Episode 310: Pharmacology 101: Androgen Receptor Inhibitors and Antiandrogens

“The things that I think creep up are things that unfortunately are quite common, and that’s hot flashes. I’ve had patients say that those are just overwhelming, and they want to go off therapy because of it. So I think talking about pharmacologic management, as well as lifestyle management, of hot flashes, are equally as important,” Rowena “Moe” Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about androgen receptor inhibitor and antiandrogen drug classes.

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 myoutcomes.ons.org by May 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 NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to androgen receptor inhibitors and antiandrogens.

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast episodes:
  • Pharmacology 101 series
  • Episode 242: Oncology Pharmacology 2023: Today’s Treatments and Tomorrow’s Breakthroughs
  • Episode 194: Sex Is a Component of Patient-Centered Care
  • Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™
• ONS Voice articles:
  • Oncology Drug Reference Sheet: Darolutamide
  • Oncology Drug Reference Sheet: Relugolix
  • Genetic Disorder Reference Sheet: HOXB13
  • Sexual Considerations for Patients With Cancer
  • Nursing Considerations for Prostate Cancer Survivorship Care
  • Exercise Before ADT Treatment Reduces Rate of Side Effects
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Oncology Nursing Forum articles:
  • An Exploratory Study of Cognitive Function and Central Adiposity in Men Receiving Androgen Deprivation Therapy for Prostate Cancer
  • Management of Androgen Deprivation Therapy–Associated Hot Flashes in Men With Prostate Cancer
• Clinical Journal of Oncology Nursing articles:
  • Hot Flashes: Clinical Summary of the ONS Guidelines™ for Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer
  • Hot Flashes: Common Side Effect
  • Genitourinary Distress: Common Side Effect
• ONS Guidelines™ and Symptom Interventions
  • Fatigue
  • Hot Flashes
  • Oral Anticancer Medication
• ONS Huddle Cards:
  • Altered Body Image
  • Hormone Therapy
  • Sexuality
• ONS Cancer of the Genitourinary Tract Learning Library
• Cancer Research article: Studies on Prostatic Cancer. I. The Effect of Castration, of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate

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 androgen deprivation therapy is either orchiectomy, which we tend not to use as much anymore; LHRH agonists, meaning that they act like LHRH…and then now LHRH antagonists are taking an increased role because we now have an oral drug that is an LHRH antagonist.” TS 3:44

“When you give an LHRH agonist, you initially have an increase in testosterone, but over time you cause a decrease in the ability of the pituitary to produce luteinizing hormone. Therefore, you get decreased stimulation in the testes to produce androgens. So when you think of an LHRH agonist, by continual use, what you do—you get an initial surge and then a decrease overall if patients stay on the drug. And so LHRH agonists—leuprolide, goserelin, triptorelin—those are agents that are agonist. LHRH antagonists have a direct effect to block the receptor and decrease release of luteinizing hormone and follicle-stimulating hormone, ultimately decreasing testosterone. LHRH antagonists don't have that surge of testosterone. They have an immediate effect of decreasing testosterone.” TS 4:41

“In terms of the LHRH antagonists, we’ve only had one drug for a while that’s an antagonist. That’s degarelix. Recently there was the approval of relugolix, which is an oral LHRH antagonist. And that has shown to have great effect in a noninferiority trial in terms to the LHRH agonists. And also there’s some benefit with decreased cardiovascular risk with that drug. So I think this is the drug we’re starting to see more and more.” TS 7:01

“The other thing with abiraterone acetate, it is recommended by labeling to take on an empty stomach at least an hour before two hours after a meal. But there is data that you can use a lower dose with a low-fat meal, and so you will see many providers providing a lower dose, often to get around the cost issue sometime around the pill burden. And that needs to be taken with a low-fat meal. So I have patients who are on the lower dose. We’ve talked about taking it with a low-fat meal. Now specialty pharmacy has talked about it. And then they read stuff that’s online or in the literature and they’re like, ‘Oh, I shouldn’t be taking this with any food at all.’ So it’s really important to make sure that you educate patients how to take the medication and warn them if there’s different instruction out there than what you’re giving.” TS 16:47

“Adherence to the schedule—a lot of times people are getting LHRH agonists every three months. … Maybe you’re going to miss it this month. You miss one dose—that’s six months. So it’s really important that if people are going to not be able to get their injection, that they call, and it’s rescheduled, and they have a mechanism to make sure that you don’t lose people to follow up. So adherence to all therapy—essential.” TS 21:27

“It was really the ability to be able to connect with many individuals from my profession. Reflecting on what initially drew me to ONS Congress, I can’t help but reminisce about my first time attending in 2002. I was going down memory lane the other day and found some pictures from my first time attending. As I reflected, I could not help but feel immensely grateful for the support and education I received as a novice nurse during that time from attending Congress,” Jessica MacIntyre, DNP, MBA, APRN, AOCNP®, 2024–2026 ONS president, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about ONS Congress. Taylor spoke with several 2024 ONS Congress attendees, asking the question “What brought you to ONS Congress?” Listen to their stories and learn how the conference has affected their careers in this special episode.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• Information on submitting an abstract to ONS Congress
• Oncology Nursing Foundation ONS Congress Scholarships
• Oncology Nursing Podcast episodes:
  • Episode 258: ONS Through the Ages: Stories From the Early Days With Cindi Cantril and George Hill
  • Episode 160: Build Innovative Staff Education Tools and Resources
  • Episode 191: Explore Orientation Opportunities for New-to-Practice Nurses
• ONS Voice articles:
  • Our Unified Voices Can Improve Cancer Survivorship Care
  • Personalized Patient Education: Ensure Effective, Inclusive, and Equitable Patient Education With These Five Strategies
• ONS Congress presentations from episode guests
  • The Nurse as an Effective Educator: Facilitating Patient-Centered Learning (Beau Amaya)
  • Powerful Outcomes From Nurse and Patient Policy Advocacy (Gilanie De Castro)
  • Back to Basics: Utilizing Huddles to Emphasize Standard Care and Maintenance of Central Venous Catheters in an Effort to Reduce CLABSI (Erin Hillmon)
  • Enhancing Triage Precision: Nurse Navigation's Impact on a Lymphedema Program (Jessica MacIntyre)
  • Implementing a Graduate Nurse Residency Program (Leah Scaramuzzo)

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

“What I want to accomplish is really to contribute significantly to an organization that has contributed so greatly to me. And until you go to Congress, you don’t fully realize the ripple effect that ONS has on the field of oncology nursing. They really are a cornerstone to our profession. So when I volunteer with ONS, I feel like I’m serving the oncology nursing community as a whole, and I’m so grateful to get to do that on a national level.” (Stacey Clements, BSN, RN) TS 3:35

“What is bringing me to Congress is to talk about patient education, health literacy, ways that we can improve the patient experience and help them understanding. And I think this is such an important topic because it’s what we do at the core of nursing. We really teach patients and their caregivers how to take care of themselves. And sometimes we forget that it’s not just a checklist to get the education done. It’s really learning what the patient needs, what they need to think about—some consideration about what may be affecting the way that they’re retaining information. Then hopefully I can give some tools and have some discussion with many different nurses across the U.S.” (Beau Amaya, MS, RN, OCN®) TS 5:04

“Why I am so excited to attend Congress is that it really gives us an opportunity to work together with our colleagues, learn what each other is doing, and kind of leverage our collective wisdom. So this way we work smarter instead of harder.” (Leah Scaramuzzo, MSN, RN, MEDSURG-BC, AOCN®) TS 7:58

“I was a scholarship recipient, which I was super excited to receive this year for the Congress 2024 in D.C. … Out of COVID, we all were virtual, so I wanted to able to see people in person and attend a national event. Also, I’m looking forward to reigniting my passion for oncology nursing because you kind of get burned out after a while in this field.” (Brenda Marsolek, BSN, RN, OCN®) TS 9:14

“I’m also really excited to share my role as a nurse resident. I hear a lot that new nurses shouldn’t be hired in oncology or it’s difficult to hire them. And I did it. I successfully did it with the help of [Leah and Brenda]. And so, I think other people can do that as well and that we can have new grad nurses have really healthy careers in oncology in the future.” (Brandy Thornberry, ASN, RN, OCN®) TS 10:38

“I chose to be a presenter this year because I always enjoyed listening to the presentations that everyone else brings to Congress. I always learned so much. I wanted the opportunity to be able to share one of the projects I did last year that had great results attached to it, so that hopefully others can listen to my presentation and maybe take something away from it back to their own centers.” (Erin Hillmon, MSN, RN, BMTCN®) TS 11:28

“Nurses can find ways to engage in shaping health policy. Many nurses don’t recognize the connection between health policy and the bedside. Policies beyond one’s institutions or organizations have a direct impact on how we nurses practice. And my goal is to empower nurses to understand that because of our professional experience, education, and interactions with those populations who we care for, we are really poised to influence and shape health policy.” (Gilanie De Castro, MSN, RN, OCN®, NE-BC, CNML) TS 14:38

“The big thing I want to let everybody know about Congress is that there’s so much to learn, and there’s so much experience that every attendee brings. No matter what level of education you have, what setting you work in, what kind of patients you take care of, everybody has something that they can bring to the table. It doesn’t matter where you learn this information either. There’s lots of sessions, posters, and networking roundtables. What I’ve learned in these few years is really just embracing what Congress can bring to everybody. So for anybody that’s on the fence, I’d urge you to take that leap and register. Attending Congress is a decision you won’t regret.” (Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®) TS 19:47

“One of the things that I know Dr. [Tom] Connor worked on very heavily in his career is the long-term impact on the health of nurses and other exposed healthcare workers. We definitely need more longitudinal studies, which are difficult to do. And it’s not something that you see every day where I talk to chemo nurses and said, ‘Hey, I’ve been in this 20 years. It hasn't bothered me at all.’ Well, until it does. Therefore, it’s so important when we’re training incoming nurses—how very important it is to start with these practices early in the career and throughout the career,” Charlotte A. Smith, RPh, MS, senior regulatory advisor at Waste Management PharmEcology Services in Milwaukee, WI, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about hazardous drug and waste disposal.

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 myoutcomes.ons.org by April 19, 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 NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to hazardous drugs and hazardous waste.

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast episodes:
  • Episode 209: Updates in Chemo PPE and Safe Handling
  • Episode 142: The How-To of Home Infusions
• ONS Voice articles:
  • Two Oncology Nurses Implement Process to Allow Patients to Disconnect Pumps From the Comfort of Their Own Homes
  • The Oncology Nurse’s Role in Oral Anticancer Therapies
  • Strategies to Promote Safe Medication Administration Practices
• ONS Safe Handling of Hazardous Drugs Learning Library
• ONS position statement: Infusion of Antineoplastic Therapies in the Home
• ONS book: Safe Handling of Hazardous Drugs (fourth edition)
• ONS course: Safe Handling Basics
• Clinical Journal of Oncology Nursing articles:
  • Environmental Risk Factors: The Role of Oncology Nurses in Assessing and Reducing the Risk for Exposure
  • Oral Chemotherapy: A Home Safety Educational Framework for Healthcare Providers, Patients, and Caregivers
  • Oral Chemotherapy: An Evidence-Based Practice Change for Safe Handling of Patient Waste
  • Reconciliation and Disposal of Oral Medication: Creating a Safe Process for Clinical Research Personnel
• Pharmacy Practice News article: Applying NIOSH Hazardous Drug Assessment of Risk Principles To Home Healthcare (by Charlotte Smith and Tom Connor)
• Books mentioned in this episode:
  • Silent Spring by Rachel Carson
  • Our Stolen Future by Theo Colborn, Diane Dumanoski, and John Peterson Myers
  • Generations at Risk by Ted Schettler, Gina Solomon, Maria Valenti, and Annette Huddle
• Drug Enforcement Agency: National Prescription Drug Takeback Day
• Environmental Protection Agency: Final Rule: Management Standards for Hazardous Waste Pharmaceuticals and Amendment to the P075 Listing for Nicotine
• MD Anderson Cancer Center: Chemotherapy at Home: 9 Things to Know (patient resource)
• Memorial Sloan Kettering Cancer Center: Safe Handling of Chemotherapy and Biotherapy at Home (patient resource)
• National Institute for Occupational Safety and Health:
  • Hazardous Drugs in Healthcare Settings
  • Managing Hazardous Drug Exposures: Information for Healthcare Settings
  • NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016

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

“A hazardous waste is a chemical, some of which are drugs, that EPA has determined is hazardous to the environment. Hazardous waste may be listed waste, which are given actual numbers, or they may be characteristic waste, which meets certain levels of concern, such as ignitability or toxicity. Only a small percentage of drug waste meets the EPA’s definition of hazardous waste, including a number of chemotherapy drugs.” TS 2:09

“The poster child for hazardous waste is warfarin, which, as you may be aware, is not only appropriate for managing clotting time but is also available commercially as rat poison. This is an example of how chemicals can serve more than one purpose and why dosage and regulation are so important.” TS 4:04

“Some of your listeners may have been around long enough to remember the book Silent Spring, by Rachel Carson, in which she eloquently exposed the risks to many species by the widespread use of DDT, an insecticide, at that time. More recently, the book Our Stolen Future by Theo Colborn, a pharmacist, Diane Dumanoski, and John Peterson Myers, raised the specter of the effects of endocrine disruption on wildlife and humans. The effects of drugs like diethylstilbestrol, or DES, once given during pregnancy, on the fetus, impacted the risk of cancer and other untoward effects in the offspring. The book remains a dramatic reminder of the risk of exposure to hazardous chemicals, including drugs.” TS 9:37

“Providing a homecare checklist for both the nurse and the patient and family is a simple way to keep track of all areas that need to be covered. For example, who in the household may be at most risk from exposure? This list includes infants, elderly family members, caregivers, pregnant family members, even pets. Is there a secure area to store the drug that cannot be reached by children?” TS 14:21

“I think what happens—we become so into our routine that what we do on a daily basis, we just kind of go through and do it without always thinking about it. And we can forget that not everyone has the same context of understanding these risks that the medications have to both the environment and the individual exposed to them. And I know it’s challenging to put on all the gowns and the gloves and whatnot. And, you know, it gets in the way of doing their job. It's important to educate each individual potentially exposed to these drugs, as if they do not have the understanding that we do. So embedding those consistent safety practices into daily routine is so imperative to ensure safe handling of hazardous drugs and then the proper disposal of hazardous waste pharmaceuticals.” TS 18:55

“When we’re talking about the role of nurses in addressing these challenges, they play a critical role because of when they actually get to see patients. And so, if we can help with early identification and assessment, really finding out, using financial screening tools to identify any patients that might be at risk, early on, of financial toxicity, that can really allow for timely interventions,” Sarah Paul, LCSW, OSW-C, senior director of social work at CancerCare in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about financial toxicity in adolescent and young adult (AYA) cancer survivors.

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 myoutcomes.ons.org by April 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 NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to financial toxicity in the adolescent and young adult population.

Episode Notes 

• Complete this evaluation for free NCPD.
• Oncology Nursing Podcast episodes:
  • Episode 300: AYAs With Cancer: End-of-Life Care Planning
  • Episode 294: AYAs With Cancer: Clinical Trial Enrollment Barriers and Facilitators
  • Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care
  • Episode 276: Support Young Families During a Parent’s Cancer Journey
  • Episode 62: Financial Toxicity Legislation
• ONS Voice articles:
  • AYA Cancer Survivorship: Younger Survivors Face Different Challenges and Prefer More Casual Support Programs
  • Nursing Considerations for Adolescent and Young Adult Cancer Survivorship Care
  • How to Support Adolescents and Young Adults With Cancer at the End of Life
  • LGB AYA Patients With Cancer Have High Burden of Chronic Conditions in Survivorship
  • AYA Champions Clinic Fills Gaps in Care and Addresses Unmet Needs
• ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
• Clinical Journal of Oncology Nursing articles:
  • Two Case Reports on Financial Toxicity and Healthcare Transitions in Adolescent and Young Adult Cancer Survivors
  • Crucial Conversations: Addressing Informational Needs of Adolescents and Young Adults Diagnosed With Cancer
  • A Nurse-Pharmacist Collaborative Approach to Reducing Financial Toxicity in Cancer Care
• Oncology Nursing Forum article: A Brief Screening Tool for Assessment of Financial Toxicity
• ONS Financial Toxicity Huddle Card
• ONS Nurse Navigation Learning Library
• Adolescent and Young Adult Cancer Awareness Week
• American Society of Clinical Oncology
• CancerCare
• Got Transition
• National Comprehensive Cancer Network
• Patient Advocate Foundation
• Triage Cancer

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

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“For nurses that are caring for AYA patients, it’s really important to not only be aware of financial toxicity but know how to assess for financial toxicity because of the pivotal stage that these patients are at in their life. They often don’t have the financial stability or insurance coverage that adults who are maybe middle age or even in the older adult population might have.” TS 2:11

“The idea of [AYAs] not really understanding insurance coverage—I think it’s really important that as a team, we simplify some of this complex information, breaking it down into more manageable steps and providing that guidance on the documents and all the information that’s needed to apply [for financial assistance].” TS 8:59

“We see significant impacts in the AYA community, especially those that are in school or at the early stages of their career, because putting a job or school on hold to focus on treatment can have long-term effects. So, we see a couple of things. In education, we see academic delays; interrupting education can delay graduation or achievement of certain educational milestones, which would affect their ability to pursue higher education or even specialized training for their career. We also see, which is very difficult, loss of scholarships or financial aid. Some AYAs are starting school. It’s based on a scholarship or a grant or financial aid, and they can’t meet those full-time enrollment requirements or be able to maintain the GPA that they need to stay in the program. We see people losing their scholarships, and this is not their fault.” TS 10:11

“Down the road, you have this stress leading to chronic stress. We know that constant worry about finances can create a chronic stress environment. That is going to impact mental health across the board, which can lead to increased irritability, feelings of sadness, or even conflict among family members. So when we talk about managing these dynamics, we really want to focus on the importance of open communication because a lot of times we see families avoid discussing financial issues to shield each other from that additional stress.” TS 18:06

“One of the challenges that we face with this population is that we might assume that if they’re not talking about it, if an AYA is not bringing up finances, that it’s not an issue. And so sometimes even our own assumptions or assumptions of healthcare professionals that they don’t even need to ask, ‘How are finances going? Are you working currently? Do you feel financially stable? Are you insured?’ Often, maybe there’s not room for those questions. Maybe the appointments are too rushed. … Healthcare professionals could maybe take a pause to evaluate their own hidden or implicit bias, reflecting on their own experience, really trying to become aware of the assumptions they might have about this population.” TS 32:46

“At the beginning, like when you first meet someone before they’ve even started anything, kind of get a baseline of ‘What’s your ability to complete your daily activities? How is your coordination? How’s your speech now? How is your writing ability?’ up front before we start anything that could be toxic. And then prior to every treatment, I tend to look at their gait, watch them walk in or walk out of the office, to see if they’re changing at all,” Colleen Erb, MSN, CRNP, ACNP-BC, AOCNP®, hematology and oncology nurse practitioner at Jefferson Health Asplundh Cancer Pavilion in Willow Grove, PA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about central nervous system toxicity.

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 myoutcomes.ons.org by April 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 NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome:  Learners will report an increase in knowledge related to CNS toxicities.

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast episodes:
  • Episode 303: Cancer Symptom Management Basics: Ocular Toxicities
  • Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy
  • Episode 278: Cancer Symptom Management Basics: Hepatic Complications
  • Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications
  • Episode 256: Cancer Symptom Management Basics: Hematologic Complications
  • Episode 250: Cancer Symptom Management Basics: Dermatologic Complications
  • Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications
• ONS Voice articles:
  • Cognitive Impairment Is Much More Than “Chemo Brain”
  • When Delirium Is Recognized and Addressed Early, Patient Outcomes Improve
  • An Oncology Nurse’s Guide to Bispecific Antibodies
  • CNS Survivorship Needs More Research, Funding, and Training, Expert Panel Says
• ONS courses:
  • Essentials in Advanced Practice Symptom Management
  • Treatment and Symptom Management—Oncology RN
  • Nursing Considerations for CAR T-Cell Therapy for Patients With Hematologic Malignancies: Patient Education and Symptom Management
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition)
  • Core Curriculum for Oncology Nursing (seventh edition)
• Clinical Journal of Oncology Nursing articles:
  • Associated Toxicities: Assessment and Management Related to CAR T-Cell Therapy
  • Dronabinol Therapy: Central Nervous System Adverse Events in Adults With Primary Brain Tumors
  • Primary Central Nervous System Lymphoma: Treatment and Nursing Management of Immunocompetent Patients
• ONS Huddle Card: Immune Effector Cell–Associated Neurotoxicity Syndrome (ICANS)
• American Society of Clinical Oncology (ASCO)
  • Nervous System Side Effects
  • Management of Immune-Related Adverse Events in Patients Treated With Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline

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

“Biotherapy, immunotherapy, and cellular therapy can cause changes in cognitive function and personality, even without other signs of obvious neurotoxicity. Things like cytokines, whether it’s infused or as a result of side effects, can bypass the blood-brain barrier and can also alter that vascular permeability to allow other substances to kind of cross the barrier and can also alter your hypothalamic activity.” TS 2:26

“There’s definitely an effect on patients who are older. You know, there’s less pliability, less ability of their nervous system to sort of rebound from an insult in some cases. And I think there’s more exposure. There’s more risk of coexisting conditions, things like diabetes or thyroid issues. There’s also higher risk of impaired liver and renal function or dehydration or polypharmacy-type things. So I think there’s just a lot of sort of inherent risks as people get older and have more coexisting conditions.” TS 5:33

“[Their caregiver says] they used to read all the time—and if you ask the patients, they’re like, “Oh, well, I can’t focus on the words because they all seem too blurry.” … But when you, if you ask them specifically, “Is your vision blurry?” they’ll say no. Then when you really get down to it, that caregiver piece I think is really crucial in this kind of toxicity, because it’s the little things that if you catch them when they’re little things, then won't lead to big things.” TS 11:00

“A couple of things I think are really important when you look at this class of drug: It developed by a concerted effort in cancer drug development to look at new agents that would be effective based on the mechanism. And then once they found a drug in this class that was beneficial, they further modified it to try to get better efficacy and less toxicity,” Rowena “Moe” Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the nitrosoureas 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 myoutcomes.ons.org by March 29, 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 NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to nitrosourea administration.

Episode Notes 

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast episodes:
  • Episode 286: Pharmacology 101: Alkylating Agents
  • Episode 288: Pharmacology 101: Antimetabolites
  • Episode 296: Pharmacology 101: Anthracyclines and Other Antitumor Antibiotics
  • Episode 299: Pharmacology 101: Plant Alkaloids
• ONS Voice article: The Oncology Nurse’s Role in Oral Anticancer Therapies
• ONS courses:
  • ONS/ONCC Chemotherapy Immunotherapy Administration Certificate™
  • ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
  • Safe Handling of Hazardous Drugs (fourth edition)
• Clinical Journal of Oncology Nursing article: Primary Central Nervous System Lymphoma: Treatment and Nursing Management of Immunocompetent Patients
• Oncology Nursing Forum article: ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications
• ONS Oral Anticancer Medication Learning Library
• ONS Oral Adherence Video
• National Institute for Occupational Safety and Health: Hazardous Drugs in Healthcare Settings

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

“With the nitrosoureas, there’s something really interesting because there’s another mechanism that has been identified. And that is that when you put these nitrosoureas in the body, they break down into intermediates, and one of them is an isocyanate. … These isocyanates, what they do is they inhibit DNA repair, therefore have an impact on cells that are damaged. You can think of it as the second mechanism, and people that work in the neuro-oncology space think of this when they think of drugs like lomustine in brain cancer, how that drug decreases the DNA repair protein O6-methylguanine-DNA methyltransferase.” TS 4:11

“These drugs are very lipophilic, meaning they cross the blood-brain barrier. That’s why we use them in brain tumors, so that’s one of the key things. That’s also one of the toxicities we see when drugs cross blood-brain barrier; we see neurotoxicity. So that’s one to at least always consider but also the benefit of it crossing over and being able to treat cancers within the CNS.” TS 8:19

“As a group, these drugs are alkylating agents, so definitely the safe handling is essential. And with DNA-damaging agents, that means anybody who is going to come in contact with these drugs. So, carmustine is given intravenously. Lomustine or CCNU, those are capsules. So handling is different depending on the agents.” TS 12:45

“The thing with the lomustine or the CCNU capsules, the thing that’s really important here is that the dosing is really different than how we normally give oral medications. And so, it’s really important that patients are aware of exactly how much they take and not that they don’t repeat the dose every day. So I think just like with other oral regimens that are not daily, we really have to make sure patients are aware of the specifics of how they take the drug.” TS 14:25

“The prescribing information is really a reliable data-driven and comprehensively reviewed tool. That’s not just for healthcare providers when writing a prescription, but also, for example, it is a tool that can be used to generate educational content for healthcare systems as they update formularies and create drug information,” Elizabeth Everhart, MSN, RN, ACNP, associate director for labeling at the U.S. Food and Drug Administration (FDA) in Silver Spring, MD, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about drug package inserts and labeling.

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 myoutcomes.ons.org by March 22, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to FDA drug labeling.

Episode Notes

• Complete this evaluation for free NCPD.
• Oncology Nursing Podcast episodes:
  • Episode 126: Oncology Clinical Trials and Drug Development
  • Episode 242: Oncology Pharmacology 2023: Today’s Treatments and Tomorrow’s Breakthroughs
  • Episode 273: Updates in Chemotherapy and Immunotherapy
• ONS Voice articles:
  • Oncology Drug Reference Sheets
  • FDA Updates
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• ONS Drug Development Learning Library
• ONS and Hematology/Oncology Pharmacy Association: Safe Handling Q&A: How to Determine if a Drug is Hazardous
• National Library of Medicine: DailyMed
• FDA
  • Prescribing Information Resources
  • Drugs@FDA: FDA-Approved Drugs
• National Institute for Occupational Safety and Health: Hazardous Drug Exposures in Health Care

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

“Nurses can be involved in several ways in creating the labeling. They can be members of the FDA multidisciplinary team that reviews the information submitted by the drug maker. Also in the review and development of the patient package insert or medication guide or the instructions for use that are used to help a healthcare practitioner, patients, or family members use the drug safely and accurately.” TS 2:08

“[Nurses] can use the sections to guide their teaching and instruction to patients, particularly about dosing and any tests that will be done to monitor for adverse reactions and any needed changes in the dosing, like whether they need to hold the medication or take less of it. They can also use the information to describe what the expected and serious adverse reactions for the drug are and how frequently they occurred in clinical trials.” TS 9:12

“The patient package inserts and medication guides that I mentioned are written in patient-friendly language and are good resources for nurses to use to educate patients and their caregivers or family members about what the product is used for, what its main and most serious side effects are, as well as what to expect in terms of the need for any special tests.” TS 11:04

“In the FDA’s public Prescribing Information Resources page, there are several excellent resources for healthcare providers to learn more about specific sections of the label, as well as to find good educational material for patients and their caregivers. There are also several presentations and videos available related to many sections of the label that are excellent resources for oncology nurses.” TS 14:26

“First, you want to refer patients to an eye care provider prior to initiating therapy, and I think communication at this point is really important. You need to tell the eye care provider why they’re being referred, what treatment they’re getting, the most common ocular toxicities, and also what needs to be done at every visit. They need to do a visual acuity; they need to do a slit-lamp eye exam. And these eye care providers need to know that ahead of time, so they’re doing everything at that visit,” Courtney Arn, APRN-CNP, nurse practitioner at the Ohio State University James Cancer Hospital in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ocular toxicities and their management in cancer care.

The advertising messages in this episode are paid for by Dartmouth Hitchcock Cancer Center.

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.
• Oncology Nursing Podcast Cancer Symptom Management Basics series:
  • Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications
  • Episode 250: Cancer Symptom Management Basics: Dermatologic Complications
  • Episode 256: Cancer Symptom Management Basics: Hematologic Complications
  • Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications
  • Episode 278: Cancer Symptom Management Basics: Hepatic Complications
  • Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy
• ONS Voice articles:
  • Oncology Drug Reference Sheet: Mirvetuximab Soravtansine-Gynx
  • Oncology Drug Reference Sheet: Tisotumab Vedotin-Tftv
  • Oncology Drug Reference Sheet: Belantamab Mafodotin-Blmf
• ONS courses:
  • ONS Cancer Basics™
  • Essentials in Advanced Practice Symptom Management
  • Treatment and Symptom Management—Oncology RN
  • Symptom Management—Oncology APN
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition)
• Clinical Journal of Oncology Nursing articles:
  • Transfusion Reactions: A Case Study of an Ocular Adverse Event During Autologous Transplantation
  • Ocular Graft-Versus-Host Disease After Allogeneic Transplantation
  • Enfortumab Vedotin: Nursing Perspectives on the Management of Adverse Events in Patients With Locally Advanced or Metastatic Urothelial Carcinoma
• Oncology Nursing Forum article: Ocular Toxicity of Tyrosine Kinase Inhibitors

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 most common ocular toxicities that we see with cancer treatments currently are vision impairment, which can include decreased visual acuity or blurred vision. We also see keratopathy or keratitis, very common to have dry eyes, photophobia, eye pain. Sometimes patients can develop cataracts, conjunctivitis, or even blepharitis, which is inflammation of the eyelid.” TS 2:27

“Fortunately, most of the ocular toxicities that develop when being treated with these treatments are short term, and so most of them are reversible. And they actually resolve relatively quickly after stopping treatment that’s causing the ocular toxicity. So usually within one to two months, the ocular toxicities have significantly improved or resolved.” TS 4:55

“Sometimes patients come in and you’re asking them, ‘Are you having any symptoms, or do you have any blurred vision?’ And they’ll say, you know, ‘I haven't been able to see my computer as well,’ or ‘I’ve noticed when driving, I can’t read the road sign.’ And what I really hear often is watching TV, they can’t see the scores of sports games at the bottom of the screen.” TS 7:43

“The nurses are very important in this process from the beginning of doing the patient education prior to them starting therapy, helping with the referral process to getting them in, making sure the patients have their eye drops, making sure they know how to use their eye drops, making sure they’re aware of the signs and symptoms to be calling and reporting, and then also identifying at their visits, too, if they’re having any new symptoms. So they definitely play a heavy, heavy role in this process.” TS 14:22

“We’ve seen over and over from an access standpoint how that makes a difference, then especially when you’re looking across racial disparities, ethnic disparities, geographic disparities, that having that person who can break down those barriers then is a great equalizer in that process,” Bonny Morris, PhD, MSPH, RN, senior director of navigation at the American Cancer Society, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about addressing disparities in cancer care through patient navigation and new rules from the Centers for Medicare and Medicaid Services (CMS) on principal illness navigation.

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 myoutcomes.ons.org by March 8, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the role of the oncology navigator.

Episode Notes

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast episodes:
  • Episode 64: Oncology Nurse Navigators
  • Episode 158: Navigate Patients Through Metastatic Colorectal Cancer Treatment and Survivorship
  • Episode 229: How Advocacy Can Shape Your Nursing Career
• ONS courses: Equipping the Novice Oncology Nurse Navigator: An ONS Collaboration with AONN+
• ONS books:
  • Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
  • Telephone Triage for Oncology Nurses (third edition)
• ONS Voice articles:
  • Oncology Navigation Standards Help Patients Overcome Disparities and Barriers to Care
  • Task Force Recommends Patient Navigation Services Increase Certain Cancer Screening to Advance Health Equity
  • Oncology Nurse Navigator Roles Are Transforming Cancer Outcomes for Underserved Rural Patients
  • New Roles in Oncology Nurse Navigation
• Clinical Journal of Oncology Nursing articles:
  • Lean Practices for Resource Use, Timeliness, and Coordination of Care in Breast Cancer Navigation
  • Low-Dose Computed Tomography: Effects of Oncology Nurse Navigation on Lung Cancer Screening
  • Oncology Nurse Navigation: Expansion of the Navigator Role Through Telehealth
• Oncology Nursing Forum article: Oncology Nurse Navigator Effect on Emergency Department Visits and Hospital Admissions of Adults With Cancer Post–Outpatient Chemotherapy
• ONS Huddle Cards
• ONS Nurse Navigation Learning Library
• ONS 2017 Oncology Nurse Navigator Core Competencies
• Oncology Navigation Standards of Professional Practice
• Oncology Nursing Certification Corporation CBCN® Role Delineation Study: Executive Summary
• American Cancer Society resources:
  • ACS CARES™ (Community Access to Resources, Education, and Support)
  • Building Expertise, Advocacy, and Capacity for Oncology Navigation (BEACON) Initiative
  • Cancer Action Network
  • Health Equity Ambassador Program
  • Leadership in Oncology Navigation (LION)
  • National Navigation Roundtable
  • What Can a Cancer Navigator Do for Me? (patient resource)
• CMS: Health Equity Services in the 2024 Physician Fee Schedule Final Rule

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 you get hit with that diagnosis, it’s like time stops. And even if the person that’s delivering that news—they’re trying to provide the best communication possible—but you just don’t hear anything else. And you’re overwhelmed trying to process everything and trying to just figure out, what is that next step?” TS 8:52

“There’s the person providing the navigation services, and then there’s the billing practitioner who then is submitting the codes that allow for the reimbursement. . . . So you have the person providing navigation services who may be an oncology nurse. It may be a health worker. It may be a patient navigator. It could be an ambulatory nurse. So it’s dependent upon these services being provided and not the title, and CMS is clear about that. And it describes within the final rule the different activities that can be applied and how they relate to then competencies that the person providing navigation services should either be trained or certified in.” TS 16:53

[American Cancer Society has] a training program to support. We have implementation programs that we’re supporting that we’ve built out. And so it’s really trying to be responsive to the needs of those who are boots on the ground implementing these codes. And how can we make it easier? Because we know that patients deserve this. So if we’re able to now have this more sustainable pathway, let’s make it easier to get to that point.” TS 20:10

“So for the patient consent process, it can be done verbally, as long as it’s documented that it took place, because there is that 20% cost sharing that the patient could receive a bill for if they don’t have additional coverage for that. And I worry that that could increase disparities, truthfully, because it’s going to be the subset of the population that then needs it the most, that then could say no because of the concern over that additional copay. I think that is something that we need to watch very carefully and continue to advocate for alternatives around and how we can support patients in continuing to have equitable access regardless of the ability to pay for that portion of navigation. Because we’ve never done that. We’ve never charged patients for navigation until now.” TS 21:22

One of the things that [American Cancer Society] is committed to is continuing to keep our training relevant, updated year after year, with having annual refreshers, having curriculum that is responsive—we know that oncology landscape is ever-changing, right? So how do we stay abreast of that as professionals? And working with ONS to make sure that we’re keeping all of those hot topics infused within that curriculum in a way that is practical and meaningful for the professional. They need to digest that information and then run with it. ONS is a fabulous partner with that.” TS 39:02

“Social work was involved because we could be radiation gung-ho, ready to go; chemo can be ready, but whoops, this patient doesn’t have a ride. It can be little things like that, you know, where we kind of forget. That’s why you need kind of a multidisciplinary approach. If it’s not your social worker, your navigator is going to know more and be like, ‘This patient needs a ride. I’m working on gas cards.’ Something like that can also halt a patient starting [treatment],” ONS member John Hollman, RN, BSN, OCN®, senior nurse manager of radiation oncology at AdventHealth Cancer Institute in Orlando, FL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about care coordination between radiation oncology and other oncology subspecialties.

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 myoutcomes.ons.org by March 1, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning objective: Learners will report an increase in knowledge related to coordination of care to assist with the management of radiation-related side effects.

Episode Notes

• Complete this evaluation for free NCPD.
• Oncology Nursing Podcast:
  • Episode 12: The Intersection of Radiation and Medical Oncology Nursing
  • Episode 60: Radiation Side Effects With Head and Neck Cancers—ONS Congress
  • Episode 128: Manage Treatment-Related Radiodermatitis With ONS Guidelines™
  • Episode 272: Oncologic Emergencies 101: Radiation Therapy for Emergent and Urgent Interventions
  • Episode 298: Radiation Oncology: Nursing’s Essential Roles
• Clinical Journal of Oncology Nursing articles:
  • Patient Handoff Processes: Implementation and Effects of Bedside Handoffs, the Teach-Back Method, and Discharge Bundles on an Inpatient Oncology Unit
  • Radiation Therapy Pain Management: Prevalence of Symptoms and Effectiveness of Treatment Options
  • Partial Breast Irradiation: A Longitudinal Study of Symptoms and Quality of Life
• Oncology Nursing Forum article: Symptom Clusters in Patients With Brain Tumors Undergoing Proton Beam Therapy
• ONS Voice articles:
  • The Intersection of Radiation and Medical Oncology Nursing (featuring an interview with John Hollman)
  • Today’s Immunotherapy Combinations
  • New Treatments in Radiation Oncology
• 49th Annual ONS Congress® Radiation Track and John Hollman’s radiopharmaceuticals session
• ONS book: Manual for Radiation Oncology Nursing Practice and Education
• ONS course: ONS/ONCC Radiation Therapy Certificate™
• ONS Communities: Radiation
• ONS Huddle Cards:
  • External beam radiation
  • Brachytherapy
  • Proton therapy
  • Radiation
• Find your local ONS Chapter’s next meeting.
• RT Answers
• American Brachytherapy 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

“Skin reaction is a big thing in our field for breast cancer. Managing it with lotions, creams, and stuff like that is temporary. To something more complicated, like the head and neck cancer patients with base of the tongue, where the beam is directed straight at that area of the body, which is very delicate, as we know, very, very, very tough treatment. You know, anything from esophagitis to dysphagia, dry mouth, no taste. Salivary glands are affected. So it really kind of depends, obviously, where we aim the machine.” TS 2:04

“I think it really determines on how that radiation nurse knows how radiation affects the cells that we treat. So, for instance, I always tell my patients when I’m educating them for head and neck, and I know they’re going to be getting concurrent cisplatin or something like that once a week, I’m going to tell them, like, ‘The majority of your acute side effects are us. Like, the chemo is going to work as a sensitizer. You’re going to have fluids that you’re going to be needing, but the difficulty swallowing, you know, all that stuff is our fault.’” TS 6:12

“If your med-onc is not affiliated with your rad-onc site, that can be a horrible barrier to try to break through because you don’t know anybody in that office. You identify yourself on the phone as someone from a competing company. . . . But it’s just breaking through that, and it just takes that nurse’s initiative and, hopefully, physician coordination as well, to work on, rad-onc between med-onc and getting that to kind of facilitate that.” TS 11:29

“Social work was involved because we could be radiation gung-ho, ready to go; chemo can be ready, but whoops, this patient doesn’t have a ride. It can be little things like that, you know, where we kind of forget. That’s why you need kind of a multidisciplinary approach. If it’s not your social worker, your navigator is going to know more and be like, ‘This patient needs a ride. I’m working on gas cards.’ Something like that can also halt a patient starting [treatment].” TS 20:52

“I love the ONS radiation communities. We do a lot of idea sharing on communities. A rad-onc nurse from New York can post something like, ‘Hey, what are you guys doing for this side effect? We’re not having any luck with this.’ And you get some buy-in. And as long as the nurses remember evidence-based practice is always key. You know, just because you use one lotion, it doesn't mean, it’s going to be good for everybody. I like to see the evidence behind it.” TS 22:42

“With the ever-evolving radiopharms that are coming out, you know, that we’re doing here, too, it’s turning more into nurses are actually giving the treatment. And that’s what I’m speaking on in Congress, is a nurse’s evolving role in radiation and radiopharms especially. It’s a huge breakthrough. It’s the future pretty much.” TS 24:19

“Trying to give them as much autonomy as possible is really important. I always like to ask, ‘Would you like to have a conversation? Do you think that you can handle a conversation about advance care planning?’ Or ‘What you would want someone to do for you if you're not able to speak for yourself?’ They may say no, you know, and we have to respect that too,” Mandi Zucker, LSW, CT, executive director of End of Life Choices New York in New York City, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about end-of-life and advance care planning for adolescents and young adults with cancer.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by February 23, 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 NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to advance care planning with the adolescent and young adult cancer population.

Episode Notes

• Complete this evaluation for free NCPD.
• Oncology Nursing Podcast:
  • Episode 9: How to Support Adolescent and Young Adult Patients With Cancer
  • Episode 41: Advocating for Palliative Care and Hospice Education
  • Episode 135: ELNEC Has Trained More Than One Million Nurses in End-of-Life Care
  • Episode 251: Palliative Care Programs for Patients With Cancer
  • Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care
• ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum
• ONS courses: Facilitating Intentional Conversations—Parts 1 and 2
• ONS Voice articles:
  • How to Support Adolescents and Young Adults With Cancer at the End of Life
  • Palliative Care Reduces Pain Trajectory in AYAs With Cancer
  • Advance Care Planning: Nurse-Led Programs Increase Patient Conversations, Understanding, and—Ultimately—Documentation and Completion Rates
  • Help Your Patients Prepare for the End From the Beginning
• ONS Huddle Cards: Palliative and Hospice Care
• National Hospice and Palliative Care Organization
• End of Life Choices New York
• Five Wishes
• Hello game
• The Death Deck/The EOL Deck
• The Conversation Project
• MyDirectives website and app
• VitalTalk website and app

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

“There’s a saying in this field: It’s never too early to have the conversation until it’s too late. And like I said, when my children turned 18, we completed advance care plans with each of them. … Thankfully, they were, and they still are, healthy, and they didn’t need an advance care plan imminently, but that’s actually the perfect time to do it. So, we had this conversation when there was no emotionality really attached to it, and that’s the best time.” TS 7:31

“So, trying to give them as much autonomy as possible is really important. I always like to ask, ‘Would you like to have a conversation? Do you think that you can handle a conversation about advance care planning?’ Or ‘What you would want someone to do for you if you’re not able to speak for yourself?’ They may say no, you know, and we have to respect that too.” TS 11:28

“I like to use an acronym called WAIT, W-A-I-T—Why am I talking? And frequently, I talk because I'm nervous. I’m so anxious at such, you know? Exactly. Just because we have a little training in this doesn’t make it an easy conversation to have. So I often notice that when I’m feeling anxious, I fill the room with words. So saying to yourself, ‘Wait, why am I talking?’ And if you realize ‘I’m talking because I'm nervous; I’m uncomfortable with this conversation,’ remind yourself to stop because a little silence is not bad. It actually gives the patient a little time to think about the question.” TS 12:25

“Some young adults are very on top of this planning. You know, I think it’s slow progress, but there has been some progress in that young adults are much more comfortable than a lot of us older people in having really difficult conversations. So we’re the ones that are afraid to bring it up, but some of them are much more comfortable. So we have to remember that each of these people are individuals, and they may be very on top of this kind of planning or feel more comfortable having the conversations than we are. So it’s important that we follow their lead and not make assumptions that because they’re young, that they haven’t thought about their own death.” TS 16:44

“I think a great question to ask them is just like, ‘What is your understanding of your diagnosis and prognosis?’ Because they may have heard it already. They may not have absorbed all of the information. They may not be ready to talk about it. So asking them what’s their understanding—if they say, ‘I’m dying; I know that,’ that makes the conversation a little bit easier, right?” TS 18:30

I actually think [it’s] more important—the healthcare proxy—than the forms, because you’re never going to be able to possibly come up with every single scenario that could happen. So you're not going to be able to document like, ‘If this happens, do this,’ for everything—but having a healthcare proxy who you’ve had conversations with about what your values are, not necessarily about every scenario.” TS 25:19

“Whatever your value is, you want to be able to have that conversation with your healthcare proxy so they can speak—I’m not even going to say for you—I’m going to say as you, so they can really advocate for you as if they were you and making sure your values and wishes are respected.” TS 25:54