"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: "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 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

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
• Episode 201: Which Survivorship Care Model Is Right for Your Patient?
• Episode 12: The Intersection of Radiation and Medical Oncology Nursing
• ONS Voice articles:
• Even Low-Dose CT Radiation Increases Risk for Hematologic Cancers in Young Patients
• Nurse-Led Survivorship Programs: Expert Advice to Help You Build Your Institution's Resources
• Secondary Cancers in Pediatric Survivors: Increased Risk and Unique Barriers to Care
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
• ONS courses:
• ONS/ONCC® Radiation Therapy Certificate™
• Essentials in Survivorship Care for the Advanced Practice Provider
• Clinical Journal of Oncology Nursing articles: Adolescent and Young Adult Cancer Survivors: Development of an Interprofessional Survivorship Clinic
• ONS Radiation Learning Library
• ONS Survivorship Learning Library
• American Cancer Society survivorship resources
• National Coalition for Cancer Survivorship
• National Comprehensive Cancer Network survivorship guidelines

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 [email protected].

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