Episode 416: Cancer Treatments for Noncancer Indications: Radiation
Release Date: 05/22/2026
The ONS Podcast
“A good way of thinking about this is this is the survival of the fittest clone. There could be a portion of a cancer that naturally has some resistance or ability to survive a particular drug. And over time, as the other cells around it are dying off, that particular clone is able to replicate and continue to survive in the face of that drug therapy and eventually take over as being the fittest clone. At that point, we’re often seeing disease progression,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh,...
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“When people with PTSD [post-traumatic stress disorder] get quite avoidant—and that can be expressed in so many different ways—the implications can be really profound. I think an important invitation to oncologists and oncology nurses and primary care providers who care for people battling cancer is let’s explore what's underneath these avoidant behaviors. Is it a very practical thing? Or is it that underneath this avoidant behavior is really profound fear?” James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Lenise Taylor, MN,...
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“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...
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“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...
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“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...
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“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®,...
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“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,...
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“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...
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“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...
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“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“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, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation therapy for noncancer indications.
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 May 22, 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 about the use of radiation to treat noncancerous conditions.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes:
- Episode 365: Radiation-Associated Secondary Cancers
- Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
- ONS Voice articles:
- Augmented Reality Simulations Reduce Patient Anxiety by Teaching Them About Radiation Therapy
- Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education
- Quick Quiz: Test Your Knowledge of Radiation Care Coordination
- ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
- ONS courses:
- ONS Radiation Oncology Conference Recordings Bundle™
- ONS ROCN™ Certification Review™
- Radiation Oncology 101: 2024 ONS Bridge™ Session
- ONS/ONCC® Radiation Therapy Certificate™
- Clinical Journal of Oncology Nursing articles:
- Findings From the 2023 Radiation Oncology Nursing Role Delineation Study to Shape the Future of the Subspecialty
- The Role of Advanced Practice Providers in Radiation Oncology in 2025
- ONS Huddle Cards:
- German Society for Radiation Oncology (DEGRO): Guidelines in Radiotherapy: Radiotherapy for Benign Diseases
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 always typically think of it as cancer treatment, but we can use radiation for noncancerous conditions, as well. And radiation was actually used for benign diseases right after the discovery of x-rays. By the 1920s it was used a lot for different types of musculoskeletal, dermatologic issues, and different types of inflammatory conditions. And over time, since the 1920s, we’ve actually really gotten a really good understanding of it.” TS 1:37
“When we’re looking at what are good candidate characteristics, we do typically like older patients, so patients over the age of 65. And the rationale behind that is we know that there is a potential for a secondary risk of a skin cancer about 20 to 30 years after getting low-dose radiation, like a basal cell or squamous cell skin cancer. The older the patient is, the less likely they are to have any adverse effects from that.” TS 8:22
“When we do the low-dose radiation, they’ve tried other measures that haven’t been successful. However, we don’t want a patient who is so severe that they’re ready for surgery, when they’re bone on bone, because we know that radiation isn’t as effective when they are that severe. So there’s this sweet window where low-dose radiation works best in these patients.” TS 9:39
“When we’re treating with a little bit higher dose for like a Dupuytren’s or a Ledderhose, because it’s an anti-proliferative dose, those patients, they do get more skin redness, more dry skin. That’s very temporary, and it resolves within a week or two after treatment. But really, we don’t see any acute side effects. The long-term side effect of the radiation-induced malignancy, again, is a very low—0.05% according to some of the European guidelines.” TS 12:34
“I really wish people appreciated how interdisciplinary this is. We need to get referrals from family medicine and from primary care and internal medicine and pain medicine physicians and inflammatory physicians and podiatry and pain specialists. And we really need to use this multidisciplinary approach to get earlier referrals for patients because there is this sweet window of time where low-dose radiation works the best.” TS 18:40