A nurse-led clinic to deal with bowel problems in rectal cancer survivors

Survivors of rectal cancer often face bowel problems known as Low Anterior Resection Syndrome (LARS). This complication can have a profound impact on the quality of life of patients. During ESMO 2024, Dr Eva Pape, clinical nurse specialist at the Ghent University Hospital explained how they set up a nurse-led clinic to better inform and follow-up rectal cancer survivors with LARS.

The rationale for the implementation of this nurse led clinic was formed by an exploratory study evaluating the needs of LARS patients. This study learned that patients were not sufficiently informed on the possibility of LARS prior to the surgery and indicated a lack of adequate counselling once LARS had developed. Based on these results, the University Hospital Ghent developed a decision aid that is now used by surgeons and clinical nurse specialists to better inform patients and to facilitate shared decision-making in patients who are planned for rectal surgery.

In addition to this, a nurse-led clinic was installed to follow-up rectal cancer survivors with bowel complications. In this clinic, a stepped approach is used to manage patients. On a first level, all LARS patients received basic support. For patients with more severe symptoms or needs, a more comprehensive counselling and more intensive follow-up is provided. In the third step, more specialised care/information from other (para)medical experts or experts by experience is offered. Examples of additional care that can be given in this third step include psychological support, or nutritional advice.

To evaluate how patients experience the care in this nurse-led clinic, a series of interviews were performed. These interviews learned that patients especially appreciate the fact that they have a fixed point of contact that is easy to reach and very approachable. In addition, patients feel more recognized and see the nurse specialist as a guide for their care trajectory