"The nurse practitioner, nurse, and other ancillary providers who make up the urology team are an essential and valuable asset in the consideration of adding oral androgen receptor inhibitors into the office setting," writes Gwendolyn Hooper, PhD, APRN.
A recent Urology Timesarticle reporting on results of a survey on the experience of Canadian urologists in integrating abiraterone acetate (ZYTIGA) into the urology practice suggests that other forms of chemotherapy are at least being investigated for office use, barring reimbursement issues. Although many offices are familiar with managing prostate cancer patients with anti-androgens, oral androgen receptor inhibitors such as abiraterone are the next step in treatment for our patients, which makes this a topic of interest to many urology providers, as well as their office staff and support personnel.
Although the urologist takes the lead in any decision to institute these therapies into the office setting, it is the urology team that most often assists in overcoming the barriers mentioned by some urologists in the survey. Typically, the urology team consists of an assistant, nurse, and advanced practice provider, who are all familiar with the special needs of the prostate cancer patient. As a group, these specialized caregivers are accustomed to engaging, managing, supporting, and educating the patient, as well as his family, in all aspects of prostate cancer care.
With appropriate education and training, the requirements of monitoring and follow-up presented by the patient receiving oral androgen receptor inhibitor therapy can be met. As those of us in practice know, the needs of the prostate cancer patient also include assistance in the acquisition of medications and insurance pre-authorizations, monitoring for medication tolerance/efficacy, lab tests, and imaging. Beyond these tasks, prostate cancer patients may also require additional support such as assistance in decision-making and, in some cases, palliative care.
The nurse practitioner, nurse, and other ancillary providers who make up the urology team are an essential and valuable asset in the consideration of adding oral androgen receptor inhibitors into the office setting. In order to achieve safe, positive patient outcomes, collaboration and communication, as well as education and training, are an absolute priority for the urologist and the urology team.
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