APP Experience Can Garner Conversations Around Restaging of Cancer

With experience, oncology nurse practitioners (NPs) and physician assistants (PAs) can become more comfortable having conversations with patients with cancer about restaging of their disease, according to an oncology nurse practitioner of the Mayo Clinic.

Following an Oncology Nursing News® Community Case Forum, Jamie Carroll, APRN, CNP, MSN, shared that advanced practice providers (APPs) are often uncomfortable with restaging cancer. She noted that in asking participants how many see restages of cancer in their practice, few to none of those oncology nurses and APPs in attendance reported such experience.

While some interaction with a medical oncologist (MD) may be necessary for restaging, Carroll explained that with more experience, APPs can address restages with patients and rely less on MDs to have those conversations.

She added that her institution sees more frequent restages, and when dealing with those cases, Carroll will typically have a quick conversation with her MD to get on the same page before having a conversation with a patient.

Transcript

So I did ask [at the event], “Hey, raise of hands: How many of you are seeing restages?”

And nobody—nobody raised their hand. I said, “OK, what happens if your MD is gone? Then what happens?” And they were like, “eh, they see another MD.”

I think within the scope of an NP or PA…you can’t come up with a new plan. And so oftentimes it’s easier to have the patient see an MD with the restage, because then if the patient’s progressing, they can come up with the new plan. And then everyone carries on their merry way.

The institution in which I work, I do see restaging [of patients’ cancers]. So this morning, my…patient was progressing, and I just did a touch point with my MD: “Hey, what do you think?” And then it really varies on the level of experience of an NP or PA, on how much guidance they need in discussing next line of therapy.

This transcript has been edited for clarity and conciseness.