Prostate Cancer - Episode 18

Additional Insights: The Presentation of Prostate Cancer

November 19, 2019

EXPERT PERSPECTIVE VIRTUAL TUMOR BOARD

Leanne Schimke, CRNP, CUNP:There really is no typical presentation for prostate cancer patients. It used to be that they’d be in their 70s, would have some definitive treatments—say surgery, or radiation therapy in the past—would have a biochemical recurrence, and then we’d put them on androgen deprivation therapy. They would progress from that and become metastatic.

Now we’re managing patients as young as 47, 50 years of age, who are coming in with metastatic hormone-sensitive prostate cancer. We have patients up to age 90 who come in, who have had prostate cancer for maybe 10 years, for whom all of a sudden it’s taken off and is becoming metastatic. So the typical patient is really hard to describe now.

For our patients, it’s critical to control their adverse effects, because we’re helping them live longer and we want to manage their quality of life. If you live longer and your quality of life is really poor, as men say, “I would rather have 2 months of a good life than 5 months of lying on the couch not being able to do anything.”

We are very closely monitoring for any adverse effects that they might have, to maintain their quality of life, because we tell them we want to protect their quality of life and prolong their quality of life, and that’s our goal for them.

My role, as part of the multidisciplinary team, is, I’m the nurse practitioner. I monitor all of their laboratory studies and imaging studies, and I order them when needed. I see them on a routine basis, so I know them personally. I know when things are changing with them. I try to help with the emotional aspects of prostate cancer and their journey, along with their families. I’m also talking to the urologists I work with. If we see someone who is getting into trouble, for whom we need to do something different, I’ll also talk about that.

Transcript edited for clarity.