IMPLICATIONS FOR ONCOLOGY PROFESSIONALS
Findings from the Advanced Prostate Cancer Patient and Caregiver Burden of Illness Survey highlight several critical issues that oncology nurses should consider to help improve the health and well-being of both patients and their caregivers. As men with advanced prostate cancer live longer, quality of life becomes the central issue for many of these men, and there is a need for further research in this area. Research needs to further define the issues that these men are struggling with and how health care professionals can address them.
In the meantime, if men with advanced prostate cancer are primarily concerned with the ability to care for themselves (not becoming a burden) and participating in the activities of life that are meaningful to them, the health care team should aim to help preserve that level of function for as long as possible. The findings from this survey also suggest that patients and their caregivers need help and support to deal with the stress and demands of living with a serious illness. Nurses play a key role in helping these patients: 43% of patients surveyed rated their oncology nurse as important or very important in helping them make decisions about prostate cancer treatment. A 2012 Gallup poll showed that, for the 12th year in a row, nurses were perceived as the most honest health care professional amongst pharmacists, medical doctors, dentists, psychiatrists, and chiropractors.4 Given the degree to which patients rely on and trust their nurses, these professionals may play a critical role in helping patients understand that their feelings are normal and allowing them to verbalize their experience.
As we all know, caregivers need support as well. These survey findings showed that caregivers often prioritize their patient over their own health and well-being. Nurses should encourage patients to include their caregivers in visits with their health care professional. In that way, caregivers can be encouraged to seek support for themselves and care for their own needs because providing support effectively is difficult when feeling overwhelmed and/or experiencing stress and anxiety.
In this study, both groups of respondents also expressed concern about accessing and navigating information about their illness and treatment. Although a vast amount of information is available for both patients and caregivers, it is difficult to identify credible and trustworthy sources of evidence-based medical information. Oncology nurses have an opportunity to help patients and their caregivers traverse the available information and determine what is accurate. This could then empower patients and caregivers to feel they are making better-informed decisions.
As experienced educators and advocates, nurses can help patients with advanced prostate cancer and their caregivers understand that they are not alone, while offering excellent, high-quality education and resources to help them deal with the many issues they are facing. In addition to providing in-office support, a good way to help patients and caregivers is to encourage them to access appropriate, trusted resources such as Us TOO Prostate Cancer Support & Education Network, the Prostate Health Education Network (PHEN), or CancerCare for information about their disease, help coping with the disease, and ways to connect with other people in similar situations. Nurses can provide help and hope to preserve the highest quality of life for these men and their caregivers.
Jeffrey Albaugh is a board certified Urology Clinical Nurse Specialist and The Director of Sexual Health at the John & Carol Walter Center for Urological Health at NorthShore University HealthSystem in the Chicago area.
Acknowledgement: Editorial assistance was provided by Astellas Pharmaceuticals Inc and Medivation Inc.
1. Prostate Cancer. American Cancer Society Web site. http://www.cancer.org/cancer/prostatecancer/index. Accessed April 16, 2014.
2. Omlin A, Pezaro C, Mukherji D, et al. Improved survival in a cohort of trial participants with metastatic castration-resistant prostate cancer demonstrates the need for updated prognostic nomograms. Eur Urol. 2013;64(2):300-306.
3. Mukherji D, Pezaro CJ, Shamseddine A, De Bono JS. New treatment developments applied to elderly patients with advanced prostate cancer. Cancer Treat Rev. 2013;39(6):578-583.
4. Newport F. Congress retains low honesty rating: Nurses have highest honesty rating; car salespeople, lowest. Gallup Politics Web site. http://www.gallup.com/poll/159035/congress-retains-low-honesty-rating.aspx. Published December 3, 2012. Accessed April 16, 2014.