title: Navigating Treatment of Metastatic Castration- Resistant Prostate Cancer: Nursing Perspectives.
abstract: BACKGROUND
  Treatment of metastatic castration-resistant prostate cancer (mCRPC) has evolved rapidly. In particular, five new treatments that extend survival in mCRPC have been approved since 2010, including the chemotherapy cabazitaxel (Jevtana®), hormonal agents abiraterone (Zytiga®) and enzalutamide (Xtandi®), vaccine sipuleucel-T (Provenge®), and radiopharmaceutical radium-223 (Xofigo®); all have different indications and toxicity profiles.
  
  
  OBJECTIVE
  This review discusses treatment advances in mCRPC, including considerations for side-effect management and treatment sequencing. Studies relating to quality of care in prostate cancer are also discussed.
  
  
  METHODS
  Nonsystematic searches were performed on published manuscripts and abstracts from major oncology or urology congresses, focusing on practical characteristics of the previously mentioned new treatments that extend survival in mCRPC, as well as studies relating to quality of care and the role of nurses in prostate cancer management.
  
  
  RESULTS
  To ensure that patients derive optimal clinical benefit, assessing overall health and proactively managing expected side effects are essential. Treatment sequencing in mCRPC is an important consideration, but clinical data in this area are limited. Despite medical advances in mCRPC, studies have identified other aspects of care in which improvement is needed. Nurses can make major contributions to addressing supportive care needs, which has been shown to improve patient care and outcomes in prostate cancer. Although patient navigation programs have improved coordination of care, inconsistent implementation among centers has been identified for prostate cancer. Greater use of outcome measures can help to identify unmet patient needs.
authors.affiliation: Palo Alto Medical Foundation.
authors.forename: Frank
authors.initials: F
authors.lastname: dela Rama
authors.affiliation: Sidney Kimmel Comprehensive Cancer Center.
authors.forename: Caroline
authors.initials: C
authors.lastname: Pratz
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000628:therapy; D064129:Prostatic Neoplasms, Castration-Resistant / Q000451:nursing / Q000473:pathology / Q000628:therapy*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals
keywords: management; nurse; nurse navigator; prostate cancer; treatment sequencing