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“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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“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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“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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“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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“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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“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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“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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“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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“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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“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,...
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