Prostate cancer is the second most common form of cancer in men (skin cancer is first), with the American Cancer Society estimating 161,360 new cases in 2017. A nurse’s role in prostate cancer awareness, prevention, diagnosis, and treatment is essential. As a professional nurse, a loved one, friend, or peer, nurses are on the front lines. They have the knowledge to help people identify what’s going on and have the resources and expertise to help them with treatment options and cutting-edge developments.
Leanne Schimke, MSN, FNP-C, CRNP, CUNP, works with urology patients in private practice and also with the Lancaster Rehab Hospital, and uses Prostate Cancer Awareness Month as a great opportunity to inform people about the disease. Of all things a patient might hear, getting any kind of life changing diagnosis like a cancer diagnosis is overwhelming. A nurse can help educate patients and also offer support. “Nurses need to understand it will take multiple discussions for the patient to retain the information,” says Schimke. “It is helpful to include family members and correct any misconceptions.”
Involving the patient and their loved ones in discussions helps ensure that the information will be understood and retained. Nurses can help patients by answering their questions, of which they probably have many, and making sure they know where to find additional reliable and accurate information. Surfing the internet for information about prostate cancer treatment and prognosis isn’t going to give them the information a nurse can. “I help provide context on information they obtain through the Internet, friends and family,” says Schimke, “such as helping them understand if a certain treatment is an option for them, especially at later stages of disease progression.”
And she also acts as a reference. She encourages patients and their loved ones to write down questions and to understand that while they can’t delay treatment decisions, they should not rush into them. They can take the time to choose the best option for them, and they have time to get a second opinion. “I help them have realistic expectations – some assume when they are diagnosed with prostate cancer they are going to die soon when that is not the case – and in others I need to help them understand that their time is limited. I am a contact for patients to answer their questions and help with their symptoms.”
Schimke also helps dispel the many myths about prostate cancer. Prostate cancer may not be the leading cause of cancer deaths in men, but it is a killer. “I would like to discuss the statement ‘no one dies from prostate cancer,’” she says. “Approximately 14 to 20 percent of men diagnosed with prostate cancer will progress and die from advanced prostate cancer and not another cause. This statement trivializes prostate cancer and may lead men to make decisions that are not in their best interest.”
As a nurse working closely with patients, Schimke is able to work with men and notice signs of the disease’s progression. “When left untreated in an advanced stage, prostate cancer can spread to other bones in the body, which is difficult to treat and can impact survival,” she says. But there are new options for patients. “There are many treatments for prostate cancer depending on the stage of the prostate cancer when diagnosed,” Schimke says. “Our goal is to hopefully cure the cancer if at an early stage, but if it is metastatic at diagnosis, we want to maintain their quality of life and prolong their life through the various treatment options that are available.” One new option is a short-range radioactive treatment that kills cancer cells in men whose cancer has been resistant to medical and surgical treatments. They may have metastasized cancer that has spread but the spread is limited to the bones. Called Xofigo, the option can help extend the life of metastatic castration-resistant prostate cancer (mCRPC) patients.
What can men who do not have prostate cancer do to protect their health? Schimke says getting a PSA test is important. While some men think the test isn’t useful, Schimke says the test is a screening tool, not a diagnostic tool, that can spot potential red flags in men who are at high risk of prostate cancer or those in the 55- to 70-year-old age range who feel they would like the test and understand it. “PSA testing should be done in men with a high risk for prostate cancer, such as men who have a father or brother that has had prostate cancer,” she says. “The American Urological Association has guidelines for which men should be tested.” And while the test results might lead to a biopsy to rule out cancer, the biopsy isn’t always going to come back positive.
And if men do get a cancer diagnosis, each case is very different and finding a reliable and knowledgeable healthcare team with expert urology and oncology teams working together is essential. “Not all prostate cancer needs to be treated,” says Schimke. “Many men can be followed and treated only if their prostate cancer progresses.”