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 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

Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan 11/15/2024

Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan “The gravity of the responsibility was realized when you walked into the boardroom and you’re there to make decisions, and the perspective you have to take shifts. Of course, I bring to the table my expertise and my perspective, but the decision-making and strategy behind it is really geared at sustaining the organization and moving us towards our mission, which is to advance excellence in oncology nursing and quality cancer care. Being able to reframe your perspective a little bit around those decisions is something that you don’t realize until you’re there to do that,” ONS director-at-large Ryne Wilson, DNP, RN, OCN®, told Brenda Nevidjon, MSN, RN, FAAN, chief executive officer at ONS, during a conversation with the three new 2024–2027 directors-at-large on the ONS Board. Nevidjon spoke with Wilson, Heidi Haynes, MN, CRNP, OCN®, and Susan Yackzan, PhD, APRN, AOCN®, about their careers, paths to serving on the Board, and passions in oncology. 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 November 15, 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 key roles of the ONS Board of Directors. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS courses: 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 Wilson: “After graduating and moving to Minnesota, I immediately joined the Southeast Minnesota chapter of the Oncology Nursing Society and served on the board and a few different positions, as membership chair and as the legislative liaison for the chapter, as well. And I had the opportunity to go to my first ONS Congress®. That really opened my eyes to all of the possibilities and all the really incredible work that so many of our colleagues across the country have been doing, which really was inspiring and really made me want to do more. I took on more volunteer opportunities within society—things like the OCN® Passing Score Task Force with ONCC, as a Biomarker Database expert reviewer, the Symptom Intervention Guidelines reviewer, and several other volunteer opportunities, just to stay connected and build relationships, but also give back to the profession that had really given so much to me.” TS 10:06 Haynes: “What I’ve been learning is how to transfer that passion and leadership experience that I learned at the local level and grow them into bigger-picture skills, sort of switching my hat and supporting our oncology nurses on more of a global level. I would say for those interested in a national Board position but unsure how they would navigate being new to the role, I can tell you the personal support of the new Board members has been wonderful. Brenda, you and the more senior members of the Board and the National ONS team have all been welcoming and willingly share their knowledge. We even get assigned a Board buddy, and I have to give a shoutout to my Board buddy, Trey Woods, who has graciously—more than graciously—put up with all of my questions and pestering along the way.” TS 16:39 Yackzan: “Well, the health of the organization is a responsibility. So that’s what you’re giving yourself over to and the task. The chapter board is just on a much more local and scaled back level. I mean this reaches a different proportion. So, you know, it’s not that it was the prior. I just think the full impact of it sort of comes to you when you’re in the Board meeting and you’re thinking through those things. The budget committee is one of the committees that I’m on, and I’m happy to report that we’re very healthy. And that’s because of the great stewards who came before me, and so, like everybody else on the Board, we feel the impact of making sure that that continues because oncology nursing is essential. We must continue to go forward.” TS 18:18 /episode/index/show/onsvoice/id/33933017

Episode 336: Pharmacology 101: EGFR Inhibitors 11/08/2024

Episode 336: Pharmacology 101: EGFR Inhibitors “Under normal conditions, EGFR [epidermal growth factor receptor] is in an auto-inhibited state. And it’s only when it’s needed that it’s upregulated. But when you have cancers that there is either a mutation in the EGFR or an overexpression, what you see is a dysregulation of normal cellular processes. So you get overexpression or switching on of prosurvival or antiapoptotic responses,” Rowena “Moe” Schwartz, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about the EGFR 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 November 8, 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 EGFR inhibitor drugs. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS books: (Second Edition) (Fourth Edition) ONS courses: Clinical Journal of Oncology Nursing articles: ONS Learning Libraries: Seminars in Cancer Biology 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 “It wasn’t until 2004 that the mutations affecting the tyrosine kinase domain of epidermal growth factor receptor was linked to the responses that were seen in gefitinib. And that’s when we really started to understand the way that this was targeting certain patients’ cancers. So that led to the phase three study. People may remember the IPASS study that demonstrated that when patients had an activating mutation of EGFR, that that was a really good biomarker that selected out patients that would respond to therapy.” TS 2:58 “The new player on the market is the bispecific. … This was a bispecific that was developed to hit two different targets. The one target is EGFR. The second target was MET. And the reason MET was targeted is because when you have patients who are on EGFR tyrosine kinase inhibitors, they do so well. But over time, resistance develops. And one of the mechanisms that are thought to be important for resistance is that MET pathway. So it was a development of a bispecific antibody that hit two different targets, EGFR and MET, hoping that you would get less resistance.” TS 7:12 “The other thing that I see with these agents is seeing them combined with chemotherapy. For a long time, it was these drugs were used as the single approach to someone with non-small cell lung cancer who had an EGFR mutation, and they did well. But I think we’re starting to see that because resistance does develop, that there may be roles for combination with chemotherapy, and you’re seeing that in terms of drug approval.” TS 19:10 “I think that people that don’t work in the clinic, say, with non-small cell lung cancer—they think of these as a group and don’t realize the uniqueness of specific agents, what mutations that they hit that affected those that penetrate into the [central nervous system], the drug interactions that are specific for certain agents. So I think that’s one of the common misconceptions.” TS 22:02 “The education, because it evolves so rapidly, is to realize that what you know, if it’s from a year ago, may not be the full picture. And so again, I’m going to call out ONS for the phenomenal resources on the Genomics and Precision Oncology Learning Library to help providers learn. And that is updated, and it is readily available. I think it is phenomenal, and I think it helps people build on their basic understanding of any of these types of therapy, including EGFR inhibitors.” TS 23:24 /episode/index/show/onsvoice/id/33829027

Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting 11/01/2024

Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting “Much like many experienced oncology nurses, I learned how to do IVs with palpation. I got really good at it. And so I thought, there’s no way I need this ultrasound. But we know now that our patients are sicker. There are more DIVA patients, or difficult IV access patients. We’ve got to put the patient first, and we’ve got to use the best technology. So I’ve really come full circle with my thinking. In fact, now it’s like driving a car without a seatbelt,” MiKaela Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director of oncology at Johns Hopkins Hospital and Johns Hopkins Health System told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ultrasound-guided IV placement. 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 1, 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 ultrasound-guided peripheral IV placement in the oncology setting. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: (Fourth Edition) ONS courses: Clinical Journal of Oncology Nursing article: StatPearls Video: Infusion Nurses Society: (Ninth Edition) 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 “The benefit of having an ultrasound, it allows you to see through. You’re no longer sort of bound by, ‘Can I feel it? Are there skin discolorations or skin colors that are affecting my ability to see the vein clearly?’ You don’t have to worry about any of that. Is there edema? Is there lots of tissue? You can actually directly visualize the veins to assess not only the health of the vein, but some of the complications that could be there, like a thrombus in the vein or sclerosis or tortuous anatomy, arteries, nerve bundles. Those are things that you can now see with your machine.” TS 8:55 “I think that the most important part of [training] is having a really good didactic session where nurses come in and they learn reminders about the anatomy. Where are these veins? Where are the best veins to canulate when you’re using ultrasound? And we like to avoid the veins above the antecube for regular long peripheral IVs that we insert with ultrasound because we want to preserve those veins up higher for our [peripherally inserted central catheter] lines and midline. So we want to teach to try to use the forearm. The cephalic vein in the forearm is a really excellent vein to choose.” TS 17:24 “[Patients] are usually kind of impressed with the machine and the technology, and I explain that ‘We’re not able to get it without being able to see better, so I’m going to use my machine so that I can see better.’ And almost every time after I’m done, the patient is like, ‘Wow, are you done?’ … It’s the initial little puncture that hurts the patient. But unlike when we do it blindly and maybe we don’t get it right in the vein, and we’re having to dig around and reposition ourselves and get into that vein, we’re not doing that with ultrasound because you’re going to go into the vein, and then you're starting to do the threading, and you’re pulling your probe up as you go to get that catheter in the vein. The patient doesn’t feel that part. So they often comment about how they barely felt it and they can’t believe it’s over.” TS 21:21 “This is kind of my measure of success when we’re no longer kind of putting this on the patient. We’re not saying, ‘You have difficult veins. Your veins roll. You’re not drinking enough.’ That’s not okay anymore. We’ve got to take responsibility and use technology to do this more successfully.” TS 30:24 /episode/index/show/onsvoice/id/33703447

Episode 334: Oral Care for Patients With Cancer 10/25/2024

Episode 334: Oral Care for Patients With Cancer “There is an old saying that if you ignore your teeth, they’ll go away. I think that’s a true, true statement. People may think they can get away without daily hygiene. I think that’s kind of important, that you should at least get your teeth taken care of at least once or twice a day by brushing and flossing. I mean this has been proven. Our dental people have really taken the lead on preventive care with oral hygiene in that respect,” Raymond Scarpa, DNP, APN-C, AOCN® clinical program manager of head and neck oncology and supervisory advanced practice nurse in the department of otolaryngology at the Rutgers Cancer Institute of New Jersey at University Hospital in Newark,told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the importance of oral health for patients with cancer. 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 October 25, 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 oral care for patients with cancer. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: (Fourth Edition) ONS course: Clinical Journal of Oncology Nursing articles: ONS Symptom Interventions: 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 “Radiation, with or without a combination of chemotherapy, can lead to xerostomia, which is like a dry mouth. When this occurs, there’s reduced or even absent salivary flow. When this happens, it can lead to mucositis, which is a very painful swelling of the mucous membranes in the oral cavity. This increases the risk of infection and compromises speaking, chewing, and swallowing. Certain chemotherapeutic agents can also accelerate and increase the severity of these side effects.” TS 3:54 “I think pretreatment of the oral cavity prior to starting any of these treatments is a key to managing some of the side effects that can occur. This includes a referral to the dentist for any kind of extractions and removal of any nonviable dentation, along with providing some what they call fluoride treatments. The nurses can also influence the patient by helping them with their nutrition. It’s important for them to continue to try to swallow despite some of the side effects that can cause the discomfort in swallowing.” TS 6:53 “I always encourage [patients] to try to use soft-bristle toothbrushes, [water flossers] if necessary, soft foods, nonspicy foods, foods with moderate temperatures. … Try to make sure that they have enough lubrication to get the nutrition they need by including some gravies or sauces or water to help them swallow when their saliva is altered due to these side effects from the treatments.” TS 10:18 “I’ve been working in the head and neck cancer field for quite some time, and over the years, I’ve come to realize that this is probably one of the most devastating types of malignancies that someone has. … Head and neck cancer and oral cancers—they affect your basic survival needs. They affect your ability to communicate. They affect your ability to take in nutrition. They can affect your ability to breathe and certainly affect when someone looks at you. It’s right there. It’s staring them in the face. You can see the side effects of their treatments.” TS 22:41 /episode/index/show/onsvoice/id/33597172

Episode 333: Pharmacology 101: CDK Inhibitors 10/18/2024

Episode 333: Pharmacology 101: CDK Inhibitors “CDK4/6 inhibition is considered to be a milestone in the realm of targeted breast cancer therapy. The combination of CDK4/6 inhibitors with the endocrine therapy has really emerged as the foremost therapeutic modality for patients diagnosed with hormone receptor–positive, HER2-negative, advanced breast cancer,” ONS member Teresa Knoop, MSN, RN, AOCN®-emeritus, independent nurse consultant in Nashville, TN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during the latest episode in our series about anticancer drug classes. 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 October 18, 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 CDK inhibitors. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: Clinical Journal of Oncology Nursing article: ONS Symptom Intervention: Susan G. Komen: 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 “Common toxicity among this class of agents are things like nausea/vomiting, diarrhea, fatigue. All three are associated with low white blood cell counts, which we know as neutropenia, which can cause an increased risk of infection.” TS 10:46 “All three of these CDK4/6 inhibitors are pills taken by mouth, and in most cases they’re all given along with endocrine therapy treatments. So, patients will be taking more than one drug. Teach patients how they will take their medication. And the frequency among the three drugs may vary.” TS 13:33 “Patients and caregivers need to know the time of day to take the pills, whether they need to be taken with or without food, or what to do if they miss a dose. We need to help them with a system for organizing the medications. They may find it helpful to use a pill organizer or set reminders on their smartphone, their smartwatch, their computer.” TS 14:29 “Pharmacy and nursing, in my experience, collaborate greatly by determining those drug–drug and drug–food interactions. It is so crucial in determining those interactions and educating our patients because we have to remind patients at each appointment and review these drugs and foods and other things they may be taking, at each appointment. And that often can be done by either pharmacists or nurses or both in collaboration.” TS 23:29 “This class of drug is generally well-tolerated, and I do want nurses to know that that we can help patients with these side effects. And they are generally well-tolerated with appropriate management.” TS 30:55 /episode/index/show/onsvoice/id/33502552

Episode 332: Best Nursing Practices for Pain Management in Patients With Cancer 10/11/2024

Episode 332: Best Nursing Practices for Pain Management in Patients With Cancer “Nurses really are the professionals who educate how to take these medicines, why we use multimodal therapies, why it isn’t medicine alone—helping patients to understand that pain is a biopsychosocial spiritual phenomenon, and the pills are just going to hit one little aspect of that entire phenomenon,” Judy Paice, PhD, RN, director of the cancer pain program at Northwestern University Feinberg School of Medicine in Chicago, IL, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about nursing practices for cancer pain management. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 11, 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 managing pain in patients with cancer. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: (fourth edition) ONS courses: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum articles: ONS Position Statement: ONS Learning Library: Diagnostics article: National Cancer Institute’s Cancer Pain PDQ Pain Medicine 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 “Who do patients speak to about their pain? They’re often afraid to tell their oncologist, and studies have backed this up. The patient is worried that if they admit to more symptoms, they won’t be able to enroll in that clinical trial, so they talk to us, the nurse. And part of our role is to encourage that dialog and assess the pain fully.” TS 7:00 “The nonpharmacologic, which is equally important—and I see these as partners in relief, not as one versus the other. But we may have physical measures like [physical therapy] and [occupational therapy] and orthotics, heat and cold. We may have more emotional or psychological kinds of therapies—cognitive behavioral techniques. We may have integrative measures—mindfulness guided imagery, yoga, tai chi. And some of these kind of transcend multiple categories.” TS 15:57 “For breakthrough [pain], we try to again treat the underlying cause. If this is an unstable vertebral body, is a kyphoplasty or vertebroplasty a possibility for this patient? If there’s compression of nerve roots, might an epidural steroid injection or some other interventional procedure help, so that when the patient stands—and that’s often what we see the breakthrough pain occurring—or moves position, maybe we can provide some relief that’s more directed to the site of pain or source.” TS 24:35 “I set expectations. Again, this is where nurses are key. It is so important that you use these medicines for pain. Yes, they’re going to make you feel a little bit less anxious, a little warm and fuzzy, and maybe even help you fall asleep at night, but you cannot use them for that purpose. You can only use these medicines for pain control. We have other medicines to help you if you’re feeling anxious or if you’re having trouble sleeping at night. And if you use your opioids for those purposes, you are going to get into trouble.” TS 41:11 /episode/index/show/onsvoice/id/33407857

Episode 331: DNP and PhD Collaboration Strategies to Help Advance Oncology Care 10/04/2024

Episode 331: DNP and PhD Collaboration Strategies to Help Advance Oncology Care “One of the biggest things we’ve heard in nursing school and we continue to hear in practice is it takes anywhere from 15 to 20 years for knowledge in the literature to reach practice in a significant way. The DNP was designed to speed that up. We don’t want the best practices in literature to take 15 years. We want it to take 1 or 2 at best,” James Q. Simmons, DNP, AG/ACNP-BC, acute care nurse practitioner at Epic Medical Group in Los Angeles, CA, and founder of drjamesqsimmons.com, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about how DNP- and PhD-prepared nurses can collaborate to advance patient care and research. 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 October 4, 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 strategies for DNP and PhD collaboration. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS courses: Clinical Journal of Oncology Nursing (CJON) articles: CJON call for manuscripts: Oncology Nursing Forum articles: 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 “Nurses are expertly and perfectly positioned to be the leaders in [artificial intelligence] and technology, and reduction in workforce, and robotics, and all these different things that are happening in our healthcare system right now. I think nurses are primed to be the leaders of that, not just the ones reacting to it. And I think we become the leaders of that by having really, really eloquent, really fine-tuned PhD and DNP collaboration.” TS 6:42 “We had 30 people in this room all ‘speed dating’ each other. They were told beforehand to bring their 30-second elevator pitch; bring their business cards, either electronic or in person; bring what they’re looking for; bring a fun attitude. … There were two individuals who were focused on pediatric populations, both working on vaccine initiatives in marginalized and underserved communities, and they had no idea that each other had existed.” TS 12:59 “I think we’ve got to think about how we approach our own profession in service of our patients and the communities that we serve. We’ve got to think about things differently, and I think that we as nurses are the ones to do that. We are in such a sweet spot where we can be innovators, and we can be quick thinkers because we are, and we’re so highly educated and so highly experienced as a profession, that we’ve got to take as much of this knowledge as we can and share it with everyone and figure out what the best practices are going to be.” TS 19:14 “I think it’s also really important to acknowledge that PhD nurses are not just our friends in ivory towers who don’t practice and haven’t seen the inside of a clinic or listened to a patient’s lung sounds in 38 years. Sure, there are some of those PhD nurses that exist right now, and we need them. They play a valuable role. But that’s not all that being a PhD nurse means. There are plenty of PhD nurses who are doing really incredible things in the grind, in the hustle, on a day-to-day basis.” TS 24:07 /episode/index/show/onsvoice/id/33301682

Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs 09/20/2024

Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs “The reality is that we are responsible for creating a culture of safety together for everybody in the clinical area. We have to think not only about ourselves and our personal risk, but how exposure to these hazardous drugs persists in the work environment for everybody. And we have to be part of the solution for everybody, even if it’s not something that we’re personally really worried about being exposed to,” AnnMarie Walton, PhD, MPH, RN, OCN®, CHES, FAAN, associate professor at Duke University School of Nursing in Durham, NC, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about updates to the fourth edition of Safe Handling of Hazardous Drugs, one of ONS’s book publications. 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 September 20, 2026. AnnMarie Walton serves in a compensated consultant role with Splashblocker LLC and as a compensated speaker for BD. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to safe handling of hazardous drugs. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) ONS courses: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum articles: ONS Learning Library: Joint ONS and Hematology/Oncology Pharmacy Association position statement: ONS Voice video: 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 “We know that this book is used in practice sites across the country and increasingly around the world, and we have the privilege of answering lots of questions of ONS’s members routinely. And we’ve also been part of writing guidance documents for ONS. And so, we utilized, as well, some of those questions that have come to us, and we know what people want to know more about. So we’ve made sure that we’ve developed a book that would be the most helpful in clinical practice settings.” TS 2:42 “We ensured that the book was in alignment with all of the most recent organizational position statements, standards, and recommendations. And there have been some big ones between the publication of the third and fourth book. So USP 800 is one that everyone knows about, and that became enforceable in November of 2023. … The ONS/HOPA [Hematology/Oncology Pharmacy Association] position statement, which was most recently updated in 2022, was also folded into this book. NIOSH [National Institute for Occupational Safety and Health] came out with two new guidance documents in 2023, and I had the opportunity to serve as a reviewer on one and a contributor to the other. Those two NIOSH guidelines have been folded into this book And then the ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice, which MiKaela Olsen was a lead editor on and I was an author for, have also been folded into this text.” TS 7:01 “We’ve understood the NIOSH hierarchy of controls for years, and if we look at that hierarchy, it tells us that PPE is important but also the least effective when it comes to controlling exposure. And what’s slightly more effective is administrative controls, which are things like changes in our practices, more education, and training. And then even more powerful than administrative controls are engineering controls, and these are your closed-system transfer devices, for example, that are really important in minimizing exposure.” TS 10:31 “[Toilet pluming] is a place that I, for better or worse, spend a lot of time. And I have a colleague, Tom Connor from NIH [National Institutes of Health], who likes to joke when people ask him about his work. He says, ‘Oh, it’s in the toilet.’ And so I’m going to steal that from him and say a lot of my research is in the toilet, too.” TS 13:16 “I feel like people don’t know how contaminated toilets are and how contaminated floors are. And I’ve already told you my tip about leaving your work shoes outside. But I think if people were more aware that the toilets and the floors are often the most contaminated places on a unit, there would be more attention paid to people who are coming into contact with those surfaces and bear a lot of the exposure risk.” TS 22:51 /episode/index/show/onsvoice/id/33072347

Episode 329: Pharmacology 101: BRAF Inhibitors 09/13/2024

Episode 329: Pharmacology 101: BRAF Inhibitors “One of the things that’s really challenging with these BRAF inhibitors, plus MEK inhibitors, is that there’s a huge scope of potential toxicity, and they’re not all going to happen. So I think that there’s a real need to educate patients that they need to work with us so that when a toxicity develops, we can help address it. We can help think of strategies, whether it be medication strategies or whether it be other types of strategies, to make them feel better,” Rowena “Moe” Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the BRAF 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 September 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 BRAF inhibitors. Episode Notes . Oncology Nursing Podcast episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) Clinical Journal of Oncology Nursing article: Oncology Nursing Forum articles: ONS 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 “BRAF is a gene found on chromosome 7 that encodes for protein that is also called BRAF. And this protein is really important in cell growth and signaling and promoting cell division, as well as some other functions. When you have a variant in BRAF, this causes that gene to turn on the protein and to keep it on. That means there’s a continual signaling to the cell to keep dividing and there’s no instruction to stop dividing.” TS 2:24 “[Side effects] are things like pyrexia, fatigue, muscle aches, those things. There is definitely rash. And as I mentioned, there are those secondary skin cancers, which are significantly less with the combination with MEK inhibitors. GI [gastrointestinal] toxicities are not uncommon. Different patients, different tolerance in terms of like nausea, taste changes. I think taste changes are one of the ones that are really challenging.” TS 10:17 “How to get rid of the agents when they’re done—I love that our institution has a program where they can bring them back, and we can help them get rid of it, because people just don’t know how to get rid of them when they’re no longer taking them. And you really don’t want them having them around the house.” TS 15:28 “Don’t assume that you can modify formulation. So if there is someone who can’t take oral pills and has to use a suspension, some drugs, there’s clear indications how to do that. Other ones there’s not. So collaborating on that is a really good thing. I hear too much where people will say, ‘Just crush the pill.’ These are not the drugs that you want to do that with.” TS 23:07 /episode/index/show/onsvoice/id/33010852

Episode 328: Supportive Roles in Oncology Units Improve Staffing and Patient Care 09/06/2024

Episode 328: Supportive Roles in Oncology Units Improve Staffing and Patient Care “Supportive personnel have a great ability to connect with patients and peers, and if that’s utilized effectively, it will make a great, great, great, great place to work, with great people to work with, because utilizing the supportive personnel and the great connections that they have, assistive personnel are kind of a lot of times the middle piece, and we don’t utilize it in that way,” Danielle Steele Anderson, CST II, NA II, research assistant at UNC Medical Center in Chapel Hill, NC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about how supportive personnel are improving staffing and patient care in oncology units. 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 by September 6, 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 role of supportive staff in the care of people with cancer. Episode Notes . Oncology Nursing Podcast™ episode: ONS Voice article: ONS book: ONS Learning Library: 2023 ONS Congress poster presentation: Anderson’s ONS Congress® poster presentation: 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 worked on a 53-bed oncology unit that had limited staff and resources to complete audits on things like central lines, Foleys, tubings, turn compliance, falls—different things like that. Our nurses were dealing with high patient acuity and task overload, so one of our amazing CN4s came up with this awesome rule as a cost-effective way to perform and sustain quality improvements on our unit.” TS 3:15 “Even before this role, I never thought about being on a committee. I never even knew that assistive personnel could even be on committees. I thought committees were tailored more toward nursing. But being in this committee, I feel like involving assistive personnel in committees, can number one, empower them and boost their morale, which in turn, can have higher job satisfaction, good retention.” TS 11:42 “Encouraging assistive personnel and participating in continuing education programs that may be offered to learn more about oncology-specific care, teaching clinical skills that may be within the scope of practice. With this position, I am able to do a lot of tasks that are beneficial to both our nurses and assistive personnel.” TS 16:08 “Opportunities to shadow with nurses during procedures can kind of give us that hands-on learning experience to know more about specific things that are going on and what to monitor with patients. And then also it just will help build connections within our healthcare team and your workplace and your unit.” TS 16:59 /episode/index/show/onsvoice/id/32927832

Episode 327: Journey of a Student Nurse: Choosing Oncology Nursing and the Value of a Professional Home 08/30/2024

Episode 327: Journey of a Student Nurse: Choosing Oncology Nursing and the Value of a Professional Home “It’s not often in life that you find something that gives you this feeling, but I’m really so fortunate to have found mine, and I know this is only just the beginning, and I cannot wait to see what the future holds. I definitely owe a lot of that to the Oncology Nursing Society for opening up all those doors for me and really getting me into this field.” Samantha Paulen, BSN, RN, told Jessica MacIntyre, DNP, MBA, APRN, AOCNP®, 2024–2026 ONS president, during a conversation about student nurses entering the oncology field. MacIntyre spoke with Paulen and Tayler Covino, BSN, RN, both recent graduate nurses, about why they chose oncology nursing as a specialty. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS book: (third edition) ONS courses: Clinical Journal of Oncology Nursing articles: ONS Learning Library: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an Oncology Nursing PodcastÔ 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 was first drawn to oncology nursing freshman year of high school when my grandmother, who was my ultimate best friend, was diagnosed with pancreatic cancer, and by the time they had caught it, it had metastasized to nearly every surrounding organ. And as I mentioned earlier, my grandmother was a nurse. So being a nurse, she was very stubborn, and when she finally had gone to the hospital after having a variety of symptoms, it was almost too late.” (Paulen) TS 7:27 “There’s really nothing more special to me than being able to develop relationships with my patients and support them throughout their journey. It’s incredibly rewarding making such a difference in their lives and being able to witness the strength and resilience of patients battling cancer, and it’s such an inspiration. Being able to provide my support both medically and empathetically is truly such an honor.” (Paulen) TS 10:04 “I also had a family member who was diagnosed with cancer. He was my uncle. And I witnessed firsthand the impact that compassionate and knowledgeable oncology nurses had on his treatment, and it really did leave such a lasting impact on me. … This experience deeply inspired me, and I just always wanted to be part of a team that offers hope and comfort to their patients and their families.” (Covino) TS 12:10 “I touched on my pediatric oncology clinical rotation, but I really do think it gave me insights into caring for younger cancer patients. This experience really emphasized the importance of a holistic approach to nursing, considering not just medical but also the emotional and developmental needs of children who are battling cancer.” (Covino) TS 24:05 “I also joined ONS as a student, so it was a large part of my college education and really gave me great access to resources, being able to attend meetings, and just stay updated on the latest in oncology nursing with the articles that they send out and just provided me with great networking opportunities with so many experienced oncology nurses who have such a wide breadth of knowledge.” (Covino) TS 24:27 “Practicing mindfulness and meditation has also been incredibly helpful in staying grounded and managing the emotional stress. These practices help me stay present. They reduce anxiety and maintain a positive outlook, even in these challenging environments. It’s really important to just set emotional boundaries as well to avoid burnout.” (Covino) TS 33:05 “There’s such a fulfillment that you get for making a significant impact on patients’ lives, and that’s what inspires me and should inspire others to consider this specialty. There’s also a lot of growth opportunities, and I think it’s really important to emphasize the growth opportunities within the field. And also just the advancements in cancer treatment can attract new nurses because there really is so much advancement in the field of cancer treatment.” (Paulen) TS 42:59 “I feel that specifically in this specialty, oncology nurses in particular are so much more willing to help versus they say that sometimes some nurses may eat their prey or whatever they might say. But I really think that oncology nurses are so willing to help, but sometimes you just have to really expose yourself and open up that door.” (Paulen) TS 45:07 /episode/index/show/onsvoice/id/32795082

Episode 326: Intramuscular Injections: The Oncology Nurse’s Role 08/23/2024

Episode 326: Intramuscular Injections: The Oncology Nurse’s Role “One of the big misconceptions is that this is just a quick shot. And this is a patient’s treatment regimen. So, it is not just a quick shot. It is treatment, and we need to get it where it is supposed to go so that the patient’s, cancer treatment is not impacted,” Caroline Clark, MSN, APRN, OCN®, AG-CNS, EBP-C, director of evidence-based practice and inquiry at ONS, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about administering intramuscular (IM) injections in oncology. 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 by August 23, 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 administration of antineoplastic medications by IM injection. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice article: ONS books: (second edition) (fourth edition) ONS course: ONS Huddle Card: American Journal of Therapeutics article: Centers for Disease Control and Prevention resources: Concordia University Ann Arbor School of Nursing video: Elsevier Clinical Skills: Healthline article: Journal of Advanced Nursing article: Journal of Clinical Nursing article: Journal of Nursing Research article: National Institute of Occupational Safety and Health: Novartis education sheet: Oncology Nurse Advisor 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 “More frequently oncology nurses are using intramuscular injection techniques when giving certain hormonal therapies for cancer treatment and for cancer symptom management. Some examples of those are fulvestrant for treatment of hormone receptor–positive, HER2-negative breast cancer, leuprolide as androgen deprivation therapy in prostate cancer. This is also used off label for breast cancer management. It’s used for premenopausal ovarian suppression and also in noncancerous conditions like endometriosis and uterine fibroids.” TS 2:04 “Inadvertent injection into the sciatic nerve is one of the most common causes of sciatic injury. It has significant morbidity associated with it. And even for drugs like fulvestrant, the prescribing information notes reports of sciatica, neuropathic pain, neuralgia, peripheral neuropathy—all related to dorsogluteal injection.” TS 6:09 “When administering an IM injection to someone who is cachectic, you don’t want the subcutaneous tissue to bunch up. So you can kind of stretch this over with your nondominant hand, as in the Z-track method, and then grasp the muscle between your thumb and index finger. That’s going to help you ensure that you’re getting that muscular injection.” TS 11:47 “Z-track is a way that you inject so that there’s no leakage back out into the subcutaneous space. Clean your area as usual. You displace the skin and the subcutaneous tissue that’s over that muscle, and then you inject slowly into the muscle. Once you remove the needle, then you release that tissue. And it kind of seals it over and prevents that leakage back up into the subcutaneous space.” TS 14:19 “I think ventrogluteal injection is less commonly done. There are documented issues with confidence in landmarking and giving it to that site, so practice is necessary. A great way to identify the ventrogluteal site on yourself to start is to stand up and put your hand at your side. You feel for the top of that iliac crest. Place your hand right below the iliac crest and then just start marching in place. You’re going to feel that muscle contraction right away. This also works when you abduct your leg. Abducting the leg is helpful when a patient is at a side-lying position to give a ventrogluteal injection—you feel that muscle contraction.” TS 17:06 “I wish it would be front of mind to encourage adverse event reporting related to any injection you’re giving. These types of reports—they drive improvement measures and monitoring. And then when things are underreported, it leads us to anecdotal reports. So really monitoring any change, trying to get some baseline data on adverse events with injection is really important.” TS 26:32 /episode/index/show/onsvoice/id/32691992

Episode 325: What Changed in the 2024 ASCO/ONS Antineoplastic Administration Safety Standards 08/16/2024

Episode 325: What Changed in the 2024 ASCO/ONS Antineoplastic Administration Safety Standards “These evidence-based standards provide a great framework for best practice in cancer care and the 2016 publication is extensively referenced. However, patient care mistakes and medication errors still happen. So, it’s imperative that we review the current literature and look for new evidence that’s been published,” ONS member MiKaela Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director of oncology at Johns Hopkins Hospital and Johns Hopkins Health System told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the new Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology from ASCO and ONS. 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 by August 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 increasing safety of antineoplastic medication administration. Episode Notes . Oncology Nursing Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) ONS courses: Oncology Nursing Forum article: ONS 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 “The target population for these standards are, first, our patients—adult and pediatric patients with cancer who are receiving antineoplastic therapy—but as well as those who care for patients with cancer. And we’re not distinguishing between the healthcare worker, the caregiver, all people who care for patients with cancer, including those practitioners or healthcare workers that are not in a traditional oncology setting.” TS 3:25 “The audience is, first of all, oncology clinicians. We spent a lot of time on this panel writing the definition, so it was very clear who people were as we use terminology in the standards. So, an oncology clinician, when we refer to that in the standards, that's a licensed nurse, like a nurse or pharmacist, a licensed clinician, or it could be a non-licensed clinician like a patient care assistant or tech. So, we refer to people as clinicians that are licensed or unlicensed.” TS 4:14 “We need to define all types of therapy for cancer, and chemo is one type of treatment modality. The explosion of new therapies that include cellular therapies such as CAR T and other exciting emerging treatment options are not our traditional chemotherapy. And so the term antineoplastic was agreed upon for all these therapies to treat cancer. That definition in the standards is, and I quote, ‘All antineoplastic agents used to treat cancer regardless of the route.’ And that’s important because the previous guidelines were not as inclusive about that.” TS 6:58 “Another high-level change was the new language about the location of administration to include new healthcare settings. We know that antineoplastic medications are given in a variety of settings, not just your typical inpatient or ambulatory oncology infusion center anymore. We’ve got health plans that are increasingly developing strategies to direct patients to more convenient and less costly sites of service, such as the physician’s office or home infusion, unregulated sites, and more care is being given in these settings. So, it’s really important that we adapt the standards to make sure those patients treated in the home or in a freestanding center are given the same opportunity for safety and quality.” TS 8:39 “The other thing in Domain 1 that I think is crucial for nurses to understand, because it’s a big change, and we made this change based on the literature, looking at patient safety events related to inaccurate weight and height measurements. Domain 1 has a standard 1.7 that says weight and height are measured and documented in the medical record in metric units only. And I see that a lot when I’m going around the country. People still have their scales and pounds and their height in inches, and we’ve got to change that. We shouldn’t be converting things. Both the measurement and the documentation are verified by two individuals, one of whom is a licensed clinician. Prior to preparation and administration of a newly prescribed antineoplastic treatment plan.” TS 13:32 “That third verification is an independent safety check and, in my opinion, should be done in a quiet place where you can go through and do the safety checks that are listed in the standards quietly and thoughtfully, without being in the presence of the patient or caregiver. Those are done in an attempt to do some preliminary safety checks to make sure that when I go in the room to do my safety checks—we often call those bedside safety checks—that if I have an error before that with a dose or something, I’ve caught that before I get to the patient’s side.” TS 20:52 /episode/index/show/onsvoice/id/32592757

Episode 324: Pharmacology 101: LHRH Antagonists and Agonists 08/09/2024

Episode 324: Pharmacology 101: LHRH Antagonists and Agonists “A lot of the efforts have been made to improve the patient experience for these treatments, as they can be given for years at a time. For example, when leuprolide debuted way back in 1985, it was a daily injection. But four years later, they developed the monthly depo formulation. Now we have formulations that are approved for administration once only every three, four, and even six months,” 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 the luteinizing hormone–releasing hormone (LHRH) antagonist and agonist drug classes. 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 by August 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 LHRH antagonists and agonists. Episode Notes Oncology Nursing Podcast episodes: ONS Voice article: ONS books: (second edition) (fourth edition) ONS course: ONS Huddle Card: ONS Learning Libraries: (by George T. Beatson) 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 “Between all of these agonists and antagonists, there’s a broad spectrum of applications, including hormone-positive breast cancer, androgen-deprivation therapy for prostate cancer, uterine cancer, and then other non-cancer uses like uterine fibroids, and assisted reproduction fertility treatments, and other things too.” TS 3:24 “In the education of my female patients, I basically use the analogy that it is functionally inducing menopause in that person, so there can be changes to mood and cognition, energy level fatigue, body morphology, and shifts in fat distribution metabolism, which can unfortunately increase the risk of cardiovascular disease. One that almost everyone’s familiar with is hot flashes, but also changes to bone mineral density, libido and physically to atrophy and dryness of vaginal mucosa, which can make sex for our patients more difficult as well.” TS 10:33 “A concept that’s familiar to all professionals in the care of prostate cancer is that because LHRH agonists cause an initial increase in testosterone, which can, in essence, feed the cancer, some patients can experience worsening symptoms of their cancer, such as difficulty voiding their bladder pain, or even vertebral collapse or spinal cord compression when bone metastases are present. This is a really serious issue that should be considered ahead of starting an agonist in these patients.” TS 12:39 “I don’t think we’ll see any dramatic changes in treating breast cancer, since the role of these agents is a lot more limited and simply really exist to suppress estrogen and premenopausal patients. But as a referral center that routinely sees patients with breast cancer and their 40s and 30s and even their 20s, it’s crucial to consider these agents in their role for not only actively treating certain types of breast cancer, but also in preserving fertility for patients who desire to have children and they are receiving gonadotoxic chemotherapy.” TS 25:32 /episode/index/show/onsvoice/id/32497607

Episode 323: What It’s Like to Participate in an ONS Think Tank 08/02/2024

Episode 323: What It’s Like to Participate in an ONS Think Tank “Instead of creating silos, how can we work together, create networks, and elaborate more in the future? Because we have such a robust wealth of knowledge and expertise, that ONS is very good at helping to facilitate that,” Jan Tipton, DNP, APRN-CNS, AOCN®, clinical assistant professor in the School of Nursing at Purdue University in West Lafayette, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about her volunteer experience in a think tank held during the 2024 ONS Congress®. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at by August 2, 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 participation in professional collaboration opportunities. Episode Notes . Oncology Nursing Podcast episodes: ONS Voice articles: Luma Institute: 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 “Individuals that would be helpful for this type of think tank would be those that view themselves as change agents, those who are willing and motivated to confront uncomfortable truths, persistent issues, that might think of a better way to do things. In addition, people that are highly inquisitive, curious, eager to learn, and those that have out-of-the-box type thinking, flexible, creative, and would work well in this group environment.” TS 3:29 “We all came from very diverse backgrounds, all over the country, and it was a great opportunity to blend our backgrounds in academia, clinical practice, and then be able to share not only some of the dilemmas and hardships that we see, but then to recommend some actions for the future.” TS 6:12 “But things that sparked my interest were things that were very small scale and then things that were very large scale that everyone could benefit from hearing. And one that comes to mind was, in a very small way, how can we collaborate with our various backgrounds and PhDs and DNPs and have more of a meet-and-greet? We’re sometimes in our silos. And how can we create opportunities for each other to learn from each other, to have these meetings, maybe in social venues, to learn about interests, research, collaborations in the future?” TS 6:55 “I think it’s important to challenge yourself to be open to new ideas, to keep an open mind. Consider that your idea may not be agreeable to everyone. So to think through, everyone that you may be participating with and have a heightened awareness of all the differences that we may have in our different backgrounds, gender, characteristics that we believe in, in terms of our practice. So thinking through those things in advance and being open to new ideas, I think, is really important and sort of self-reflecting before the event.” TS 15:41 /episode/index/show/onsvoice/id/32383762

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