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

Release Date: 06/05/2026

Episode 433: Cancer Treatments for Noncancer Indications: Chemotherapy/Immunotherapy

The ONS Podcast

“Unlike our cancer indications where we use these medications often to activate the immune system to target cancerous cells, in noncancer indications, the goal is really to either suppress an overactive immune or inflammatory cells or modulate the immune system. Immune modulation by use of chemotherapy and immunotherapy can help reduce abnormal inflammation, decrease autoantibody production, and also can alter T-cell and B-cell activity,” ONS member Kelsey Miller, MSN, RN, AGCNS-BC, OCN®, clinical nurse specialist in oncology and infusion therapy at Reading Hospital in West Reading, PA,...

Episode 432: Long-Term Chronic Lymphocytic Leukemia Considerations for Oncology Nurses

The ONS Podcast

“It’s a chronic disease. It never goes away for some people, and so therefore it has these periods of remission where it’s really quiet and well controlled. Then there can be periods of flares where you’re actively engaged in treatment or it’s impacting other pieces. There’s this feeling patients have of, ‘When am I going to have that flare?’ You know, this anticipatory anxiety of, ‘When are things going to be done differently?’ or ‘When do I need to change?’” ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer...

Episode 431: Oncologic Emergencies 101: Urinary Obstruction

The ONS Podcast

“Think about all the important things our kidneys do for the body. Those things are compromised. If we have excess buildup of toxins and waste in the body, you’re having problems with fluid reabsorption. Then you have also problems with electrolytes not being balanced. Then in turn, you have ongoing shutdown of systems. So the cardiopulmonary system gets compromise. Your circulatory system then gets compromised. And then all the things in the body that depend upon ongoing circulatory flow are then causing major resets in the system that need to be addressed,” ONS member Brenda S....

Episode 430: Leadership Unlocked: Is It Your Time to Serve?

The ONS Podcast

“If you are considering board service, I would say take the leap. Start with your local chapter. It will give you some valuable skills that will help prepare you when you are applying for your national level. And I always say, if you want to do it, just do it because what’s the worst that can happen? They can say no, but that doesn’t mean that you will never serve on a board. I always tell people delayed is not denied,” Cassandra Green, DNP, RN, OCN®, ONS member and past president of the Oncology Nursing Certification Corporation (ONCC) Board of Directors, told Evelyn Wempe, DNP,...

Episode 429: Radiation Site-Specific Side Effects: CNS Cancers

The ONS Podcast

“They’re really worried that radiation is going to be painful. So they come in for that first day of treatment very anxious. With our patients with brain cancer, we’re using the masks on the table, and those masks are very tight and hold their heads very, very still. So they’ll be very worried about being claustrophobic. We may start out the first day or two with a little bit of [lorazepam]. And they’ll come to me and they’ll say, ‘This really hasn’t been as bad as I thought it was going to be,’” ONS member Catherine McCluskey, BSN, RN, OCN®, ROCN™, radiation oncology...

Episode 428: Chronic Lymphocytic Leukemia Treatment Considerations for Oncology Nurses

The ONS Podcast

“Measurable residual disease is where I think the terminology fits best in that, it is intended to measure the amount of cancer cells that are present in the blood or bone marrow at the time the sample was collected. We can identify one cancer cell in a million. Where that can be really valuable is when we start to think about the duration of treatments and the response to some of our treatments,” ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical...

Episode 427: Pharmacology 101: Resistance Pathways

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,...

Episode 426: Tools to Support Patients and Nurses Through Medical Trauma in Oncology

The ONS Podcast

“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,...

Episode 425: How AI Can Help Healthcare Organizations Improve the Cancer Experience

The ONS Podcast

“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...

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...

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

ONS Voice articles:

Clinical Journal of Oncology Nursing articles:

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To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

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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