The ONS Podcast

Where ONS Voices Talk Cancer Join oncology nurses on the Oncology Nursing Society's award-winning podcast as they sit down to discuss the topics important to nursing practice and treating patients with cancer. ISSN 2998-2308

Episode 367: Pharmacology 101: PARP Inhibitors 06/13/2025

Episode 367: Pharmacology 101: PARP Inhibitors Episode 367: Pharmacology 101: PARP Inhibitors “We know that in cells that are proliferating very quickly, including cancer cells, single-strand DNA breaks are very common. When that happens, these breaks are often repaired by the PARP enzyme, and the cells can continue their replication process. If we block PARP, that repair cannot happen. So in blocking that, these single-strand breaks then lead to double-strand breaks, which ultimately is leading to cell apoptosis,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the PARP inhibitor drug class. Music Credit: “” 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 13, 2026. 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 use of PARP inhibitors in cancer care. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) ONS courses: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “The big toxicities here to watch for are primarily hematologic toxicities. It is one of those targeted therapies that does affect blood cell counts. So I’d say the blood cell count that is most commonly affected here is the hemoglobin. So, anemia very frequent complication that we see, probably a little bit more with olaparib compared with other drugs, but we see it as a class side effect. And we can also see neutropenia and thrombocytopenia with these agents, probably a little bit more with niraparib versus the others, but again, you can see it across all of these drugs.” TS 8:16 “We mentioned that rare risk of MDS and AML. This isn’t a particularly scary thing if you talk to patients about it. Because of the rarity that we see this, it isn’t something that we need to overemphasize, but I think careful monitoring of blood counts in is stressing the importance of that and early intervention here is very important.” TS 16:55 “This is a collaborative effort. And because of the home administration here, these patients do need to be followed very closely. So we are not laying eyes on them usually with the frequency that we do when we have patients actually coming into our infusion centers for treatments—so making sure that there is a plan for regular follow-up with these patients to ensure that they’re getting that lab work done, that that’s being looked at closely, that we’re adjusting the dose if we need to based on that lab work, that we are managing the patient’s fatigue. Again, that potentially dose reductions may be needed if patients are having that extreme fatigue.” TS 19:34 “I think one of those [misconceptions] could be that they’re only effective in patients that have that BRCA1/2 mutation. And again, remember here that there is some data in particular disease states that we can use them and that they work in the absence of those mutations.” TS 25:12 /episode/index/show/onsvoice/id/36969310

Episode 366: ONS 50th Anniversary: Generations of Nurses Keep Oncology in the Family 06/06/2025

Episode 366: ONS 50th Anniversary: Generations of Nurses Keep Oncology in the Family “[My mom] would always be very inspirational whenever I would see her studying so long. And when she finally got to be a nurse, I always admired her vocation and compassion with her patients. She would always go above and beyond for all of her patients. I also got inspired a lot by my brother, as well, just seeing how passionate he was for caring for his patients for the families as well, and helping them deal with the any grief or loss that they were experiencing, Carolina Rios, MSN, RN, CPhT, told Valerie Burger, RN, MA, MS, OCN®, CPN, member of the ONS 50th anniversary planning committee, during a conversation about families in nursing. Burger spoke with Carolina, her mother Lissette Gomez-Rios, MSN, APRN, AGACNP-BC, FNP-BC, OCN®, BMTCN®, and her brother Carlos Rios, BSN, RN, BMTCN®, about how having multiple nurses in their family has affected them personally and professionally. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice articles: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode Lissette: “Being in the oncology nursing as a family, when I feel the necessity to talk to them, they listen to me. They pay attention, and we help each other to cope, especially when there is a loss of our patients, so we help each other. We are understanding. We give them compassion and the advice that we need.” TS 6:51 Carlos: I remember growing up—and [my mom] would always be in school and in the healthcare field, so I knew growing up I wanted to be in the healthcare field. She was the one that guided me into going to nursing because at a certain point, I wasn’t sure what I was going to be doing. She guided me, and once I started doing nursing, this has been the career I want to do, I want to continue doing. I’m very grateful for her guiding me into nursing.” TS 9:48 Carolina: “Anytime I had a question I would ask them. They would always help me out, make sure I really understood. It would actually be a little funny because sometimes they would overexplain, and I was a little overwhelmed, and I would have to be like, ‘OK, let’s dial it back. Let’s get back to the basics.’” TS 14:22 /episode/index/show/onsvoice/id/36849640

Episode 365: Radiation-Associated Secondary Cancers 05/30/2025

Episode 365: Radiation-Associated Secondary Cancers “From a radiation standpoint, the biggest thing we’re looking at is the treatment site, the dosage, and the way the radiation has been delivered. There are different ways that we can focus radiation using methods such as intensity-modulated radiotherapy, volumetric modulated arc therapy, flattening radiation beams, and proton beam therapy to try to help minimize radiation exposure to healthy tissues to minimize patient risk for secondary cancers,” ONS member Andrea Matsumoto, DNP, AGACNP-BC, AOCNP®, radiation oncology nurse practitioner at Henry Ford Health in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation-associated secondary cancers. Music Credit: “” 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 May 30, 2026. 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 radiation-associated secondary cancers. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS book: (fifth edition) ONS courses: Clinical Journal of Oncology Nursing articles: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “It’s hypothesized that radiation can also induce different DNA mutations in healthy cells or in tissues surrounding cancers that we’re treating, including alterations in the structure of signal genes or chromosomes, or also causing changes in gene expression, which may help develop a neoplasia or a cancer in a patient’s future. The development of cancer carcinogenesis that is impacted or caused by radiation has to do with the chemicals that are produced, the impact it has on cell proliferation, and how these changes and mutations can also pass on to daughter cells in the future as cells are replicating.” TS 2:34 “Younger people are much more susceptible to having a secondary cancer, especially because we know with treatments, we expect them to live a longer time. And once patients get to 5 and 10 years out from radiation is when we may see a secondary cancer develop. We also have seen research showing that females may be more sensitive to some of the carcinogenic effects of radiation. Underlying diseases and genetic mutations can also impact patients’ risk.” TS 5:27 “I think a big thing is remembering that although the risk is really small, the risks does exist, and so it’s something that we want to bring up with patients. And even if it is something 20 years down the line for a child being treated and making sure that this information is written down somewhere. So when reviewing records, anyone from a care provider to a family member might be able to say, ‘Okay, I see that, and I’m going to keep that on my radar.’ And that’s another big benefit of using NP- and nurse-led survivorship clinics and creating survivorship care plans.” TS 17:20 /episode/index/show/onsvoice/id/36769525

Episode 364: How to Prepare for a Nursing Examination 05/23/2025

Episode 364: How to Prepare for a Nursing Examination “Everyone will probably say this, but it is so true. Do not cram the night before the exam. The most important thing the night before the exam is to get a good night’s sleep. You might be so nervous. You’re like, ‘I can get any new information that matters right before the exam,’ but you can’t. Any information that you know you will have gotten in the time that you spent studying already. Really, you have to trust yourself,” Talia Lapidus, BSN, RN, professional staff nurse in the neonatal intensive care unit at UPMC in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about preparing for the NCLEX. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice articles: ONCC Certification Exam Resources: ONS books: (second edition) (second edition) (seventh edition) (seventh edition) ONS course: Cleveland Clinic article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “The biggest studying tip that I found when I was studying was just consistency. I was studying every day, and I was setting time aside every single day to study. It’s really just about making sure that it’s part of your daily routine. At first it feels weird, like going from school to just straight up studying. But that’s really what school was for—finding a study method that works for you, that you can then implement into studying for the biggest test that you have to take.” TS 1:52 “Practice questions are everything. You mentioned already that the NCLEX questions are formulated in a very specific way. And I know some schools do all their exams in NCLEX style, but some schools don’t, so some people might not know how the NCLEX formulates their questions. A lot of the time it’s like you have to pick the most correct out of a lot of correct answers. And if you don’t have practice critically thinking about how to answer these questions, you might get tripped up. So practicing these questions, knowing what the test will be like, is so important.” TS 6:46 “Time management is the best thing that you can do. When I was working, I still had goals for myself for studying, even if it was just study this topic today or do 10 practice questions today. Anything that you’re doing is better than nothing. So if you have to color-code your life and, in Google Calendar, have two hours to work, two hours to study, or eat lunch from 12 to 1, and then from 1 to 2, you study. Anything that you have to do to make sure that you get at least a little bit of studying in matters.” TS 9:05 “You don’t have to be studying 24/7. You have a life outside of the exam, and you should still live it. You should still see your friends, and you should still go out to eat. Do things that make you feel good because if you are not in your best headspace, you won’t be able to study appropriately.” TS 18:50 /episode/index/show/onsvoice/id/36655360

Episode 363: Lung Cancer Treatment Considerations for Nurses 05/16/2025

Episode 363: Lung Cancer Treatment Considerations for Nurses “A lot of other disease sites, they have some targeted therapies, they have some immunotherapies [IO]. In lung cancer, we have it all. We have chemo. We have IO. We have targeted therapies. We have bispecific T-cell engagers. We have orals, IVs. I think it’s just so important now that, particularly for lung cancer, you have to be well versed on all of these,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer treatment. Music Credit: “” 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 May 16, 2026. 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 lung cancer treatments. Episode Notes . ONS Podcast™ episode: ONS Voice articles: Clinical Journal of Oncology Nursing article: ONS video: ONS Huddle Cards: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Unfortunately, because lung cancer is pretty aggressive, we’ll see lung cancer mostly in stage IV. So about 50%–55% of all cases are not caught until they are already metastatic, or stage IV. And then about another 25%–30% of cases are caught in stage III, which means they’re locally advanced and often not resectable, but we do still treat that with curative intent with concurrent chemoradiation. And then 10%–20% of cases are found in the early stage, and that’s stage I and II, where we can do surgical approaches.” TS 2:53 “The majority of radiation that you’re going to see is for patients with stage III disease that’s inoperable. At my institution, a lot of stage III is inoperable. Now, neoadjuvant immunotherapy has changed that a little bit. But if you have several big, bulky, mediastinal lymph nodes that makes you stage III, surgery is probably not going to be a great option. So we give curative-intent chemoradiation to these patients.” TS 10:51 “Oligoprogression would mean they have metastases but only to one site. And sometimes we will be aggressive with that. Particularly, there’s good data, if the only site of progression is in the brain, we can do stereotactic radiation to the brain and then treat the chest with concurrent chemoradiation as a more definitive approach. But outside of that, the majority of stage IV lung cancer is going to be treated with systemic therapy.” TS 15:00 “It’s important for nurses to know that there’s a lot of different options now for treatment. Probably one of the most important things is making sure patients are aware of what their biomarker status is, what their PD-L1 expression level is, and make sure those tests have been done. … It’s good that the patients understand that there’s a myriad of options. And a lot of that depends on what we know about their cancer, and then that guides our treatment.” TS 31:05 /episode/index/show/onsvoice/id/36578685

Episode 362: Pharmacology 101: MET Inhibitors 05/09/2025

Episode 362: Pharmacology 101: MET Inhibitors “The signaling and that binding of the MET and the HGF help, in a downstream way, lead to cell proliferation, cell motility, survival, angiogenesis, and also invasion—so all of those key cancer hallmarks. And because of it being on an epithelial cell, it’s a really good marker because it’s found in many, many different types of cancers, so it makes it what we call kind of a nice actionable mutation,” ONS member Marianne Davies, DNP, ACNP, AOCNP®, FAAN, senior oncology nurse practitioner at Yale Comprehensive Cancer Center in New Haven, CT, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the MET inhibitor drug class. Music Credit: “” 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 May 9, 2026. 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 MET inhibitors. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) (third edition) ONS courses: ONS Huddle Cards: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “The MET receptor was actually identified back in 1984. And it was actually identified as an oncogene in osteosarcoma. And so basically what that MET receptor does—it’s a tyrosine kinase pathway, and the ligand that it attaches to is something called HGF/SF. That’s hepatocyte growth factor/scatter factor. And so this MET pathway tyrosine kinase pathway is really important in tumor cell growth and migration. And it’s expressed specifically on epithelial cells, so that’s going to really help us in identifying how it can be a pathway for cancer treatments.” TS 1:35 “But in the particular classes, there kind of are some unique things that are with these MET inhibitors. For example, crizotinib, we found early on, causes some vision changes. Patients would report things like floaters or a little bit of blurry vision. For the capmatinib, things like elevation of amylase and lipase, fluid retention and bloating, and hypersensitivity reactions and photosensitivity.” TS 7:36 “Other things to teach for the TKI is the self-management strategies in terms of nausea management and dietary changes for the risk of peripheral edema. Having them do things like maybe doing daily weights, or at least weights every other day, and sometimes doing limb measurements so it can help us really quantify the amount of fluid retention they have. And then from a nursing perspective, meeting with these patients, is to do really good skin inspection. When people have peripheral edema, they’re at risk for skin breakdown, and that can lead obviously to infection.” TS 16:06 “The biggest [misconception] is that people assume that all MET mutations are going to be equally responsive to the same targeted therapies, that all of the abnormalities are the same and react the same, and they really don’t. We’re really diving down and carving that pie thinner and thinner in terms of each individual MET abnormality, in terms of what drugs responds it to and what that means for patient outcomes and prognosis.” TS 25:21 /episode/index/show/onsvoice/id/36471020

Episode 361: ONS 50th Anniversary: The Value of ONS Membership in Advancing the Oncology Nursing Profession 05/02/2025

Episode 361: ONS 50th Anniversary: The Value of ONS Membership in Advancing the Oncology Nursing Profession “We spent time today discussing all the ways that owners can have a positive impact on career growth, whether you’re a bedside nurse or just in teaching, research, hospital leadership. More than career growth, I see ONS as kind of a barrier to burnout and a catalyst for professional self-care. I think that no matter what aspect of oncology care you’re involved in, it is a difficult and complex specialty. And I think with that can come a lot of challenges and tough days, and ONS brings a sense of community to that and, specifically, a community that is pushing cancer care forward,” ONS member Amy Kaiser, MSN, CPNP-PC, told Nick Escobedo, DNP, RN, OCN®, NE-BC, member of the ONS 50th anniversary committee, during a conversation about the benefits of ONS membership. Escobedo spoke with Kaiser, who joined ONS as a student, and Susan Groenwald, PhD, RN, ANEF, FAAN, a charter ONS member, about how ONS membership and resources have helped them grow in their careers. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice articles: ONS book: (third edition) ONS course: Clinical Journal of Oncology Nursing article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode Groenwald: “ONS was groundbreaking in so many areas. The area that sticks out to me was, I was the board liaison to the standards committee. And so, the development of oncology nursing standards, it was a hallmark and critical to the field and to me and my practice, as well as education. It was very exciting time.” TS 4:18 Kaiser: “I think that my very first introduction to cancer care came from the Cancer Basics course. I think I feel fortunate that I probably was the recipient of a lot of the efforts of Susan, who has pioneered so many of these different oncology resources. I had the benefit of being at school during a time where there were a ton of resources available through ONS.” TS 5:38 Groenwald: “Having attended the meetings and getting involved in some of the committees is where I met people and worked with people. And that became, for me, very vital for doing a book, where it was a contributed book, an edited book [Cancer Nursing: Principles and Practice], so we had lots of different chapters and contributors, but I met them all through ONS. And how we communicated was via the old-fashioned mail and telephone. I didn’t even have a computer. We typed the whole manuscript, thousands and thousands of pages, the first couple editions.” TS 12:25 Kaiser: “What’s so wonderful about going to [Congress] is everybody there is looking to move oncology nursing forward and meet people and connect and network. And it's this, you know, magical space of people who are meeting and sharing shared experiences, and I got to feel all of that prior to even being an oncology nurse. And I went home from that first conference, immediately discussed with my manager that I wanted to move to the oncology floor, and I did. But it was meeting all of those people and hearing about those career paths that did that for me.” TS 16:42 Kaiser: “I think people who are involved with ONS, I found, are also very, very willing to mentor. I was very fortunate as I was speaking to these people, not even being an oncology nurse, that they were so welcoming and wanted to welcome me into the specialty and wanted to show me how to get involved. So I think it's just taking that very first step of talking to somebody or going to that local chapter meeting, and then the rest of it becomes a lot easier.” TS 19:29 Groenwald: “One thing Amy mentioned that I think is important is that new nurses have so many opportunities. I think it’s scary to put forth an abstract to speak at the conference. It’s scary, but it's such a great opportunity for anybody at any level in their career. If they have something of interest to share, it’s such a great place. I feel like it launched my career in terms of being able to speak in front of people and think critically about things and put together some projects. This all came from my work with ONS.” TS 20:51 /episode/index/show/onsvoice/id/36377910

Episode 360: An Overview of Brain Malignancies for Oncology Nurses 04/25/2025

Episode 360: An Overview of Brain Malignancies for Oncology Nurses “Everyone’s brain is extremely heterogenic, so it’s different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They’re highly aggressive biologically. It’s a small area in a hard shell. So trying to get through the blood–brain barrier is different. There’s a lot of areas of hypoxia in the brain. There’s a lot of pressure there. The microbiology is very different—it’s a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C, CCRP, research advanced practice nurse at the John Theurer Cancer Center of Hackensack Meridian Health in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about brain malignancies and caring for patients with them. Music Credit: “” 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 April 25, 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 brain malignancies and their diagnosis and treatment. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS book: (fifth edition) Clinical Journal of Oncology Nursing articles: Nurse.org article: Lori Cappello’s contact information: [email protected] To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “A glioblastoma actually is the most predominant brain tumor that we do see. It is the most diagnosed of the brain tumors. And then I would say that an anaplastic astrocytoma is probably the second diagnosed. Historically a GBM, they used to say was probably an elderly patient for these. But we are definitely seeing it diagnosed at a much younger age now, definitely much more prevalent for people under 60.” TS 3:17 “Nine times out of ten, either a patient out of nowhere has a seizure, or they present with what they think are stroke-like symptoms. They noticed that they were slurring, or they were becoming more forgetful, or a family member noticed it and said, ‘Hey, what is going on with you?’ But usually they present to the [emergency department], and a [computed tomography] scan is always done first. And lo and behold, something is seen.” TS 4:50 “The only other U.S. Food and Drug Administration-approved treatment that has come along in the last 20 years is a device called Optune Gio, which is an alternating electric field that stops cell division at the mitosis stage.” TS 7:45 “They lose so much of their independence, especially if they don’t have a caregiver or help. That is huge. Medication management at home, to making sure that they’re taking the medication properly, that they are actually taking their medication. Transportation is another huge problem. Getting to and from appointments is a challenge. Those are big issues—real, day-to-day, simple issues that people don’t think about.” TS 17:11 “I think that having a brain tumor is very unique in the fact that you really need a dedicated neuro-oncologist. And depending on where you live, there are not a lot in the area. I actually had a patient that was moving out west, and the closest dedicated neuro-oncologist was four hours from them. … if you're not seeing dedicated neuro oncologists, you might not be getting the best treatment for yourself. So I think that having the resources and helping patients find the best care or the best brain tumor society—and there’s a bunch of really good brain tumor groups to help patients find the best resources out there. I think that's really, really important for patients to know or for families to know.” TS 19:17 “So trying to help patients, there are always going to be challenges, and there are always going to be ups and downs. But finding that one person that they can go to, that they trust, that they have a great relationship with, whether at the doctor's office or whatever, and being available to them makes such a difference in their journey. I think that that is the most important for anybody in the journey.” TS 22:08 “With brain, there are going to be expectations. They are going to lose functionality at some point—and preparing them for that thing or preparing them for things that can help themselves. Like sometimes I say, ‘Go to the dollar store, get coloring books,’ if they have weakness in one hand. Little tricks of the trade that can help them. About treatment options, going through the side effects, preparing them for whatever they can be prepared for.” TS 22:39 “It is not one of the better cancers to have, but it doesn’t immediately mean it’s a death sentence, and we shouldn’t treat them like they’re dying. We shouldn’t take away their ability to live just because they were diagnosed with it. We shouldn’t take away hope.” TS 25:35 “I think there's not enough discussed about [brain malignancies] and the lack of resources for this. These patients need a lot more resources and are available. There’s just not enough available for it.” TS 26:59 /episode/index/show/onsvoice/id/36296745

Episode 359: Lung Cancer Screening, Early Detection, and Disparities 04/18/2025

Episode 359: Lung Cancer Screening, Early Detection, and Disparities Episode 359: Lung Cancer Screening, Early Detection, and Disparities “I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don’t want to do it.’ And I said, ‘Do you remind them that lung cancer is curable?’ Because everybody thinks it is a death sentence. But when you’re talking about screening a patient, I think it’s really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60% to 70%,’” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer screening. Music Credit: “” 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 April 18, 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 lung cancer screening. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Unfortunately, the current state of lung cancer screening is pretty low. Our rate of uptake in eligible patients is somewhere between 6% and 20%. And that falls much further below what we see for screening, such as breast cancer screening, prostate cancer screening, and colorectal cancer screening. So certainly, we can do better.” TS 1:32 “If you quit more than 15 or 20 years, your risk of developing lung cancer at that point is significantly lower. And so that’s why once patients have quit more than 15 years, they’re actually not eligible for screening anymore—because their risk of developing lung cancer is dramatically reduced. And that takes into account when you are a primary care provider, pulmonary, whatever field you work in, and you are running a screening clinic each year that you screen the patient, you have to remind yourself when they quit smoking, because once they reach that 15 years, then they’re no longer eligible for screening.” TS 5:17 “One of the strategies that they’ve used to get the word out is, I watch a lot of baseball. I love the Philadelphia Phillies, watch Phillies games. And so at least once a year, maybe even twice a year, they will take an inning of the baseball broadcast on TV and on the radio separately, and they will bring on either an oncologist or pulmonologist from one of the local cancer centers in our area, and the whole inning—between batters of course—they will talk about lung cancer screening and why it’s beneficial.” TS 13:16 “Medicare always has its idiosyncrasies. So Medicare—I went over the rules with you, so the age, the smoking. They follow all of it, except they have a slight difference in age. They cover it for age 50 to 77, as opposed to 80.” TS 16:52 “I think just the other thing that people don't think about is that to go get a medical test done, no matter what test it is, typically people have to take time off of work. And it can be really hard to do that when you are relying on your job, maybe you don't have vacation time, maybe you have children at home that you need to get home to. When people are weighing the risk/benefit and thinking, ‘Well, I’d love to get screened for lung cancer, but I just can’t find time to fit it into my schedule, and my job won’t let me take off.’ These are all things that we don’t always think about if you have the luxury of just taking the day off.” TS 20:01 /episode/index/show/onsvoice/id/36209005

Episode 358: Pharmacology 101: KRAS Inhibitors 04/11/2025

Episode 358: Pharmacology 101: KRAS Inhibitors “It’s been known for quite a while that [KRAS] is a mutation that leads to cancer development, but for really over four decades, researchers couldn’t figure out a way to target it. And so, it was often considered something that was undruggable. But all of this changed recently. So about four years ago, in 2021, we had the approval of the first KRAS inhibitor. So it’s specifically a KRAS G12C inhibitor known as sotorasib,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the KRAS inhibitor drug class. Music Credit: “” 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 April 11, 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 KRAS inhibitors used for cancer treatment. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) ONS course: ONS video: (formerly Lexicomp) To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “If we look at specifically non-small cell lung cancer, this KRAS mutation is one of the most frequently detected cancer drivers or driver mutations. It’s thought that about a quarter of cases of non-small cell lung cancer have this KRAS mutation, and it’s usually a specific amino acid substitution that we see in non-small cell lung cancer, so what’s known as KRAS G12C mutation.” TS 2:31 “Both of these agents, sotorasib and adagrasib, have the same mechanism of action. They bind to a pocket, very specifically on the KRAS G12C protein, and they lock it in an inactive state so that it can’t cause that downstream uncontrolled signaling to happen. So they’re kind of shutting down the signaling, and therefore you don’t get that uncontrolled cell growth and proliferation.” TS 4:27 “Another big difference to point out, and one that is often used in clinical practice to differentiate when to use these agents, is specifically adagrasib is known to have activity in patients with metastatic non-small cell lung cancer that have active brain metastases. In the clinical trial, they included patients with active brain metastases, and they found that this drug has great [central nervous system] penetration. And so it may be considered the agent of choice in patients with brain metastases.” TS 7:19 “Other considerations—I think one of the big ones—is that there are a lot of drug interactions. Just specifically calling one out that I think is pretty impactful, is sotorasib has an interaction with acid-suppressing medications. So there is the recommendation to avoid [proton pump inhibitors] and H2 antagonists in patients receiving sotorasib. They can take antacids, but you would need to space those out from their dose of sotorasib.” TS 14:14 “This needs to be a collaborative endeavor to make sure these patients are monitored appropriately. We are putting a lot of responsibility on the patients with all of this. So, again, completely administered generally in the home setting, a lot of monitoring, a lot of adverse effects, need for reporting and management—so there’s a lot happening here. And it takes a team to accomplish this and to do it right. And I firmly believe that this is often a collaborative effort between our pharmacy and oncology nursing teams to make this happen. Working together to ensure outreach to patients—I think that patients are often more successful with these medications with early identification of toxicities when we’re doing scheduled outreach.” TS 19:44 /episode/index/show/onsvoice/id/36055915

Episode 357: ONS 50th Anniversary: The Evolution of Cancer Treatment: Stories From the Front Lines 04/04/2025

Episode 357: ONS 50th Anniversary: The Evolution of Cancer Treatment: Stories From the Front Lines “There have been many changes since the ’70s that have shaped the nurse’s role in administering chemo, and in supporting patients. The major change early on was the transition from that of nurses mixing chemo to that of pharmacists. Regulatory agencies like NIOSH and OSHA defined chemotherapy as hazardous drugs, and professional organizations became involved, leading to the publication of the joint ASCO and ONS Standards of Safe Handling,” ONS member Scarlott Mueller, MPH, RN, FAAN, secretary of the American Cancer Society Cancer Action Network Board and member of the Oncology Nursing Foundation Capital Campaign Cabinet, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, ONS member and chair of the ONS 50th Anniversary Committee during a conversation about the evolution of chemotherapy treatment. Along with Mueller, Burbage spoke with John Hillson, DNP, NP, Mary Anderson, BSN, RN, OCN®, and Kathleen Shannon-Dorcy, PhD, RN, FAAN, about the changes in radiation, oral chemotherapy, and cellular therapy treatments they have witnessed during their careers. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice article: ONS books: (second edition) (third edition) (second edition) (fourth edition) ONS courses: Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode Hillson: “I remember as a new grad, from back in ’98, walking up to the oncology floor. We had patients with pink labels on the chart and that was the radiation oncology service. I hadn’t heard of such a thing before. … I’d gone through nursing school and hospital orientation and unit orientation without ever hearing of these therapies. At the time, both the management and the union had no interest in specialist nurses, and the really weren’t any books that were targeting the role. And it was very isolating and frightening. I was very glad to find ONS when I moved to the U.S. Right now, the Oncology Nursing Society Manual for Radiation Oncology, Nursing Practice, and Education, it’s in its fifth edition and a sixth is underway. There’s nothing else like it. Most books are very much geared towards other professions.” TS 5:34 Mueller: “We mixed our chemo in a very small medication room on the unit, under a horizontal laminar flow hood, which we later discovered should have been a vertical laminar flow hood. Initially, we did not use any personal protective equipment. I remember mixing drugs like bleomycin and getting a little spray that from the vial onto my face. And to this day, I still have a few facial blemishes from that.” TS 14:28 Anderson: “As the increasing number of these actionable mutations continue to grow, so will the number of oral anticancer medications that patients are going to be taking. And we are already seeing that there's multiple combination regimens and complex schedules that the patients have to take. So this role the oral oncolytic nurse and the nursing role, like you said, it cannot be owned by one individual or discipline. So it’s not a pharmacist; the pharmacies aren’t owning this. The nurses are not owning this. It takes a village.” TS 32:12 Shannon-Dorcy: Then as immunotherapy comes into the picture, we start to learn about [cytokine release syndrome]. All of a sudden, we had no concept that this was a deadly consequence. ONS was on the front lines, convening people across the country together so we could speak to the investigative work with science and find ways that we could intervene, how we can look for signs of it early on with handwriting testing.” TS 39:58 /episode/index/show/onsvoice/id/35964105

Episode 356: A Nurse’s Guide to the 2024 NIOSH List of Hazardous Drugs 03/28/2025

Episode 356: A Nurse’s Guide to the 2024 NIOSH List of Hazardous Drugs “And so you have different kinds of hazards with the drugs that you’re using. That means that in the past, when a lot of oncology drugs, antineoplastic drugs used to treat cancer would have been added, you may see that a lot of oncology drugs either weren’t added or they’re added in a different place on the list than they were in the past. That’s due to some of the restructuring of the list we’ll probably talk about later,” Jerald L. Ovesen, PhD, pharmacologist at the National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the latest update to the NIOSH list of hazardous drugs. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  NCPD contact hours are not available for this episode. ONS Podcast™ episodes: ONS Voice articles: ONS book: ONS course: Clinical Journal of Oncology Nursing article: ONS Learning Library: ONS Position Statement: National Institute for Occupational Safety and Health article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “So we look for a carcinogenic hazard. So does this molecule, does this chemical, this drug, have the ability to increase the risk of cancer? A lot of the time that will also tie with genotoxic hazards, but not always. There are some drugs on the list that are carcinogenic through other mechanisms. Sometimes carcinogenicity can be related to hormone signals, can lead to increased risk of cancer. There’s some nuance there, but is it a carcinogenic hazard? That can get it onto the list. Is it a developmental and reproductive hazard?” TS 10:48 “NIOSH can’t say what’s right for every situation, but some organizations have suggested further precautions such as temporary alternative duty for workers who are pregnant or are looking to become pregnant. NIOSH can’t say what’s best for any given facility, but other organizations have given some good suggestions you may want to look into.” TS 13:18 “The list doesn’t really rank hazard. I know a lot of people have kind of treated it that way a lot of times. We don’t say that something is less hazardous if it’s only a developmental or reproductive hazard, because if you’re trying to have a child, then that’s an important hazard to you. And we don’t necessarily say something that’s carcinogenic is more hazardous.” TS 14:34 “Some standard setting organizations have set standards for handling. Really in the oncology setting, particularly oncology pharmacy setting, it’s really changed how some of the handling happens there because some of the standards come out of the pharmacy world. And what’s happened there is some drugs that are oncology drugs, they might have been on table one before just because they were used in the treatment of cancer. They were antineoplastics, so they were on table one. Now, because they’re not identified as a potential carcinogen and they don’t have manufactured special handling information, they are now on table two.” TS 23:39 “Occasionally, if a drug comes out and has manufacturer special handling information, we’ll go ahead and add it to the list. And since we won’t add it into the publication, we typically have a table on that page that puts that there. If a drug is reevaluated and we find that the hazard is not as bad as expected or it’s not a hazard, actually, and we can remove it from the list; sometimes we get new information and that happens.” TS 30:30 /episode/index/show/onsvoice/id/35890440

Episode 355: Pharmacology 101: Hedgehog Pathway Inhibitors 03/21/2025

Episode 355: Pharmacology 101: Hedgehog Pathway Inhibitors “I genuinely think nurses and pharmacists need to know why these medicines are called hedgehog inhibitors so that we can, in fact, effectively educate our patients. Just because to date, this class has the weirdest name I’ve encountered, and I almost expect at this point that my patients are going to ask me about it. I think that we need to be informed that, just on, where do these names come from, why is it called this, and does it matter to my patient?” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about hedgehog pathway inhibitors. Music Credit: “” 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 March 14, 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 hedgehog pathway inhibitors used for cancer treatment. Episode Notes  .  ONS Podcast™ ONS Voice articles: ONS courses: ONS Guidelines™ and Symptom Interventions:  ONS Huddle Card: ONS Learning Libraries:   American Association for Cancer Research article: American Journal of Clinical Dermatology article: Cureas article: International Journal of Molecular Sciences article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Many patients unfortunately will have side effects with this class. I mean—and I know that’s not controversial—but you actually find callouts in some of the kind of the national consensus guidelines. These treatments might not be tolerable for a decent number of patients. Some of these side effects can certainly reduce quality of life. Again, nothing that controversial here when we say it out loud, but just the frequency with which it occurs can make it quite difficult for some patients.” TS 9:13 “Certainly, based on what we said before, I think one of the easiest things to do for patients starting this class is to just make sure that they have really classical supportive medicines like antidiarrheals and antiemetics before they start treatment. Diarrhea, nausea occurred in about 20%–40% of patients across trials. So certainly patients should be aware of that risk. Again, not a controversial side effect, but it’s just simple things we can do to make sure that our patients are quick to start treatment is to make sure that they have these medicines and they’re educated on how to use them.” TS 11:21 “I think patients need to be aware that side effects, as I had mentioned before, can be especially frequent with this class. So for a patient, they need to be aware that communicating your needs to your oncology team is really crucial to their own ability to use these treatments with minimal interruptions.” TS 14:45 “I think that regardless of whoever is following up with our patients, though, as our arsenal of oral anticancer therapies does continue to expand, both nurses and pharmacists need to have specialized knowledge of these agents to be successful in their patient care roles.” TS 18:28 “When there are clear recommendations for reproductive health, as I summarized before with these agents, I obviously think we need to be aware of them and not just defer to these generic recommendations. Because if you just defer to, ‘Well, use barrier contraception and then for a week after your last dose,’ you know, ‘Okay, it’s not true with these agents.’” TS 24:37 /episode/index/show/onsvoice/id/35796540

Episode 354: Breast Cancer Survivorship Considerations for Nurses 03/14/2025

Episode 354: Breast Cancer Survivorship Considerations for Nurses “You can give someone a survivorship care plan, but just giving them doesn’t mean that it’s going to happen. Maybe there’s no information about family history. Or maybe there’s information and there’s quite a bit of family history, but there’s nothing that says, ‘Oh, they were ever had genetic testing,’ or ‘Oh, they were ever referred.’ So the intent is so good because it’s to really take that time out when they’re through with active treatment and, you know, try to help give the patient some guidance as to what to expect down the line,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer survivorship. Music Credit: “” 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 March 14, 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 breast cancer survivorship. Episode Notes  .  Previous ONS Podcast™ site-specific episodes: ONS Voice articles: ONS books: ONS course: ONS Learning Libraries:    ONS Guidelines™ and Symptom Interventions:  Clinical Journal of Oncology Nursing article: Clinical Journal of Oncology Nursing supplement: American Cancer Society:    To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “I think the biggest thing is to really communicate is that people are living with breast cancer for a long, long periods of time, and a lot of that with really good quality overall.” TS 4:07 “As a general rule, they’re going to be seen by the breast surgeon probably every four to six months for a while. After about five years, a lot of times people are ready to say, ‘Okay, annually is okay.’ And eventually they may let that drop off. But it also depends on did they have a mastectomy? Did they have breast conserving surgery? And then if they had reconstruction with an implant, how often do they see the plastic surgeon? Because they need to check integrity of the implant. So those schedules are really individualized.” TS 13:24 “When you think about long-term effects, I think you need to kind of think about that survivors can have both acute and long-term chronic effects. And a lot of that depends on the specifics of the treatment they had. I think as oncology nurses, we’re used to, ‘We give you this chemotherapy or this agent, and these are the side effects.’” TS 15:36 “The diet issues are huge. And I think we are slow to refer to the dietician, you know, you can get them a couple of consults and because you’re saying to them, ‘This is really important. We need you to lose weight or we need you to eat more of this.’ Ideally, fruits and vegetables are going to be about half of your plate. And what’s the difference between a whole grain and not, less processed foods, making sure that they’re getting enough protein. And then once again, really kind of making sure that they’re not taking a lot of supplements and extra stuff because we don’t really understand all that fully and it could be harmful.” TS 34:53 “Breast cancer is a long, long journey, and I think you should never underestimate the real difference that nurses can make. I think they can ask those tough questions. And I think ask the questions that are important to patients that patients may be reluctant to ask. I think giving patients permission to talk about those less-talked-about symptoms and acknowledge that those symptoms are real and that there are some strategies to mitigate those symptoms.” TS 42:28 /episode/index/show/onsvoice/id/35686425

Episode 353: ONS 50th Anniversary: Evolution of Oncology Nursing Certification 03/07/2025

Episode 353: ONS 50th Anniversary: Evolution of Oncology Nursing Certification “The response was, in my opinion, sort of overwhelmingly positive. I think all of us old-timers who were at ONS Congress® in 1986 remember those 1,600 nurses waiting in line to enter the ballroom to take that inaugural exam. It takes a while to check in 1,600 people. They kind of all filled up the lobby outside of the ballroom, and then they spilled over down into the escalator, and the escalators had to be turned off,” Cyndi Miller-Murphy, MSN, FAAN, CAE, first executive director of the Oncology Nursing Certification Corporation (ONCC), told Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, ONS member and member of the ONS 50th anniversary committee, during a conversation about the evolution of oncology nursing certification. Beaver spoke with Tony Ellis, MSEd, CAE, ICE-CCP, executive director of ONCC, and Miller-Murphy about the history, current landscape, and future of certification in oncology nursing. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. ONS Podcast™ episodes: ONS Voice articles: ONS books: (third edition) (second edition) (second edition) (seventh edition) (seventh edition) ONS courses: Clinical Journal of Oncology Nursing article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode Miller-Murphy: “Oncology nursing is a highly specialized area with a broad, well-defined body of knowledge, and it’s essential for employees and healthcare consumers to be able to identify nurses who have demonstrated that they possess the knowledge that’s necessary to practice competently in the specialty. Nurses who become certified take that essential step to publicly demonstrate their knowledge. And I believe this makes them a known commodity, so to speak.” TS 1:49 Ellis: “Oncology nursing is an area of high-stakes patient care, and a core purpose of certification is to safeguard the public. This is certainly an area of health care that benefits from having that role of professional certification being played, from the knowledge requirements to the practice hours that a nurse must have, to the performance on the exam and continued competence required to maintain the certification. Our certifications hold nurses to a higher standard, which helps protect the public in the care that they provide.” TS 2:45 Miller-Murphy: “A group of, I think, 200 nurses got together at an American Cancer Society conference back in 1980 to discuss the desire for certification in ontology. Nurses wanted a way to verify their specialized knowledge and skills. They wanted to raise the level of professionalism, and ONS was the most appropriate organization to develop the certifications. And by 1983, a survey of members revealed strong interest in specialty certification in oncology.” TS 5:29 Ellis: “The pace of change in oncology care is really the challenge for certification programs proper right now. There’s so many wonderful advances—oncology treatments and drugs that are coming to the market that are being used in non-oncology settings and other advancements in the practice, that keeping up with that change puts pressure on certification programs because they must validate knowledge and practice that has become standard. It has to have been in the practice long enough that whatever the content, whatever the practice is that you’re testing on, that there is one single correct answer. So you can’t necessarily test on the very latest of what has come to the market or to the practice. The other flipside of that is that pace of change, the new emerging things in the practice create opportunities for other kinds of credentials.” TS 24:31 Ellis: “What we have found is that there are thousands and thousands of oncology nurses that are practicing at a level and doing specialized work beyond the scope of the OCN® body of knowledge—so at the master’s level, PhD, especially with the advent of the DNP, and there is work there. And this really came out of our work to update the advanced oncology nurse competencies. … So the new certification is the Advanced Certified Oncology Nurse, or the ACON. In certification, and it is suited for those nurses that are practicing at that higher level.” TS 32:52 /episode/index/show/onsvoice/id/35543305

Episode 352: Pharmacology 101: Epigenetics 02/28/2025

Episode 352: Pharmacology 101: Epigenetics “Now, what we found is that epigenetics is actually heritable and it’s actually reversible. And we can now manipulate these principles with pharmacotherapy drugs,” Eric Zack, RN, OCN®, BMTCN®, clinical assistant professor at Loyola College Chicago Marcella Niehoff School of Nursing in Chicago, IL, and RN3 at Rush University Medical Center in Chicago, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the epigenetics drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours (including 40 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 28, 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 epigenetics drug class. Episode Notes  .  ONS Podcast™ ONS Voice articles: ONS book: ONS course: ONS Huddle Card: ONS Learning Libraries: American Cancer Society: Centers for Disease Control and Prevention: Leukemia & Lymphoma Society: National Institutes of Health: University of Pennsylvania: University of Utah: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Epigenetics is influenced by several factors. Right now, there’s about seven of them that we’ve identified, and we can only manipulate right now about two of those seven. So the first one is DNA methylation. When you methylate DNA, that’s adding or subtracting a methyl group, which is CH3, chemically. The addition of methyl to DNA tightens the DNA around the chromatin, which then can block some genes from being expressed.” TS 7:21 “Histones basically package DNA into the chromatin, which is a mixture of DNA and proteins, and they spool around this structure like the DNA is coiled around that. And again, it has to do with how tight or loose that is coiled. That determines if the genes are expressed or not. And again, we found that histones also play a role in DNA repair as well as regulating the cell cycle.” TS 8:21 “When we’re dealing with the azacitidine and decitabine, these drugs cause pancytopenia. Pancytopenia is neutropenia, thrombocytopenia, and anemia. So it affects the complete blood count. We see GI toxicity, nausea, vomiting, diarrhea, constipation, sometimes mouth sores, and urticaria—hives.” TS 15:34 “It’s really, really important to take these drugs exactly as they are prescribed. They have to follow the doctor’s orders carefully, which requires taking them properly, doing the proper follow up. There’s a lot of blood tests and appointments that we have to do to make sure that everything is okay. And again, because we know when there is nonadherence, the disease progresses and becomes resistant, so that’s a really, really important teaching point. We have to monitor the patient for expected side effects and unexpected side effects.” TS 23:58 “Now, we expect the landscape to change dramatically over the next few years. And again, it’s just an explosion of science information. As we learn more about the science, it’s going to translate into practice. We’re always identifying new biomarkers. These biomarkers are essentially DNA mutations or variations. There’s so many variants of unknown significance.” TS 30:02 “Every patient deserves biomarker testing. Very important, whether it’s through IHC, polymerase chain reactions, or the most common next-gen sequencing. Again, there’s several companies out there that have standard kits available.” TS 31:33 “This is a precision medicine. This is what we’ve always dreamed about—tailoring the treatment to the specific patient. We’ve gone away from treating standard diseases, like lung cancer and breast cancer, the way they’re supposed to be treated to now looking at these biomarkers and using epigenetic drugs and other medications tailored to those variants that that patient is having, not necessarily based on their disease type.” TS 33:59 /episode/index/show/onsvoice/id/35465820

Episode 351: What It’s Like to Develop Symptom Intervention Resources 02/21/2025

Episode 351: What It’s Like to Develop Symptom Intervention Resources “It is very much a collaborative group process. There are group meetings where we come to consensus on our different ratings. There’s so much support from ONS staff, even amongst our different groups, even when you’re assigned to one peer reviewer. Let’s say you go on vacation, sometimes we’re paired with other people, too. So there is some flexibility in the opportunity as well,” Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®, lecturer at Old Dominion University in Norfolk, VA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about volunteering as a reviewer for ONS’s symptom intervention resources. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  NCPD contact hours are not available for this episode. ONS Podcast™ episodes: ONS Voice articles: ONS blog: ONS course: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “As far as how it would help oncology nurses, we try to make it honestly simpler by doing the legwork of reviewing the evidence, synthesizing what the rating of the evidence and what it means. And then as you’ll see on the symptom intervention resource, you’ll see kind of a snapshot of what our recommendations are for applying it to practice.” TS 7:46 “I am a clinical nurse specialist and now that I work in academia, this is a very important skill for me to build and have in my profession. Also, those group meetings that we have, I really appreciated being able to learn from others and then being able to teach that to others. So in this second round, for example, the thing that I’ve really enjoyed personally is actually being able to mentor somebody that maybe hasn’t done it as often and just being able to watch them grow and improve in their skills while you provide feedback.” TS 9:05 “We get a new article about every two weeks, and this involves about a week for myself and then about a week or less than that for my partner to go through this process as well. So being able to manage your time to afford your partner the time to solidly look through the article as well. And then being able to collaborate and receive feedback from your peers.” TS 13:06 “There have been times where the evidence has not given us the results that I think we were assuming we would see. And so while the standardized tools mitigate some of the bias, we do recognize that it won’t remove the bias entirely, but it does help make your view more objective. What are some common misconceptions about developing symptom intervention resources? I’d say personally, I don’t know if I had misconceptions before I was part of the team as much as I just didn’t know what the process entailed.” TS 18:18 “ONS is really committed to the growth of its members. I’ve really enjoyed being part of this volunteer opportunities and the other ones that I’ve been a part of. So truly, if you have a passion for something and you have the skills, ONS would love to have you and you will meet some of the greatest people in doing these opportunities. I’ve made some of the best connections and friendships through the volunteer opportunities I’ve done.” TS 21:35 /episode/index/show/onsvoice/id/35378285

Episode 350: Breast Cancer Treatment Considerations for Nurses 02/14/2025

Episode 350: Breast Cancer Treatment Considerations for Nurses “This is what totally drives the treatment decisions, and that’s why having that pathology report when the nurse is educating the patient is so important, because you can say, well, you have this kind of breast cancer, and this kind of breast cancer is generally treated this way,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 1.0 contact hours (including 15 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 14, 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 breast cancer treatment considerations. Episode Notes  . Previous ONS Podcast™ site-specific episodes: ONS Voice articles: ONS Voice articles: ONS books: ONS courses: ONS Learning Libraries:    American Cancer Society:      To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Local treatment is typically going to consider some kind of surgery with or without radiation, depending on the surgery and the extent of the breast cancer. All women are going to have, and today when you use the word women, individuals assigned female at birth, they are the vast majority of individuals being treated for breast cancer, but for individuals assigned male at birth, there’s not near as much research, but generally their treatment is very similar. So that’s something to kind of keep in the back of your mind.” TS 2:39 “This is very confusing for patients because they’re like, ‘Well, my friend at church had this and why am I getting this and why are they getting something different?’ And that is because of the pathology report. So taking that time to explain that with a pathology, I think is really important.” TS 8:31 “When they see the breast surgeon, all individuals are going to have some kind of axillary evaluation. Now, hopefully it’s going to be a sentinel lymph node. So they’re going to, at the time of surgery, put a tracer and, you know, they’re going to take out maybe one, two, three lymph nodes and hopefully, you know, there is not a lot of disease there. And if that’s the case, they’re kind of done with that. So the sentinel lymph node evaluation, it’s really more to stage and provide that information, but it kind of sets the stage a lot of times for the other treatments selections. And I think people need to realize that this is important. This is a very important procedure.” TS 15:31 “Years ago, when women had a breast mass, they went to the OR and it was biopsied in a frozen section and if it was positive, they had a mastectomy. So women would wake up and they’d be feeling their chest because they’re like, ‘What happened here?’ And that is not great care. It doesn’t give that woman any autonomy, but it was the best that could be done at that point. Now, with the diagnostic where we can do a needle biopsy, they can kind of stop and take a timeout and we can kind of clinically stage that.” TS 17:04 “For women that really desire breast-conserving therapy, they can anticipate that postoperatively at some point, they’re going to have treatment to the entire breast, we typically call whole breast radiation, and then they may have a boost. Now, in many, many probably cases, that’s going to be over five to six weeks, Monday through Friday. So the treatment itself doesn’t take but a couple of minutes, but you have to get to the facility. And even though we streamline check-in processes and whatnot, you have to get undressed, you have to get positioned on the table. So it is a commitment, and it can be disruptive.” TS 24:49 “The hormone-blocking agents are going to be the cornerstone of all those treatments for anyone who has hormone receptor–positive breast cancer. So they are going to take these agents and as you said, they’re probably going to take them for 5–10 years. It’s quite the journey.” TS 32:33 “I think you need to be mindful that if someone has had germline testing and they’ve tested positive, they are not only worried about themselves, and they are worried about the rest of their family. That is a big deal. And even though I’ll hear mothers say, ‘I feel so guilty, now my daughter has this,’ now, I’ve never heard a daughter come and say, ‘Gosh, I wish my mom hadn’t had me because of this.’ There’s a lot of feeling and emotion that goes on with that, and realize that those individuals are probably going to have fairly complicated management that goes over and above their breast cancer.” TS 41:50 /episode/index/show/onsvoice/id/35277265

Episode 349: ONS 50th Anniversary: Evolution of Safe Handling and ONS’s Legacy in Developing Safe Handling Guidelines 02/07/2025

Episode 349: ONS 50th Anniversary: Evolution of Safe Handling and ONS’s Legacy in Developing Safe Handling Guidelines “What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, there were a lot of nurses who were skeptical about the need for self-protection. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors,” ONS member Martha Polovich, PhD, RN, AOCN®-Emeritus, adjunct professor in the School of Medicine at the University of Maryland, told Liz Rodriguez, DNP, RN, OCN®, CENP, ONS member and 50th anniversary committee member, during a conversation about the evolution of safe handling of hazardous drugs and ONS’s role in shaping safe handling policies. Music Credit: “” 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 February 7, 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 evolution of safe handling guidelines. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) ONS courses: Clinical Journal of Oncology Nursing articles: Huddle Card: Joint ONS and Hematology/Oncology Pharmacy Association (HOPA) position statement: National Institute for Occupational Safety and Health: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “PPE has always been recommended to reduce exposure because gloves and gowns provide physical barrier to protect against dermal absorption. But what we didn’t know back then was what gloves and gowns were made of mattered. So PVC gloves were often used just because they were readily available in all our clinical settings. Gowns were rarely worn for drug administration, even though they had been recommended since early on, and many considered gowns back then as optional because the wording in the [Occupational Safety and Health Administration] guidelines said ‘recommended’ and not ‘required.’” TS 3:19 “Those early chemo gloves were a bit like wearing gloves you might use to clean your oven. They were so thick and got in the way of taking care of patients or mixing drugs or administering drugs. So the biggest change, I think, is that gloves that are currently available are very thin, and they provide the necessary protection for those who are handling hazardous drugs. We now have a gloves standard that requires permeation studies to demonstrate the protective ability of the gloves before they can be labeled for use with hazardous drugs.” TS 11:56 “ONS and HOPA developed a position statement on safe handling of hazardous drugs. … This came because our two organizations were unable to support some of the other proposed guidelines from another organization. So we got together, and through our cooperation, resulted in language about the importance of safe handling, about supporting safe handling for practitioners, pharmacists, and nurses. Also, I feel really good about this—our cooperation resulted in language about protecting the rights of staff who are trying to conceive or who are pregnant or who are breastfeeding to engage in alternative duty that doesn’t require them to handle hazardous drugs.” TS 17:12 “If there’s no worker safety, then who’s going to take care of the patients?” TS 21:52 “What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, and that’s going back a long way, there were a lot of nurses who were skeptical about the need for self-protection. They had been handling hazardous drugs for years and had no signs of ill effects, and so they assumed that we weren't overreacting with all of the recommendations. They saw the use of precautions and PPE as a speed bump in their busy day and also thought that was unnecessary. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors.” TS 23:50 /episode/index/show/onsvoice/id/35174725

Episode 348: Breast Cancer Diagnostic Considerations for Nurses 01/31/2025

Episode 348: Breast Cancer Diagnostic Considerations for Nurses “We know that some women are going to get called back. And it’s just because usually they can’t see something clearly enough. And so in most cases, those women are going to get cleared with one or two images, and they’re going to say, ‘Oh, we compressed that better, we checked it with an ultrasound, we’re fine.’ That woman can go ahead and go. But we don’t want to miss those early breast cancers,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer diagnosis. Music Credit: “” 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 January 31, 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 breast cancer diagnostic considerations. Episode Notes  . Previous ONS Podcast™ site-specific episodes: ONS Voice articles: ONS books: ONS courses: ONS Learning Libraries:    American Cancer Society:      To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “When a woman gets a callback, that is incredibly anxiety provoking, because they’re very scared and they don’t know what it means. And I think that’s a place where oncology nurses can remind—if it’s patients or friends who are asking—that just because you have a call back, doesn’t mean you have a malignancy.” TS 8:16 “We also know that when we call somebody back, that’s very scary and anxiety provoking. And we don’t want to subject women to unnecessary anxiety and stress through the procedure. And if it’s too stressful, they won’t come back again. That is actually a big harm that we don’t want to occur. That’s considered an acceptable amount. So we know that some women are going to get called back, and it’s just because usually they can’t see something clearly enough.” TS 11:26 “I think one of the most important things is to really help that woman understand the biopsy report. So now everybody, with most of the electronic medical records, that woman seeing that biopsy result—maybe before her provider is seeing it, depending on whether they get a chance to call that individual. But, you know, they could get a notification in their medical record, or a new report is available, and they can click on there and they could be looking at something that is very scary, not necessarily a good time, you know, like they’re getting ready to do something. And so that is a problem overall with sometimes getting bad news in oncology.” TS 15:09 “Sometimes it’s really good [for patients to bring] someone who can just be that set of ears or who can answer those questions, who’s emotionally involved but maybe not so emotionally involved, if that makes sense. And I think that that is something we can really encourage people to identify that person who’s going to really be able to support them.” TS 16:42 “When we approach a pathology report, the patient, you know, if they open that on their own, they’re just going to see breast carcinoma, or they aren’t going to look at all of the details of it. They can be quite overwhelming to look at. But I think that it’s important to kind of take the patient through it, step by step, and realize that it’s often a case of repeated measures—that you might do it and then you might do it again the next day or a day later.” TS 20:55 “Breast cancer care has changed so much over the past few decades. And I think people forget, you know, I’ve been in the business a long time, but years ago, everybody kind of got the same treatment if they got diagnosed. And we now understand so much about breast cancer treatment, but I think that has come on the shoulders of so, so, so many women who have enrolled in clinical trials to help us understand pathology better, to help us understand the impact of certain treatments. And so I think, first of all, we need to thank those women who have generously contributed to this base of knowledge. And it’s a place where those clinical trials have really made a difference.” TS 35:46 /episode/index/show/onsvoice/id/35086395

Episode 347: Care Considerations for Radiopharmaceuticals and Theranostics in Patients With Cancer 01/24/2025

Episode 347: Care Considerations for Radiopharmaceuticals and Theranostics in Patients With Cancer "If you take your normal radiation oncology experience, as we know in radiation oncology, radiations are done by the machines, you know, externally. Nurses deal with the side effects and everything like that, whereas radiopharmaceuticals are given kind of on the internal basis, they’re systemic,” ONS member John Hollman, BSN, RN, OCN®, radiation nurse educator for Texas Oncology, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about caring for patients receiving radiopharmaceuticals and theranostics. Music Credit: “” 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 January 24, 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 radiopharmaceuticals and theranostics in cancer care. Episode Notes  . ONS Podcast™ episodes: ONS Voice articles: ONS book: ONS courses: . To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode "I think most places are now doing the seven days, just to be extra cautious and you know, can't you be around any pregnant women or children, you can’t just be going to Target and stuff like that right after your injection because you are radioactive, and try not to share a bathroom with your family, that can be difficult and that leads into, as we’ve talked about in many talks that we’ve had, the social situation.” TS 8:08 really up to that nurse to recognize, like a good infusion nurse, to recognize the signs and symptoms of an infusion reaction and then to catch it at the earliest possible moment.” TS We’re not really dependent on lab values between treatments, whereas the infusion you have to look at your lab values. These are the game changer.” TS “You just hear the term radiation, and you just think of Chernobyl, or you think of like these worst-case, media-blown things and you think, how are you not being dosed with radiation every day? Because they don’t realize that you have this whole radiation safety team that’s required to be overseeing that you’re doing things safely and effectively, that these nurses that are administering these therapies or these therapists that are helping with the therapy are the safest as possible.” TS “If it wasn’t safe, we wouldn’t be doing it. You know what I mean? So, there is that implicit bias that I think I can foresee a lot of people trying hard to get over. And if you do have questions, anyone who’s listening, and you’re scared that your center is going to roll this out, please talk to your physicians, please talk to your radiation oncologists, please talk to your radiation safety officers. They can definitely assure and put your fears at rest, hopefully. I 100% trust the radiation safety officers.” TS 19:45 “That’s why the nurses really need to be educated by those radiation safety teams so they can pass those questions, or they can answer those questions, alleviate those fears on consultation—or actually during the week when we’re calling in for questions.” TS “I think getting both teams involved, if you’re going to really do this partnership, I find it really rare that it’s ever solely in rad onc. It’s always usually a combination of both. They’re always referred to us from that onc or somewhere. So, you really need that partnership.” TS 23:20 “This is so great to see what the future holds with these. And like I said, now they’re trying to do clinical studies for different diagnoses. So I think it’s just going to explode in the next few years about what we can use these for. It’s really an exciting time to be not only in oncology, but in radiation oncology.” TS 26:54 /episode/index/show/onsvoice/id/34993815

Episode 346: Pharmacology 101: BTK Inhibitors 01/17/2025

Episode 346: Pharmacology 101: BTK Inhibitors "In B cell malignancies, BTKi inhibits that BTK enzyme which is very upstream. It tells NF-κB to stop signaling into the nucleus and then inhibits proliferation and survival of B cells," Puja Patel, PharmD, BCOP, clinical oncology pharmacist at Northwestern Medicine Cancer Center at Delnor Hospital in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about BTK inhibitors. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.0 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 17, 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 BTK inhibitor drug class. Episode Notes ONS Podcast™ ONS Voice articles: ONS books: Clinical Journal of Oncology Nursing article: ONS courses: ONS Guidelines™ and Symptom Interventions: ONS Learning Library: ONS/NCODA/HOPA/ACCC’s Other resources: Ash Publications article: Blood Advances article: International Journal of Molecular Sciences article: National Cancer Institute article: National Comprehensive Cancer Network Guidelines for Patients: (University of Oxford network site-specific group— Hematology) Pharmacy Times ScienceDirect article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “1952 we have the discovery by Colonel Ogden Bruton of that severe immunodeficiency due to lack of B-cell maturation, and next linked to e-gamma globular anemia. In 1993, we had Professor Vetrie and colleagues discover that this was actually due to mutation in a kinase, and they called that BTK. And then in 1993 was a discovery of our first BTKi inhibitor in the lab setting, and that’s called LFM-A13. It wasn’t until 2013, so that’s 20 years after BTK kinase was discovered, where ibrutinib was our first-in-class BTK inhibitor, and the success of ibrutinib really promoted the exploration of second- and third-generation BTKis.” TS 6:24 “It’s thought that BTK and other members in the pathway are constitutively phosphorylated, which just means they’re spontaneously on. This leads to this uncontrolled activation of NF- κB signaling and thus uncontrolled proliferation and suppression of apoptosis. So, these B cells are rapidly dividing, but they’re not functioning like they’re supposed to be, meaning they won’t differentiate, or, you know, they won’t grow up to be either a plasma cell, like we talked about, or a memory B cell. They’ve been hacked.” TS 10:11 “This class is generally called—if you have to think of an umbrella term—it’s just called targeted small molecule therapies. Now a subclass is BTKi or Bruton tyrosine kinase inhibitors. So, we’re really shifting away from the use of cytotoxic chemotherapy, which is kind of designed to indiscriminately destroy rapidly dividing cells, to a more precise approach of targeting cells based on specific molecular changes in tumor DNA.” TS 13:47 “Cardiac toxicity can manifest as atrial fibrillation. And here I’ll specifically talk about ibrutinib values because we have the most data with it, and the numbers actually get better with second- and third-generation BTKis. So frequency: Grade 1–2 atrial fibrillation was reported in 12%–15% of patients on Ibrutinib. And grade 3 AFib is 3%–5%. The onset, median onset is 8–13 months.” TS 20:23 “For nurses, they should really advise their patients that the caliber of headaches are easily managed and they will decrease over time over a period of four weeks. This is an upfront conversation reassuring the patient that this is not a long-term side effect.” TS 33:47 “One aspect that was being discussed at length was kind of identifying biases and then methods to neutralize those biases. So, I think first you have to identify what your bias could be toward BTK, maybe it’s age or comorbidities or side-effect profile. And then, how can we mitigate our own biases is kind of the solution part to that.” TS 46:26 /episode/index/show/onsvoice/id/34895040

Episode 345: Breast Cancer Screening, Detection, and Disparities 01/10/2025

Episode 345: Breast Cancer Screening, Detection, and Disparities “The statistic you always kind of want to keep in the back of your brain is that over a lifetime, one in eight women will be diagnosed with breast cancer. So that means for an individual assigned female at birth, there’s a 13% chance that if that individual lives to age 85, that they will be diagnosed with breast cancer. So, it’s the most common cancer diagnosed in this group,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in St. Louis, MO, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer screening. Music Credit: “” 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 January 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 an increase in knowledge related to breast cancer screening, detection, and disparities. Episode Notes  ONS Podcast™ episodes: ONS Voice articles:   ONS books: Clinical Journal of Oncology Nursing article: ONS courses: ONS Learning Library:   To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Unfortunately, probably about 42,500 women die every year from breast cancer, and that number still seems really high because mammography screening has really enabled us to detect breast cancer in many, many cases when it would be most treatable. And so that’s a place where you would like to see some real progress.” TS 3:32 “Primary prevention for all individuals, which is always best to prevent, would include 150 minutes of intentional exercise, watching the diet, keeping that weight as low as possible—we want more muscle and less fat mass—and limiting alcohol intake. Then we go and we talk about screening.” TS 7:29 “The most recent statistic, and this kind of is post-COVID, is that 67% of women age 40 and over have had breast cancer screening in the last two years, which means that there’s a hunk of women, 33% of women who have not had breast cancer screening in the last two years and that who are 40 and over. And that to me is a really, really sad statistic because that’s a missed opportunity for screening.” TS 11:32 “Sometimes we forget that women and individuals who’ve had breast cancer, especially if they had it at a younger age, their risk of a second breast cancer over time is about 1% or 2% per year. So, if you have a first breast cancer at 40, and you live another 30 years, two times 30 is 60, that risk is substantial. A lot of times we don’t see as much anymore, which is good. Individuals who had a lot of radiation to the chest, we used to see a lot of young individuals having radiation therapy for Hodgkin’s disease that encompassed the chest, and a lot of them were diagnosed with breast cancer afterwards.” TS 15:31 “One of the things that always makes me really sad is that probably less than 40% of people who are eligible for this cascade testing, and mind you, many of the laboratories, if we test a parent and say they have a pathogenic variant, they will offer free testing to relatives for 90–120 days in that lab. They don’t even have to pay for the genetic test. They just have to get the counseling and send it. But less than 40% of individuals who would benefit from cascade testing ever get it done.” TS 35:02 “I have had this privilege of sitting for decades watching genetics. That’s the only area I’ve ever worked in that is always completely changing. And just when you think you got it, there is something new and it’s really driving our oncology care. And I would really encourage people, I know we’ve said it about 10 times now, to look at that Genomics and Precision Medicine Learning Library, there are resources in there if you want to spend 3 minutes, 5 minutes, 10 minutes—if you got a whole hour or two, there’s courses. There are so many things in there, and if you really want to become more savvy, you can, and that’s a great place to start.” TS 45:34 /episode/index/show/onsvoice/id/34793120

Episode 344: ONS 50th Anniversary: Founding Leaders’ Vision and Challenges, Then and Now 01/03/2025

Episode 344: ONS 50th Anniversary: Founding Leaders’ Vision and Challenges, Then and Now “Who would think that we would be here 50 years later? And with the excitement that I think will build even more, I’m so humbled and honored to talk to young nurses. And their excitement—the same excitement that we had in the very beginning—is inherent. I hope that our legacy will be that we are able to pass on this tremendous gift of our careers to new nurses,” Cindi Cantril, MPH, RN, OCN®-Emeritus, founding ONS member and first vice president, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about the history of ONS’s inception. Burbage spoke with Cantril and Connie Henke Yarbro, , and first treasurer, about the inspirational nurses who started the organization and its impact over the past 50 years. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. ONS Podcast™ episodes: ONS Voice articles: Clinical Journal of Oncology Nursing article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Yarbro: “In 1973, there was really kind of the first nursing conference for oncology nurses in Chicago. At that conference, Lisa Begg and Shirlee Koons, myself, and about 20 nurses met to discuss how we could identify each other and that we needed to communicate because we were really each isolated in our own separate cancer center or clinic.” TS 2:09 Cantril: “What’s interesting is that I contacted a lawyer in Louis and told him what we were trying to do, and the comment was shocking at the time. And he said, ‘Well, you know, you really could have your own autonomy. It would just cost $25, and you could start your own charter organization.’ Little did we know that we would grow to be where we are.” TS 3:50 Yarbro: “I was with medical oncology, and you [Cindi] were with surgeons, so we were really all defining our roles. At that time, I was medical oncology, and I would travel the state of Alabama with the medicine to give the Hodgkin’s disease patients or children with leukemia their second dose, so they did not have to drive to the medical center because there weren’t any oncologists in the community. They were just made at the academic centers. Today, I don’t know whether you could get in a car and travel with your vincristine, procarbazine, and all the other medicines.” TS 11:24 Cantril: “How do we facilitate a large, organized fashion and allowing people to have some sort of more intimate autonomy in their own environment? Because let’s face it, not every nurse is going to be able to go to Congress. Not every nurse is going to be able to go to a regional meeting. So the chapters really allowed for a wider net for us to identify nurses so invested in cancer nursing.” TS 25:23 /episode/index/show/onsvoice/id/34699300

Episode 343: Cancer Cachexia Considerations for Nurses and Patients 12/27/2024

Episode 343: Cancer Cachexia Considerations for Nurses and Patients “There’s actually quite a bit of debate about what the clinical definition of cancer cachexia is, but in its simplest definition of cachexia in this case is cancer-induced body weight loss. You can have cachexia in other diseases, for heart failure or renal failure, but it's basically tumor-induced metabolic derangement that leads to inflammation and often anorexia, which produces body weight loss,” Teresa Zimmers, PhD, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about cancer cachexia. Music Credit: “” 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 December 27, 2026. 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: The learner will report an increase in knowledge related to cancer cachexia. Episode Notes Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: (Third Edition) ONS course: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Anorexia is often a component of cancer cachexia. In fact, some people call it cancer-induced anorexia, cachexia syndrome, because the tumors produce factors that act on the hypothalamus and hindbrain to produce, among other things, anorexia, but not just anorexia, you know, feelings of misery, anhedonia, wanting to withdraw from social interactions, but definitely altered desire to eat and altered taste of food.” TS 5:32 “Cachexia is most common, you know, where it’s been examined, in patients with upper GI cancers. You could think of those as risk factors for cachexia. So that includes, of course, head and neck cancer, esophageal, gastric, pancreatic, liver and biliary cancers. It’s also found to be very prevalent among patients with any kind of metastatic cancer and very frequent in patients who are hospitalized for their cancer. But beyond that, about half of patients with non-small cell lung cancer also experience cachexia.” TS 8:21 “I’ve been told by oncologists that cachexia is frequent in patients with certain rare cancers like ocular melanoma, small cell lung cancers, but generally speaking, cachexia is underrecognized. Most people have in their minds this picture of someone who’s sort of end-stage cachexia, that’s emaciated. And in fact, most patients, or many patients in the U.S. at least, arrive with a cachexia diagnosis and may be overweight or even indeed obese, but that does not mean that they don’t have cachexia.” TS 8:54 “I have tremendous respect for our nurses who take care of patients, and all of them have their preferred screening tools. There is no single accepted or mandated approach to diagnosing or treating someone with cancer cachexia. And I should say that I didn’t mention a widely accepted definition for cancer cachexia in the field, a diagnostic criterion, is weight loss of greater than 5% in the prior six months—and this is unintentional weight loss. TS 11:05 “I hear from family members all the time about how this was actually the most distressing part of their loved one’s cancer journey because it’s something so visible. And also, so much of our relationships happen over meals. And what I’ve heard time and time again is that telling someone that there is a word for this, cachexia, and explaining that it is the tumor—right, it’s the cancer that’s causing this appetite loss—would have helped because there tends to be a lot of conflict over meals, you know, a lot of guilt on sides when it comes to eating and trying to prepare meals that are appetizing for the person with cancer.” TS 22:24 “I think that we don’t often think about how much the cachexia itself affects the cancer treatment outcomes. The presence of weight loss correlates with treatment toxicity. Chemotherapy is often dosed on body surface area. Patients who have very low muscle, for example, experience greater toxicities, and maybe we should be dosing based on lean muscle mass. Patients with cachexia have poor outcomes after surgery. And actually, patients with cachexia don’t respond to immunotherapy, which of course has been transformative for cancer care. So, treating cachexia may actually enable patients to respond better to all of their cancer interventions.” TS 28:45 /episode/index/show/onsvoice/id/34592165

Episode 342: What It’s Like to Serve on the Leadership Development Committee 12/20/2024

Episode 342: What It’s Like to Serve on the Leadership Development Committee “The Leadership Development Committee (LDC) is one of the most important member volunteer positions in the organization, and here’s why: The main purpose of the LDC is to recruit, vet, and select ONS Board of Directors. As some of you may know, it has been three years since we moved away from members voting for directors,” ONS member Nancy Houlihan, MA, RN, AOCN®, 2020–2022 ONS president and former director of nursing practice at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what it’s like to serve on the Leadership Development Committee. The advertising messages in this podcast episode are paid for by Ipsen. Music Credit: “” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD. Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS course:   Leadership Learning Library To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an Oncology Nursing Podcast™ Club in your chapter or nursing community, visit the To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “I feel like I have come full circle, developing my knowledge and leadership skills over 25 years, both at ONS and in my professional career, applying them to ONS leadership as a director and an officer, and then transferring that knowledge to work with a diverse team of ONS members on the LDC to build the best slate of directors.” TS 3:52 “There’s an annual review and editing of processes based on experience and discussion with board leadership and a review of the [notification of intent] and full applications of candidates for the board of directors. As you can imagine, reviewing the notifications of intent packages and the full applications, references, and interviews is very time consuming and requires significant at home and meeting time to complete. The application process is rigorous. The LDC members are the stewards of that work, ensuring fairness and ending with the best possible board of directors.” TS 6:22 Each member of the LDC recognizes the importance of their role in identifying future leaders. They regularly interact with chapter members and leaders and others to relay the opportunities and processes for leadership roles, as I mentioned already, the LDC annually offers Round Table sessions at Congress and bridge. They are advertised to appeal to nurses with an interest in leadership in general, as well as at ONS.” TS 8:28 “An important component to this role is meeting the diversity needs on the board, and every effort is made to ensure that our net is cast wide and is inclusive, while the skill set for board service is at a higher level, we uphold ONS principles relative to belonging and look for an inclusive compliment of directors.” TS 9:33 “Frequently, the LDC works with qualified candidates who opt to wait to move forward because of work commitments, graduate school demands, or family concerns and come back when their lives are more settled, enough to take on the commitments of ONS. Support of employers is a required part of the application for the LDC and the board of directors, since time away from work can be challenging. However, many employees see ONS affiliation as a positive for their organization and are willing to engage in discussions with you about how to make a leadership role possible with your work responsibilities.” TS 10:28 “Historically, there has been a misconception that you can’t ‘break into ONS leadership.’ I have served the last four years, and my experience has been that we are always looking for new qualified thought leaders from every possible group that ONS serves. For example, we track what worksites our leaders come from so that we have every subspecialty’s voice over time.” TS 16:27 “Bottom line is, ONS needs you. Don't be shy to try. The door is open to discuss, and the right opportunity could be available.” TS 17:00 “I am constantly reminded about how smart and influential nurses are and how much they have to contribute. Working with an organization like ONS that unites you with others around a common purpose is very powerful.” TS 17:15 “You know, ONS needs leaders; we’re always looking to talk with people about what their interests and strengths are and how they can develop some of those strengths through various volunteer activities.” TS 18:39 /episode/index/show/onsvoice/id/34511400

Episode 341: Pharmacology 101: HER Inhibitors 12/13/2024

Episode 341: Pharmacology 101: HER Inhibitors “Key thing here is that it was discovered that when you have gene amplification of HER2 you get a resultant overexpression of that HER protein and that overexpression leads to a driver for certain cancers. So, when you have an overexpression of HER2, it leads to the cancer being more aggressive,” ONS member Rowena “Moe” Schwartz, PharmD, BCOP, FHOP, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about HER inhibitors. Music Credit: “” 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 December 13, 2026. 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: The learner will report an increase in knowledge related to HER inhibitor drugs. Episode Notes    Oncology Nursing Podcast™ ONS Voice articles: ONS book: (Second Edition)  ONS courses:        ONS Learning Libraries:   To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “It was discovered that when you have gene amplification of HER2, you get a resultant overexpression of that HER protein, and that overexpression leads to a driver for certain cancers. So, when you have an overexpression of HER2, it leads to the cancer being more aggressive. In fact, when we first started talking about HER2 positive breast cancer, the key thing is, if we look at just the disease, not disease and treatment, that the patients that have HER2-positive breast cancers, they tended to be more aggressive because you had those drivers.” TS 3:30 “Pertuzumab is also a naked antibody, but it binds to a different part of the extracellular domain. It prevents heterodimerization, so where trastuzumab prevents HER2/HER2, this presents HER2 and HER1, HER2 and HER3, HER2 and HER4 dimerization, and then that leads to downstream effects that causes cell arrest and leads to the benefit of inhibition.” TS 6:03 “Key thing here is that we’ve learned, is that sometimes, that drug, when it’s released from the antibody, can be released from the cell and can hit cells around the cancer cell that overexpresses HER2. So that’s called the innocent bystander effect. So we’re learning a lot more about antibody–drug conjugates.” TS 7:35 “The tyrosine kinase inhibitors, they’re interesting in that there are these small molecules, just like we know about other tyrosine kinase inhibitors that target intracellular catalytic kinase domain of HER2, so the internal part. Key thing is we have a number of different tyrosine kinase inhibitors and they target different parts of that family.” TS 7:54 “The infusion-related reactions are really interesting, because one of the things we do with infusion-related reactions is, if we’re giving it in an IV formulation, we use those prolonged infusions for the first dose and then go faster with subsequent doses after we see how they tolerate. And then of course there is the development of these onc products that are given sub-Q that have less of the infusion-related reaction.” TS 15:49 “One of the things that I see, I hear, is people say about these antibody–drug conjugates, which, you know, we use in all different diseases now. I hear so many people say these are not chemotherapy, and the thing of it is, they’re chemotherapy. I think people like to say they’re not chemotherapy because it makes people feel better that they’re not getting chemotherapy. But the reality of it is, is that they are monoclonal antibodies linked to a chemotherapy. So some of the side effects that you get are related to the chemotherapy. I think people need to realize that. You need to know what you’re giving.” TS 18:31 /episode/index/show/onsvoice/id/34418980

Episode 340: What It’s Like to Plan an ONS Conference 12/06/2024

Episode 340: What It’s Like to Plan an ONS Conference “Don’t be afraid of applying, even if you’ve never planned a conference before, and you think, ‘Well, I have no idea what I’m doing.’ You probably know more than you think you do. You probably have more connections than you think you do, and it is such a worthwhile experience,” Colleen Erb, MSN, CRNP, ACNP-BC, AOCNP®, hematology and oncology nurse practitioner at Jefferson Health Asplundh Cancer Pavilion in Willow Grove, PA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, conferences oncology clinical specialist at ONS, during a conversation about serving on a planning committee for an ONS conference. Music Credit: “” by Kevin MacLeod Episode Notes  Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD contact hours. Oncology Nursing Podcast™ episodes: ONS Voice articles: Clinical Journal of Oncology Nursing article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “I saw a link on the ONS website looking for volunteer opportunities and applied, not thinking that I’d actually get chosen because I had never done anything like this before. I had spoken at conferences, but I had never been part of the planning committee. The application [had] some open-ended questions about what your expertise is and where your interests lie. … And then I got a phone call from the planning chair for that year, and we talked a little bit more in depth about the questions that were on the application, and my interests, and how I thought I would fit on the team.” TS 2:05 “The main part [of the work] was topic selection and then speaker selection once we narrowed down the topics. I feel like there was a lot of brainstorming and group effort to both of those things. You don’t have to individually have an exact topic or an exact speaker. There was a lot of ‘I think this general broad topic would be good,’ and then we narrowed it down as a group to something that would fit into a 45-minute presentation.” TS 4:30 “We talked about interventional radiology and how it seemed like it was taking on much more of a bigger role in oncology and how that could fit into the conference and whether we wanted to have a specific topic or an overview of the things that interventional radiology can offer for oncology patients. And we ended up doing kind of like a 101 topic on that one, because it was a newer topic that people were kind of interested in just hearing, like, ‘Hey, what do you guys do for cancer patients?’” TS 8:44 “I learned a lot about the backstage process of conferences. I had spoken before, but seeing the other side of it was a whole different picture—and all the work that goes into it—and I really learned a lot about picking the topics and how do we find the best information and the best sort of new themes to present to every time.” TS 12:04 “Just do it. Don’t be afraid of applying, even if you’ve never planned a conference before, and you think, ‘Well, I have no idea what I’m doing.’ You probably know more than you think you do. You probably have more connections than you think you do, and it is such a worthwhile experience. And you learn so much about yourself and about the other people on the team. And the information that you’re presenting just is huge for a lot of people. So if you’re even thinking about it, just fill out the application.” TS 14:06 /episode/index/show/onsvoice/id/34302060

Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer 11/29/2024

Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer “The nurse’s role in monitoring the lab values really depends on the clinics you're working at, but really when our patients are receiving treatment, especially in the infusion center, the nurses should be looking at those lab values prior to treatment being started,” Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, clinical nurse specialist at Karmanos Cancer Center in Michigan told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS during a conversation about how to monitor and educate patients with cancer. Music Credit: “” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn [#] contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 29, 2026. 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: The learner will report an increase in knowledge related to monitoring labs and educating patients with cancer. Episode Notes  .  Oncology Nursing Podcast™ episodes: ONS Voice articles:  ONS Course: Oncology Nursing Forum article: To discuss the information in this episode with other oncology nurses, visit the .   To find resources for creating an Oncology Nursing Podcast club in your chapter or nursing community, visit the .  To provide feedback or otherwise reach ONS about the podcast, email .  “Your traditional chemotherapy agents are the ones that we see the most lab abnormalities with, and we can predict those a little bit more with the advent of more of the advanced targeted therapies and immunotherapies, we still see lab values that are altered because of the way that the treatment works, but they may differ a little bit than what we traditionally saw with our normal chemotherapy agents.” TS 2:51 “I talked about the lifespan of all the other cells, and Neutrophils are usually what stop treatment, and part of that is, is that the lifespan of a neutrophil is 48 hours. It is proliferated very frequently in the bone marrow. But that is usually what we see. The cells that we see that stop treatment, and as you mentioned earlier, classic chemotherapy really the types of treatment that historically, we've been given and we have given to patients, and we've seen those blood counts really significantly impacted.” TS 6:21 “Kidney function, or renal function tests, are really determined whether the kidneys are functioning the way they should be. We look at an estimated glomerular filtration rate, or GFR, which is really based on the patient’s protein level, their age, gender, and race. And the test really looks at how efficiently the kidneys are clearing the waste from the body. So that’s really one that we need to look at, especially as we’re giving agents that are excreted through the kidneys.” TS 12:23 “I think it’s important for nurses to start looking at lab results with their patient very early on, you know, even before treatment starts, so they understand what the normals look like. So when they do get those lab results, because now pretty much everybody has patient portals, right? So the labs are reported in there, and they’re seeing the labs before they're talking to their providers. if we can start early on and talk to them about what the normal lab values are, what they mean, and what we're looking at when we're drawing these labs. I think it’s really important for the patient.” TS 27:00 /episode/index/show/onsvoice/id/34182195

Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse’s Role 11/22/2024

Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse’s Role “Although the patient is spending a little less time in the clinic, the administration actually requires the nurse to be at the chairside the entire time. This has allowed nurses to spend potentially uninterrupted time to sit and converse with the patients that they may not have had with an IV infusion. It’s been a wonderful unintentional outcome from the development of the large-volume subcutaneous injections,” Crystal Derosier, MSN, RN, OCN®, clinical specialist at Dana-Farber Cancer Institute, in Boston, MA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about administering high-volume subcutaneous injections in cancer care. Music Credit: “” 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 November 22, 2026. 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: The learner will report an increase in knowledge related to the administration of high-volume subcutaneous injections. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: (Fourth Edition) ONS course: Clinical Journal of Oncology Nursing article: Oncology Nursing Forum article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an Oncology Nursing Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Some challenges with subcutaneous injections are with the administration, especially when we’re thinking about large-volume drugs. … Some of these patients who have been through multiple therapies, they’ve been on a long journey, or just in general they may have small amounts of subcutaneous injection areas and tissues, so that could be problematic. … Also, some patients may want to go back to receiving IV medications if they experience severe pain at an injection site during administration, or maybe they had a site-related reaction. This is where the nurses play a huge, crucial role in the administration of these subcutaneous drugs.” TS 5:17 “When administering large-volume subcutaneous injections, good ergonomics is very important during the administration because this can help reduce the fatigue and discomfort not only for [nurses] but for the patients as well. If you’re trying to hold the needle in place for 5–10 minutes, it’s a lot of work. Your arms can start to shake, and that shaking can cause discomfort for the patient as well. The utilization of a winged infusion set for these large volumes allows more space between the patient and the nurse, which supports better ergonomics.” TS 11:20 “When they came to the market, there was an unfounded concern from patients and practitioners that these injections would not be as effective as their IV counterparts. This is totally incorrect. We know that these options have the same efficacy and may actually also help to reduce the incidence of any infusion-related reactions, as well as lower side-effect impacts on patients, so overall, a lot of improvement with these high-volume subcutaneous injections for the patient experience.” TS 21:37 “I’m just really looking forward to the future landscape of oncology practice and drug approvals and drug administration. It’s so important that subcutaneous injections have really made a name for themselves in nursing practice today. We continue to see more subcutaneous formulations on the market that are available for patients, allowing them less time in infusion chairs and more flexibility and freedom outside of the healthcare setting.” TS 24:39 /episode/index/show/onsvoice/id/34091321

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