Shock. Numbness. Slow Motion. Weak in the knees. “Is it a dream?”

These are just a few descriptors of the initial mindset when men first receive word that they have prostate cancer … devastating news that leads to a myriad of questions about what to do next.

As a nurse navigator, other than their diagnosing physician, I am the first point of contact soon after this news is received. In my meetings with these men and their families, a crash course in prostate cancer biology is soon followed by in-depth discussions of the options for cancer treatment, as well as what to expect with each proposed care path. There is rarely a clear cut choice, and many times surgery and radiation offer similar expected outcomes, in effect giving men too many choices … a set of choices they probably would have preferred to avoid altogether.

Prostate cancer is a male cancer, but it affects the entire family unit, from wives and partners to children and siblings. The clinical side effects of treatment unfortunately are often intertwined with very personal and intimate issues. Since we identify prostate cancer at an early stage most of the time, these men are also usually very healthy otherwise. (“I eat right, exercise regularly, and now I have cancer?!)

The good news is prostate cancer is very well managed … not a “death sentence” but considered more in line with diabetes or heart disease, a chronic condition that we can monitor and treat with many medical tools. The best case scenarios are those men who have definitive treatment, eventually needing only a yearly PSA blood test as they progress years, even decades after treatment. Even those men who need additional treatment for prostate cancer that comes back, we have treatment options that can also keep the cancer in check for months to many years.

I have had the privilege of working with hundreds of men and their families, in an effort to guide them through this decision-making process. Serving as teacher, advocate, confidant, and any other roles as called for (eg, sounding board, referee, buddy, etc.), I aim to make the tortuous journey from diagnosis through treatment as smooth as possible.

By contributing to Oncology Nurse Advisor, I hope to use my expertise, plus knowledge culled from the shared experiences from all the men and families I have encountered, to provide some useful insights into prostate cancer, from screening and prevention, to diagnosis and treatment, and on into survivorship or the “new normal.”

As oncology nurses, we all serve to some degree as navigators for our patients. I hope that this will be yet another forum to share ideas and stories about how to best impact the lives of patients and families dealing with cancer. Please feel free to share your feedback and comments, so we can address the issues most pertinent in our day-to-day practice in cancer care.


Frank de la Rama is a clinical nurse specialist, oncology/genomics, and prostate cancer navigator at Palo Alto Medical Foundation, Palo Alto, California.