“It is very much a collaborative group process. There are group meetings where we come to consensus on our different ratings. There’s so much support from ONS staff, even amongst our different groups, even when you’re assigned to one peer reviewer. Let’s say you go on vacation, sometimes we’re paired with other people, too. So there is some flexibility in the opportunity as well,” Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®, lecturer at Old Dominion University in Norfolk, VA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment. 

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Episode Notes  

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes: 
  • Episode 342: What It’s Like to Serve on the Leadership Development Committee 
  • Episode 323: What It’s Like to Participate in an ONS Think Tank 
  • Episode 76: ONS Guidelines Will Answer Key Symptom Management Questions 
• ONS Voice articles:
  • A Spirit of Inquiry Leads to Evidence-Based Answers to Practice Questions 
  • Search the Literature to Critically Appraise Evidence 
  • Working Together, Passionate ONS Volunteers Are Transforming Cancer Care 
  • What Brings You Value in ONS? You Can Thank a Volunteer for That 
• ONS blog: I Volunteered at the 47th Annual ONS Congress®—Here’s What I Learned 
• ONS course: Treatment and Symptom Management—Oncology RN 

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 far as how it would help oncology nurses, we try to make it honestly simpler by doing the legwork of reviewing the evidence, synthesizing what the rating of the evidence and what it means. And then as you’ll see on the symptom intervention resource, you’ll see kind of a snapshot of what our recommendations are for applying it to practice.” TS 7:46 

“I am a clinical nurse specialist and now that I work in academia, this is a very important skill for me to build and have in my profession. Also, those group meetings that we have, I really appreciated being able to learn from others and then being able to teach that to others. So in this second round, for example, the thing that I’ve really enjoyed personally is actually being able to mentor somebody that maybe hasn’t done it as often and just being able to watch them grow and improve in their skills while you provide feedback.” TS 9:05 

“We get a new article about every two weeks, and this involves about a week for myself and then about a week or less than that for my partner to go through this process as well. So being able to manage your time to afford your partner the time to solidly look through the article as well. And then being able to collaborate and receive feedback from your peers.” TS 13:06 

“There have been times where the evidence has not given us the results that I think we were assuming we would see. And so while the standardized tools mitigate some of the bias, we do recognize that it won’t remove the bias entirely, but it does help make your view more objective. What are some common misconceptions about developing symptom intervention resources? I’d say personally, I don’t know if I had misconceptions before I was part of the team as much as I just didn’t know what the process entailed.” TS 18:18 

“ONS is really committed to the growth of its members. I’ve really enjoyed being part of this volunteer opportunities and the other ones that I’ve been a part of. So truly, if you have a passion for something and you have the skills, ONS would love to have you and you will meet some of the greatest people in doing these opportunities. I’ve made some of the best connections and friendships through the volunteer opportunities I’ve done.” TS 21:35 

“This is what totally drives the treatment decisions, and that’s why having that pathology report when the nurse is educating the patient is so important, because you can say, well, you have this kind of breast cancer, and this kind of breast cancer is generally treated this way,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment. 

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Earn 1.0 contact hours (including 15 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: Learners will report an increase in knowledge related to breast cancer treatment considerations. 

Episode Notes  

• Complete this evaluation for free NCPD.
• Previous ONS Podcast™ site-specific episodes: ONS Voice articles:
  • Episode 348: Breast Cancer Diagnostic Considerations for Nurses
  • Episode 345: Breast Cancer Screening, Detection, and Disparities
• ONS Voice articles:
  • An Oncology Nurse’s Guide to Cascade Testing 
  • Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations 
  • Learn How to Read a Germline Genomic Testing Report 
  • Learn How to Read a Somatic Biomarker Testing Report 
  • Sexual Considerations for Patients With Cancer 
• ONS books:
  • Breast Care Certification Review (second edition) 
  • Guide to Breast Care for Oncology Nurses 
• ONS courses:
  • Breast Cancer Bundle 
  • Breast Cancer: Treatment and Symptom Management 
• ONS Biomarker Database results for breast cancer
• ONS Next-Generation Sequencing Sample Report 
• ONS Learning Libraries:
  • Breast Cancer
  • Genomics and Precision Oncology  
• American Cancer Society:
  • Breast Cancer Facts and Figures 
  • Your Breast Pathology Report: Breast Cancer
• National Comprehensive Cancer Network  
• National Cancer Institute Breast Cancer—Patient Version 

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 

“Local treatment is typically going to consider some kind of surgery with or without radiation, depending on the surgery and the extent of the breast cancer. All women are going to have, and today when you use the word women, individuals assigned female at birth, they are the vast majority of individuals being treated for breast cancer, but for individuals assigned male at birth, there’s not near as much research, but generally their treatment is very similar. So that’s something to kind of keep in the back of your mind.” TS 2:39 

“This is very confusing for patients because they’re like, ‘Well, my friend at church had this and why am I getting this and why are they getting something different?’ And that is because of the pathology report. So taking that time to explain that with a pathology, I think is really important.” TS 8:31 

“When they see the breast surgeon, all individuals are going to have some kind of axillary evaluation.  Now, hopefully it’s going to be a sentinel lymph node. So they’re going to, at the time of surgery, put a tracer and, you know, they’re going to take out maybe one, two, three lymph nodes and hopefully, you know, there is not a lot of disease there. And if that’s the case, they’re kind of done with that. So the sentinel lymph node evaluation, it’s really more to stage and provide that information, but it kind of sets the stage a lot of times for the other treatments selections. And I think people need to realize that this is important. This is a very important procedure.” TS 15:31 

“Years ago, when women had a breast mass, they went to the OR and it was biopsied in a frozen section and if it was positive, they had a mastectomy. So women would wake up and they’d be feeling their chest because they’re like, ‘What happened here?’ And that is not great care. It doesn’t give that woman any autonomy, but it was the best that could be done at that point. Now, with the diagnostic where we can do a needle biopsy, they can kind of stop and take a timeout and we can kind of clinically stage that.” TS 17:04 

“For women that really desire breast-conserving therapy, they can anticipate that postoperatively at some point, they’re going to have treatment to the entire breast, we typically call whole breast radiation, and then they may have a boost. Now, in many, many probably cases, that’s going to be over five to six weeks, Monday through Friday. So the treatment itself doesn’t take but a couple of minutes, but you have to get to the facility. And even though we streamline check-in processes and whatnot, you have to get undressed, you have to get positioned on the table. So it is a commitment, and it can be disruptive.” TS 24:49 

“The hormone-blocking agents are going to be the cornerstone of all those treatments for anyone who has hormone receptor–positive breast cancer. So they are going to take these agents and as you said, they’re probably going to take them for 5–10 years. It’s quite the journey.” TS 32:33  

“I think you need to be mindful that if someone has had germline testing and they’ve tested positive, they are not only worried about themselves, and they are worried about the rest of their family. That is a big deal. And even though I’ll hear mothers say, ‘I feel so guilty, now my daughter has this,’ now, I’ve never heard a daughter come and say, ‘Gosh, I wish my mom hadn’t had me because of this.’ There’s a lot of feeling and emotion that goes on with that, and realize that those individuals are probably going to have fairly complicated management that goes over and above their breast cancer.” TS 41:50 

“What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, there were a lot of nurses who were skeptical about the need for self-protection. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors,” ONS member Martha Polovich, PhD, RN, AOCN®-Emeritus, adjunct professor in the School of Medicine at the University of Maryland, told Liz Rodriguez, DNP, RN, OCN®, CENP, ONS member and 50th anniversary committee member, during a conversation about the evolution of safe handling of hazardous drugs and ONS’s role in shaping safe handling policies.

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 February 7, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the evolution of safe handling guidelines.

Episode Notes 

• Complete this evaluation for free NCPD.   
• ONS Podcast™ episodes:
  • Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs
  • Episode 308: Hazardous Drugs and Hazardous Waste: Personal, Patient, and Environmental Safety
  • ONS 50th Anniversary series
• ONS Voice articles:
  • Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE
  • NIOSH Releases Its 2024 List of Hazardous Drugs
  • USP Answers Some Difficult Questions About Hazardous Drug Safety
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses:
  • ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
  • ONS/ONCC Chemotherapy Immunotherapy Certificate™
  • Safe Handling Basics
• Clinical Journal of Oncology Nursing articles:
  • Hazardous Drug Contamination: Presence of Bathroom Contamination in an Ambulatory Cancer Center
  • Oral Chemotherapy: An Evidence-Based Practice Change for Safe Handling of Patient Waste
• Huddle Card: Introduction to Safe Handling
• ONS Safe Handling Learning Library
• Joint ONS and Hematology/Oncology Pharmacy Association (HOPA) position statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs
• National Institute for Occupational Safety and Health: Managing Hazardous Drug Exposures: Information for Healthcare Settings
• American Society of Health-System Pharmacists Guidelines on Handling Hazardous Drugs
• USP FAQs
• Connie Henke Yarbro Oncology Nursing History Center

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

“PPE has always been recommended to reduce exposure because gloves and gowns provide physical barrier to protect against dermal absorption. But what we didn’t know back then was what gloves and gowns were made of mattered. So PVC gloves were often used just because they were readily available in all our clinical settings. Gowns were rarely worn for drug administration, even though they had been recommended since early on, and many considered gowns back then as optional because the wording in the [Occupational Safety and Health Administration] guidelines said ‘recommended’ and not ‘required.’” TS 3:19

“Those early chemo gloves were a bit like wearing gloves you might use to clean your oven. They were so thick and got in the way of taking care of patients or mixing drugs or administering drugs. So the biggest change, I think, is that gloves that are currently available are very thin, and they provide the necessary protection for those who are handling hazardous drugs. We now have a gloves standard that requires permeation studies to demonstrate the protective ability of the gloves before they can be labeled for use with hazardous drugs.” TS 11:56

“ONS and HOPA developed a position statement on safe handling of hazardous drugs. … This came because our two organizations were unable to support some of the other proposed guidelines from another organization. So we got together, and through our cooperation, resulted in language about the importance of safe handling, about supporting safe handling for practitioners, pharmacists, and nurses. Also, I feel really good about this—our cooperation resulted in language about protecting the rights of staff who are trying to conceive or who are pregnant or who are breastfeeding to engage in alternative duty that doesn’t require them to handle hazardous drugs.” TS 17:12

“If there’s no worker safety, then who’s going to take care of the patients?” TS 21:52

“What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, and that’s going back a long way, there were a lot of nurses who were skeptical about the need for self-protection. They had been handling hazardous drugs for years and had no signs of ill effects, and so they assumed that we weren't overreacting with all of the recommendations. They saw the use of precautions and PPE as a speed bump in their busy day and also thought that was unnecessary. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors.” TS 23:50

“We know that some women are going to get called back. And it’s just because usually they can’t see something clearly enough. And so in most cases, those women are going to get cleared with one or two images, and they’re going to say, ‘Oh, we compressed that better, we checked it with an ultrasound, we’re fine.’ That woman can go ahead and go. But we don’t want to miss those early breast cancers,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer diagnosis. 

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 January 31, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to breast cancer diagnostic considerations. 

Episode Notes  

• Complete this evaluation for free NCPD. 
• Previous ONS Podcast™ site-specific episodes: Episode 345: Breast Cancer Screening, Detection, and Disparities 
• ONS Voice articles:
  • An Oncology Nurse’s Guide to Cascade Testing 
  • Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations 
• ONS books:
  • Breast Care Certification Review (second edition) 
  • Guide to Breast Care for Oncology Nurses 
• ONS courses:
  • Breast Cancer Bundle 
  • Breast Cancer: Prevention, Detection, and Pathophysiology 
• ONS Biomarker Database results for breast cancer 
• ONS Learning Libraries: 
  • Breast Cancer 
  • Genomics and Precision Oncology   
• American Cancer Society:
  • Early Detection and Diagnosis 
  • Breast Cancer Facts and Figures  
  • Your Breast Pathology Report: Breast Cancer 
• National Comprehensive Cancer Network   
• National Cancer Institute Breast Cancer—Patient Version 

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 a woman gets a callback, that is incredibly anxiety provoking, because they’re very scared and they don’t know what it means. And I think that’s a place where oncology nurses can remind—if it’s patients or friends who are asking—that just because you have a call back, doesn’t mean you have a malignancy.” TS 8:16 

“We also know that when we call somebody back, that’s very scary and anxiety provoking. And we don’t want to subject women to unnecessary anxiety and stress through the procedure. And if it’s too stressful, they won’t come back again. That is actually a big harm that we don’t want to occur. That’s considered an acceptable amount. So we know that some women are going to get called back, and it’s just because usually they can’t see something clearly enough.” TS 11:26 

“I think one of the most important things is to really help that woman understand the biopsy report. So now everybody, with most of the electronic medical records, that woman seeing that biopsy result—maybe before her provider is seeing it, depending on whether they get a chance to call that individual. But, you know, they could get a notification in their medical record, or a new report is available, and they can click on there and they could be looking at something that is very scary, not necessarily a good time, you know, like they’re getting ready to do something. And so that is a problem overall with sometimes getting bad news in oncology.” TS 15:09 

“Sometimes it’s really good [for patients to bring] someone who can just be that set of ears or who can answer those questions, who’s emotionally involved but maybe not so emotionally involved, if that makes sense. And I think that that is something we can really encourage people to identify that person who’s going to really be able to support them.” TS 16:42 

“When we approach a pathology report, the patient, you know, if they open that on their own, they’re just going to see breast carcinoma, or they aren’t going to look at all of the details of it. They can be quite overwhelming to look at. But I think that it’s important to kind of take the patient through it, step by step, and realize that it’s often a case of repeated measures—that you might do it and then you might do it again the next day or a day later.” TS 20:55 

“Breast cancer care has changed so much over the past few decades. And I think people forget, you know, I’ve been in the business a long time, but years ago, everybody kind of got the same treatment if they got diagnosed. And we now understand so much about breast cancer treatment, but I think that has come on the shoulders of so, so, so many women who have enrolled in clinical trials to help us understand pathology better, to help us understand the impact of certain treatments. And so I think, first of all, we need to thank those women who have generously contributed to this base of knowledge. And it’s a place where those clinical trials have really made a difference.” TS 35:46

"If you take your normal radiation oncology experience, as we know in radiation oncology, radiations are done by the machines, you know, externally. Nurses deal with the side effects and everything like that, whereas radiopharmaceuticals are given kind of on the internal basis, they’re systemic,” ONS member John Hollman, BSN, RN, OCN®, radiation nurse educator for Texas Oncology, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about caring for patients receiving radiopharmaceuticals and theranostics. 

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 January 24, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: Learners will report an increase in knowledge related to radiopharmaceuticals and theranostics in cancer care. 

Episode Notes  

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:

  • Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer 

  • Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
  • Episode 298: Radiation Oncology: Nursing’s Essential Roles
  • Episode 12: The Intersection of Radiation and Medical Oncology Nursing
• ONS Voice articles:
  • Radiopharmaceuticals and Theranostics Offer New Options for Oncology Nurses to Transform Cancer Care
  • Radiopharmaceuticals Pack a One-Two Punch Against Cancer
  • Oncology Drug Reference Sheet: Radium 223 Dichloride
  • Oncology Drug Reference Sheet: Lutetium Lu 177 Dotatate
  • Oncology Drug Reference Sheet: Lutetium Lu 177 Vipivotide Tetraxetan
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
• ONS courses:
  • Essentials in Advanced Practice Cancer Treatments
  • ONS/ONCC Radiation Therapy Certificate™

• Step Outside Your Specialty: Broaden Your Learning Horizon Across ONS Congress™ Session Tracks 

• Share your experience with ONS Voice. 

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 most places are now doing the seven days, just to be extra cautious and you know, can't you be around any pregnant women or children, you can’t just be going to Target and stuff like that right after your injection because you are radioactive, and try not to share a bathroom with your family, that can be difficult and that leads into, as we’ve talked about in many talks that we’ve had, the social situation.” TS 8:08

“It’s really up to that nurse to recognize, like a good infusion nurse, to recognize the signs and symptoms of an infusion reaction and then to catch it at the earliest possible moment.” TS 11:42

We’re not really dependent on lab values between treatments, whereas the infusion you have to look at your lab values. These are the game changer.” TS 13:20

“You just hear the term radiation, and you just think of Chernobyl, or you think of like these worst-case, media-blown things and you think, how are you not being dosed with radiation every day? Because they don’t realize that you have this whole radiation safety team that’s required to be overseeing that you’re doing things safely and effectively, that these nurses that are administering these therapies or these therapists that are helping with the therapy are the safest as possible.” TS 18:37

“If it wasn’t safe, we wouldn’t be doing it. You know what I mean? So, there is that implicit bias that I think I can foresee a lot of people trying hard to get over. And if you do have questions, anyone who’s listening, and you’re scared that your center is going to roll this out, please talk to your physicians, please talk to your radiation oncologists, please talk to your radiation safety officers. They can definitely assure and put your fears at rest, hopefully. I 100% trust the radiation safety officers.” TS 19:45

“That’s why the nurses really need to be educated by those radiation safety teams so they can pass those questions, or they can answer those questions, alleviate those fears on consultation—or actually during the week when we’re calling in for questions.” TS 21:07

“I think getting both teams involved, if you’re going to really do this partnership, I find it really rare that it’s ever solely in rad onc. It’s always usually a combination of both. They’re always referred to us from that onc or somewhere. So, you really need that partnership.” TS 23:20

“This is so great to see what the future holds with these. And like I said, now they’re trying to do clinical studies for different diagnoses. So I think it’s just going to explode in the next few years about what we can use these for. It’s really an exciting time to be not only in oncology, but in radiation oncology.” TS 26:54

"In B cell malignancies, BTKi inhibits that BTK enzyme which is very upstream. It tells NF-κB to stop signaling into the nucleus and then inhibits proliferation and survival of B cells,"  Puja Patel, PharmD, BCOP, clinical oncology pharmacist at Northwestern Medicine Cancer Center at Delnor Hospital in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about BTK inhibitors. 

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Earn 1.0 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 17, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: Learners will report an increase in knowledge related to the BTK inhibitor drug class. 

Episode Notes  

• Complete this evaluation for free NCPD.
• ONS Podcast™ Pharmacology 101 series
• ONS Voice articles:
  • BTK Inhibitor Effective for Relapsed Hairy Cell Leukemia
  • FDA Grants Accelerated Approval to Pirtobrutinib for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
  • Ibrutinib Is the First Anticancer Agent to Be Negotiated for Medicare Drug Pricing
  • Oncology Drug Reference Sheet: Pirtobrutinib
  • Oncology Drug Reference Sheet: Zanubrutinib
• ONS books:
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Journal of Oncology Nursing article: B-Cell Malignancies: The Use of Small Molecule Agents for Treatment and Management
• ONS courses:
  • ONS Cancer Biology™
  • ONS/ONCC Chemotherapy Immunotherapy Certificate™
  • Safe Handling Basics
• ONS Guidelines™ and Symptom Interventions:  
  • Chemotherapy-Induced Diarrhea
  • Prevention of Bleeding
  • Prevention of Infection: General
• ONS Learning Library: Oral Anticancer Medication
• ONS/NCODA/HOPA/ACCC’s Oral Chemotherapy Education Sheets
• Other resources:
• Advanced Practice Providers Oncology Summit
• Ash Publications article: Managing Toxicities of Bruton Tyrosine Kinase Inhibitors
• Blood Advances article: BTK Inhibitors in CLL: Second-Generation Drugs and Beyond
• CLL Society Fact Sheets
• International Journal of Molecular Sciences article: Bruton’s Tyrosine Kinase Inhibitors: Recent Updates
• National Cancer Institute article: Two Drugs Show Efficacy against Common Form of Leukemia
• National Comprehensive Cancer Network Guidelines for Patients: Chronic Lymphocytic Leukemia
• National Study of Lymphoma (University of Oxford network site-specific group— Hematology)
• NCODA’s Positive Quality Intervention resources
• Pharmacy Times BTK Inhibitor Comparison Charts
• ScienceDirect article: Treating CLL with Bruton Tyrosine Kinase Inhibitors: The Role of the Outpatient Oncology Nurse
• The Video Journal of Hematology and Hematological Oncology 

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 

“1952 we have the discovery by Colonel Ogden Bruton of that severe immunodeficiency due to lack of B-cell maturation, and next linked to e-gamma globular anemia. In 1993, we had Professor Vetrie and colleagues discover that this was actually due to mutation in a kinase, and they called that BTK. And then in 1993 was a discovery of our first BTKi inhibitor in the lab setting, and that’s called LFM-A13. It wasn’t until 2013, so that’s 20 years after BTK kinase was discovered, where ibrutinib was our first-in-class BTK inhibitor, and the success of ibrutinib really promoted the exploration of second- and third-generation BTKis.” TS 6:24   

“It’s thought that BTK and other members in the pathway are constitutively phosphorylated, which just means they’re spontaneously on. This leads to this uncontrolled activation of NF- κB signaling and thus uncontrolled proliferation and suppression of apoptosis. So, these B cells are rapidly dividing, but they’re not functioning like they’re supposed to be, meaning they won’t differentiate, or, you know, they won’t grow up to be either a plasma cell, like we talked about, or a memory B cell. They’ve been hacked.” TS 10:11 

“This class is generally called—if you have to think of an umbrella term—it’s just called targeted small molecule therapies. Now a subclass is BTKi or Bruton tyrosine kinase inhibitors. So, we’re really shifting away from the use of cytotoxic chemotherapy, which is kind of designed to indiscriminately destroy rapidly dividing cells, to a more precise approach of targeting cells based on specific molecular changes in tumor DNA.” TS 13:47 

“Cardiac toxicity can manifest as atrial fibrillation. And here I’ll specifically talk about ibrutinib values because we have the most data with it, and the numbers actually get better with second- and third-generation BTKis. So frequency: Grade 1–2 atrial fibrillation was reported in 12%–15% of patients on Ibrutinib. And grade 3 AFib is 3%–5%. The onset, median onset is 8–13 months.” TS 20:23 

“For nurses, they should really advise their patients that the caliber of headaches are easily managed and they will decrease over time over a period of four weeks. This is an upfront conversation reassuring the patient that this is not a long-term side effect.” TS 33:47 

“One aspect that was being discussed at length was kind of identifying biases and then methods to neutralize those biases. So, I think first you have to identify what your bias could be toward BTK, maybe it’s age or comorbidities or side-effect profile. And then, how can we mitigate our own biases is kind of the solution part to that.” TS 46:26 

“The statistic you always kind of want to keep in the back of your brain is that over a lifetime, one in eight women will be diagnosed with breast cancer. So that means for an individual assigned female at birth, there’s a 13% chance that if that individual lives to age 85, that they will be diagnosed with breast cancer. So, it’s the most common cancer diagnosed in this group,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in St. Louis, MO, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer screening. 

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 January 10, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: Learners will report an increase in knowledge related to breast cancer screening, detection, and disparities. 

Episode Notes  

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes: 
  • Episode 333: Pharmacology 101: CDK Inhibitors 
  • Episode 316: Pharmacology 101: Estrogen-Targeting Therapies 
• ONS Voice articles: 
  • An Oncology Nurse’s Guide to Cascade Testing 
  • Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations 
  • Encourage Breast Cancer Screening in Childhood Cancer Survivors  

  • Genetic Disorder Reference Sheet: BARD1 

  • Genetic Disorder Reference Sheet: BRCA1 and BRCA2 Hereditary Cancers 
  • Genetic Disorder Reference Sheet: PALB2 
• ONS books:
  • Breast Care Certification Review (second edition) 
  • Guide to Breast Care for Oncology Nurses
• Clinical Journal of Oncology Nursing article: Germline Cancer Genetic Counseling: Clinical Care for Transgender and Nonbinary Individuals 
• ONS courses:  
  • Breast Cancer Bundle 
  • Breast Cancer: Prevention, Detection, and Pathophysiology 
• ONS Learning Library: Genomics and Precision Oncology  
• American Cancer Society Breast Cancer Facts and Figures 
• Breast Cancer Risk Assessment Calculator 
• Breast Cancer Risk Assessment Tool  
• National Comprehensive Cancer Network  
• Tyrer-Cuzick Risk Assessment Calculator 

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 

“Unfortunately, probably about 42,500 women die every year from breast cancer, and that number still seems really high because mammography screening has really enabled us to detect breast cancer in many, many cases when it would be most treatable. And so that’s a place where you would like to see some real progress.” TS 3:32 

“Primary prevention for all individuals, which is always best to prevent, would include 150 minutes of intentional exercise, watching the diet, keeping that weight as low as possible—we want more muscle and less fat mass—and limiting alcohol intake. Then we go and we talk about screening.” TS 7:29 

“The most recent statistic, and this kind of is post-COVID, is that 67% of women age 40 and over have had breast cancer screening in the last two years, which means that there’s a hunk of women, 33% of women who have not had breast cancer screening in the last two years and that who are 40 and over. And that to me is a really, really sad statistic because that’s a missed opportunity for screening.” TS 11:32 

“Sometimes we forget that women and individuals who’ve had breast cancer, especially if they had it at a younger age, their risk of a second breast cancer over time is about 1% or 2% per year. So, if you have a first breast cancer at 40, and you live another 30 years, two times 30 is 60, that risk is substantial. A lot of times we don’t see as much anymore, which is good. Individuals who had a lot of radiation to the chest, we used to see a lot of young individuals having radiation therapy for Hodgkin’s disease that encompassed the chest, and a lot of them were diagnosed with breast cancer afterwards.” TS 15:31 

“One of the things that always makes me really sad is that probably less than 40% of people who are eligible for this cascade testing, and mind you, many of the laboratories, if we test a parent and say they have a pathogenic variant, they will offer free testing to relatives for 90–120 days in that lab. They don’t even have to pay for the genetic test. They just have to get the counseling and send it. But less than 40% of individuals who would benefit from cascade testing ever get it done.” TS 35:02 

“I have had this privilege of sitting for decades watching genetics. That’s the only area I’ve ever worked in that is always completely changing. And just when you think you got it, there is something new and it’s really driving our oncology care. And I would really encourage people, I know we’ve said it about 10 times now, to look at that Genomics and Precision Medicine Learning Library, there are resources in there if you want to spend 3 minutes, 5 minutes, 10 minutes—if you got a whole hour or two, there’s courses. There are so many things in there, and if you really want to become more savvy, you can, and that’s a great place to start.” TS 45:34

“Who would think that we would be here 50 years later? And with the excitement that I think will build even more, I’m so humbled and honored to talk to young nurses. And their excitement—the same excitement that we had in the very beginning—is inherent. I hope that our legacy will be that we are able to pass on this tremendous gift of our careers to new nurses,” Cindi Cantril, MPH, RN, OCN®-Emeritus, founding ONS member and first vice president, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about the history of ONS’s inception. Burbage spoke with Cantril and Connie Henke Yarbro, MS, RN, FAAN, founding ONS member and first treasurer, about the inspirational nurses who started the organization and its impact over the past 50 years.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• NCPD contact hours are not available for this episode.
• ONS Podcast™ episodes:
  • Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan
  • Episode 258: ONS Through the Ages: Stories From the Early Days With Cindi Cantril and George Hill
• ONS Voice articles:
  • Connie Henke Yarbro Oncology Nursing History Center Commemorates the Legacy of Oncology Nurses
  • Nurses Empower Change Through Leadership and Advocacy Roles
  • Seeds Planted Today Nurture a Harvest of Future Generations of Oncology Nurses
  • ONS’s Success Is Our Success
• Connie Henke Yarbro Oncology Nursing History Center
• ONS Mission, Vision, and Values
• Oncology Nursing Foundation
• Clinical Journal of Oncology Nursing article: Supporting One Another for 40 Years

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

Yarbro: “In 1973, there was really kind of the first nursing conference for oncology nurses in Chicago. At that conference, Lisa Begg Marino and Shirlee Koons, myself, and about 20 nurses met to discuss how we could identify each other and that we needed to communicate because we were really each isolated in our own separate cancer center or clinic.” TS 2:09 

Cantril: “What’s interesting is that I contacted a lawyer in St. Louis and told him what we were trying to do, and the comment was shocking at the time. And he said, ‘Well, you know, you really could have your own autonomy. It would just cost $25, and you could start your own charter organization.’ Little did we know that we would grow to be where we are.” TS 3:50 

Yarbro: “I was with medical oncology, and you [Cindi] were with surgeons, so we were really all defining our roles. At that time, I was medical oncology, and I would travel the state of Alabama with the medicine to give the Hodgkin’s disease patients or children with leukemia their second dose, so they did not have to drive to the medical center because there weren’t any oncologists in the community. They were just made at the academic centers. Today, I don’t know whether you could get in a car and travel with your vincristine, procarbazine, and all the other medicines.” TS 11:24 

Cantril: “How do we facilitate a large, organized fashion and allowing people to have some sort of more intimate autonomy in their own environment? Because let’s face it, not every nurse is going to be able to go to Congress. Not every nurse is going to be able to go to a regional meeting. So the chapters really allowed for a wider net for us to identify nurses so invested in cancer nursing.” TS 25:23

“There’s actually quite a bit of debate about what the clinical definition of cancer cachexia is, but in its simplest definition of cachexia in this case is cancer-induced body weight loss. You can have cachexia in other diseases, for heart failure or renal failure, but it's basically tumor-induced metabolic derangement that leads to inflammation and often anorexia, which produces body weight loss,” Teresa Zimmers, PhD, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about cancer cachexia.

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 December 27, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: The learner will report an increase in knowledge related to cancer cachexia. 

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast™ episodes: 
  • Episode 251: Palliative Care Programs for Patients With Cancer
  • Episode 116: Screen and Manage Malnutrition in Patients With Cancer
  • Episode 93: How to Manage Nutrition for Patients With Cancer
• ONS Voice articles: 
  • An Oncology Nurse’s Guide to Cachexia in Patients With Cancer 
  • Manage Malnutrition’s Monstrous Consequences in Patients With Cancer 
  • Managing Weight Loss in Patients With Cancer 
  • Nutritional Support Reduces Weight Loss for Patients With Head and Neck Cancer 
• ONS book: Cancer Basics (Third Edition)
• ONS course: Introduction to Nutrition in Cancer Care 
• ONS Nutrition Learning Library 
• ONS Symptom Intervention Resource: Anorexia 
• American Society of Clinical Oncology (ASCO) Cancer Cachexia Guidelines 
• Cachexia Score screening tool 
• Cancer Cachexia Network 
• Cancer Cachexia Society 
• Malnutrition Screening Tool  
• Patient-Generated Subjective Global Assessment 
• Society on Sarcopenia, Cachexia, and Wasting Disorders  

To discuss the information in this episode with other oncology nurses, visit the ONS Communities. 

To find resources for creating an Oncology Nursing 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 

“Anorexia is often a component of cancer cachexia. In fact, some people call it cancer-induced anorexia, cachexia syndrome, because the tumors produce factors that act on the hypothalamus and hindbrain to produce, among other things, anorexia, but not just anorexia, you know, feelings of misery, anhedonia, wanting to withdraw from social interactions, but definitely altered desire to eat and altered taste of food.” TS 5:32 

“Cachexia is most common, you know, where it’s been examined, in patients with upper GI cancers. You could think of those as risk factors for cachexia. So that includes, of course, head and neck cancer, esophageal, gastric, pancreatic, liver and biliary cancers. It’s also found to be very prevalent among patients with any kind of metastatic cancer and very frequent in patients who are hospitalized for their cancer. But beyond that, about half of patients with non-small cell lung cancer also experience cachexia.” TS 8:21 

“I’ve been told by oncologists that cachexia is frequent in patients with certain rare cancers like ocular melanoma, small cell lung cancers, but generally speaking, cachexia is underrecognized.  Most people have in their minds this picture of someone who’s sort of end-stage cachexia, that’s emaciated. And in fact, most patients, or many patients in the U.S. at least, arrive with a cachexia diagnosis and may be overweight or even indeed obese, but that does not mean that they don’t have cachexia.” TS 8:54 

“I have tremendous respect for our nurses who take care of patients, and all of them have their preferred screening tools. There is no single accepted or mandated approach to diagnosing or treating someone with cancer cachexia. And I should say that I didn’t mention a widely accepted definition for cancer cachexia in the field, a diagnostic criterion, is weight loss of greater than 5% in the prior six months—and this is unintentional weight loss. TS 11:05 

“I hear from family members all the time about how this was actually the most distressing part of their loved one’s cancer journey because it’s something so visible. And also, so much of our relationships happen over meals. And what I’ve heard time and time again is that telling someone that there is a word for this, cachexia, and explaining that it is the tumor—right, it’s the cancer that’s causing this appetite loss—would have helped because there tends to be a lot of conflict over meals, you know, a lot of guilt on sides when it comes to eating and trying to prepare meals that are appetizing for the person with cancer.” TS 22:24 

“I think that we don’t often think about how much the cachexia itself affects the cancer treatment outcomes. The presence of weight loss correlates with treatment toxicity. Chemotherapy is often dosed on body surface area. Patients who have very low muscle, for example, experience greater toxicities, and maybe we should be dosing based on lean muscle mass. Patients with cachexia have poor outcomes after surgery. And actually, patients with cachexia don’t respond to immunotherapy, which of course has been transformative for cancer care. So, treating cachexia may actually enable patients to respond better to all of their cancer interventions.” TS 28:45 

“The Leadership Development Committee (LDC) is one of the most important member volunteer positions in the organization, and here’s why: The main purpose of the LDC is to recruit, vet, and select ONS Board of Directors. As some of you may know, it has been three years since we moved away from members voting for directors,” ONS member Nancy Houlihan, MA, RN, AOCN®, 2020–2022 ONS president and former director of nursing practice 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 what it’s like to serve on the Leadership Development Committee. 

The advertising messages in this podcast episode are paid for by Ipsen.   

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. 
• Oncology Nursing Podcast™ episodes: 
  • Episode 340: What It’s Like to Plan an ONS Conference 
  • Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan 
  • Episode 270: Meet the ONS Board of Directors: Brown, MacIntyre, and Woods 
  • Episode 239: Meet the ONS Board of Directors: Allen, Mathey, and Robison 
  • Episode 224: Meet the ONS Board of Directors: Nevidjon, Geddie, and Garner 
  • Episode 213: Meet the ONS Board of Directors: Brant, Burger, and Knoop 
  • Episode 200: Meet the ONS Board of Directors: Houlihan, Ferguson, and Polovich 
• ONS Voice articles: 
  • Find Your Voice With ONS’s Leadership Development Committee 
  • Nursing Leadership Unlocked 
  • Nurses Empower Change Through Leadership and Advocacy Roles 
  • Think Tank Will Explore Nurse Leadership Development Initiatives 
• ONS course: Board Leadership: Nurses in Governance 
• ONS Volunteer Opportunities  
• ONS Leadership Learning Library 
• Contact the LDC 

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  

To find resources for creating an Oncology Nursing 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 feel like I have come full circle, developing my knowledge and leadership skills over 25 years, both at ONS and in my professional career, applying them to ONS leadership as a director and an officer, and then transferring that knowledge to work with a diverse team of ONS members on the LDC to build the best slate of directors.” TS 3:52 

“There’s an annual review and editing of processes based on experience and discussion with board leadership and a review of the [notification of intent] and full applications of candidates for the board of directors. As you can imagine, reviewing the notifications of intent packages and the full applications, references, and interviews is very time consuming and requires significant at home and meeting time to complete. The application process is rigorous. The LDC members are the stewards of that work, ensuring fairness and ending with the best possible board of directors.” TS 6:22 

Each member of the LDC recognizes the importance of their role in identifying future leaders. They regularly interact with chapter members and leaders and others to relay the opportunities and processes for leadership roles, as I mentioned already, the LDC annually offers Round Table sessions at Congress and bridge. They are advertised to appeal to nurses with an interest in leadership in general, as well as at ONS.” TS 8:28 

“An important component to this role is meeting the diversity needs on the board, and every effort is made to ensure that our net is cast wide and is inclusive, while the skill set for board service is at a higher level, we uphold ONS principles relative to belonging and look for an inclusive compliment of directors.” TS 9:33 

“Frequently, the LDC works with qualified candidates who opt to wait to move forward because of work commitments, graduate school demands, or family concerns and come back when their lives are more settled, enough to take on the commitments of ONS. Support of employers is a required part of the application for the LDC and the board of directors, since time away from work can be challenging. However, many employees see ONS affiliation as a positive for their organization and are willing to engage in discussions with you about how to make a leadership role possible with your work responsibilities.”  TS 10:28 

“Historically, there has been a misconception that you can’t ‘break into ONS leadership.’ I have served the last four years, and my experience has been that we are always looking for new qualified thought leaders from every possible group that ONS serves. For example, we track what worksites our leaders come from so that we have every subspecialty’s voice over time.” TS 16:27  

“Bottom line is, ONS needs you. Don't be shy to try. The door is open to discuss, and the right opportunity could be available.” TS 17:00 

“I am constantly reminded about how smart and influential nurses are and how much they have to contribute. Working with an organization like ONS that unites you with others around a common purpose is very powerful.” TS 17:15  

“You know, ONS needs leaders; we’re always looking to talk with people about what their interests and strengths are and how they can develop some of those strengths through various volunteer activities.” TS 18:39