Carole Farrell

Cancer Nursing Practice

An evaluation of acceptance by new patients of advanced nurse practitioners

Changes in cancer policies and professional evolution, including non-medical prescribing, have led to an increase in nurse-led clinics and developments in advanced nursing practice. However, there is a paucity of evidence evaluating nurse-led clinics and a lack of evidence for new patients seen by nurses instead of doctors. Two audits were conducted to determine whether new patients accepted being seen by an advanced nurse practitioner (ANP), and to assess patient expectations, satisfaction and concerns. The questionnaires were completed by 116 new patients. Although 90% expected to see a consultant, only one expected to see an ANP. However, 17 (15%) patients saw a consultant; 60 (52%) saw a registrar and 33 (28%) saw the ANP. Despite this, 58 (77%) were not disappointed and 106 (91%) were very satisfied. However, 34-52% of patients found aspects of the consultation upsetting. The results support the use of ANPs for new patient consultations in breast medical oncology. However, it is crucial to obtain patients’ views and evaluate nurse-led developments to ensure patient acceptability.

Bevacizumab
Cancer Nursing Practice

Use of bevacizumab in patients with advanced or metastatic disease

Over the past ten years there has been a rapid increase in new biological (targeted) anti-cancer therapies. This brings challenges for nurses to understand how such drugs work, how they are administered and the implications for patients in terms of potential side effects. Bevacizumab (Avastin ® ▼) is a monoclonal antibody that targets vascular endothelial growth factor. It is licensed for use in several cancers to treat patients with advanced or metastatic disease including breast, colorectal, renal, non-small cell lung and ovarian. However, there are regional variations in funding arrangements, which nurses should be aware of.

Cancer Nursing Practice

Benefits of denosumab in treating bone metastases

This article discusses normal bone remodelling and explains how this changes when cancer cells invade the bone. Denosumab is a new agent for the treatment of bone metastases that has a different mode of action from the bisphosphonates used traditionally to treat metastatic bone disease. The article goes on to outline the potential benefits of denosumab use for patients, health professionals and service delivery.

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