Episode 408: Radiation Site-Specific Side Effects: Breast Cancer
Release Date: 03/27/2026
The ONS Podcast
“We thought, from a nursing standpoint, ‘What is our goal for doing this?’ What we wanted was first, education of the patient. Can we successfully educate the patient to prepare them? Can we alleviate as much anxiety as possible so that they feel comfortable coming in and having this done? The second goal is to preserve kidney function throughout the treatment. To date, we’ve been successful with that. And the third goal is to complete treatment without infection,” ONS member Chris Amoroso, BSN, RN, OCN®, registered nurse at Fox Chase Cancer Center in Philadelphia, PA, told Jaime...
info_outlineThe ONS Podcast
“They are small, powerful little nuggets. They are actually small signaling proteins that our immune cells use to communicate. They really help regulate immune activation or inflammation and even the growth and survival of immune cells. When cytokines are used therapeutically in oncology, they help to stimulate immune cells such as T cells or natural killer cells to better recognize and attack cancer cells,” Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center of Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN,...
info_outlineThe ONS Podcast
“Not every patient with myelodysplastic syndrome (MDS) is going to progress and die. Only 10%–20% of them will evolve into acute myeloid leukemia. And not all of them need blood transfusions. Some present with low platelet count. It’s not just people who are anemic that have MDS—it’s different depending on what type of MDS they have. These are averages. We’re giving you statistics based on averages, and you’re an individual, so we want to treat you as an individual,” ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt...
info_outlineThe ONS Podcast
“Cancer and environmental disasters in particular, but the worsening of our environment, are really things that are great equalizers. And we recognize that we’re all kind of in this world together. We can really face these issues on a more human level. I think always recognizing that if we look at something, we think, ‘Well, that doesn’t relate to me or that problem is it really isn’t my problem’—it sure is,” ONS member Margaret “Peggy” Rosenzweig, PhD, CRNP-C, AOCNP®, FAAN, ONS scholar-in-residence and distinguished service professor of nursing and Nancy Glunt Hoffman...
info_outlineThe ONS Podcast
“Interventional oncology has really evolved into an important component of modern cancer care and is often described now as the fourth pillar alongside medical, surgical, and radiation oncology. The specialty now encompasses a broad spectrum of image-guided procedures that support from cancer diagnosis, treatment, to effectively managing symptoms that are caused by the disease. In other words, what we’re seeing is that across the continuum of care, IO is playing a vital role,” ONS member Evelyn P. Wempe, DNP, MBA, APRN, ACNP-BC, AOCNP®, CRN, NEA-BC, executive director for advanced...
info_outlineThe ONS Podcast
“A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It’s quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it’s throbbing or heavy. Clothing may not fit quite right. So we’re always on the lookout for lymphedema,” Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice...
info_outlineThe 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...
info_outlineThe ONS Podcast
“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...
info_outlineThe ONS Podcast
“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®,...
info_outlineThe ONS Podcast
“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,...
info_outline“A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It’s quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it’s throbbing or heavy. Clothing may not fit quite right. So we’re always on the lookout for lymphedema,” Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation site-specific side effects in breast cancer.
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 March 27, 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 side effects experienced with radiation therapy to the breast.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes:
- Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer
- Episode 354: Breast Cancer Survivorship Considerations for Nurses
- Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
- Episode 298: Radiation Oncology: Nursing’s Essential Roles
- Episode 194: Sex Is a Component of Patient-Centered Care
- ONS Voice articles:
- Could High-Dose Radiation Be the Missing Link in Breast Cancer Immunotherapy?
- Exercise Program Improves Quality of Life in Patients With Breast Cancer—and Keeps Them Moving Daily
- Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer
- How to Handle Even the Worst Radiation Therapy Side Effects
- Clinical Journal of Oncology Nursing articles:
- Oncology Nursing Forum articles:
- ONS books:
- ONS/ONCC® courses:
- ONS Huddle Cards:
- ONS Guidelines™:
- ONS Learning Libraries:
- American Society for Radiation Oncology (ASTRO)
- National Comprehensive Cancer Network home page
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 goals of radiation to the breast are typically broken out into three different rationales. Either adjuvant treatment, where the tumor is removed surgically from the breast first and then radiation is delivered to lower the likelihood of return of the cancer. And then the second way it’s given is with a curative intent. That may be for tumors that couldn’t be fully resected, and the hope is to eradicate the tumor that is still present in the tissue. Lastly, it can be given in a palliative fashion where you’re not expecting to completely cure the person of the cancer, but you hope to shrink the tumor enough to relieve symptoms.” TS 1:46
“We really try to focus on patients managing fatigue by ensuring that they’re having an appropriate, balanced diet with proper macro and micronutrients and that they’re having adequate protein intake. We encourage patients to get adequate sleep. There is a culture of people pushing themselves and working into late hours of the night, and this would be quite difficult if you’re experiencing radiation-induced fatigue. If someone is familiar and does regular exercise, we highly encourage them to continue that. If someone has not done much exercise and has slipped into a little bit of deconditioning or they’re older or more frail, we might refer them for physical therapy or strength training to rebuild some of that stamina and energy.” TS 7:56
“One of the key products to use for prevention of radiation dermatitis are silicone patches, and there are many on the market that are worn during the course of radiation or when the skin reaction begins. And they could stay on for several days during treatment, even if you’re gently showering around the area. There are many homeopathic creams made from calendula flower, aloe vera, or some kind of combination of these types of products. The real issue with these products is that many of them aren’t covered by insurance, so patients have to buy them out of pocket, over the counter. For some of our patients who are more financially challenged, it may be a problem. So I think [it’s important] to be familiar with many different products so that patients have access to something that will minimize their skin reaction.” TS 14:48
“After 90 days, it may be more common to see some of the cosmetic changes that can happen in the soft tissue of the breast. One of them is radiation fibrosis, which can be like a diffused scar tissue in the breast. It can sometimes cause hardening, retraction, or asymmetry. Sometimes it can cause a tight feeling where people can’t stretch their arm to the full extent. We also know that there can be slower healing if surgery is done. For people that have tissue expanders or still want to have corrective plastic surgery, we really encourage them to wait at least six months or longer before approaching any of those plastic surgery procedures.” TS 19:55
“Sexual health is such a big topic, but I think that nurses in radiation oncology are in a very good position to discuss that because we see patients for repeated period of time. So, there’s maybe a quicker intimacy or familiarity that happens with the nurses in radiation. Personally, I always bring it up at a follow-up visit, which we do about a month after radiation ends. And it’s kind of because the dust is settling and people are getting back to their lives.” TS 23:53