Care provided by specialist cancer nurses helps improve life expectancy of patients with lung cancer

July 4, 2018 by Emma Thorne, University of Nottingham

A new study looking at the picture of lung cancer care in England finds that patients with lung cancer experience significantly better outcomes in terms of life expectancy, avoiding unnecessary hospital admissions and managing the effects of treatment when cared for by specialist lung cancer nurses.

The research, entitled Can nurse specialist working practices reduce the burdens of ? was presented at the National Cancer Registration and Analysis Service (NCRAS) conference on 21 June 2018. The work looked at diagnoses between 2007 and 2011 and was undertaken by academics at The University of Nottingham and London South Bank University (LSBU) and funded by the charity, Dimbleby Cancer Care.

The research team used anonymised patient healthcare records available from Public Health England and a nationwide survey of lung cancer nurse specialists (LCNS), analysing more than 100,000 people with lung cancer and more than 200 nurses across England.

The findings, which have yet to be peer-reviewed, indicate that radiotherapy and chemotherapy patients have a lower risk of early death or emergency admission once they have received an assessment and care from a lung cancer nurse specialist (LCNS), particularly if contact began at the time of diagnosis.

Patients within this sample receiving radiotherapy treatment for their cancer were 17 per cent less likely to die in the first year when assessed by a lung cancer nurse specialist than those not assessed, while chemotherapy patients had a reduced mortality risk where nurses reported confidence in working with multi-disciplinary teams.

Patient outcomes

These findings also significantly provide an evidence-base for workforce policies governing delivery of the Government's Cancer Strategy for the UK. The strategy currently faces significant challenges posed by a lack of a substantial specialist cancer workforce. The advanced practice specialist nursing workforce is known to improve patient satisfaction and care quality, but little is currently known about their impact on patient outcomes.

The results of this study show the importance of the timing of LCNS assessment. Early LCNS assessments were associated with a lower risk of emergency cancer admissions for surgical patients, and for those who did not receive anti-cancer therapy, for example those receiving palliative care, this was also associated with proactive management of symptom issues. The results of this study elucidate areas in lung cancer care where improvement could be made, and identify opportunities to lessen the burdens lung cancer places on healthcare resources and individuals with lung cancer.

Presenting his findings at the Public Health England (PHE) Cancer Services, Data and Outcomes Conference 2018, Assistant Professor Iain Stewart, of The University of Nottingham, said: "A cancer diagnosis is a life-changing moment and guidelines recognise the importance of specialist nurse support for those individuals. We are grateful to be able to use patient records from across the country, which demonstrated that timely nurse involvement and effective multidisciplinary team working can lead to a quantifiably better life with cancer. It is essential that workforces are empowered to deliver the best care."

Tangible benefit

Professor Alison Leary, Chair of Healthcare Workforce Modelling, London South Bank University (LSBU), said: "This work shows the real tangible benefit of advanced practice nursing in cancer. It is clear that receiving care from a lung nurse specialist is fundamental to better outcomes for patients and families. Patients with lung cancer nurse specialists not only had a lower risk of dying, but also had a lower risk of being admitted to hospital unnecessarily."

Vanessa Beattie, Chair of the National Lung Cancer Forum for Nurses said: "The National Lung Cancer Forum for Nurses (NLCFN) welcome the research undertaken confirming the benefits to patients who have access to a cancer nurse specialist (LCNS). This work demonstrates that LCNS are pivotal in the care for and are at the frontline of cancer care. An increase in the LCNS workforce is required in order to continue to deliver the high quality care of which is reflected in this work."

Dimbleby Cancer Care was set up in 1966 in memory of broadcaster Richard Dimbleby and is based at Guy's Cancer Centre in Southwark, London. It provides practical and psychological support to people living with cancer and to their families and carers. The charity runs the UK wide online directory of support services which helps people locate care and support services in their local area wherever they are in the UK and has its own information and support centres at Guy's Cancer Centre and Queen Mary's Hospital, Sidcup.

The Dimbleby Cancer Care Research Fund awards has awarded over £2.7million in funding since 2004 to research projects looking at all aspects of cancer care.

Jonathan Dimbleby, broadcaster and Chair of Dimbleby Cancer Care said: "This is an invaluable piece of research which shows the real need for a one to one support system can make to an individual's prognosis. Through the work Dimbleby Cancer Care does we know the damaging impact cancer can have not just on the individual but also on the network of support that surrounds that person. By developing a system by which everyone diagnosed has access to a specialist has clear benefits for all. Everyone deserves the opportunity to receive the very best care possible."

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