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,...
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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...
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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....
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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,...
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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...
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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...
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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,...
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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,...
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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...
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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...
info_outline“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 nursing practice at ONS, during a conversation about interaction pathways.
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), including 30 minutes of pharmacotherapeutic content, by listening to the full recording and completing an evaluation at courses.ons.org by July 10, 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 increased knowledge related to drug interactions in oncology care.
Episode Notes
- Complete this evaluation for free NCPD.
- ONS Podcast™ episodes: Pharmacology 101 series
- ONS Voice articles:
- Are Your Patients Taking Herbs That May Interact With Their Cancer Drugs?
- Pharmacogenomics Testing Helps to Ensure That Effective Therapy Is Safe Therapy
- Use of Herbal Products Carries Risk for Drug Interactions, but Patient–Clinician Knowledge, Communication Remain Low
- What the Research Says About Drug Interactions and Medical Cannabis
- ONS books:
- Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
- Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
- ONS Huddle Cards:
- ONS Oral Anticancer Medication Toolkit
- American Journal of Nursing articles:
- Understanding Pharmacokinetics: Part1: Drug Absorption
- Understanding Pharmacokinetics: Part 2: Drug Distribution
- Understanding Pharmacokinetics: Part 3: Drug Metabolism
- Understanding Pharmacokinetics: Part 4: Drug Elimination
- Journal of Nuclear Medicine Technology articles:
- Pharmacology, Part 1: Introduction to Pharmacology and Pharmacodynamics
- Pharmacology, Part 2: Introduction to Pharmacokinetics
- ClinPGx
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
“One of the most notable food interactions that interacts with many different medications is actually grapefruit or grapefruit juice. This is known to be a very strong CYP3A4 inhibitor. … A lot of medications are metabolized through the CYP3A4 pathway. By inhibiting the effect of these enzymes, that can actually increase and significantly increase the concentrations of these therapies. It’s not an interaction that’s just limited to grapefruit. I would say grapefruit being in the food interaction is kind of one of the most well-known, but it can also be seen with other foods as well, like pomegranate juice or a very specific type of orange called Seville oranges. And this is really just due to the presence of a substance called furanocoumarins.” TS 6:12
“There have been a pretty large number of genes identified that are responsible for coding some of those common enzyme families that I had been discussing, some of those CYP450 enzymes, but other enzymes as well that are important for drug metabolism. Based on the type of gene, there could be some different categories where patients are normal metabolizers, intermediate metabolizers, or poor metabolizers. There are some other categories as well based on the type of gene we’re looking at. And that can ultimately impact the way you are able to metabolize drugs.” TS 15:56
“Another common [geneotypic variation] that we always think about in oncology is G6PD, where if someone has G6PD deficiency, these patients can be at greater risk of hemolytic anemias when receiving certain types of therapies. Dapsone and rasburicase are just a couple that have been associated with this risk.” TS 17:50
“One of the big concerns is always polypharmacy. Our patients truly can be on a lot of medications. In the field that I work in, transplant, patients automatically from their transplant are on many, many different medications that can potentially predispose them to side effects. … But I think when it comes to the many drug interactions that may flag in these situations, we really have to look at the patient as a whole. Like, how long have these patients been on these therapies? Are they having side effects? Have they been on the combination for a very long time now? So I think that not just looking at the drug reference and seeing that there are like 10 different interactions flagged, but really assessing your patient as a whole can be very important—just because real-world practice, of course, is not black and white. It’s often very gray, so it’s just important to use clinical judgment in those scenarios.” TS 26:10