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Episode 418: Radiation Site-Specific Side Effects: Colorectal Cancer

Release Date: 06/05/2026

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

“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^®, manager of oncology nursing practice at ONS, during a conversation about radiation side effects in colorectal 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 June 5, 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 side effects of radiation to treat colorectal cancer.

Episode Notes

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Highlights From This Episode

“In recent years, there has been more nonsurgical management of rectal cancer, especially in what we call the low-lying population. This is the population of patients who would likely end up with a permanent colostomy because their cancer is so low in terms of being close to or involving the anal verge. There is now a regimen where these patients can get their chemotherapy followed by their chemoradiation and then be monitored on close surveillance without surgery.” TS 2:23

“Another assessment would be to assess what effects have they had from their chemotherapy that they’re bringing with them. FOLFOX-based treatment is commonly used, and the platinum therapy oxaliplatin often causes peripheral neuropathy. What is the patient having? What are those symptoms like? Are they having peripheral neuropathy? If they are that is likely not going to get better or improve during their whole course of radiation. In fact, sometimes when oxaliplatin therapy stops, the peripheral neuropathy can get worse as patients are going through other treatments.” TS 5:42

“If the 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. And then proactively minimizing radiation dermatitis effects, such as keeping the area clean, good washing of the area, and prophylactically starting them on or having someone start them on steroid creams a couple of times a day to minimize that radiation dermatitis effect in the long run.” TS 7:25

“I have a sexual health clinic for women with these effects. It’s very important as nurses that if you can develop the comfort to ask patients about their sexual activity—it’s hard, but it really needs to be done. And I will tell you that the healthcare providers are not doing it. They don’t have time, and like us as nurses, we don’t get this in school, and neither do they. The other providers don’t get it in school either, but it’s important. Patients are getting more and more worried about their sexual health. They’re coming to us at a younger age, and this is really, really important to address.” TS 15:35

“I would say that working with your advanced practice providers and education for advanced practice providers has definitely been focusing on [sexual health] more. Your PAs and your NPs—I think they’re going to have the ears and the wherewithal to be able to be your allies and colleagues in this. By and large, it’s my APP colleagues and nursing that I talk to the most about this. … Again, it’s not an easy thing to bring forward, having dilators in place. But I will tell you in the department that I work in, it was me and couple of nurses who pushed this issue with the physicians for two years and finally got it put in place. It can be done. There’s a lot more centers out there doing that.” TS 21:51

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