy. This information can be extremely helpful when we’re talking about making choices about second-line or subsequent-line therapy,” ONS member Danielle Fournier, DNP, APRN, AGPCNP-BC, AOCNP®, advanced practice RN at the University of Texas MD Anderson Cancer...
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“The disease is increasingly managed as a chronic condition rather than a diagnosis with an immediate terminal outcome. Particularly, with earlier and more effective and sustained treatment options, we can make this disease a very chronic, long-term, livable condition. I want to make sure that patients are aware that this is not a death sentence. This is something that patients can live with for the long term,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University Medical Center in Neptune, NJ, told Lenise Taylor, MN, RN, AOCNS®,...
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“We print education sheets that we have, and we say, ‘Just ignore this part that says cancer. You’re getting this med but for a different indication.’ And then you have to really point out what our goals of care are. You’re using the information that, as oncology nurses, we like and love, but we’re having to cross it out and say, ‘Just read this portion and just do this here.’ And that can be challenging for the nurse and probably confusing for the patient,” ONS member Brandy Thornberry, RN, OCN®, outpatient infusion and VAD supervisor at Logan Health in Kalispell, MT,...
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“Because the premise of immune checkpoint blockade centers around elevating the immune function, we should always take a great deal of caution around those patients who have high immune risks. Those include patients with autoimmune disorders. That’s one of our biggest questions that we ask, usually every consult that we’re seeing with solid tumor. ‘Do you have any history of autoimmune disorders? Tell me a little bit more about it. Is it being treated? What are your symptoms like?’ And then also patients who have undergone organ transplants. Now, interestingly, this does include stem...
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“It’s important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education,” ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager...
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“You also want to deal with patient preferences. We do want to get their disease under control. We want to make them live a long, good quality of life. But do they want to come to the clinic once a week? Is it a far distance? Is geography a problem? Do they prefer not taking oral chemotherapies at home? We have to think about what the patient’s preferences are to some degree and kind of incorporate that in our decision-making plan for treatments for relapsed and refractory myeloma,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer Center at Jersey Shore University...
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“Radioimmunoconjugates work through a dual mechanism that combines immunologic targeting with localized radiation delivery. The monoclonal antibody components bind to specific tumor-associated antigens such as CD20, expressed on malignant B cells. Once found, the attached radioisotope delivers beta radiation directly to the tumor, causing DNA damage and cell death,” Sabrina Enoch, MSN, RN, OCN®, CNMT, NMTCB (CT), theranostics clinical specialist at Highlands Oncology in Rogers, AR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a...
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“The United States does not have a national cancer registry. We have a bunch of state registries. Some of those registries do collaborate and share information, but the issue is the registries that do exist typically do not report cancer by occupation. So, we cannot get our arms around the potential work-relatedness of the health outcome given the current way the state registries collect information. What we’re trying to set up, is a way to make what is currently an invisible risk, visible,” ONS member Melissa McDiarmid, MD, MPH, DABT, professor of medicine and epidemiology and public...
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“[Multiple myeloma] is very treatable, very manageable, but right now it is still considered an incurable disease. So, patients are on this journey with myeloma for the long term. It’s very important for us to realize that during their journey, we will see them repeatedly. They are going to be part of our work family. They will be with us for a while. I think it’s our job to be their advocate. To be really focused on not just the disease, but periodically assessing that financial burden and psychosocial aspect,” Ann McNeill, RN, MSN, APN, nurse practitioner at the John Theurer Cancer...
info_outline“[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,” ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager of clinical education and clinical nurse specialist at Karmanos Cancer Institute in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about prostate cancer screening, early detection, and disparities.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 31, 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: Learners will report an increase in knowledge related to prostate screening, early detection, and disparities.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ Episode 149: Health Disparities and Barriers in Metastatic Castration-Sensitive Prostate Cancer
- ONS Voice articles:
- Gender-Affirming Hormones May Lower PSA and Delay Prostate Cancer Diagnosis in Transgender Women
- Healthy Lifestyles Reduce Prostate Cancer Mortality in Patients With Genetic Risk
- Hispanic Patients Are at Higher Risk for Aggressive Prostate Cancer but Less Likely to Get Treatment
- Leveling State-Level Tax Policies May Increase Equality in Cancer Screening and Mortality Rates
- Most Cancer Screening Guidelines Don’t Disclose Potential Harms
- 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 article: Barriers and Solutions to Cancer Screening in Gender Minority Populations
- Oncology Nursing Forum articles:
- Other ONS resources:
- National Institutes of Health prostate cancer screening page
- U.S. Preventive Services Task Force prostate cancer screening recommendation statement
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
“The recommendations are men [aged] 45 who are at high risk, including African American men and men who have a first-degree relative who has been diagnosed with prostate cancer younger than 65 should go through screening. And men aged 40 at an even higher risk, these are the men that have that one first-degree relative who has had prostate cancer before 65. Screening includes the PSA blood test and a digital exam. Those are the screening recommendations, although they are a little bit controversial.” TS 3:42
“You still see PSAs and DREs as the first line because they’re easier for primary care providers to perform. ... Those are typically covered by insurance, so they still play that role in screening. But with the advent of MRIs and biomarkers, these have really helped refine that screening process and determine treatment options for our patients. Again, those patients who may be at a bit of a higher risk could go for an MRI or have biomarkers completed. Or if they’re on that verge with their Gleason score, instead of doing a biopsy, they may send the patient for an MRI or do biomarkers for that patient. ... These updated technologies put [patients] a little bit more at ease that someone’s watching what’s going on, and they don’t have to have anything invasive done to see where they’re at with their staging.” TS 4:35
“Disparities in screening access exist based on race, socioeconomic status, gender identity, education, and geography. It’s really hard in rural areas to get primary care providers or urologists who can actually see these patients, [and] sometimes in urban areas. So socioeconomic status can affect that, but also where a person lives. African American men with lower incomes and people in rural areas face the greatest barriers to receiving screening. It’s also important to encourage anyone with a prostate to be screened and offer gender-neutral settings for patients to feel comfortable.” TS 7:50
“I think a lot of men feel like if they have no symptoms, they don’t have prostate cancer ... so a lot of patients may put off screening because they feel fine, [they] haven’t had any urinary symptoms, it doesn’t run in their family. ...With prostate cancer, there usually are not symptoms that a patient’s having—they may have some urinary issues or some pain—but it’s not very frequent that they have that. So, just making sure our patients understand that even though they’re not feeling something, it doesn’t mean there’s not something else going on there.” TS 12:53
“Prostate cancer found at an early age can be very curable, so it’s really important for men to have those conversations with their providers about the risk and benefits of screening. And anyone that we can help along the way to be able to have those conversations, I think is a great thing for oncology nurses to do.” TS 15:44