“As ONS continues to look ahead, its commitment to shaping the future of oncology nursing remains unwavering. ONS is proactively developing the tools, capabilities, and strategies needed to support oncology nurses in a rapidly evolving healthcare landscape. ONS will continue to set the standard, ensuring that oncology nurses are equipped with clinical expertise, collaborative skills, technology proficiency, and mentorship necessary to thrive,” Diane Barber, PhD, APRN, ANP-BC, AOCNP®, FAANP, FAAN, member of the ONS 50th anniversary committee, said regarding the continuously changing roles of oncology nurses. Barber spoke with ONS members Danelle Johnston, MSN, RN, HON-ONN-CG, OCN®, RuthAnn Gordon, MSN, RN, FNP-BC, OCN®, Tamika Turner, DNP, NP-C, AOCNP®, and Bertie Fields, MS, RN, about their experience in nursing roles in navigation, clinical trials, advanced practice, and the pharmaceutical industry and how these roles have evolved and may change in the future.

The advertising messages in this episode are paid for by Natera. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• This episode is not eligible for NCPD.
• ONS Podcast™ episodes:
• ONS 50th anniversary series
• Episode 331: DNP and PhD Collaboration Strategies to Help Advance Oncology Care
• Episode 312: Virtual Nursing in Health Care
• Episode 304: Nursing Roles in FDA: The Drug Labeling and Package Insert Process
• Episode 302: Patient Navigation Eliminates Disparities in Cancer Care
• Episode 284: How AI Is Influencing Cancer Care and Oncology Nursing
• Episode 119: What Will the Future of Cancer Care Look Like in 2029?
• ONS Voice articles:
• Leadership Is the Foundational Competency for Oncology Nursing in 2029
• New Technology Tools Help Oncology APRNs Improve Patient Outcomes
• Oncology Nurses Drive Discovery in Cancer Clinical Research
• The Oncology Nurse’s Role in Interprofessional Collaboration in Clinical Research
• What the New CMS Reimbursement for Principal Illness Navigation Means for Oncology Nurses
• ONS books:
• Manual for Clinical Trials Nursing (third edition)
• Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (third edition)
• ONS competencies:
• Oncology Clinical Nurse Specialist Competencies
• Oncology Clinical Research Nurse Competencies
• Oncology Nurse Generalist Competencies
• Oncology Nurse Navigator Competencies
• Oncology Nurse Practitioner Competencies
• ONS course: Professional Practice for the Advanced Practice Registered Nurse
• Clinical Journal of Oncology Nursing articles:
• How Do I Evolve as a Research Nurse Practitioner?
• Incorporating Nurse Navigation to Improve Cancer Survivorship Care Plan Delivery
• Oncology Nurse Practitioner Competencies: Defining Best Practices in the Oncology Setting
• ONS Learning Libraries:
• Clinical Trials
• Nurse Navigation
• Connie Henke Yarbro Oncology Nursing History Center
• American Cancer Society National Navigation Roundtable

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

Johnston: “In the early years, navigation programs varied widely. We had minimal technology, no standardized training, and often tracked our work on spreadsheets and narrative notes. The broader healthcare team didn’t always understand navigation, so educating colleagues in defining our role was essential. Today, navigation is becoming a well-established specialty. It’s recognized by the Commission on Cancer, supported by [Centers for Medicare and Medicaid Services] reimbursement codes, and integrated across diverse care settings. It’s backed by evidence, standardized training, and emerging technologies that improve both patient care and program sustainability. I’m proud to have witnessed and contributed to the incredible evolution, and I’m excited for what’s next in advancing navigation to better support patients and families.” TS 6:20

Gordon: “When I was first introduced to the [clinical trial nurse] role, there weren’t published competencies in order to learn the role or any real standardization of the role. And so when you worked in clinical trials, you kind of picked up things from the providers, from the other investigators on how you should operationalize the role. We’ve seen that evolve. We’ve seen ONS develop competencies, ONS come out with the clinical trial nursing manual. And our organization has been able to use those tools to standardize the practice of the clinical trial nurse across our institution. So we take those competencies, and they are the foundation of our program. And we’ve been able to build our program over the last decade, mostly by the use of the tools that ONS has and the ability to share knowledge.” TS 14:22

Fields: “For nurses, many of my colleagues are going on to get master’s in things other than nursing. They’re getting master’s in public health. They’re getting master’s in business. I have a colleague who is in [information technology], and so we should not limit ourselves. We should expand ourselves. And the more varied degrees that we have, we are more viable candidates for positions. I was never a clinical nurse specialist, even though that was my goal, but I have done above and beyond what I ever anticipated that I would do. And there are so many more new degrees for us to make us viable in this changing environment.” TS 28:30

Turner: “It is vital that the current generation of oncology nurse practitioners take the lead to mentor the next generation. The next generation needs to be educated regarding the importance of oncology nurse practitioners, filling those critical gaps in health care by caring for patients in rural areas and those areas where healthcare resources are scarce. Technology should be utilized to bring oncology care—for example, office visits, imaging, and treatments—closer to those areas where patients live further away or have difficulty accessing transportation and health care. This will provide continuity of care.” TS 32:42

“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 in 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: “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 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 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Episode 374: Colorectal Cancer Treatment Considerations for Nurses
• Episode 370: Colorectal Cancer Screening, Early Detection, and Disparities
• Episode 201: Which Survivorship Care Model Is Right for Your Patient?
• Episode 153: Metastatic Colorectal Cancer Has More Treatment Options Than Ever Before
• ONS Voice articles:
• Genetic Disorder Reference Sheet: Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)
• Here Are the Current Nutrition and Physical Activity Recommendations for Cancer Survivors
• ONS course: Essentials in Survivorship Care for the Advanced Practice Provider
• Clinical Journal of Oncology Nursing article: Closing the Gaps: Addressing the Unmet Needs of Cancer Survivors
• Oncology Nursing Forum articles:
• Symptom Occurrence, Frequency, and Severity During Acute Colorectal Cancer Survivorship
• The Relationship Between Colorectal Cancer Survivors’ Positive Psychology, Symptom Characteristics, and Prior Trauma During Acute Cancer Survivorship
• ONS Survivorship Care Plan Huddle Card
• ONS Learning Libraries:
• Colorectal cancer
• Survivorship
• Academy of Oncology Nurse and Patient Navigators
• American Cancer Society National Colorectal Cancer Roundtable
• Colorectal Cancer Alliance
• Colorectal Cancer Resource and Action Network
• Fight Colorectal Cancer
• Resource Library
• Livestrong at the YMCA
• Pan Ohio Hope Ride

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

“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

“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: “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 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  

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Pharmacology 101 series
  • Episode 322: Nursing Strategies to Reduce Readmission Rates for Patients With Cancer
  • Episode 215: Navigate Updates in Oral Adherence to Cancer Therapies
• ONS Voice articles:
  • Adherence to Oral Anticancer Medication
  • Combination Therapy Shows Promise for Chronic Myeloid Leukemia
  • The Case of the Medication Modification
  • The Case of the Safety Session
• ONS course: Safe Handling Basics
• Clinical Journal of Oncology Nursing articles:
  • Targeted Drug Therapies: Beyond Blood Counts and Chemistries
• Oncology Nursing Forum articles:
  • Adherence and Coping Strategies in Outpatients With Chronic Myeloid Leukemia Receiving Oral Tyrosine Kinase Inhibitors
  • Fear of Progression in Outpatients With Chronic Myeloid Leukemia on Oral Tyrosine Kinase Inhibitors
• Other ONS resources:
  • Biomarker Database
  • Financial Toxicity Huddle Card
  • Tyrosine Kinase Inhibitors Huddle Card
  • Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation
  • Oral Anticancer Medication Learning Library
• National Comprehensive Cancer Network
• National Comprehensive Cancer Network patient resources

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 

“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

“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: “Fireflies and Stardust” 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 Notes

• This episode is not eligible for NCPD.
• ONS Podcast™ episodes:
  • Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer
  • Episode 354: Breast Cancer Survivorship Considerations for Nurses
  • Episode 350: Breast Cancer Treatment Considerations for Nurses
  • Episode 345: Breast Cancer Screening, Detection, and Disparities
  • Episode 307: AYAs With Cancer: Financial Toxicity
  • Episode 300: AYAs With Cancer: End-of-Life Care Planning
• ONS Voice articles:
  • ‘Cancer Ghosting’ May Add Another Layer of Emotional Burden for Patients
  • Discoveries in Race-Related Breast Cancer Biomarkers May Improve Precision Treatments
  • What Is HER-2-Low Breast Cancer?
  • What Oncology Nurses Need to Know About Supporting AYAs With Cancer
• ONS books: Guide to Breast Cancer for Oncology Nurses
• Oncology Nursing Forum articles:
  • An Integrative Review of the Role of Nurses in Fertility Preservation for Adolescents and Young Adults With Cancer
  • Impact of Race and Area Deprivation on Triple-Negative Metastatic Breast Cancer Outcomes
  • Relations of Mindfulness and Illness Acceptance With Psychosocial Functioning in Patients With Metastatic Breast Cancer and Caregivers
• ONS huddle cards:
  • Altered Body Image
  • Fertility Preservation
  • Sexuality
• Other ONS resources:
  • Breast Cancer Learning Library
  • Fertility Preservation in Individuals With Cancer
  • ONS Biomarker Database
• American Cancer Society’s breast cancer resources
• American Society of Clinical Oncology continuing education resources
• Elephants and Tea
• Life, Interrupted
• Livestrong
• National Cancer Institute’s breast cancer resources
• Stupid Cancer
• Young Survival Coalition

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

“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 

“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: “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 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  

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 347: Care Considerations for Radiopharmaceuticals and Theranostics in Patients With Cancer
  • Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
  • Episode 298: Radiation Oncology: Nursing’s Essential Roles
  • Episode 104: How Radiation Affects All Areas of Oncology Nursing
• ONS Voice articles:
  • New Radiopharmaceutical Improves Survival in Advanced Prostate Cancer
  • Radiopharmaceuticals and Theranostics Offer New Options for Oncology Nurses to Transform Cancer Care
  • Radiopharmaceuticals Pack a One-Two Punch Against Cancer
  • Safety Is Key in Use of Radiopharmaceuticals
• ONS Voice oncology drug reference sheets:
  • Lutetium Lu 177 Dotatate
  • Lutetium Lu 177 Vipivotide Tetraxetan
  • Radium 223 Dichloride
  • Sodium Iodide-131
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (Fifth Edition)
• ONS course: ONS/ONCC® Radiation Therapy Certificate™
• Clinical Journal of Oncology Nursing article: Nursing Telemedicine Educational Encounters: Improved Patient Satisfaction in Radiation Therapy Clinics
• Other ONS resources:
  • ONS Radiation Learning Library
  • ONS Radiation Safety: In the Home Huddle Card
  • ONS Radiopharmaceuticals Huddle Card
• Daily Med
• Lutathera® website for healthcare professionals
• Pluvicto® website for healthcare professionals
• Xofigo® website for healthcare professionals

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 

“[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 tasks 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  

“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: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• This episode is not eligible for NCPD. 
• ONS Podcast™ episodes:
• ONS 50th anniversary series
• Episode 315: Processing Grief as an Oncology Nurse
• Episode 292: What We Need to Do to Retain Today’s Oncology Nursing Workforce
• Episode 291: Build a Sense of Belonging for Nurses and Patients
• Episode 264: Stop the Stressors and Improve Your Mental Health as a Nurse
• Episode 246: Create a Culture of Safety: Fair and Just Culture
• Episode 160: Build Innovative Staff Education Tools and Resources
• ONS Voice articles:
• Critical Event Debriefings Can Reduce Oncology Nurses’ Risk of Compassion Fatigue and Burnout
• ONS Chapters and DNP Candidates Combine Forces to Support Oncology Nurse Well-Being
• Step Out of Reality With Virtual Breaks to Support Your Wellness at Work
• Clinical Journal of Oncology Nursing articles:
• Burnout and Well-Being: Evaluating Perceptions in Bone Marrow Transplantation Nurses Using a Mindfulness Application
• Engaging Nurse Residents Through Poetry
• Strategies to Mitigate Moral Distress in Oncology Nursing
• ONS Nurse Well-Being Learning Library
• ONS Communities
• ONS Chapters
• Connie Henke Yarbro Oncology Nursing History Center
• Oncology Nursing Foundation Resiliency Resources

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

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

“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: “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 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 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ episodes:
• Pharmacology 101 series
• Episode 303: Cancer Symptom Management Basics: Ocular Toxicities
• Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications
• Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis
• Episode 161: Administer Bevacizumab Infusions With Confidence
• ONS Voice articles:
• Manage Afatinib’s Adverse Events to Keep Patients on Treatment
• Oncology Drug Reference Sheet: Cabozantinib
• Oncology Drug Reference Sheet: Fruquintinib
• Patient Education Needs With Pazopanib Therapy for Soft Tissue Sarcoma
• ONS books:
• Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
• Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses: Safe Handling Basics
• Clinical Journal of Oncology Nursing article: Safety and Adverse Event Management of VEGFR-TKIs in Patients With Metastatic Renal Cell Carcinoma
• Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation
• ONS Oral Anticancer Medication Learning Library
• ONS Oral Anticancer Medication Toolkit
• IV Cancer Treatment Education Sheets
• Oral Chemotherapy 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 [email protected].

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

“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: “Fireflies and Stardust” 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 

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 370: Colorectal Cancer Screening, Early Detection, and Disparities
  • Episode 153: Metastatic Colorectal Cancer Has More Treatment Options Than Ever Before
• ONS Voice articles:
  • Colorectal Cancer Prevention, Screening, Treatment, and Survivorship Recommendations
  • Genetic Disorder Reference Sheet: Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)
  • How Liquid Biopsies Are Used in Cancer Treatment Selection
  • Oncology Drug Reference Sheet: 5-Fluorouracil
  • Oncology Drug Reference Sheet: Oxaliplatin
  • What Is a Liquid Biopsy?
• Clinical Journal of Oncology Nursing article: Colorectal Cancer in Young Adults: Considerations for Oncology Nurses
• Oncology Nursing Forum article: Neurotoxic Side Effects Early in the Oxaliplatin Treatment Period in Patients With Colorectal Cancer
• ONS Colorectal Cancer Learning Library
• ONS Biomarker Database (filtered by colorectal cancer)
• ONS Peripheral Neuropathy Symptom Interventions
• American Cancer Society colorectal cancer resources
• CancerCare
• Colorectal Cancer Alliance
• Colorectal Cancer Resource and Action Network
• Fight Colorectal Cancer
• 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 [email protected].

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

“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: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Episode Notes

• This episode is not eligible for NCPD.
• ONS Podcast™ episodes:
  • Episode 324: Pharmacology 101: LHRH Antagonists and Agonists
  • Episode 321: Pharmacology 101: CYP17 Inhibitors
  • Episode 180: Learn How Nurse Practitioners Use Biomarker Testing in Cancer Care
• ONS Voice articles:
  • An Oncology Nurse's Guide to Cascade Testing
  • Genetic Disorder Reference Sheet: BRCA1 and BRCA2 Hereditary Disorders
  • Genetic Disorder Reference Sheet: Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)
  • Germline and Somatic Variants: What Is the Difference?
  • Help Patients Understand Genomic Variants of Unknown Significance
  • Prostate Cancer Clinical Trials Don't Reflect Racial Diversity—And It's Getting Worse Over Time
  • Prostate Cancer Disparities Disappear With Equal Access to Care
  • Prostate Cancer Prevention, Screening, Treatment, and Survivorship Recommendations
  • The Case of the Genomics-Guided Care for Prostate Cancer
• ONS book: Understanding Genomic and Hereditary Cancer Risk: A Handbook for Oncology Nurses
• ONS course: Genomic Foundations for Precision Oncology
• Clinical Journal of Oncology Nursing articles:
  • Metastatic Prostate Cancer: An Update on Treatments and a Review of Patient Symptom Management
  • Prostate Cancer: How Nurse Practicioners Can Aid in Disease Diagnosis and Management
• Oncology Nursing Forum article: Identification of Symptom Profiles in Prostate Cancer Survivors
• Other ONS Resources:
  • Biomarker Database (refine by prostate cancer or specific biomarkers)
  • Clinical tool/case study: Biomarker Testing in Prostate Cancer: The Role of the Oncology Nurse
  • Genomics and Precision Oncology Learning Library
  • Huddle Card: Genomic Biomarkers
  • Infographic: Talking to Your Patient About a Germline Variant of Uncertain Significance (VUS)
• American Cancer Society - Genetic Testing and Counseling for Prostate Cancer Risk
• American Cancer Society - Prostate Cancer
• Clinicaltrials.gov
• National Cancer Institute - Prostate Cancer
• National Comprehensive Cancer Network
• ZERO Prostate Cancer

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

“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

“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: “Fireflies and Stardust” 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 

• Complete this evaluation for free NCPD. 
• ONS Podcast™ Pharmacology 101 series
• ONS Voice article: AI Multiple Myeloma Model Predicts Individual Risk, Outcomes, and Genomic Implications
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
  • Guide to Cancer Immunotherapy (second edition)
  • Multiple Myeloma: A Textbook for Nurses (third edition)
• 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 Guidelines™ and Symptom Interventions
  • Adherence to Oral Anticancer Medication
  • Peripheral neuropathy
• ONS Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library
• American Society of Hematology
• International Myeloma Foundation
• Leukemia and Lymphoma Society
• Multiple Myeloma Research 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 [email protected].

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