ABSTRACT
The University Hospital of Lausanne has heavily invested in the development of interdisciplinary oncology centers to improve the quality of care, and structure research and training. By integrating specialist nurses, it follows international recommendations. These specialists' nurses rephrase the information given by the doctor and ensure patients' understanding. They assess the patient's psychosocial situation and provides guidance if necessary. They support the patient in making informed choices about treatment and coping strategies. In addition to the outpatient clinics planned in accordance with the care pathway, she can be contacted between appointments to answer questions or concerns of any kind. This article shows the added value of these nurses in the care of oncology patients.
Le CHUV s'est fortement investi dans le développement de centres interdisciplinaires en oncologie afin d'améliorer la qualité de la prise en charge, de structurer la recherche et la formation. En y intégrant des infirmières cliniciennes, il suit les recommandations internationales. Ces infirmières reprennent les informations données par le médecin et s'assurent de la compréhension du patient. Elles évaluent sa situation psychosociale et l'orientent au besoin. Elles soutiennent le patient dans ses choix de traitement ainsi que dans ses stratégies d'adaptation. Outre les entretiens planifiés en fonction du parcours de soins, elles sont joignables entre les rendez-vous pour répondre à des questions ou préoccupations de tout ordre. Cet article montre la plus-value que la présence de ces infirmières offre à la prise en charge des patients oncologiques.
Subject(s)
Prostatic Neoplasms , Ambulatory Care Facilities , Humans , Male , Prostatic Neoplasms/therapyABSTRACT
PURPOSE: To compare the clinical outcome of males with low-risk and favorable intermediate-risk prostate cancer managed within a standardized modern protocol of active surveillance. MATERIALS AND METHODS: This was a prospective cohort study with strict and expanded active surveillance criteria in males with prostate cancer. Baseline assessment included multiparametric magnetic resonance imaging (mpMRI), extended systematic biopsy, and software-based MR-targeted biopsy. Follow-up included biannual prostate-specific antigen (PSA) check, mpMRI, and control biopsy once a year for the first 2 years, and afterward mpMRI every 2 years with additional tests as clinically indicated. The primary outcome was the transition rate to active treatment. RESULTS: A total of 51 patients were included: 17 (33%) and 34 (67%) followed protocols of strict (study arm 1) and expanded (study arm 2) active surveillance criteria, respectively. Median age and PSA were 65 years (IQR, 60-69 years) and 5.3 ng/mL (IQR, 4.5-7.7 ng/mL), respectively. At baseline, a median of 2 (IQR, 1-3) cores were positive out of 13 (IQR, 12-14) cores; 22 males (43%) had visible mpMRI lesions. Eight males (24%) in study arm 2 had Gleason score 3+4. After a median follow-up of 36 months (IQR, 24-48 mo), no patient in study arm 1 compared with 17 patients (33%) in arm 2 underwent active treatment (p<0.0005). CONCLUSIONS: Although expanding eligibility criteria leads to a greater transition rate to active treatment, active surveillance should be contemplated in well-selected males with favorable intermediate-risk prostate cancer as the curability window seems to be maintained.
Subject(s)
Patient Selection , Prostatic Neoplasms/pathology , Prostatic Neoplasms/therapy , Watchful Waiting , Aged , Biopsy , Disease Progression , Humans , Male , Middle Aged , Multiparametric Magnetic Resonance Imaging , Neoplasm Grading , Prospective Studies , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/diagnostic imaging , Risk FactorsABSTRACT
The prostate cancer is a complex pathology involving oncological, functional and psychosocial items. The prostate's center of CHUV harmonize the know-how of urologists, oncologist, radiotherapists and clinical nurses to offer a global management to patients attempts by prostate cancer, from diagnosis to therapy and follow-up.
Subject(s)
Cancer Care Facilities , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Humans , Male , Patient Care TeamABSTRACT
A urology nursing team examined its perioperative practices in the light of scientific data and implemented updated care practices adapted to this context.This experience favours the development of skills essential for interdisciplinary collaboration drawing on the resources of each profession, to work towards a common goal for the benefit of the patient.
