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Episode 420: Long-Term Myelodysplastic Syndrome Considerations for Oncology Nurses

Release Date: 06/19/2026

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,...

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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 Taylor, MN, RN, AOCNS^®, TCTCN^™, oncology clinical specialist at ONS, during a conversation about long-term myelodysplastic syndrome (MDS) considerations for oncology nurses.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 19, 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 management of long-term side effects related to myelodysplastic syndrome and its treatment.

Episode Notes

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

“When our higher-risk patients have disease-related progression, their [malignancy] can transform to AML. And we know this occurs in about one-third of our patients and is one of the most serious late effects. Even in lower-risk disease, we have this worsening marrow failure with or without increasing blast, where [patients] may have just started out with anemia, then they also develop neutropenia and thrombocytopenia. And as those counts worsen, we usually know that their disease is progressing.” TS 2:47

“The golden rule is looking at the blood count but also looking at the patient and how they’re doing over time. The backbone of MDS monitoring is the complete blood cell count with the differential. What you’re looking for is trends over time. How many units of blood are they receiving, what threshold are you going to transfuse them at, and how many units of blood are they getting at a time? ... And then paying attention to the absolute neutrophil count for infection risk. [Another] really important piece of when you look at the differential with patients is seeing if they have any abnormal cell counts. Do they have circulating blasts? Are those monocytes going up? If you start to see blasts circulating or increasing monocytes, then their disease could be changing, even if they have low-risk disease.” TS 15:58

“For lower-risk disease, we’re paying more attention to their quality of life, how the patient’s tolerating therapy, trying to help them stay safe over the long haul, and starting them on iron chelation if it matches that patient and they can have access to those drugs. ... For higher-risk disease, if the patient’s goal is to be cured and not to progress to AML, you want to get them to transplant if that’s [also] one of their goals. If they do evolve into AML, try and see what treatment matches best for them.” TS 22:28

“You want to start early for patients who have febrile neutropenia—that’s really important when a patient is an hour or two away from a center where they can get started on antibiotics. So, you have to think outside the box. What can we do to keep them safe? ... I know this group in Alaska that’s in our advisory meetings and they try to facilitate transportation to Seattle. That’s the closest academic center to them. Collaborating with telemedicine appointments, starting earlier, developing that strong relationship with patients, and contacting them between visits [can help patients living in rural areas].” TS 25:22

“I think the biggest [psychosocial challenge] I see is a lot of unmet anxiety and depression counseling. A lot of times, [patients are] losing their place in their family because they’re the ones that need all the help now. Also, the uncertainty that goes along with the diagnosis. There is communication skills counseling, and End-of-Life Nursing Education Consortium (ELNEC) has a lot of training for communication skills and how to really talk to patients. Not that we take the place of a psychologist, but just being able to talk to somebody can go a long way. And if we can get training for that, we can help more patients.” TS 31:15

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