Learning points from the 7th course of the European School of Urology Nurses (ESUN): NMIBC patient pathways

During EMUC24 in Lisbon, the 7th ESUN Course took place from 9-10 November. Titled, “Improving NMIBC (non-muscle invasive bladder cancer) patient pathways”, this course focused on enhancing the care experience for NMIBC patients by addressing intravesical therapies, side effect management, communication, and new approaches like laser ablation and home-based treatments.

Delegates completed an online questionnaire after the course and here are their key learning points:

• Managing side effects, particularly from BCG and mitomycin therapies, remains a universal challenge. It was noted that dwell time adjustments are less impactful than previously thought, with severe LUTS (lower urinary tract symptoms) often arising after the first dose. Counselling, education and support systems like buddy programmes and pre-TURBT “schools” have proven to have a positive effect on patient outcomes. It was emphasised that sexual function needs more open discussion during consultations when considering the impact of treatment on intimacy.

• In the light of innovations and new treatment approaches, home-based BCG therapy might be a promising development, reducing treatment burden and improving access. Transurethral laser ablation (TULA) presents an opportunity for expanding nurse-led services, showcasing the evolving role of nurses in NMIBC management. Lastly, it is vital that PROMs (patient-reported outcome measures) and patient feedback of their experiences should guide treatment pathways to align care more closely with patient needs.

• The power of collaboration and networking: Improved communication skills and education strategies can enhance patient recall and adherence to treatments, especially for the management of side effects. There was an emphasis on holistic patient evaluation, highlighting that good communication on emotional and sexual health aspects can increase quality of care

During the group discussions and workshop module there was the opportunity for delegates to collaborate with their colleagues. This workshop format provided valuable exchange of evidence-based practices and insights, enabling participating nurses to tackle shared challenges. This course re-iterated that nurses play a pivotal role in improving NMIBC care through patient education, communication, extended services, and research.

The course addressed the importance of being aware of the burden of treatment and how essential it is to have supportive patient pathways. A ‘parting quote’ to take home was to pay attention to the human aspect of care and strive to understand a patient’s perspective.