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Lutetium Li 177 dotatate was linked with partial responses in patients with metastatic bronchopulmonary neuroendocrine tumors, per real-world data.

Lutetium Lu 177 Dotatate Brings Partial Response in Metastatic BP-NETs

Benjamin Besse, MD, PhD, shares AE management strategies with amivantamab/lazertinib in EGFR-positive NSCLC following CHRYSALIS-2 results.

Safety Management With Amivantamab Plus Lazertinib in NSCLC

Tepotinib was associated with frequent but manageable adverse events in MET exon 14–positive NSCLC, with peripheral edema most common.

Tepotinib Shows Manageable Safety in MET Exon 14+ NSCLC

Ghayas C. Issa, MD, MS, discusses key adverse events of menin inhibitors in NPM1-mutated and KMT2Ar AML.

Adverse Events of Menin Inhibitors in AML: What Nurses Should Know

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Michelle Kirschner, RN, MSN, ACNP, APRN-BC, is a nurse practitioner and director of program development at the Cancer Survivorship and Supportive Care Professionals Network.

Bridget Hoyt is the assistant editor for Oncology Nursing News. She earned her BA in communication studies at Rider University with a minor in public relations. She can be reached at 

Michelle Kirschner, MSN, RN, ACNP, APRN-BC, discusses how precision supportive care tailors interventions to patient needs.

Precision Supportive Care Centers Patient Preference in Oncology

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Benjamin Besse, MD, PhD, is the director of Clinical research at Gustave Roussy.

Abigail T. Ramontal, MHP, MSN, APRN-FP-C, is an advanced practice nurse at Sylvester Comprehensive Cancer Center at the University of Miami in Miami, Florida.

Read an advanced practice nurse's tips for treating patients with endometrial cancer with durvalumab.

Rx Road Map: Durvalumab for Endometrial Cancer

Oncology Nursing News connects oncology nurses and APPs with updates on therapy advances, side effect management, and patient-centered cancer care.

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Healthcare providers of all disciplines should work together to educate individuals about the symptoms of colorectal cancer.

Taking It One Step Further: How to Educate on Early Age Onset Colorectal Cancer

Preliminary findings from the SLI phase of the BEACON CRC trial show tri-drug combo has durable response in patients with BRAF V600E-mutant metastatic CRC.

Triplet Regimen Shows Durable Responses in BRAF V600E-Mutant Metastatic CRC

, Holly Chitwood, DNP, FNP-C, AGACNP-BC, walks through a patient case with a 70-year-old male with metastatic colorectal cancer.

 His providers used circulating tumor DNA (ctDNA) testing to monitor his minimal residual disease (MRD) levels throughout active treatment. This approach, although not currently addressed in National Comprehensive Cancer Center Guidelines, allows patients and providers to have an idea of how the treatment is working earlier compared with what imaging can usually demonstrate, she explains.

Chitwood is an assistant professor in the College of Nursing at the University of Kentucky, as well as a practicing oncology APRN who primarily cares for patients with gastrointestinal, hepatic-biliary, and sarcoma tumors in her clinic. To read the full case study, please check out our show notes below.

“This is a new technology that we have. It is basically looking at what is in your blood to see how much circulating tumor DNA is floating around.”

“In this case, and in a lot of my patients, you will see ctDNA is about, you know, anywhere from 2 to 3 months [ahead], predating what you will see on imaging.”

“You have to be very judicious in explaining the results, 

 if you have a positive result, and the patient should be included in the decision making.”

ctDNA Continues to Emerge As A Potentially Useful Disease Monitoring Tool in CRC

ctDNA Makes Headway as Promising Marker for Patients With Anal Cancer and Other GI Malignancies

ESMO Guideline on Liquid Biopsy Address Quality Standards for Clinical Implementation

New Treatment Methods Launch a Shift in CRC Treatment

Terri Pollack Offers Perspective on 2023 ASCO GI Cancers Symposium

Chitwood H, Myers A. Use of circulating tumor DNA to monitor minimal residual disease among patients with colorectal cancer. 

 2023;27(4):369-374. doi:10.1188/23.CJON.369-374

Holly Chitwood, DNP, FNP-C, AGACNP-BC, explains how circulating tumor DNA monitoring helps providers screen minimal residual disease in individuals with colorectal cancer. 

ctDNA Monitoring is a Piece of the Puzzle in CRC Treatment

Ronald Bleday, MD, discusses how nurses support a step-wise model to minimize opioid use after colorectal surgery while ensuring safe pain control.

Nurses Are Key to Reducing Opioid Use After Colorectal Surgery

A significant reduction of opioid use in patients after colorectal surgery was supported by clinician and patient compliance, says Ronald Bleday, MD.

Opioid Reduction in Surgical Oncology Supported by Cultural Shift

In a phase 1 study, ELI-002 2P improved relapse-free survival in pancreatic and colorectal cancer, with stronger benefit in patients with T-cell responses.

Amphiphile Vaccine Extends RFS in KRAS+ Pancreatic Cancer

Panitumumab plus FOLFIRINOX or mFOLFOX6 failed to yield meaningful responses in liver-limited, RAS/BRAF wild-type unresectable mCRC.

Panitumumab-Based Chemo Falls Short in Liver-Limited mCRC

Adjuvant aspirin did not reduce recurrence or improve survival in patients with CRC liver metastases, phase 3 data showed at the 2025 ASCO Meeting.

No Survival, Recurrence Benefit With Aspirin in CRC Liver Metastases

Ronald Bleday, MD, describes how nurses help patients reduce opioid use following colorectal surgery.

Ronald Bleday, MD, discusses the role of nurses in reducing opioid use.

Oncology nurses are a crucial part of a stepwise opioid reduction plan that showed efficacy in reducing narcotic drug use for patients who have undergone colorectal surgery in a recent study, said Ronald Bleday, MD, a researcher in the study.

Bleday, who works in the Division of Colorectal Surgery at Brigham and Women’s Hospital in Boston, Massachusetts, said that the stepwise model relies on regionalization, ensuring that patients are receiving 

 from nurses who are used to treating patients who have undergone colorectal surgery.

By placing patients in the care of nurses familiar with pain levels expected for colorectal surgery, patients are less likely to receive higher levels of pain medication than appropriate, Bleday explained.

The study on the stepwise plan, which observed 1363 patients undergoing colorectal surgery across 5 institutions from 2017 to 2020, was associated with a reduction in 

 at 6 and 12 months, respectively, from 16% and 11% of patients in 2017 to 2018, to 15% and 8% of patients in 2018 to 2019, to 11% and 4% of patients in 2019 to 2020 (

In addition to treating all patients with an incisional non-narcotic block, the model employed 3 policy changes over the years that standardized opioid prescription for this patient population:

2017: Intravenous acetaminophen was scheduled every 6 hours for the first 24 hours following surgery, with oral acetaminophen every 6 hours following

2017-2018: The dose and number of opioid tablets dispensed at patient discharge was standardized and provided to clinicians with a reference guide

2019: At 1 institution, liposomal bupivacaine was used as a long-acting local anesthetic at the end of surgery, while the other institutions maximized block use.

The nurses at the bedside are the first people that a patient asks for any pain medication, so nurses need to be included on the team and educated as to how we, as clinicians, would like our patients to get their pain control.

There are adverse effects (AEs) to each tool that you use to control pain. The blocks can have AEs, the non-narcotic medicines, and, of course, the narcotics. What has really helped is regionalization. Most of our patients go to a floor where the nurses are used to taking care of gastrointestinal surgery patients, so they know the usual rhythm of when pain is the worst. They also know the stepwise approach that we as clinicians are familiar with, which they can offer to the patients.

[We can] always having a narcotic as rescue, but use it as a last resort. This has helped significantly in regionalization because the type of pain that you get after orthopedic surgery is going to be a little bit different than the type of pain you get after colorectal surgery. Working with the nursing leaders, initially, then with all the frontline nurses, we have been able to get everyone on the same page to give good pain control but also to minimize narcotics.

This transcript has been edited for clarity and conciseness.

McKie KA, Malizia RA, Fields AC, et al. Long-term opioid use after colon and rectal surgery. 

. 2025;311:86-91. doi:10.1016/j.jss.2025.04.019

Ronald Bleday, MD, explained that a model to reduce opioid use in patients after colorectal surgery relies on nurses familiar with the relevant surgeries.

Oncology Nurse Inclusion Is Crucial to Stepwise Opioid Reduction Model

Ronald Bleday, MD, explained that nurses and APPs with more experience can help newer nurses understand which patients need more pain medication.

Experience helps nurses prevent opioid addication in patients recovering from colorectal surgery

Oncology nurses and advanced practice providers (APPs) with more experience managing pain following surgery can help protect patients from opioid addiction by sharing their experience with nurses and APPs newer to oncology or pain management, shared Ronald Bleday, MD, section chief of the Division of Colorectal Surgery at Brigham and Women’s Hospital in Boston, Massachusetts.

Bleday, whose research on long-term opioid use after colon and rectal surgery was recently published in the 

, emphasized that nurses and APPs are a patient’s first point of contact for pain management following surgery.

 Because of this, nurses and APPs are positioned to become familiar with the conditions that usually are associated with more or less pain.

For instance, Bleday mentioned that patients with colorectal cancer whose disease is metastatic will likely have a greater level of pain, which is often treated with larger amounts of narcotics. On the other hand, those with nonmetastatic disease are less likely to require 

Over time, nurses and APPs gain an understanding of which patients are more likely to need greater levels of pain medication. By sharing this knowledge with their peers who are newer to the field, nurses and APPs can widen the pool of clinicians looking out for a patient’s well-being as it relates to the possibility of opioid addiction.

Oncology nurses are going to know which type of patients are going to go down a path where they may need more pain medicine, including opioids, than patients who will not. If you have a patient who does not have metastatic disease (who oftentimes has gotten through surgery and is not on opioids postsurgery), they are unlikely to need any opioids with neoadjuvant or adjuvant chemotherapy.

However, if you see a patient with metastatic disease, particularly metastatic disease to the bone, you know that the patient is going to have increasing needs for pain control, often with large doses of a narcotic. The experience and knowledge that come with getting to know the pathways that different patients with cancer go down in their treatment is very helpful. For the experienced nurses and APPs, to pass on that instinct and that knowledge to the new rookies coming into the care of patients with cancer would be the best thing that they can do for the 

Experienced oncology nurses and APPs can help nurses newer to the field understand who is more at risk of opioid addiction, says expert Ronald Bleday, MD.

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