Management and treatment of men affected by metastatic prostate cancer: evidence‐based recommendations for practice

Abstract

Currently, 250 000 men are affected by prostate cancer in the UK. Clinical guidance is crucial for nurses involved in the care delivery for men with advanced prostate cancer and for their families to maximize their quality and quantity of life. It is essential that nurses understand how prostate cancer is diagnosed, can recognize signs of disease progression, are familiar with disease management, and can educate patients and manage any symptoms appropriately and effectively. Therefore, the aim of this paper is to review current evidence‐based guidelines in relation to care delivery for men with metastatic prostate cancer in order to optimize best supportive care. A literature review was conducted in a range of electronic databases (DARE, Cochrane, MEDLINE, BNI, PsychINFO, EMBASE and CIHAHL) to identify studies employing qualitative and/or quantitative methods. National (UK) and European clinical guidelines were also reviewed. Methodological evaluation was conducted and the evidence‐based recommendations were integrated in a narrative synthesis. Supportive care is a person‐centred approach to the provision of the necessary services for those living with or affected by cancer to meet their informational, spiritual, emotional, social or physical needs during diagnosis, treatment or follow‐up phases including issues of health promotion, survivorship, palliation and bereavement. A multidisciplinary and proactive approach to the management of men with metastatic prostate cancer ensures safe and effective supportive care delivery. Nurses involved in the care delivery for this patient group need to be aware of the complex physical and psychological supportive care needs, and evidence‐based management care plans to ensure a personalized and tailored support to optimize quality of life.

A pilot randomised controlled trial of a multimodal supportive care (ThriverCare) intervention for managing unmet supportive care needs in men with metastatic prostate cancer on hormonal treatment and their partner/caregivers

“…Men affected by metastatic prostate cancer are likely to have a long illness pathway, as well as the individual burden to patients and their partner/caregivers with the associated side-effects, and this represents a burden on healthcare resources internationally (Carter et al, 2011;Chambers et al, 2018;Paterson et al, 2015a;Paterson et al, 2017).…”

A Model of Consultation in Prostate Cancer Care

“…Evidence supports that often prostate cancer specialist nurses take the lead on triggering referrals to wider members of the MDT such as physiotherapist, sexual counsellors or referrals back to the overall responsible clinician 58 Consultation models provide structure for complex interactions in modern healthcare 8 . Each consultation with a patient/family is exceptionally unique, and provides the healthcare professional with a very privileged glimpse into a person's life and concerns at that moment time.…”

Non‐medical prescribing in prostate cancer care: a case study reflection

“…Specialist nurses are already providing follow-up clinics for patients with prostate cancer as part of the multidisciplinary approach recommended in national clinical guidelines (NICE, 2014) and patient feedback has illustrated acceptance and positive attitudes towards nurse-led prostate cancer clinics (Wade et al, 2015). We argue, that prostate cancer specialist nurses are ideally suited to implement advanced levels of practice in non-medical prescribing, but recognize little has been detailed in the literature about the prescribing practice, specifically, for prostate cancer specialist nurses, and further service evaluation and research is needed (Paterson et al, 2015b). Therefore, the aim of this paper set out to critically review the evidence-based recommendations for prostate cancer nurses using a case study reflection to contextualize the role of non-medical prescribing, see Table 1.…”

“…Evidence acknowledges that men affected by prostate cancer can experience a host of unmet supportive care needs (Paterson et al, 2015c), reduced quality of life (Paterson et al, 2013;Cockle-Hearne et al, 2013;Ream et al, 2008), and evidence-based recommendation's enforce the need for MDT working (Paterson et al, 2015a). Within the clinical context of nurse-led prostate cancer clinic's, services, which include prostate assessment, performing prostate biopsies, insertion of fiducial gold seed markers in preparation of Intensity Modulated Radiotherapy Treatment, and Advanced Prostate Cancer Clinics for men with metastatic disease that prescribing practice is embedded (Prostate Cancer UK, 2014).…”

“…Within the clinical context of nurse-led prostate cancer clinic's, services, which include prostate assessment, performing prostate biopsies, insertion of fiducial gold seed markers in preparation of Intensity Modulated Radiotherapy Treatment, and Advanced Prostate Cancer Clinics for men with metastatic disease that prescribing practice is embedded (Prostate Cancer UK, 2014). Evidence acknowledges that men affected by prostate cancer can experience a host of unmet supportive care needs (Paterson et al, 2015c), reduced quality of life (Paterson et al, 2013;Cockle-Hearne et al, 2013;Ream et al, 2008), and evidence-based recommendation's enforce the need for MDT working (Paterson et al, 2015a).…”