Episode 390: Prostate Cancer Treatment Considerations for Nurses
Release Date: 11/21/2025
The ONS Podcast
“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“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 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 treatment considerations for nurses.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 21, 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 the treatment of prostate cancer.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes:
- Episode 387: Prostate Cancer Screening, Early Detection, and Disparities
- Episode 373: Biomarker Testing in Prostate Cancer
- Episode 324: Pharmacology 101: LHRH Antagonists and Agonists
- Episode 321: Pharmacology 101: CYP17 Inhibitors
- Episode 208: How to Have Fertility Preservation Conversations With Your Patients
- Episode 194: Sex Is a Component of Patient-Centered Care
- ONS Voice articles:
- Communication Models Help Nurses Confidently Address Sexual Concerns in Patients With Cancer
- Exercise Before ADT Treatment Reduces Rate of Side Effects
- Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer
- Nurses Are Key to Patients Navigating Genitourinary Cancers
- Sexual Considerations for Patients With Cancer
- The Case of the Genomics-Guided Care for Prostate Cancer
- ONS books:
- Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition)
- Manual for Radiation Oncology Nursing Practice and Education (Fifth Edition)
- Clinical Journal of Oncology Nursing articles:
- Oncology Nursing Forum articles:
- Other ONS resources:
- American Cancer Society prostate cancer page
- National Comprehensive Cancer Network homepage
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 it’s important to note that urologists are usually the ones that are doing the diagnosis of prostate cancer and really start that staging of prostate cancer. And the medical oncologists usually are not consulted until the patient is at a greater stage of prostate cancer. I find that it’s important to state because a lot of our patients start with urologists, and by the time they’ve come to us, they’re a lot further staged. But once a prostate cancer has been suspected, the patient needs to be staged for the extent of disease prior to that physician making any treatment recommendations. The staging includes doing a core biopsy of the prostate gland. During this core biopsy, they take multiple different cores at different areas throughout the prostate to really look to see what the cancer looks like.” TS 1:46
“[For] the very low- and low-risk group, the most common [treatment] is active surveillance. ... Patients can be offered other options such as radiation therapy or surgery if they’re not happy with active surveillance. ... The intermediate-risk group has favorable and unfavorable [status]. So, if they’re a favorable, their Gleason score is usually a bit lower, things are not as advanced. These patients are offered active surveillance and then either radical prostatectomy with possible removal of lymph nodes or radiation—external beam or brachytherapy. If a patient has unfavorable intermediate risk, they are offered radical prostatectomy with removal of lymph nodes, external radiation therapy plus hormone therapy, or external radiation with brachytherapy. All three of these are offered to patients, although most frequently we see that our patients are taken in for radical prostatectomy. For the high- or very high-risk [group], patients are offered radiation therapy with hormone therapy, typically for one to three years. And then radical prostatectomy with removal of lymph nodes could also be offered for those patients.” TS 7:55
“Radiation can play a role in any risk group depending on the patient’s preference. ... The types of radiation that we use are external beam, brachytherapy, which is an internal therapy, and radiopharmaceuticals, [which are] more for advanced cancer, but we are seeing them used in prostate [cancer] as well. External beam radiation focuses on the tumor and any metastasis we may have with the tumor. It can be used in any risk [group] and for recurrence if radiation has not been done previously. If a patient has already been radiated to the pelvic area or to the prostate, radiation is usually not given again because we don’t want to damage the patient any further. Brachytherapy is when we put radioactive pellets directly into the prostate. For early-stage prostate cancer, this can be given alone. And for patients who have a higher risk of the cancer growing outside the prostate, it can be given in combination with external beam radiation. It’s important to note with brachytherapy, it cannot be used on patients who’ve had a transurethral resection of the prostate or any urinary problems. And if the patient has a large prostate, they may have to be on some hormone therapy prior to brachytherapy, just to shrink that prostate down a little bit to get the best effect. ... Radiopharmaceuticals treat the prostate-specific membrane antigen.” TS 11:05
“The side effects of surgery are usually what deter the patient from wanting surgery. The first one is urinary incontinence. A lot of times, a patient has a lot of urinary incontinence after they have surgery. The other one is erectile dysfunction. A lot of patients may not want to have erectile dysfunction. Or, if having an erection is important to the patient, they may not want to have surgery to damage that. In this day and age, physicians have gotten a lot better at doing nerve-sparing surgeries. And so they really do try to do that so that the patient does not have any issues with erectile dysfunction after surgery. But [depending on] the extent of the cancer where it’s growing around those nerves or there are other things going on, they may not be able to save those nerves.” TS 15:26
“Luteinizing hormone-releasing hormone, or LHRH antagonists or analogs, lower the amount of testosterone made by the testicles. We’re trying to stop those hormones from growing to prevent the cancer. ... When we lower the testosterone very quickly, there can be a lot more side effects. But if we lower it a little bit less, we can maybe help prevent some of them. The side effects are important. When I was writing this up, I was thinking, ‘Okay, this is basically what women go through when they go through menopause.’ We’re decreasing the estrogen. We’re now decreasing the testosterone. So, the patients can have reduced or absent sexual desire, they can have gynecomastia, hot flashes, osteopenia, anemia, decreased mental sharpness, loss of muscle mass, weight gain, and fatigue.” TS 17:50
“What we all need to remember is that no patient is the same. They may not have the same goals for treatment as the physicians or the nurses want for the patient. We talked about surgery as the most common treatment modality that’s presented to patients, but it’s not necessarily the option that they want. It’s really important for healthcare professionals to understand their biases before talking to the patients and the family. It’s also important to remember that not all patients are in heterosexual relationships, so we need to explain recovery after treatment to meet the needs of our patients and their sexual relationships, which is sometimes hard for us. But remembering that—especially gay men—they may not have the same recovery period as a heterosexual male when it comes to sexual relationships. So, making sure that we have those frank conversations with our patients and really check our biases prior to going in and talking with them.” TS 27:16