Bladder health iEducate the patient on maintaining adequate hydration and strong core muscles through regular pelvic floor muscle exercises. Assess bladder function prior to treatment and provide patient education on treatment-specific bladder health considerations. Facilitate referral to specialist continence and/or pelvic floor services where indicated. Optimal bladder health supports effective urinary function, reduces the risk of urinary tract infection, and may help minimise treatment-related urinary complications.
Bowel health iEducate the patient on maintaining adequate hydration, sufficient fibre intake, and a healthy diet to prevent constipation or diarrhoea. Assess bowel health prior to treatment and provide education on treatment-specific bowel health considerations. Facilitate referral to specialist continence and/or pelvic floor services where indicated. Maintaining bowel health and a healthy gut microbiome supports immune function and may help reduce the impact of treatment-related toxicities.
Clinical trials iEducate and support the patient who is considering, or is enrolled in, cancer clinical trials. Clinical trials are research studies involving human volunteers to evaluate the safety and effectiveness of new treatments, medicines, vaccines, or medical devices and may include pharmaceutical and non-pharmaceutical (such as lifestyle) interventions.
Cultural considerations iAssess and address cultural considerations to ensure the provision of culturally safe care. Cultural considerations encompass diverse beliefs, communication styles, family structures and decision-making processes, perceptions of illness, language needs, use of traditional medicines, and gender roles and preferences.
Cytotoxic precautions iEducate the patient and carers about cytotoxic precautions, and ensure that nurses follow these cytotoxic precautions themselves as required. Cytotoxic precautions are safety measures to prevent exposure to hazardous anti-cancer therapies.
Dental and oral health iEducate the patient about the importance of dental and oral health whilst undergoing cancer treatment. Dental and oral health is care of the mouth, gums and teeth, and is crucial to prevent severe infections, manage painful side effects, and maintain nutrition, as cancer treatments can weaken the immune system and damage oral tissues, often resulting in treatment delays.
Diagnosis understanding iAssess the patient's and carer's understanding of the diagnosis including disease type, location, stage/grade and test results. Comprehensive understanding improves patient outcomes, facilitates shared decision-making, reduces anxiety, improves treatment adherence and overall quality of life.
Dietary considerations iAssess appetite and dietary intake with a validated tool and provide dietary advice, or refer as required to a dietitian to support the patient to maintain a healthy diet. The side effects of cancer treatment, or the effects of the cancer itself can make it difficult for the patient to meet their nutritional needs. Choosing nourishing foods that are high in protein and energy can help support adequate intake during this time.
Exercise and physical activity iAssess the patient's current physical activity and engagement in exercise, educate about the benefits, and refer as necessary to physiotherapy or exercise physiology. Exercise is a safe and effective therapy for people with cancer and reduces cancer-related fatigue, eases treatment side effects, boosts mood and mental wellbeing, and improves physical function, bone density, and sleep quality.
Family and caregiver support iAssess the supportive care needs of family and caregivers. Utilise valid and reliable tools to assess caregiver distress and supportive care needs and make referrals where possible. Informal caregiving for someone with cancer can cause physical, emotional and financial distress for caregivers that can compromise both their health and the patient's care.
Family history iDiscuss and document the patient's family health history and assess genetic risk. Family history is a crucial tool for assessing cancer risk, as some cancers can be caused by inherited genetic mutations, and a detailed history can determine if genetic testing is required.
Finance and employment iAssess the impact of cancer on the patient's financial and employment situation using a validated tool, and facilitate referral as required to support services, including social work. Cancer and its treatment can be a financial strain, caused by extra costs during and after treatment, or loss of income, and some people may be discriminated against at work due to their cancer diagnosis.
Functional status iAssess the patient's functional status using a validated tool such as the Eastern Cooperative Oncology Group (ECOG) scale. ECOG is a 0–5 scale used by clinicians to assess the functional ability of a person with cancer, and to guide appropriate treatment decisions.
Genetic testing and counselling iEducate the patient regarding genetic testing and provide support to discuss risks, and consider the benefits and limitations. Genetic testing (or germline testing) for cancer assesses inherited gene mutations that increase cancer risk and guide treatment decisions for some gynaecological cancers.
Goals of care iSupport the patient and carers to ensure that goals of care are person-centred and facilitate shared decision making that aligns medical treatment with a person's values, priorities, and quality of life. Goals of care in cancer align with a person's values, may focus on curing the disease, prolonging life or maximising quality of life, and can be dynamic throughout the patient's cancer journey.
Health literacy iAssess the patient's health literacy levels and adapt education and information provision to meet their needs and preferences. Health literacy is the ability to access, understand and apply health information to make informed decisions and manage health.
Lymphoedema screening, education & management iProvide the patient early education on lymphoedema, facilitate lymphoedema screening and make appropriate referrals to lymphoedema specialists. Lymphoedema is a condition resulting in chronic swelling caused by damage to the lymphatic system, which may result from cancer and/or its treatment.
Molecular profiling iEducate and support the patient regarding molecular profiling. Molecular profiling is a method used to identify specific tumour biomarkers to determine whether targeted treatments are available.
Multidisciplinary team (MDT) meeting & involvement iActively contribute and advocate for the patient within MDT meetings and throughout the care trajectory. Nurses are vital members of the MDT, acting as patient advocates, and providing holistic, person-centred insights to better coordinate clinical decisions and patient care.
Navigation support iSupport the patient to navigate through and across services ensuring they have a key point of contact at all times across the care trajectory. Navigation improves patient outcomes by providing education, emotional support, and logistical assistance, ensuring timely, high-quality, and person-centred care.
Points of contact iProvide the patient and carers with contact details for their key point of contact at your health service and who they should contact out of hours. The nurse often acts as the primary point of contact, supporting the patient and providing communication between the patient, the primary health care provider and the treating team.
Psychological and emotional support iAssess the psychological and emotional support needs of the patient and carers using validated tools and provide support and referrals to services as required. Understanding the psychological and emotional support needs can help ensure access to appropriate services, which can improve survival outcomes, enhance treatment adherence, and reduce the risk of long-term mental health issues.
Quality of life iEnhance the patient's Quality of Life (QoL) by addressing their physical, emotional, and social needs through a holistic, individualised approach to care. QoL is a multidimensional, subjective perspective of a patient's overall wellbeing – including physical, emotional, social and functional needs across their disease trajectory – and is a key goal of all cancer care.
Sexual health iAssess and discuss the impact of gynaecological cancers on the patient's sexual health, use validated screening tools to assess sexual function and refer to specialist services as required. Gynaecological cancers significantly affect sexual health, including physical and hormonal changes, psychological responses, fertility and contraception and effects on relationships and intimacy.
Side-effect management iAssess for and manage side-effects of treatment in conjunction with the multidisciplinary team using validated tools where indicated. Effective management of cancer treatment side effects is crucial to maintain treatment adherence, prevent complications, and improve quality of life.
Social supports iAssess the patient's current family and social supports and the need for referral for additional support. Family and social support can improve quality of life by providing essential resources to cope with stress, help manage treatment side effects, and reduce emotional distress.
Symptom management iAssess for and educate the patient on the symptoms of their disease and manage these in conjunction with the multidisciplinary team. The management of symptoms will be dependent on the goals of care (curative or palliative intent) but must always give consideration to the patient's quality of life, function, distress, and tolerance of treatments.
Transport and accommodation iAssess the patient's transport and accommodation needs and facilitate access to available assistance. Transport and accommodation management through government-funded Patient Assisted Travel Schemes (PATS) is important, particularly for regional and rural patients, as it can directly impact access to treatment, lower financial burden, and reduce stress.
Treatment adherence/compliance iAssess the patient for adherence to treatment and seek to understand and address any barriers to engagement in optimal care. Treatment adherence is critical to achieve optimal prognosis and improved outcomes, whilst non-adherence can lead to disease progression and increased mortality.
Treatment induced menopause iDiscuss and educate the patient for expected treatment-induced menopause and facilitate management of symptoms. Consider referral to specialised menopause after cancer services if available. Treatment-induced menopause is the sudden cessation of ovarian function due to surgical or cancer treatments.
Treatment plan iEnsure the patient understands their treatment plan including the timing, duration and expected recovery from each treatment modality. A treatment plan outlines how a patient's cancer will be treated over time.
Venous access iAssess the patient's venous access requirements, giving consideration to therapy needs (vesicant potential, duration), with patient factors, such as vein quality, lifestyle, and comorbidities, and discuss and facilitate central venous access device insertion if required. Reliable venous access is important to safely deliver long-term, intensive therapies and significantly improve patient comfort and quality of life.
