Roles of the urologist and nurse from the perspective of patients with prostate cancer receiving luteinizing hormone-releasing hormone analogue therapy

OBJECTIVES To establish the roles of the urologist, general practitioner (GP) and nurse from the perspective of the patient with prostate cancer receiving hormone therapy, and to assess patient satisfaction, in particular with management and information needs. PATIENTS AND METHODS Patients with prostate cancer receiving luteinizing hormone-releasing hormone analogue (LHRH-a) therapy were recruited by a representative sample of 58 French urologists (March to April 2007) and invited to complete a 42-item questionnaire. RESULTS In all, 350 representative patients participated in the study; > 90% were totally or quite satisfied with the information given by their urologist at diagnosis and the start of treatment. Their main contact during treatment was with the nurse who gave the injection (84% of patients). The nurse's main role was to provide clarity (60% of patients), guidance (35%) and support to the family (28%). Fewer patients discussed disease stage and progression with their nurse (29%) than with a doctor (urologist, 63%; or GP, 61%). Fewer also discussed treatment (24% vs 32%) but as many patients discussed the impact of their disease and treatment with their nurse as with their doctor (e.g. 33% discussed general health and fatigue with the nurse, vs 26% with the urologist). The need for contact with a health professional was greater during the early stages of treatment. Patients treated for < 12 months with 3-monthly injections were less likely to be in favour of spacing injections than patients treated for >= 3 years. CONCLUSION The patient consults the urologist for reliable information on disease and treatment, and to the GP for further support, if needed, but the nurse has the pivotal role. A 3-monthly injection schedule enables regular face-to-face contact between the nurse and the patient and their family, and contributes towards the patient's coping strategies and quality of life.