More nurse specialists needed to improve prostate cancer outcomes

A shortage of specialist nurses could affect outcomes for men with prostate cancer

A shortage of specialist nurses could affect outcomes for men with prostate cancer

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Prostate cancer is on track to become the UK’s most common cancer by 2030, and more than 400,000 men currently have the disease.

Dedicated nurse specialists can hugely improve patient experience and outcomes for these men, but it is important that nurses have the information they need to provide this care.

That’s why the Movember Foundation, in partnership with Prostate Cancer UK, funded the country’s largest ever patient-reported outcomes study for the disease.

The study involved more than 30,000 men and brought together researchers from the University of Leeds, Queen’s University Belfast, University of Southampton and Oxford Brookes University, along with Public Health England.

Lack of help?

The main finding of the study was that more than four in five men with prostate cancer struggle with poor sexual function following treatment for the disease, regardless of the stage of their disease, treatment or age. Despite this, just over half reported they were not offered help.

Early support and treatment are vital. If left unchecked, not only can erection problems put a complete stop to a man’s sex life, they can also have devastating longer-term implications, including depression and relationship breakdowns.

In line with National Institute for Health and Care Excellence guidelines, all men should be given the opportunity to discuss their sexual problems after prostate cancer treatment. This may involve men being offered access to an NHS erectile dysfunction clinic, an appropriate choice of medication such as tadalafil, vacuum pumps, psychosexual clinics and counselling services.

Online tools

This advice also needs to be tailored depending on what treatment they receive and their personal circumstances.

Movember Foundation and Prostate Cancer UK have also funded two online tools to help – a self-management resource to enable men to manage their own sexual well-being after prostate cancer, and an e-learning module designed to support healthcare professionals to offer sexual care to men with the disease.

The number of men diagnosed with prostate cancer is increasing year-on-year. However, the prostate cancer nursing workforce is currently under-resourced and unprepared for the expected significant increase in prostate cancer cases.

Difficult and distressing

With a significant number of nurses approaching retirement or intending to leave nursing within the next ten years, and no clear plans to train a new workforce, patients face a future without the support of healthcare professionals with the experience and expertise needed for their care.

I'm in the fortunate position of being able to provide direct support to such men at a difficult and distressing time. From the feedback, I know that what we do makes a difference to those who contact us and I would encourage any cancer nurses with an interest in prostate cancer to consider specialising.

Together we can make sure that all men are able to get the help they need.

Key findings of prostate cancer outcomes study

Three quarters of men (75%) diagnosed with localised prostate cancer reported poor sexual function, compared to 90.4% of men with locally advanced disease (cancer that has spread to the tissue surrounding the prostate gland), and 96% of men diagnosed with advanced prostate cancer.

Breakdown of the percentage of men who experienced poor sexual function, by treatment type:

  • Active Surveillance – 51%
  • Watchful waiting – 58%
  • Brachytherapy – 63%
  • Surgery – 84%
  • Surgery + radiotherapy/ADT (hormone therapy) – 92%
  • Radiotherapy – 79%
  • Radiotherapy + ADT – 88%
  • ADT – 94%
  • Systemic therapy (such as chemotherapy, abiraterone or enzalutamide) + ADT – 98%
  • Systemic therapy (such as chemotherapy, abiraterone or enzalutamide) + radiotherapy +/- ADT – 95%

Breakdown of the percentage of men who experienced poor sexual function, by age:

  • <55 years – 54%
  • 55-64 years – 66%
  • 65-74 years – 79%
  • 75-84 years 88%
  • 85+ years – 95%

Source: Downing A, Wright P, Hounsome L et al (2019) Quality of life in men living with advanced and localised prostate cancer in the UK: a population-based study. Lancet Oncology. 20, 3, 436-447. doi: 10.1016/S1470-2045(18)30780-0

Sophie Smith is a specialist nurse at Prostate Cancer UK



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