The ONS Podcast

Oncology Nursing Society
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Where ONS Voices Talk Cancer Join oncology nurses on the Oncology Nursing Society's award-winning podcast as they sit down to discuss the topics important to nursing practice and treating patients with cancer. ISSN 2998-2308

  1. 3H AGO

    Episode 413: Intrarenal Administration for Upper Urothelial Tract Disease: The Oncology Nurse's Role

    "We thought, from a nursing standpoint, 'What is our goal for doing this?' What we wanted was first, education of the patient. Can we successfully educate the patient to prepare them? Can we alleviate as much anxiety as possible so that they feel comfortable coming in and having this done? The second goal is to preserve kidney function throughout the treatment. To date, we've been successful with that. And the third goal is to complete treatment without infection," ONS member Chris Amoroso, BSN, RN, OCN®, registered nurse at Fox Chase Cancer Center in Philadelphia, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about intrarenal administration for upper urothelial tract disease. 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 May 1, 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: Nurses caring for people with cancer require knowledge of the different routes for drug administration, including intrarenal administration via a percutaneous nephrostomy. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 141: Care Coordination for Urothelial Cancer Episode 133: Treatment Advancements for Advanced or Metastatic Urothelial Cancer ONS Voice articles: A Primer on Urothelial Cancer Chemo Combo May Be a Bladder Cancer Treatment Alternative During BCG Shortage Nurses Are Key to Patients Navigating Genitourinary Cancers Clinical Journal of Oncology Nursing articles: Avelumab First-Line Maintenance Therapy: Managing Patients With Advanced Urothelial Carcinoma Percutaneous Nephrostomy Infusion: Nursing Considerations for Treatment of Upper Urinary Tract Urothelial Carcinoma ONS Learning Libraries: Cancer of the Genitourinary Tract Safe Handling of Hazardous Drugs 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 pubONSVoice@ons.org. Highlights From This Episode "In an office setting, it's not something we can really visualize. Patients will present with hematuria or flank pain, obstructions in the ureter, some hydronephrosis, they may be having a lot of urinary tract infections. And a routine cystoscopy in the office is not going to visualize the ureters. We can do biopsies like a ureteroscopy, a computerized tomography urogram, or a urine cytology. And those are usually the main ways of diagnosing upper tract disease—again, because it's rare." TS 2:33 "We ask patients to get into a comfortable position where they can sit or lay for an hour without too much movement. The movement of their body position can interfere with the flow of the medication going in. ... When we're ready to start, we're cleaning the ends of the nephrostomy tube and the IV tubing with a chlorhexidine solution. We're instilling this using micro drip tubing. The tubing has to be microchipped so we can accurately control the flow. The IV bag with medication is hung about 10 inches above kidney level. And the reason we do that is because we do not want to increase the intrarenal pressure. ... We want a slow infusion via gravity over about an hour. We're watching throughout the procedure to make sure that there's no leakage, no discomfort, really just watching the patient and having that communication with the patient. Are they feeling anything different? Do we notice a difference in the flow rate? Is it slowing down? And if so, why is it? Did the patient change position? If we have any [instance] where the patient says, 'I can feel something there,' or we see leakage, we stop that infusion immediately, emphasizing that it has to be gravity, never on a pump." TS 7:30 "We go over all the bacillus Calmette-Guérin (BCG) precautions because this is the drug that we're giving. As if we were doing traditional intravesical therapy such as placing a catheter up into the bladder, we're still giving patients BCG. So, we need them to follow the special precautions. We ask every patient, regardless of the drug we're giving them, to sit down to urinate, pour two cups of bleach in the toilet, let it sit for about 15 minutes, then close the lid and flush twice. Even though we're giving this for upper tract disease, it's still being excreted into the urine. So, precautions need to be followed. Sitting down to urinate to avoid splashing of the drug, putting the two cups of bleach in every time they urinate for a duration of six hours, closing the lid, and then flushing that toilet twice. The same precautions, whether it's traditional intravesical or intrarenal." TS 14:20 "The induction phase is the first six installations. So, the first time we give this drug, we're doing it once a week for six weeks. And during those six weeks, we're communicating with the patient. We'll do a follow-up phone call and ask, 'How are you feeling? Any issues?' And we do get to know our patients really well. ... If they call, we're going to send them for a urine culture and make sure there's nothing there. ... After those six weeks, we make sure the patient understands that this is not one course and done. We want to continue to do this to give them the best chance at preventing recurrence. After we've done those six, we'll wait about four to six weeks, and then we'll do a cystoscopy and ureteroscopy in the operating room to make sure we have the response we're looking for. Again, letting the patients know because sometimes they don't understand that this is going to continue—it's not six treatments and done." TS 23:08 "You can't think of this as the same as bladder cancer. This is in the upper tract. We can't approach it as if it was non-muscular invasive bladder cancer. The diagnosis is different. It's harder to diagnose. Again, we're not visualizing the ureters in a routine office cystoscopy.  ... You can't resect it out. When I was talking to our surgeon, he said, 'You can't resect the urothelial disease in the ureters like you would in a bladder tumor.' You can't go and just pick it apart. It's a little bit more complex than that. You can't go in and resect out lesions in the ureter itself." TS 36:20

    42 min

  2. APR 24

    Episode 412: Pharmacology 101: Cytokines

    "They are small, powerful little nuggets. They are actually small signaling proteins that our immune cells use to communicate. They really help regulate immune activation or inflammation and even the growth and survival of immune cells. When cytokines are used therapeutically in oncology, they help to stimulate immune cells such as T cells or natural killer cells to better recognize and attack cancer cells," Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center of Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the cytokine drug class. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours (including 30 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 24, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Nurses caring for people with cancer require knowledge of cytokines to provide appropriate education and to safely administer related therapies. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis ONS Voice articles: FDA Approves Nogapendekin Alfa Inbakicept-Pmln for BCG-Unresponsive Non–Muscle Invasive Bladder Cancer Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Oncology Drug Reference Sheet: Motixafortide ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) and 2024 Drug Supplement Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Guide to Cancer Immunotherapy (second edition) Clinical Journal of Oncology Nursing article: Tumor-Infiltrating Lymphocyte Therapy for Melanoma: Nursing Considerations What's Old Is New Again, Unfortunately ONS Symptom Interventions Colony-Stimulating Factors Including Biosimilars for At-Risk Patients for Prevention of Infection: General Platelet Growth Factors for Prevention of Bleeding National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Cytokines are actually among some of the earliest forms of immunotherapy used in the treatment of cancer, and it really goes back to the 1980s and the 1990s. We're talking therapies like interferon [alpha] or interleukin-2 that were used to stimulate the immune system, with the idea that they would recognize and attack cancer cells, particularly in diseases like metastatic melanoma and renal cell carcinoma. What made these therapies unique was that although the overall response rates were relatively modest, when patients did respond, those responses could be very durable and sometimes long lasting. And that observation was really important for the field of oncology, because it was part of the process that demonstrated that the immune system could potentially control cancer in really meaningful ways." TS 1:49 "One nice new example of an engineered cytokine is nogapendekin alfa inbakicept, which is quite the tongue twister to say. … This agent is really interesting because it's an engineered interleukin-15 receptor agonist that works on stimulating natural killer cells and CD8-positive T cells. And what makes this so interesting is that it's used in combination with a medication that probably some of us are familiar with—good old BCG—for patients specifically with invasive bladder cancer. The other really interesting thing about this new therapy is the fact that it is one of our first ones to be engineered in a combination fashion. So the nogapendekin alfa is combined with a receptor component that is called inbakicept. And what happens is it forms a complex to enhance signaling and prolong the activity of the cytokine." TS 7:50 "When you're looking at our therapeutic cytokines, those tend to produce larger-scale systemic inflammatory effects leading to much more global side effect reactions, while your supportive care cytokines are more commonly associated with either bone marrow stimulation effects or hematologic changes." TS 14:01 "Regardless of what type of cytokine therapy may you be using, across the board, early recognition of the symptoms and proactive supportive care are really important. And this is where many of our oncology nurses play such a critical role in identifying changes that are happening in real time to the patient's condition and helping to coordinate, relay information to the rest of the providing team so that timely interventions can occur for the best care of the patient." TS 18:01 "The other fascinating thing about these cytokines is that they're not being used as monotherapy anymore. They're now being looked at in combination with other therapies or even other immunotherapies like our checkpoint inhibitors. They're being looked at in the sense that they may be able to help expand and further activate immune cells that our current therapies rely on. And so it's really interesting that while cytokines were some of the earliest forms of cancer immunotherapy, they're now being reimagined as part of modern combination strategies designed to really further help enhance the immune responses against cancer." TS 29:08

    35 min

  3. APR 17

    Episode 411: An Overview of Myelodysplastic Syndrome for Oncology Nurses

    "Not every patient with myelodysplastic syndrome (MDS) is going to progress and die. Only 10%–20% of them will evolve into acute myeloid leukemia. And not all of them need blood transfusions. Some present with low platelet count. It's not just people who are anemic that have MDS—it's different depending on what type of MDS they have. These are averages. We're giving you statistics based on averages, and you're an individual, so we want to treat you as an individual," ONS member Sara Tinsley-Vance, PhD, APRN, AOCN®, nurse practitioner and quality-of-life researcher at Moffitt Cancer Center in Tampa, FL, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about myelodysplastic syndrome. 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 April 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: Nurses caring for people with myelodysplastic syndrome require knowledge of its pathophysiology, the presenting symptoms, and its diagnosis. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer Episode 302: Patient Navigation Eliminates Disparities in Cancer Care Episode 256: Cancer Symptom Management Basics: Hematologic Complications ONS Voice articles: Manage Cancer-Associated Anemia With Erythropoietin-Stimulating Agents Whole-Genome Sequencing May Guide Treatment Choices for AML and MDS Clinical Journal of Oncology Nursing articles:  Deciphering TP53 Mosaic Variants on Germline Biomarker Testing: Implications for Oncology Nurses Myeloid Malignancies: Recognizing the Risk of Germline Predisposition and Supporting Patients and Families Oncology Nursing Forum article: Impact of a Hematologic Malignancy Diagnosis and Treatment on Patients and Their Family Caregivers ONS book: BMTCN™ Certification Review Manual (second edition) ONS Clinical Practice resource: Genomics Taxonomy Genomics and Precision Oncology Learning Library American Cancer Society: Myelodysplastic Syndrome Prognostic Scores Aplastic Anemia and MDS International Foundation Blood Cancer United: MDS Diagnosis HealthTree Foundation Myelodysplastic Syndromes Foundation: What Is MDS? 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 pubONSVoice@ons.org. Highlights From This Episode "In the bone marrow maturation process, you have a pluripotent stem cell. You have myeloid and lymphoid, and then on the myeloid side, you make your white blood cells, your red blood cells, and your platelets. And during that maturation process, there's this problem that arises. It's called a clonal variation. Or something goes wrong as the cells go through that process year after year. It's called ineffective hematopoiesis. ... That process of becoming mature, functioning cells, arising from that hematopoietic stem cell is broken, and this leads to low blood counts. Usually, it's anemia, so the hemoglobin is low. You can see that the mean corpuscular volume (MCV) is really high, and those are clues that a patient might have MDS—anemia with a high MCV." TS 3:05 "The International Prognostic Scoring System (IPSS) was the first way that we staged MDS into lower-risk and higher-risk disease. Now we have the IPSS-R, which is the revised system. And that was intended to be a way of classifying patients into lower-risk or higher-risk disease, where we talked about the goals being different. And it's really looking at the depth of the cytopenias, so how low are those neutrophils? How low is the hemoglobin and the platelet level? What percentage of blast does the patient have in their bone marrow? [This] gauges whether they have lower-risk or higher-risk disease. And now that we have the Molecular International Prognostic Scoring System (IPSS-M), we also take into account the variants that a patient has and that can really change whether you think they have lower-risk or higher-risk disease." TS 8:46 "During a person's lifetime, if they were a heavy smoker, we always think of lung cancer, but it can actually predispose a person to MDS. If they worked heavily in chemicals. I can remember more than one patient who worked for pesticide companies. Repeated exposure to these things that can affect our blood cells cumulatively, they can make a person more prone to MDS. Also, patients who have family members who have had bone marrow problems." TS 13:39 "The way I explain it to patients who say, 'What does dysplasia mean?' I say, 'Well, if you had a picture of a face. If the cell has too many eyes, or one eye above the other or below the other, or too many ears, or they're just disfigured. They don't look right and they don't mature normally.' And so, the descriptions I frequently see are nuclear budding and micromegakaryocytes. Once you read a lot of the reports, you start to pick out, 'Okay, these are the terms that go along with dysplastic red blood cells or dysplastic megakaryocytes,' which are your precursors to platelets." TS 21:28 "The cytogenetics and the variants—that's a hard concept to explain to patients. And staying current on how we understand the disease and how it evolves. Now we have pre-MDS states called clonal cytopenia of undetermined significance. That was new to me. And then clonal hematopoiesis of indeterminate significance. And some of those clones have other healthcare problems that go along with them." TS 30:52

    34 min

  4. APR 10

    Episode 410: The Evidence for the Environment's Impact on Cancer Outcomes

    "Cancer and environmental disasters in particular, but the worsening of our environment, are really things that are great equalizers. And we recognize that we're all kind of in this world together. We can really face these issues on a more human level. I think always recognizing that if we look at something, we think, 'Well, that doesn't relate to me or that problem is it really isn't my problem'—it sure is," ONS member Margaret "Peggy" Rosenzweig, PhD, CRNP-C, AOCNP®, FAAN, ONS scholar-in-residence and distinguished service professor of nursing and Nancy Glunt Hoffman Chair in Oncology Nursing at the University of Pittsburgh School of Nursing in Pennsylvania told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the effects of the environment on cancer care and outcomes. 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 April 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: Nurses caring for people with cancer require knowledge to recognize and address how environmental factors influence cancer care delivery, patient outcomes, and workforce resilience. Episode Notes  Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 190: The Environment, Cancer, and Nurses' Role in Advocating for Climate Change Episode 107: Social Determinants Lead to Unequal Access to Health Care ONS Voice articles: Most Oncology Nurses Want to Address Climate Change but Don't Know How to Start Here's How the Environment Affects Cancer Care—and What Oncology Nurses Can Do About It Climate Change Is Contributing to the Cancer Burden, and Nurses Must Take Action Clinical Journal of Oncology Nursing articles: Oncology Nurses' Awareness, Concern, Motivations, and Behaviors Related to Climate Change and Health Environmental Risk Factors: The Role of Oncology Nurses in Assessing and Reducing the Risk for Exposure Oncology Nursing Forum articles: Research Priorities of the Oncology Nursing Society: 2024–2027 The Impact of Climate Change Across the Cancer Control Continuum: Key Considerations for Oncology Nurses (ONS white paper) ONS Huddle Card: Environmental Health and Climate Change ONS Congress® session: The Impact of Climate Change on Patient Care Supportive Care in Cancer article: Climate Disasters and Oncology Care: A Systematic Review of Effects on Patients, Healthcare Professionals, and Health Systems What If We Get It Right? by Ayana Elizabeth Johnson The Cancer–Climate Connection: Environmental Drivers of Cancer in the Climate Era (webinar by AnnMarie L. Walton) 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 pubONSVoice@ons.org. Highlights From This Episode "The process of establishing these research priorities usually happens every three or so years. And there's a lot of preliminary work of talking to multiple parties of interest regarding what they believe the research priorities are, what nurses are seeing in clinics and in the community, and really multiple opinions regarding where the direction of research for ONS should go. And we heard this time—loud and clear—from researchers, from nurses in clinics and in communities, from scholars, and multiple other interested parties, that the environment in a very broad context was very much a concern and specifically a concern for impact on cancer care delivery, quality, and outcomes." TS 1:49 "You can take some cancer outcome data and you can take patient data related to home address or zip code or even larger geographic areas and kind of do correlational studies to see 'Does one impact the other?' … There's been a lot of those in the literature. But they are very helpful because they're starting to define this idea that beyond the idea of just demographics—gender, age, race—that the whole concept of neighborhood and the influences of the neighborhood do impact cancer outcomes. And that's where we're seeing the sort of explosion in literature across multiple malignancies, stages of cancer, and across multiple questions—specific kinds of outcomes, everything from quality of life to tumor progression." TS 8:43 "There is growing literature around how cancer delivery can be better prepared for climate-related disasters. … There's a good article by Pamela Ginex that was published in Supportive Care in Cancer talking about climate disasters and oncology care. And that was really a systematic review looking at published literature and starting to classify where are the disruptions and how could we think about that from a research perspective. They ended up saying there are these patient-level outcome disruptions that of course include treatment disruption but also include this inability to communicate with the oncology care team, which is quite distressing. And there's a workforce disruption because there are very distressed clinicians who are experiencing the same climate-related disaster in their own lives and feeling like they are torn between their commitment to work and their commitment to family." TS 13:25 "After all these years in oncology nursing, I am convinced that we have to get the consideration of neighborhood. I think we do have to get back to the neighborhood level in order to boost the resilience of communities against cancer throughout the cancer trajectory." TS 31:53 "Let's take some of this to the community and boost the community in that way. I really feel like we have to think about just boots on the ground outside of the cancer center, instead of just documenting disparities or even doing interventional work, but still within our little ivory towers." TS 34:21 "You see the work of many in looking at the specific environmental risks to nurses through the toxic chemicals to which were exposed. But then thinking about the people who aren't as protected as nurses and the environmental workers, who are usually contracted out or not in unions, who don't have some of the same protections that nurses or other healthcare workers might have, and they are exposed to the chemicals without proper training or sometimes without protection. All of these things are very much worthy of an oncology nursing voice elevating these questions and saying, 'How can we study this? How can we best mitigate some of these risks?' Oncology nursing—we have to use our respect and good name in elevating all of these questions." TS 35:39

    42 min

  5. APR 3

    Episode 409: An Overview of Interventional Oncology for Nurses

    "Interventional oncology has really evolved into an important component of modern cancer care and is often described now as the fourth pillar alongside medical, surgical, and radiation oncology. The specialty now encompasses a broad spectrum of image-guided procedures that support from cancer diagnosis, treatment, to effectively managing symptoms that are caused by the disease. In other words, what we're seeing is that across the continuum of care, IO is playing a vital role," ONS member Evelyn P. Wempe, DNP, MBA, APRN, ACNP-BC, AOCNP®, CRN, NEA-BC, executive director for advanced practice providers for the oncology service line at the University of Miami Sylvester Comprehensive Cancer Center in Florida, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about interventional oncology. 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 April 3, 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 interventional oncology as a treatment modality for cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 347: Care Considerations for Radiopharmaceuticals and Theranostics in Patients With Cancer Episode 285: Transarterial Chemoembolization: The Oncology Nurse's Role ONS Voice articles: Advancements in Interventional Oncology Ease Pain and Limit Opioid Use Build Your Confidence in Understanding Vascular IO Procedures From Heat to Cold to Electrical Pulses, Here's How Percutaneous IO Can Preserve Life and Function Interventional Oncology Is an Evolving Subspecialty for Oncology Nurses Clinical Journal of Oncology Nursing articles: Interventional Oncology (December 2025 supplement) Expanding the Scope: The Emergence of Interventional Oncology Nursing The Evolution of Interventional Oncology and the Specialized Role of Oncology Nursing Interventional Oncology Learning Library Interventional Oncology Huddle Card Society of Interventional Oncology Association for Radiologic and Imaging Nursing Society of Interventional Radiology: Cancer resources RadiologyInfo.org (Radiological Society of North America) 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 pubONSVoice@ons.org. Highlights From This Episode "In the 1990s, tumor-focused procedures such as embolization and ablation began to emerge, marking a shift toward oncologic applications. The 2000s saw rapid technologic advancements that expanded the scope and volume of oncology-directed interventions, including vascular access device placement, liver-directed transcatheter therapies for tumor control, and more sophisticated ablation modalities. Today, interventional oncology, or IO, extends beyond procedural work, encompassing comprehensive clinical care through dedicated IO clinics that support patient consultations, treatment planning, and postprocedure follow-up." TS 1:50 "In the immediate postprocedure phase, the IO nurse plays a critical role in patient safety in education, and oftentimes it may not be the same nurse that's caring for the patient in the procedural environment versus the postprocedural environment. But the role is really about continuous need to assess the patient's comfort level, to ensure that there is hemodynamic stability of the patient while closely monitoring for complications such as bleeding at the access site—of course, depending on the procedure—if there's any hematoma formation or changes in vital signs, or if there's any pain that needs to be addressed. Most importantly is maintaining patient safety in that immediate phase after the procedure." TS 8:07 "Before an IO procedure, both teams really must review the patient's clinical status. There has to be a clear understanding of: Is this patient ready to undergo a procedure? Is there any necessary imaging that needs to be done, as well as laboratory review and any systemic treatments, that may affect procedural planning? And oftentimes, in my experience, really, the oncology nurses are the ones really speaking with each other based on what the decision has been from both teams working together and communicating this to the patient." TS 13:49 "I think the oncology nurse needs to assess the patient's baseline understanding of interventional oncology. I often began my visits with a simple, open-ended question, 'Tell me why you're here today.' This allowed me to gauge their knowledge of the specialty and the purpose of the visit with the IO team. And in many cases, patients were unfamiliar with interventional oncology, which meant education needed to start with an explanation of what IO is and how it fits into their cancer care journey. Once that foundation was established, I was then able to introduce information about the specific procedure and its role in their overall treatment plan. And we can work together to establish goals of care and health. Having this approach ensured patients were informed, engaged, and better prepared for the procedure ahead." TS 16:06 "As nurses explore career options, interventional oncology is definitely one to consider. It really unites technology and innovation, and I think that's where we're heading with health care, with so much advancement in research and science. There's definitely a place for oncology nurses in this space, and it would be great to see that continue to flourish." TS 24:23

    30 min

  6. MAR 27

    Episode 408: Radiation Site-Specific Side Effects: Breast Cancer

    "A side effect patients might experience is lymphedema. This is an increased buildup of lymphatic fluid in the tissues, either in the breast or in the arm and hand of the affected side. It's quite problematic for women. They might feel self-conscious. It might feel uncomfortable that the arm feels like it's throbbing or heavy. Clothing may not fit quite right. So we're always on the lookout for lymphedema," Maria Fenton-Kerimian, APRN, AOCNP®, nurse practitioner at Weill Cornell Medicine in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation site-specific side effects in breast 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 courses.ons.org by March 27, 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 side effects experienced with radiation therapy to the breast. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 368: Best Practices for Challenging Patient Conversations in Metastatic Breast Cancer Episode 354: Breast Cancer Survivorship Considerations for Nurses Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 298: Radiation Oncology: Nursing's Essential Roles Episode 194: Sex Is a Component of Patient-Centered Care ONS Voice articles: Could High-Dose Radiation Be the Missing Link in Breast Cancer Immunotherapy? Exercise Program Improves Quality of Life in Patients With Breast Cancer—and Keeps Them Moving Daily Frank Conversations Enhance Sexual and Reproductive Health Support During Cancer How to Handle Even the Worst Radiation Therapy Side Effects Clinical Journal of Oncology Nursing articles: Instruments to Evaluate Self-Management of Radiation Dermatitis in Patients With Breast Cancer The Effects of a Clinical Care Model on Quality Process Outcomes in Radiation Oncology Oncology Nursing Forum articles: Feasibility of Breast Radiation Therapy Video Education Combined With Standard Radiation Therapy Education for Patients With Breast Cancer ONS Guidelines™ for Cancer Treatment–Related Radiodermatitis ONS books:  Guide to Breast Care for Oncology Nurses Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS/ONCC® courses:  Radiation Oncology Conference Recordings Bundle™ Radiation Therapy Certificate™ ONS Huddle Cards: Altered Body Image Late Effects of Cancer Treatment Radiation Sexuality ONS Guidelines™: Cancer Treatment–Related Lymphedema Cancer Treatment–Related Radiodermatitis ONS Learning Libraries: Breast Cancer Radiation American Society for Radiation Oncology (ASTRO) National Comprehensive Cancer Network home page 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 pubONSVoice@ons.org. Highlights From This Episode "The goals of radiation to the breast are typically broken out into three different rationales. Either adjuvant treatment, where the tumor is removed surgically from the breast first and then radiation is delivered to lower the likelihood of return of the cancer. And then the second way it's given is with a curative intent. That may be for tumors that couldn't be fully resected, and the hope is to eradicate the tumor that is still present in the tissue. Lastly, it can be given in a palliative fashion where you're not expecting to completely cure the person of the cancer, but you hope to shrink the tumor enough to relieve symptoms." TS 1:46 "We really try to focus on patients managing fatigue by ensuring that they're having an appropriate, balanced diet with proper macro and micronutrients and that they're having adequate protein intake. We encourage patients to get adequate sleep. There is a culture of people pushing themselves and working into late hours of the night, and this would be quite difficult if you're experiencing radiation-induced fatigue. If someone is familiar and does regular exercise, we highly encourage them to continue that. If someone has not done much exercise and has slipped into a little bit of deconditioning or they're older or more frail, we might refer them for physical therapy or strength training to rebuild some of that stamina and energy." TS 7:56 "One of the key products to use for prevention of radiation dermatitis are silicone patches, and there are many on the market that are worn during the course of radiation or when the skin reaction begins. And they could stay on for several days during treatment, even if you're gently showering around the area. There are many homeopathic creams made from calendula flower, aloe vera, or some kind of combination of these types of products. The real issue with these products is that many of them aren't covered by insurance, so patients have to buy them out of pocket, over the counter. For some of our patients who are more financially challenged, it may be a problem. So I think [it's important] to be familiar with many different products so that patients have access to something that will minimize their skin reaction." TS 14:48 "After 90 days, it may be more common to see some of the cosmetic changes that can happen in the soft tissue of the breast. One of them is radiation fibrosis, which can be like a diffused scar tissue in the breast. It can sometimes cause hardening, retraction, or asymmetry. Sometimes it can cause a tight feeling where people can't stretch their arm to the full extent. We also know that there can be slower healing if surgery is done. For people that have tissue expanders or still want to have corrective plastic surgery, we really encourage them to wait at least six months or longer before approaching any of those plastic surgery procedures." TS 19:55 "Sexual health is such a big topic, but I think that nurses in radiation oncology are in a very good position to discuss that because we see patients for repeated period of time. So, there's maybe a quicker intimacy or familiarity that happens with the nurses in radiation. Personally, I always bring it up at a follow-up visit, which we do about a month after radiation ends. And it's kind of because the dust is settling and people are getting back to their lives." TS 23:53

    34 min

  7. MAR 20

    Episode 407: Pharmacology 101: CAR T-Cell Immunotherapy

    "You want to try to act quickly and be able to know what the pathways are for appropriate escalating when a patient is having symptoms that are reflective of cytokine release syndrome (CRS) or neurotoxicity. These toxicities are very manageable and treatable when recognized early. To summarize, choosing the right patient, knowing the toxicity profile for each product, and acting early is really what helps to prevent severe outcomes with chimeric antigen receptor (CAR) T-cell therapy," Maribel Pereiras, PharmD, BCPS, BCOP, clinical pharmacy specialist at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about CAR T-cell immunotherapy. 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 March 20, 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 CAR T-Cell immunotherapy in the treatment of cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 267: Side-Effect Management for CAR T-Cell Therapy for Hematologic Malignancies Episode 261: CAR T-Cell Therapy for Hematologic Malignancies Requires Education and Navigation Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome ONS Voice articles: A Body of Evidence Helps Nurses Manage CAR T-Cell Therapy Toxicities CAR T-Cell Therapy Programs Oncology Clinical Social Workers Add Layers of Support for Patients and Families During CAR T-Cell Therapy Studies Show Best Practices to Manage CAR T-Cell Therapies' irAEs and Improve Outcomes ONS Voice oncology drug reference sheet: Lisocabtagene Maraleucel Clinical Journal of Oncology Nursing articles: CAR T-Cell Therapy for Relapsed/Refractory Aggressive Large B-Cell Lymphoma CAR T-Cell Therapy: Updates in Nursing Management Nursing Considerations in Navigating Patients Receiving CAR T-Cell Therapy ONS book: Guide to Cancer Immunotherapy (second edition) ONS Huddle Cards: Chimeric Antigen Receptor T-Cell Therapy Cytokine Release Syndrome Immune Effector Cell–Associated Neurotoxicity Syndrome Immunotherapy Immuno-Oncology Learning Library American Society of Gene and Cell Therapy: Learning Center American Society for Transplantation and Cellular Therapy: Learning Center National Comprehensive Cancer Network home page 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 pubONSVoice@ons.org. Highlights From This Episode "CAR T-cell therapy combines an adoptive cell transfer with genetic engineering. And what that really means is that we are harvesting a patient's own T cells and then we engineer them with a synthetic receptor that helps them recognize that cancer. And all of this work has evolved through many decades of stepwise advances in how we design and activate the T cells. That led us to several landmark trials and ultimately the first CAR T-cell therapy approved by the U.S. Food and Drug Administration in 2017, which was tisagenlecleucel for pediatric and young adult patients that had acute lymphoblastic leukemia." TS 3:34 "If a patient has higher disease burden or an inflammatory biology, that does tend to correlate with higher toxicity risk. And then that might influence the way we monitor the patients who are getting the CAR T therapy. And then finally, baseline neurologic examinations, because neurotoxicity can occur with these agents. It's very important that we as a whole healthcare team really understand what the patient looks like at baseline to be able to determine if they're having any altered changes or confusion. If I had to summarize it, we want to confirm the target and make sure that we have the right CAR T product for the patient. We want to confirm that the patient, physiologically and mentally, is ready for the CAR T therapy." TS 10:53 "I think the two [toxicities] that every nurse will hear about almost immediately when talking about CAR T therapy are CRS or ICANS, which stands for immune effector cell–associated neurotoxicity syndrome. ... ICANS can either follow or even occur alongside CRS. And this can present as something as simple as just being slightly confused or altered, leading into progressively more severe elements such as word-finding difficulties, tremors, or changes in handwriting. Or even more severe cases that lead to seizures or decreased levels of consciousness. So, in this setting, neurologic assessments and knowing and understanding what your patient's baseline neurologic status is is so important. Those are really the two largest side effects that cross the board when it comes to CAR T therapies." TS 16:02 "In terms of the more practical aspects of administration, this is not a typical medication infusion. CAR T cells are living cells. So the way they are handled and administered is very specific. The majority of CAR T products are given as a single IV infusion. The cells come to us frozen either from a cellular lab or they will come from the pharmacy department. So those cells are typically thawed, and timing is of the essence. You really need to coordinate the timing of [thawing] to when they get infused to your patient. They tend to have a short shelf life once they're not frozen anymore." TS 26:34 "Now that therapy has, in many places, transitioned to be administered in the outpatient setting, education becomes absolutely critical. The patient is coming for their daily visit to clinic and then they're going home. And it's really up to the caregiver, who is usually not a nurse, who has to recognize early signs of toxicity. They need to be educated about what a fever is, what number constitutes a fever, what does confusion look like, what does hypotension look like? ... Do they have access to a thermometer? If you are asking them to look at blood pressure, do they have access to a blood pressure monitor? And sometimes those can be subtle things that might be overlooked. So, the emphasis in outpatient quality education is teaching those caregivers what to watch for, how to act quickly, and who to call immediately. You need to make sure that they have that information readily available if something happens." TS 30:55

    49 min

  8. MAR 13

    Episode 406: Drug Resistance Biomarkers and Their Impact on Cancer Treatment Choices

    "Our goal of precision oncology has been to shift to tailored therapies that can help to improve treatment efficacy and ultimately improve patient outcomes. Resistance biomarker testing can help the care team to detect these genomic changes that the tumor may have acquired during therapy that makes the cells resistant to therapy. This information can be extremely helpful when we're talking about making choices about second-line or subsequent-line therapy," ONS member Danielle Fournier, DNP, APRN, AGPCNP-BC, AOCNP®, advanced practice RN at the University of Texas MD Anderson Cancer Center in Houston, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about drug resistance biomarker testing. This podcast episode is sponsored by AstraZeneca. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD credit.  ONS Podcast™ episodes: Episode 389: Biomarker Testing for Non-Small Cell Lung Cancer Episode 373: Biomarker Testing in Prostate Cancer Episode 169: How Biomarker Testing Drives the Use of Targeted Therapies ONS Voice articles: Help Your Patients Understand Biomarker Resistance Testing Key Patient Education Points for Biomarker Resistance Testing Quick Quiz: How Much Do You Know About Drug Resistance in Cancer? Quick Quiz: How Much Do You Know About Somatic Biomarker Resistance Testing? When Targeted Therapy Stops Working, What's Next? Discover How Biomarker Resistance Testing Opens New Doors ONS Biomarker Database Clinical Journal of Oncology Nursing article: Tumor-Agnostic Therapies Reshaping Cancer Care ONS book: Understanding Genomic and Hereditary Cancer Risk: A Handbook for Oncology Nurses ONS course: Genomic Foundations for Precision Oncology ONS Genomics and Precision Oncology Learning Library American Cancer Society Cancer Action Network: Access to Biomarker Testing page White paper: The Landscape of Biomarker Testing Coverage in the United States Find out which states are currently discussing biomarker testing bills and how you can advocate for them through ONS. 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 pubONSVoice@ons.org. Highlights From This Episode "We know that biomarkers are playing an ever more important role in cancer care, and really, their use can range anywhere from helping us to confirm a given diagnosis, understand a patient's cancer susceptibility or risk, evaluate prognosis, as well as personalize treatment recommendations. … But in some cases, though, biomarkers can also help us to avoid therapies that are not likely to work. We also call these drug resistance biomarkers. These are those biomarkers that signify that a tumor is unlikely to respond to a given therapy." TS 1:50 "Resistance to cancer therapies is one of the most common issues that arises during cancer treatment. Because the populations of cancer cells within a tumor can be very diverse, when a given drug kills the cells that are sensitive to that therapy, it can also eventually leave behind resistant tumor cells, which can grow and multiply over time. So this can ultimately lead to a point where the treatment that was initially effective is no longer able to control the disease." TS 4:33 "While costs have come down, there can still be a cost associated with biomarker testing, and in some cases, this can be considered a barrier to care. What patients pay out of pocket can vary widely depending on their insurance coverage. So we have some data that was published from the American Cancer Society Cancer Action Network, and this was published a few years ago in 2023, which showed the average allowed unit cost to insurers per biomarker test ranged anywhere from about $79 for patients who were on Medicaid to about $224 for large-group, self-insured patients." TS 10:03 "There's research underway that's looking not only at genomic changes—so DNA changes that impact drug resistance—but how other substances such as RNA and proteins within the cell can also contribute to drug resistance. And this kind of falls into not just genomics but multiomics field. I have no doubt whatsoever that the use of artificial intelligence and machine learning is likely going to play a large role in drug resistance research. And really, these tools can help researchers to analyze complex data sets, identify novel resistance biomarkers, predict resistance patterns, as well as help to develop treatments that may overcome some of those resistance mechanisms." TS 17:00

    24 min
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About

Where ONS Voices Talk Cancer Join oncology nurses on the Oncology Nursing Society's award-winning podcast as they sit down to discuss the topics important to nursing practice and treating patients with cancer. ISSN 2998-2308

Information

  • Creator
    Oncology Nursing Society
  • Years Active
    2017 - 2026
  • Episodes
    416
  • Rating
    Clean
  • Copyright
    © Copyright 2025
  • Show Website
    The ONS Podcast

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