Operational scope and clinical practice profile of a nurse practitioner-led advanced prostate cancer clinic A retrospective review from a Canadian cancer center.

INTRODUCTION

The use of androgen receptor pathway inhibitors (ARPIs) in advanced prostate cancer has improved survival outcomes, leading to increased survivorship followup demands and resource utilization. To address this, nurse practitioner-led prostate cancer clinics (NPPCCs) were implemented at a Canadian regional academic cancer center. We aimed to evaluate the scope and care delivery practices of NPPCCs managing patients on androgen deprivation therapy (ADT) and ARPI therapy.

METHODS

A retrospective review of electronic medical records (EMR) was conducted at the Verspeeten Family Cancer Centre for patients ≥18 years old with confirmed prostate cancer managed in NPPCCs from December 2018 to November 2024. Data included patient volumes/visits, as well as prescription, test, and referral orders within the EMR.

RESULTS

A total of 531 patients were managed in the NPPCCs from December 2018 to November 2024. Visits were performed by two full-time NPs, each devoting one weekday to an NPPCC. In a one-year timeframe, each NP provided followup care to 167 and 162 patients, respectively. ARPI prescriptions were completed by NPs in 91.1% of patients. Across the 12-month evaluation period, 990 followup visits were delivered through NPPCCs, representing a redistribution of longitudinal monitoring visits that would otherwise have occurred within physician clinics. Genetic testing was ordered in 35.3% of patients, and 39% received supportive medications for symptoms and toxicity management.

CONCLUSIONS

NPPCCs represent a feasible NP-led followup model for patients with prostate cancer receiving ADT and ARPIs. This descriptive evaluation characterizes the operational scope and clinical activities of the clinic, and provides a foundation for future studies evaluating safety, effectiveness, and economic impact.