Quality statement 1: Discussion with a named nurse specialist

Quality statement

Men with prostate cancer have a discussion about treatment options and adverse effects with a named nurse specialist.

Rationale

Nurse specialists are key points of contact for men with prostate cancer. They provide information about treatment options, answer questions or concerns and support men to make decisions about their care. This is particularly important immediately after diagnosis and when difficult choices about treatment need to be made. Nurse specialists also provide personalised care plans and information about support services.

Quality measures

Structure

Evidence of local arrangements to ensure that men with prostate cancer have a discussion about treatment options and adverse effects with a named nurse specialist.

Data source: Local data collection, National Prostate Cancer Audit and National Cancer Patient Experience Survey 2014.

Process

Proportion of men with prostate cancer who have a recorded discussion about treatment options and adverse effects with a named nurse specialist.

Numerator – the number in the denominator who have a recorded discussion about treatment options and adverse effects with a named nurse specialist.

Denominator – the number of men with prostate cancer.

Data source: Local data collection, National Prostate Cancer Audit  and National Cancer Patient Experience Survey 2014.

Outcome

Rates of men with prostate cancer satisfied with the discussion about treatment options and adverse effects.

Data source: Local data collection and National Cancer Patient Experience Survey 2014.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as hospitals, specialist prostate cancer multidisciplinary teams and specialist prostate cancer services) ensure that men with prostate cancer have a discussion about treatment options and adverse effects with a named nurse specialist.

Healthcare professionals ensure that men with prostate cancer have a discussion about treatment options and adverse effects with a named nurse specialist.

Commissioners (such as clinical commissioning groups and NHS England area teams) ensure that the services they commission have sufficient nurse specialists available to offer a discussion about treatment options and adverse effects to men with prostate cancer.

What the quality statement means for patients and carers

Men with prostate cancer have a discussion about treatment options and adverse effects with a named nurse with experience in prostate cancer. The man can then feel informed about his treatment options and their side effects, and supported to make decisions about his treatment.

Source guidance

Definitions of terms used in this quality statement

Adverse effects

Adverse effects of prostate cancer treatment may include:

  • sexual dysfunction

  • loss of libido

  • impotence

  • urinary incontinence

  • radiation‑induced enteropathy

  • hot flushes

  • osteoporosis

  • cardiovascular complications

  • gynaecomastia

  • fatigue

  • weight gain

  • metabolic syndrome.

[Adapted from Prostate cancer (NICE guideline CG175)]

Nurse specialist

A nurse with a urology or oncology background who is a specialist in the management of prostate cancer.

[Expert opinion]

Support services

Supportive care includes a number of services, both generalist and specialist, that may be required to support people with cancer and their carers.

[Adapted from Improving supportive and palliative care for adults with cancer (NICE cancer service guidance)]

Equality and diversity considerations

Men of black African or Caribbean family origin are more likely to develop prostate cancer than other men. Despite this, awareness of prostate cancer is low among men in these groups and the nurse specialist should be aware of this when discussing prostate cancer with these men.

Similarly, older men are at higher risk of developing prostate cancer than younger men, but may be less likely to continue to engage with health services after the initial contact. The nurse specialist should be aware of this when discussing prostate cancer with older men.

Gay and bisexual men, and transgender women have a risk of developing prostate cancer. Healthcare professionals should be aware of their psychosexual needs, lifestyle and the impact of different treatment options.