As members of the interprofessional team (IPT), nurses play a vital role in the care of patients with bladder cancer, bringing a holistic approach to managing symptoms in both early and advanced disease.
That role begins with obtaining a thorough health history and physical assessment and continues through diagnosis, treatment response, nursing interventions, and patient education, as outlined in “Bladder Cancer: An Update,” published in Nursing2024.
Nurses caring for these patients should have training in wound, ostomy, and continence care and should be able to evaluate the patient’s response to treatment, which can include intravesical and systemic chemotherapy, immunotherapy, targeted therapies, and radiation therapy.
For patients undergoing radical cystectomy with urinary diversion, preoperative nursing care includes education and emotional support. The author suggests that this can include recommending that the patient and their partner or spouse visit someone who’s adjusted to life since having the same procedure.
Postoperatively, nurses instruct patients in using common urinary diversion devices. They must also be prepared to discuss sexual health, a common concern for patients undergoing treatment. The author notes that although nurses should encourage patients to discuss their concerns with their urologist, adding a counselor with expertise in sexual dysfunction to the IPT can prove valuable.
Patient education also includes instruction in self-catheterization. Priority teaching points include the following:
- Explain the underlying etiology that led to the need for intermittent self-catheterization.
- Teach a step-by-step process for performing intermittent self-catheterization.
- Provide instruction in infection prevention, especially good hand hygiene.
- Review signs of a urinary tract infection.
The paper includes detailed teaching points for Continent Urinary Diversion: Internal Pouch with Stoma (Indiana Pouch), Internal Pouch (Neobladder), and Incontinent Urinary Diversion Ileal Conduit.
Bladder cancer is the 10th most common cancer globally, with roughly 90% of patients diagnosed at age 55 or older. It is the sixth leading cause of death in males and 17th in females. Because the bladder has the highest rate of recurrence of all malignancies, it requires close monitoring that aligns with a patient’s signs, symptoms, labs, and imaging.
The overall prognosis for bladder cancer is favorable with early diagnosis and treatment. Lifestyle changes can help reduce risks.
The author concludes that, along with other IPT members, the nurse’s role “focuses on the patient’s surgical recovery, responses to chemotherapy, physical and emotional responses to changes in urinary patterns, and fear and anxiety about mortality. The IPT can help the patient to achieve a quality of life.”
Adapted from: Pullen RL Jr. Bladder cancer: An Update. Nursing 2024;54:27-39 https://journals.lww.com/nursing/fulltext/2024/04000/bladder_cancer__an_update.8.aspx
