Aim
This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in managing disease and treatment related care for a person at risk of or diagnosed with prostate cancer across a cancer journey.
Rationale
In 2017, it is estimated that 16,665 new cases of prostate cancer will be diagnosed in Australia. 88 Prostate cancer was the most commonly diagnosed cancer in Australia in 2013. In 2013, it was also the most commonly diagnosed cancer among males. 88 In 2009–2013, males diagnosed with prostate cancer had a 95% chance of surviving for 5 years compared to their counterparts in the general Australian population. Between 1984–1988 and 2009–2013, 5-year relative survival from prostate cancer improved from 58% to 95%. 88
In 2014, prostate cancer was the 3rd most common cause of cancer deaths in Australia, with 3,102 deaths from prostate cancer in Australia. In 2017, it is estimated that this will increase to 3,452 deaths. 88
There are many points along the cancer journey when the SCN can improve outcomes for people at risk of or affected by prostate cancer. These include:
Section 1: Reduce risk
Prostate cancer is the most common cancer amongst Australian men, yet its exact aetiology is not well understood.
While a number of risk factors have been proposed as being important in the development of prostate cancer, including age and family history, there is limited evidence regarding lifestyle or behavioural risk factors. Public education about risks for prostate cancer needs to reflect contemporary, evidence-based messages.
Section 2: Find the condition early
The benefits of population screening for prostate cancer are at this time unproven.7
With no current formalised, population-based screening programs for prostate cancer in Australia, the SCN can play an important role in ensuring men are informed about the risks and benefits of screening tests and about signs and symptoms that should lead to health practitioner consultation.
Section 3: Have the best treatment and support during active treatment
Men diagnosed with prostate cancer face difficult treatment decisions. This is, in part, due to the lack of clear survival advantage of one treatment path over another.
In order to make an informed treatment decision, individuals need information about the benefits and harms of all treatment options. The SCN plays an important role in providing information and support to men making treatment decisions.
Treatments for prostate cancer can include surgery, radiotherapy, antineoplastic agents and androgen deprivation therapy, each of which can result in significant morbidity. The SCN has an important role in prevention, detection and management of these adverse effects.
Section 4: Have the best treatment and support between and after active treatment
Relative survival after diagnosis with prostate cancer is high compared with other cancers.6 However, men treated for prostate cancer require long-term follow up due to the unpredictable trajectory of the disease.
Following completion of treatment for prostate cancer men can experience significant adverse effects across all domains of their health.
The SCN can minimise the impact of these adverse effects with targeted supportive care strategies to ensure optimal quality of life outcomes.