This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in the delivery of evidence-based supportive care, including provision of information and education for people affected by oesophageal cancer.
The person with oesophageal cancer is often required to undergo complex, multi-modal treatments. The disease and its associated management may result in a range of physical, psychological, spiritual and social changes, requiring a coordinated multidisciplinary approach to care.
Some facts about oesophageal cancer:
- Oesophageal cancer occurs three times more often in men.5 This has been attributed to men’s greater use of tobacco and alcohol.6
- In Australia in 2007, oesophageal cancer ranked 16th for incidence and 12th for mortality.3
- Between 1982 and 2007 there was a slight increase in the incidence and mortality from oesophageal cancer in Australia.3
- There was a significant increase in the male age-standardised mortality rate for oesophageal cancer, with a 15% increase for the period 1983-2003. However by 2012 this trend appeared to be changing, with a 7% fall in age-standardised mortality rate for oesophageal cancer in men from 2003 to 2012.7
There are many points along the cancer journey when the SCN can improve outcomes for people at risk or affected by oesophageal cancer. These include:
Section 1: Reduce risk
- Possible risk factors for oesophageal cancer include a number of lifestyle behaviours which are amenable to change, including alcohol and tobacco intake. SCNs have an important role in public education to minimise these risks.
Section 2: Have the best treatment and support during active treatment
- People affected by oesophageal cancer require supportive interventions to deal with a range of physical, psychological, spiritual and social challenges when faced with this potentially life threatening disease and its associated multimodal treatments.
- Oesophageal cancer and the associated treatment effects impact individuals’ quality of life. Within a multidisciplinary team, the SCN can support people affected by oesophageal cancer to make difficult treatment decisions, as they often have to weigh up survival and quality of life outcomes.
- Information provision is important in meeting the needs of people affected by oesophageal cancer.8
Section 3: Have the best treatment and support between and after active treatment
- The SCN, working closely with other members of the multidisciplinary team, supports people affected by oesophageal cancer to manage the impact of the disease and its treatment across all domains of health.
- Due to the nature of the disease and its short and longer term treatment effects, people affected by oesophageal cancer need support across the continuum of care, including when living in the community.
- The SCN collaborates with other care providers and facilitates supportive networks to ensure continuity of care and support.
Section 4: Have the best care at the end of life
- While radical surgery following neoadjuvant therapies has resulted in improved survival, late diagnosis means that curative treatments may not be available for many people diagnosed with oesophageal cancer. In these cases, palliative care can play an important role.
- The SCN plays an integral role in coordinating care and the range of services involved in providing supportive and palliative care.
- Supportive communication with people affected by oesophageal cancer may assist difficult decision making processes regarding treatment and supportive care interventions when a person's disease progresses.