This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in managing disease and treatment related care for a person at risk of or diagnosed with colorectal cancer across the cancer journey.
Colorectal cancer is the second most common cancer diagnosed in Australia, affecting both men and women, and the second most common cause of cancer-related death. In 2011 colorectal cancer represented 12.8% of all cancer diagnoses and was responsible for 9.3% of cancer deaths.6
There are many points along the cancer journey when the SCN can improve outcomes for people at risk of or affected by colorectal cancer. These include:
Section 1: Reduce risk
Interactions between inherited susceptibility and environmental factors appear to be the cause of colorectal cancer.6
The SCN has a role in informing people of risk factors and promoting healthy lifestyles to reduce the risk of colorectal cancer.
Section 2: Find the condition early
The biology of colorectal cancer provides the opportunity for a variety of approaches to primary prevention.
Early detection is key as cancers detected at the earliest (localised) stage have survival rates range from about 90% five-year survival.4
The Australian Government supports a national screening program for colorectal cancer.4 The SCN can provide education to promote participation of target groups in screening and support people throughout the screening process.
Section 3: Have the best treatment and support during active treatment
Depending on the type, stage and site of the tumour, there are a number of treatment options for colorectal cancer, including surgical resection with or without adjuvant antineoplastic agents or radiotherapy.
Colorectal cancer and its treatments can have substantial effects on:7
- psychological wellbeing
- social functioning, affecting work and productivity
- relationships with friends, relatives, and partners
- other social activities.
A range of symptoms associated with the disease and its treatments can interfere with the person's quality of life. Such symptoms can relate to altered bowel function and include:
- dietary disruptions
For those who require a stoma, specialised education and support is required to enable the person to adjust to body image changes and to manage stoma care.
SCN interventions can:
- prevent or minimise symptoms and treatment side effects
- support effective treatment decision making
- reduce psychological distress
- promote optimal functioning across all domains of health.
Section 4: Have the best treatment and support between and after active treatment
People with colorectal cancer can experience ongoing effects across all domains of health following treatment. Follow up surveillance, according to evidence-based guidelines, is required:7
- for ongoing support
- to enable detection and removal of metachronous polyps and cancers
- to enable detection of potentially curable recurrent disease.
SCN interventions may prevent and minimise the longer-term impact of the diagnosis and treatment of colorectal cancer and promote self-care.