Frank delaRama, RN, MS, AOCNS®
A strong advocate for empowering patients through a shared decision-making (SDM) model, delaRama, clinical nurse specialist with the Cancer Care Centers, Palo Alto Medical Foundation, noted that prostate cancer is different from other cancers in many respects, and that in its early stages, physicians are not always able to determine how the cancer will act. Information is key, as patients with early-stage prostate cancer typically choose among three standard treatment options: watchful waiting/active surveillance, surgery, and radiation—the latter two options carrying the risk of both physical and psychosocial side effects.
For later-stage patients, “again, it’s all about information and education, whatever the stage is,” delaRama stressed. Logistics remain important supports that the oncology nurse navigator (ONN) can provide—for example, making sure patients get to their appointments, setting up a timeline for scheduling them, and assisting with transportation needs—but he also sees a vital role for ONNs in arming patients with information, resources, and decisionmaking tools that will help them in choosing the best options for their own treatment (See below).
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“In prostate cancer, the ONN provides a unique, valuable service as an SDM coach. Patients who use SDM are more satisfied with their treatment decisions, regardless of outcomes,” he concluded.