Driving change at our National Colorectal Cancer Nurse Network (NCCNN) Study Day
Healthcare professionals from across the UK attended our successful colorectal cancer study day in Birmingham this September to find out more about the future of bowel cancer treatment and care. Chaired by Dr Claire Taylor MBE, the day was packed with engaging speakers and innovative projects, stirring interesting debate and conversation. Our Information Officer, Enna Christmas, reflects on the key learnings from the day.
The evolving role of our health service
The presentations started by focussing on how the health service needs to develop to meet the changing needs of patients. Speakers discussed the evolving role of the Clinical Nurse Specialist (CNS) and new ways of working to improve care for patients.
The changing role of the Clinical Nurse Specialist
Dr Terri Porrett is Head of Education at Coloplast, who develop products and services that make life easier for people with very personal and private medical conditions. Dr Porrett gave an empowering talk reflecting on the role of nurses before CNSs existed, the budget cuts faced by the NHS, and the wide-ranging job it is today.
Terri continued by discussing the changes in society and patient needs, such as instant access to information and the use of digital, to demonstrate how this will continue to affect the role of the CNS. She talked about the importance of patient engagement and empowering patients to have control to look after themselves, changing ‘What’s the matter with you?’ to ‘What matters to you?’
Meeting the needs of patients with advanced bowel cancer
20% of patients diagnosed with bowel cancer at NHS Lothian had advanced disease, yet the services available for these patients did not reflect this demand. As treatments improve, the way advanced cancer patients are diagnosed, cared for, and how long they survive is changing too, so patient services need to be developed in response.
Colorectal CNS, Linda Sherwood and Lead Colorectal CNS, Sharon Course discussed how introducing a dedicated CNS service that specialises in advanced bowel cancer care allowed nurses to enhance specialist knowledge and skills, notice patterns and themes, and work in a more sustainable way to provide a better service. This included:
- improving shared knowledge between nurses through the use of patient databases
- carrying out holistic needs assessments to fully understand the physical, emotional, practical and spiritual concerns of advanced bowel cancer patients
- developing communication skills to build better relationships with patients and their loved ones
Innovative changes to the bowel cancer treatment pathway
Another thought-provoking theme throughout the day was about changes to the care patients received, both before and after treatment.
Enhanced recovery – is prehab an essential part of the recovery pathway?
Zoe Merchant, from Prehab4Cancer and Imogen Fecher-Jones, Perioperative Medicine Lead Nurse, talked about the improvement in recovery and survival in cancer patients who had had prehabilitation.
Prehabilitation is a form of care before surgery that promotes health, fitness and wellbeing that is personalised to the individual patient. By being healthier and fitter before treatment, patients are more likely to have a swift recovery with fewer complications.
Prehab involves bringing together professionals from different specialisms including CNSs, oncologists, fitness instructors, dieticians, psychologists and many more to work out the individual needs for each patient diagnosed. They can then give patients personalised care and advice on exercise and nutrition, and provide psychological support so that the patients can be best prepared for their treatment.
Social prescribing after treatment
Fiona Flowers, Community Settings Specialist Advisor at Macmillan Cancer Support, explained social prescribing, its benefits and how to put it into practice. She explained that with more people surviving cancer, it’s important that the physical, emotional, social and financial needs of patients are met and improved.
Social prescribing means taking a holistic approach to patients’ health and wellbeing by addressing wider issues linked to illness, such as poor housing and debt. Healthcare professionals can refer people to a link worker who can actively support patients through working with a variety of different companies in their local area. For example, patients can get help accessing gym memberships, arranging transport to appointments, or an oven to encourage healthy eating.
Cutting edge research and technology
Novel research and technology continues to drive change and improve outcomes for patients with bowel cancer. Speakers discussed some of the latest developments in medical technology and clinical trials.
Robotic vs. keyhole surgery
Robotic surgery for treatment of rectal cancer is gaining popularity but evidence for how effective it is, is still limited. Henry Tilney, Consultant Colorectal Surgeon, Frimley Park Hospital gave an overview of robotic surgery, summarising the results of key research studies comparing how well it works to keyhole surgery.
Robotic surgery is similar to keyhole surgery as small cuts are made in the body to allow the surgeon to operate. It is also called robot-assisted surgery, as the surgeon carries out the operation by controlling a ‘robot’, which holds the surgical instruments. Robotic surgery can have better outcomes as the visibility and the ability of the robot to move the surgical instruments inside the body is better than in keyhole surgery.
But Henry described how the research so far showed the differences between robotic and keyhole surgery were small. More research is needed to fully understand its role in bowel cancer surgery.
Treating advanced bowel cancer: is immunotherapy the answer?
Gary Middleton, Professor of Medical Oncology at the University of Birmingham talked about the role of immunotherapy in bowel cancer treatment. Immunotherapy is a type of treatment that helps our bodies’ own immune system to fight cancer. However, immunotherapy doesn’t work for everyone. This is why it was particularly interesting to hear about the new clinical trial called ANICCA. This study looks at the immunotherapy drug, nivolumab, which is for people with certain types of bowel cancer. It was clear that further research into targeted treatments and immunotherapy is necessary to improve the outcomes for bowel cancer patients.
The reason we do this
The day’s talks were fittingly brought to a close with some inspiring talks from bowel cancer patients. Anna Gilmour and Neil Barker told us about their own experiences of having bowel cancer and the physical and mental impact it had on them and their loved ones. Anna movingly described how she talked to her children about her diagnosis and treatment and the ways they came to terms with it. Neil talked about how maintaining a positive outlook really helped him throughout his diagnosis, treatment and beyond - a positivity that shone through as he delivered his talk.
The Gary Logue Colorectal Cancer Nurse Award winners
Finally, a huge congratulations to the winners of the fifth annual Gary Logue Colorectal Cancer Nurse awards: Tracey Becker from Warwick Hospital, as nominated by patients;and Wayne Croves from Nottingham University Hospital, as nominated by his colleagues.