Insufficient access to quality diagnostics and care, including dedicated lung cancer clinical nurse specialists (CNS) and lung cancer nurse coordinators (CNC), is putting Australian lung cancer patients at risk, research reveals.
It’s unclear how many lung cancer nurses there are in Australia, however in 2011 it appeared there were only seven for 3,610 people diagnosed in that year alone in New South Wales. This equates to an annual case load of 515 patients per lung cancer CNS[i].
A study from the UK found the CNS annual case load was 122 patients and this was considered ‘overstretched’ compared to breast cancer CNS where the annual case load was only 79[ii].
The primary role of the lung cancer CNS and CNC as part of a multidisciplinary team (MDT) is to support the patient and their family to understand their cancer and treatment options and ensure they receive appropriate initial treatment and long-term follow-up.
“The diagnosis and subsequent treatment of lung cancer can leave patients and their families overwhelmed, anxious and afraid,” Lung Cancer Nurse Coordinator at Royal North Shore Hospital, Helen Westman said.
“Unsure of what lies ahead, a CNS or CNC can provide a central point of contact, lead them through this uncertainty and assist them to navigate their way through the complexities of the disease, multiple specialists and the multiple treatment modalities available.”
Lung cancer nurses are central to ensuring people living with lung cancer receive appropriate treatment and long-term follow up. It is estimated that 20% of people living with lung cancer in Australia receive no active treatment after diagnosisi. Research shows people who have access to a lung cancer nurse are 34% more likely to receive treatment[iii] and those who don’t have access are at greater risk of therapeutic nihilism and developing severe treatment and cancer related toxicities[iv].
“By ensuring their care is co-ordinated and delivered in a timely and effective manner, the nurses can provide education, information, support and reassurance through each step of the patient’s diagnosis and treatment,” Mrs Westman said.
“By building relationships with patients and their family, the lung cancer nurses can assess and identify their holistic needs and ensure access and referral to appropriate support mechanisms to meet these needs, such as palliative care and psychological support.”
Lung Foundation Australia’s Making Lung Cancer a Fair Fight: A Blueprint for Reform recommends increasing the availability of lung cancer nurses at the time of diagnosis to assist people in navigating the complexities of the health system and improve quality of life.
“There is a critical shortage of lung cancer nurses in Australia, which is inconsistent with evidence-based clinical practice guidelines and international best practice and is compromising quality of care,” Lung Foundation Australia’s Advocacy and Policy Manager Judy Powell said.
“Ensuring a lung cancer nurse is associated with each Lung Cancer Multidisciplinary Team in Australia is a key priority of the National Strategic Action Plan for Lung Conditions. It’s critical that the Federal, State and Territory Governments start investing in a better future for all Australians.”
[i] Australian Institute of Health and Welfare, 2017. ‘Australian Cancer Incidence and Mortality (ACIM) books’ [online] Available from: https://www.aihw.gov.au/reports/cancer/acimbooks/contents/acim-books
[ii] UK Lung Cancer Coalitions, 2012. ‘The Dream MDT for lung cancer: Delivering high quality lung cancer care and outcomes’, [online] Available from: https://www.nursingtimes.net/ Journals/2012/11/20/w/h/f/The-Dream-MDT-for-Lung-Cancer.pdf
[iii] Lung Foundation Australia, Making Lung Cancer a Fair Fight: A Blueprint for Reform (2018)
[iv] Vinod SK, Sidhom MA, Gabriel GS, Lee MT, Delaney GP, 2010. ‘Why Do Some Lung Cancer Patients Receive No Anticancer Treatment?’, Journal of Thoracic Oncology 5 (1025-1032)