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The Oncology Nursing Podcast

Oncology Nursing Society

  • 52 minutes 47 seconds
    Episode 346: Pharmacology 101: BTK Inhibitors

    "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  

    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 

    17 January 2025, 8:00 am
  • 48 minutes 7 seconds
    Episode 345: Breast Cancer Screening, Detection, and Disparities

    “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  

    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

    10 January 2025, 8:00 am
  • 35 minutes
    Episode 344: ONS 50th Anniversary: Founding Leaders’ Vision and Challenges, Then and Now

    “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 

    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

    3 January 2025, 8:00 am
  • 32 minutes 45 seconds
    Episode 343: Cancer Cachexia Considerations for Nurses and Patients

    “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 

    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 

    27 December 2024, 8:00 am
  • 20 minutes 13 seconds
    Episode 342: What It’s Like to Serve on the Leadership Development Committee

    “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  

    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 

    20 December 2024, 8:00 am
  • 32 minutes 6 seconds
    Episode 341: Pharmacology 101: HER Inhibitors

    “Key thing here is that it was discovered that when you have gene amplification of HER2 you get a resultant overexpression of that HER protein and that overexpression leads to a driver for certain cancers. So, when you have an overexpression of HER2, it leads to the cancer being more aggressive,” ONS member Rowena “Moe” Schwartz, PharmD, BCOP, FHOP, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about HER inhibitors. 

    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 13, 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 HER inhibitor drugs. 

    Episode Notes  

    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 

    “It was discovered that when you have gene amplification of HER2, you get a resultant overexpression of that HER protein, and that overexpression leads to a driver for certain cancers. So, when you have an overexpression of HER2, it leads to the cancer being more aggressive. In fact, when we first started talking about HER2 positive breast cancer, the key thing is, if we look at just the disease, not disease and treatment, that the patients that have HER2-positive breast cancers, they tended to be more aggressive because you had those drivers.” TS 3:30 

    “Pertuzumab is also a naked antibody, but it binds to a different part of the extracellular domain. It prevents heterodimerization, so where trastuzumab prevents HER2/HER2, this presents HER2 and HER1, HER2 and HER3, HER2 and HER4 dimerization, and then that leads to downstream effects that causes cell arrest and leads to the benefit of inhibition.” TS 6:03 

    “Key thing here is that we’ve learned, is that sometimes, that drug, when it’s released from the antibody, can be released from the cell and can hit cells around the cancer cell that overexpresses HER2. So that’s called the innocent bystander effect. So we’re learning a lot more about antibody–drug conjugates.” TS 7:35 

    “The tyrosine kinase inhibitors, they’re interesting in that there are these small molecules, just like we know about other tyrosine kinase inhibitors that target intracellular catalytic kinase domain of HER2, so the internal part. Key thing is we have a number of different tyrosine kinase inhibitors and they target different parts of that family.” TS 7:54 

    “The infusion-related reactions are really interesting, because one of the things we do with infusion-related reactions is, if we’re giving it in an IV formulation, we use those prolonged infusions for the first dose and then go faster with subsequent doses after we see how they tolerate. And then of course there is the development of these onc products that are given sub-Q that have less of the infusion-related reaction.” TS 15:49 

    “One of the things that I see, I hear, is people say about these antibody–drug conjugates, which, you know, we use in all different diseases now. I hear so many people say these are not chemotherapy, and the thing of it is, they’re chemotherapy. I think people like to say they’re not chemotherapy because it makes people feel better that they’re not getting chemotherapy. But the reality of it is, is that they are monoclonal antibodies linked to a chemotherapy. So some of the side effects that you get are related to the chemotherapy. I think people need to realize that. You need to know what you’re giving.” TS 18:31 

    13 December 2024, 8:00 am
  • 18 minutes 2 seconds
    Episode 340: What It’s Like to Plan an ONS Conference

    “Don’t be afraid of applying, even if you’ve never planned a conference before, and you think, ‘Well, I have no idea what I’m doing.’ You probably know more than you think you do. You probably have more connections than you think you do, and it is such a worthwhile experience,” 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®, conferences oncology clinical specialist at ONS, during a conversation about serving on a planning committee for an ONS conference. 

    Music Credit: “Fireflies and Stardust” by Kevin MacLeod Episode Notes  

    Licensed under Creative Commons by Attribution 3.0  

    Episode Notes  

    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 saw a link on the ONS website looking for volunteer opportunities and applied, not thinking that I’d actually get chosen because I had never done anything like this before. I had spoken at conferences, but I had never been part of the planning committee. The application [had] some open-ended questions about what your expertise is and where your interests lie. … And then I got a phone call from the planning chair for that year, and we talked a little bit more in depth about the questions that were on the application, and my interests, and how I thought I would fit on the team.” TS 2:05 

    “The main part [of the work] was topic selection and then speaker selection once we narrowed down the topics. I feel like there was a lot of brainstorming and group effort to both of those things. You don’t have to individually have an exact topic or an exact speaker. There was a lot of ‘I think this general broad topic would be good,’ and then we narrowed it down as a group to something that would fit into a 45-minute presentation.” TS 4:30 

    “We talked about interventional radiology and how it seemed like it was taking on much more of a bigger role in oncology and how that could fit into the conference and whether we wanted to have a specific topic or an overview of the things that interventional radiology can offer for oncology patients. And we ended up doing kind of like a 101 topic on that one, because it was a newer topic that people were kind of interested in just hearing, like, ‘Hey, what do you guys do for cancer patients?’” TS 8:44 

    “I learned a lot about the backstage process of conferences. I had spoken before, but seeing the other side of it was a whole different picture—and all the work that goes into it—and I really learned a lot about picking the topics and how do we find the best information and the best sort of new themes to present to every time.” TS 12:04 

    “Just do it. Don’t be afraid of applying, even if you’ve never planned a conference before, and you think, ‘Well, I have no idea what I’m doing.’ You probably know more than you think you do. You probably have more connections than you think you do, and it is such a worthwhile experience. And you learn so much about yourself and about the other people on the team. And the information that you’re presenting just is huge for a lot of people. So if you’re even thinking about it, just fill out the application.” TS 14:06

    6 December 2024, 8:00 am
  • 35 minutes 56 seconds
    Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer

    “The nurse’s role in monitoring the lab values really depends on the clinics you're working at, but really when our patients are receiving treatment, especially in the infusion center, the nurses should be looking at those lab values prior to treatment being started,” Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, clinical nurse specialist at Karmanos Cancer Center in Michigan told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS during a conversation about how to monitor and educate patients with cancer. 

    Music Credit: “Fireflies and Stardust” by Kevin MacLeod  

    Licensed under Creative Commons by Attribution 3.0  

    Earn [#] contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 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 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 monitoring labs and educating patients with cancer.

    Episode Notes  

    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].  

    “Your traditional chemotherapy agents are the ones that we see the most lab abnormalities with, and we can predict those a little bit more with the advent of more of the advanced targeted therapies and immunotherapies, we still see lab values that are altered because of the way that the treatment works, but they may differ a little bit than what we traditionally saw with our normal chemotherapy agents.” TS 2:51 

    “I talked about the lifespan of all the other cells, and Neutrophils are usually what stop treatment, and part of that is, is that the lifespan of a neutrophil is 48 hours. It is proliferated very frequently in the bone marrow. But that is usually what we see. The cells that we see that stop treatment, and as you mentioned earlier, classic chemotherapy really the types of treatment that historically, we've been given and we have given to patients, and we've seen those blood counts really significantly impacted.” TS 6:21 

    “Kidney function, or renal function tests, are really determined whether the kidneys are functioning the way they should be. We look at an estimated glomerular filtration rate, or GFR, which is really based on the patient’s protein level, their age, gender, and race. And the test really looks at how efficiently the kidneys are clearing the waste from the body. So that’s really one that we need to look at, especially as we’re giving agents that are excreted through the kidneys.” TS 12:23 

    “I think it’s important for nurses to start looking at lab results with their patient very early on, you know, even before treatment starts, so they understand what the normals look like. So when they do get those lab results, because now pretty much everybody has patient portals, right? So the labs are reported in there, and they’re seeing the labs before they're talking to their providers.  if we can start early on and talk to them about what the normal lab values are, what they mean, and what we're looking at when we're drawing these labs. I think it’s really important for the patient.” TS 27:00 

    29 November 2024, 8:00 am
  • 25 minutes 33 seconds
    Episode 338: High-Volume Subcutaneous Injections: The Oncology Nurse’s Role

    “Although the patient is spending a little less time in the clinic, the administration actually requires the nurse to be at the chairside the entire time. This has allowed nurses to spend potentially uninterrupted time to sit and converse with the patients that they may not have had with an IV infusion. It’s been a wonderful unintentional outcome from the development of the large-volume subcutaneous injections,” Crystal Derosier, MSN, RN, OCN®, clinical specialist at Dana-Farber Cancer Institute, in Boston, MA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about administering high-volume subcutaneous injections in cancer care.

    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 November 22, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

    Learning outcome: The learner will report an increase in knowledge related to the administration of high-volume subcutaneous injections.

    Episode Notes 

    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

    “Some challenges with subcutaneous injections are with the administration, especially when we’re thinking about large-volume drugs. … Some of these patients who have been through multiple therapies, they’ve been on a long journey, or just in general they may have small amounts of subcutaneous injection areas and tissues, so that could be problematic. … Also, some patients may want to go back to receiving IV medications if they experience severe pain at an injection site during administration, or maybe they had a site-related reaction. This is where the nurses play a huge, crucial role in the administration of these subcutaneous drugs.” TS 5:17

    “When administering large-volume subcutaneous injections, good ergonomics is very important during the administration because this can help reduce the fatigue and discomfort not only for [nurses] but for the patients as well. If you’re trying to hold the needle in place for 5–10 minutes, it’s a lot of work. Your arms can start to shake, and that shaking can cause discomfort for the patient as well. The utilization of a winged infusion set for these large volumes allows more space between the patient and the nurse, which supports better ergonomics.” TS 11:20

    “When they came to the market, there was an unfounded concern from patients and practitioners that these injections would not be as effective as their IV counterparts. This is totally incorrect. We know that these options have the same efficacy and may actually also help to reduce the incidence of any infusion-related reactions, as well as lower side-effect impacts on patients, so overall, a lot of improvement with these high-volume subcutaneous injections for the patient experience.” TS 21:37

    “I’m just really looking forward to the future landscape of oncology practice and drug approvals and drug administration. It’s so important that subcutaneous injections have really made a name for themselves in nursing practice today. We continue to see more subcutaneous formulations on the market that are available for patients, allowing them less time in infusion chairs and more flexibility and freedom outside of the healthcare setting.” TS 24:39

    22 November 2024, 8:00 am
  • 36 minutes 44 seconds
    Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan

    “The gravity of the responsibility was realized when you walked into the boardroom and you’re there to make decisions, and the perspective you have to take shifts. Of course, I bring to the table my expertise and my perspective, but the decision-making and strategy behind it is really geared at sustaining the organization and moving us towards our mission, which is to advance excellence in oncology nursing and quality cancer care. Being able to reframe your perspective a little bit around those decisions is something that you don’t realize until you’re there to do that,” ONS director-at-large Ryne Wilson, DNP, RN, OCN®, told Brenda Nevidjon, MSN, RN, FAAN, chief executive officer at ONS, during a conversation with the three new 2024–2027 directors-at-large on the ONS Board. Nevidjon spoke with Wilson, Heidi Haynes, MN, CRNP, OCN®, and Susan Yackzan, PhD, APRN, AOCN®, about their careers, paths to serving on the Board, and passions in oncology.

    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 November 15, 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 the key roles of the ONS Board of Directors.

    Episode Notes 

    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

    Wilson: “After graduating and moving to Minnesota, I immediately joined the Southeast Minnesota chapter of the Oncology Nursing Society and served on the board and a few different positions, as membership chair and as the legislative liaison for the chapter, as well. And I had the opportunity to go to my first ONS Congress®. That really opened my eyes to all of the possibilities and all the really incredible work that so many of our colleagues across the country have been doing, which really was inspiring and really made me want to do more. I took on more volunteer opportunities within society—things like the OCN® Passing Score Task Force with ONCC, as a Biomarker Database expert reviewer, the Symptom Intervention Guidelines reviewer, and several other volunteer opportunities, just to stay connected and build relationships, but also give back to the profession that had really given so much to me.” TS 10:06

    Haynes: “What I’ve been learning is how to transfer that passion and leadership experience that I learned at the local level and grow them into bigger-picture skills, sort of switching my hat and supporting our oncology nurses on more of a global level. I would say for those interested in a national Board position but unsure how they would navigate being new to the role, I can tell you the personal support of the new Board members has been wonderful. Brenda, you and the more senior members of the Board and the National ONS team have all been welcoming and willingly share their knowledge. We even get assigned a Board buddy, and I have to give a shoutout to my Board buddy, Trey Woods, who has graciously—more than graciously—put up with all of my questions and pestering along the way.” TS 16:39

    Yackzan: “Well, the health of the organization is a responsibility. So that’s what you’re giving yourself over to and the task. The chapter board is just on a much more local and scaled back level. I mean this reaches a different proportion. So, you know, it’s not that it was the prior. I just think the full impact of it sort of comes to you when you’re in the Board meeting and you’re thinking through those things. The budget committee is one of the committees that I’m on, and I’m happy to report that we’re very healthy. And that’s because of the great stewards who came before me, and so, like everybody else on the Board, we feel the impact of making sure that that continues because oncology nursing is essential. We must continue to go forward.” TS 18:18

    15 November 2024, 8:00 am
  • 28 minutes 12 seconds
    Episode 336: Pharmacology 101: EGFR Inhibitors

    “Under normal conditions, EGFR [epidermal growth factor receptor] is in an auto-inhibited state. And it’s only when it’s needed that it’s upregulated. But when you have cancers that there is either a mutation in the EGFR or an overexpression, what you see is a dysregulation of normal cellular processes. So you get overexpression or switching on of prosurvival or antiapoptotic responses,” Rowena “Moe” Schwartz, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about the EGFR inhibitor drug class.

    Music Credit: “Fireflies and Stardust” by Kevin MacLeod

    Licensed under Creative Commons by Attribution 3.0 

    Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by November 8, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

    Learning outcome: The learner will report an increase in knowledge related to EGFR inhibitor drugs.

    Episode Notes 

    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

    “It wasn’t until 2004 that the mutations affecting the tyrosine kinase domain of epidermal growth factor receptor was linked to the responses that were seen in gefitinib. And that’s when we really started to understand the way that this was targeting certain patients’ cancers. So that led to the phase three study. People may remember the IPASS study that demonstrated that when patients had an activating mutation of EGFR, that that was a really good biomarker that selected out patients that would respond to therapy.” TS 2:58

    “The new player on the market is the bispecific. … This was a bispecific that was developed to hit two different targets. The one target is EGFR. The second target was MET. And the reason MET was targeted is because when you have patients who are on EGFR tyrosine kinase inhibitors, they do so well. But over time, resistance develops. And one of the mechanisms that are thought to be important for resistance is that MET pathway. So it was a development of a bispecific antibody that hit two different targets, EGFR and MET, hoping that you would get less resistance.” TS 7:12

    “The other thing that I see with these agents is seeing them combined with chemotherapy. For a long time, it was these drugs were used as the single approach to someone with non-small cell lung cancer who had an EGFR mutation, and they did well. But I think we’re starting to see that because resistance does develop, that there may be roles for combination with chemotherapy, and you’re seeing that in terms of drug approval.” TS 19:10

    “I think that people that don’t work in the clinic, say, with non-small cell lung cancer—they think of these as a group and don’t realize the uniqueness of specific agents, what mutations that they hit that affected those that penetrate into the [central nervous system], the drug interactions that are specific for certain agents. So I think that’s one of the common misconceptions.” TS 22:02

    “The education, because it evolves so rapidly, is to realize that what you know, if it’s from a year ago, may not be the full picture. And so again, I’m going to call out ONS for the phenomenal resources on the Genomics and Precision Oncology Learning Library to help providers learn. And that is updated, and it is readily available. I think it is phenomenal, and I think it helps people build on their basic understanding of any of these types of therapy, including EGFR inhibitors.” TS 23:24

    8 November 2024, 8:00 am
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