The role of the nurse in the Prostate Cancer patient journey Lawrence Drudge-Coates, European Association of Urology Nurses (EAUN)

1. Lawrence Drudge-Coates
Urological Oncology Clinical Nurse Specialist & Hon Lecturer
Past President European Association of Urology Nurses
EAUN
The role of the Nurse in
the Prostate Cancer
Patient Journey

2. Prostate Cancer and treatment significantly impacts
on Quality of Life, irrespective of care boundaries!
Emotional
Depression
Worry/
anxiety
Stress
Fear of the
future
Physical
Mobility
Exercise
Social
activities
Body
image
Sleep
Sleep
quality
Energy
during the
day
Mood
Social
activities
Energy
Lack of
vitality
Impact on
self-care
and
activities of
living
Sexual
function
Diminished
sex life
Relation-
ship and
intimacy
Sense of
manhood
Role
function
Social life
Relation-
ships
Self-care
Effect on
work
Effect on
activities of
living
Gater A, et al. Health Qual Life Outcomes 2011;12;88.

3. http://www.tackleprostate.org/ *Clinical Nurse Specialist
*
“A Patient’s Perspective”

4. Nurses have been recognised as fulfilling essential roles
related specifically to patient-centred care, patient safety
and enhancement of the quality of care:
Responding effectively to patients' complex needs by
promoting holistic and person-centred approaches to
care and referring on to specialised care when needed
(e.g. psycho-oncology services).
Developing and leading innovative supportive care
services to meet the holistic needs of cancer.
Ensuring patient-centred quality and safety of care in
relation to technologies and increasingly sophisticated
treatment modalities.
EONS (2012) the role of nurses in cancer care. NHS England (2014) Cancer Patient Experience NHS England and Macmillan Cancer Support (2010)
Excellence in Cancer Care

5. Pivotal role of the Urology Nurse in Prostate
Cancer
 Educate patients and
caregivers about
treatment options,
benefits and risks
 Monitor treatment
response
 Patient advocate
 Care coordination
 Point of contact/liaison
with other clinical
services
 Arrange follow-up
appointments and
monitor blood results
 Survivorship – supporting
in living with or beyond
cancer
Urologist
Oncologist
Pathologist
Palliative
care and
pain
specialist
Nuclear
medicine
specialist
Others
Psychological
support team,
physiotherapists,
pharmacists,
community
medical services Patient
Nurse
Specialist and
general
Radiologist/
radiographer
Orthopaedic
surgeon
Coordinating
nurse
EAUN symposium (2016) The pivotal role of the nurse in managing Prostate Cancer: collaborating to improve patient care

6. Nurses – an essential contributor to high quality cancer
care through multidisciplinarity………
 A wide range of multi-professional disciplines must work together to
manage disease and improve quality of life……
 Oncologists
 Urologists
 Orthopaedic surgeons
 Specialist and general nursing staff
 Palliative care and pain specialists
 Psychological support team
 Sexologists
 Radiographers
 Physiotherapists
 Pharmacists
 General practitioners
 Practice & community nurses
 Social care services
EAUN elearning bone health course 2013

7. Primary care investment is crucial….
Primary Care is defined by the WHO as “first contact,
accessible, continued, comprehensive and coordinated care,
however widespread inequalities exist.
Cancer and its consequences will be an increasingly
prominent part of the primary care workload in the future,
while the breadth of involvement of health care professionals
in primary care will also increase.
The strengths of primary care are particularly evident in
prevention and diagnosis but also in shared follow-up,
survivorship care and in end of life care.
Community nurses have a central role in proactively planning
and organising a person-centred care plan for the person with
cancer in the home by working together in an MDT approach.
Integrated Cancer Care: Bringing Primary Care and Secondary Care Together ECCO Position Statement May 2017

8. Take home musts!!
 With more than 417,000 men diagnosed and more than
92,000 men recorded dying from Prostate cancer, European
institutions and Member States need to ensure that
individuals receive care that :
Focuses and ensures a patient-centred multidisciplinary
approach.
Is high quality & evidence based.
Standardised – including re-defined coordination of the total
care process. Clearly defined roles and responsibilities.
Integrated across all spectrums of care -Adequate
education, clear guidelines/protocols on management/follow-
up care.

9. And in addition……….
As a multi-professional approach to Prostate Cancer Care has
therefore become of paramount importance to deliver effective
patient care…..
 Urgent attention now needs to be directed towards strategic workforce
planning to address a landscape with continually growing financial
pressure to deliver timely and effective healthcare.
 Integral to develop appropriate expertise and ensure that the workforce
is a sustainable one and meets the individuals needs.
 Be supported by education, recognition and role developments. Clearly
defined roles and responsibilities.
 Must support and provide optimal care for individuals living with or
beyond cancer!