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...
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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...
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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®,...
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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,...
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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...
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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...
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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®,...
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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...
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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,...
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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,...
info_outline“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 Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about oncolytic viral therapy.
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 May 29, 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 oncolytic viruses to treat cancer.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes:
- ONS Voice articles:
- Clinical Journal of Oncology Nursing articles:
- Oncology Nursing Forum article: Administration and Handling of Talimogene Laherparepvec: An Intralesional Oncolytic Immunotherapy for Melanoma
- ONS book: Guide to Cancer Immunotherapy (second edition)
- ONS clinical practice resource: Safe Handling of Oncolytic Viruses
- ONS Huddle Card: Immunotherapy
- Association of Community Cancer Centers (ACCC)
- Drugs@FDA
- Hematology/Oncology Pharmacy Association (HOPA)
- Network for Collaborative Oncology Development and Advancement (NCODA)
- Patient Education Sheets
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Highlights From This Episode
“[Oncolytic viruses] can have direct lysis to the tumor cells themselves, or they can cause immunogenic activation. They release tumor-associated antigens and then proinflammatory signals, so think of T cells, natural killer cells, those sorts of things, that can convert to immunologically cold tumors. Those are tumors that are immune silenced into hot tumors which are now immune activated. By doing that, they recruit those T cells and other cells to the area to attack both the primary tumors. But that’s also thought to be how they work on distant or noninjected sites as well. This immunomodulatory capacity has led to the reclassification of oncolytic viruses as a form of cancer immunotherapy. So, think of it kind of similarly to how we think of immune checkpoint inhibitors in recruiting immune cells and leaving our immune system in the on position. This is also kind of a form of immunotherapy.” TS 4:35
“One of the toxicities I know that is of significant concern to patients, family members, and healthcare workers is the incidence of herpes infections. Systemic herpetic infections are extremely rare and usually more common in patients who may be immunocompromised. In patients who also have other immune-related diseases—such as vitiligo, vasculitis, pneumonitis, sometimes worsening psoriasis—because you’re mounting an immune response with these types of things, sometimes you can see a worsening of those types of immune symptoms. But for the most part, these types of side effects are very well tolerated in most patients.” TS 9:07
“Talimogene is generally transmitted via bodily fluids or touch. It’s not airborne. Herpes simplex virus isn’t an airborne type of virus. Another thing to consider is where are you going to inject this? Are you going to do this in your infusion therapy unit? Are you going to do it in a dedicated room? Who’s going to escort the patient to the room? How is the virus going to arrive at the room? How will you clean the room and all of the laboratory equipment or any of the exam tables that may be in there? I think having all of that discussed and assigned mitigates the consternation that can sometimes occur—the fear that occurs with administering a virus that is thought to be fairly communicable.” TS 15:44
“Helping patients understand how this works [is important] because hearing that you’re receiving a virus, particularly a herpes simplex virus, can be scary to a patient. I think understanding that it’s modified or essentially we’re taking the parts out of it so that we can directly inject a portion that recruits immune cells to that area, because the goal is for the oncolytic virus to attack cancer cells and then destroy them by triggering an immune response in the body.” TS 20:51
“Sometimes patients are very concerned about urine in the toilet, bodily fluids, kissing loved ones, holding hands, hugging, you know, am I going to infect my loved one because I’m getting this type of an oncolytic virus therapy? I like to reassure patients that they can continue to hold hands and hug their loved ones as normal. Viral DNA is usually only present on the injection site. And as I mentioned previously, we want to cover that injection site with an occlusive dressing, at least with talimogene, for up to seven days. And particularly, if those injection sites are at all oozing or weeping, active virus is usually only on that injection site itself.” TS 24:14