"[When] a lot of men think about prostate exams, they immediately think of the glove going on the hand of the physician, and they immediately clench. But really try to talk with them and discuss with them what some of the benefits are of understanding early detection. Even just having those conversations with their providers so that they understand what the risk and benefits are of having screening. And then educate patients on what a prostate-specific antigen (PSA) and digital rectal exam (DRE) actually are—how it happens, what it shows, and what the necessary benefits of those are," ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager of clinical education and clinical nurse specialist at Karmanos Cancer Institute in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about prostate cancer screening, early detection, and disparities.

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 October 31, 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 prostate screening, early detection, and disparities.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ Episode 149: Health Disparities and Barriers in Metastatic Castration-Sensitive Prostate Cancer
• ONS Voice articles:
  • Gender-Affirming Hormones May Lower PSA and Delay Prostate Cancer Diagnosis in Transgender Women
  • Healthy Lifestyles Reduce Prostate Cancer Mortality in Patients With Genetic Risk
  • Hispanic Patients Are at Higher Risk for Aggressive Prostate Cancer but Less Likely to Get Treatment
  • Leveling State-Level Tax Policies May Increase Equality in Cancer Screening and Mortality Rates
  • Most Cancer Screening Guidelines Don't Disclose Potential Harms
• 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 article: Barriers and Solutions to Cancer Screening in Gender Minority Populations
• Oncology Nursing Forum articles:
  • Disparities in Cancer Screening in Sexual and Gender Minority Populations: A Secondary Analysis of Behavioral Risk Factor Surveillance System Data
  • Symptom Experiences Among Individuals With Prostate Cancer and Their Partners: Influence of Sociodemographic and Cancer Characteristics
• Other ONS resources:
  • Genomics and Precision Oncology Learning Library
  • ONS Biomarker Database (refine by prostate cancer)
  • American Cancer Society prostate cancer early detection, diagnosis, and staging page
• National Institutes of Health prostate cancer screening page
• U.S. Preventive Services Task Force prostate cancer screening recommendation statement

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 recommendations are men [aged] 45 who are at high risk, including African American men and men who have a first-degree relative who has been diagnosed with prostate cancer younger than 65 should go through screening. And men aged 40 at an even higher risk, these are the men that have that one first-degree relative who has had prostate cancer before 65. Screening includes the PSA blood test and a digital exam. Those are the screening recommendations, although they are a little bit controversial." TS 3:42

"You still see PSAs and DREs as the first line because they're easier for primary care providers to perform. ... Those are typically covered by insurance, so they still play that role in screening. But with the advent of MRIs and biomarkers, these have really helped refine that screening process and determine treatment options for our patients. Again, those patients who may be at a bit of a higher risk could go for an MRI or have biomarkers completed. Or if they're on that verge with their Gleason score, instead of doing a biopsy, they may send the patient for an MRI or do biomarkers for that patient. ... These updated technologies put [patients] a little bit more at ease that someone's watching what's going on, and they don't have to have anything invasive done to see where they're at with their staging." TS 4:35

"Disparities in screening access exist based on race, socioeconomic status, gender identity, education, and geography. It's really hard in rural areas to get primary care providers or urologists who can actually see these patients, [and] sometimes in urban areas. So socioeconomic status can affect that, but also where a person lives. African American men with lower incomes and people in rural areas face the greatest barriers to receiving screening. It's also important to encourage anyone with a prostate to be screened and offer gender-neutral settings for patients to feel comfortable." TS 7:50

"I think a lot of men feel like if they have no symptoms, they don't have prostate cancer ... so a lot of patients may put off screening because they feel fine, [they] haven't had any urinary symptoms, it doesn't run in their family. ...With prostate cancer, there usually are not symptoms that a patient's having—they may have some urinary issues or some pain—but it's not very frequent that they have that. So, just making sure our patients understand that even though they're not feeling something, it doesn't mean there's not something else going on there." TS 12:53

"Prostate cancer found at an early age can be very curable, so it's really important for men to have those conversations with their providers about the risk and benefits of screening. And anyone that we can help along the way to be able to have those conversations, I think is a great thing for oncology nurses to do." TS 15:44

"This was a panel of subject matter experts of various nurses and pharmacists. We often found common ground but also discovered new ideas, different touchpoints, and key junctures along that oral anticancer medication journey. For example, the pharmacists were able to share their insights into their unique workflows within their practice setting. What resulted is a resource that truly reflects that collaborative effort between the disciplines," ONS member Mary Anderson, BSN, RN, OCN®, senior manager of nursing membership and professional development at the Network for Collaborative Oncology Development and Advancement (NCODA) in Cazenovia, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS. Weimer spoke with Anderson and Kris LeFebvre, DNP, RN, NPD-BC, AOCN®, oncology clinical specialist at ONS, about the Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation, a project created as a collaboration between ONS and NCODA.

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 contact hours.
• ONS Podcast™ episodes:
  • Episode 215: Navigate Updates in Oral Adherence to Cancer Therapies
  • Episode 16: Navigating the Challenges of Oral Chemotherapy
• ONS Voice articles:
  • As Institutions Establish Oral Agent Workflows, Savvy Educators Help Nurses Apply Them to Practice
  • Maintain Oral Adherence With ONS Guidelines™
  • The Oncology Nurse's Role in Oral Anticancer Therapies
• ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition)
• ONS courses:
  • ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
  • ONS/ONCC®Chemotherapy Immunotherapy Certificate™
• Clinical Journal of Oncology Nursing article: Implementation of an Oral Antineoplastic Therapy Program: Results From a Pilot Project
• Oncology Nursing Forum articles:
  • Domains of Structured Oral Anticancer Medication Programs: A Scoping Review
  • Interventions to Support Adherence to Oral Anticancer Medications: Systematic Review and Meta-Analysis
  • ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications
• Other ONS resources:
• ASCO/ONS Antineoplastic Therapy Administration Safety Standards
• Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation
• Oral Anticancer Medication Learning Library
• Drugs@FDA
• Hematology/Oncology Pharmacy Association Oral Chemotherapy Collaborative
• National Comprehensive Cancer Network homepage
• NCODA homepage
• Patient Education Sheets website

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

LeFebvre: "There are five different elements to the care compass itself. The first is called the OAM [oral anticancer medication] workflow analysis tool. ... This [tool] allows an OAM program to really study where their processes are. Where are the gaps in the process and where might their patients be at risk? It's something that you can use within your setting to analyze your current processes and see where you can strengthen them. The second tool is something focused on patient and caregiver education. This includes a lot of information about what should be taught, how it could be taught, the best timing and so forth, according to the literature. ... The third tool is an assessment and grading tool. It's a fun tool that approaches symptom management using the Common Terminology Criteria for Adverse Events grading tool. ... The fourth tool is a specialty pharmacy and patient assistance contact directory template. This is a spreadsheet that can be used by anyone navigating patient care with OAMs to keep track of their professional contacts. ... The final [tool] is the OAM adherence blueprint. This has a lot of important information on adherence, methods to assess adherence, and calculate adherence rate." TS 7:15

LeFebvre: "Interprofessional collaboration is so essential just in day-to-day care, and OAM care is no different in that regard. Oncology nurses work in so many different settings and their role may be very different even if they have the same title. You can have OAM navigation that is completely handled in the pharmacy. I've talked with nurses who have said, 'We don't even touch it.' But they do. Because when a patient has a combination regimen, they might have an infusion regimen that goes along with an oral therapy. Or that patient might just know that infusion room nurse so much better and they feel more comfortable [contacting them] when they have a side effect from their oral therapy. So, infusion nurses need to be aware of what the patients are on and what the potential side effects are." TS 14:14

Anderson: "The resource for OAM education that we created is literally a blueprint of many resources out there to help nurses, pharmacists, and oncology professionals educate their patients on taking OAMs. ... [The OAM Care Compass] also helps with communication channels. It helps knowing that all the documentation is occurring and when everybody is documenting within their role and according to those key touchpoints, there's less opportunity to lose track of your patients because we know what's happening." TS 16:33

Anderson: "I think the biggest misconception we see is that people think taking OAMs is easier than infusion therapies. And while it's true that OAMs do offer significant benefits such as the convenience and the ability for patients to take their medication at home, we are also placing a huge burden on our patients. They need to navigate that very complex health system to obtain their medication and understand their treatment plan and adhere to that precise regimen. Additionally, we are seeing more and more complex treatment regimens with combination therapies, which further increases the need for that early and ongoing education, monitoring, and support." TS 20:38

"It started out by doing a kind of a white paper that we called Imperatives for Quality Cancer Care. Ellen Stovall, our CEO [of the National Coalition for Cancer Survivorship] at the time, gave this report to Dr. Richard Klausner, who was the head of National Cancer Institute at the time. He called Ellen immediately and said, 'Why are we not doing something about this?' Within one year, we had the Office of Cancer Survivorship at NCI," ONS member Susan Leigh, BSN, RN, told ONS member Ruth Van Gerpen, MS, RN-BC, APRN-CNS, AOCNS®, PMGT-BC, member of the ONS 50th anniversary committee, during a conversation about her involvement in cancer survivorship advocacy. Van Gerpen also spoke with ONS members Deborah Mayer, PhD, RN, AOCN®, FAAN, and Timiya S. Nolan, PhD, APRN-CNP, ANP-BC, about the history and future of cancer survivorship.

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 201: Which Survivorship Care Model Is Right for Your Patient?
• Episode 91: The Seasons of Survivorship
• Episode 49: The Cancer Survivorship Conundrum
• ONS Voice article: Our Unified Voices Can Improve Cancer Survivorship Care
• ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (third edition)
• ONS course: Essentials in Survivorship Care for the Advanced Practice Provider
• Clinical Journal of Oncology Nursing articles:
• Incorporating Nurse Navigation to Improve Cancer Survivorship Care Plan Delivery
• Survivorship Care: More Than Checking a Box
• The Missing Piece of Survivorship: Cancer Prevention
• Oncology Nursing Forum articles:
• Patient Perceptions of Survivorship Care Plans: A Mixed-Methods Evaluation
• Survivorship Care Plans: Health Actions Taken and Satisfaction After Use
• ONS Survivorship Learning Library
• Rehabilitation of People With Cancer: Position Statement from the Association of Rehabilitation Nurses (ARN) and endorsed by the Oncology Nursing Society
• Connie Henke Yarbro Oncology Nursing History Center
• American Cancer Society
• Survivorship resources
• Cancer Survivors Network
• Cancer Nation (formerly National Coalition for Cancer Survivorship)
• Cancer Survival Toolbox
• Imperatives for Quality Cancer Care: Access, Advocacy, Action, and Accountability (white paper)
• National Cancer Survivors Day Foundation
• New England Journal of Medicine article: Seasons of Survival: Reflections of a Physician With Cancer by Fitzhugh Mullan

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

Leigh: "Another way that [National Coalition of Cancer Survivorship] got very involved with looking at how we keep this information coming and how we really share care with our outside physicians is the development of survivorship care plans. And then we also hoped that we would see more survivorship clinics by now. But between trying to get people to develop care plans and clinics, it's been like pulling teeth. It has been very difficult. And a lot of this struggle to get this going has been, first of all, there isn't enough money to do this. There isn't enough time for immediate staff to take these on, and we just don't have enough staff as it is now. And survivorship is not a moneymaker, so it's just something that has to be done kind of on the side." TS 11:54

Mayer: "When I became ONS president in the '80s—I was the fourth ONS president—we were given a cancer grant to do something with our presidency. And that was when I really wanted to bring attention to rehabilitation as a means to address cancer survivorship issues because we had a very 'treat 'em and street 'em' attitude. We gave you your treatment, and we sent you home, and you had to figure out the rest. And there wasn't a lot of knowledge or support to help you put your life back together again afterwards. And so in that process, it was an interdisciplinary group of professionals that tried to come up with what was an appropriate position statement because ONS was just starting to do position statements. And so we developed a first position statement on cancer rehabilitation to address survivorship issues in like 1987 to '89." TS 17:15

Mayer: "When I went back to school for my PhD, I did my dissertation on health behaviors of cancer survivors and realizing the huge gap in the care that they were getting for anything other than their cancer. We were still focused on their tumor and on treating their tumor. But we were missing the picture that if the cancer didn't kill them, their heart disease would, and they would develop diabetes and other things. … But as people started living longer and longer, we were missing all these other chronic illnesses that would contribute to their quality of life and overall lifespan. So my dissertation put me on a different path, and I think the second part of my career was really focusing on instead of just relieving suffering and the quality of life issues, really looking at cancer care delivery and how we could do a better job of doing the team of teams that people needed to have their issues addressed." TS 19:34

Nolan: "I ended up having my first permanent role on a hematology-oncology unit at the University of Alabama at Birmingham. And there, I literally saw patients who were fighting for their lives. And despite the severity of their illness, they wanted more than just survival. They wanted to have meaning. They wanted to have dignity. They wanted to have impact with the time that they had left, whatever it was. And so those experiences planted a seed in me. And that seed was that cancer care must extend beyond treatment and we need to embrace, really, quality of life." TS 23:31

Leigh: "I was not the researcher. I was not the major writer. I was not the identifier of a lot of the risk factors. But I spread the seed. I took all that information from different sources and shared that with all of the audiences that I spoke to. So I was called a seed spreader, kind of the Johnny Appleseed of oncology nursing at that particular time. And then once we saw academia step in and say, 'We need to get good data about what's going on here,' … then my stories and stories from survivors started decreasing and the presentations were given more from the academic standpoint." TS 34:41

Nolan: "I really believe in community, academic, government, and industry approaches to survivorship as well. We can no longer operate in silos. We really need to learn how to walk across the aisle, build bridges as we can so that we can do this work together because we know that communities bring lived wisdom and context. And academicians bring the research and the ability to create the evidence. The government brings policy and public health infrastructure, and certainly industry brings innovation and scalability. But also in this new paradigm that we find ourselves in, the industry may also bring the dollars to be able to help us to do even more work." TS 43:45

"Chemotherapy-induced alopecia does cause a lot of stress. It's associated with lower quality of life. Scalp cooling may really help improve quality of life. Some studies have shown that women in the scalp cooling group felt less upset about losing their hair and less dissatisfied with their appearance compared to the women in the control group that didn't receive any scalp cooling. So a lot of these studies are showing it does have a very positive impact on psychosocial feelings and side effects in relation to overall cancer treatment," ONS member Jaclyn Andronico, MSN, CNS, OCN®, AOCNS®, clinical nurse specialist at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about chemotherapy-induced alopecia and scalp cooling.

The advertising messages in this episode are paid for by Paxman. 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™ Episode 250: Cancer Symptom Management Basics: Dermatologic Complications
• ONS Voice articles:
• Diagnose and Manage Dermatologic Toxicity Secondary to Immunotherapy
• Follow the Evidence When Using Scalp Cooling for Cancer Alopecia
• Reimbursements Are Making Scalp Cooling More Accessible for Patients With Cancer
• The Case of the CIA-Combatting Combination
• ONS Voice oncology drug reference sheets:
• Docetaxel
• Doxorubicin Hydrochloride
• Sacituzumab Govitecan-Hziy
• ONS Guidelines™ for Cancer Treatment-Related Skin Toxicity
• Clinical Journal of Oncology Nursing articles:
• Chemotherapy-Induced Alopecia: Examining Patient Perceptions and Adherence to Home Haircare Recommendations
• Scalp Cooling: Implementing a Cold Cap Program at a Community Breast Health Center
• Scalp Cooling: Implementation of a Program at a Multisite Organization
• Oncology Nursing Forum articles:
• Effectiveness, Safety, and Tolerance of Scalp Cooling for Chemotherapy-Induced Alopecia
• The Effect of Chemotherapy-Induced Alopecia on Distress and Quality of Life in Male Patients With Cancer
• ONS Altered Body Image Huddle Card
• Journal of Market Access and Health Policy article: Expanding the Availability of Scalp Cooling to All Patients at Risk of Chemotherapy-Induced Alopecia
• HairToStay
• Paxman patient assistance program
• Rapunzel Project

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 classes that are high risk for chemotherapy-induced alopecia can include antitumor antibiotics, such as doxorubicin, epirubicin; antimicrotubule drugs, such as taxanes like docetaxel, paclitaxel; alkylating agents such as cyclophosphamide. The lower risk alopecia-causing chemo agents are the antimetabolite classes, which a lot of people know as gemcitabine or fluorouracil. We also are seeing patients experience some degree of alopecia with a drug called sacituzumab govitecan, which is an actual antibody–drug conjugate." TS 2:09

"Scalp cooling is approved for solid tumor patients. Patients receiving chemotherapy agents, as we discussed before, with that high incidence of chemotherapy-induced alopecia really should be considered for scalp cooling as long as they don't have certain contraindications. Some contraindications do exist for these populations. Those are patients that have cold agglutinin diseases, cryoglobulinemia, cryofibrinogenemia, and any cold sensitivity issues. Patients also with abnormal liver functions are not suggested to receive scalp cooling because their liver function is associated with the metabolism of the drug agent. It's also not recommended for patients with hematologic malignancies who are higher risk for cutaneous metastatic disease or failed chemotherapy and even reduced survival rates." TS 9:23

"Overall, scalp cooling has a good tolerance, but it's important to be aware that scalp cooling can be uncomfortable for some, and it isn't always tolerated by some patients. Patients have reported side effects such as headaches, dizziness, chills, cold sensations, scalp pain, head discomfort, and even claustrophobia. Among these, the most common is the cold feeling and headaches. So when caring for patients that undergo scalp cooling, the nurses really should recognize the patient's feelings and help relieve that discomfort with position changes, prophylactic painkillers such as [acetaminophen] or [ibuprofen] if they're allowed to take that, additional warm blankets. Even antianxiety medications can really help, especially if that claustrophobia feeling is there. So collaborating with that team, the doctors, the nurse practitioners, just to be aware that if the patient's not comfortable during this treatment of scalp cooling, they should have those things on board prior to starting." TS 12:23

"A lot of primary education points for nurses to review with patients is explaining the financial reimbursement process and assistance options—collaborating with that financial department within your institution. Also discussing the efficacy of the scalp cooling and the tolerability of it as well. I don't know if patients are always aware of the feeling of the cold—really warning them, letting them know what they're going to experience while in the chair attached to that cooling machine." TS 18:55

"Nurses, we're at the forefront of scalp cooling, and we manage a lot of this area that comes with the service. They are managing, the coordination of the care, the education. They're assisting with that financial discussion and collaborating with the financial department. The symptom management—they're helping make the patients feel more comfortable with the symptoms of scalp cooling. They are the real deal here, so they are the best in helping with the situation. Nurses should be really familiar with the efficacy, again, and the tolerability, the contraindications, the side effects, and the costs and even the access for scalp cooling." TS 20:57

"I think that this is an area that is exploding. Working with drug development, I see new agents all the time, with unique targets I've never heard about, with targets I have heard about used in a different way. So, I really think we're going to see more and more bispecifics. A lot of these drugs are used second line, third line, fourth line. I would not be surprised if they moved up in treatment, especially as we learn safer ways to give these drugs," ONS member Moe Schwartz, PharmD, BCOP, FHOP, professor of pharmacy practice at the James L. Winkle College of Pharmacy at the University of Cincinnati, OH, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about bispecific antibodies.

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 October 3, 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 bispecific antibodies in the treatment of cancer.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Pharmacology 101 series
  • Episode 275: Bispecific Monoclonal Antibodies in Hematologic Cancers and Solid Tumors
  • Episode 261: CAR T-Cell Therapy for Hematologic Malignancies Requires Education and Navigation
  • Episode 176: Oncologic Emergencies: Cytokine Release Syndrome
• ONS Voice articles:
  • An Oncology Nurse's Guide to Bispecific Antibodies
  • Bispecific Antibodies
  • Cross-Discipline Cancer Care
• ONS Voice oncology drug reference sheets:
  • Amivantamab-Vmjw
  • Blinatumomab
  • Epcoritamab-Bysp
  • Glofitamab-Gxbm
  • Mosunetuzumab-Axgb
  • Tebentafusp-Tebn
  • Teclistamab-Cqyv
• ONS book: Guide to Cancer Immunotherapy (second edition)
• ONS course: ONS/ONCC® Chemotherapy Immunotherapy Certificate™
• Clinical Journal of Oncology Nursing article: Optimizing Transitions of Care in Multiple Myeloma Immunotherapy: Nurse Roles
• Other ONS resources:
  • Bispecific Antibodies Video
  • Bispecifics Huddle Card
  • Cytokine Release Syndrome Huddle Card
  • Immune Effector Cell–Associated Neurotoxicity Syndrome Huddle Card
• DailyMed homepage
• Hematology/Oncology Pharmacy Association late-breaking news article: The Emerging Use of Bispecific Antibodies with Chemotherapy in Diffuse Large B-Cell Lymphoma

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 was 2014 that most of us think of as the beginning of bispecifics in cancer, and that was with approval of blinatumomab. That was granted accelerated approval for the treatment of patients with Philadelphia chromosome–negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia. It is a bispecific that targets CD19-expressing tumor cells and CD3 on T cells. It's the original bispecific T-cell engager and is often called a 'BiTE.'" TS 2:11

"The term 'bispecific' means that this is an artificial protein that's developed to hit two different antigens simultaneously. They can be two different epitopes on the same antigen. They can be an antigen on a cancer cell and CD3 on a T cell that kind of recruits the T cell to the cancer. So, there are different types [of bispecific antibodies]. The subtype that we often talk about are bispecific T-cell engagers, which are those bispecifics that do target the T cell. And currently, the target on the T cell that's utilized is the CD3 molecule. That's not the only one that will be used in the future because there's a lot of work being done on other types of T-cell engagers." TS 4:21

"The targets for lymphoma are CD20. Those are bispecific T-cell engagers that hit CD20 on the lymphoma cell, as well as CD3 on a T cell. ... In myeloma, we have two different targets that have been utilized. One is BCMA or B-cell maturation antigen. That sits on the surface of myeloma cells and on some healthy B cells. ... There's also a target used in myeloma that's called GPRC5D, which stands for G protein–coupled receptor, class C, group 5, member D. ... In small cell lung cancer, there's delta-like ligand 3 (DLL3); it's part of the NOTCH pathway. ... And then this year, we've had a couple agents come out that target HER2." TS 6:52

"[Toxicities] are very dependent on what your target is. ... The bispecific T-cell engager that's used in myeloma that targets the GPRC5D is also expressed on tissues that produce hard keratin like hair follicles and actually, within the tongue. So the toxicities that we see with that agent are something you wouldn't expect to see if you were using a myeloma agent. You see nail and skin issues. You see taste problems. So it's very specific about the target, which says to me, that every time a new one of these agents comes out, I have to learn about the target that helps me learn about the toxicity. I find that fascinating and really appreciate that." TS 16:19

"Cytokine release syndrome has been one of the areas that drug development has really focused on to see how they can help mitigate the severity [of it]. ... [One of] the strategies that has been incorporated and studied in clinical trials is the step-up dosing scheme. [It's] where you give initial small doses and over time, increase the dose to the dose you're going to continue with. Usually, monitoring in the hospital is required by the FDA approval for anywhere from 28–48 hours for the first couple of doses. And that's a real common strategy that you'll see. Premedication with H2 blockers, H1 blockers, sometimes steroids. These are also things that are incorporated within the approvals of these drugs and are important to look at." TS 20:53

"I think sometimes people don't expect pediatric patients to handle radiation as well as they do. They may have a family member who also had radiation for breast cancer or for prostate cancer and they were an older adult and had really severe side effects. And then they say, 'Oh, no, I've got to put my little baby through this. I don't really want to do this.' We say kids are very different in how they handle this. They're very resilient, so we can provide good education about that," Elizabeth Cummings, MSN, CPNP-AC, CPHON®, radiation oncology nurse practitioner at Children's Hospital of Philadelphia in Pennsylvania, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation treatment care for pediatric patients.

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 26, 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 radiation oncology treatment care for pediatric patients.

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
  • Episode 298: Radiation Oncology: Nursing's Essential Roles
  • Episode 204: How Radiation Is Used in Palliative Care
  • Episode 50: Difficult Decisions in Childhood Cancer
• ONS Voice articles:
  • Fertility Preservation Protects Possibilities for Patients With Cancer
  • Have Meaningful Conversations With Pediatric, Adolescent, and Young Adult Patients and Their Families
  • Pediatric Cancer Survivors Require Additional Care and Monitoring
  • Prepare Survivors for the Risk of Secondary Cancers
  • Secondary Cancers in Pediatric Survivors
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (Fifth Edition)
• ONS courses:
  • Essentials in Survivorship Care for the Advanced Practice Provider
  • ONS/ONCC® Radiation Therapy Certificate™
• Clinical Journal of Oncology Nursing articles:
  • Radiation Therapy Survivorship: Healthcare Providers' Perspectives on Education and Care
  • Radiation Therapy: Understanding the Patient Experience
  • Reducing Pediatric Patient Anxiety: Implementing a Nonpharmacologic Intervention to Aid Patients Undergoing Radiation Therapy
• Other ONS Resources
  • Inclusive Care Learning Library
  • Late Effects of Cancer Treatment Huddle Card
  • Proton Therapy Huddle Card
  • Radiation Huddle Card
  • Radiation Learning Library
• Oncolink Jr.
• Pediatric Radiation Oncology Society

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

"I think one of the things to think about with kids is sometimes they're not as forthcoming with what's going on, and sometimes it's a little bit harder to understand. Sometimes that's just because developmentally, they're much younger. A 1-year-old can't exactly tell you what's wrong. And so you're really trying to figure it out based on their cues versus a teenager who can tell you, but maybe they're too embarrassed about something in a way that an adult might not be." TS 7:01

"Child life specialists are incredible. ... They provide age-appropriate education and explanations for patients, so talking to a 3-year-old about cancer is very different from an 8-year-old or even a teenager. They really are able to meet each patient exactly where they are and at the level that they are, and then provide the appropriate amount of information, which is so helpful for a patient since they learn to build trust and cope with their treatment and [they feel like they] have somebody who can relay that information in a clear and concise way." TS 11:16

"There's certainly growing concern about the potential effects of anesthesia on brain health, especially in a vulnerable population like very young children, which are the ones who need anesthesia. We really try to mitigate this by optimizing our anesthetic agents, so we'll use propofol, which has a really quick onset and offset. And even when the radiation treatment is done, they'll stop the propofol in the radiation room—even though they are still walking back to recovery, just to minimize the amount of time that it's on—and trying to use the lowest dose possible. We also [explore] a lot of nonanesthetic strategies, [like] child life support, trying to introduce video distraction when we can, and having music and audiobooks." TS 17:47

"[In] pediatrics, the patient, not the parent, is your patient. And that can look really different for a 3-year-old versus a 17-year-old. Somebody who can't officially sign consent, but they certainly have a lot of buy-in about the things that reach their body, versus a 3-year-old, where the parents are really taking ownership of that. I think sometimes it's tricky in the world of pediatrics as we think about the ethics of 'Who are we training here? Is it the patients? Is it the parents?' And we continue to advocate for our patients." TS 23:32

"I think that pediatric patients still want to be normal kids. They still want to do their normal activities. ... Our pediatric patients, a lot of times, have healthier tissues. They haven't seen as much wear and tear. They haven't developed the bad habits of some adults. They don't have the same environmental exposures, they're not smoking, they probably have fewer comorbidities. ... They're a different population. ... They're just amazing. They still want to be a kid, they still want to go to school, they still want to be with their friends. It's really encouraging to see that." TS 36:03

"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," ONS member 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