Podcast
The ONS Podcast
Hosted by Oncology Nursing Society · EN
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
35episodes
Episodes
Newest firstAll episodes
Episode 421: Medical Trauma in Oncology
1w ago00:41:19Tap to summarize"There are a huge array of medical dynamics that people endure, and when they leave a lasting impact, a word that we don't use widely enough is the word 'trauma.' There's an entire category of phenomena in the medical arena that are, in fact, traumatic. One way we know that these experiences are traumatic is that we know that huge portions of people who experience things like cancer do indeed develop problems like [post-traumatic stress disorder]," James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about understanding medical trauma in oncology. Music Credit: "Fireflies and Stardust" 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 June 26, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report increased knowledge of medical trauma and its effects on patients with cancer, caregivers, and healthcare professionals. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 315: Processing Grief as an Oncology Nurse Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care Episode 276: Support Young Families During a Parent's Cancer Journey Episode 257: Redefining the Bell: The Ethics of Hope for Oncology Nurses and Patients Episode 103: What Oncology Nurses Need to Know to Support Caregivers ONS Voice articles: 'Between Two Kingdoms' Gives Us a Glimpse Into How Patients and Families Experience Malignancy AYA Cancer Survivors Experience Five Times Higher Depression Rates Than Individuals Diagnosed at Older Ages From Stigma to Support: Changing the Cancer Conversation Help Caregivers Control the Chronic Stress of Cancer Care and Manage PTSD Moral Injury and Trauma in Nursing Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress When the Story Ends, Cancer Does Not Win: Reframing Death in Terminal Cancer Care Word Choice Matters When Caring for Patients With Cancer ONS course: ONS Psychosocial Dimensions of Cancer Care™ Clinical Journal of Oncology Nursing articles: Psychosocial Barriers to Care: Recognizing and Responding Through a Trauma-Informed Care Approach Trauma-Informed Care Addressing the Mental and Emotional Needs of Patients With Cancer Oncology Nursing Forum articles: Post-Traumatic Distress and Symptom Experience in Patients With Head and Neck Cancer–Related Tracheostomy and Family Caregivers The Effect of Neuroticism, Fear of Progression, and Self-Efficacy on Post-Traumatic Growth in Patients With Lung Cancer Undergoing Chemotherapy Reclaiming Your Life From Medical Trauma by James C. Jackson To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Many people have a notion about what medical trauma is, but perhaps they lack a definition. I use a definition that is deliberately broad because I think it is better to be inclusive than exclusive. A medical trauma to me is a medical experience or a medical encounter that basically leaves a mark. It leaves an emotional mark, and that mark is significant enough to disrupt your daily life." TS 2:06 <p class="MsoNormal" style="m...
Transcribe →Episode 420: Long-Term Myelodysplastic Syndrome Considerations for Oncology Nurses
2w ago00:43:04Tap to summarize"We typically think of the disease progressing for our higher-risk patients because many of them already start with increased blasts or a lot of dysplasia. And they have these chromosomal variants that make them prone to evolving into acute myeloid leukemia (AML). With them, we can anticipate that they are going to progress to AML. And that's what we're trying to prevent. It's kind of like a biologic evolution and not a switch," ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about long-term myelodysplastic syndrome (MDS) considerations for oncology nurses. Music Credit: "Fireflies and Stardust" 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 June 19, 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 management of long-term side effects related to myelodysplastic syndrome and its treatment. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 415: Myelodysplastic Syndrome Treatment Considerations for Oncology Nurses Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 220: Oncologic Emergencies 101: Febrile Neutropenia and Sepsis Clinical Journal of Oncology Nursing articles: Exploring Experiences of Bereaved Caregivers of Older Adult Patients With Acute Myeloid Leukemia Family Caregiver Preparedness: Developing an Educational Intervention for Symptom Management Incorporating Nurse Navigation to Improve Cancer Survivorship Care Plan Delivery Oncology Nursing Forum article: An Integrative Review of Sex Differences in Quality of Life and Symptoms Among Survivors of Hematologic Malignancies ONS book: BMTCN® Certification Review Manual (second edition) ONS course: Psychosocial Dimensions of Cancer Care™ ONS Learning Libraries: Survivorship Learning Library Hematology, Cellular Therapy, and Stem Cell Transplantation Survivorship Care Plan Huddle Card American Association of Colleges of Nursing End-of-Life Nursing Education Consortium (ELNEC) American Cancer Society: Living As a Myelodysplastic Syndrome Survivor American Society of Hematology Aplastic Anemia and MDS International Foundation: MDS Toolkit Blood Cancer United: Myelodysplastic Syndromes Family Caregiver Alliance HealthTree Foundation Inspire: MDS Support and Discussion Community Myelodysplastic Syndromes Foundation To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "When our higher-risk patients have disease-related progression, their [malignancy] can transform to AML. And we know this occurs in about one-third of our patients and is one of the most serious late effects. Even in lower-risk disease, we have this worsening marrow failure with or without increasing blast, where [patients] may have just started out with anemia, then they also develop neutropenia and thrombocytopenia. And as those counts worsen, we usually know that their disease is progressing." TS 2:47 "The golden rule is looking at the blood count but also looking at the patient and how they're doing over time. The backbone of MDS monitoring is the complete blood cell count with the differential. What you're looking for is trends over time. How many units of blood are they receiving, what threshold are you going to transfuse them at, and how many units of blood are they getting at a time? ... And then paying attention to the absolute neutrophil count for infection risk. [Another] really important piece of when you look at the differential with patients is seeing if they have any abnormal cell counts. Do they have circulating blasts? Are those monocytes going up? If you start to see blasts circulating or increasing monocytes, then their disease could be changing, even if they have low-risk disease." TS 15:58 "For lower-risk disease, we're paying more attention to their quality of life, how the patient's tolerating therapy, trying to help them stay safe over the long haul, and starting them on iron chelation if it matches that patient and they can have access to those drugs. ... For higher-risk disease, if the patient's goal is to be cured and not to progress to AML, you want to get them to transplant if that's [also] one of their goals. If they do evolve into AML, try and see what treatment matches best for them." TS 22:28 "You want to start early for patients who have febrile neutropenia—that's really important when a patient is an hour or two away from a center where they can get started on antibiotics. So, you have to think outside the box. What can we do to keep them safe? ... I know this group in Alaska that's in our advisory meetings and they try to facilitate transportation to Seattle. That's the closest academic center to them. Collaborating with telemedicine appointments, starting earlier, developing that strong relationship with patients, and contacting them between visits [can help patients living in rural areas]." TS 25:22 "I think the biggest [psychosocial challenge] I see is a lot of unmet anxiety and depression counseling. A lot of times, [patients are] losing their place in their family because they're the ones that need all the help now. Also, the uncertainty that goes along with the diagnosis. There is communication skills counseling, and End-of-Life Nursing Education Consortium (ELNEC) has a lot of training for communication skills and how to really talk to patients. Not that we take the place of a psychologist, but just being able to talk to somebody can go a long way. And if we can get training for that, we can help more patients." TS 31:15
Transcribe →Episode 419: Pharmacology 101: Immunomodulators
3w ago00:44:26Tap to summarize"Until immunomodulators, patients [with myeloma] did not have a great overall survival rate. But when we introduced lenalidomide, we started seeing our patients have life expectancies between five and seven years—which was unheard of prior to these immunomodulators going forward. I think it's promising and allows patients to have quality of life versus therapy of life," ONS member Daniel Verina, DNP, RN, ACNP-BC, nurse practitioner for the multiple myeloma program at Mount Sinai Medical Center in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about immunomodulators. Music Credit: "Fireflies and Stardust" 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 June 12, 2027. Daniel Verina is on the speakers' bureau for Johnson & Johnson, GlaxoSmithKline, and Pfizer. This financial relationship has been mitigated. 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 about the use of immunomodulators to treat cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 401: Multiple Myeloma Treatment Considerations for Oncology Nurses Episode 386: Interprofessional Navigation and the Oral Anticancer Medication Care Compass Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy ONS Voice articles: Maintain Oral Adherence With ONS Guidelines™ Multiple Myeloma Prevention, Screening, Treatment, and Survivorship Recommendations Sexual Considerations for Patients With Cancer Clinical Journal of Oncology Nursing article: Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles Oncology Nursing Forum articles: Changes in Health-Related Quality of Life During Multiple Myeloma Treatment: A Qualitative Interview Study Facilitators of Multiple Myeloma Treatment: A Qualitative Study ONS book: Multiple Myeloma: A Textbook for Nurses (third edition) ONS Symptom Intervention resource: Peripheral Neuropathy Risk Evaluation and Mitigation Strategies (REMS) Lenalidomide Pomalidomide Thalidomide International Myeloma Foundation: Using Immune Therapy to Fight Multiple Myeloma International Myeloma Society Multiple Myeloma Research Foundation: Treatments for Multiple Myeloma To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "We definitely want the diagnosis of multiple myeloma before initiating these drugs. We're going to look at serum protein electrophoresis. We want to make sure that we know the patient has serum free light chains and myeloma proteins to really confirm their disease. Plus, a bone marrow biopsy." TS 7:21 "Each immunomodulator has slightly different side effects. Thalidomide's biggest side effects are constipation, weakness, fatigue, somnolence, peripheral neuropathy, mood swings, hand tremors, and depression. With each generation, less of the side effects actually occurred. Most of lenalidomide's side effects, not discounting the deep vein thrombosis, are pancytopenia—the neutropenia, the anemia, and the thrombocytopenia. [The side effects] are very similar in pomalidomide." TS 15:40 "The REMS program is critical for oral immunomodulator therapies—thalidomide, pomalidomide, and lenalidomide. It was developed due to the risk of developing embryofetal toxicities. ... It is mandatory testing and counseling, so all females of reproductive potential must have two negative pregnancy tests prior to starting the therapy and then monthly pregnancy tests while on the therapy alone. Again, they must use two forms of effective contraceptives or abstain from heterosexual sex four weeks prior, during, and after. And the same thing for men. I focus on that because males may say, 'I have a vasectomy.' These therapies tend to bind to the semen. So, males must still use a latex or synthetic condom during any sexual contact with a female of reproductive potential, even if they did have a vasectomy." TS 18:31 "The capsule itself cannot be chewed, crushed, or opened. I bring that up because as healthcare professionals, we have educated our patients. If it's difficult to swallow capsules or tablets, we've always said to them, 'Oh, don't worry, just crush it into applesauce or open it up and sprinkle it on your mashed potatoes.' But because of this embryofetal toxicity, I advise my patients not to open the capsule. If they can't swallow it for any reason, they have a sore throat or they're just unable to, then [we tell them] to hold the therapy and then call us." TS 22:49 "We spoke about three generations already, but there's actually a fourth generation [of immunomodulators]. They're called cereblon E3 ligase modulators(CELMoDs). They're still in clinical trials but really showing promise in the therapy of myeloma. They're showing very good affinity to cereblons, just like the immunomodulators do. I think, in all cancer therapies, as newer generations come out or newer therapies move forward, some of the older generations might move aside, but they get integrated later on. So I don't think [immunomodulators] will disappear totally, but they will probably be modified." TS 36:39
Transcribe →Episode 418: Radiation Site-Specific Side Effects: Colorectal Cancer
4w ago00:28:36Tap to summarize"Radiation therapy is often extremely well tolerated in colorectal cancer. Technology has really changed things. But location of the tumor can affect side effects, such as radiation dermatitis. If a patient has a low-lying tumor, if it's less than six centimeters from the anal verge, the patient is likely to have some skin reaction. It's good to be proactive if that's the case," ONS member Lorraine Drapek, DNP, FNP-BC, AOCNP®, nurse practitioner in the Department of Radiation Oncology at Massachusetts General Hospital in Boston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation side effects in colorectal cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by June 5, 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 side effects of radiation to treat colorectal cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 374: Colorectal Cancer Treatment Considerations for Nurses Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 194: Sex Is a Component of Patient-Centered Care ONS Voice articles: Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer High-Fiber Diet Reduces Diarrhea in Colorectal Cancer Survivors Hyperbaric Oxygen Therapy Shows Promise for Certain Radiation Side Effects Increasing Incidence of Colorectal Cancer in Younger Adults Is a Call to Action for Oncology Nurses Oncology Drug Reference Sheet: 5-Fluorouracil Oncology Drug Reference Sheet: Oxaliplatin Oncology Nurses Are Key in Sexual Health Conversations With Minority Women Sexual Considerations for Patients With Cancer The Intersection of Pelvic Health and Oncology Optimizes Sexual Symptom Management ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ ONS ROCN™ Certification Review™ Clinical Journal of Oncology Nursing articles: Sexual Dysfunction: Common Side Effect Updated Interventions for Radiation-Induced Diarrhea: Putting Evidence Into Practice With the Oncology Nursing Society Physical Activity: A Systematic Review to Inform Nurse Recommendations During Treatment for Colorectal Cancer ONS Learning Libraries: Colorectal Cancer Radiation Advanced Practitioner Society for Hematology and Oncology American Society for Radiation Oncology American Society of Clinical Oncology Clinical Practice Guidelines Colontown Colorectal Cancer Alliance To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the <a href= "https://www.ons.org/learning-libraries/o...
Transcribe →Episode 417: Pharmacology 101: Oncolytic Viral Therapy
May 2900:35:22Tap to summarize"There are a lot of specifics that nurses need to keep in mind as they are administering this herpes simplex modified virus to patients because accidental exposure is of concern both to the patient, to their family members, as well as to healthcare workers. I always recommend nurses wear personal protective equipment, such as a gown, safety glasses, gloves, and/or a face shield," Heidi Finnes, PharmD, RPh, BCOP, director of clinical ambulatory practice at Mayo Clinic and assistant professor of pharmacy at Mayo Clinic Alix School of Medicine in Rochester, MN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about oncolytic viral therapy. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 29, 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 about the use of oncolytic viruses to treat cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse's Role Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs Episode 273: Updates in Chemotherapy and Immunotherapy ONS Voice articles: Cutaneous Malignancies Have High Response to Oncolytic Virus Plus Immunotherapy Oncolytic Virus Kills Tumor Cells While Supporting T Cells What Nurses Need to Know About Talimogene Laherparepvec for Advanced Melanoma Clinical Journal of Oncology Nursing articles: Intralesional Therapy: Consensus Statements for Best Practices in Administration From the Melanoma Nursing Initiative Safe and Effective Standards of Care: Supporting the Administration of T-VEC for Patients With Advanced Melanoma in the Outpatient Oncology Setting Oncology Nursing Forum article: Administration and Handling of Talimogene Laherparepvec: An Intralesional Oncolytic Immunotherapy for Melanoma ONS book: Guide to Cancer Immunotherapy (second edition) ONS clinical practice resource: Safe Handling of Oncolytic Viruses ONS Huddle Card: Immunotherapy Association of Community Cancer Centers (ACCC) Drugs@FDA Hematology/Oncology Pharmacy Association (HOPA) Network for Collaborative Oncology Development and Advancement (NCODA) Patient Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "[Oncolytic viruses] can have direct lysis to the tumor cells themselves, or they can cause immunogenic activation. They release tumor-associated antigens and then proinflammatory signals, so think of T cells, natural killer cells, those sorts of things, that can convert to immunologically cold tumors. Those are tumors that are immune silenced into hot tumors which are now immune activated. By doing that, they recruit those T cells and other cells to the area to attack both the primary tumors. But that's also thought to be how they work on distant or noninjected sites as well. This immunomodulatory capacity has led to the reclassification of oncolytic viruses as a form of cancer immunotherapy. So, think of it kind of similarly to how we think of immune checkpoint inhibitors in recruiting immune cells and leaving our immune system in the on position. This is also kind of a form of immunotherapy." TS 4:35 "One of the toxicities I know that is of significant concern to patients, family members, and healthcare workers is the incidence of herpes infections. Systemic herpetic infections are extremely rare and usually more common in patients who may be immunocompromised. In patients who also have other immune-related diseases—such as vitiligo, vasculitis, pneumonitis, sometimes worsening psoriasis—because you're mounting an immune response with these types of things, sometimes you can see a worsening of those types of immune symptoms. But for the most part, these types of side effects are very well tolerated in most patients." TS 9:07 "Talimogene is generally transmitted via bodily fluids or touch. It's not airborne. Herpes simplex virus isn't an airborne type of virus. Another thing to consider is where are you going to inject this? Are you going to do this in your infusion therapy unit? Are you going to do it in a dedicated room? Who's going to escort the patient to the room? How is the virus going to arrive at the room? How will you clean the room and all of the laboratory equipment or any of the exam tables that may be in there? I think having all of that discussed and assigned mitigates the consternation that can sometimes occur—the fear that occurs with administering a virus that is thought to be fairly communicable." TS 15:44 "Helping patients understand how this works [is important] because hearing that you're receiving a virus, particularly a herpes simplex virus, can be scary to a patient. I think understanding that it's modified or essentially we're taking the parts out of it so that we can directly inject a portion that recruits immune cells to that area, because the goal is for the oncolytic virus to attack cancer cells and then destroy them by triggering an immune response in the body." TS 20:51 "Sometimes patients are very concerned about urine in the toilet, bodily fluids, kissing loved ones, holding hands, hugging, you know, am I going to infect my loved one because I'm getting this type of an oncolytic virus therapy? I like to reassure patients that they can continue to hold hands and hug their loved ones as normal. Viral DNA is usually only present on the injection site. And as I mentioned previously, we want to cover that injection site with an occlusive dressing, at least with talimogene, for up to seven days. And particularly, if those injection sites are at all oozing or weeping, active virus is usually only on that injection site itself." TS 24:14
Transcribe →Episode 416: Cancer Treatments for Noncancer Indications: Radiation
May 2200:21:38Tap to summarize"When you have benign conditions, we're actually treating 3 gray, so a significant difference [versus doses of 60 gray for brain cancer]. Typically, when you treat at a high dose, the goal is to destroy tissue, like cancer tissue or cancer cells. But when we give a low dose, the goal is actually to modulate inflammation. And what it does is it slows down those inflammatory cells or those cells that release the chemicals that cause pain and inflammation," Amanda Meyer, DNP, APRN, CNP, family nurse practitioner in the Department of Radiation Oncology at the Mayo Clinic in Rochester, MN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation therapy for noncancer indications. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 22, 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 about the use of radiation to treat noncancerous conditions. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 365: Radiation-Associated Secondary Cancers Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices ONS Voice articles: Augmented Reality Simulations Reduce Patient Anxiety by Teaching Them About Radiation Therapy Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education Quick Quiz: Test Your Knowledge of Radiation Care Coordination ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS Radiation Oncology Conference Recordings Bundle™ ONS ROCN™ Certification Review™ Radiation Oncology 101: 2024 ONS Bridge™ Session ONS/ONCC® Radiation Therapy Certificate™ Clinical Journal of Oncology Nursing articles: Findings From the 2023 Radiation Oncology Nursing Role Delineation Study to Shape the Future of the Subspecialty The Role of Advanced Practice Providers in Radiation Oncology in 2025 ONS Huddle Cards: Radiation Radiobiology German Society for Radiation Oncology (DEGRO): Guidelines in Radiotherapy: Radiotherapy for Benign Diseases To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "We always typically think of it as cancer treatment, but we can use radiation for noncancerous conditions, as well. And radiation was actually used for benign diseases right after the discovery of x-rays. By the 1920s it was used a lot for different types of musculoskeletal, dermatologic issues, and different types of inflammatory conditions. And over time, since the 1920s, we've actually really gotten a really good understanding of it." TS 1:37 "When we're looking at what are good candidate characteristics, we do typically like older patients, so patients over the age of 65. And the rationale behind that is we know that there is a potential for a secondary risk of a skin cancer about 20 to 30 years after getting low-dose radiation, like a basal cell or squamous cell skin cancer. The older the patient is, the less likely they are to have any adverse effects from that." TS 8:22 "When we do the low-dose radiation, they've tried other measures that haven't been successful. However, we don't want a patient who is so severe that they're ready for surgery, when they're bone on bone, because we know that radiation isn't as effective when they are that severe. So there's this sweet window where low-dose radiation works best in these patients." TS 9:39 "When we're treating with a little bit higher dose for like a Dupuytren's or a Ledderhose, because it's an anti-proliferative dose, those patients, they do get more skin redness, more dry skin. That's very temporary, and it resolves within a week o...
Transcribe →Episode 415: Myelodysplastic Syndrome Treatment Considerations for Oncology Nurses
May 1500:30:53Tap to summarize"We want to make sure that we discuss the details of the treatment and what treatments there are, whether it's an oral drug, whether it's a subcutaneous injection or an IV injection, [the patient's] potential for responding, whether this treatment is curative or supportive, and what the number of visits are. All of those different pieces of information that go into the decision-making process are really important," ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about myelodysplastic syndrome (MDS) treatment considerations. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 15, 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 about the treatment considerations for MDS. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses Episode 256: Cancer Symptom Management Basics: Hematologic Complications ONS Voice articles: FDA Approves Luspatercept-Aamt for Anemia in Adults With MDS Infection Prevention for Oncology Nurses Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Whole-Genome Sequencing May Guide Treatment Choices for AML and MDS Clinical Journal of Oncology Nursing articles: Reducing Effects of Hospital-Associated Deconditioning in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation Resilience in Older Adults Diagnosed With Cancer and Receiving Chemotherapy Targeted Drug Therapies: Beyond Blood Counts and Chemistries Oncology Nursing Forum article: Frailty in Patients With Hematologic Malignancies and Those Undergoing Transplantation: A Scoping Review ONS books: BMTCN™ Certification Review Manual (second edition) Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition) ONS course: Hematopoietic Stem Cell Transplantation™ ONS Learning Library: Hematology, Cellular Therapy, and Stem Cell Transplantation ONS Symptom Intervention resources: Prevention of Infection: General Prevention of Infection: Transplant Aplastic Anemia and MDS International Foundation: MDS Drugs and Treatments Blood Cancer United: MDS Treatment HealthTree Foundation Myelodysplastic Syndromes Foundation To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The goals that I try to consolidate to make sure they're consistent with the patient's goals are to improve their counts, especially the anemia or cytopenias. If they're getting blood transfusions, we want to reduce the number of transfusions that they receive because we know that's linked to reduced overall survival, and it really impacts quality of life. ... And then for high-risk patients, it's a more serious discussion because we know that they are the ones who can progress to acute myeloid leukemia (AML). And we're trying to delay progression to AML. That means we're trying to improve their survival and we're also trying to manage their cytopenias and decrease their infection risk." TS 2:28 "If we look at approvals for low-risk disease and high-risk disease, those were really made based on the Revised International Prognostic Scoring System (IPSS-R) and sometimes the International Prognostic Scoring System (IPSS). Under those classification systems, when we think of lower-risk MDS, we think of patients who are primarily anemic but don't have increased blasts in their bone marrow. ... For higher-risk MDS, we want to have that discussion with those patients because their life expectancy is much shorter than patients with lower-risk MDS. We want to see if hematopoietic stem cell transplant would be something that they would be interested in if they don't have a lot of comorbidities and are relatively healthy." TS 11:41 "There are a lot of things to consider—[patients'] blood counts, comorbidities, whether they're frail, and what their goals are. There are some patients where there's no way they would want to go through transplant. And some patients want to be cured, so it just depends on your patient." TS 14:22 "I think of hematopoietic allogeneic transplants as a treatment for more of the patients with higher-risk MDS. ... With the Molecular International Prognostic Scoring System (IPSS-M), a patient can have pretty good blood counts and not have increased blasts in the bone marrow. You could send them for a transplant referral upfront without having to give them additional treatment. ... There is a recent publication that said if a patient doesn't have more than 10% blast, you could refer to transplant as a first option. ... Also, if you had a lower-risk patient who is relatively young and doesn't have any other treatment options, this would also be a patient that you could refer to transplant to see if we could care for them, and then they wouldn't have to be getting transfused all the time." TS 21:12 "I think that we often think low-risk, no treatment needed, but it depends on the person. They often need ongoing supportive care to manage their symptoms even if they're not getting treatment. And just because we're not treating them, active observation, bringing them in to see how they're doing, if they've had infections, if their blood counts are changing, that is paying attention to them and doing something. Just because they're low-risk doesn't mean they don't need anything and we can just schedule for a one-year follow-up." TS 26:30
Transcribe →Episode 414: Radiation Site-Specific Side Effects: Lung Cancer
May 800:14:28Tap to summarize"Skin reactions, such as redness, dryness, and just irritation of the skin, can occur. Since we're irradiating the lung, we can also cause a cough, and that's due to the inflammation from the radiation. Patients can also get esophagitis if the tumor that we're treating is close to the midline of the chest near the esophagus. And probably the most common side effect that we see is fatigue," ONS member Amy MacRostie, RN, OCN®, radiation oncology nurse at St. Charles Cancer Center in Bend, OR, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation side effects in lung cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 8, 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 side effects of radiation to treat lung cancer. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 369: Lung Cancer Survivorship Considerations for Nurses Episode 363: Lung Cancer Treatment Considerations for Nurses Episode 359: Lung Cancer Screening, Early Detection, and Disparities Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion ONS Voice article: Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ ONS ROCN™ Certification Review™ ONS Radiation Learning Library ONS Guidelines™ and Symptom Intervention Resources National Comprehensive Cancer Network LUNGevity Foundation Inspire Lung Cancer Survivors Community To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The types of radiation that can be used are external beam radiation and stereotactic body radiation treatment, or SBRT. External beam radiation is often used in combination with other treatment modalities, like chemotherapy, immunotherapy, and targeted therapy, to treat these cancers. And SBRT is usually done solo, and it's a highly precise treatment for inoperable or early-stage lung cancers." TS 1:52 "[Physicians and] providers can also help prevent side effects by reducing the dose to the heart and reducing the dose to the good lung tissue, if you will, as much as they possibly can. And this is done using intensity-modulated techniques, or IMRT. And that's where the linear accelerator sculpts the radiation beams conforming to the shape of the tumor itself." TS 6:37 "I think overall cancer treatment can lead to decreased libido and decreased sexual interest. Depression and fear can definitely play a role in this. And with lung radiation, specifically, fatigue and possibly shortness of breath with the exertion may decrease sexual interest. Nurses and providers should support the patient in their desire or lack thereof in sexual activities. We should have open discussions … and these can take place with patients about intimacy and how that can be approached in a different way that can accommodate for the side effects that the patients might be experiencing." TS 8:57 "Post-radiation scans will be abnormal. Post-radiation imaging can be misread as a progression of disease or residual disease. And I tell patients, 'Don't panic. Talk to your radiation oncologist so they can read the imaging themselves and interpret the results.' Oftentimes what's read as progression is radiation treatment sequela of scarring or fibrosis." TS 11:25
Transcribe →Episode 413: Intrarenal Administration for Upper Urothelial Tract Disease: The Oncology Nurse's Role
May 100:41:32Tap to summarize"We thought, from a nursing standpoint, 'What is our goal for doing this?' What we wanted was first, education of the patient. Can we successfully educate the patient to prepare them? Can we alleviate as much anxiety as possible so that they feel comfortable coming in and having this done? The second goal is to preserve kidney function throughout the treatment. To date, we've been successful with that. And the third goal is to complete treatment without infection," ONS member Chris Amoroso, BSN, RN, OCN®, registered nurse at Fox Chase Cancer Center in Philadelphia, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about intrarenal administration for upper urothelial tract disease. Music Credit: "Fireflies and Stardust" 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 May 1, 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: Nurses caring for people with cancer require knowledge of the different routes for drug administration, including intrarenal administration via a percutaneous nephrostomy. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 141: Care Coordination for Urothelial Cancer Episode 133: Treatment Advancements for Advanced or Metastatic Urothelial Cancer ONS Voice articles: A Primer on Urothelial Cancer Chemo Combo May Be a Bladder Cancer Treatment Alternative During BCG Shortage Nurses Are Key to Patients Navigating Genitourinary Cancers Clinical Journal of Oncology Nursing articles: Avelumab First-Line Maintenance Therapy: Managing Patients With Advanced Urothelial Carcinoma Percutaneous Nephrostomy Infusion: Nursing Considerations for Treatment of Upper Urinary Tract Urothelial Carcinoma ONS Learning Libraries: Cancer of the Genitourinary Tract Safe Handling of Hazardous Drugs To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "In an office setting, it's not something we can really visualize. Patients will present with hematuria or flank pain, obstructions in the ureter, some hydronephrosis, they may be having a lot of urinary tract infections. And a routine cystoscopy in the office is not going to visualize the ureters. We can do biopsies like a ureteroscopy, a computerized tomography urogram, or a urine cytology. And those are usually the main ways of diagnosing upper tract disease—again, because it's rare." TS 2:33 "We ask patients to get into a comfortable position where they can sit or lay for an hour without too much movement. The movement of their body position can interfere with the flow of the medication going in. ... When we're ready to start, we're cleaning the ends of the nephrostomy tube and the IV tubing with a chlorhexidine solution. We're instilling this using micro drip tubing. The tubing has to be microchipped so we can accurately control the flow. The IV bag with medication is hung about 10 inches above kidney level. And the reason we do that is because we do not want to increase the intrarenal pressure. ... We want a slow infusion via gravity over about an hour. We're watching throughout the procedure to make sure that there's no leakage, no discomfort, really just watching the patient and having that communication with the patient. Are they feeling anything different? Do we notice a difference in the flow rate? Is it slowing down? And if so, why is it? Did the patient change position? If we have any [instance] where the patient says, 'I can feel something there,' or we see leakage, we stop that infusion immediately, emphasizing that it has to be gravity, never on a pump." TS 7:30 "We go over all the bacillus Calmette-Guérin (BCG) precautions because this is the drug that we're giving. As if we were doing traditional intravesical therapy such as placing a catheter up into the bladder, we're still giving patients BCG. So, we need them to follow the special precautions. We ask every patient, regardless of the drug we're giving them, to sit down to urinate, pour two cups of bleach in the toilet, let it sit for about 15 minutes, then close the lid and flush twice. Even though we're giving this for upper tract disease, it's still being excreted into the urine. So, precautions need to be followed. Sitting down to urinate to avoid splashing of the drug, putting the two cups of bleach in every time they urinate for a duration of six hours, closing the lid, and then flushing that toilet twice. The same precautions, whether it's traditional intravesical or intrarenal." TS 14:20 "The induction phase is the first six installations. So, the first time we give this drug, we're doing it once a week for six weeks. And during those six weeks, we're communicating with the patient. We'll do a follow-up phone call and ask, 'How are you feeling? Any issues?' And we do get to know our patients really well. ... If they call, we're going to send them for a urine culture and make sure there's nothing there. ... After those six weeks, we make sure the patient understands that this is not one course and done. We want to continue to do this to give them the best chance at preventing recurrence. After we've done those six, we'll wait about four to six weeks, and then we'll do a cystoscopy and ureteroscopy in the operating room to make sure we have the response we're looking for. Again, letting the patients know because sometimes they don't understand that this is going to continue—it's not six treatments and done." TS 23:08 "You can't think of this as the same as bladder cancer. This is in the upper tract. We can't approach it as if it was non-muscular invasive bladder cancer. The diagnosis is different. It's harder to diagnose. Again, we're not visualizing the ureters in a routine office cystoscopy. ... You can't resect it out. When I was talking to our surgeon, he said, 'You can't resect the urothelial disease in the ureters like you would in a bladder tumor.' You can't go and just pick it apart. It's a little bit more complex than that. You can't go in and resect out lesions in the ureter itself." TS 36:20
Transcribe →Episode 412: Pharmacology 101: Cytokines
Apr 2400:35:18Tap to summarize"They are small, powerful little nuggets. They are actually small signaling proteins that our immune cells use to communicate. They really help regulate immune activation or inflammation and even the growth and survival of immune cells. When cytokines are used therapeutically in oncology, they help to stimulate immune cells such as T cells or natural killer cells to better recognize and attack cancer cells," Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center of Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the cytokine drug class. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours (including 30 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 April 24, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Nurses caring for people with cancer require knowledge of cytokines to provide appropriate education and to safely administer related therapies. Episode Notes Complete this evaluation for free NCPD. ONS Podcast™ episodes: Pharmacology 101 series Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis ONS Voice articles: FDA Approves Nogapendekin Alfa Inbakicept-Pmln for BCG-Unresponsive Non–Muscle Invasive Bladder Cancer Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Oncology Drug Reference Sheet: Motixafortide ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) and 2024 Drug Supplement Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Guide to Cancer Immunotherapy (second edition) Clinical Journal of Oncology Nursing article: Tumor-Infiltrating Lymphocyte Therapy for Melanoma: Nursing Considerations What's Old Is New Again, Unfortunately ONS Symptom Interventions Colony-Stimulating Factors Including Biosimilars for At-Risk Patients for Prevention of Infection: General Platelet Growth Factors for Prevention of Bleeding National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Cytokines are actually among some of the earliest forms of immunotherapy used in the treatment of cancer, and it really goes back to the 1980s and the 1990s. We're talking therapies like interferon [alpha] or interleukin-2 that were used to stimulate the immune system, with the idea that they would recognize and attack cancer cells, particularly in diseases like metastatic melanoma and renal cell carcinoma. What made these therapies unique was that although the overall response rates were relatively modest, when patients did respond, those responses could be very durable and sometimes long lasting. And that observation was really important for the field of oncology, because it was part of the process that demonstrated that the immune system could potentially control cancer in really meaningful ways." TS 1:49 "One nice new example of an engineered cytokine is nogapendekin alfa inbakicept, which is quite the tongue twister to say. … This agent is really interesting because it's an engineered interleukin-15 receptor agonist that works on stimulating natural killer cells and CD8-positive T cells. And what makes this so interesting is that it's used in combination with a medication that probably some of us are familiar with—good old BCG—for patients specifically with invasive bladder cancer. The other really interesting thing about this new therapy is the fact that it is one of our first ones to be engineered in a combination fashion. So the nogapendekin alfa is combined with a receptor component that is called inbakicept. And what happens is it forms a complex to enhance signaling and prolong the activity of the cytokine." TS 7:50 <p class="MsoNormal" style="margin: 6.0pt 0i...
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