The essential multidisciplinary approach to prostate cancer acknowledged through its SIG members
have been a member of the EAUN since 2009 and recently joined the EAUN Prostate Cancer Special Interest Group (SIG). My professional development has led me to the field of prostate cancer and I would like to use my expertise to benefit urology nurses and more specifically all the EAUN members. The special interest groups support the EAUN in any way they are able, such as putting together scientific programmes and courses, writing guidelines and articles.
I qualified as a therapeutic radiographer in 1999 from the University of Liverpool and commenced my career at Auckland Hospital in New Zealand, then moved across The Tasman to work in Australia. I moved back to the UK in 2002, settling at Guy’s and St Thomas in London. After years of being a treatment radiographer, I moved into treatment review in 2005 and developed the review service for urological patients, becoming the advanced urology practitioner. This role allowed me to combine my technical skills with a more holistic approach. Therefore allowing me to deal better with the side effects of treatment whilst also providing support for both patients and their families throughout treatment as well as developing my clinical understanding of prostate cancer.
For the last eighteen months, I have been one of two newly appointed consultant radiographers in prostate radiotherapy at The Clatterbridge Cancer Centre in the northwest of England.
The nurse consultant role was originally established in 1999 with allied health professional posts outlined by the Department of Health in 20011 with the aim of improving clinical outcomes2, reducing wait times whilst allowing senior experienced staff to remain in clinical practice3. This led to the first consultant radiographer post in oncology being established in 2003.
It has also been well documented that there is a shortage of oncologists in the UK. The workforce census compiled by The Royal College of Radiologists in 20185 estimates that there could be a shortfall of 272 fulltime oncologists by 2023. Although small in number, around 30, the number of consultant therapeutic radiographers, therefore, is only going to grow.
Guidance dictates that the four domains of nonmedical consultant practice1 are followed, which are defined as:
1) Expert clinical practice
2) Professional leadership
3) Practice and service development, research and evaluation
4) Education and professional development
It is therefore important for my role that I am not only clinical but I am able to hone my skills in research and education. As such I have completed a masters degree in prostate cancer care. I teach regularly to both under and post-graduate students, which has allowed me to develop my research and educational skills. I do have a good clinical understanding of prostate cancer. However, to become an expert clinical practitioner I looked to my clinician colleagues and other consultant radiographers in the development of a training package. Therefore I have followed an adapted version of the educational standards set out by the Fellowship of the Royal College of radiologists (FRCR) for clinical oncologists allowing me to become competent to practice.
Become an independent practitioner
I now have the scientific knowledge and understanding of prostate cancer and its treatment, which allows me to review new patients in clinic to discuss non-surgical options of treatment, consent and plan and prescribe their radiotherapy. I have also been trained to undertake prostate biopsies both transrectally and template, which has also allowed me to insert gold seed fiducial markers into the prostate to aid in the accuracy of radiotherapy. I have also undertaken extra MSc modules in non-medical prescribing, clinical assessment and diagnostics; all of which have allowed me to become an independent, autonomous practitioner. It is now commonplace for a prostate cancer patient to never meet an oncologist on their cancer journey through radiotherapy.
I have a specialist interest in improving communications between clinicians and patients undergoing hormone radiotherapy for prostate cancer. I discuss erectile/sexual dysfunction and its management and have set up specialist clinics in my hospital and educated staff to be able to have these upfront conversations to offer pre-rehabilitation and earlier intervention for these patients. If the EAUN members have any proposals or queries in the field of prostate cancer or the role of consultant radiographer, our SIG group will be happy to assist. Just contact us through the EAUN’s central email address firstname.lastname@example.org or directly. Should you be interested to join the group then please send your CV and motivation to our Chair, Mr. Lawrence Drudge-Coates at email@example.com. We hope to hear from you soon!
1. Department of Health. Advanced Letter PAM (PTA) 2/2001. Arrangements for Consultant Posts e for Staff Covered by the Professions Allied to Medicine PT ‘‘A’’ Whitley Council. London: Department of Health; 2001.
2. J. Kelly, K. Piper, J. Nightingale Factors influencing the development of advanced and consultant radiographer practice – a review of the literature Radiography, 14(2008), pp. e71–e78.
3. F. Kennedy, A. McDonnell, K. Gerrish, A. Howarth, C. Pollard, J. Redman Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review J Adv Nurs, 68 (2012), pp. 721–742.
4. J. Kelly, P. Hogg, S. Henwood The role of a consultant breast radiographer: A description and a reflection Radiography, 14 (2008), pp. e2-e10.
5. Clinical Oncology UK workforce census report 2018 https://www.rcr.ac.uk/system/files/publication/field_publication_files/bfco192-co-workforce-census-2018.pdf [Accessed June 2019]
Philip Reynolds, Consultant Radiographer in Prostate Radiotherapy, SIG Prostate Group Member, Clatterbridge Cancer Centre, Wirral (UK)