The Oncology Nursing Podcast

“That's what metastatic breast cancer looks like now—patients can live an extended period of time. And sometimes I think we forget to cheer for stable disease. I tell patients they can live with weeds in their garden; they just can't let the weeds take over their garden. And today we don't have a cure. We live in a rapidly changing time in oncology, and so there's just so much hope right now that we can offer patients,” ONS member Kristi Orbaugh, RN, MSN, RNP, AOCN®, nurse practitioner at Community Hospital North Cancer Center in Indianapolis, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about patient communication in the metastatic breast cancer setting. This podcast episode was developed by ONS through a sponsorship from Lilly. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD.  ONS Podcast™ episodes: Episode 354: Breast Cancer Survivorship Considerations for Nurses Episode 350: Breast Cancer Treatment Considerations for Nurses Episode 345: Breast Cancer Screening, Detection, and Disparities ONS Voice articles: Black Patients With Metastatic Breast Cancer Are Less Informed About Their Clinical Trial Options What Is HER2-Low Breast Cancer? ONS books: Guide to Breast Care for Oncology Nurses ONS course: Breast Cancer Bundle Oncology Nursing Forum article: Relations of Mindfulness and Illness Acceptance With Psychosocial Functioning in Patients With Metastatic Breast Cancer and Caregivers ONS Biomarker Database American Cancer Society breast cancer resources METAvivor National Cancer Institute resources: Breast cancer—Patient version To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “I think the most important and vital piece of having those conversations is making sure that we know—really know—that patient, because if we know them, that helps guide what they're needing right then, helps guide our verbiage, helps guide disciplines that we bring in.” TS 2:04 “What do they want to hear? I've been in practice a really, really long time, and I've had the entire spectrum. I've had patients say, ‘Tell me every single detail.' I mean, they want pictures. They want graphs. They want me to draw things. I've even had patients that want me to take markers and mark their body parts. … And then I've had patients that say, ‘I don't want to know anything. I trust my healthcare team. I'm going to proceed with treatment, but I really don't want to know anything.'” TS 3:40 “Remember to make things as simple as possible until we really know what the patient knows. We don't send our children to school and start them out in eighth grade; we send them to kindergarten for a reason. So we get basic information, and then we build on that. And I think we need to remember that when we're doing our patient education, whether it's regarding new chemotherapy or treatment plans or palliative care, we've got to remember to start simple. And maybe we build on that very quickly, or maybe it takes a bit more time. Number one—I actually think it helps with adherence because patients understand what we're asking of them and why we're asking that of them.” TS 12:00 “I think what's really kind of key to keep in mind is that patients are going to seek information. And so, we need to make sure that we're giving them really good, reliable, durable information because if we are not giving them good websites, if we're not giving them good written material, if we're not giving them good verbal information and education, they're going to contact ‘Dr. Google.' Dr. Google is good for a lot of things, but sometimes patients can go down a rabbit hole that's not appropriate or not accurate. That's not a good place for them to be.” TS 14:35 “If we find biomarkers that we call actionable, meaning that we find this mutation and we have a drug that blocks that mutation, that is what is going to guide and drive our treatment. Sometimes that can take a bit of time, right? And if we have a patient and they just find out they have metastatic disease, will they want treatment yesterday. And I understand that. … But frequently there is a very important period of waiting and allowing us to learn that enemy better by reviewing genomic testing, looking at that next-generation sequencing, looking at any positive biomarkers in breast cancer. They may have started out ER/PR positive. Are they still ER/PR positive?” TS 23:46 “I think when we're talking about goals of care, first of all, we need to make sure that the patient understands, when we're talking about metastatic disease today…, this is not a disease that we can cure, but hopefully it's a disease that we can manage for years to come. With that in mind, what's important to that patient? What is important to that patient in terms of life goals? What's important to that patient in terms of toxicities that they will allow and toxicities that they won't allow? TS 29:22 “If don't have a lot of medical knowledge, taking a pill seems less important than getting an IV. It seems like a bigger deal if I would miss getting my IV therapy. ‘Oh, whoops, I forgot to take a pill. Maybe it's not such a big, important piece of my treatment.' So education—when we set that patient down, helping them understand how this drug works, mechanism of action in a simple term, why it's important to take it as scheduled, why it's important to take it with food or without food, why it's important to take it consistently.” TS 34:41

Episode 367: Pharmacology 101: PARP Inhibitors “We know that in cells that are proliferating very quickly, including cancer cells, single-strand DNA breaks are very common. When that happens, these breaks are often repaired by the PARP enzyme, and the cells can continue their replication process. If we block PARP, that repair cannot happen. So in blocking that, these single-strand breaks then lead to double-strand breaks, which ultimately is leading to cell apoptosis,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the PARP 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 June 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: Learners will report an increase in knowledge related to the use of PARP inhibitors in cancer care. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs Episode 232: Managing Fatigue During PARP Inhibitor Maintenance Therapy Episode 227: Biomarker Testing, PARP Inhibitors, and Oral Adherence During Ovarian Cancer Maintenance Therapy ONS Voice articles: PARP Inhibitors and Ovarian Cancer Genomics May Trick PARP Inhibitors to Treat More Cancers Oncology Drug Reference Sheet: Niraparib ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) ONS courses: Safe Handling Basics Clinical Journal of Oncology Nursing articles: PARP Inhibition: Genomics-Informed Care for Patients With Malignancies Driven by BRCA1/BRCA2 Pathogenic Variants Talazoparib Plus Enzalutamide in Patients With HRR-Deficient mCRPC: Practical Implementation Steps for Oncology Nurses and Advanced Practice Providers Oncology Nursing Forum article: Familiarity and Perceptions of Ovarian Cancer Biomarker Testing and Targeted Therapy: A Survey of Oncology Nurses in the United States Oral Anticancer Medication Care Compass: Resources for Interprofessional Navigation ONS Biomarker Database ONS Oral Anticancer Medication Learning Library ONS Oral Anticancer Medication Toolkit Oral Chemotherapy Education Sheets 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 big toxicities here to watch for are primarily hematologic toxicities. It is one of those targeted therapies that does affect blood cell counts. So I'd say the blood cell count that is most commonly affected here is the hemoglobin. So, anemia very frequent complication that we see, probably a little bit more with olaparib compared with other drugs, but we see it as a class side effect. And we can also see neutropenia and thrombocytopenia with these agents, probably a little bit more with niraparib versus the others, but again, you can see it across all of these drugs.” TS 8:16 “We mentioned that rare risk of MDS and AML. This isn't a particularly scary thing if you talk to patients about it. Because of the rarity that we see this, it isn't something that we need to overemphasize, but I think careful monitoring of blood counts in is stressing the importance of that and early intervention here is very important.” TS 16:55 “This is a collaborative effort. And because of the home administration here, these patients do need to be followed very closely. So we are not laying eyes on them usually with the frequency that we do when we have patients actually coming into our infusion centers for treatments—so making sure that there is a plan for regular follow-up with these patients to ensure that they're getting that lab work done, that that's being looked at closely, that we're adjusting the dose if we need to based on that lab work, that we are managing the patient's fatigue. Again, that potentially dose reductions may be needed if patients are having that extreme fatigue.” TS 19:34 “I think one of those [misconceptions] could be that they're only effective in patients that have that BRCA1/2 mutation. And again, remember here that there is some data in particular disease states that we can use them and that they work in the absence of those mutations.” TS 25:12

“[My mom] would always be very inspirational whenever I would see her studying so long. And when she finally got to be a nurse, I always admired her vocation and compassion with her patients. She would always go above and beyond for all of her patients. I also got inspired a lot by my brother, as well, just seeing how passionate he was for caring for his patients for the families as well, and helping them deal with the any grief or loss that they were experiencing, Carolina Rios, MSN, RN, CPhT, told Valerie Burger, RN, MA, MS, OCN®, CPN, member of the ONS 50th anniversary planning committee, during a conversation about families in nursing. Burger spoke with Carolina, her mother Lissette Gomez-Rios, MSN, APRN, AGACNP-BC, FNP-BC, OCN®, BMTCN®, and her brother Carlos Rios, BSN, RN, BMTCN®, about how having multiple nurses in their family has affected them personally and professionally. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD.  ONS Podcast™ episodes: 50th anniversary series Episode 327: Journey of a Student Nurse: Choosing Oncology Nursing and the Value of a Professional Home ONS Voice articles: Innovation Inspires Hope: A Nurse's Journey of Passion and Purpose When Health Care Is Woven in Our Family Fabric, We Find Support in Unexpected Places Is Work–Life Balance Possible? The Evidence Says It Isn't—Rather, It's About Reframing Our Thinking ONS Nurse Well-Being Learning Library Oncology Nursing Foundation Resiliency Resources Connie Henke Yarbro Oncology Nursing History Center To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Lissette: “Being in the oncology nursing as a family, when I feel the necessity to talk to them, they listen to me. They pay attention, and we help each other to cope, especially when there is a loss of our patients, so we help each other. We are understanding. We give them compassion and the advice that we need.” TS 6:51 Carlos: I remember growing up—and [my mom] would always be in school and in the healthcare field, so I knew growing up I wanted to be in the healthcare field. She was the one that guided me into going to nursing because at a certain point, I wasn't sure what I was going to be doing. She guided me, and once I started doing nursing, this has been the career I want to do, I want to continue doing. I'm very grateful for her guiding me into nursing.” TS 9:48 Carolina: “Anytime I had a question I would ask them. They would always help me out, make sure I really understood. It would actually be a little funny because sometimes they would overexplain, and I was a little overwhelmed, and I would have to be like, ‘OK, let's dial it back. Let's get back to the basics.'” TS 14:22  

“From a radiation standpoint, the biggest thing we're looking at is the treatment site, the dosage, and the way the radiation has been delivered. There are different ways that we can focus radiation using methods such as intensity-modulated radiotherapy, volumetric modulated arc therapy, flattening radiation beams, and proton beam therapy to try to help minimize radiation exposure to healthy tissues to minimize patient risk for secondary cancers,” ONS member Andrea Matsumoto, DNP, AGACNP-BC, AOCNP®, radiation oncology nurse practitioner at Henry Ford Health in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation-associated secondary cancers. 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 May 30, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to radiation-associated secondary cancers. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 201: Which Survivorship Care Model Is Right for Your Patient? Episode 12: The Intersection of Radiation and Medical Oncology Nursing  ONS Voice articles: Even Low-Dose CT Radiation Increases Risk for Hematologic Cancers in Young Patients Nurse-Led Survivorship Programs: Expert Advice to Help You Build Your Institution's Resources Secondary Cancers in Pediatric Survivors: Increased Risk and Unique Barriers to Care ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ Essentials in Survivorship Care for the Advanced Practice Provider Clinical Journal of Oncology Nursing articles: Adolescent and Young Adult Cancer Survivors: Development of an Interprofessional Survivorship Clinic ONS Radiation Learning Library ONS Survivorship Learning Library American Cancer Society survivorship resources National Coalition for Cancer Survivorship National Comprehensive Cancer Network survivorship guidelines 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 “It's hypothesized that radiation can also induce different DNA mutations in healthy cells or in tissues surrounding cancers that we're treating, including alterations in the structure of signal genes or chromosomes, or also causing changes in gene expression, which may help develop a neoplasia or a cancer in a patient's future. The development of cancer carcinogenesis that is impacted or caused by radiation has to do with the chemicals that are produced, the impact it has on cell proliferation, and how these changes and mutations can also pass on to daughter cells in the future as cells are replicating.” TS 2:34 “Younger people are much more susceptible to having a secondary cancer, especially because we know with treatments, we expect them to live a longer time. And once patients get to 5 and 10 years out from radiation is when we may see a secondary cancer develop. We also have seen research showing that females may be more sensitive to some of the carcinogenic effects of radiation. Underlying diseases and genetic mutations can also impact patients' risk.” TS 5:27 “I think a big thing is remembering that although the risk is really small, the risks does exist, and so it's something that we want to bring up with patients. And even if it is something 20 years down the line for a child being treated and making sure that this information is written down somewhere. So when reviewing records, anyone from a care provider to a family member might be able to say, ‘Okay, I see that, and I'm going to keep that on my radar.' And that's another big benefit of using NP- and nurse-led survivorship clinics and creating survivorship care plans.” TS 17:20

“Everyone will probably say this, but it is so true. Do not cram the night before the exam. The most important thing the night before the exam is to get a good night's sleep. You might be so nervous. You're like, ‘I can get any new information that matters right before the exam,' but you can't. Any information that you know you will have gotten in the time that you spent studying already. Really, you have to trust yourself,” Talia Lapidus, BSN, RN, professional staff nurse in the neonatal intensive care unit at UPMC in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about preparing for the NCLEX. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD.  ONS Podcast™ episodes: Episode 85: Nursing Resilience and Self-Care Aren't Optional Episode 27: How Self-Care Can Impact Your Nursing Practice ONS Voice articles: OCN® Certification Test-Taking Tips to Ease Your Anxiety Find Your Balance Between Work, Life, and School Practice These Five Self-Care Strategies in Less Than Five Minutes ONCC Certification Exam Resources: Benefits of certification  Prepare to test Review courses Practice tests ONS books: BMTCN® Certification Review Manual (second edition) Breast Care Certification Review (second edition) Core Curriculum for Oncology Nursing (seventh edition) Study Guide for the Core Curriculum for Oncology Nursing (seventh edition) ONS course: OCN® Certification Review Bundle ONS Wellness Breaks Joint Position Statement From ONS and ONCC: Oncology Certification for Nurses ONS Nurse Well-Being Learning Library Oncology Nursing Foundation Resiliency Resources NCLEX (National Council of State Boards of Nursing's licensure exam) UWorld Quizlet Cleveland Clinic article: How Box Breathing Can Help You Destress 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 biggest studying tip that I found when I was studying was just consistency. I was studying every day, and I was setting time aside every single day to study. It's really just about making sure that it's part of your daily routine. At first it feels weird, like going from school to just straight up studying. But that's really what school was for—finding a study method that works for you, that you can then implement into studying for the biggest test that you have to take.” TS 1:52 “Practice questions are everything. You mentioned already that the NCLEX questions are formulated in a very specific way. And I know some schools do all their exams in NCLEX style, but some schools don't, so some people might not know how the NCLEX formulates their questions. A lot of the time it's like you have to pick the most correct out of a lot of correct answers. And if you don't have practice critically thinking about how to answer these questions, you might get tripped up. So practicing these questions, knowing what the test will be like, is so important.” TS 6:46 “Time management is the best thing that you can do. When I was working, I still had goals for myself for studying, even if it was just study this topic today or do 10 practice questions today. Anything that you're doing is better than nothing. So if you have to color-code your life and, in Google Calendar, have two hours to work, two hours to study, or eat lunch from 12 to 1, and then from 1 to 2, you study. Anything that you have to do to make sure that you get at least a little bit of studying in matters.” TS 9:05 “You don't have to be studying 24/7. You have a life outside of the exam, and you should still live it. You should still see your friends, and you should still go out to eat. Do things that make you feel good because if you are not in your best headspace, you won't be able to study appropriately.” TS 18:50

“A lot of other disease sites, they have some targeted therapies, they have some immunotherapies [IO]. In lung cancer, we have it all. We have chemo. We have IO. We have targeted therapies. We have bispecific T-cell engagers. We have orals, IVs. I think it's just so important now that, particularly for lung cancer, you have to be well versed on all of these,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer treatment. 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 May 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to lung cancer treatments. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episode: Episode 359: Lung Cancer Screening, Early Detection, and Disparities ONS Voice articles: Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship Oncology Drug Reference Sheet: Amivantamab-Vmjw Oncology Drug Reference Sheet: Cisplatin Oncology Drug Reference Sheet: Lazertinib Oncology Drug Reference Sheet: Nivolumab and Hyaluronidase-Nvhy Oncology Drug Reference Sheet: Fam-Trastuzumab Deruxtecan-Nxki Optimize Your Testing Strategy and Improve Patient Outcomes With NeoGenomics' Neo Comprehensive™–Solid Tumor Assay Clinical Journal of Oncology Nursing article: Oncogenic-Directed Therapy for Advanced Non-Small Cell Lung Cancer: Implications for the Advanced Practice Nurse ONS Biomarker Database ONS video: What is the role of the KRAS biomarker in NSCLC? Biomarker Testing in Non-Small Cell Lung Cancer Discussion Tool ONS Huddle Cards: Checkpoint inhibitors External beam radiation Monoclonal antibodies Proton therapy 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 “Unfortunately, because lung cancer is pretty aggressive, we'll see lung cancer mostly in stage IV. So about 50%–55% of all cases are not caught until they are already metastatic, or stage IV. And then about another 25%–30% of cases are caught in stage III, which means they're locally advanced and often not resectable, but we do still treat that with curative intent with concurrent chemoradiation. And then 10%–20% of cases are found in the early stage, and that's stage I and II, where we can do surgical approaches.” TS 2:53 “The majority of radiation that you're going to see is for patients with stage III disease that's inoperable. At my institution, a lot of stage III is inoperable. Now, neoadjuvant immunotherapy has changed that a little bit. But if you have several big, bulky, mediastinal lymph nodes that makes you stage III, surgery is probably not going to be a great option. So we give curative-intent chemoradiation to these patients.” TS 10:51 “Oligoprogression would mean they have metastases but only to one site. And sometimes we will be aggressive with that. Particularly, there's good data, if the only site of progression is in the brain, we can do stereotactic radiation to the brain and then treat the chest with concurrent chemoradiation as a more definitive approach. But outside of that, the majority of stage IV lung cancer is going to be treated with systemic therapy.” TS 15:00 “It's important for nurses to know that there's a lot of different options now for treatment. Probably one of the most important things is making sure patients are aware of what their biomarker status is, what their PD-L1 expression level is, and make sure those tests have been done. … It's good that the patients understand that there's a myriad of options. And a lot of that depends on what we know about their cancer, and then that guides our treatment.” TS 31:05

“The signaling and that binding of the MET and the HGF help, in a downstream way, lead to cell proliferation, cell motility, survival, angiogenesis, and also invasion—so all of those key cancer hallmarks. And because of it being on an epithelial cell, it's a really good marker because it's found in many, many different types of cancers, so it makes it what we call kind of a nice actionable mutation,” ONS member Marianne Davies, DNP, ACNP, AOCNP®, FAAN, senior oncology nurse practitioner at Yale Comprehensive Cancer Center in New Haven, CT, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the MET 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 May 9, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to MET inhibitors. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs ONS Voice articles: Oncology Drug Reference Sheet: Amivantamab-Vmjw Oncology Drug Reference Sheet: Cabozantinib Oncology Drug Reference Sheet: Capmatinib Oncology Drug Reference Sheet: Tepotinib Predictive and Diagnostic Biomarkers: Identifying Variants Helps Providers Tailor Cancer Surveillance Plans and Treatment Selection ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) Telephone Triage for Oncology Nurses (third edition) ONS courses: Safe Handling Basics ONS Biomarker Database ONS Huddle Cards: Monoclonal Antibodies Targeted Therapy ONS Oral Anticancer Medication Learning Library ONS Oral Anticancer Medication Toolkit ONS and NCODA Oral Anticancer Medication Compass Oral Chemotherapy Education Sheets IV Chemotherapy Education Sheets Drugs@FDA 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 MET receptor was actually identified back in 1984. And it was actually identified as an oncogene in osteosarcoma. And so basically what that MET receptor does—it's a tyrosine kinase pathway, and the ligand that it attaches to is something called HGF/SF. That's hepatocyte growth factor/scatter factor. And so this MET pathway tyrosine kinase pathway is really important in tumor cell growth and migration. And it's expressed specifically on epithelial cells, so that's going to really help us in identifying how it can be a pathway for cancer treatments.” TS 1:35 “But in the particular classes, there kind of are some unique things that are with these MET inhibitors. For example, crizotinib, we found early on, causes some vision changes. Patients would report things like floaters or a little bit of blurry vision. For the capmatinib, things like elevation of amylase and lipase, fluid retention and bloating, and hypersensitivity reactions and photosensitivity.” TS 7:36 “Other things to teach for the TKI is the self-management strategies in terms of nausea management and dietary changes for the risk of peripheral edema. Having them do things like maybe doing daily weights, or at least weights every other day, and sometimes doing limb measurements so it can help us really quantify the amount of fluid retention they have. And then from a nursing perspective, meeting with these patients, is to do really good skin inspection. When people have peripheral edema, they're at risk for skin breakdown, and that can lead obviously to infection.” TS 16:06 “The biggest [misconception] is that people assume that all MET mutations are going to be equally responsive to the same targeted therapies, that all of the abnormalities are the same and react the same, and they really don't. We're really diving down and carving that pie thinner and thinner in terms of each individual MET abnormality, in terms of what drugs responds it to and what that means for patient outcomes and prognosis.” TS 25:21

“We spent time today discussing all the ways that owners can have a positive impact on career growth, whether you're a bedside nurse or just in teaching, research, hospital leadership. More than career growth, I see ONS as kind of a barrier to burnout and a catalyst for professional self-care. I think that no matter what aspect of oncology care you're involved in, it is a difficult and complex specialty. And I think with that can come a lot of challenges and tough days, and ONS brings a sense of community to that and, specifically, a community that is pushing cancer care forward,” ONS member Amy Kaiser, MSN, CPNP-PC, told Nick Escobedo, DNP, RN, OCN®, NE-BC, member of the ONS 50th anniversary committee, during a conversation about the benefits of ONS membership. Escobedo spoke with Kaiser, who joined ONS as a student, and Susan Groenwald, PhD, RN, ANEF, FAAN, a charter ONS member, about how ONS membership and resources have helped them grow in their careers. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD.  ONS Podcast™ episodes: 50th anniversary series Episode 331: DNP and PhD Collaboration Strategies to Help Advance Oncology Care Episode 327: Journey of a Student Nurse: Choosing Oncology Nursing and the Value of a Professional Home Episode 160: Build Innovative Staff Education Tools and Resources ONS Voice articles: Your ONS Membership Offers You Benefits in Other Organizations, Too Co-Creation Modernizes ONS Chapters to Meet Member Needs ONS book: Cancer Basics (third edition) ONS course: ONS Cancer Basics™ Clinical Journal of Oncology Nursing article: Professional Organization Membership: The Benefits of Increasing Nursing Participation ONS membership ONS chapters ONS Communities Connie Henke Yarbro Oncology Nursing History Center To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Groenwald: “ONS was groundbreaking in so many areas. The area that sticks out to me was, I was the board liaison to the standards committee. And so, the development of oncology nursing standards, it was a hallmark and critical to the field and to me and my practice, as well as education. It was very exciting time.” TS 4:18 Kaiser: “I think that my very first introduction to cancer care came from the Cancer Basics course. I think I feel fortunate that I probably was the recipient of a lot of the efforts of Susan, who has pioneered so many of these different oncology resources. I had the benefit of being at school during a time where there were a ton of resources available through ONS.” TS 5:38 Groenwald: “Having attended the meetings and getting involved in some of the committees is where I met people and worked with people. And that became, for me, very vital for doing a book, where it was a contributed book, an edited book [Cancer Nursing: Principles and Practice], so we had lots of different chapters and contributors, but I met them all through ONS. And how we communicated was via the old-fashioned mail and telephone. I didn't even have a computer. We typed the whole manuscript, thousands and thousands of pages, the first couple editions.” TS 12:25 Kaiser: “What's so wonderful about going to [Congress] is everybody there is looking to move oncology nursing forward and meet people and connect and network. And it's this, you know, magical space of people who are meeting and sharing shared experiences, and I got to feel all of that prior to even being an oncology nurse. And I went home from that first conference, immediately discussed with my manager that I wanted to move to the oncology floor, and I did. But it was meeting all of those people and hearing about those career paths that did that for me.” TS 16:42 Kaiser: “I think people who are involved with ONS, I found, are also very, very willing to mentor. I was very fortunate as I was speaking to these people, not even being an oncology nurse, that they were so welcoming and wanted to welcome me into the specialty and wanted to show me how to get involved. So I think it's just taking that very first step of talking to somebody or going to that local chapter meeting, and then the rest of it becomes a lot easier.” TS 19:29 Groenwald: “One thing Amy mentioned that I think is important is that new nurses have so many opportunities. I think it's scary to put forth an abstract to speak at the conference. It's scary, but it's such a great opportunity for anybody at any level in their career. If they have something of interest to share, it's such a great place. I feel like it launched my career in terms of being able to speak in front of people and think critically about things and put together some projects. This all came from my work with ONS.” TS 20:51

“Everyone's brain is extremely heterogenic, so it's different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They're highly aggressive biologically. It's a small area in a hard shell. So trying to get through the blood–brain barrier is different. There's a lot of areas of hypoxia in the brain. There's a lot of pressure there. The microbiology is very different—it's a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C, CCRP, research advanced practice nurse at the John Theurer Cancer Center of Hackensack Meridian Health in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about brain malignancies and caring for patients with them. 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 25, 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 brain malignancies and their diagnosis and treatment. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 235: Self-Advocacy Skills for Patients Episode 166: Cognitive Behavioral Interventions Help Patients With a Spectrum of Cancer Symptoms ONS Voice articles: Glioblastoma Diagnosis, Treatment, Side Effect Management, and Survivorship Recommendations Blocking Fatty Acid Storage May Induce Glioblastoma Apoptosis Brain Tumor Navigator Role Bridges the Intersection of Cancer and Neuroscience Researchers Tie More Cancers, Mortality to NF1 Disorders Larotrectinib and Other Tumor-Agnostic Targeted Therapies Are Leading Cancer Care Into the Next Frontier McCain Announcement Sheds Light on Nurses' Role in Advance Care Planning ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) Clinical Journal of Oncology Nursing articles: Implementing a Standardized Educational Tool for Patients With Brain Tumors Undergoing Concurrent Temozolomide and Radiation Therapy Exercise Intervention: A Pilot Study to Assess the Feasibility and Impact on Cancer-Related Fatigue and Quality of Life Among Patients With High-Grade Glioma Society for Neuro-Oncology Musella Foundation End Brain Cancer Initiative Brain Tumor Network American Brain Tumor Association Glioblastoma Research Organization Brain Tumor Funders' Collaborative Optune Gio® website Nurse.org article: Mysterious Brain Tumor Cluster Grows: Another Nurse Diagnosed at Newton-Wellesley Lori Cappello's contact information: lori.cappello@hmhn.org 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 “A glioblastoma actually is the most predominant brain tumor that we do see. It is the most diagnosed of the brain tumors. And then I would say that an anaplastic astrocytoma is probably the second diagnosed. Historically a GBM, they used to say was probably an elderly patient for these. But we are definitely seeing it diagnosed at a much younger age now, definitely much more prevalent for people under 60.” TS 3:17 “Nine times out of ten, either a patient out of nowhere has a seizure, or they present with what they think are stroke-like symptoms. They noticed that they were slurring, or they were becoming more forgetful, or a family member noticed it and said, ‘Hey, what is going on with you?' But usually they present to the [emergency department], and a [computed tomography] scan is always done first. And lo and behold, something is seen.” TS 4:50 “The only other U.S. Food and Drug Administration-approved treatment that has come along in the last 20 years is a device called Optune Gio, which is an alternating electric field that stops cell division at the mitosis stage.” TS 7:45 “They lose so much of their independence, especially if they don't have a caregiver or help. That is huge. Medication management at home, to making sure that they're taking the medication properly, that they are actually taking their medication. Transportation is another huge problem. Getting to and from appointments is a challenge. Those are big issues—real, day-to-day, simple issues that people don't think about.” TS 17:11 “I think that having a brain tumor is very unique in the fact that you really need a dedicated neuro-oncologist. And depending on where you live, there are not a lot in the area. I actually had a patient that was moving out west, and the closest dedicated neuro-oncologist was four hours from them. … if you're not seeing dedicated neuro oncologists, you might not be getting the best treatment for yourself. So I think that having the resources and helping patients find the best care or the best brain tumor society—and there's a bunch of really good brain tumor groups to help patients find the best resources out there. I think that's really, really important for patients to know or for families to know.” TS 19:17 “So trying to help patients, there are always going to be challenges, and there are always going to be ups and downs. But finding that one person that they can go to, that they trust, that they have a great relationship with, whether at the doctor's office or whatever, and being available to them makes such a difference in their journey. I think that that is the most important for anybody in the journey.” TS 22:08 “With brain, there are going to be expectations. They are going to lose functionality at some point—and preparing them for that thing or preparing them for things that can help themselves. Like sometimes I say, ‘Go to the dollar store, get coloring books,' if they have weakness in one hand. Little tricks of the trade that can help them. About treatment options, going through the side effects, preparing them for whatever they can be prepared for.” TS 22:39 “It is not one of the better cancers to have, but it doesn't immediately mean it's a death sentence, and we shouldn't treat them like they're dying. We shouldn't take away their ability to live just because they were diagnosed with it. We shouldn't take away hope.” TS 25:35 “I think there's not enough discussed about [brain malignancies] and the lack of resources for this. These patients need a lot more resources and are available. There's just not enough available for it.” TS 26:59

Episode 359: Lung Cancer Screening, Early Detection, and Disparities “I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don't want to do it.' And I said, ‘Do you remind them that lung cancer is curable?' Because everybody thinks it is a death sentence. But when you're talking about screening a patient, I think it's really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60% to 70%,'” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer screening. 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 18, 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 lung cancer screening. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion Episode 247: Tobacco Treatment for Patients With Cancer ONS Voice articles: Lung Cancer Screening and Early Detection Drastically Improves Survival Rates Pack-Year History Is a Biased and Inadequate Criterion for Lung Cancer Screening Eligibility, Researchers Say CMS Expands Eligibility Criteria for Lung Cancer Screening With Low-Dose Computed Tomography Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship Clinical Journal of Oncology Nursing articles: Nurse-Led Tobacco Cessation for Veterans Using Motivational Interviewing in a Lung Cancer Screening Program Identifying Primary Care Patients at High Risk for Lung Cancer: A Quality Improvement Study Oncology Nursing Forum article: Patient–Provider Discussion About Lung Cancer Screening Is Related to Smoking Quit Attempts in Smokers ONS Tobacco, E-Cigarettes, and Vaping Learning Library American Cancer Society Lung Cancer Screening Guidelines American Lung Association lung cancer resources To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Unfortunately, the current state of lung cancer screening is pretty low. Our rate of uptake in eligible patients is somewhere between 6% and 20%. And that falls much further below what we see for screening, such as breast cancer screening, prostate cancer screening, and colorectal cancer screening. So certainly, we can do better.” TS 1:32 “If you quit more than 15 or 20 years, your risk of developing lung cancer at that point is significantly lower. And so that's why once patients have quit more than 15 years, they're actually not eligible for screening anymore—because their risk of developing lung cancer is dramatically reduced. And that takes into account when you are a primary care provider, pulmonary, whatever field you work in, and you are running a screening clinic each year that you screen the patient, you have to remind yourself when they quit smoking, because once they reach that 15 years, then they're no longer eligible for screening.” TS 5:17 “One of the strategies that they've used to get the word out is, I watch a lot of baseball. I love the Philadelphia Phillies, watch Phillies games. And so at least once a year, maybe even twice a year, they will take an inning of the baseball broadcast on TV and on the radio separately, and they will bring on either an oncologist or pulmonologist from one of the local cancer centers in our area, and the whole inning—between batters of course—they will talk about lung cancer screening and why it's beneficial.” TS 13:16 “Medicare always has its idiosyncrasies. So Medicare—I went over the rules with you, so the age, the smoking. They follow all of it, except they have a slight difference in age. They cover it for age 50 to 77, as opposed to 80.” TS 16:52 “I think just the other thing that people don't think about is that to go get a medical test done, no matter what test it is, typically people have to take time off of work. And it can be really hard to do that when you are relying on your job, maybe you don't have vacation time, maybe you have children at home that you need to get home to. When people are weighing the risk/benefit and thinking, ‘Well, I'd love to get screened for lung cancer, but I just can't find time to fit it into my schedule, and my job won't let me take off.' These are all things that we don't always think about if you have the luxury of just taking the day off.” TS 20:01

“It's been known for quite a while that [KRAS] is a mutation that leads to cancer development, but for really over four decades, researchers couldn't figure out a way to target it. And so, it was often considered something that was undruggable. But all of this changed recently. So about four years ago, in 2021, we had the approval of the first KRAS inhibitor. So it's specifically a KRAS G12C inhibitor known as sotorasib,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the KRAS 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 April 11, 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 KRAS inhibitors used for cancer treatment. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Cancer Symptom Management Basics series Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs ONS Voice articles: First KRAS-Targeted Therapy Receives FDA Approval for Lung Cancer Oncology Drug Reference Sheet: Adagrasib Oncology Drug Reference Sheet: Sotorasib ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) ONS course: Safe Handling Basics ONS video: What is the role of the KRAS biomarker in NSCLC? ONS Targeted Therapy Huddle Card ONS Oral Anticancer Medication Learning Library ONS Oral Anticancer Medication Toolkit ONS and NCODA Oral Anticancer Medication Compass Oral Chemotherapy Education Sheets Lumakras® (sotorasib) manufacturer website Krazati® (adagrasib) manufacturer website UpToDate Lexidrug (formerly Lexicomp) 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 “If we look at specifically non-small cell lung cancer, this KRAS mutation is one of the most frequently detected cancer drivers or driver mutations. It's thought that about a quarter of cases of non-small cell lung cancer have this KRAS mutation, and it's usually a specific amino acid substitution that we see in non-small cell lung cancer, so what's known as KRAS G12C mutation.” TS 2:31 “Both of these agents, sotorasib and adagrasib, have the same mechanism of action. They bind to a pocket, very specifically on the KRAS G12C protein, and they lock it in an inactive state so that it can't cause that downstream uncontrolled signaling to happen. So they're kind of shutting down the signaling, and therefore you don't get that uncontrolled cell growth and proliferation.” TS 4:27 “Another big difference to point out, and one that is often used in clinical practice to differentiate when to use these agents, is specifically adagrasib is known to have activity in patients with metastatic non-small cell lung cancer that have active brain metastases. In the clinical trial, they included patients with active brain metastases, and they found that this drug has great [central nervous system] penetration. And so it may be considered the agent of choice in patients with brain metastases.” TS 7:19 “Other considerations—I think one of the big ones—is that there are a lot of drug interactions. Just specifically calling one out that I think is pretty impactful, is sotorasib has an interaction with acid-suppressing medications. So there is the recommendation to avoid [proton pump inhibitors] and H2 antagonists in patients receiving sotorasib. They can take antacids, but you would need to space those out from their dose of sotorasib.” TS 14:14 “This needs to be a collaborative endeavor to make sure these patients are monitored appropriately. We are putting a lot of responsibility on the patients with all of this. So, again, completely administered generally in the home setting, a lot of monitoring, a lot of adverse effects, need for reporting and management—so there's a lot happening here. And it takes a team to accomplish this and to do it right. And I firmly believe that this is often a collaborative effort between our pharmacy and oncology nursing teams to make this happen. Working together to ensure outreach to patients—I think that patients are often more successful with these medications with early identification of toxicities when we're doing scheduled outreach.” TS 19:44

“There have been many changes since the '70s that have shaped the nurse's role in administering chemo, and in supporting patients. The major change early on was the transition from that of nurses mixing chemo to that of pharmacists. Regulatory agencies like NIOSH and OSHA defined chemotherapy as hazardous drugs, and professional organizations became involved, leading to the publication of the joint ASCO and ONS Standards of Safe Handling,” ONS member Scarlott Mueller, MPH, RN, FAAN, secretary of the American Cancer Society Cancer Action Network Board and member of the Oncology Nursing Foundation Capital Campaign Cabinet, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, ONS member and chair of the ONS 50th Anniversary Committee during a conversation about the evolution of chemotherapy treatment. Along with Mueller, Burbage spoke with John Hillson, DNP, NP, Mary Anderson, BSN, RN, OCN®, and Kathleen Shannon-Dorcy, PhD, RN, FAAN, about the changes in radiation, oral chemotherapy, and cellular therapy treatments they have witnessed during their careers. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  This episode is not eligible for NCPD. ONS Podcast™ episodes: 50th anniversary series Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs Episode 59: Blood and Marrow Transplant Nursing Episode 16: Navigating the Challenges of Oral Chemotherapy ONS Voice article:Safe Handling—We've Come a Long Way, Baby! ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition) Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition) Safe Handling of Hazardous Drugs (fourth edition) ONS courses: ONS Hematopoietic Stem Cell Transplantation™ ONS/ONCC® Chemotherapy Immunotherapy Certificate™ ONS/ONCC® Radiation Therapy Certificate™ Safe Handling Basics Oral Anticancer Medication Toolkit Oral Anticancer Medication Care Compass Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers: IV Cancer Treatment Education Sheets Oral Chemotherapy Education Sheets Connie Henke Yarbro Oncology Nursing History Center To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Hillson: “I remember as a new grad, from back in '98, walking up to the oncology floor. We had patients with pink labels on the chart and that was the radiation oncology service. I hadn't heard of such a thing before. … I'd gone through nursing school and hospital orientation and unit orientation without ever hearing of these therapies. At the time, both the management and the union had no interest in specialist nurses, and the really weren't any books that were targeting the role. And it was very isolating and frightening. I was very glad to find ONS when I moved to the U.S. Right now, the Oncology Nursing Society Manual for Radiation Oncology, Nursing Practice, and Education, it's in its fifth edition and a sixth is underway. There's nothing else like it. Most books are very much geared towards other professions.” TS 5:34 Mueller: “We mixed our chemo in a very small medication room on the unit, under a horizontal laminar flow hood, which we later discovered should have been a vertical laminar flow hood. Initially, we did not use any personal protective equipment. I remember mixing drugs like bleomycin and getting a little spray that from the vial onto my face. And to this day, I still have a few facial blemishes from that.” TS 14:28 Anderson: “As the increasing number of these actionable mutations continue to grow, so will the number of oral anticancer medications that patients are going to be taking. And we are already seeing that there's multiple combination regimens and complex schedules that the patients have to take. So this role the oral oncolytic nurse and the nursing role, like you said, it cannot be owned by one individual or discipline. So it's not a pharmacist; the pharmacies aren't owning this. The nurses are not owning this. It takes a village.” TS 32:12 Shannon-Dorcy: Then as immunotherapy comes into the picture, we start to learn about [cytokine release syndrome]. All of a sudden, we had no concept that this was a deadly consequence. ONS was on the front lines, convening people across the country together so we could speak to the investigative work with science and find ways that we could intervene, how we can look for signs of it early on with handwriting testing.” TS 39:58

“And so you have different kinds of hazards with the drugs that you're using. That means that in the past, when a lot of oncology drugs, antineoplastic drugs used to treat cancer would have been added, you may see that a lot of oncology drugs either weren't added or they're added in a different place on the list than they were in the past. That's due to some of the restructuring of the list we'll probably talk about later,” Jerald L. Ovesen, PhD, pharmacologist at the National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the latest update to the NIOSH list of hazardous drugs.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Episode Notes   NCPD contact hours are not available for this episode.  ONS Podcast™ episodes: Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs  Episode 142: The How-To of Home Infusions Episode 68: Empowering Healthcare Workers to Handle Hazardous Drugs Episode 53: Home Care Nursing for Patients With Cancer ONS Voice articles: Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE  NIOSH Releases Its 2024 List of Hazardous Drugs  No Place Like It: Home Care for Patients With Cancer  What Is ONS's Stance on Handling Chemotherapy While Pregnant, Breastfeeding, or Trying to Conceive?  What You Wear Matters When It Comes to Safety  ONS book: Safe Handling of Hazardous Drugs (Fourth Edition)  ONS course: Safe Handling Basics  Clinical Journal of Oncology Nursing article: Safe Management of Chemotherapy in the Home  ONS Learning Library: Safe Handling of Hazardous Drugs  ONS Position Statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs  National Institute for Occupational Safety and Health article: Managing Hazardous Drug Exposures: Information for Healthcare Settings  NIOSH List of Hazardous Drugs in Healthcare Settings, 2024  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  “So we look for a carcinogenic hazard. So does this molecule, does this chemical, this drug, have the ability to increase the risk of cancer? A lot of the time that will also tie with genotoxic hazards, but not always. There are some drugs on the list that are carcinogenic through other mechanisms. Sometimes carcinogenicity can be related to hormone signals, can lead to increased risk of cancer. There's some nuance there, but is it a carcinogenic hazard? That can get it onto the list. Is it a developmental and reproductive hazard?” TS 10:48  “NIOSH can't say what's right for every situation, but some organizations have suggested further precautions such as temporary alternative duty for workers who are pregnant or are looking to become pregnant. NIOSH can't say what's best for any given facility, but other organizations have given some good suggestions you may want to look into.” TS 13:18  “The list doesn't really rank hazard. I know a lot of people have kind of treated it that way a lot of times. We don't say that something is less hazardous if it's only a developmental or reproductive hazard, because if you're trying to have a child, then that's an important hazard to you. And we don't necessarily say something that's carcinogenic is more hazardous.” TS 14:34  “Some standard setting organizations have set standards for handling. Really in the oncology setting, particularly oncology pharmacy setting, it's really changed how some of the handling happens there because some of the standards come out of the pharmacy world. And what's happened there is some drugs that are oncology drugs, they might have been on table one before just because they were used in the treatment of cancer. They were antineoplastics, so they were on table one. Now, because they're not identified as a potential carcinogen and they don't have manufactured special handling information, they are now on table two.” TS 23:39  “Occasionally, if a drug comes out and has manufacturer special handling information, we'll go ahead and add it to the list. And since we won't add it into the publication, we typically have a table on that page that puts that there. If a drug is reevaluated and we find that the hazard is not as bad as expected or it's not a hazard, actually, and we can remove it from the list; sometimes we get new information and that happens.” TS 30:30 

“I genuinely think nurses and pharmacists need to know why these medicines are called hedgehog inhibitors so that we can, in fact, effectively educate our patients. Just because to date, this class has the weirdest name I've encountered, and I almost expect at this point that my patients are going to ask me about it. I think that we need to be informed that, just on, where do these names come from, why is it called this, and does it matter to my patient?” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about hedgehog pathway 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 March 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase in knowledge related to hedgehog pathway inhibitors used for cancer treatment.  Episode Notes   Complete this evaluation for free NCPD.  ONS Podcast™ Pharmacology 101 series  ONS Voice articles: An Oncology Nurse's Guide to Targeted Therapy FDA Approves Glasdegib for AML in Adults Aged 75 or Older or Who Have Comorbidities Oncology Drug Reference Sheet: Glasdegib Understanding Precision Medicine Therapeutics ONS courses: Genomic Foundations for Precision Oncology ONS Cancer Biology™   ONS Guidelines™ and Symptom Interventions:  Diarrhea Fatigue ONS Huddle Card: Targeted Therapy ONS Learning Libraries: Oral Anticancer Medication Pain Management  Oral Chemotherapy Education Sheets American Association for Cancer Research article: Hedgehog Pathway Inhibitors: A New Therapeutic Class for the Treatment of Acute Myeloid Leukemia American Journal of Clinical Dermatology article: Evaluation of the Tolerability of Hedgehog Pathway Inhibitors in the Treatment of Advanced Basal Cell Carcinoma: A Narrative Review of Treatment Strategies Cureas article: Hedgehog Pathway Inhibitors: Clinical Implications and Resistance in the Treatment of Basal Cell Carcinoma International Journal of Molecular Sciences article: Hedgehog Pathway Inhibitors as Targeted Cancer Therapy and Strategies to Overcome Drug Resistance  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  “Many patients unfortunately will have side effects with this class. I mean—and I know that's not controversial—but you actually find callouts in some of the kind of the national consensus guidelines. These treatments might not be tolerable for a decent number of patients. Some of these side effects can certainly reduce quality of life. Again, nothing that controversial here when we say it out loud, but just the frequency with which it occurs can make it quite difficult for some patients.” TS 9:13  “Certainly, based on what we said before, I think one of the easiest things to do for patients starting this class is to just make sure that they have really classical supportive medicines like antidiarrheals and antiemetics before they start treatment. Diarrhea, nausea occurred in about 20%–40% of patients across trials. So certainly patients should be aware of that risk. Again, not a controversial side effect, but it's just simple things we can do to make sure that our patients are quick to start treatment is to make sure that they have these medicines and they're educated on how to use them.” TS 11:21  “I think patients need to be aware that side effects, as I had mentioned before, can be especially frequent with this class. So for a patient, they need to be aware that communicating your needs to your oncology team is really crucial to their own ability to use these treatments with minimal interruptions.” TS 14:45  “I think that regardless of whoever is following up with our patients, though, as our arsenal of oral anticancer therapies does continue to expand, both nurses and pharmacists need to have specialized knowledge of these agents to be successful in their patient care roles.” TS 18:28  “When there are clear recommendations for reproductive health, as I summarized before with these agents, I obviously think we need to be aware of them and not just defer to these generic recommendations. Because if you just defer to, ‘Well, use barrier contraception and then for a week after your last dose,' you know, ‘Okay, it's not true with these agents.'” TS 24:37   

“You can give someone a survivorship care plan, but just giving them doesn't mean that it's going to happen. Maybe there's no information about family history. Or maybe there's information and there's quite a bit of family history, but there's nothing that says, ‘Oh, they were ever had genetic testing,' or ‘Oh, they were ever referred.' So the intent is so good because it's to really take that time out when they're through with active treatment and, you know, try to help give the patient some guidance as to what to expect down the line,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer survivorship.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by March 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase in knowledge related to breast cancer survivorship.  Episode Notes   Complete this evaluation for free NCPD.   Previous ONS Podcast™ site-specific episodes: Episode 350: Breast Cancer Treatment Considerations for Nurses  Episode 348: Breast Cancer Diagnostic Considerations for Nurses  Episode 345: Breast Cancer Screening, Detection, and Disparities  ONS Voice articles: Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations  Improve Management of Common Symptoms for Breast Cancer Survivors  Nursing Considerations for Breast Cancer Survivorship Care  Sexual Considerations for Patients With Cancer ONS books:  Breast Care Certification Review (second edition)  Guide to Breast Care for Oncology Nurses  ONS course: Breast Cancer Bundle  ONS Learning Libraries:  Breast Cancer  Genomics and Precision Oncology  Nurse Navigation  Oral Anticancer Medication   Survivorship  ONS Guidelines™ and Symptom Interventions:  Anxiety  Cognitive Impairment  Depression  Fatigue  Clinical Journal of Oncology Nursing article: Survivorship Care: More Than Checking a Box  Clinical Journal of Oncology Nursing supplement: Survivorship Care  American Cancer Society:  Cancer Treatment and Survivorship Facts and Figures  Survivorship: During and After Treatment  Livestrong® Program at the YMCA  National Comprehensive Cancer Network  National Cancer Institute Breast Cancer—Patient Version    To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From This Episode  “I think the biggest thing is to really communicate is that people are living with breast cancer for a long, long periods of time, and a lot of that with really good quality overall.” TS 4:07   “As a general rule, they're going to be seen by the breast surgeon probably every four to six months for a while. After about five years, a lot of times people are ready to say, ‘Okay, annually is okay.' And eventually they may let that drop off. But it also depends on did they have a mastectomy? Did they have breast conserving surgery? And then if they had reconstruction with an implant, how often do they see the plastic surgeon? Because they need to check integrity of the implant. So those schedules are really individualized.” TS 13:24  “When you think about long-term effects, I think you need to kind of think about that survivors can have both acute and long-term chronic effects. And a lot of that depends on the specifics of the treatment they had. I think as oncology nurses, we're used to, ‘We give you this chemotherapy or this agent, and these are the side effects.'” TS 15:36  “The diet issues are huge. And I think we are slow to refer to the dietician, you know, you can get them a couple of consults and because you're saying to them, ‘This is really important. We need you to lose weight or we need you to eat more of this.' Ideally, fruits and vegetables are going to be about half of your plate. And what's the difference between a whole grain and not, less processed foods, making sure that they're getting enough protein. And then once again, really kind of making sure that they're not taking a lot of supplements and extra stuff because we don't really understand all that fully and it could be harmful.” TS 34:53  “Breast cancer is a long, long journey, and I think you should never underestimate the real difference that nurses can make. I think they can ask those tough questions. And I think ask the questions that are important to patients that patients may be reluctant to ask. I think giving patients permission to talk about those less-talked-about symptoms and acknowledge that those symptoms are real and that there are some strategies to mitigate those symptoms.” TS 42:28   

“The response was, in my opinion, sort of overwhelmingly positive. I think all of us old-timers who were at ONS Congress® in 1986 remember those 1,600 nurses waiting in line to enter the ballroom to take that inaugural exam. It takes a while to check in 1,600 people. They kind of all filled up the lobby outside of the ballroom, and then they spilled over down into the escalator, and the escalators had to be turned off,” Cyndi Miller-Murphy, MSN, FAAN, CAE, first executive director of the Oncology Nursing Certification Corporation (ONCC), told Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, ONS member and member of the ONS 50th anniversary committee, during a conversation about the evolution of oncology nursing certification. Beaver spoke with Tony Ellis, MSEd, CAE, ICE-CCP, executive director of ONCC, and Miller-Murphy about the history, current landscape, and future of certification in oncology nursing. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  NCPD contact hours are not available for this episode.  ONS Podcast™ episodes: Episode 254: Oncology Nursing Certification Affects the Entire Cancer Care System Episode 186: Certification Can Fuel Your Leadership Skills and Professional Growth ONS Voice articles: Certification Was a Critical Step Along My Oncology Nursing Career Journey OCN® Certification Test-Taking Tips to Ease Your Anxiety ONS books: Advanced Oncology Nursing Certification Review and Resource Manual (third edition) Breast Care Certification Review (second edition) BMTCN® Certification Review Manual (second edition) Core Curriculum for Oncology Nursing (seventh edition) Study Guide for the Core Curriculum for Oncology Nursing (seventh edition) ONS courses: OCN® Certification Review Bundle ONS AOCNP® Certification Review Bundle™ Clinical Journal of Oncology Nursing article: Findings From the 2023 Radiation Oncology Nursing Role Delineation Study to Shape the Future of the Subspecialty Oncology Certification for Nurses: Joint Position Statement From the Oncology Nursing Society and the Oncology Nursing Certification Corporation ONCC website Connie Henke Yarbro Oncology Nursing History Center To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Miller-Murphy: “Oncology nursing is a highly specialized area with a broad, well-defined body of knowledge, and it's essential for employees and healthcare consumers to be able to identify nurses who have demonstrated that they possess the knowledge that's necessary to practice competently in the specialty. Nurses who become certified take that essential step to publicly demonstrate their knowledge. And I believe this makes them a known commodity, so to speak.” TS 1:49 Ellis: “Oncology nursing is an area of high-stakes patient care, and a core purpose of certification is to safeguard the public. This is certainly an area of health care that benefits from having that role of professional certification being played, from the knowledge requirements to the practice hours that a nurse must have, to the performance on the exam and continued competence required to maintain the certification. Our certifications hold nurses to a higher standard, which helps protect the public in the care that they provide.” TS 2:45 Miller-Murphy: “A group of, I think, 200 nurses got together at an American Cancer Society conference back in 1980 to discuss the desire for certification in ontology. Nurses wanted a way to verify their specialized knowledge and skills. They wanted to raise the level of professionalism, and ONS was the most appropriate organization to develop the certifications. And by 1983, a survey of members revealed strong interest in specialty certification in oncology.” TS 5:29 Ellis: “The pace of change in oncology care is really the challenge for certification programs proper right now. There's so many wonderful advances—oncology treatments and drugs that are coming to the market that are being used in non-oncology settings and other advancements in the practice, that keeping up with that change puts pressure on certification programs because they must validate knowledge and practice that has become standard. It has to have been in the practice long enough that whatever the content, whatever the practice is that you're testing on, that there is one single correct answer. So you can't necessarily test on the very latest of what has come to the market or to the practice. The other flipside of that is that pace of change, the new emerging things in the practice create opportunities for other kinds of credentials.” TS 24:31 Ellis: “What we have found is that there are thousands and thousands of oncology nurses that are practicing at a level and doing specialized work beyond the scope of the OCN® body of knowledge—so at the master's level, PhD, especially with the advent of the DNP, and there is work there. And this really came out of our work to update the advanced oncology nurse competencies. … So the new certification is the Advanced Certified Oncology Nurse, or the ACON. In certification, and it is suited for those nurses that are practicing at that higher level.” TS 32:52

“Now, what we found is that epigenetics is actually heritable and it's actually reversible. And we can now manipulate these principles with pharmacotherapy drugs,” Eric Zack, RN, OCN®, BMTCN®, clinical assistant professor at Loyola College Chicago Marcella Niehoff School of Nursing in Chicago, IL, and RN3 at Rush University Medical Center in Chicago, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the epigenetics drug class.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 0.75 contact hours (including 40 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 28, 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 epigenetics drug class.  Episode Notes   Complete this evaluation for free NCPD.  ONS Podcast™ Pharmacology 101 series ONS Voice articles: Financial Navigation During Hematologic Cancer Saves Patients and Caregivers $2,500 Oncology Drug Reference Sheets What Is MCED Testing? ONS book: Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (Fourth Edition) ONS Biomarker Database ONS course: Genomic Foundations for Precision Oncology ONS Huddle Card: Financial Toxicity  ONS Learning Libraries: Genomics and Precision Oncology Oral Anticancer Medication American Cancer Society: Patient Programs and Services Centers for Disease Control and Prevention: Epigenetics, Health, and Disease Leukemia & Lymphoma Society: Financial Support National Institutes of Health: Epigenetics University of Pennsylvania: Epigenetics Institute University of Utah: Genetic Science Learning Center To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From This Episode  “Epigenetics is influenced by several factors. Right now, there's about seven of them that we've identified, and we can only manipulate right now about two of those seven. So the first one is DNA methylation. When you methylate DNA, that's adding or subtracting a methyl group, which is CH3, chemically. The addition of methyl to DNA tightens the DNA around the chromatin, which then can block some genes from being expressed.” TS 7:21  “Histones basically package DNA into the chromatin, which is a mixture of DNA and proteins, and they spool around this structure like the DNA is coiled around that. And again, it has to do with how tight or loose that is coiled. That determines if the genes are expressed or not. And again, we found that histones also play a role in DNA repair as well as regulating the cell cycle.” TS 8:21  “When we're dealing with the azacitidine and decitabine, these drugs cause pancytopenia. Pancytopenia is neutropenia, thrombocytopenia, and anemia. So it affects the complete blood count. We see GI toxicity, nausea, vomiting, diarrhea, constipation, sometimes mouth sores, and urticaria—hives.” TS 15:34  “It's really, really important to take these drugs exactly as they are prescribed. They have to follow the doctor's orders carefully, which requires taking them properly, doing the proper follow up. There's a lot of blood tests and appointments that we have to do to make sure that everything is okay. And again, because we know when there is nonadherence, the disease progresses and becomes resistant, so that's a really, really important teaching point. We have to monitor the patient for expected side effects and unexpected side effects.” TS 23:58  “Now, we expect the landscape to change dramatically over the next few years. And again, it's just an explosion of science information. As we learn more about the science, it's going to translate into practice. We're always identifying new biomarkers. These biomarkers are essentially DNA mutations or variations. There's so many variants of unknown significance.” TS 30:02  “Every patient deserves biomarker testing. Very important, whether it's through IHC, polymerase chain reactions, or the most common next-gen sequencing. Again, there's several companies out there that have standard kits available.” TS 31:33  “This is a precision medicine. This is what we've always dreamed about—tailoring the treatment to the specific patient. We've gone away from treating standard diseases, like lung cancer and breast cancer, the way they're supposed to be treated to now looking at these biomarkers and using epigenetic drugs and other medications tailored to those variants that that patient is having, not necessarily based on their disease type.” TS 33:59   

“It is very much a collaborative group process. There are group meetings where we come to consensus on our different ratings. There's so much support from ONS staff, even amongst our different groups, even when you're assigned to one peer reviewer. Let's say you go on vacation, sometimes we're paired with other people, too. So there is some flexibility in the opportunity as well,” Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®, lecturer at Old Dominion University in Norfolk, VA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Episode Notes   Complete this evaluation for free NCPD. ONS Podcast™ episodes:  Episode 342: What It's Like to Serve on the Leadership Development Committee  Episode 323: What It's Like to Participate in an ONS Think Tank  Episode 76: ONS Guidelines Will Answer Key Symptom Management Questions  ONS Voice articles: A Spirit of Inquiry Leads to Evidence-Based Answers to Practice Questions  Search the Literature to Critically Appraise Evidence  Working Together, Passionate ONS Volunteers Are Transforming Cancer Care  What Brings You Value in ONS? You Can Thank a Volunteer for That  ONS blog: I Volunteered at the 47th Annual ONS Congress®—Here's What I Learned  ONS course: Treatment and Symptom Management—Oncology RN  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.    To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.   To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.   Highlights From This Episode   “As far as how it would help oncology nurses, we try to make it honestly simpler by doing the legwork of reviewing the evidence, synthesizing what the rating of the evidence and what it means. And then as you'll see on the symptom intervention resource, you'll see kind of a snapshot of what our recommendations are for applying it to practice.” TS 7:46  “I am a clinical nurse specialist and now that I work in academia, this is a very important skill for me to build and have in my profession. Also, those group meetings that we have, I really appreciated being able to learn from others and then being able to teach that to others. So in this second round, for example, the thing that I've really enjoyed personally is actually being able to mentor somebody that maybe hasn't done it as often and just being able to watch them grow and improve in their skills while you provide feedback.” TS 9:05  “We get a new article about every two weeks, and this involves about a week for myself and then about a week or less than that for my partner to go through this process as well. So being able to manage your time to afford your partner the time to solidly look through the article as well. And then being able to collaborate and receive feedback from your peers.” TS 13:06  “There have been times where the evidence has not given us the results that I think we were assuming we would see. And so while the standardized tools mitigate some of the bias, we do recognize that it won't remove the bias entirely, but it does help make your view more objective. What are some common misconceptions about developing symptom intervention resources? I'd say personally, I don't know if I had misconceptions before I was part of the team as much as I just didn't know what the process entailed.” TS 18:18  “ONS is really committed to the growth of its members. I've really enjoyed being part of this volunteer opportunities and the other ones that I've been a part of. So truly, if you have a passion for something and you have the skills, ONS would love to have you and you will meet some of the greatest people in doing these opportunities. I've made some of the best connections and friendships through the volunteer opportunities I've done.” TS 21:35 

“This is what totally drives the treatment decisions, and that's why having that pathology report when the nurse is educating the patient is so important, because you can say, well, you have this kind of breast cancer, and this kind of breast cancer is generally treated this way,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer treatment.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 1.0 contact hours (including 15 minutes of pharmacotherapeutic content) of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase in knowledge related to breast cancer treatment considerations.  Episode Notes   Complete this evaluation for free NCPD. Previous ONS Podcast™ site-specific episodes: ONS Voice articles: Episode 348: Breast Cancer Diagnostic Considerations for Nurses Episode 345: Breast Cancer Screening, Detection, and Disparities ONS Voice articles: An Oncology Nurse's Guide to Cascade Testing  Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations  Learn How to Read a Germline Genomic Testing Report  Learn How to Read a Somatic Biomarker Testing Report  Sexual Considerations for Patients With Cancer  ONS books: Breast Care Certification Review (second edition)  Guide to Breast Care for Oncology Nurses  ONS courses: Breast Cancer Bundle  Breast Cancer: Treatment and Symptom Management  ONS Biomarker Database results for breast cancer ONS Next-Generation Sequencing Sample Report  ONS Learning Libraries: Breast Cancer Genomics and Precision Oncology   American Cancer Society: Breast Cancer Facts and Figures  Your Breast Pathology Report: Breast Cancer National Comprehensive Cancer Network   National Cancer Institute Breast Cancer—Patient Version  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From This Episode  “Local treatment is typically going to consider some kind of surgery with or without radiation, depending on the surgery and the extent of the breast cancer. All women are going to have, and today when you use the word women, individuals assigned female at birth, they are the vast majority of individuals being treated for breast cancer, but for individuals assigned male at birth, there's not near as much research, but generally their treatment is very similar. So that's something to kind of keep in the back of your mind.” TS 2:39  “This is very confusing for patients because they're like, ‘Well, my friend at church had this and why am I getting this and why are they getting something different?' And that is because of the pathology report. So taking that time to explain that with a pathology, I think is really important.” TS 8:31  “When they see the breast surgeon, all individuals are going to have some kind of axillary evaluation.  Now, hopefully it's going to be a sentinel lymph node. So they're going to, at the time of surgery, put a tracer and, you know, they're going to take out maybe one, two, three lymph nodes and hopefully, you know, there is not a lot of disease there. And if that's the case, they're kind of done with that. So the sentinel lymph node evaluation, it's really more to stage and provide that information, but it kind of sets the stage a lot of times for the other treatments selections. And I think people need to realize that this is important. This is a very important procedure.” TS 15:31  “Years ago, when women had a breast mass, they went to the OR and it was biopsied in a frozen section and if it was positive, they had a mastectomy. So women would wake up and they'd be feeling their chest because they're like, ‘What happened here?' And that is not great care. It doesn't give that woman any autonomy, but it was the best that could be done at that point. Now, with the diagnostic where we can do a needle biopsy, they can kind of stop and take a timeout and we can kind of clinically stage that.” TS 17:04  “For women that really desire breast-conserving therapy, they can anticipate that postoperatively at some point, they're going to have treatment to the entire breast, we typically call whole breast radiation, and then they may have a boost. Now, in many, many probably cases, that's going to be over five to six weeks, Monday through Friday. So the treatment itself doesn't take but a couple of minutes, but you have to get to the facility. And even though we streamline check-in processes and whatnot, you have to get undressed, you have to get positioned on the table. So it is a commitment, and it can be disruptive.” TS 24:49  “The hormone-blocking agents are going to be the cornerstone of all those treatments for anyone who has hormone receptor–positive breast cancer. So they are going to take these agents and as you said, they're probably going to take them for 5–10 years. It's quite the journey.” TS 32:33   “I think you need to be mindful that if someone has had germline testing and they've tested positive, they are not only worried about themselves, and they are worried about the rest of their family. That is a big deal. And even though I'll hear mothers say, ‘I feel so guilty, now my daughter has this,' now, I've never heard a daughter come and say, ‘Gosh, I wish my mom hadn't had me because of this.' There's a lot of feeling and emotion that goes on with that, and realize that those individuals are probably going to have fairly complicated management that goes over and above their breast cancer.” TS 41:50 

“What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, there were a lot of nurses who were skeptical about the need for self-protection. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors,” ONS member Martha Polovich, PhD, RN, AOCN®-Emeritus, adjunct professor in the School of Medicine at the University of Maryland, told Liz Rodriguez, DNP, RN, OCN®, CENP, ONS member and 50th anniversary committee member, during a conversation about the evolution of safe handling of hazardous drugs and ONS's role in shaping safe handling policies. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 7, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the evolution of safe handling guidelines. Episode Notes  Complete this evaluation for free NCPD.    ONS Podcast™ episodes: Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs Episode 308: Hazardous Drugs and Hazardous Waste: Personal, Patient, and Environmental Safety ONS 50th Anniversary series ONS Voice articles: Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE NIOSH Releases Its 2024 List of Hazardous Drugs USP Answers Some Difficult Questions About Hazardous Drug Safety ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Safe Handling of Hazardous Drugs (fourth edition) ONS courses: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ ONS/ONCC Chemotherapy Immunotherapy Certificate™ Safe Handling Basics Clinical Journal of Oncology Nursing articles: Hazardous Drug Contamination: Presence of Bathroom Contamination in an Ambulatory Cancer Center Oral Chemotherapy: An Evidence-Based Practice Change for Safe Handling of Patient Waste Huddle Card: Introduction to Safe Handling ONS Safe Handling Learning Library Joint ONS and Hematology/Oncology Pharmacy Association (HOPA) position statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs National Institute for Occupational Safety and Health: Managing Hazardous Drug Exposures: Information for Healthcare Settings American Society of Health-System Pharmacists Guidelines on Handling Hazardous Drugs USP FAQs Connie Henke Yarbro Oncology Nursing History Center To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “PPE has always been recommended to reduce exposure because gloves and gowns provide physical barrier to protect against dermal absorption. But what we didn't know back then was what gloves and gowns were made of mattered. So PVC gloves were often used just because they were readily available in all our clinical settings. Gowns were rarely worn for drug administration, even though they had been recommended since early on, and many considered gowns back then as optional because the wording in the [Occupational Safety and Health Administration] guidelines said ‘recommended' and not ‘required.'” TS 3:19 “Those early chemo gloves were a bit like wearing gloves you might use to clean your oven. They were so thick and got in the way of taking care of patients or mixing drugs or administering drugs. So the biggest change, I think, is that gloves that are currently available are very thin, and they provide the necessary protection for those who are handling hazardous drugs. We now have a gloves standard that requires permeation studies to demonstrate the protective ability of the gloves before they can be labeled for use with hazardous drugs.” TS 11:56 “ONS and HOPA developed a position statement on safe handling of hazardous drugs. … This came because our two organizations were unable to support some of the other proposed guidelines from another organization. So we got together, and through our cooperation, resulted in language about the importance of safe handling, about supporting safe handling for practitioners, pharmacists, and nurses. Also, I feel really good about this—our cooperation resulted in language about protecting the rights of staff who are trying to conceive or who are pregnant or who are breastfeeding to engage in alternative duty that doesn't require them to handle hazardous drugs.” TS 17:12 “If there's no worker safety, then who's going to take care of the patients?” TS 21:52 “What I find most rewarding is connecting with nurses, who now understand the risks of exposure and are committed to minimizing their personal exposure. When I first started speaking about safe handling, and that's going back a long way, there were a lot of nurses who were skeptical about the need for self-protection. They had been handling hazardous drugs for years and had no signs of ill effects, and so they assumed that we weren't overreacting with all of the recommendations. They saw the use of precautions and PPE as a speed bump in their busy day and also thought that was unnecessary. I rarely see that now. Nurses are concerned for their own safety and more open to protective behaviors.” TS 23:50

“We know that some women are going to get called back. And it's just because usually they can't see something clearly enough. And so in most cases, those women are going to get cleared with one or two images, and they're going to say, ‘Oh, we compress that better, we checked it with an ultrasound, we're fine.' That woman can go ahead and go. But we don't want to miss those early breast cancers,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in Missouri, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what oncology nurses need to know about breast cancer diagnosis.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 31, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to breast cancer diagnostic considerations.  Episode Notes   Complete this evaluation for free NCPD.  Previous ONS Podcast™ site-specific episodes: Episode 345: Breast Cancer Screening, Detection, and Disparities  ONS Voice articles: An Oncology Nurse's Guide to Cascade Testing  Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations  ONS books: Breast Care Certification Review (second edition)  Guide to Breast Care for Oncology Nurses  ONS courses: Breast Cancer Bundle  Breast Cancer: Prevention, Detection, and Pathophysiology  ONS Biomarker Database results for breast cancer  ONS Learning Libraries:  Breast Cancer  Genomics and Precision Oncology    American Cancer Society: Early Detection and Diagnosis  Breast Cancer Facts and Figures   Your Breast Pathology Report: Breast Cancer  National Comprehensive Cancer Network    National Cancer Institute Breast Cancer—Patient Version  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From This Episode  “When a woman gets a callback, that is incredibly anxiety provoking, because they're very scared and they don't know what it means. And I think that's a place where oncology nurses can remind—if it's patients or friends who are asking—that just because you have a call back, doesn't mean you have a malignancy.” TS 8:16  “We also know that when we call somebody back, that's very scary and anxiety provoking. And we don't want to subject women to unnecessary anxiety and stress through the procedure. And if it's too stressful, they won't come back again. That is actually a big harm that we don't want to occur. That's considered an acceptable amount. So we know that some women are going to get called back, and it's just because usually they can't see something clearly enough.” TS 11:26  “I think one of the most important things is to really help that woman understand the biopsy report. So now everybody, with most of the electronic medical records, that woman seeing that biopsy result—maybe before her provider is seeing it, depending on whether they get a chance to call that individual. But, you know, they could get a notification in their medical record, or a new report is available, and they can click on there and they could be looking at something that is very scary, not necessarily a good time, you know, like they're getting ready to do something. And so that is a problem overall with sometimes getting bad news in oncology.” TS 15:09  “Sometimes it's really good [for patients to bring] someone who can just be that set of ears or who can answer those questions, who's emotionally involved but maybe not so emotionally involved, if that makes sense. And I think that that is something we can really encourage people to identify that person who's going to really be able to support them.” TS 16:42  “When we approach a pathology report, the patient, you know, if they open that on their own, they're just going to see breast carcinoma, or they aren't going to look at all of the details of it. They can be quite overwhelming to look at. But I think that it's important to kind of take the patient through it, step by step, and realize that it's often a case of repeated measures—that you might do it and then you might do it again the next day or a day later.” TS 20:55  “Breast cancer care has changed so much over the past few decades. And I think people forget, you know, I've been in the business a long time, but years ago, everybody kind of got the same treatment if they got diagnosed. And we now understand so much about breast cancer treatment, but I think that has come on the shoulders of so, so, so many women who have enrolled in clinical trials to help us understand pathology better, to help us understand the impact of certain treatments. And so I think, first of all, we need to thank those women who have generously contributed to this base of knowledge. And it's a place where those clinical trials have really made a difference.” TS 35:46

"If you take your normal radiation oncology experience, as we know in radiation oncology, radiations are done by the machines, you know, externally. Nurses deal with the side effects and everything like that, whereas radiopharmaceuticals are given kind of on the internal basis, they're systemic,” ONS member John Hollman, BSN, RN, OCN®, radiation nurse educator for Texas Oncology, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about caring for patients receiving radiopharmaceuticals and theranostics.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 24, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase in knowledge related to radiopharmaceuticals and theranostics in cancer care.  Episode Notes   Complete this evaluation for free NCPD. ONS Podcast™ episodes: Episode 339: A Lesson on Labs: How to Monitor and Educate Patients With Cancer  Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 298: Radiation Oncology: Nursing's Essential Roles Episode 12: The Intersection of Radiation and Medical Oncology Nursing ONS Voice articles: Radiopharmaceuticals and Theranostics Offer New Options for Oncology Nurses to Transform Cancer Care Radiopharmaceuticals Pack a One-Two Punch Against Cancer Oncology Drug Reference Sheet: Radium 223 Dichloride Oncology Drug Reference Sheet: Lutetium Lu 177 Dotatate Oncology Drug Reference Sheet: Lutetium Lu 177 Vipivotide Tetraxetan ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: Essentials in Advanced Practice Cancer Treatments ONS/ONCC Radiation Therapy Certificate™ Step Outside Your Specialty: Broaden Your Learning Horizon Across ONS Congress™ Session Tracks  Share your experience with ONS Voice.  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.    Highlights From This Episode  "I think most places are now doing the seven days, just to be extra cautious and you know, can't be around any pregnant women or children, you can't just be going to Target and stuff like that right after your injection because you are radioactive, and try not to share a bathroom with your family, that can be difficult and that leads into, as we've talked about in many talks that we've had, the social situation.” TS 8:08  “It's really up to that nurse to recognize, like a good infusion nurse, to recognize the signs and symptoms of an infusion reaction and then to catch it at the earliest possible moment.” TS 11:42  “We're not really dependent on lab values between treatments, whereas the infusion you have to look at your lab values to see how much of it. These are the game changer.” TS 13:20  “You just hear the term radiation, and you just think of Chernobyl, or you think of like these worst-case, media-blown things and you think, how are you not being dosed with radiation every day? Because they don't realize that you have this whole radiation safety team that's required to be overseen, that you're doing things safely and effectively, that these nurses that are administering these therapies or these therapists that are helping with the therapy are the safest as possible.” TS 18:37   “If it wasn't safe, we wouldn't be doing it. You know what I mean? So, there is that implicit bias. I think I can foresee a lot of people trying hard to get over. And if you do have questions, anyone who's listening, and you're scared that your center is going to roll this out, please talk to your physicians, please talk to your radiation oncologist, please talk to your radiation safety officers. They can definitely assure and put your fears at rest, hopefully. And if you're still uncomfortable, then maybe that's not the role for you.” TS 19:45  “That's why the nurses really need to be educated by those radiation safety teams so they can pass those questions, or they can answer those questions, alleviate those fears on consultation—or actually during the week when we're calling in for questions.” TS 21:16  “I think getting both teams involved, if you're going to really do this partnership, I find it really rare that it's ever solely in rad onc. It's always usually a combination of both. They're always referred to us from that on or somewhere. So, you really need that partnership.” TS 23:20 “This is so great to see what the future holds with these. And like I said, now they're trying to do clinical studies for different diagnoses. So, I think it's just going to explode in the next few years about what we can use these for. It's really an exciting time to be not only in oncology, but in radiation oncology.” TS 26:54 

"In B cell malignancies, BTKi inhibits that BTK enzyme which is very upstream. It tells NF-κB to stop signaling into the nucleus and then inhibits proliferation and survival of B cells."  Puja Patel, PharmD, BCOP, Clinical Oncology Pharmacist at Northwestern Medicine Cancer Center at Delnor Hospital in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about BTK inhibitors.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 1.0 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 17, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase in knowledge related to the BTK inhibitor drug class.  Episode Notes   Complete this evaluation for free NCPD.  ONS Podcast™ Pharmacology 101 series  ONS Voice articles:  BTK Inhibitor Effective for Relapsed Hairy Cell Leukemia  FDA Grants Accelerated Approval to Pirtobrutinib for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma  Ibrutinib Is the First Anticancer Agent to Be Negotiated for Medicare Drug Pricing  Oncology Drug Reference Sheet: Pirtobrutinib  Oncology Drug Reference Sheet: Zanubrutinib  ONS books:  Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)  Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)  Clinical Journal of Oncology Nursing article: B-Cell Malignancies: The Use of Small Molecule Agents for Treatment and Management  ONS courses:   ONS Cancer Biology™  ONS/ONCC Chemotherapy Immunotherapy Certificate™   Safe Handling Basics   ONS Guidelines™ and Symptom Interventions:   Chemotherapy-Induced Diarrhea  Prevention of Bleeding  Prevention of Infection: General  ONS Learning Library: Oral Anticancer Medication  ONS/NCODA/HOPA/ACCC's Oral Chemotherapy Education Sheets  Other resources:  Advanced Practice Providers Oncology Summit  Ash Publications article: Managing Toxicities of Bruton Tyrosine Kinase Inhibitors  Blood Advances article: BTK Inhibitors in CLL: Second-Generation Drugs and Beyond  CLL Society Fact Sheets  International Journal of Molecular Sciences article: Bruton's Tyrosine Kinase Inhibitors: Recent Updates  National Cancer Institute article: Two Drugs Show Efficacy against Common Form of Leukemia  National Comprehensive Cancer Network Guidelines for Patients: Chronic Lymphocytic Leukemia  National Study of Lymphoma (University of Oxford network site-specific group— Hematology)  NCODA's Positive Quality Intervention resources  Pharmacy Times BTK Inhibitor Comparison Charts  ScienceDirect article: Treating CLL with Bruton Tyrosine Kinase Inhibitors: The Role of the Outpatient Oncology Nurse  The Video Journal of Hematology and Hematological Oncology  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.    Highlights From This Episode  “1952 we have the discovery by Colonel Ogden Bruton of that severe immunodeficiency due to lack of B-cell maturation, and next linked to e-gamma globular anemia. In 1993, we had Professor Vetrie and colleagues discover that this was actually due to mutation in a kinase, and they called that BTK. And then in 1993 was a discovery of our first BTKi inhibitor in the lab setting, and that's called LFM-A13. It wasn't until 2013, so that's 20 years after BTK kinase was discovered, where ibrutinib was our first-in-class BTK inhibitor, and the success of ibrutinib really promoted the exploration of second- and third-generation BTKis.” TS 6:24     “It's thought that BTK and other members in the pathway are constitutively phosphorylated, which just means they're spontaneously on. This leads to this uncontrolled activation of NF- κB signaling and thus uncontrolled proliferation and suppression of apoptosis. So, these B cells are rapidly dividing, but they're not functioning like they're supposed to be, meaning they won't differentiate, or, you know, they won't grow up to be either a plasma cell, like we talked about, or a memory B cell. They've been hacked.” TS 10:11     “This class is generally called—if you have to think of an umbrella term—it's just called targeted small molecule therapies. Now a subclass is BTKi or Bruton tyrosine kinase inhibitors. So, we're really shifting away from the use of cytotoxic chemotherapy, which is kind of designed to indiscriminately destroy rapidly dividing cells, to a more precise approach of targeting cells based on specific molecular changes in tumor DNA.” TS 13:47     “Cardiac toxicity can manifest as atrial fibrillation. And here I'll specifically talk about ibrutinib values because we have the most data with it, and the numbers actually get better with second- and third-generation BTKis. So frequency: Grade 1–2 atrial fibrillation was reported in 12%–15% of patients on Ibrutinib. And grade 3 AFib is 3%–5%. The onset, median onset is 8–13 months.” TS 20:23     “For nurses, they should really advise their patients that the caliber of headaches are easily managed and they will decrease over time over a period of four weeks. This is an upfront conversation reassuring the patient that this is not a long-term side effect.” TS 33:47     “One aspect that was being discussed at length was kind of identifying biases and then methods to neutralize those biases. So, I think first you have to identify what your bias could be toward BTK, maybe it's age or comorbidities or side-effect profile. And then, how can we mitigate our own biases is kind of the solution part to that.” TS 46:26 

“The statistic you always kind of want to keep in the back of your brain is that over a lifetime, one in eight women will be diagnosed with breast cancer. So that means for an individual assigned female at birth, there's a 13% chance that if that individual lives to age 85, that they will be diagnosed with breast cancer. So, it's the most common cancer diagnosed in this group,” Suzanne Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, professor emeritus at Saint Louis University in St. Louis, MO, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about breast cancer screening.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 10, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase in knowledge related to breast cancer screening, detection, and disparities.  Episode Notes   Complete this evaluation for free NCPD. ONS Podcast™ episodes:  Episode 333: Pharmacology 101: CDK Inhibitors  Episode 316: Pharmacology 101: Estrogen-Targeting Therapies  ONS Voice articles:  An Oncology Nurse's Guide to Cascade Testing  Breast Cancer Prevention, Screening, Diagnosis, Treatment, Side Effect, and Survivorship Considerations  Encourage Breast Cancer Screening in Childhood Cancer Survivors   Genetic Disorder Reference Sheet: BARD1  Genetic Disorder Reference Sheet: BRCA1 and BRCA2 Hereditary Cancers  Genetic Disorder Reference Sheet: PALB2  ONS books: Breast Care Certification Review (second edition)  Guide to Breast Care for Oncology Nurses Clinical Journal of Oncology Nursing article: Germline Cancer Genetic Counseling: Clinical Care for Transgender and Nonbinary Individuals  ONS courses:   Breast Cancer Bundle  Breast Cancer: Prevention, Detection, and Pathophysiology  ONS Learning Library: Genomics and Precision Oncology   American Cancer Society Breast Cancer Facts and Figures  Breast Cancer Risk Assessment Calculator  Breast Cancer Risk Assessment Tool   National Comprehensive Cancer Network   Tyrer-Cuzick Risk Assessment Calculator  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From This Episode  “Unfortunately, probably about 42,500 women die every year from breast cancer, and that number still seems really high because mammography screening has really enabled us to detect breast cancer in many, many cases when it would be most treatable. And so that's a place where you would like to see some real progress.” TS 3:32  “Primary prevention for all individuals, which is always best to prevent, would include 150 minutes of intentional exercise, watching the diet, keeping that weight as low as possible—we want more muscle and less fat mass—and limiting alcohol intake. Then we go and we talk about screening.” TS 7:29  “The most recent statistic, and this kind of is post-COVID, is that 67% of women age 40 and over have had breast cancer screening in the last two years, which means that there's a hunk of women, 33% of women who have not had breast cancer screening in the last two years and that who are 40 and over. And that to me is a really, really sad statistic because that's a missed opportunity for screening.” TS 11:32  “Sometimes we forget that women and individuals who've had breast cancer, especially if they had it at a younger age, their risk of a second breast cancer over time is about 1% or 2% per year. So, if you have a first breast cancer at 40, and you live another 30 years, two times 30 is 60, that risk is substantial. A lot of times we don't see as much anymore, which is good. Individuals who had a lot of radiation to the chest, we used to see a lot of young individuals having radiation therapy for Hodgkin's disease that encompassed the chest, and a lot of them were diagnosed with breast cancer afterwards.” TS 15:31  “One of the things that always makes me really sad is that probably less than 40% of people who are eligible for this cascade testing, and mind you, many of the laboratories, if we test a parent and say they have a pathogenic variant, they will offer free testing to relatives for 90–120 days in that lab. They don't even have to pay for the genetic test. They just have to get the counseling and send it. But less than 40% of individuals who would benefit from cascade testing ever get it done.” TS 35:02  “I have had this privilege of sitting for decades watching genetics. That's the only area I've ever worked in that is always completely changing. And just when you think you got it, there is something new and it's really driving our oncology care. And I would really encourage people, I know we've said it about 10 times now, to look at that Genomics and Precision Medicine Learning Library, there are resources in there if you want to spend 3 minutes, 5 minutes, 10 minutes—if you got a whole hour or two, there's courses. There are so many things in there, and if you really want to become more savvy, you can, and that's a great place to start.” TS 45:34

“Who would think that we would be here 50 years later? And with the excitement that I think will build even more, I'm so humbled and honored to talk to young nurses. And their excitement—the same excitement that we had in the very beginning—is inherent. I hope that our legacy will be that we are able to pass on this tremendous gift of our careers to new nurses,” Cindi Cantril, MPH, RN, OCN®-Emeritus, founding ONS member and first vice president, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about the history of ONS's inception. Burbage spoke with Cantril and Connie Henke Yarbro, MS, RN, FAAN, founding ONS member and first treasurer, about the inspirational nurses who started the organization and its impact over the past 50 years. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  NCPD contact hours are not available for this episode. ONS Podcast™ episodes: Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan Episode 258: ONS Through the Ages: Stories From the Early Days With Cindi Cantril and George Hill ONS Voice articles: Connie Henke Yarbro Oncology Nursing History Center Commemorates the Legacy of Oncology Nurses Nurses Empower Change Through Leadership and Advocacy Roles Seeds Planted Today Nurture a Harvest of Future Generations of Oncology Nurses ONS's Success Is Our Success Connie Henke Yarbro Oncology Nursing History Center ONS Mission, Vision, and Values Oncology Nursing Foundation Clinical Journal of Oncology Nursing article: Supporting One Another for 40 Years To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Yarbro: “In 1973, there was really kind of the first nursing conference for oncology nurses in Chicago. At that conference, Lisa Begg Marino and Shirlee Koons, myself, and about 20 nurses met to discuss how we could identify each other and that we needed to communicate because we were really each isolated in our own separate cancer center or clinic.” TS 2:09  Cantril: “What's interesting is that I contacted a lawyer in St. Louis and told him what we were trying to do, and the comment was shocking at the time. And he said, ‘Well, you know, you really could have your own autonomy. It would just cost $25, and you could start your own charter organization.' Little did we know that we would grow to be where we are.” TS 3:50  Yarbro: “I was with medical oncology, and you [Cindi] were with surgeons, so we were really all defining our roles. At that time, I was medical oncology, and I would travel the state of Alabama with the medicine to give the Hodgkin's disease patients or children with leukemia their second dose, so they did not have to drive to the medical center because there weren't any oncologists in the community. They were just made at the academic centers. Today, I don't know whether you could get in a car and travel with your vincristine, procarbazine, and all the other medicines.” TS 11:24  Cantril: “How do we facilitate a large, organized fashion and allowing people to have some sort of more intimate autonomy in their own environment? Because let's face it, not every nurse is going to be able to go to Congress. Not every nurse is going to be able to go to a regional meeting. So the chapters really allowed for a wider net for us to identify nurses so invested in cancer nursing.” TS 25:23

“There's actually quite a bit of debate about what the clinical definition of cancer cachexia is, but in its simplest definition of cachexia in this case is cancer-induced body weight loss. You can have cachexia in other diseases, for heart failure or renal failure, but it's basically tumor-induced metabolic derangement that leads to inflammation and often anorexia, which produces body weight loss,” ONS member 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:  Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes:  Episode 251: Palliative Care Programs for Patients With Cancer Episode 116: Screen and Manage Malnutrition in Patients With Cancer Episode 93: How to Manage Nutrition for Patients With Cancer ONS Voice articles:  An Oncology Nurse's Guide to Cachexia in Patients With Cancer  Manage Malnutrition's Monstrous Consequences in Patients With Cancer  Managing Weight Loss in Patients With Cancer  Nutritional Support Reduces Weight Loss for Patients With Head and Neck Cancer  ONS course: Introduction to Nutrition in Cancer Care  ONS Nutrition Learning Library  ONS Symptom Intervention Resource: Anorexia  American Society of Clinical Oncology (ASCO) Cancer Cachexia Guidelines  Cachexia Score screening tool  Cancer Cachexia Network  Cancer Cachexia Society  Malnutrition Screening Tool   Patient Generated Subjective Global Assessment  Society on Sarcopenia, Cachexia, and Wasting Disorders   To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode  “Anorexia is often a component of cancer cachexia. In fact, some people call it cancer-induced anorexia, cachexia syndrome, because the tumors produce factors that act on the hypothalamus and hindbrain to produce, among other things, anorexia, but not just anorexia, you know, feelings of misery, anhedonia, wanting to withdraw from social interactions, but definitely altered desire to eat and altered taste of food.” TS 5:32  “Cachexia is most common, you know, where it's been examined, in patients with upper GI cancers. You could think of those as risk factors for cachexia. So that includes, of course, head and neck cancer, esophageal, gastric, pancreatic, liver and biliary cancers. It's also found to be very prevalent among patients with any kind of metastatic cancer and very frequent in patients who are hospitalized for their cancer. But beyond that, about half of patients with non-small cell lung cancer also experience cachexia.” TS 8:21  “I've been told by oncologists that cachexia is frequent in patients with certain rare cancers like ocular melanoma, small cell lung cancers, but generally speaking, cachexia is underrecognized.  Most people have in their minds this picture of someone who's sort of end-stage cachexia, that's emaciated. And in fact, most patients, or many patients in the U.S. at least, arrive with a cachexia diagnosis and may be overweight or even indeed obese, but that does not mean that they don't have cachexia.” TS 8:54  “I have tremendous respect for our nurses who take care of patients, and all of them have their preferred screening tools. There is no single accepted or mandated approach to diagnosing or treating someone with cancer cachexia. And I should say that I didn't mention a widely accepted definition for cancer cachexia in the field, a diagnostic criterion, is weight loss of greater than 5% in the prior six months—and this is unintentional weight loss. TS 11:05  “I hear from family members all the time about how this was actually the most distressing part of their loved one's cancer journey because it's something so visible. And also, so much of our relationships happen over meals. And what I've heard time and time again is that telling someone that there is a word for this, cachexia, and explaining that it is the tumor—right, it's the cancer that's causing this appetite loss—would have helped because there tends to be a lot of conflict over meals, you know, a lot of guilt on sides when it comes to eating and trying to prepare meals that are appetizing for the person with cancer.” TS 22:24    “I think that we don't often think about how much the cachexia itself affects the cancer treatment outcomes. The presence of weight loss correlates with treatment toxicity. Chemotherapy is often dosed on body surface area. Patients who have very low muscle, for example, experience greater toxicities, and maybe we should be dosing based on lean muscle mass. Patients with cachexia have poor outcomes after surgery. And actually, patients with cachexia don't respond to immunotherapy, which of course has been transformative for cancer care. So, treating cachexia may actually enable patients to respond better to all of their cancer interventions.” TS 28:45 

“The Leadership Development Committee (LDC) is one of the most important member volunteer positions in the organization, and here's why: The main purpose of the LDC is to recruit, vet, and select ONS Board of Directors. As some of you may know, it has been three years since we moved away from members voting for directors,” ONS member Nancy Houlihan, MA, RN, AOCN®, ONS past president and former director of nursing practice at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about what it's like to serve on the Leadership Development Committee.  The advertising messages in this podcast episode are paid for by Ipsen.    Music Credit: “Fireflies and Stardust” by Kevin MacLeod   Licensed under Creative Commons by Attribution 3.0   Episode Notes   This episode is not eligible for NCPD.  Oncology Nursing Podcast™ episodes:  Episode 340: What It's Like to Plan an ONS Conference  Episode 337: Meet the ONS Board of Directors: Haynes, Wilson, and Yackzan  Episode 270: Meet the ONS Board of Directors: Brown, MacIntyre, and Woods  Episode 239: Meet the ONS Board of Directors: Allen, Mathey, and Robison  Episode 224: Meet the ONS Board of Directors: Nevidjon, Geddie, and Garner  Episode 213: Meet the ONS Board of Directors: Brant, Burger, and Knoop  Episode 200: Meet the ONS Board of Directors: Houlihan, Ferguson, and Polovich  ONS Voice articles:  Find Your Voice With ONS's Leadership Development Committee  Nursing Leadership Unlocked  Nurses Empower Change Through Leadership and Advocacy Roles  Think Tank Will Explore Nurse Leadership Development Initiatives  ONS course: Board Leadership: Nurses in Governance  ONS Volunteer Opportunities   ONS Leadership Learning Library  Contact the LDC  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an Oncology Nursing Podcast™ Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  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 

“Key thing here is that it was discovered that when you have gene amplification of her two you get a resultant over expression of that HER protein and that over expression leads to a driver for certain cancers. So, when you have an over expression 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   Complete this evaluation for free NCPD.   Oncology Nursing Podcast™ Pharmacology 101 series   ONS Voice articles:  Antibody–Drug Conjugates Join the Best of Two Worlds Into One New Treatment  HER2 Therapies May Be Effective in a Variety of Solid Tumors  Management Strategies for Cutaneous Toxicity From EGFR Inhibitors  Manage Common Ocular Toxicities From Tyrosine Kinase Inhibitors  Oncology Drug Reference Sheet: Combination Trastuzumab and Hyaluronidase-Oysk  Oncology Drug Reference Sheet: Elacestrant  Oncology Drug Reference Sheet: Margetuximab-Cmkb  Oncology Drug Reference Sheet: Talazoparib  ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition)   ONS courses:  ONS Cancer Biology™   ONS/ONCC Chemotherapy Immunotherapy Certificate™   Safe Handling Basics   ONS Biomarker Database  ONS Learning Libraries:  Genomics and Precision Oncology  Oral Anticancer Medication   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 pubONSVoice@ons.org.  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  “Hertuzumab 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 

“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   This episode is not eligible for NCPD contact hours.   Oncology Nursing Podcast™ episodes:  Episode 323: What It's Like to Participate in an ONS Think Tank  Episode 320: What It's Like to Be a Peer Reviewer or Associate Editor for an ONS Journal  Episode 309: What Brings You to ONS Congress®? Episode 183: How Oncology Nurses Find and Use Credible Patient Education Resources ONS Voice articles:  What Brings You Value in ONS? You Can Thank a Volunteer for That  The Power of Connection in Oncology Nursing  What Brings You Value in ONS? You Can Thank a Volunteer for That  The Power of Connection in Oncology Nursing  Clinical Journal of Oncology Nursing article: What Is It Like to Chair the ONS Bridge™ Content Planning Team?  ONS Volunteer Opportunities  ONS Congress  ONS Evidence-Based Practice Learning Library  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 pubONSVoice@ons.org.  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

“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   Complete this evaluation for free NCPD.   Oncology Nursing Podcast™ episodes:  Episode 319: Difficult Conversations About Pregnancy Testing in Cancer Care Episode 311: Standardized Pregnancy Testing Processes in Cancer Care Episode 183: How Oncology Nurses Find and Use Credible Patient Education Resources  Episode 179: Learn How to Educate Patients During Immunotherapy  Episode 87: What Are the Biggest Barriers to Patient Education?  Episode 43: Sharing Patient, Provider, and Caregiver Resources  ONS Voice articles:   Patient Education Reduces Barriers and Increases Adherence Rates  Nurses Must Understand Health Disparities to Provide Effective Patient Education  Oncology Nurses Can Improve Oral Medication Management With Patient Education Program  ONS Course: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™   Oncology Nursing Forum article: Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards Clinical Calculations—ANC Huddle Card 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 pubONSVoice@ons.org.   “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 

“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  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 326: Intramuscular Injections: The Oncology Nurse's Role Episode 285: Transarterial Chemoembolization: The Oncology Nurse's Role Episode 271: Intraventricular and Intrathecal Administration: The Oncology Nurse's Role Episode 265: Intravesical Administration: The Oncology Nurse's Role Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role ONS Voice articles: Administration Considerations Amid the Large-Volume Subcutaneous Injection Revolution FDA Approves Atezolizumab and Hyaluronidase-Tqjs for Subcutaneous Injection Make Subcutaneous Administration More Comfortable for Your Patients Oncology Drug Reference Sheet: Pertuzumab, Trastuzumab, and Hyaluronidase-Zzxf Subcutaneous Injection ONS Voice Oncology Drug Reference Sheets ONS book: Access Device Guidelines: Recommendations for Nursing Practice and Education (Fourth Edition) ONS course: ONS/ONCC Chemotherapy Immunotherapy Certificate™ Clinical Journal of Oncology Nursing article: Subcutaneous Administration: Evolution, Challenges, and the Role of Hyaluronidase Oncology Nursing Forum article: Administration of Subcutaneous Monoclonal Antibodies in Patients With Cancer 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 pubONSVoice@ons.org. 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

“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  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 270: Meet the ONS Board of Directors: Brown, MacIntyre, and Woods Episode 239: Meet the ONS Board of Directors: Allen, Mathey, and Robison Episode 224: Meet the ONS Board of Directors: Nevidjon, Geddie, and Garner Episode 213: Meet the ONS Board of Directors: Brant, Burger, and Knoop Episode 200: Meet the ONS Board of Directors: Houlihan, Ferguson, and Polovich ONS Voice articles: Climate Change Is Contributing to the Cancer Burden, and Nurses Must Take Action Mentorships Open Opportunities for Oncology Nurses' Career Growth and Wellness Oncology Nurse Joins Panel to Discuss Solutions to Advance Equitable Cancer Care for the LGBTQ+ Community Seeds Planted Today Nurture a Harvest of Future Generations of Oncology Nurses Find Your Voice With ONS's Leadership Development Committee ONS courses: Advocacy 101: Making a Difference A Guide to Chapter Leadership: Chapter President Training A Guide to Chapter Finances: Chapter Treasurer Training Board Leadership: Nurses in Governance ONS Leadership ONS Leadership Learning Library ONS Network and Advocacy Resources Joint Position Statement from APHON, CANO/ACIO, and ONS Regarding Fertility Preservation in Individuals with Cancer 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 pubONSVoice@ons.org. 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

“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  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Pharmacology 101 series Episode 250: Cancer Symptom Management Basics: Dermatologic Complications Episode 226: Patient Education for Next-Generation Sequencing to Guide Cancer Therapy Episode 169: How Biomarker Testing Drives the Use of Targeted Therapies Episode 157: Biomarker Testing Improves Outcomes for Patients With Non-Small Cell Lung Cancer ONS Voice articles: Management Strategies for Cutaneous Toxicity From EGFR Inhibitors Oncology Drug Reference Sheet: Amivantamab-Vmjw Oncology Drug Reference Sheet: Osimertinib Oncology Drug Reference Sheet: Panitumumab Targeted Therapies Are Transforming the Treatment of Non-Small Cell Lung Cancer ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (Second Edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (Fourth Edition) ONS courses: ONS Cancer Biology™ ONS/ONCC Chemotherapy Immunotherapy Certificate™ Safe Handling Basics Clinical Journal of Oncology Nursing articles: Afatinib Therapy: Practical Management of Adverse Events With an Oral Agent for Non-Small Cell Lung Cancer Treatment Cutaneous Toxicities With Amivantamab for Non-Small Cell Lung Cancer: A Practical Guide and Best Practices Medication Adherence Barriers: Development and Retrospective Pilot Test of an Evidence-Based Screening Instrument ONS Guidelines™ for Cancer Treatment–Related Skin Toxicity Nursing Management of Skin Toxicities in Diverse Skin Tones ONS Bispecific Antibody Video ONS Learning Libraries: Genomics and Precision Oncology Oral Anticancer Medication Oral Chemotherapy Education Sheets Seminars in Cancer Biology article: EGFR signaling pathway as therapeutic target in human cancers 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 pubONSVoice@ons.org. 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

Episode 335: Ultrasound-Guided IV Placement in the Oncology Setting “Much like many experienced oncology nurses, I learned how to do IVs with palpation. I got really good at it. And so I thought, there's no way I need this ultrasound. But we know now that our patients are sicker. There are more DIVA patients, or difficult IV access patients. We've got to put the patient first, and we've got to use the best technology. So I've really come full circle with my thinking. In fact, now it's like driving a car without a seatbelt,” MiKaela Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director of oncology at Johns Hopkins Hospital and Johns Hopkins Health System told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ultrasound-guided IV placement. 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 1, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of 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 ultrasound-guided peripheral IV placement in the oncology setting. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 127: Reduce and Manage Extravasation When Administering Antineoplastic Agents ONS Voice articles: Access Devices and Central Lines: New Evidence and Innovations Are Changing Practice, but Individual Patient Needs Always Come First Standardizing Venous Access Assessment and Validating Safe Chemo Administration Drastically Lowers Rates of Adverse Venous Events ONS book: Access Device Guidelines: Recommendations for Nursing Practice and Education (Fourth Edition) ONS courses: Complications of Vascular Access Devices (VAD) and Intravenous (IV) Therapy Vascular Access Devices Clinical Journal of Oncology Nursing article: Standardized Venous Access Assessment and Safe Chemotherapy Administration to Reduce Adverse Venous Events StatPearls Video: Forearm Anatomy Review and Ultrasound Probing Infusion Nurses Society: Infusion Therapy Standards of Practice (Ninth Edition) 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 pubONSVoice@ons.org. Highlights From This Episode “The benefit of having an ultrasound, it allows you to see through. You're no longer sort of bound by, ‘Can I feel it? Are there skin discolorations or skin colors that are affecting my ability to see the vein clearly?' You don't have to worry about any of that. Is there edema? Is there lots of tissue? You can actually directly visualize the veins to assess not only the health of the vein, but some of the complications that could be there, like a thrombus in the vein or sclerosis or tortuous anatomy, arteries, nerve bundles. Those are things that you can now see with your machine.” TS 8:55 “I think that the most important part of [training] is having a really good didactic session where nurses come in and they learn reminders about the anatomy. Where are these veins? Where are the best veins to canulate when you're using ultrasound? And we like to avoid the veins above the antecube for regular long peripheral IVs that we insert with ultrasound because we want to preserve those veins up higher for our [peripherally inserted central catheter] lines and midline. So we want to teach to try to use the forearm. The cephalic vein in the forearm is a really excellent vein to choose.” TS 17:24 “[Patients] are usually kind of impressed with the machine and the technology, and I explain that ‘We're not able to get it without being able to see better, so I'm going to use my machine so that I can see better.' And almost every time after I'm done, the patient is like, ‘Wow, are you done?' … It's the initial little puncture that hurts the patient. But unlike when we do it blindly and maybe we don't get it right in the vein, and we're having to dig around and reposition ourselves and get into that vein, we're not doing that with ultrasound because you're going to go into the vein, and then you're starting to do the threading, and you're pulling your probe up as you go to get that catheter in the vein. The patient doesn't feel that part. So they often comment about how they barely felt it and they can't believe it's over.” TS 21:21 “This is kind of my measure of success when we're no longer kind of putting this on the patient. We're not saying, ‘You have difficult veins. Your veins roll. You're not drinking enough.' That's not okay anymore. We've got to take responsibility and use technology to do this more successfully.” TS 30:24

“There is an old saying that if you ignore your teeth, they'll go away. I think that's a true, true statement. People may think they can get away without daily hygiene. I think that's kind of important, that you should at least get your teeth taken care of at least once or twice a day by brushing and flossing. I mean this has been proven. Our dental people have really taken the lead on preventive care with oral hygiene in that respect,” Raymond Scarpa, DNP, APN-C, AOCN® clinical program manager of head and neck oncology and supervisory advanced practice nurse in the department of otolaryngology at the Rutgers Cancer Institute of New Jersey at University Hospital in Newark,told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the importance of oral health for patients with cancer. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 25, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to oral care for patients with cancer. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications Episode 116: Screen and Manage Malnutrition in Patients With Cancer ONS Voice articles: Manage Late Effects From HPV-Positive Oropharyngeal Cancers Nursing Considerations for Head and Neck Cancer Survivorship Care Research Shows That Vaping Alters Mouth Microbes The Case of the Missing Oral Mucositis What Advanced Practice Providers Need to Know About Oral Mucositis ONS book: Clinical Manual for the Oncology Advanced Practice Nurse (Fourth Edition) ONS course: Introduction to Nutrition in Cancer Care Clinical Journal of Oncology Nursing articles: Dental Care: Unmet Oral Needs of Patients With Cancer and Survivors HPV-Positive Oropharyngeal Cancer: The Nurse's Role in Patient Management of Treatment-Related Sequelae Low-Level Laser Therapy: A Literature Review of the Prevention and Reduction of Oral Mucositis in Patients Undergoing Stem Cell Transplantation ONS Symptom Interventions: Mucositis American Cancer Society Oral Cavity (Mouth) and Oropharyngeal (Throat) Cancer Palliative Treatment for Oral Cavity and Oropharyngeal Cancer Head and Neck Cancer Alliance 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 pubONSVoice@ons.org. Highlights From This Episode “Radiation, with or without a combination of chemotherapy, can lead to xerostomia, which is like a dry mouth. When this occurs, there's reduced or even absent salivary flow. When this happens, it can lead to mucositis, which is a very painful swelling of the mucous membranes in the oral cavity. This increases the risk of infection and compromises speaking, chewing, and swallowing. Certain chemotherapeutic agents can also accelerate and increase the severity of these side effects.” TS 3:54 “I think pretreatment of the oral cavity prior to starting any of these treatments is a key to managing some of the side effects that can occur. This includes a referral to the dentist for any kind of extractions and removal of any nonviable dentation, along with providing some what they call fluoride treatments. The nurses can also influence the patient by helping them with their nutrition. It's important for them to continue to try to swallow despite some of the side effects that can cause the discomfort in swallowing.” TS 6:53 “I always encourage [patients] to try to use soft-bristle toothbrushes, [water flossers] if necessary, soft foods, nonspicy foods, foods with moderate temperatures. … Try to make sure that they have enough lubrication to get the nutrition they need by including some gravies or sauces or water to help them swallow when their saliva is altered due to these side effects from the treatments.” TS 10:18 “I've been working in the head and neck cancer field for quite some time, and over the years, I've come to realize that this is probably one of the most devastating types of malignancies that someone has. … Head and neck cancer and oral cancers—they affect your basic survival needs. They affect your ability to communicate. They affect your ability to take in nutrition. They can affect your ability to breathe and certainly affect when someone looks at you. It's right there. It's staring them in the face. You can see the side effects of their treatments.” TS 22:41

“CDK4/6 inhibition is considered to be a milestone in the realm of targeted breast cancer therapy. The combination of CDK4/6 inhibitors with the endocrine therapy has really emerged as the foremost therapeutic modality for patients diagnosed with hormone receptor–positive, HER2-negative, advanced breast cancer,” ONS member Teresa Knoop, MSN, RN, AOCN®-emeritus, independent nurse consultant in Nashville, TN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during the latest episode in our series about anticancer drug classes. 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 October 18, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to CDK inhibitors. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Pharmacology 101 series Episode 329: Pharmacology 101: BRAF Inhibitors Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion Episode 80: Patients Need Checkpoint Inhibitor Education Episode 5: New Guidelines for Managing Immunotherapy-Related Adverse Events ONS Voice articles: Combination CDK4/6 and Fulvestrant Has Survival Benefits in Late-Stage Breast Cancer FDA Approves Inavolisib With Palbociclib and Fulvestrant for Endocrine-Resistant, PIK3CA-Variant, HR-Positive, HER2-Negative, Advanced Breast Cancer FDA Approves Ribociclib With an Aromatase Inhibitor and Ribociclib and Letrozole Co-Pack for Early High-Risk Breast Cancer FDA Expands Early Breast Cancer Indication for Abemaciclib With Endocrine Therapy FDA Warns of Rare Lung Inflammation With Certain CDK4/6 Inhibitors Manage Immunotherapy-Related Diarrhea and Colitis Oncology Drug Reference Sheet: Ribociclib The Case of the CTCAE Assessment for CDK4/6 Adverse Events ONS book: Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Clinical Journal of Oncology Nursing article: Targeted Therapies: Treatment Options for Patients With Metastatic Breast Cancer ONS Symptom Intervention: Prevention of Infection: General  ONS Breast Cancer Learning Library ONS CDK4/6 Administration Checklist ONS Oral Anticancer Medication Toolkit  Breastcancer.org Susan G. Komen: CDK4/6 Inhibitors Ibrance® (palbociclib) patient site Kisqali® (ribociclib) patient site Verzenio® (abemaciclib) patient site 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 pubONSVoice@ons.org. Highlights From This Episode “Common toxicity among this class of agents are things like nausea/vomiting, diarrhea, fatigue. All three are associated with low white blood cell counts, which we know as neutropenia, which can cause an increased risk of infection.” TS 10:46 “All three of these CDK4/6 inhibitors are pills taken by mouth, and in most cases they're all given along with endocrine therapy treatments. So, patients will be taking more than one drug. Teach patients how they will take their medication. And the frequency among the three drugs may vary.” TS 13:33 “Patients and caregivers need to know the time of day to take the pills, whether they need to be taken with or without food, or what to do if they miss a dose. We need to help them with a system for organizing the medications. They may find it helpful to use a pill organizer or set reminders on their smartphone, their smartwatch, their computer.” TS 14:29  “Pharmacy and nursing, in my experience, collaborate greatly by determining those drug–drug and drug–food interactions. It is so crucial in determining those interactions and educating our patients because we have to remind patients at each appointment and review these drugs and foods and other things they may be taking, at each appointment. And that often can be done by either pharmacists or nurses or both in collaboration.” TS 23:29 “This class of drug is generally well-tolerated, and I do want nurses to know that that we can help patients with these side effects. And they are generally well-tolerated with appropriate management.” TS 30:55 

“Nurses really are the professionals who educate how to take these medicines, why we use multimodal therapies, why it isn't medicine alone—helping patients to understand that pain is a biopsychosocial spiritual phenomenon, and the pills are just going to hit one little aspect of that entire phenomenon,” Judy Paice, PhD, RN, director of the cancer pain program at Northwestern University Feinberg School of Medicine in Chicago, IL, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about nursing practices for cancer pain management. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 1 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 11, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to managing pain in patients with cancer. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 165: Safely Administer and Prescribe Opioids for Cancer-Related Pain Episode 3: Opioids, Addiction, and Complex Care  ONS Voice articles: Alternative Funding Programs: Don't Be Fooled by Promises of 'Free' Specialty Cancer Drugs CMS's Chronic Pain Experience Journey Map Will Help Patients and Providers Latest CDC Clinical Practice Guideline Facilitates Safe Use of Opioids for Pain What the Evidence Says About Tai Chi in Cancer Care ONS book: Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) ONS courses: Essentials in Advanced Practice Symptom Management Treatment and Symptom Management—Oncology RN Clinical Journal of Oncology Nursing articles: Effects of a Nurse-Initiated Telephone Care Path for Pain Management in Patients With Head and Neck Cancer Receiving Radiation Therapy Pain Management Revisited Symptom Distress: Implementation of Palliative Care Guidelines to Improve Pain, Fatigue, and Anxiety in Patients With Advanced Cancer Oncology Nursing Forum articles: Barriers for Nurses Providing Cancer Pain Management: A Qualitative Systematic Review Framing Cancer Survivors' Access to and Use and Disposal of Prescribed Opioids Within the Opioid Epidemic Interventions for Managing a Symptom Cluster of Pain, Fatigue, and Sleep Disturbances During Cancer Survivorship: A Systematic Review ONS Position Statement: Cancer Pain Management ONS Learning Library: Pain Management Diagnostics article: Diagnosing Pain in Individuals With Intellectual and Developmental Disabilities: Current State and Novel Technological Solutions End-of-Life Nursing Education Consortium Harvard Implicit Association Test National Cancer Institute's Cancer Pain PDQ Health professional version Patient version Opioid Risk Tool Pain Medicine article: A Tactile Pain Evaluation Scale for Persons With Visual Deficiencies 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 pubONSVoice@ons.org. Highlights From This Episode “Who do patients speak to about their pain? They're often afraid to tell their oncologist, and studies have backed this up. The patient is worried that if they admit to more symptoms, they won't be able to enroll in that clinical trial, so they talk to us, the nurse. And part of our role is to encourage that dialog and assess the pain fully.” TS 7:00 “The nonpharmacologic, which is equally important—and I see these as partners in relief, not as one versus the other. But we may have physical measures like [physical therapy] and [occupational therapy] and orthotics, heat and cold. We may have more emotional or psychological kinds of therapies—cognitive behavioral techniques. We may have integrative measures—mindfulness guided imagery, yoga, tai chi. And some of these kind of transcend multiple categories.” TS 15:57 “For breakthrough [pain], we try to again treat the underlying cause. If this is an unstable vertebral body, is a kyphoplasty or vertebroplasty a possibility for this patient? If there's compression of nerve roots, might an epidural steroid injection or some other interventional procedure help, so that when the patient stands—and that's often what we see the breakthrough pain occurring—or moves position, maybe we can provide some relief that's more directed to the site of pain or source.” TS 24:35 “I set expectations. Again, this is where nurses are key. It is so important that you use these medicines for pain. Yes, they're going to make you feel a little bit less anxious, a little warm and fuzzy, and maybe even help you fall asleep at night, but you cannot use them for that purpose. You can only use these medicines for pain control. We have other medicines to help you if you're feeling anxious or if you're having trouble sleeping at night. And if you use your opioids for those purposes, you are going to get into trouble.” TS 41:11

“One of the biggest things we've heard in nursing school and we continue to hear in practice is it takes anywhere from 15 to 20 years for knowledge in the literature to reach practice in a significant way. The DNP was designed to speed that up. We don't want the best practices in literature to take 15 years. We want it to take 1 or 2 at best,” James Q. Simmons, DNP, AG/ACNP-BC, acute care nurse practitioner at Epic Medical Group in Los Angeles, CA, and founder of drjamesqsimmons.com, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about how DNP- and PhD-prepared nurses can collaborate to advance patient care and research. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 4, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to strategies for DNP and PhD collaboration. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 323: What It's Like to Participate in an ONS Think Tank Episode 248: The Basics of Evidence-Based Practice for Every Oncology Nurse Episode 150: Career Planning for Oncology Nurses ONS Voice articles: Adopt an Evidence-Based Practice Model to Facilitate Practice Change Oncology Nurses Drive Discovery in Cancer Clinical Research Overcome Barriers to Applying an Evidence-Based Process for Practice Change Research Has a Role for Every Oncology Nurse Strengthen a Commitment to Practice Change Through EBP Immersions The Difference Between Quality Improvement, Evidence-Based Practice, and Research What the Next Generation of Nurse Researchers Learned From the ONS Precision Symptom Science Workshop ONS courses: Introduction to Evidence-Based Practice Professional Practice for the Advanced Practice RN Professional Practice—Oncology RN Clinical Journal of Oncology Nursing (CJON) articles: Introducing the DNP Projects Department SEEK™: A Program to Implement Evidence-Based Practice and Transform Oncology Nursing Practice CJON call for manuscripts: DNP-PhD Collaborative Work Manuscript Submissions  Oncology Nursing Forum articles: Considerations for the Doctor of Nursing Practice Degree The Research Doctorate in Nursing: The PhD ONS Learning Libraries: Evidence-Based Practice  Leadership ONS Spirit of Inquiry Worksheet 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 pubONSVoice@ons.org. Highlights From This Episode “Nurses are expertly and perfectly positioned to be the leaders in [artificial intelligence] and technology, and reduction in workforce, and robotics, and all these different things that are happening in our healthcare system right now. I think nurses are primed to be the leaders of that, not just the ones reacting to it. And I think we become the leaders of that by having really, really eloquent, really fine-tuned PhD and DNP collaboration.” TS 6:42 “We had 30 people in this room all ‘speed dating' each other. They were told beforehand to bring their 30-second elevator pitch; bring their business cards, either electronic or in person; bring what they're looking for; bring a fun attitude. … There were two individuals who were focused on pediatric populations, both working on vaccine initiatives in marginalized and underserved communities, and they had no idea that each other had existed.” TS 12:59 “I think we've got to think about how we approach our own profession in service of our patients and the communities that we serve. We've got to think about things differently, and I think that we as nurses are the ones to do that. We are in such a sweet spot where we can be innovators, and we can be quick thinkers because we are, and we're so highly educated and so highly experienced as a profession, that we've got to take as much of this knowledge as we can and share it with everyone and figure out what the best practices are going to be.” TS 19:14 “I think it's also really important to acknowledge that PhD nurses are not just our friends in ivory towers who don't practice and haven't seen the inside of a clinic or listened to a patient's lung sounds in 38 years. Sure, there are some of those PhD nurses that exist right now, and we need them. They play a valuable role. But that's not all that being a PhD nurse means. There are plenty of PhD nurses who are doing really incredible things in the grind, in the hustle, on a day-to-day basis.” TS 24:07

“The reality is that we are responsible for creating a culture of safety together for everybody in the clinical area. We have to think not only about ourselves and our personal risk, but how exposure to these hazardous drugs persists in the work environment for everybody. And we have to be part of the solution for everybody, even if it's not something that we're personally really worried about being exposed to,” AnnMarie Walton, PhD, MPH, RN, OCN®, CHES, FAAN, associate professor at Duke University School of Nursing in Durham, NC, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about updates to the fourth edition of Safe Handling of Hazardous Drugs, one of ONS's book publications. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 20, 2026. AnnMarie Walton serves in a compensated consultant role with Splashblocker LLC and as a compensated speaker for BD. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to safe handling of hazardous drugs.  Episode Notes Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episode 325: What Changed in the 2024 ASCO/ONS Antineoplastic Administration Safety Standards Episode 308: Hazardous Drugs and Hazardous Waste: Personal, Patient, and Environmental Safety ONS Voice articles: Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE Strategies to Promote Safe Medication Administration Practices ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Safe Handling of Hazardous Drugs (fourth edition) ONS courses: ONS/ONCC Chemotherapy Immunotherapy Certificate™ Safe Handling Basics Clinical Journal of Oncology Nursing articles: Environmental Risk Factors: The Role of Oncology Nurses in Assessing and Reducing the Risk for Exposure Oral Chemotherapy: A Home Safety Educational Framework for Healthcare Providers, Patients, and Caregivers Oral Chemotherapy: An Evidence-Based Practice Change for Safe Handling of Patient Waste Personal Protective Equipment Use and Surface Contamination With Antineoplastic Drugs: The Impact of the COVID-19 Pandemic Oncology Nursing Forum articles: Factors Influencing Nurses' Use of Hazardous Drug Safe Handling Precautions Randomized Controlled Trial of an Intervention to Improve Nurses' Hazardous Drug Handling ONS Learning Library: Safe Handling of Hazardous Drugs Joint ONS and Hematology/Oncology Pharmacy Association position statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs ONS Voice video: Hazardous Drug Surface Contamination—The Science Behind the Study 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 pubONSVoice@ons.org. Highlights From This Episode “We know that this book is used in practice sites across the country and increasingly around the world, and we have the privilege of answering lots of questions of ONS's members routinely. And we've also been part of writing guidance documents for ONS. And so, we utilized, as well, some of those questions that have come to us, and we know what people want to know more about. So we've made sure that we've developed a book that would be the most helpful in clinical practice settings.” TS 2:42 “We ensured that the book was in alignment with all of the most recent organizational position statements, standards, and recommendations. And there have been some big ones between the publication of the third and fourth book. So USP 800 is one that everyone knows about, and that became enforceable in November of 2023. … The ONS/HOPA [Hematology/Oncology Pharmacy Association] position statement, which was most recently updated in 2022, was also folded into this book. NIOSH [National Institute for Occupational Safety and Health] came out with two new guidance documents in 2023, and I had the opportunity to serve as a reviewer on one and a contributor to the other. Those two NIOSH guidelines have been folded into this book And then the ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice, which MiKaela Olsen was a lead editor on and I was an author for, have also been folded into this text.” TS 7:01 “We've understood the NIOSH hierarchy of controls for years, and if we look at that hierarchy, it tells us that PPE is important but also the least effective when it comes to controlling exposure. And what's slightly more effective is administrative controls, which are things like changes in our practices, more education, and training. And then even more powerful than administrative controls are engineering controls, and these are your closed-system transfer devices, for example, that are really important in minimizing exposure.” TS 10:31 “[Toilet pluming] is a place that I, for better or worse, spend a lot of time. And I have a colleague, Tom Connor from NIH [National Institutes of Health], who likes to joke when people ask him about his work. He says, ‘Oh, it's in the toilet.' And so I'm going to steal that from him and say a lot of my research is in the toilet, too.” TS 13:16 “I feel like people don't know how contaminated toilets are and how contaminated floors are. And I've already told you my tip about leaving your work shoes outside. But I think if people were more aware that the toilets and the floors are often the most contaminated places on a unit, there would be more attention paid to people who are coming into contact with those surfaces and bear a lot of the exposure risk.” TS 22:51

“One of the things that's really challenging with these BRAF inhibitors, plus MEK inhibitors, is that there's a huge scope of potential toxicity, and they're not all going to happen. So I think that there's a real need to educate patients that they need to work with us so that when a toxicity develops, we can help address it. We can help think of strategies, whether it be medication strategies or whether it be other types of strategies, to make them feel better,” Rowena “Moe” Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the BRAF inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 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: Learners will report an increase in knowledge related to BRAF inhibitors.  Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Pharmacology 101 series Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs ONS Voice articles: First-Line Combination Immunotherapy Prolongs Survival in BRAF Advanced Melanoma Predictive and Diagnostic Biomarkers: Identifying Variants Helps Providers Tailor Cancer Surveillance Plans and Treatment Selection BRAF Mutations Guide Treatment in Metastatic Colorectal Cancer Melanoma Prevention, Screening, Treatment, and Survivorship Recommendations Nursing Considerations for Melanoma Survivorship Care ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)  Clinical Journal of Oncology Nursing article: BRAF/MEK Inhibitor Therapy: Consensus Statement From the Faculty of the Melanoma Nursing Initiative on Managing Adverse Events and Potential Drug Interactions Oncology Nursing Forum articles:  Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards MAPK Pathway–Targeted Therapies: Care and Management of Unique Toxicities in Patients With Advanced Melanoma ONS Learning Library: Oral Anticancer Medication ONS Biomarker Database Oral Chemotherapy Education Sheets 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 pubONSVoice@ons.org. Highlights From This Episode “BRAF is a gene found on chromosome 7 that encodes for protein that is also called BRAF. And this protein is really important in cell growth and signaling and promoting cell division, as well as some other functions. When you have a variant in BRAF, this causes that gene to turn on the protein and to keep it on. That means there's a continual signaling to the cell to keep dividing and there's no instruction to stop dividing.” TS 2:24 “[Side effects] are things like pyrexia, fatigue, muscle aches, those things. There is definitely rash. And as I mentioned, there are those secondary skin cancers, which are significantly less with the combination with MEK inhibitors. GI [gastrointestinal] toxicities are not uncommon. Different patients, different tolerance in terms of like nausea, taste changes. I think taste changes are one of the ones that are really challenging.” TS 10:17  “How to get rid of the agents when they're done—I love that our institution has a program where they can bring them back, and we can help them get rid of it, because people just don't know how to get rid of them when they're no longer taking them. And you really don't want them having them around the house.” TS 15:28 “Don't assume that you can modify formulation. So if there is someone who can't take oral pills and has to use a suspension, some drugs, there's clear indications how to do that. Other ones there's not. So collaborating on that is a really good thing. I hear too much where people will say, ‘Just crush the pill.' These are not the drugs that you want to do that with.” TS 23:07

“Supportive personnel have a great ability to connect with patients and peers, and if that's utilized effectively, it will make a great, great, great, great place to work, with great people to work with, because utilizing the supportive personnel and the great connections that they have, assistive personnel are kind of a lot of times the middle piece, and we don't utilize it in that way. ,” Danielle Steele Anderson, CST II, NA II, research assistant at UNC Medical Center in Chapel Hill, NC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about how supportive personnel are improving staffing and patient care in oncology units. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 6, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the role of supportive staff in the care of people with cancer. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episode: Episode 160: Build Innovative Staff Education Tools and Resources ONS Voice article: Upskilled Medical Assistants Can Improve Quality and Efficiency of Cancer Care ONS book: Oncology Nursing: Scope and Standards of Practice ONS Learning Library: Staffing 2023 ONS Congress poster presentation: Building a Staffing Plan for the Future Anderson's ONS Congress® poster presentation: The Development of an Assistive Personnel Role to Support Quality Initiative Compliance and Improve Patient Outcomes on an Inpatient Hematology/Oncology Unit National Guidelines for Nursing Delegation 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 pubONSVoice@ons.org. Highlights From This Episode “I worked on a 53-bed oncology unit that had limited staff and resources to complete audits on things like central lines, Foleys, tubings, turn compliance, falls—different things like that. Our nurses were dealing with high patient acuity and task overload, so one of our amazing CN4s came up with this awesome rule as a cost-effective way to perform and sustain quality improvements on our unit.” TS 3:15  “Even before this role, I never thought about being on a committee. I never even knew that assistive personnel could even be on committees. I thought committees were tailored more toward nursing. But being in this committee, I feel like involving assistive personnel in committees, can number one, empower them and boost their morale, which in turn, can have higher job satisfaction, good retention.” TS 11:42 “Encouraging assistive personnel and participating in continuing education programs that may be offered to learn more about oncology-specific care, teaching clinical skills that may be within the scope of practice. With this position, I am able to do a lot of tasks that are beneficial to both our nurses and assistive personnel.” TS 16:08  “Opportunities to shadow with nurses during procedures can kind of give us that hands-on learning experience to know more about specific things that are going on and what to monitor with patients. And then also it just will help build connections within our healthcare team and your workplace and your unit.” TS 16:59 

“It's not often in life that you find something that gives you this feeling, but I'm really so fortunate to have found mine, and I know this is only just the beginning, and I cannot wait to see what the future holds. I definitely owe a lot of that to the Oncology Nursing Society for opening up all those doors for me and really getting me into this field.” Samantha Paulen, BSN, RN, told Jessica MacIntyre, DNP, MBA, APRN, AOCNP®, 2024–2026 ONS president, during a conversation about student nurses entering the oncology field. MacIntyre spoke with Paulen and Tayler Covino, BSN, RN, both recent graduate nurses, about why they chose oncology nursing as a specialty. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes  NCPD contact hours are not available for this episode.  Oncology Nursing Podcast™ episodes: Episode 191: Explore Orientation Opportunities for New-to-Practice Nurses Episode 20: Advance Your Career Through Awards, Grants, and Scholarships ONS Voice articles: Nursing Students Connect Beyond the Classroom With ONS Resources One Oncology Lecture Isn't Enough Nurse Residency Programs Improve New Graduate RNs' Transition to Clinical Practice Train and Retain: From Orientation to Leadership, Here Are the Strategies That Experienced Staff Developers Use Innovative Programs Help Institution Grow Its Own Nursing Workforce Oncology Nurses Enhance Cancer Care Through Mentorship Opportunities Nursing Team Shares Process of Training a New Nurse in Oncology Outpatient Care ONS book: Cancer Basics (third edition) ONS courses: ONS Cancer Basics™ ONS Cancer Biology™ ONS Oncology Nurse Orientation Preceptor Bundle™ Clinical Journal of Oncology Nursing articles: American Association of Colleges of Nursing: New Essentials, Quality and Safety Domain Can a Recent Nurse Graduate Thrive in the Oncology Setting? Prelicensure Nursing Students' Attitudes Toward Patients With Cancer Revisited ONS Learning Library: Nurse Orientation ONS Undergrad/Pre-Licensure Core Competencies ONS Career Guide ONS Resources for Student Nurses To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an Oncology Nursing PodcastÔ 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 “I was first drawn to oncology nursing freshman year of high school when my grandmother, who was my ultimate best friend, was diagnosed with pancreatic cancer, and by the time they had caught it, it had metastasized to nearly every surrounding organ. And as I mentioned earlier, my grandmother was a nurse. So being a nurse, she was very stubborn, and when she finally had gone to the hospital after having a variety of symptoms, it was almost too late.” (Paulen) TS 7:27  “There's really nothing more special to me than being able to develop relationships with my patients and support them throughout their journey. It's incredibly rewarding making such a difference in their lives and being able to witness the strength and resilience of patients battling cancer, and it's such an inspiration. Being able to provide my support both medically and empathetically is truly such an honor.” (Paulen) TS 10:04  “I also had a family member who was diagnosed with cancer. He was my uncle. And I witnessed firsthand the impact that compassionate and knowledgeable oncology nurses had on his treatment, and it really did leave such a lasting impact on me. … This experience deeply inspired me, and I just always wanted to be part of a team that offers hope and comfort to their patients and their families.” (Covino) TS 12:10  “I touched on my pediatric oncology clinical rotation, but I really do think it gave me insights into caring for younger cancer patients. This experience really emphasized the importance of a holistic approach to nursing, considering not just medical but also the emotional and developmental needs of children who are battling cancer.” (Covino) TS 24:05 “I also joined ONS as a student, so it was a large part of my college education and really gave me great access to resources, being able to attend meetings, and just stay updated on the latest in oncology nursing with the articles that they send out and just provided me with great networking opportunities with so many experienced oncology nurses who have such a wide breadth of knowledge.” (Covino) TS 24:27 “Practicing mindfulness and meditation has also been incredibly helpful in staying grounded and managing the emotional stress. These practices help me stay present. They reduce anxiety and maintain a positive outlook, even in these challenging environments. It's really important to just set emotional boundaries as well to avoid burnout.” (Covino) TS 33:05 “There's such a fulfillment that you get for making a significant impact on patients' lives, and that's what inspires me and should inspire others to consider this specialty. There's also a lot of growth opportunities, and I think it's really important to emphasize the growth opportunities within the field. And also just the advancements in cancer treatment can attract new nurses because there really is so much advancement in the field of cancer treatment.” (Paulen) TS 42:59  “I feel that specifically in this specialty, oncology nurses in particular are so much more willing to help versus they say that sometimes some nurses may eat their prey or whatever they might say. But I really think that oncology nurses are so willing to help, but sometimes you just have to really expose yourself and open up that door.” (Paulen) TS 45:07 

“One of the big misconceptions is that this is just a quick shot. And this is a patient's treatment regimen. So, it is not just a quick shot. It is treatment, and we need to get it where it is supposed to go so that the patient's, cancer treatment is not impacted,” Caroline Clark, MSN, APRN, OCN®, AG-CNS, EBP-C, director of evidence-based practice and inquiry at ONS, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about administering intramuscular (IM) injections in 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 myoutcomes.ons.org by August 23, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of 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 administration of antineoplastic medications by IM injection. Episode Notes Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Episodes on administration topics Episode 324: Pharmacology 101: LHRH Antagonists and Agonists Episode 316: Pharmacology 101: Estrogen-Targeting Therapies ONS Voice article:  Oncology Drug Reference Sheet: Asparaginase Erwinia Chrysanthemi (Recombinant)–Rywn ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) ONS course: Introduction to Evidence-Based Practice ONS Huddle Card: Hormone Therapy American Journal of Therapeutics article: Body Mass Index: A Reliable Predictor of Subcutaneous Fat Thickness and Needle Length for Ventral Gluteal Intramuscular Injections Centers for Disease Control and Prevention resources: Administering Vaccines: Dose, Route, Site, and Needle Size Vaccine Administration: General Best Practices for Immunization Concordia University Ann Arbor School of Nursing video:  Ventrogluteal identification Elsevier Clinical Skills: Medication Administration: Intramuscular Injections—Acute Care Healthline article: Z-Track Injections Overview Journal of Advanced Nursing article: Does Obesity Prevent the Needle From Reaching Muscle in Intramuscular Injections? Journal of Clinical Nursing article: Dorsogluteal Intramuscular Injection Depth Needed to Reach Muscle Tissue According to Body Mass Index and Gender: A Systematic Review Journal of Nursing Research article: Gluteal Muscle and Subcutaneous Tissue Thicknesses in Adults: A Systematic Review and Meta-Analysis National Institute of Occupational Safety and Health: Hazardous Drug Exposures in Health Care Novartis education sheet: Additional Considerations for Dorsogluteal and Ventrogluteal Intramuscular Injections Oncology Nurse Advisor article: Large-Volume IM Injections: A Review of Best Practices 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 pubONSVoice@ons.org. Highlights From This Episode “More frequently oncology nurses are using intramuscular injection techniques when giving certain hormonal therapies for cancer treatment and for cancer symptom management. Some examples of those are fulvestrant for treatment of hormone receptor–positive, HER2-negative breast cancer, leuprolide as androgen deprivation therapy in prostate cancer. This is also used off label for breast cancer management. It's used for premenopausal ovarian suppression and also in noncancerous conditions like endometriosis and uterine fibroids.” TS 2:04 “Inadvertent injection into the sciatic nerve is one of the most common causes of sciatic injury. It has significant morbidity associated with it. And even for drugs like fulvestrant, the prescribing information notes reports of sciatica, neuropathic pain, neuralgia, peripheral neuropathy—all related to dorsogluteal injection.” TS 6:09 “When administering an IM injection to someone who is cachectic, you don't want the subcutaneous tissue to bunch up. So you can kind of stretch this over with your nondominant hand, as in the Z-track method, and then grasp the muscle between your thumb and index finger. That's going to help you ensure that you're getting that muscular injection.” TS 11:47  “Z-track is a way that you inject so that there's no leakage back out into the subcutaneous space. Clean your area as usual. You displace the skin and the subcutaneous tissue that's over that muscle, and then you inject slowly into the muscle. Once you remove the needle, then you release that tissue. And it kind of seals it over and prevents that leakage back up into the subcutaneous space.” TS 14:19 “I think ventrogluteal injection is less commonly done. There are documented issues with confidence in landmarking and giving it to that site, so practice is necessary. A great way to identify the ventrogluteal site on yourself to start is to stand up and put your hand at your side. You feel for the top of that iliac crest. Place your hand right below the iliac crest and then just start marching in place. You're going to feel that muscle contraction right away. This also works when you abduct your leg. Abducting the leg is helpful when a patient is at a side-lying position to give a ventrogluteal injection—you feel that muscle contraction.” TS 17:06 “I wish it would be front of mind to encourage adverse event reporting related to any injection you're giving. These types of reports—they drive improvement measures and monitoring. And then when things are underreported, it leads us to anecdotal reports. So really monitoring any change, trying to get some baseline data on adverse events with injection is really important.” TS 26:32 

“These evidence-based standards provide a great framework for best practice in cancer care and the 2016 publication is extensively referenced. However, patient care mistakes and medication errors still happen. So, it's imperative that we review the current literature and look for new evidence that's been published,” ONS member MiKaela Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director of oncology at Johns Hopkins Hospital and Johns Hopkins Health System told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the new Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology from ASCO and ONS. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by August 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to increasing safety of antineoplastic medication administration. Episode Notes  Complete this evaluation for free NCPD. Oncology Nursing Podcast™ episodes: More episodes about antineoplastic administration Episode 209: Updates in Chemo PPE and Safe Handling Episode 142: The How-To of Home Infusions ONS Voice articles: Are You Following the Latest Chemo Safety Recommendations? Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE Respect Patients' Religious Hair Wraps or Coverings When Taking Accurate Height and Weight Measurements ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Oncology Nursing: Scope and Standards of Practice Safe Handling of Hazardous Drugs (fourth edition) ONS courses: ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ Safe Handling Basics Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards Oncology Nursing Forum article: ASCO/ONS Antineoplastic Therapy Administration Safety Standards ONS Learning Library: 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 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 pubONSVoice@ons.org. Highlights From This Episode “The target population for these standards are, first, our patients—adult and pediatric patients with cancer who are receiving antineoplastic therapy—but as well as those who care for patients with cancer. And we're not distinguishing between the healthcare worker, the caregiver, all people who care for patients with cancer, including those practitioners or healthcare workers that are not in a traditional oncology setting.” TS 3:25 “The audience is, first of all, oncology clinicians. We spent a lot of time on this panel writing the definition, so it was very clear who people were as we use terminology in the standards. So, an oncology clinician, when we refer to that in the standards, that's a licensed nurse, like a nurse or pharmacist, a licensed clinician, or it could be a non-licensed clinician like a patient care assistant or tech. So, we refer to people as clinicians that are licensed or unlicensed.” TS 4:14 “We need to define all types of therapy for cancer, and chemo is one type of treatment modality. The explosion of new therapies that include cellular therapies such as CAR T and other exciting emerging treatment options are not our traditional chemotherapy. And so the term antineoplastic was agreed upon for all these therapies to treat cancer. That definition in the standards is, and I quote, ‘All antineoplastic agents used to treat cancer regardless of the route.' And that's important because the previous guidelines were not as inclusive about that.” TS 6:58 “Another high-level change was the new language about the location of administration to include new healthcare settings. We know that antineoplastic medications are given in a variety of settings, not just your typical inpatient or ambulatory oncology infusion center anymore. We've got health plans that are increasingly developing strategies to direct patients to more convenient and less costly sites of service, such as the physician's office or home infusion, unregulated sites, and more care is being given in these settings. So, it's really important that we adapt the standards to make sure those patients treated in the home or in a freestanding center are given the same opportunity for safety and quality.” TS 8:39 “The other thing in Domain 1 that I think is crucial for nurses to understand, because it's a big change, and we made this change based on the literature, looking at patient safety events related to inaccurate weight and height measurements. Domain 1 has a standard 1.7 that says weight and height are measured and documented in the medical record in metric units only. And I see that a lot when I'm going around the country. People still have their scales and pounds and their height in inches, and we've got to change that. We shouldn't be converting things. Both the measurement and the documentation are verified by two individuals, one of whom is a licensed clinician. Prior to preparation and administration of a newly prescribed antineoplastic treatment plan.” TS 13:32 “That third verification is an independent safety check and, in my opinion, should be done in a quiet place where you can go through and do the safety checks that are listed in the standards quietly and thoughtfully, without being in the presence of the patient or caregiver. Those are done in an attempt to do some preliminary safety checks to make sure that when I go in the room to do my safety checks—we often call those bedside safety checks—that if I have an error before that with a dose or something, I've caught that before I get to the patient's side.” TS 20:52

“A lot of the efforts have been made to improve the patient experience for these treatments, as they can be given for years at a time. For example, when leuprolide debuted way back in 1985, it was a daily injection. But four years later, they developed the monthly depo formulation. Now we have formulations that are approved for administration once only every three, four, and even six months,” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the luteinizing hormone–releasing hormone (LHRH) antagonist and agonist drug classes. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by August 9, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to LHRH antagonists and agonists. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Pharmacology 101 series Episode 321: Pharmacology 101: CYP17 Inhibitors Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs Episode 154: New Drug Approvals for Metastatic Castration-Sensitive Prostate Cancer Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™ ONS Voice article: Oncology Drug Reference Sheet: Relugolix ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Safe Handling of Hazardous Drugs (fourth edition) Guide to Breast Care for Oncology Nurses ONS course: Safe Handling Basics ONS Guidelines™ and Symptom Interventions ONS Huddle Card: Hormone Therapy ONS Learning Libraries: Breast Cancer Cancer of the Genitourinary Tract Oral Chemotherapy Education Sheets National Comprehensive Cancer Network On the Treatment of Inoperable Cases of Carcinoma of the Mamma: Suggestions for a New Method of Treatment, With Illustrative Cases (by George T. Beatson) 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 Oncology Nursing Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Between all of these agonists and antagonists, there's a broad spectrum of applications, including hormone-positive breast cancer, androgen-deprivation therapy for prostate cancer, uterine cancer, and then other non-cancer uses like uterine fibroids, and assisted reproduction fertility treatments, and other things too.” TS 3:24 “In the education of my female patients, I basically use the analogy that it is functionally inducing menopause in that person, so there can be changes to mood and cognition, energy level fatigue, body morphology, and shifts in fat distribution metabolism, which can unfortunately increase the risk of cardiovascular disease. One that almost everyone's familiar with is hot flashes, but also changes to bone mineral density, libido and physically to atrophy and dryness of vaginal mucosa, which can make sex for our patients more difficult as well.” TS 10:33 “A concept that's familiar to all professionals in the care of prostate cancer is that because LHRH agonists cause an initial increase in testosterone, which can, in essence, feed the cancer, some patients can experience worsening symptoms of their cancer, such as difficulty voiding their bladder pain, or even vertebral collapse or spinal cord compression when bone metastases are present. This is a really serious issue that should be considered ahead of starting an agonist in these patients.” TS 12:39 “I don't think we'll see any dramatic changes in treating breast cancer, since the role of these agents is a lot more limited and simply really exist to suppress estrogen and premenopausal patients. But as a referral center that routinely sees patients with breast cancer and their 40s and 30s and even their 20s, it's crucial to consider these agents in their role for not only actively treating certain types of breast cancer, but also in preserving fertility for patients who desire to have children and they are receiving gonadotoxic chemotherapy.” TS 25:32

“Instead of creating silos, how can we work together, create networks, and elaborate more in the future? Because we have such a robust wealth of knowledge and expertise, that ONS is very good at helping to facilitate that,” Jan Tipton, DNP, APRN-CNS, AOCN®, clinical assistant professor in the School of Nursing at Purdue University in West Lafayette, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about her volunteer experience in a think tank held during the 2024 ONS Congress®. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by August 2, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to participation in professional collaboration opportunities. Episode Notes  Complete this evaluation for free NCPD.  Volunteer Opportunities on ONS Communities Oncology Nursing Podcast episodes: Episode 320: What It's Like to Be a Peer Reviewer or Associate Editor for an ONS Journal Episode 309: What Brings You to ONS Congress®? ONS Voice articles: What Brings You Value in ONS? You Can Thank a Volunteer for That The Power of Connection in Oncology Nursing ONS Health Policy Priorities and Agenda ONS Resources for Researchers Luma Institute: Abstraction laddering American Organization of Nursing Leadership think tanks National Association of Clinical Nurse Specialists health policy think tanks 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 pubONSVoice@ons.org. Highlights From This Episode “Individuals that would be helpful for this type of think tank would be those that view themselves as change agents, those who are willing and motivated to confront uncomfortable truths, persistent issues, that might think of a better way to do things. In addition, people that are highly inquisitive, curious, eager to learn, and those that have out-of-the-box type thinking, flexible, creative, and would work well in this group environment.” TS 3:29 “We all came from very diverse backgrounds, all over the country, and it was a great opportunity to blend our backgrounds in academia, clinical practice, and then be able to share not only some of the dilemmas and hardships that we see, but then to recommend some actions for the future.” TS 6:12 “But things that sparked my interest were things that were very small scale and then things that were very large scale that everyone could benefit from hearing. And one that comes to mind was, in a very small way, how can we collaborate with our various backgrounds and PhDs and DNPs and have more of a meet-and-greet? We're sometimes in our silos. And how can we create opportunities for each other to learn from each other, to have these meetings, maybe in social venues, to learn about interests, research, collaborations in the future?” TS 6:55 “I think it's important to challenge yourself to be open to new ideas, to keep an open mind. Consider that your idea may not be agreeable to everyone. So to think through, everyone that you may be participating with and have a heightened awareness of all the differences that we may have in our different backgrounds, gender, characteristics that we believe in, in terms of our practice. So thinking through those things in advance and being open to new ideas, I think, is really important and sort of self-reflecting before the event.” TS 15:41

“I think poor discharge planning is that top contributor [to readmission]. And by that, I mean discharge planning that doesn't assess a patient's educational level, their support at home, what resources they have, like transportation and finances, and then to go further, evaluating if the patient even understand the reason they were admitted and then how to manage their care once they leave. There's only so much we can treat in the hospital. what happens at home is what we need to prepare our patients for,” Stephanie Frost, MN, RN, OCN®, manager of outpatient clinics at City of Hope Cancer Center Chicago in Illinois, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about preventing hospital readmissions in patients with cancer. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by July 26, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to nursing strategies to reduce readmission rates for patients with cancer. Episode Notes Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Cancer Symptom Management Basics series Episode 193: How Social Determinants of Health Affect Cardio-Oncology Survivorship Episode 107: Social Determinants Lead to Unequal Access to Health Care ONS Congress® presentations: Implementing Continuous Care Program and Streamlined Care Team Communication to Reduce Hospital Readmission and Emergency Department Visits (coauthored by Stephanie Frost) Improving Readmission Rates Through Transitional Care Management for Oncology Patients at Highest Risk for Readmission ONS Voice articles: Cross-Discipline Cancer Care: Oncology Nurses Share Specialized Knowledge With Non-Oncology Settings Postdischarge ICI Patient Education Eliminates Hospital Readmissions Symptom Management Strategies You May Not Be Using Transitions in Care: Communication Builds a Bridge of Consistent Support for Patients ONS books: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition) Telephone Triage for Oncology Nurses (third edition) ONS courses: Treatment and Symptom Management—Oncology RN Clinical Journal of Oncology Nursing articles: Decreasing Readmission Rates in Patients With Immune-Mediated Toxicities Using an APRN-Led Discharge Teaching Program Patient Handoff Processes: Implementation and Effects of Bedside Handoffs, the Teach-Back Method, and Discharge Bundles on an Inpatient Oncology Unit Oncology Nursing Forum articles: Predictors of Unplanned Hospitalizations in Patients With Nonmetastatic Lung Cancer During Chemotherapy Systematic Review of Hospital Readmissions Among Patients With Cancer in the United States ONS Huddle Card: Handoff Communication ONS Guidelines™ and Symptom Interventions Healthy People 2030: Social Determinants of Health Journal of the Advanced Practitioner in Oncology article: Uncovering and Addressing Implicit Bias in Oncology 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 pubONSVoice@ons.org. Highlights From This Episode “Of course readmissions are inevitable, but ultimately, high rates may indicate that there's a problem. Something is wrong. The quality of our care is not up to par. So looking at the rate of unplanned readmissions encourages hospitals to look inward, to see what's going on, and find the gaps.” TS 2:31 “The number one thing we can do is review the patient's social determinants of health. We're seeing this assessment tool used more and more in the hospital system, and it can truly help identify high-risk patients. … But it really takes into consideration a patient's environment, and it includes five components—access and quality of education, economic stability, healthcare access and quality, home environment, and then the patient's community.” TS 5:17 “Recently, we had a patient that was seen in our ED [emergency department] for nausea and vomiting. And then due to that follow-up call the nurse made, she was able to get another set of labs drawn on the patient, found that they had an electrolyte imbalance, and then got the patient set up for fluids in an outpatient setting. So I think that really prevented that patient from going back to the ED, probably for the same reason they were there in the first place.” TS 18:00 “When we reviewed the data, we saw our readmission rates had dropped by 51% at the six-month mark, and same with our ED visit rates. And then our referrals to the continuous care team jumped 155%. … But we were able to discover some other opportunities through the process. So for example, through the chart audits completed, we were able to identify an increased need for our pain management services. There was a large number of patients that the reason for visit was pain, so we ended up expanding our templates for our pain management providers to meet that need and ultimately reduced the admissions for pain.” TS 22:38

Episode 321: Pharmacology 101: CYP17 Inhibitors “I think we're in a scientific golden age for prostate cancer and probably cancer as a whole, but we're talking about prostate cancer today. So I'm excited to be sitting on the front lines, seeing the new ways that we can help our patients. But I do still think CYP17 inhibitors will continue to be one of our main weapons against prostate cancer for a very long time,” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the CYP17 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 myoutcomes.ons.org by July 19, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to CYP17 inhibitors. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Pharmacology 101 series Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs Episode 154: New Drug Approvals for Metastatic Castration-Sensitive Prostate Cancer ONS Voice article: The Case of the Genomics-Guided Care for Prostate Cancer ONS course: Safe Handling Basics ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Safe Handling of Hazardous Drugs (fourth edition) Clinical Journal of Oncology Nursing article: Navigating Treatment of Metastatic Castration-Resistant Prostate Cancer: Nursing Perspectives Oncology Nursing Forum articles: Interventions to Support Adherence to Oral Anticancer Medications: Systematic Review and Meta-Analysis ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications ONS Huddle Card: Hormone Therapy ONS Biomarker Database (refine by prostate cancer) ONS Learning Libraries: Cancer of the Genitourinary Tract Oral Anticancer Medication Oral Chemotherapy Education Sheets 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 pubONSVoice@ons.org. Highlights From This Episode “Identification of CYP17 as a target to decrease androgen production led to the first synthesis of a dedicated inhibitor of CYP17 named abiraterone acetate in the 1990s. But it would also not be until 2011, when there was sufficient evidence through clinical trials, for the [U.S. Food and Drug Administration] to approve abiraterone as treatment for castrate-resistant prostate cancer. And since then, abiraterone has been studied in many different stages of prostate cancer and has demonstrated clear benefits to survival for patients with metastatic or nonmetastatic prostate cancer and in the castrate-sensitive setting, as well.” TS 3:07 “Patients on abiraterone, regardless of the formulation that they get, they also have to receive an oral steroid every day while undergoing treatment due to the risk of that mineralocorticoid excess. … CYP17 inhibition by abiraterone leads to the loss of negative feedback on the adrenocorticotropic hormone, or ACTH, through a relative cortisol deficiency, which then results in higher levels of ACTH, which then cause the formation of excess precursors, including those mineralocorticoids that are upstream of the CYP17 inhibition step of androgen formation.” TS 14:04 “I recommend that patients take the standard formulation of abiraterone on an empty stomach. Conversely, I do recommend patients take their steroids with food to reduce the chances of [gastrointestinal] upset from their steroids. And so, I emphasize to these patients that abiraterone and the steroid do not need to be taken together at the same time, even though they are both a component of their treatment, and that they probably should, in fact, take them a little bit separately.” TS 23:00 “Now we're really in the phase of studying combination treatments, and we've had some really good results so far. So, one of the combinations that made a splash a few years ago is what we call triplet therapy, so abiraterone plus docetaxel plus [androgen-deprivation therapy], docetaxel being a traditional cytotoxic chemotherapy that's been used in prostate cancer for several decades now. But now we're combining it with CYP17 inhibitors and other novel hormonal therapies, which has been exciting. So, this has been implemented into the standard of care for metastatic hormone-sensitive prostate cancer.” TS 27:26  

“In my role as an associate editor, I truly felt like I was bringing the voices of nurses who were new to oncology or new to writing forward. I was able to provide a venue for those oncology nurses who also wanted to bring forward some of the cool quality improvement projects that they were working on. I was really happy to share that knowledge through this role, so that all the other institutions can learn and maybe implement some of those solutions,” Megha Shah, DNP, FNP, OCN®, charge nurse at Northwestern Medicine Cancer Center Delnor in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during about her experience volunteering as a peer reviewer and associate editor for the Clinical Journal of Oncology Nursing (CJON). Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by July 12, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to the role of a peer reviewer and associate editor for an ONS journal. Episode Notes  Complete this evaluation for free NCPD.  Volunteer Opportunities on ONS Communities Open Call for CJON Peer Reviewers Open Call for Oncology Nursing Forum Peer Reviewers Oncology Nursing Podcast episodes: Episode 73: Overcoming Challenges as a New Nurse Author Episode 25: How Publishing Can Advance Your Nursing Career – Part 2 Episode 24: How Publishing Can Advance Your Nursing Career – Part 1 ONS Voice articles: Publish Your First Article With ONS Voice The Power of Peer Review: With a Little Professional Polish, Your Work Will Shine Clinical Journal of Oncology Nursing resources: For Authors Peer Review CJON Writing Mentorship Program Oncology Nursing Forum resources: For Authors Peer Review Upon Further Review: Peer Process Vital to Publishing ONS Career Development Learning Library ONS Resources for Book Authors and Editors ONS Books Peer Review 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 pubONSVoice@ons.org. Highlights From This Episode “I review an article for relevancy and accuracy, score the article, provide detailed comments and feedback on sections that need improvement or the sections that look wonderful and can go straight to publishing. After that, I submit the article to the editor. You have to meet the deadlines that are given. So, I could say an article on an average takes me about one to two hours to review, which is not bad. And you're given about three or four days to review an article, so it's very attainable.” TS 7:23 “Honestly, I wasn't expecting to be picked for the associate editor position because I did not have any prior experience when I applied. But then soon after I applied, I got a call from the editor of CJON that she had reviewed my resume, she had reviewed my application, and she would love for me to join the team. She couldn't see me on the call, but I was jumping up and down.” TS 9:24 “It's fun, it's rewarding, and I promise it will help you at some point in your career or your personal life. Whether you're helping to lead a project at work or helping your child to write a paper for school, it's going to come in handy; I promise you.” TS 17:00 “I feel like one of the biggest common misconceptions is [that volunteering as a peer reviewer] is a lot of work and it's boring. That's what I hear some of the nurses say. I disagree with that. I feel like it's a lot of fun, and it's rewarding, and it's a great opportunity. I feel like everybody should try it.” TS 18:47

Episode 319: Difficult Conversations About Pregnancy Testing in Cancer Care “For people diagnosed with cancer that are of childbearing potential, we have to consider how [pregnancy] testing could impact them. So we never know what someone has been through, and it's important to lead with empathy while providing education of the importance of this testing. So someone may find now that pregnancy testing is a dreaded experience instead of what they thought would be a joyous one,” Marissa Fors, LCSW, OSW-C, CCM, director of specialized programs at CancerCare in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the psychosocial aspects of pregnancy testing 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 myoutcomes.ons.org by July 5, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome:  Learners will report an increase in knowledge related to the patient experience of pregnancy testing during cancer treatment. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 311: Standardized Pregnancy Testing Processes in Cancer Care Episode 293: Access to Care: How to Manage Moral Dilemmas and Advocate for Your Patients  Episode 262: LGBTQ+ Inclusive Nursing Care Begins With Using Supportive Language Episode 217: Support Pregnant and Postpartum Patients During Cancer Diagnosis and Treatment Episode 211: Apply the LGBTQIA+ Lived Experience to Your Patient Interactions Episode 208: How to Have Fertility Preservation Conversations With Your Patients ONS Voice articles: Cultural Humility Is a Nursing Clinical Competency The Case of the Pregnancy Predicament Transgender Patient Populations: Inclusive Care Involves Listening and Communicating Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress Use Active Listening to Engage More Deeply in Patient Discussions ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition) Clinical Journal of Oncology Nursing articles: Pregnancy and Cancer Treatment: Developing a Standardized Testing Policy and Procedure Unintended Pregnancy: A Systematic Review of Contraception Use and Counseling in Women With Cancer ONS Congress® abstract: System Approach to Fertility Preservation and Pregnancy Status During Active Cancer Treatment ONS Huddle Cards: Fertility Preservation Sexuality ECHO Training Program (Enriching Communication Skills for Health Professionals in Oncofertility) Journal of the National Comprehensive Cancer Network article: Pregnancy Screening in Patients With Cancer To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “In everyday life, pregnancy testing is actually still really complex. It's more than just the positive pregnancy test and the happy parent we may see on commercials. For those that are hopeful for a positive test, there's still a lot of anxiety, worry, fear, maybe before, during, or after the results. And I think about how long this person has been trying to conceive and the financial impacts involved, change in family dynamics. What if that test comes back negative? Then I think about the potential disappointment or the heartbreak. I also consider the flipside—those that are scared of a positive result for fears of becoming pregnant for a range of different reasons.” TS 3:40 “I think it's important to always lead with empathy and kindness and an open mind. So you don't want to assume you know or understand how a person feels or may respond. Allow your patients to share with you how they're feeling in a nonjudgmental manner. This could be an incredibly vulnerable moment, and nurses can be a valuable source of support. Take a moment to just listen, normalize their feelings or let them ask questions. And I recognize it can be difficult to know what to say or do, but sometimes just being there for someone in those ways is incredibly meaningful and opens up more effective communication and trust.” TS 8:48 “For the patient that has been trying to conceive, taking another pregnancy test could be so daunting or triggering and bring back so many moments of grief. Seeing the results being negative could be heartbreaking all over again. Some people may find some relief knowing their fetus will be harmed and they won't have to make tough decisions. And then there may be guilt for feeling that way. There's no one way to feel or right or wrong way to feel. … Let them know their feelings are valid and anything they feel is okay and normal.” TS 13:40 “I think that a common misconception is that if a pregnancy test comes back positive, there are no options for treatment. Education and communication with your healthcare team can help clear up those options you may have and bring back the element of shared decision-making to make these decisions together with your healthcare team.” TS 31:03

“We put into effect a program that supports guaranteed mobilization of every patient at least twice a day, which is such a huge change from where we were before, where patients were maybe getting out of bed just to go to the bathroom or maybe just to sit in the chair for one meal a day. So it really had a huge impact on overall mobility,” Jennifer Pouliot, MSN, RN, OCN®, clinical program director of oncology safety and quality at Mount Sinai Health System in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the benefits of mobility in hospitalized patients with cancer. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by June 28, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to patient mobility. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 195: Exercise's Effect on Patient and Provider Well-Being Episode 82: Physical Activity Prescriptions in Cancer Care Episode 15: Incorporating Physical Activity in Patient Care  2024 ONS Congress® session: Benefits of an Early Mobility Program for Hospitalized Patients (Presented by Jennifer Pouliot and Mark Liu) ONS Voice articles: Does Dance/Movement Therapy Affect Outcomes for Pediatric Patients With Cancer? During or After Chemo, Exercise Fights Fatigue and Supports Cancer Recovery Exercise Program Improves Quality of Life in Patients With Breast Cancer—and Keeps Them Moving Daily Exercise the Evidence: How I Moved From an Idea to Program Development More Survivors Have Functional Limitations After Cancer What the Evidence Says About Low-Intensity Exercise in Cancer Care What the Evidence Says About Tai Chi in Cancer Care ONS courses: Incorporating Physical Activity Into Cancer Care Quality and Physical Activity Course Bundle Clinical Journal of Oncology Nursing articles: Increased Mobility and Fall Reduction: An Interdisciplinary Approach on a Hematology-Oncology and Stem Cell Transplantation Unit Multimodal Exercise Program: A Pilot Randomized Trial for Patients With Lung Cancer Receiving Surgical Treatment ONS's Get Up, Get Moving resources American Physical Therapy Association's Activity Measure for Post-Acute Care (AM-PAC) National Database of Nursing Quality Indicators (NDNQI) 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 Oncology Nursing Podcast™ Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Mount Sinai developed a mobility mission. And this mission included interdisciplinary approach. So that's talking with the whole team about mobility, knowing the patient's baseline, documenting and understanding the functional status and that it should not decline during hospitalization. Every patient is mobilized unless medically contraindicated. We have a mission to get patients out of bed for every meal. Physical therapy is not required before nursing can mobilize patients, and then to escalate the inability to mobilize patient to the provider upon admission, so we can address that in real time and see what we can do to make sure that they don't stay in the bed.” TS 7:30 “We measured the progress of the program through documented mobility interventions, trending the patient's mobility score and AM-PAC functional assessment, which is the Activity Measure for Post-Acute Care. And then also with NDNQI data like falls, falls with injury, pressure injuries, and then also patient satisfaction surveys.” TS 9:44 “We saw that 76% of our patients, they either maintained or improved their mobility score while they were in the hospital. We had a 6% reduction in excess days. We had a decrease in readmissions, about 6%. And then we saw an increase in our patient satisfaction score about the willingness to recommend the hospital from 63% to 91%. So we found those really powerful, meaningful, and we also had a lot of comment cards from patients highlighting the mobility program.” TS 17:16 “We know the literature is out there. We know the benefits exist. It's really just about advocating and having a business plan that benefits both the organization, the staff, and the patients. And then pilot; start small. So you learn, you grow, you adjust. You figure out what works, what doesn't, and then you scale it out.” TS 19:38