One of the recommendations published in the NICE guidance on Prostate Cancer (2008) is ‘Men with prostate cancer should be offered individualised information tailored to their own needs. This information should be given by a healthcare professional, for example a consultant or specialist nurse.’
Urological Clinical Nurse Specialists play an important role as keyworkers in caring for a prostate cancer patient. They have specialist knowledge which can be invaluable to a patient or his family, enabling them to ask detailed questions which they may feel uncomfortable posing to a consultant with whom they will generally spend less time. Similarly, Clinical Nurse Specialists should be on hand to help manage more complex or challenging symptoms or side effects associated with prostate cancer. Most urology departments also have specialist nurses dealing with incontinence and erectile dysfunction problems.
The Improving Outcomes Guidance for Urological Cancers (NICE), which sets out how prostate cancer services should be organised and delivered, is explicit on the importance of Clinical Nurse Specialists: ‘All patients with urological cancers should be managed by multidisciplinary urological cancer teams. These teams should function in the context of dedicated specialist services… Nurse specialist members of urological cancer teams will have key roles in these services.’
Prostate cancer is by far the most common form of tumour for which a urological Clinical Nurse Specialist will be responsible. A major national survey of the NHS experience of over 1,100 men affected by prostate cancer, carried out by The Prostate Cancer Charity in 2005, showed that when asked the question: ‘Who was the most helpful in providing you with emotional support?’, specialist nurses were ranked the highest around the time of diagnosis and treatment decisions. Yet, 38% of men did not have the opportunity of speaking to a specialist nurse about these issues.
The National Audit Office survey of newly diagnosed men with prostate cancer (2005) showed more than 66% had not been given information about support or self-help; over 50% had no named nurse in charge of their care, and over 30% did not fully understand the explanation of how their treatment had gone.