Transcript Prostate Cancer Support Group - Nurses Organization of Veterans

*
Kassandra August-Marcucio, RN, APRN, ACNP-BC
VA CT Medical Center
* I do not have any financial obligations or
affiliations that would conflict with this
presentation
*
* Identify how and why the support group was
established
* Identify the fundamentals that the group is
based upon
* Identify the importance of survivorship in the
cancer treatment continuum
* Describe future plans and directions of the
support group
*
* Groups led by myself and Peter Weiss,
APRN; Kate Hope, RN assists in
researching presentations, arranging
notifications, and writing a progress
note; Phil Willis, HT helps to get
refreshments, IT equipment and
helping sign up veterans for the group
* My colleagues deserve
acknowledgment
* Without them this group would not be
possible
*
* APRN driven and led group
* Currently held once a month on the 3rd Thursday
* Patient’s are identified by ICD-10 codes for prostate cancer and are sent
post-cards regarding date, time and location of the support group each
month
* Each session includes:
a presentation pertaining to an aspect of prostate cancer in relation to
disease management, side effects of treatment, or lifestyle modification
30 minutes of socialization time prior to the official start of the group
15-30 minutes of time allotted to ask questions of providers or share
personal experiences
Refreshments provided by Volunteer Services
*
* Veteran’s Requested a Support Group!
questions
-They felt lost after treatment
-Patient’s who were several years out from treatment for their prostate cancer still had
-They desired knowledge about their disease
-Many suffer from side effects that they are afraid to mention to their primary care
providers
* Identified a gap in Care/Literature
-An opportunity to improve patient’s health-related quality of life
-Provide a way to identify those who are still struggling post-treatment
-Many articles identifying that patient’s have needs after prostate cancer treatment, but
no evidence-based established guidelines
* Survivorship identified as a quality of care measure
-Seen in the development of Cancer Care Plans
-Now becoming a goal for organizations like the American Society of Clinical Oncology to
ensure that patient’s are provided with survivorship care
*
* Fundamentals of the support group focus on:
1. Empowerment through knowledge of prostate cancer and its
treatments to enhance and promote improved quality of life after
prostate cancer diagnosis
2. Support and comradery from other veterans who have been
diagnosed with or treated for prostate cancer
3. Enhance survivorship and living beyond diagnosis to improve
long-term quality of life, establish new norms and paradigms after
prostate cancer treatment
*
* We now have many patient’s who live long after diagnosis and treatment
* Especially for prostate cancer which 5-year survival rates approach 98% per
SEER data
* We are now seeing men, who had localized prostate cancer that was
treated, who are living 10-20 years after treatment
* There is a new push by organizations like the American Cancer Society, the
American Society of Clinical Oncology and the National Comprehensive
Cancer Network to implement survivorship practices to improve our
patient’s health-related quality of life after cancer treatment
*
* Survivorship focuses on cohesively monitoring a patient after cancer
treatment for side effects related to treatment, dealing with
psychosocial issues that may have been born out of cancer
treatment, anxiety, fear, knowledge gaps related to diagnosis,
prognosis or recurrence
* Focuses also on monitoring the patient for lifestyle modifications
including smoking cessation, weight loss, diet, self-image
* A way to capture the patient and continue to support them in their
cancer journey which often does not end with treatment
*
Caregiver
Burden/Stress
Anxiety,
Depression, Fear,
Cancer Fatalism
Survivorship
Clinic
Support
Group
Primary
Care
Provider
Interdisciplinary
Team
Erectile
Dysfunction
Urinary
Incontinence
Proposed Continuum of Survivorship Care for
patient’s post-prostate cancer treatment
* Improvements to lecture series
* Program Expansion to our West Haven, CT Campus
* Additional times to allow for a morning and afternoon meeting
* Survivorship Clinic
* Establishing partnerships with other specialties for complete care
of the patient as a whole
* Research projects to establish connection between the support
group and improved health-related quality of life
*
* Our group was originally created at the behest of veterans for
veterans
* Our goals are to Empower through knowledge, Support through
comradery and Enhance their overall health-related quality of life
during the survivorship period
* Survivorship models will play a large role in post-cancer care in
years to come
* Evidenced-Based guidelines are needed! Hopefully we will play a
large role in contributing to this gap in practice and literature
*
*
*
*
*
A. (2014). Prostate cancer survivorship guidelines. CA: A Cancer Journal for Clinicians, 64(4), 250-251.
*
Ferguson, J., & Aning, J. (2015). Prostate cancer survivorship: a nurse-led service model. British Journal of Nursing, 24(Sup18).
doi:10.12968/bjon.2015.24.sup18.s14
*
Gilbert, S. M., Dunn, R. L., Wittmann, D., Montgomery, J. S., Hollingsworth, J. M., Miller, D. C., . . . Montie, J. E. (2014). Quality of life and
satisfaction among prostate cancer patients followed in a dedicated survivorship clinic. Cancer, 121(9), 1484-1491. doi:10.1002/cncr.29215
*
Goonewardene, S. S., & Persad, R. (2014). Psychosexual care in prostate cancer survivorship: a systemic review. Translational Andrology and
Urology, 4(4), 413-420. doi:10.3978/j.issn.2223-4683.2015.08.04
*
Goonewardene, S. S., Persad, R., Nanton, V., Young, A., & Makar, A. (2015). The prostate cancer survivorship care assessment tool: development of
a new way to assess survivorship care quality. European Journal of Cancer Care Eur J Cancer Care (Engl), 24(5), 762-764. doi:10.1111/ecc.12264
*
Mullan, F. (1985). Seasons of survival: reflections of a physician with cancer. New England Journal of Medicine N Engl J Med, 313(4), 270-273.
doi:10.1056/nejm198507253130421
*
Resnick, M. J., Lacchetti, C., & Penson, D. F. (2015). Prostate cancer survivorship care guidelines: American society of clinical oncology practice
guideline endorsement. Journal of Oncology Practice, 11(3). doi:10.1200/jop.2015.004606
*
Richards, M., Corner, J., & Maher, J. (2011). The national cancer survivorship initiative: new and emerging evidence on the ongoing needs of cancer
survivors. Br J Cancer British Journal of Cancer, 105. doi:10.1038/bjc.2011.416
*
Saylor, P. J., Keating, N. L., & Smith, M. R. (2009). Prostate cancer survivorship: prevention and treatment of the adverse effects of androgen
deprivation therapy. Journal of General Internal Medicine, (24), 389-394.
*
Skolarus, T. A., Wolf, A. M., Erb, N. L., Brooks, D. D., Rivers, B. M., Underwood, W., . . . Cowens-Alvarado, R. L. (2014). American cancer society
prostate cancer survivorship care guidelines. CA: A Cancer Journal for Clinicians CA A Cancer Journal for Clinicians, 64(4), 225-249.
doi:10.3322/caac.21234
*
Skolarus, T. A., Zhang, Y., & Hollenbeck, B. K. (2011). Understanding fragmentation of prostate cancer survivorship care. Cancer, 118(11), 28372845. doi:10.1002/cncr.26601
Cognetti, K., & Dunne, M. (2013). The survivorship care model at MSKCC. Oncology Times, 35, 4-5. doi:10.1097/01.cot.0000432300.69137.33
Eisenberg, S. A., Kurita, K., Taylor-Ford, M., Agus, D. B., Gross, M. E., & Meyerowitz, B. E. (2015). Intolerance of uncertainty, cognitive complaints,
and cancer-related distress in prostate cancer survivors. Psycho-Oncology, 24, 228-235. doi:10.1002/pon.3590
*