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Episode 399: National Hazardous Drug Exposure Registry

Release Date: 01/23/2026

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...

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...

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®,...

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,...

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...

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...

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®,...

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...

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,...

Episode 415: Myelodysplastic Syndrome Treatment Considerations for Oncology Nurses

The ONS Podcast

“We want to make sure that we discuss the details of the treatment and what treatments there are, whether it’s an oral drug, whether it’s a subcutaneous injection or an IV injection, [the patient’s] potential for responding, whether this treatment is curative or supportive, and what the number of visits are. All of those different pieces of information that go into the decision-making process are really important,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN,...

More Episodes

“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 health director of the division of occupational and environmental medicine at the University of Maryland School of Medicine in Baltimore, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about the University of Maryland School of Medicine Hazardous Drug Safety Center Exposure Registry.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 23, 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 in the incidence of hazardous drug exposure and the tracking and reporting of healthcare worker exposures.

Episode Notes

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

“We thought that in order to answer some of the unclear questions about health risk, we would set up an exposure registry, in this case, for oncology personnel who handle the drugs. This would then create a cohort that we could ask questions to. For example, we could try to characterize whether there is a cancer excess in this group. Or characterize the reproductive abnormalities in excess that people are experiencing.” TS 6:21

“It’s sort of counterintuitive that the healthcare industry, whose mission itself is care of the sick, is a high-hazard industry. We typically think about the risk as being from infectious diseases, and certainly we’ve all lived in our practice lifetime through some examples of that. Even before COVID-19, some of us were doing preparation for Ebola and that sort of thing. So, we’re kind of used to that. But the hazards that you kind of grew up with, we’ve routinized or normalized handling group one, human carcinogens, which a number of these drugs are—it’s just something we do every day. Well, it is, but we have to do it with respect and with care every day. And I think sometimes in that routineness of it, we have sort of lost sight of the vigilance that we need to maintain.” TS 11:19

“It’s very easy in the life cycle of a drug in an organization to do something that doesn’t just impact you, but unknowingly, you’ve contaminated a surface for somebody who comes behind you. Who maybe doesn’t have plastic protective equipment on because something that got contaminated shouldn’t have been contaminated in the first place. If we could all be thinking of it as more of a team sport, especially in terms of safe handling, that our disposition and drug handling affects not just us and our health, but those of our colleagues.” TS 24:47

“For the job history pieces, we ask what year you started, what year you stopped, and we ask about estimations of handling. So we’ll be able to come up with either a duration or some kind of metric for the intensity and duration of your handling history, which will then permit us to sort the population who completed the survey into sort of low, medium, high. And we’ll see whether the health outcomes that are being reported are influenced by that drug handling history.” TS 27:45

“The idea that we aren’t exposed to the same therapeutic dose we give to our patients is absolutely true. However, the dosing schedule to them versus us is very different, and we are exposed frequently, if not daily, to very small concentrations. They don’t reach a cytotoxic dose necessarily, but we do know from a lot of studies that either ourselves or our colleagues are taking up drug from contaminated work environments. And you’ve probably seen there is an awful lot of intermediate evidence looking at genotoxic insult in pharmacists and nurses who handle the drugs. So clearly we’re showing uptake and we're showing that there are biologically plausible, concerning measures that are taking place in us. So, I think that we need to come back and circle around the idea that we need to have deep respect for the toxicity of these agents.” TS 35:03

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