Episode 425: How AI Can Help Healthcare Organizations Improve the Cancer Experience
The ONS Podcast
“In oncology specifically, where care is complex, artificial intelligence (AI) can really synthesize large volumes of clinical information, flag risks such as treatment complications, and support adherence to evidence-based pathways. For nurses specifically, this enables them more time for direct patient care, clinical judgment, and care coordination, and really practice to the top of their license while reducing repetitive time and administrative tasks,” Jenn Frith, DNP, RN, OCN®, NE-BC, associate vice president of clinical operations at Duke Cancer Institute in Durham, NC, told Jaime...
info_outline
Episode 424: Radiation Site-Specific Side Effects: Cancers of the Pelvis
The ONS Podcast
“Think about what organs lie in the radiation field, and anything that lies in that radiation field is likely going to have some potential temporary—hopefully temporary—side effects. If you think about the pelvis, the things that live in there are the bladder, urethra, some bowel, rectum, reproductive organs, skin, some lymph nodes. And so, all of those things could potentially have associated side effects,” ONS member Kayla Kafka-Peterson, BSN, RN, ROCN™, nurse navigator and leader in the brachytherapy and peri-anesthesia programs at UCLA Health, in Los Angeles, CA, told Lenise...
info_outline
Episode 423: Pharmacology 101: Interaction Pathways
The ONS Podcast
“When we think of drug interactions, specifically, the National Cancer Institute actually defines this as a change in the way a drug acts in the body when taken with certain other drugs, herbals, or foods or when taken with certain medical conditions. Drug interactions may cause the drug to either be more or less effective or cause effects on the body that are not expected,” Carissa Ganihong, PharmD, BCOP, oncology and bone marrow transplantation clinical pharmacist at Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology...
info_outline
Episode 422: An Overview of Chronic Lymphocytic Leukemia for Oncology Nurses
The ONS Podcast
“What I appreciate about our patients with chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia is the consideration that they receive a cancer diagnosis, and the best thing for them to do is actually nothing. There is a large population of patients that we don’t recommend any type of treatment. We recommend that they establish care with an oncologist and that they have a relationship with those care teams,” ONS member Caitilin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®,...
info_outline
Episode 421: Medical Trauma in Oncology
The ONS Podcast
“There are a huge array of medical dynamics that people endure, and when they leave a lasting impact, a word that we don’t use widely enough is the word ‘trauma.’ There’s an entire category of phenomena in the medical arena that are, in fact, traumatic. One way we know that these experiences are traumatic is that we know that huge portions of people who experience things like cancer do indeed develop problems like [post-traumatic stress disorder],” James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Jaime Weimer, MSN, RN,...
info_outline
Episode 420: Long-Term Myelodysplastic Syndrome Considerations for Oncology Nurses
The ONS Podcast
“We typically think of the disease progressing for our higher-risk patients because many of them already start with increased blasts or a lot of dysplasia. And they have these chromosomal variants that make them prone to evolving into acute myeloid leukemia (AML). With them, we can anticipate that they are going to progress to AML. And that’s what we’re trying to prevent. It’s kind of like a biologic evolution and not a switch,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise...
info_outline
Episode 419: Pharmacology 101: Immunomodulators
The ONS Podcast
“Until immunomodulators, patients [with myeloma] did not have a great overall survival rate. But when we introduced lenalidomide, we started seeing our patients have life expectancies between five and seven years—which was unheard of prior to these immunomodulators going forward. I think it’s promising and allows patients to have quality of life versus therapy of life,” ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist...
info_outline
Episode 418: Radiation Site-Specific Side Effects: Colorectal Cancer
The ONS Podcast
“Radiation therapy is often extremely well tolerated in colorectal cancer. Technology has really changed things. But location of the tumor can affect side effects, such as radiation dermatitis. If a patient has a low-lying tumor, if it’s less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It’s good to be proactive if that’s the case,” ONS member Lorraine Drapek, DNP, FNP-BC, AOCNP®, nurse practitioner in the Department of Radiation Oncology at Massachusetts General Hospital in Boston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®,...
info_outline
Episode 417: Pharmacology 101: Oncolytic Viral Therapy
The ONS Podcast
“There are a lot of specifics that nurses need to keep in mind as they are administering this herpes simplex modified virus to patients because accidental exposure is of concern both to the patient, to their family members, as well as to healthcare workers. I always recommend nurses wear personal protective equipment, such as a gown, safety glasses, gloves, and/or a face shield,” Heidi Finnes, PharmD, RPh, BCOP, director of clinical ambulatory practice at Mayo Clinic and assistant professor of pharmacy at Mayo Clinic Alix School of Medicine in Rochester, MN, told Jaime...
info_outline
Episode 416: Cancer Treatments for Noncancer Indications: Radiation
The ONS Podcast
“When you have benign conditions, we’re actually treating 3 gray, so a significant difference [versus doses of 60 gray for brain cancer]. Typically, when you treat at a high dose, the goal is to destroy tissue, like cancer tissue or cancer cells. But when we give a low dose, the goal is actually to modulate inflammation. And what it does is it slows down those inflammatory cells or those cells that release the chemicals that cause pain and inflammation,” Amanda Meyer, DNP, APRN, CNP, family nurse practitioner in the Department of Radiation Oncology at the Mayo Clinic in Rochester, MN,...
info_outline“Referring patients to audiology early on has shown dramatic reduction in hearing loss or complications because the audiologist can really see where were they at before they started chemotherapy, where were they at during, if they get an audiogram during their treatment. And then after treatment, it’s really important for them to see an audiologist because this is really a survivorship journey for them. And as nurses, the ‘so what’: We are the first line of defense,” ONS member Jennessa Rooker, PhD, RN, OCN®, director of nursing excellence at the Tampa General Hospital Cancer Institute in Florida, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ototoxicity in cancer care.
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 January 9, 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 management of ototoxicity after chemotherapy treatment.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ Cancer Symptom Management Basics series
- ONS Voice articles:
- Oncology Drug Reference Sheet: Cisplatin
- Oncology Drug Reference Sheet: Carboplatin
- Oncology Drug Reference Sheet: Oxaliplatin
- FDA Approves Sodium Thiosulfate for Cisplatin-Associated Ototoxicity in Pediatric Patients
- ONS book: Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition)
- American Cancer Society resources:
- American Speech-Language-Hearing Association (ASHA)
- Hearing Loss: An Under-Recognized Side Effect of Cancer Treatment
- Embedded Ear Care: Audiology on the Cancer Treatment Team
- American Society of Clinical Oncology (ASCO) Annual Meeting abstract: Innovative Infusion Center Assessments of Chemotherapy-Induced Neurotoxicities: A Pilot Study Supporting Early and Routine Screenings as Part of Survivorship Programs
- Children’s Oncology Group supportive care endorsed guideline: Prevention of Cisplatin-Induced Ototoxicity in Children and Adolescents With Cancer: A Clinical Practice Guideline
- Ear and Hearing article: Roadmap to a Global Template for Implementation of Ototoxicity Management for Cancer Treatment
- International Ototoxicity Management Group (IOMG)
- Shoebox hearing assessments
- World Health Organization initiative: Make Listening Safe
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
“At different pitches, the eardrums move faster or slower, signaling the inner ear, or the cochlea—the thing that looks like a snail in the pictures. The cochlea has fluid and hair cells inside of it that receive movements from the eardrum. The hair cells change the movement into electrical signals that actually go to the auditory nerves or the cranial nerve VIII.” TS 2:15
“Ototoxicity is an umbrella term for some sort of exposure to a toxin that causes damage to the inner ear. These toxins can be in the environment, such as loud or different noises, or they can be from medications, including antibiotics or commonly cancer treatments, such as radiation chemotherapy. Some common chemotherapies can be platinum-based chemotherapies like cisplatin or carboplatin. And then what patients are experiencing if they have ototoxicity can be hearing loss.” TS 3:15
“The hypothesized mechanism of action is that the chemicals like the platinum compound in cisplatin … that platinum compound travels through our bloodstream. Since chemotherapy is systemic, it’ll go to the inner ear, and it gets stuck there by binding to the cellular DNA in that cochlea, or that snail-looking image. That initiates the release of the reactive oxygen species, which are really trying to help clean it out, but releases such high levels that it ends up causing damage to those inner ear hairs. These inner ear hairs cannot regenerate themselves, so then they’re permanently damaged. And remember we said that those hairs send electrical signals to the brain that recognize sound. So that function is permanently gone once those hair cells are damaged.” TS 7:10
“I definitely think this is a huge interdisciplinary collaborative effort. As nurses and advanced providers, we’re assessing and providing education. Our medical oncologists are doing those dose modifications and submitting those audiology referrals. The radiation oncologists are very important to know about this—maybe dose localization awareness. Maybe they do some changes with the doses. And then our audiologists and [ear, nose, and throat physicians], they can do that diagnostic confirmation and any rehabilitation measurements and really monitor them throughout their journey as well. And nurse navigators play a huge part in making sure those patients get those referrals, because a lot of the time the audiologists aren’t in the cancer clinic, so they may have to go to another location or may need help coordinating with all their appointments that they have.” TS 22:28
“We had a really innovative way of monitoring the hearing that a couple other studies have also tested. It’s a remote point-of-care hearing screen. It was on [a tablet] with calibrated headphones. And then it’s a paid-for subscription to an audiology testing platform. … Myself, along with a couple of other nurses, were trained how to use this testing device with the tablet and the headphones and the software program. And it was a quick down-and-dirty portable hearing assessment for patients. So anyone who was new to cisplatin, never gotten cisplatin treatment before, was enrolled into the study, and they received a hearing test every time that they came for chemo, and we gave it to them during their hydration.” TS 28:59