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 380: Colorectal Cancer Survivorship Considerations for Nurses 09/12/2025

Episode 380: Colorectal Cancer Survivorship Considerations for Nurses “One powerful, overlooked aspect of colorectal cancer survivorship is the emotional and identity transformation that our survivors undergo—and really how little space is given in the clinical arena for that. No one really talks about this ‘invisible recovery.’ Facing mortality can lead to prolonged changes is values, relationships, and life goals. And these experiences aren’t captured in lab results or imaging scans, but they really shape how survivors live, love, and heal and continue with their lives,” ONS member Kris Mathey, DNP, APRN-CNP, AOCNP®, gastrointestinal medical oncology nurse practitioner at The James Cancer Hospital of The Ohio State University Wexner Medical Center in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about colorectal cancer survivorship. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 12, 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: Learner will report an increase is knowledge related to colorectal cancer survivorship nursing considerations. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS course: Clinical Journal of Oncology Nursing article: 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 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 of the most recent data, more than 1.5 million people in the United States are living as colorectal cancer survivors. So this includes not only those who are currently undergoing active cancer treatment but also those who have completed treatment and ultimately are hopefully in remission. Just a reminder that colon cancer is the third most commonly diagnosed cancer in the United States and it’s the fourth leading cause of cancer-related deaths.” TS 1:53 “Our colorectal cancer survivors may have significant barriers when receiving this comprehensive survivorship care, and these challenges can affect not only their physical recovery but their emotional well-being and, ultimately, their long-term health outcomes. We as oncology nurses do play a pivotal role in identifying and addressing these barriers. So these can include fragmented care. Who’s caring for these patients? That care coordination between the oncologist and the oncology team and then the primary care providers and team. Limited access—so our patients that may have geographic limited access or also financial- or insurance-related obstacles to follow-up services.” TS 9:10 “Our nurses can also facilitate the communication between specialists and primary care providers, so making sure that we’re sending records, keeping those lines of communications open. Also, nurses can provide that psychosocial support, so our screening for distress and also advocating and supporting for referral to counseling or support groups for a patient. Nurses can also act as navigators to guide these patients through complex care systems.” TS 11:21 “Some of the recommended changes—nutrition—enhancing and emphasizing fruits, vegetables, that colorful plate, with whole grains. Limit those red and processed meats, and reduce sugary drinks and alcohol. I know we will all have those patients who have read things or cancer myths about, ‘Oh, cancer feeds on sugar, so I shouldn’t drink anything or eat anything with sugar,’ and maybe addressing that, just really emphasizing the well-rounded meals.” TS 19:57 “When we think about [ourselves], ‘Well, I don’t have an implicit bias,’ but we may not think about what that is. Some common preconceived assumptions are that survivorship equals a cure. And this assumption may overlook that chronic symptoms or those late effects and emotional needs of long-term survivors. So knowing that when a patient is coming to us on surveillance, they may be cured; they may not have active cancer, but they’re still dealing with some of those chronic symptoms—and acknowledging that.” TS 30:37 “There’s an assumption that an ostomy equals poor quality of life, and this may stigmatize patients and discourage open conversations about adaptation and support. A couple weeks ago, I volunteered at the Pan Ohio Hope Ride, which is with the American Cancer Society, and several states have a ride that’s similar. And there was a patient riding, and I could tell over his jersey that he had an ostomy bag underneath that. And I just looked at him and I thought, ‘That’s amazing. You are still functioning, still living, still riding a bike throughout the entire state of Ohio with an ostomy.’ So he’s still having that good quality of life. That doesn’t stop him from living.” TS 31:39 /episode/index/show/onsvoice/id/38129110

Episode 379: Pharmacology 101: BCR-ABL1 Inhibitors 09/05/2025

Episode 379: Pharmacology 101: BCR-ABL1 Inhibitors “All of these TKIs [tyrosine kinase inhibitors] inhibit BCR-ABL1 in some way, shape, or form. When BCR-ABL1 is mutated, it has uncontrolled tyrosine kinase activity, leading to rapid cell proliferation. When we then inhibit that BCR-ABL1 that’s been mutated, we disrupt this abnormal signaling pathway that drives CML [chronic myeloid leukemia] cell proliferation and survival, ultimately leading to decreased cancer cell growth, increased apoptosis or cell death, and potentially inducing a disease remission,” Samantha Maples, PharmD, BCOP, clinical pharmacy specialist supervisor for hematology and cellular therapy at Allegheny Health Network in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the BCR-ABL1 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 5, 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: Learner will report an increase in knowledge related to the use of BCR-ABL1 inhibitors in the treatment of CML. Episode Notes  ONS Podcast™ episodes: ONS Voice articles: ONS course: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum articles: Other ONS resources: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “The IRIS study led to the approval of the BCR-ABL1 and TKI, imatinib, for CML in 2001 and completely changed the landscape of CML treatment. Then came the second-generation BCR-ABL1 TKIs: dasatinib in 2006, quickly followed by nilotinib in 2007. Thereafter came our second-generation, bosutinib, and our first approved third-generation TKI, ponatinib, both in 2012, which was a huge milestone as ponatinib overcomes resistance to the T315 I mutation, which no previously approved TKIs worked against.” TS 2:16 “The newest approved TKI, asciminib, is an allosteric inhibitor that binds to a different pocket on the BCR-ABL kinase via allosteric binding to the ABL myristoyl pocket. It’s what’s called a STAMP inhibitor, where STAMP stands for ‘specifically targeting the ABL myristoyl pocket.’ And while all the TKIs target the BCR-ABL1 binding site, they can also inhibit different off-target kinases. And these differences in off-target inhibition are responsible for some of the different toxicities we see among the TKIs.” TS 4:51 “As a class, common toxicities include nausea; vomiting; diarrhea; cardiac toxicities, including cardiac arrhythmias and congestive heart failure; metabolic abnormalities such as hypercholesterolemia and hypertriglyceridemia; nephrotoxicity; hepatic toxicity; hemorrhaging and bleeding; as well as cytopenia. Individually, some of these agents are more likely to cause certain side effects compared to others, and there are unique toxicities associated with certain TKIs.” TS 8:10 “We’ve moved to using preemptive loperamide [in our clinic] for the first three days of starting treatment, because it’s really hard to get patients to continue to take a medication if they have such severe diarrhea that they end up in the hospital or they’re unable to leave their house. A lot of times, we will proactively give patients antiemetics and loperamide to help with the nausea, vomiting, and diarrhea. And then we can back off to an as-needed basis once they’ve been established on treatment. We can also use medications to help manage long-term complications that can require supportive care, such as statin therapy for high cholesterol, levothyroxine for hypothyroidism, anticoagulants for any venous thromboembolism, and antihypertensive medications for managing any new or worsening high blood pressure.” TS 12:44 “We are continually seeing these agents expand their indications to different lines of therapy, as well as more TKIs being approved for acute lymphoblastic leukemia. For example, asciminib just got approved in the frontline setting within the last year, whereas previously it was only approved in relapsed refractory setting. Last year, imatinib was the first BCR-ABL1 TKI to come out with a commercially supplied suspension option as well, which is huge in the pediatric space and [for] our adult patients who are unable to swallow tablets for other clinical reasons.” TS 21:22 “There is more information being published on the safe discontinuation of these medications with treatment-free remissions, and more information is coming out about who would be eligible and who can have the option to stop these treatments instead of having a lifelong chronic condition requiring continuous treatment. We're seeing more patients in clinical practice be able to stop BCR-ABL1 treatment, which has been a great development in CML.” TS 25:29 /episode/index/show/onsvoice/id/38056095

Episode 378: Considerations for Adolescent and Young Adult Patients With Metastatic Breast Cancer 08/29/2025

Episode 378: Considerations for Adolescent and Young Adult Patients With Metastatic Breast Cancer “She’s triple negative and has a very, very aggressive tumor. Instead of going on spring break that year, she sat in our chemo room and got chemo. Her friends from college are good to try to keep her involved and try to surround her and encourage her, but they’re right now in very, very different spots in their lives. She’s fighting for her life; her friends are fighting for the grade they get in a class—and that’s different,” ONS member Kristi Orbaugh, MSN, NP, AOCN®, AOCNP®, nurse practitioner at Community Hospital North Cancer Center in Indianapolis, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about metastatic breast cancer in adolescent and young adult patients. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 This podcast is sponsored by Lilly and is not eligible for NCPD contact hours. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Episode This episode is not eligible for NCPD. ONS Podcast™ : ONS : ONS books: Oncology Nursing Forum articles: ONS huddle cards: Other ONS resources: continuing education resources 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 we use ‘adolescent and young adult,’ we’re really talking about age 19–35. Some groups will say 15–39, but right around that age. When we think about that age, think about what all could be going on during those ages. Late teenagers, they may be going off to college, they may be graduating high school, trying to set up their own life, trying to become independent from mom and dad. If you’re talking about early to mid 30s, you could be talking about young parents, young career folks. So, just setting that into place makes you realize this can be a very tumultuous time for folks.” TS 2:06 “Unfortunately, this group tends to have more aggressive subtypes. We see more triple-negative in this group. We see more hormone-negative, HER2-positive in this group. Normal breast cancer cells should be stimulated by hormone. They are stimulated by hormones. So when you have a breast cancer cell that is not driven by hormones, it’s much more difficult to treat. We tend to see more aggressiveness in these tumors. We also see a higher incidence in non-Caucasian folks in this age group compared to the older age groups.” TS 4:53 “I think we have gotten much better about understanding the importance of fertility preservation and getting reproductive endocrinologists in, sooner rather than later. If we have earlier-stage cancers and we have patients that want to try to preserve eggs, preserve fertility, sperm banking. … If you have that time to talk to them—maybe a 21-year-old—the primary thing on her mind is not how many children she wants to have one day. Maybe she’s not even thought about having kids yet. It’s still a question you need to [ask]. Do you want to try to preserve fertility? Do you want to try to harvest some eggs? That’s a conversation that needs to be had and is very, very important for that age group.” TS 10:35 “One thing that helps is if you can get them [into] reputable support groups with people their own age that are going through what they're going through. Someone else that doesn't have hair, someone else that isn't going to make it to the big board meeting or isn’t going to get the promotion this year because they've had to take a medical leave. Someone else that understands it differently.” TS 16:47 “In breast cancer, many of those biomarkers just get reflexed. And what I mean by reflexed is a breast cancer pathology comes through, or a breast cancer specimen comes through, and it just automatically gets tested for X, Y, Z. HER2 and of course ER/PR. Now we understand that we don’t just need to know whether they're HER2 positive or HER2 negative. We need to know: What is the IHC score? And even if the IHC score is zero, is there any membrane staining? And then we need to know what’s their ESR1, their PTEN, their AKT, their PIK3CA. Those are so important to know.” TS 18:11 “I think it’s important to try to remember what our priorities were when we were in our 20s—what our priorities were when we were starting out as young mothers or starting out our career. Because that’s where these folks are. … I can’t imagine in the midst of college, when I’m trying to be independent, to suddenly have to be at home and rely on my mom to take me to my chemo appointment. … So I think one really important bias is to remember where they are in the developmental stages of life. They’re not 40-something. They haven’t lived X amount of life, and we need to take a step back and try to remember when we were their age, what was important to us? Where were our priorities at that point? And then hear them when they’re telling us what’s important to them.” TS 29:22 “From a female standpoint we frequently throw these patients into menopause or have early menopausal symptoms, and I think we forget how devastating that can be. … They now are at higher risk for osteopenia or osteoporosis. … And then we tell people, ‘Be as normal as possible, get back and do those normal things.’ Well, they’re in a relationship, and they want to be intimate [but] suddenly having sexual intercourse is incredibly painful. Or if it’s not painful, sometimes they’ve just lost pure interest in that. They don’t feel confident about their body. All of those things need to be addressed because patients are trying to live each day as normally as possible.” TS 31:55 /episode/index/show/onsvoice/id/37945780

Episode 377: Creating and Implementing Radiopharmaceutical Policies and Procedures 08/22/2025

Episode 377: Creating and Implementing Radiopharmaceutical Policies and Procedures “Policies help make sure that we’re giving patients the right education and discharge instructions. Radiation doesn’t end when the syringe is empty. Patients go home with potential radioactive exposure. They need to know how to protect their families, what precautions to take, and what healthcare providers can do if something goes wrong—like a spill, extravasation, or even a pregnant staff member who’s involved in the care. This isn’t just a documentation exercise. It’s about making sure every part of the system speaks the same language when it comes to safety, handling, and patient care,” ONS member Ella-Mae Shupe, MSN, RN, OCN®, nursing practice and professional development specialist for radiation oncology at Johns Hopkins Health System Sydney Kimmel Cancer Center based in Baltimore, MD, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about creating and implementing radiopharmaceutical policies and procedures. 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 August 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: Learner will report an increase in knowledge related to implementing policies and procedures to support administration of radiopharmaceuticals for cancer treatment. Episode Notes  ONS Podcast™ episodes: ONS Voice articles: ONS Voice oncology drug sheets: ONS book: ONS course: Clinical Journal of Oncology Nursing article: Other ONS resources: 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 “[Lutetium lu 177 vipivotide tetraxetan] has shown so effective in clinical studies that the FDA recently approved expanded use, and it can now be given prior to chemotherapy.” TS 1:56 “There are typically three parts to a radiopharmaceutical. One is a radioisotope, which emits the radiation. The second is a targeting molecule, which directs the compound to a specific site. And the third is a linker that binds the isotope to the targeting molecules securely. The targeting molecule is usually a substance that binds specifically to receptors, antigens, or metabolic pathways that are overexpressed on cancer cells.” TS 2:08 “We have an interdisciplinary team involvement. There’s a physicist, nurse, and provider that confirm lab values are within normal limits. The patient meets all the clinical and safety criteria for administration. Second is an IV placement where a nurse or clin tech starts the IV and verifies a strong blood return. This is critical to avoid extravasation, which can be harmful due to the vesicant-like nature of radiopharmaceuticals. And third, our patient voids immediately before the injection, which reduces bladder radiation dose. During the administration, our provider administers the radiopharmaceutical using a shielded syringe holder to reduce radiation exposure. The physicist remains present throughout the procedure. Lead aprons are worn by any team members close to the IV site, and then the Geiger counter is used by physics to measure ionizing radiation, which is done before, during, and after the procedure.” TS 3:28 “The policy we created doesn’t just address general principles. It includes very specific guidance for both [radium 223 dichloride] and [lutetium lu 177 vipivotide tetraxetan]. That includes everything from determining patient eligibility to completing the treatment directive, confirming patient identity, verifying delivery parameters, documenting the treatment itself, and ensuring the treatment environment is appropriate and safe. We’ve also built in drug- specific practices because [radium 223 dichloride] and [lutetium lu 177 vipivotide tetraxetan] each come with their own considerations. This includes competencies for nursing, tailored patient education for each therapy, and an extravasation checklist that outlines what to do and who’s responsible for if infiltration occurs.”TS 11:24 “We created two separate versions [of an attestation model], one for clinical staff and one for non-clinical staff. Why include non-clinical staff? Because the risks extend beyond just the clinical team. What if environmental services comes in to clean and the patient has urinated on the floor? Or what if dietary delivers a tray and moves a urinal without knowing the risk? Or what if transport comes in and handles an incontinent brief without awareness? Each of these scenarios has potential for contamination and exposure. And that’s exactly why education for all roles matter.” TS 15:22 “These are such an exciting treatment for our patients, that’s not chemotherapy, that’s not radiation, and their quality of life has been amazing. We have had patients coming in that could barely walk because of the pain from bone mets and after a few treatments, they’re much better. We’ve had PSAs go from five, six hundreds down to 0.5, so we’re seeing a lot of really good options for these patients and treatment.” TS 22:09 /episode/index/show/onsvoice/id/37864540

Episode 376: ONS 50th Anniversary: The Science Behind the History of Nursing Burnout and Compassion Fatigue 08/15/2025

Episode 376: ONS 50th Anniversary: The Science Behind the History of Nursing Burnout and Compassion Fatigue “At least some of the answer to these issues of compassion fatigue and burnout have to do making our practice environments the very, very best they can be so that nurses and other clinicians can really connect and care for patients in the ways that they want to be able to do that—and the patients need them to be able to do. I think there’s a lot that is here already and will be coming, and I feel pretty optimistic about it,” ONS member Anne Gross, PhD, RN, NEA-BC, FAAN, senior vice president for patient care services and chief nursing officer at Dana-Farber Cancer Institute in Boston, MA, told ONS member Christine Ladd, MSN, RN, OCN®, NE-BC, member of the ONS 50th anniversary committee, during a conversation about burnout and compassion fatigue in oncology nursing. Ladd spoke with Gross and ONS member Tracy Gosselin, PhD, RN, NEA-BC, AOCN®, FAAN, senior vice president and chief nursing executive at Memorial Sloan Kettering Cancer Center in New York, NY, about the history of nurse well-being and how nurses and health systems are approaching it today. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice articles: Clinical Journal of Oncology Nursing articles: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode Gross: “I was on an oncology unit early in practice. And just like today, we were dealing with very sick patients. We were dealing with death and dying. We were administering very toxic treatments and really pushing a field forward in oncology. So there were similar challenges, but I think different from today. There weren’t the kind of resources; there wasn’t the body of work that’s been done today around compassion fatigue and burnout, work-life balance, and things like that. There was not that body of literature and science like there is today. And so there was more of a grassroots kind of support building in the clinical environment that I think I experienced.” TS 2:35 Gosselin: “I think there’s also a piece when we think about nurses in the work we do—we also have families. We have aging parents and children. And sometimes that burnout is multifactorial in that we have family obligations and other obligations that make it really hard. And for some people, they say work is their escape from some of that. Yet it’s all hard to balance sometimes.” TS 8:09 Gosselin: “It’s this question that people like Anne, myself, other chief nurses are saying. If we add this new technology, what are we going to take away? Do we need another alarm to ring to the phone or to their badge? How much can you ask people to do and not be distracted when they’re at point of care delivering patient care? Technology should never be a distractor, nor should it tell us how to practice. The technologies we have today—I’m like, ‘Wow, I wish I had that when I started my career.’ And yet there’s also a double-edged sword to that. I think we have to balance when we think about care and care delivery.” TS 16:36 Gross: “There are so many resources, first of all, that ONS provides to all of us at all levels and in all points in our career and our path from novice to experts. And the needs, though, are the same. Whether you’re a novice nurse or whether you’re a very experienced nurse, you need to continue to learn and to get new information, and ONS is an incredible resource for that. … As I think both of us keep alluding to and emphasizing here, you also need that connection to other people. And that’s what ONS provides—that opportunity to get connected to other people that might be working in some other part of the country or other part of the world but is dealing with similar things that you’re dealing with. So it provides that opportunity, and then it also provides an opportunity to get involved. I think when you can get involved and be part of solving a problem, it doesn’t then control you and you won’t feel defeated by it.” TS 22:24 /episode/index/show/onsvoice/id/37800545

Episode 375: Pharmacology 101: VEGF Inhibitors 08/08/2025

Episode 375: Pharmacology 101: VEGF Inhibitors “We’re really using these in many, many types of malignancies. But you can see this class of drug, these monoclonal antibodies, the small molecule inhibitors, being used in colorectal cancer, ovarian cancer, renal cell carcinoma, brain cancers, hepatocellular, non-small cell lung cancer, gynecologic malignancies, so lots of different types of cancers where we’re seeing these drugs used,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the vascular endothelial growth factor (VEGF) 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 August 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: Learner will report an increase in knowledge related to the use of VEGF inhibitors in the treatment of cancer. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) ONS courses: Clinical Journal of Oncology Nursing article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Cancer cells are known to secrete factors that cause the formation of new blood vessels, and tumors need blood vessels to supply themselves with nutrients so that they can grow and metastasize. A lot of tumors overexpress these factors, so they had more of this ability to create new blood vessels. You may hear that term somewhere neo vascularization. … And also these factors can increase the permeability of blood vessels, so making them kind of leaky blood vessels. … So the thought behind it is being able to block the ability for this new blood vessel formation and to decrease that leakiness or permeability of those blood vessels.” TS 2:07 “These are drugs that are tyrosine kinase inhibitors. These are oral, small molecule drugs that are acting intracellular, so they are working within the cell to bind and prevent that downstream signaling of producing more blood vessels. So we have a number of small molecule drugs that fall into this class. Many of them target multiple types of receptors, VEGF being included, but also a lot of these drugs have other targets.” TS 7:58 “I would really say, number one, something that we very commonly see with this drug class is hypertension. Giving you an example of bevacizumab—If we look at any grade hypertension, this can be up to 67% of patients, so very common toxicity really spanning all of these agents. So something that we need to be monitoring closely for.” TS 13:24 “With that impaired wound healing, keeping that in mind, as we are planning for this agent, for patients and even sometimes with the minor surgical procedures, maybe a need for a short hold, and even for something like a catheter placement. I know and some of the providers I work with have a preference for holding for a short period of time around that as well.” TS 20:15 “I think one big area, and we’ve seen some of this just recently, and particularly in the hepatocellular setting, we’re seeing combinations of using the VEGF inhibitor class with immunotherapy. And so I think we’re going to continue to see that evolve. Even hearing about some bispecific antibodies that are in development, where they are targeting VEGF as well as PD-L1, so getting the immunotherapy and VEGF effects.” TS 24:44 /episode/index/show/onsvoice/id/37704345

Episode 374: Colorectal Cancer Treatment Considerations for Nurses 08/01/2025

Episode 374: Colorectal Cancer Treatment Considerations for Nurses “Colorectal cancer treatment is not just about eliminating a disease. It’s about preserving life quality and empowering patients through every phase. So I think nurses are really at the forefront that we can do that in the oncology nursing space. So from early detection to survivorship, the journey is deeply personal. Precision medicine, compassionate care, and informed decision-making are reshaping outcomes. Treatment’s just not about protocols. It’s about people,” ONS member Kris Mathey, DNP, APRN-CNP, AOCNP®, gastrointestinal medical oncology nurse practitioner at The James Cancer Hospital of The Ohio State University Wexner Medical Center in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about colorectal cancer treatment. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.0 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 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: Learner will report an increase in knowledge related to the treatment of colorectal cancer. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: Clinical Journal of Oncology Nursing article: Oncology Nursing Forum article: (filtered by colorectal cancer) 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 “Colorectal cancer has several different types, but there is one that dominates the landscape, and that is adenocarcinoma. So I think most of us have heard that. It’s fairly common, and it accounts for about 95% of all colorectal cancers. It begins in the glandular cells lining the colon or rectum and often develops from polyps, in particular adenomatous polyps.” TS 1:41 “One of the biomarkers that we’ll most commonly hear about is KRAS or NRAS mutations. This indicates tumor genetics, and these mutations suggest resistance to our EGFR inhibitors such as cetuximab. BRAF mutation or V600E is a more aggressive tumor subtype, and those may respond to our BRAF targeted therapy. … And then our MSI-high or MMR-deficient—microsatellite instability or mismatch repair deficiency—that really predicts an immunotherapy response and may indicate Lynch syndrome, which is a huge genetic component that takes a whole other level of counseling and genetic testing with our patients as well.” TS 6:02 “Polypectomy or a local excision—that removes our small tumors or polyps during that colonoscopy. And that’s what’s used for those stage 0 or early stage I cancers. A colectomy removes part or all of the colon. This may be open or laparoscopic. It can include a hemicolectomy, a segmental resection, or a total colectomy, so where you take out the entire part of the colon. A proctectomy removes part or all of the rectum. This may include a low anterior resection, also known as an LAR … or an abdominal perineal resection, which is an APR. … Colostomy or ileostomy—that diverts the stool to an external bag via stoma. Sometimes this is temporary or permanent depending on the type of surgery.” TS 14:11 “We’ll have our patients say, ‘Hey, I want immunotherapy therapy. I see commercials on it that it works so well.’ We have to make sure that these patients are good candidates for it, also that we’re treating them adequately. We need to make sure that they have those biomarkers, so as I mentioned, the MSI-high or MMR tumors. Our MSS-stable tumors—they may benefit from newer combinations or clinical trials. Metastatic disease—immunotherapy may be used alone or with other treatments. And then in the neoadjuvant setting, some trials are really showing promising results using immunotherapy prior to surgery.” TS 25:38 “Antibody-drug conjugates are really an exciting frontier in all cancer treatments as well as colorectal cancer treatment. This is used mainly for patients with advanced or treatment-resistant disease, and these therapies combine the targeted power of monoclonal antibodies with the cell-killing ability of potent chemotherapy agents. They’re still on the horizon for the most part in colorectal cancer. However, there is only one approved antibody-drug conjugate, or ADC, at this time, and that’s trastuzumab deruxtecan, or Enhertu. That’s approved for any solid tumor, such as colorectal cancer with HER2 IHC 3+. So again, looking back at that pathology in those markers, making sure that you have that HER2 mutation and that IHC.” TS 35:00 “There are a few myths going around about colorectal cancer treatment that can lead to confusion or even delayed care. One myth is only older men get colorectal cancer. As you heard me talk in my previous podcast on screening, unfortunately, this isn’t necessarily true. Colorectal cancer affects both men and women and our cases in the younger population are rising. So our screening guidelines have changed to age 45 because we are seeing it in the younger population.” TS 45:54 /episode/index/show/onsvoice/id/37608460

Episode 373: Biomarker Testing in Prostate Cancer 07/25/2025

Episode 373: Biomarker Testing in Prostate Cancer “Next-generation sequencing, or NGS, can be used to help us determine if the patient has specific biomarkers we can identify and use to target for treatment. Certain findings can tell us if a particular treatment might work for that patient, and we can see if there are any genetic variants we might have a biomarker targeted agent to use to treat them with,” ONS member Jackie Peterson, MSN, RN, OCN®, NE-BC, MBA, ambulatory nurse manager at the University of Chicago Medical Center in Illinois, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about prostate cancer and biomarker testing. This podcast is sponsored by AstraZeneca and is not eligible for NCPD contact hours. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice articles: ONS book: ONS course: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum article: Other ONS Resources: (refine by prostate cancer or specific biomarkers) Clinical tool/case study: Huddle Card: Infographic: 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 “Some of the risk factors for developing prostate cancer include age, race, family history, and certain genetic changes or variants. Prostate cancer has some hereditary components, but most prostate cancer occurs in men without any significant family history of it.” TS 1:31 “Key biomarkers include PSA and prostate cancer gene 3, which is PCA3, and prostate-specific membrane antigen, or PSMA. Other biomarkers that are important for us to test include BRCA1, BRCA2, and Lynch syndrome–associated genes, which are MLH1, MSH2, MSH6, PMS2, and EPCAM. Biomarkers can be collected via your blood, urine, saliva, or tissue samples, so these are different ways that we can test and look for biomarkers in our patients.” TS 3:24 “It does matter how advanced the disease is. Usually, for our castrate-sensitive patients, they respond better to androgen deprivation therapy because that really is slowing down the growth of the cancer by reducing the available testosterone that the cancer needs to grow. Whereas our patients that are more advanced and have castrate-resistant prostate cancer, that cancer will continue to grow despite having the lowered testosterone levels, so they might need additional layers of treatment to really get their cancer under control.” TS 7:50 “When I talk to [patients] about biomarker testing, I tell them it’s another tool in our toolbox that we can use to help us determine if they might benefit from other therapy options now or in the future. I tell them that sometimes we’ll get a report back with a variant of unknown significance, and basically that means that we don’t really know whether or not this has an impact on their health or risk factors for the disease. That can sometimes be a little bit of a concern for these patients, so we just have to reassure them that we’re continually doing research around biomarker testing. The science is always advancing, so if there’s something that [researchers] find in the future, we’ll make them aware of that.” TS 9:08 “One of the biggest topics I think about is the inequity that exists in biomarker testing and research, especially surrounding the African American population. When these tests were developed, that population really wasn’t studied as much, so there’s not a lot of good data yet to make a decision or impact on those patients and that population.” TS: 12:30 /episode/index/show/onsvoice/id/37486275

Episode 372: Pharmacology 101: Proteasome Inhibitors 07/18/2025

Episode 372: Pharmacology 101: Proteasome Inhibitors “The proteasome itself, it really helps us unfold or get rid of misfolded proteins or degradations of different cells. We used to have garbage disposals in our sinks, and we used to put food product in there. If your garbage disposal is clogged, then everything backs up. So that’s kind of what’s really going on in the cell itself, is that I’m building up these unnecessary proteins that we should be getting rid of, and it actually causes apoptosis or cell death,” ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about the proteasome inhibitor 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 July 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: Learner will report an increase in knowledge related to the use of proteasome inhibitors in the treatment of cancer. Episode Notes . ONS Podcast™ ONS Voice article: ONS books: (second edition) (fourth edition) (second edition) (third edition) Clinical Journal of Oncology Nursing article: Oncology Nursing Forum articles: ONS Guidelines™ and Symptom Interventions 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 we look at the administration, we also want to make sure that we’re looking at the blood counts, right? Because proteasome inhibitors are well known for causing thrombocytopenia and neutropenia. So making sure that the patients do meet eligibility for the treatment for that day, and do they have anemia or lower red blood cell counts. You want to make sure that, because of these therapies, that the patient has no symptoms or infections going into each therapy for that day.” TS 10:19 “[Bortezomib], interesting enough, it can cause hypotension, cardiac failure, and sometimes pulmonary edema. Switching that up a little bit, what makes it slightly different, carfilzomib … a lot of times we saw, even in the clinical trial, that there was a lot of hypertension or cardiomyopathies, or arrythmias that we saw with carfilzomib and different dosages that they have indicated from the FDA. So again, monitoring the hypertension … or heart failure.” TS 15:16 “We also want to keep in mind another adverse effect, and especially in myeloma—our patients come in the door already immunocompromised just by the disease state alone. But now I’m giving them therapies that can drop their neutrophil count, so neutropenia and thrombocytopenia, so they are at a higher risk of having serious infections, even including like pneumonia or having outbreaks of herpes zoster or shingles.” TS 16:50 “If the patient has shortness of breath or symptoms, hold the therapy. I think that’s one of my biggest messages when it comes to cancer treatments and educating other healthcare providers, or even educating our patients and their caregivers or the care partners with them, is that we need to sometimes hold the therapy for safety.” TS 22:02 “I say keep a log, keep a book. Let me know when the symptoms happen. Are they happening the day of treatment? Are they happening two days later from the treatment? Are they happening a week later from the treatment? And being able to kind of guide which therapy is causing some of these adverse events or side effects alone. So, making them have calendars. When did you take the drug, when did you get your last infusion or your last [subcutaneous] injection? Always talk to your care team, whether it’s in the academic center or next to your house in the community.” TS 26:17 “It’s us learning how to listen to the patient going forward. We have tasks to do—we all have tasks to do in our lives—but we have to take a breath, be mindful who’s in front of us, listen to them first, and then be able to talk to them and care for them upfront and see what the symptoms are. I think that’s what we need to do. We have to take a breath in cancer.” TS 39:35 /episode/index/show/onsvoice/id/37417920

Episode 371: ONS 50th Anniversary: ONS’s Rich History of International Work Advances the Future of Global Oncology Nursing 07/11/2025

Episode 371: ONS 50th Anniversary: ONS’s Rich History of International Work Advances the Future of Global Oncology Nursing “We want to make sure that nurses, have opportunities both in our local communities as well as international communities, to engage in courageous dialog with others who may think or look different than we do and whose culture or language may also be different. The difference is what brings us together and allows us to have more of this tapestry of what we are about—ensuring that we advance health for all and that we are able to move forward together,” ONS member Ashley Leak-Bryant, PhD, RN, OCN®, professor at University of North Carolina (UNC) at Chapel Hill, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about international collaboration in oncology nursing. Burbage spoke with Leak-Bryant, ONS member Kristin Ferguson, DNP, MBA, RN, OCN®, senior director of strategic operations, bone marrow transplant, and cellular therapies at MedStar Georgetown University Hospital, and ONS member and Chief Clinical Officer Erica Fischer-Cartlidge, DNP, RN, AOCNS®, EBP-C, about their experiences working in the global oncology space and how ONS is advancing those efforts. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes ONS Podcast™ ONS Voice articles: Clinical Journal of Oncology Nursing articles: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode Leak-Bryant: “My first experience was when I was 21 years old. This was when I was in nursing school at UNC Greensboro. An opportunity came about where I had a chance to go to Honduras, and it was for a one-week service learning cultural immersion experience. And that really gave me my first entree into global health as well as global training. And so, as a first-generation college graduate who had never been out of North Carolina nor had ever flown, it was really an eye-opening experience that has led me now to my current role and passion for global health.” TS 3:24 Leak-Bryant: “In 2018, we had the Malawian delegation come to UNC Chapel Hill. University of North Carolina at Chapel Hill has one of the longest standing collaborations with Malawi, and we call it UNC Project Malawi, and it has been in existence for more than 30 years. … Those nurses and other allied health professionals came to UNC to our cancer center to see how we were making sure that we were engaged in best practices, then how they would be able to take that back to Malawi to make sure that they have what they need as they were opening up a new national cancer Center in Malawi.” TS 7:57 Ferguson: “I have volunteered with ONS at the Asian Pacific Breast Cancer Summit, which was in Indonesia in 2024, and then a few months ago in Singapore. And this is an exciting conference because it draws in nurses from the region, so you end up having five, six, maybe seven countries represented at these conferences, where oncology nurses are very eager to learn, meet one another. And so the teaching that we’ve provided there has been a combination of lectures and then roundtables where we’ve strategically placed nurses attending with nurses that are not at their same hospital so that they can connect and share experiences with myself and another ONS member and maybe some other local staff acting as moderators and facilitating conversations.” TS 18:04 Ferguson: “When I was in Tbilisi, Georgia, in 2019, the people there, most of them do not speak English, so they speak their native language Georgian. As I presented, I was wearing a headset, and all of the oncology nurses in the audience were wearing a headset, and I was live translated. What this means is when you’re speaking, a translator is sitting in a booth close by and you can actually very quietly hear in your ear he or she quietly translating what you’re saying into a language that the nurses can understand. It’s actually a bit funny because when you make a joke or ask a question, expecting nods or head shakes, it takes several seconds for the translation to occur. You can get used to a 10-second delay, and you have to pause your speaking and allow actually a little bit more time in presenting if translation services are required.” TS 22:25 Fischer-Cartlidge: “I think that the professional organization role is absolutely critical in how we advance global oncology. Certainly, providing education and helping empower nurses to be more autonomous and equal partners on the care team is a big piece of that. But it’s also through forming international partnerships and really elevating the collective voice of nurses in the specialty. This goes a long way in standardizing practices, promoted leadership development among oncology nurses, really across the world. We know that nurses are not seen the same country to country to country on the healthcare team. And so a big part of what we do is try to elevate the importance of what nurses bring to cancer care.” TS 36:14 Fischer-Cartlidge: “I have so many hopes. I hope more opportunities come up for us to raise awareness of this essential role and how we bring a greater spotlight to what nurses are doing across the world for patient care. I hope to see us have more collective global position statements in this space. I hope to see that we have more unified projects across nursing organizations across the world, where we then really can bring our resources and our members together to do great work more effectively and more efficiently. And I think the beginnings of that are happening right up to this point.” TS 41:17 /episode/index/show/onsvoice/id/37360620

Episode 370: Colorectal Cancer Screening, Early Detection, and Disparities 07/04/2025

Episode 370: Colorectal Cancer Screening, Early Detection, and Disparities “The five-year relative survival rate for localized, or cancer that is confined to the colon or the rectum, is 91% for colon cancer and 90% for rectal cancer. Distant, metastasized to other organs—the five-year survival rate is 13% for colon and 18% for rectal cancer. So that really shows you the huge difference in screening and where screening can come in and make better outcomes,” ONS member Kris Mathey, DNP, APRN-CNP, AOCNP®, gastrointestinal medical oncology nurse practitioner at The James Cancer Hospital of The Ohio State University Wexner Medical Center, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about colorectal 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 July 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: Leaners will report an increase in knowledge related to colorectal screening, early detection, and disparities. Episode Notes . ONS Podcast™ episode: ONS Voice articles: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum article: 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 “Interestingly, recent studies suggest that starting screening even earlier than 45, such as age 40, could significantly reduce mortality and incidence rates, especially as colorectal cancer is rising among younger adults.” TS 2:42 “[Artificial intelligence]-enhanced screening tools are also being developed to improve sensitivity, reduce turnaround time, and enable real-time monitoring of disease progression. These innovations aim to make screening more accessible and accurate, especially in our underserved populations. So there’s a huge impact on early detection.” TS 4:07 “Those with multiple chronic conditions or limited mobility may be less likely to complete screening, and those results may be harder to interpret. I mentioned a little bit earlier about our underserved or minority populations. Those barriers such as limited health literacy, lack of insurance, and cultural stigma can reduce screening uptake and ultimately follow-through.” TS 12:25 “Patient navigation programs—this is where we have trained navigators to help patients schedule appointments, understand procedures, and ultimately overcome some of these logistical hurdles. These have actually been shown to significantly boost screening rates. Also, those mailed stool-based-test kits—sending those kits directly to a patient home, especially with a personalized letter from a provider to add that extra little touch, has proven effective in increasing participation.” TS 21:29 “Our screening can detect cancer before symptoms appear and even identify precancerous polyps, which can be removed to prevent cancer altogether. Studies actually show that regular screening can reduce colorectal cancer mortality by up to 35% and the incidence of advanced-stage disease by nearly 30%. Just another reason why screening really does matter.” TS 25:53 “Evaluating our implicit bias, especially in something as critical as colorectal cancer, requires both introspection and instructional supports. One way of doing this is by auditing your practice patterns, really looking at reviewing your own screening recommendations and follow-up rates across different patient demographics. So are there certain groups that are less likely to be offered a colonoscopy? I think some of us may have an implicit bias—you see a patient; you’re like, ‘There’s no way they’re going to agree to that, so I’m just not going to offer it.’ Where we don’t offer it, they don’t have that opportunity to decline that. That can lead to further delay. And those patterns can reveal a bias in action.” TS 28:18 /episode/index/show/onsvoice/id/37257545

Episode 369: Lung Cancer Survivorship Considerations for Nurses 06/27/2025

Episode 369: Lung Cancer Survivorship Considerations for Nurses “Just remember that these patients, these are human beings who had lung cancer. It’s a scary disease. And we don’t want to just say, ‘Oh, well, that’s a horrible disease. They probably won’t do well.’ These patients are living longer. Our treatments are better. And so no matter who they are, they have every chance of surviving long term for this,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer survivorship. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 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: Learners will report an increase in knowledge related to lung cancer survivorship. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: Oncology Nursing Forum articles: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “For patients with stage I disease, they have a pretty good chance of getting to that five-year mark, somewhere probably in the 70%–80% range, depending on if you're stage IA or IB. Then it starts to drop obviously if you go up stages with patients.” TS 6:36 “Our radiation oncologists … and the dosimetrists in radiation oncology do a great job trying to line those beams up to minimize toxicity to those other vital organs. But we just can’t always do that. You may see long-term fibrotic changes within the lungs. You could see cardiac damage over time. You can see esophagitis or [gastrointestinal] toxicity, particularly in the esophagus over time, post-radiation. And just the fact of having disease or cancer in the lungs, you can have breathing problems and pulmonary issues long term.” TS 10:37 “Part of survivorship in lung cancer is smoking and smoking cessation. I know it can be hard for people to quit, even people who had curative-intent treatment for their lung cancer—and so keeping up with smoking cessation. And that can be hard again if you don’t have access to a smoking cessation specialty or if you live with other people who smoke and don't have really access to programs to help you quit and help you stay quitting.” TS 17:26 “I should talk about autoimmune diseases as part of immunotherapy. We give immunotherapy now in the curative setting preoperatively, postoperatively, post-chemoradiation, so they may get a year or so of immunotherapy. They may develop some sort of autoimmune toxicity from that. Usually that will go away once we stop the immunotherapy. But I’ve seen some things persist over time. That can go anywhere from like mild eczema that came about to things like more serious, like maybe lupus or scleroderma that may have developed as part of your immunotherapy. And we may stop the immunotherapy, but that may linger on.” TS 25:02 /episode/index/show/onsvoice/id/37152245

Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer 06/20/2025

Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer “That’s what metastatic breast cancer looks like now—patients can live an extended period of time. And sometimes I think we forget to cheer for stable disease. I tell patients they can live with weeds in their garden; they just can’t let the weeds take over their garden. And today we don’t have a cure. We live in a rapidly changing time in oncology, and so there’s just so much hope right now that we can offer patients,” ONS member Kristi Orbaugh, MSN, NP, AOCN®, AOCNP®, nurse practitioner at Community Hospital North Cancer Center in Indianapolis, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about patient communication in the metastatic breast cancer setting. This podcast episode was developed by ONS through a sponsorship from Lilly. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes This episode is not eligible for NCPD. ONS Podcast™ episodes: ONS Voice articles: ONS books: 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 ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “I think the most important and vital piece of having those conversations is making sure that we know—really know—that patient, because if we know them, that helps guide what they’re needing right then, helps guide our verbiage, helps guide disciplines that we bring in.” TS 2:04 “What do they want to hear? I’ve been in practice a really, really long time, and I’ve had the entire spectrum. I’ve had patients say, ‘Tell me every single detail.’ I mean, they want pictures. They want graphs. They want me to draw things. I’ve even had patients that want me to take markers and mark their body parts. … And then I’ve had patients that say, ‘I don’t want to know anything. I trust my healthcare team. I’m going to proceed with treatment, but I really don’t want to know anything.’” TS 3:40 “Remember to make things as simple as possible until we really know what the patient knows. We don’t send our children to school and start them out in eighth grade; we send them to kindergarten for a reason. So we get basic information, and then we build on that. And I think we need to remember that when we’re doing our patient education, whether it’s regarding new chemotherapy or treatment plans or palliative care, we’ve got to remember to start simple. And maybe we build on that very quickly, or maybe it takes a bit more time. Number one—I actually think it helps with adherence because patients understand what we’re asking of them and why we’re asking that of them.” TS 12:00 “I think what’s really kind of key to keep in mind is that patients are going to seek information. And so, we need to make sure that we’re giving them really good, reliable, durable information because if we are not giving them good websites, if we’re not giving them good written material, if we’re not giving them good verbal information and education, they’re going to contact ‘Dr. Google.’ Dr. Google is good for a lot of things, but sometimes patients can go down a rabbit hole that’s not appropriate or not accurate. That’s not a good place for them to be.” TS 14:35 “If we find biomarkers that we call actionable, meaning that we find this mutation and we have a drug that blocks that mutation, that is what is going to guide and drive our treatment. Sometimes that can take a bit of time, right? And if we have a patient and they just find out they have metastatic disease, will they want treatment yesterday. And I understand that. … But frequently there is a very important period of waiting and allowing us to learn that enemy better by reviewing genomic testing, looking at that next-generation sequencing, looking at any positive biomarkers in breast cancer. They may have started out ER/PR positive. Are they still ER/PR positive?” TS 23:46 “I think when we’re talking about goals of care, first of all, we need to make sure that the patient understands, when we’re talking about metastatic disease today…, this is not a disease that we can cure, but hopefully it’s a disease that we can manage for years to come. With that in mind, what’s important to that patient? What is important to that patient in terms of life goals? What’s important to that patient in terms of toxicities that they will allow and toxicities that they won’t allow? TS 29:22 “If don’t have a lot of medical knowledge, taking a pill seems less important than getting an IV. It seems like a bigger deal if I would miss getting my IV therapy. ‘Oh, whoops, I forgot to take a pill. Maybe it’s not such a big, important piece of my treatment.’ So education—when we set that patient down, helping them understand how this drug works, mechanism of action in a simple term, why it’s important to take it as scheduled, why it’s important to take it with food or without food, why it’s important to take it consistently.” TS 34:41 /episode/index/show/onsvoice/id/37055950

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

Episode 367: Pharmacology 101: PARP Inhibitors Episode 367: Pharmacology 101: PARP Inhibitors “We know that in cells that are proliferating very quickly, including cancer cells, single-strand DNA breaks are very common. When that happens, these breaks are often repaired by the PARP enzyme, and the cells can continue their replication process. If we block PARP, that repair cannot happen. So in blocking that, these single-strand breaks then lead to double-strand breaks, which ultimately is leading to cell apoptosis,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the PARP inhibitor drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 13, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the use of PARP inhibitors in cancer care. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) ONS courses: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “The big toxicities here to watch for are primarily hematologic toxicities. It is one of those targeted therapies that does affect blood cell counts. So I’d say the blood cell count that is most commonly affected here is the hemoglobin. So, anemia very frequent complication that we see, probably a little bit more with olaparib compared with other drugs, but we see it as a class side effect. And we can also see neutropenia and thrombocytopenia with these agents, probably a little bit more with niraparib versus the others, but again, you can see it across all of these drugs.” TS 8:16 “We mentioned that rare risk of MDS and AML. This isn’t a particularly scary thing if you talk to patients about it. Because of the rarity that we see this, it isn’t something that we need to overemphasize, but I think careful monitoring of blood counts in is stressing the importance of that and early intervention here is very important.” TS 16:55 “This is a collaborative effort. And because of the home administration here, these patients do need to be followed very closely. So we are not laying eyes on them usually with the frequency that we do when we have patients actually coming into our infusion centers for treatments—so making sure that there is a plan for regular follow-up with these patients to ensure that they’re getting that lab work done, that that’s being looked at closely, that we’re adjusting the dose if we need to based on that lab work, that we are managing the patient’s fatigue. Again, that potentially dose reductions may be needed if patients are having that extreme fatigue.” TS 19:34 “I think one of those [misconceptions] could be that they’re only effective in patients that have that BRCA1/2 mutation. And again, remember here that there is some data in particular disease states that we can use them and that they work in the absence of those mutations.” TS 25:12 /episode/index/show/onsvoice/id/36969310

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

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

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

Episode 365: Radiation-Associated Secondary Cancers “From a radiation standpoint, the biggest thing we’re looking at is the treatment site, the dosage, and the way the radiation has been delivered. There are different ways that we can focus radiation using methods such as intensity-modulated radiotherapy, volumetric modulated arc therapy, flattening radiation beams, and proton beam therapy to try to help minimize radiation exposure to healthy tissues to minimize patient risk for secondary cancers,” ONS member Andrea Matsumoto, DNP, AGACNP-BC, AOCNP®, radiation oncology nurse practitioner at Henry Ford Health in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation-associated secondary cancers. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 30, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to radiation-associated secondary cancers. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS book: (fifth edition) ONS courses: Clinical Journal of Oncology Nursing articles: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “It’s hypothesized that radiation can also induce different DNA mutations in healthy cells or in tissues surrounding cancers that we’re treating, including alterations in the structure of signal genes or chromosomes, or also causing changes in gene expression, which may help develop a neoplasia or a cancer in a patient’s future. The development of cancer carcinogenesis that is impacted or caused by radiation has to do with the chemicals that are produced, the impact it has on cell proliferation, and how these changes and mutations can also pass on to daughter cells in the future as cells are replicating.” TS 2:34 “Younger people are much more susceptible to having a secondary cancer, especially because we know with treatments, we expect them to live a longer time. And once patients get to 5 and 10 years out from radiation is when we may see a secondary cancer develop. We also have seen research showing that females may be more sensitive to some of the carcinogenic effects of radiation. Underlying diseases and genetic mutations can also impact patients’ risk.” TS 5:27 “I think a big thing is remembering that although the risk is really small, the risks does exist, and so it’s something that we want to bring up with patients. And even if it is something 20 years down the line for a child being treated and making sure that this information is written down somewhere. So when reviewing records, anyone from a care provider to a family member might be able to say, ‘Okay, I see that, and I’m going to keep that on my radar.’ And that’s another big benefit of using NP- and nurse-led survivorship clinics and creating survivorship care plans.” TS 17:20 /episode/index/show/onsvoice/id/36769525

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

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

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

Episode 363: Lung Cancer Treatment Considerations for Nurses “A lot of other disease sites, they have some targeted therapies, they have some immunotherapies [IO]. In lung cancer, we have it all. We have chemo. We have IO. We have targeted therapies. We have bispecific T-cell engagers. We have orals, IVs. I think it’s just so important now that, particularly for lung cancer, you have to be well versed on all of these,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer treatment. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to lung cancer treatments. Episode Notes . ONS Podcast™ episode: ONS Voice articles: Clinical Journal of Oncology Nursing article: ONS video: ONS Huddle Cards: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Unfortunately, because lung cancer is pretty aggressive, we’ll see lung cancer mostly in stage IV. So about 50%–55% of all cases are not caught until they are already metastatic, or stage IV. And then about another 25%–30% of cases are caught in stage III, which means they’re locally advanced and often not resectable, but we do still treat that with curative intent with concurrent chemoradiation. And then 10%–20% of cases are found in the early stage, and that’s stage I and II, where we can do surgical approaches.” TS 2:53 “The majority of radiation that you’re going to see is for patients with stage III disease that’s inoperable. At my institution, a lot of stage III is inoperable. Now, neoadjuvant immunotherapy has changed that a little bit. But if you have several big, bulky, mediastinal lymph nodes that makes you stage III, surgery is probably not going to be a great option. So we give curative-intent chemoradiation to these patients.” TS 10:51 “Oligoprogression would mean they have metastases but only to one site. And sometimes we will be aggressive with that. Particularly, there’s good data, if the only site of progression is in the brain, we can do stereotactic radiation to the brain and then treat the chest with concurrent chemoradiation as a more definitive approach. But outside of that, the majority of stage IV lung cancer is going to be treated with systemic therapy.” TS 15:00 “It’s important for nurses to know that there’s a lot of different options now for treatment. Probably one of the most important things is making sure patients are aware of what their biomarker status is, what their PD-L1 expression level is, and make sure those tests have been done. … It’s good that the patients understand that there’s a myriad of options. And a lot of that depends on what we know about their cancer, and then that guides our treatment.” TS 31:05 /episode/index/show/onsvoice/id/36578685

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

Episode 362: Pharmacology 101: MET Inhibitors “The signaling and that binding of the MET and the HGF help, in a downstream way, lead to cell proliferation, cell motility, survival, angiogenesis, and also invasion—so all of those key cancer hallmarks. And because of it being on an epithelial cell, it’s a really good marker because it’s found in many, many different types of cancers, so it makes it what we call kind of a nice actionable mutation,” ONS member Marianne Davies, DNP, ACNP, AOCNP®, FAAN, senior oncology nurse practitioner at Yale Comprehensive Cancer Center in New Haven, CT, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the MET inhibitor drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 9, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to MET inhibitors. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) (third edition) ONS courses: ONS Huddle Cards: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “The MET receptor was actually identified back in 1984. And it was actually identified as an oncogene in osteosarcoma. And so basically what that MET receptor does—it’s a tyrosine kinase pathway, and the ligand that it attaches to is something called HGF/SF. That’s hepatocyte growth factor/scatter factor. And so this MET pathway tyrosine kinase pathway is really important in tumor cell growth and migration. And it’s expressed specifically on epithelial cells, so that’s going to really help us in identifying how it can be a pathway for cancer treatments.” TS 1:35 “But in the particular classes, there kind of are some unique things that are with these MET inhibitors. For example, crizotinib, we found early on, causes some vision changes. Patients would report things like floaters or a little bit of blurry vision. For the capmatinib, things like elevation of amylase and lipase, fluid retention and bloating, and hypersensitivity reactions and photosensitivity.” TS 7:36 “Other things to teach for the TKI is the self-management strategies in terms of nausea management and dietary changes for the risk of peripheral edema. Having them do things like maybe doing daily weights, or at least weights every other day, and sometimes doing limb measurements so it can help us really quantify the amount of fluid retention they have. And then from a nursing perspective, meeting with these patients, is to do really good skin inspection. When people have peripheral edema, they’re at risk for skin breakdown, and that can lead obviously to infection.” TS 16:06 “The biggest [misconception] is that people assume that all MET mutations are going to be equally responsive to the same targeted therapies, that all of the abnormalities are the same and react the same, and they really don’t. We’re really diving down and carving that pie thinner and thinner in terms of each individual MET abnormality, in terms of what drugs responds it to and what that means for patient outcomes and prognosis.” TS 25:21 /episode/index/show/onsvoice/id/36471020

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

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

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

Episode 360: An Overview of Brain Malignancies for Oncology Nurses “Everyone’s brain is extremely heterogenic, so it’s different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They’re highly aggressive biologically. It’s a small area in a hard shell. So trying to get through the blood–brain barrier is different. There’s a lot of areas of hypoxia in the brain. There’s a lot of pressure there. The microbiology is very different—it’s a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C, CCRP, research advanced practice nurse at the John Theurer Cancer Center of Hackensack Meridian Health in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about brain malignancies and caring for patients with them. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 25, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to brain malignancies and their diagnosis and treatment. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS book: (fifth edition) Clinical Journal of Oncology Nursing articles: Nurse.org article: Lori Cappello’s contact information: [email protected] To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “A glioblastoma actually is the most predominant brain tumor that we do see. It is the most diagnosed of the brain tumors. And then I would say that an anaplastic astrocytoma is probably the second diagnosed. Historically a GBM, they used to say was probably an elderly patient for these. But we are definitely seeing it diagnosed at a much younger age now, definitely much more prevalent for people under 60.” TS 3:17 “Nine times out of ten, either a patient out of nowhere has a seizure, or they present with what they think are stroke-like symptoms. They noticed that they were slurring, or they were becoming more forgetful, or a family member noticed it and said, ‘Hey, what is going on with you?’ But usually they present to the [emergency department], and a [computed tomography] scan is always done first. And lo and behold, something is seen.” TS 4:50 “The only other U.S. Food and Drug Administration-approved treatment that has come along in the last 20 years is a device called Optune Gio, which is an alternating electric field that stops cell division at the mitosis stage.” TS 7:45 “They lose so much of their independence, especially if they don’t have a caregiver or help. That is huge. Medication management at home, to making sure that they’re taking the medication properly, that they are actually taking their medication. Transportation is another huge problem. Getting to and from appointments is a challenge. Those are big issues—real, day-to-day, simple issues that people don’t think about.” TS 17:11 “I think that having a brain tumor is very unique in the fact that you really need a dedicated neuro-oncologist. And depending on where you live, there are not a lot in the area. I actually had a patient that was moving out west, and the closest dedicated neuro-oncologist was four hours from them. … if you're not seeing dedicated neuro oncologists, you might not be getting the best treatment for yourself. So I think that having the resources and helping patients find the best care or the best brain tumor society—and there’s a bunch of really good brain tumor groups to help patients find the best resources out there. I think that's really, really important for patients to know or for families to know.” TS 19:17 “So trying to help patients, there are always going to be challenges, and there are always going to be ups and downs. But finding that one person that they can go to, that they trust, that they have a great relationship with, whether at the doctor's office or whatever, and being available to them makes such a difference in their journey. I think that that is the most important for anybody in the journey.” TS 22:08 “With brain, there are going to be expectations. They are going to lose functionality at some point—and preparing them for that thing or preparing them for things that can help themselves. Like sometimes I say, ‘Go to the dollar store, get coloring books,’ if they have weakness in one hand. Little tricks of the trade that can help them. About treatment options, going through the side effects, preparing them for whatever they can be prepared for.” TS 22:39 “It is not one of the better cancers to have, but it doesn’t immediately mean it’s a death sentence, and we shouldn’t treat them like they’re dying. We shouldn’t take away their ability to live just because they were diagnosed with it. We shouldn’t take away hope.” TS 25:35 “I think there's not enough discussed about [brain malignancies] and the lack of resources for this. These patients need a lot more resources and are available. There’s just not enough available for it.” TS 26:59 /episode/index/show/onsvoice/id/36296745

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

Episode 359: Lung Cancer Screening, Early Detection, and Disparities Episode 359: Lung Cancer Screening, Early Detection, and Disparities “I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don’t want to do it.’ And I said, ‘Do you remind them that lung cancer is curable?’ Because everybody thinks it is a death sentence. But when you’re talking about screening a patient, I think it’s really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60% to 70%,’” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer screening. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 18, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to lung cancer screening. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: Clinical Journal of Oncology Nursing articles: Oncology Nursing Forum article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Unfortunately, the current state of lung cancer screening is pretty low. Our rate of uptake in eligible patients is somewhere between 6% and 20%. And that falls much further below what we see for screening, such as breast cancer screening, prostate cancer screening, and colorectal cancer screening. So certainly, we can do better.” TS 1:32 “If you quit more than 15 or 20 years, your risk of developing lung cancer at that point is significantly lower. And so that’s why once patients have quit more than 15 years, they’re actually not eligible for screening anymore—because their risk of developing lung cancer is dramatically reduced. And that takes into account when you are a primary care provider, pulmonary, whatever field you work in, and you are running a screening clinic each year that you screen the patient, you have to remind yourself when they quit smoking, because once they reach that 15 years, then they’re no longer eligible for screening.” TS 5:17 “One of the strategies that they’ve used to get the word out is, I watch a lot of baseball. I love the Philadelphia Phillies, watch Phillies games. And so at least once a year, maybe even twice a year, they will take an inning of the baseball broadcast on TV and on the radio separately, and they will bring on either an oncologist or pulmonologist from one of the local cancer centers in our area, and the whole inning—between batters of course—they will talk about lung cancer screening and why it’s beneficial.” TS 13:16 “Medicare always has its idiosyncrasies. So Medicare—I went over the rules with you, so the age, the smoking. They follow all of it, except they have a slight difference in age. They cover it for age 50 to 77, as opposed to 80.” TS 16:52 “I think just the other thing that people don't think about is that to go get a medical test done, no matter what test it is, typically people have to take time off of work. And it can be really hard to do that when you are relying on your job, maybe you don't have vacation time, maybe you have children at home that you need to get home to. When people are weighing the risk/benefit and thinking, ‘Well, I’d love to get screened for lung cancer, but I just can’t find time to fit it into my schedule, and my job won’t let me take off.’ These are all things that we don’t always think about if you have the luxury of just taking the day off.” TS 20:01 /episode/index/show/onsvoice/id/36209005

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

Episode 358: Pharmacology 101: KRAS Inhibitors “It’s been known for quite a while that [KRAS] is a mutation that leads to cancer development, but for really over four decades, researchers couldn’t figure out a way to target it. And so, it was often considered something that was undruggable. But all of this changed recently. So about four years ago, in 2021, we had the approval of the first KRAS inhibitor. So it’s specifically a KRAS G12C inhibitor known as sotorasib,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the KRAS inhibitor drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 11, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to KRAS inhibitors used for cancer treatment. Episode Notes . ONS Podcast™ episodes: ONS Voice articles: ONS books: (second edition) (fourth edition) (fourth edition) ONS course: ONS video: (formerly Lexicomp) To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “If we look at specifically non-small cell lung cancer, this KRAS mutation is one of the most frequently detected cancer drivers or driver mutations. It’s thought that about a quarter of cases of non-small cell lung cancer have this KRAS mutation, and it’s usually a specific amino acid substitution that we see in non-small cell lung cancer, so what’s known as KRAS G12C mutation.” TS 2:31 “Both of these agents, sotorasib and adagrasib, have the same mechanism of action. They bind to a pocket, very specifically on the KRAS G12C protein, and they lock it in an inactive state so that it can’t cause that downstream uncontrolled signaling to happen. So they’re kind of shutting down the signaling, and therefore you don’t get that uncontrolled cell growth and proliferation.” TS 4:27 “Another big difference to point out, and one that is often used in clinical practice to differentiate when to use these agents, is specifically adagrasib is known to have activity in patients with metastatic non-small cell lung cancer that have active brain metastases. In the clinical trial, they included patients with active brain metastases, and they found that this drug has great [central nervous system] penetration. And so it may be considered the agent of choice in patients with brain metastases.” TS 7:19 “Other considerations—I think one of the big ones—is that there are a lot of drug interactions. Just specifically calling one out that I think is pretty impactful, is sotorasib has an interaction with acid-suppressing medications. So there is the recommendation to avoid [proton pump inhibitors] and H2 antagonists in patients receiving sotorasib. They can take antacids, but you would need to space those out from their dose of sotorasib.” TS 14:14 “This needs to be a collaborative endeavor to make sure these patients are monitored appropriately. We are putting a lot of responsibility on the patients with all of this. So, again, completely administered generally in the home setting, a lot of monitoring, a lot of adverse effects, need for reporting and management—so there’s a lot happening here. And it takes a team to accomplish this and to do it right. And I firmly believe that this is often a collaborative effort between our pharmacy and oncology nursing teams to make this happen. Working together to ensure outreach to patients—I think that patients are often more successful with these medications with early identification of toxicities when we’re doing scheduled outreach.” TS 19:44 /episode/index/show/onsvoice/id/36055915

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

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

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

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

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

Episode 355: Pharmacology 101: Hedgehog Pathway Inhibitors “I genuinely think nurses and pharmacists need to know why these medicines are called hedgehog inhibitors so that we can, in fact, effectively educate our patients. Just because to date, this class has the weirdest name I’ve encountered, and I almost expect at this point that my patients are going to ask me about it. I think that we need to be informed that, just on, where do these names come from, why is it called this, and does it matter to my patient?” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about hedgehog pathway inhibitors. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to hedgehog pathway inhibitors used for cancer treatment. Episode Notes  .  ONS Podcast™ ONS Voice articles: ONS courses: ONS Guidelines™ and Symptom Interventions:  ONS Huddle Card: ONS Learning Libraries:   American Association for Cancer Research article: American Journal of Clinical Dermatology article: Cureas article: International Journal of Molecular Sciences article: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Many patients unfortunately will have side effects with this class. I mean—and I know that’s not controversial—but you actually find callouts in some of the kind of the national consensus guidelines. These treatments might not be tolerable for a decent number of patients. Some of these side effects can certainly reduce quality of life. Again, nothing that controversial here when we say it out loud, but just the frequency with which it occurs can make it quite difficult for some patients.” TS 9:13 “Certainly, based on what we said before, I think one of the easiest things to do for patients starting this class is to just make sure that they have really classical supportive medicines like antidiarrheals and antiemetics before they start treatment. Diarrhea, nausea occurred in about 20%–40% of patients across trials. So certainly patients should be aware of that risk. Again, not a controversial side effect, but it’s just simple things we can do to make sure that our patients are quick to start treatment is to make sure that they have these medicines and they’re educated on how to use them.” TS 11:21 “I think patients need to be aware that side effects, as I had mentioned before, can be especially frequent with this class. So for a patient, they need to be aware that communicating your needs to your oncology team is really crucial to their own ability to use these treatments with minimal interruptions.” TS 14:45 “I think that regardless of whoever is following up with our patients, though, as our arsenal of oral anticancer therapies does continue to expand, both nurses and pharmacists need to have specialized knowledge of these agents to be successful in their patient care roles.” TS 18:28 “When there are clear recommendations for reproductive health, as I summarized before with these agents, I obviously think we need to be aware of them and not just defer to these generic recommendations. Because if you just defer to, ‘Well, use barrier contraception and then for a week after your last dose,’ you know, ‘Okay, it’s not true with these agents.’” TS 24:37 /episode/index/show/onsvoice/id/35796540

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

Episode 354: Breast Cancer Survivorship Considerations for Nurses “You can give someone a survivorship care plan, but just giving them doesn’t mean that it’s going to happen. Maybe there’s no information about family history. Or maybe there’s information and there’s quite a bit of family history, but there’s nothing that says, ‘Oh, they were ever had genetic testing,’ or ‘Oh, they were ever referred.’ So the intent is so good because it’s to really take that time out when they’re through with active treatment and, you know, try to help give the patient some guidance as to what to expect down the line,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer survivorship. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to breast cancer survivorship. Episode Notes  .  Previous ONS Podcast™ site-specific episodes: ONS Voice articles: ONS books: ONS course: ONS Learning Libraries:    ONS Guidelines™ and Symptom Interventions:  Clinical Journal of Oncology Nursing article: Clinical Journal of Oncology Nursing supplement: American Cancer Society:    To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “I think the biggest thing is to really communicate is that people are living with breast cancer for a long, long periods of time, and a lot of that with really good quality overall.” TS 4:07 “As a general rule, they’re going to be seen by the breast surgeon probably every four to six months for a while. After about five years, a lot of times people are ready to say, ‘Okay, annually is okay.’ And eventually they may let that drop off. But it also depends on did they have a mastectomy? Did they have breast conserving surgery? And then if they had reconstruction with an implant, how often do they see the plastic surgeon? Because they need to check integrity of the implant. So those schedules are really individualized.” TS 13:24 “When you think about long-term effects, I think you need to kind of think about that survivors can have both acute and long-term chronic effects. And a lot of that depends on the specifics of the treatment they had. I think as oncology nurses, we’re used to, ‘We give you this chemotherapy or this agent, and these are the side effects.’” TS 15:36 “The diet issues are huge. And I think we are slow to refer to the dietician, you know, you can get them a couple of consults and because you’re saying to them, ‘This is really important. We need you to lose weight or we need you to eat more of this.’ Ideally, fruits and vegetables are going to be about half of your plate. And what’s the difference between a whole grain and not, less processed foods, making sure that they’re getting enough protein. And then once again, really kind of making sure that they’re not taking a lot of supplements and extra stuff because we don’t really understand all that fully and it could be harmful.” TS 34:53 “Breast cancer is a long, long journey, and I think you should never underestimate the real difference that nurses can make. I think they can ask those tough questions. And I think ask the questions that are important to patients that patients may be reluctant to ask. I think giving patients permission to talk about those less-talked-about symptoms and acknowledge that those symptoms are real and that there are some strategies to mitigate those symptoms.” TS 42:28 /episode/index/show/onsvoice/id/35686425

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

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

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

Episode 352: Pharmacology 101: Epigenetics “Now, what we found is that epigenetics is actually heritable and it’s actually reversible. And we can now manipulate these principles with pharmacotherapy drugs,” Eric Zack, RN, OCN®, BMTCN®, clinical assistant professor at Loyola College Chicago Marcella Niehoff School of Nursing in Chicago, IL, and RN3 at Rush University Medical Center in Chicago, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the epigenetics drug class. Music Credit: “” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours (including 40 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 28, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the epigenetics drug class. Episode Notes  .  ONS Podcast™ ONS Voice articles: ONS book: ONS course: ONS Huddle Card: ONS Learning Libraries: American Cancer Society: Centers for Disease Control and Prevention: Leukemia & Lymphoma Society: National Institutes of Health: University of Pennsylvania: University of Utah: To discuss the information in this episode with other oncology nurses, visit the . To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the . To provide feedback or otherwise reach ONS about the podcast, email . Highlights From This Episode “Epigenetics is influenced by several factors. Right now, there’s about seven of them that we’ve identified, and we can only manipulate right now about two of those seven. So the first one is DNA methylation. When you methylate DNA, that’s adding or subtracting a methyl group, which is CH3, chemically. The addition of methyl to DNA tightens the DNA around the chromatin, which then can block some genes from being expressed.” TS 7:21 “Histones basically package DNA into the chromatin, which is a mixture of DNA and proteins, and they spool around this structure like the DNA is coiled around that. And again, it has to do with how tight or loose that is coiled. That determines if the genes are expressed or not. And again, we found that histones also play a role in DNA repair as well as regulating the cell cycle.” TS 8:21 “When we’re dealing with the azacitidine and decitabine, these drugs cause pancytopenia. Pancytopenia is neutropenia, thrombocytopenia, and anemia. So it affects the complete blood count. We see GI toxicity, nausea, vomiting, diarrhea, constipation, sometimes mouth sores, and urticaria—hives.” TS 15:34 “It’s really, really important to take these drugs exactly as they are prescribed. They have to follow the doctor’s orders carefully, which requires taking them properly, doing the proper follow up. There’s a lot of blood tests and appointments that we have to do to make sure that everything is okay. And again, because we know when there is nonadherence, the disease progresses and becomes resistant, so that’s a really, really important teaching point. We have to monitor the patient for expected side effects and unexpected side effects.” TS 23:58 “Now, we expect the landscape to change dramatically over the next few years. And again, it’s just an explosion of science information. As we learn more about the science, it’s going to translate into practice. We’re always identifying new biomarkers. These biomarkers are essentially DNA mutations or variations. There’s so many variants of unknown significance.” TS 30:02 “Every patient deserves biomarker testing. Very important, whether it’s through IHC, polymerase chain reactions, or the most common next-gen sequencing. Again, there’s several companies out there that have standard kits available.” TS 31:33 “This is a precision medicine. This is what we’ve always dreamed about—tailoring the treatment to the specific patient. We’ve gone away from treating standard diseases, like lung cancer and breast cancer, the way they’re supposed to be treated to now looking at these biomarkers and using epigenetic drugs and other medications tailored to those variants that that patient is having, not necessarily based on their disease type.” TS 33:59 /episode/index/show/onsvoice/id/35465820

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

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

The ONS Podcast

TOPICS