Establishing a Nurse-Led Follow-Up Clinic for Colorectal Cancer Patients

Background: Following surgery for colorectal cancer, clinical follow-up had been thought to lead to earlier identification and management of recurrent disease in appropriate sub group of patients. Traditionally these patients are followed up in a consultant-led clinic. We describe the effectiveness of a nurse-led colorectal cancer follow-up clinic.

Method: Colorectal clinical nurse specialist (CNS) led follow-up clinic was established with selected colorectal cancer patients referred by a colorectal surgeon or oncologist via an agreed protocol. The clinical focus mirrored that of the consultants and included physical examination, review of investigations, ordering investigations and psychological support.

Results: Analysis of the prospectively collected data revealed 151 referrals (24 self-referrals). Of these 100 were men and 51 were women. One patient was found to have a metachronous lesion. Two patients had US scan findings requiring further evaluation with CT scan. Both required referral to gynaecologist. Clinical assessment of two patients led to additional investigation and referral back to multidisciplinary team for liver metastases. One patient in self-referral group was found to have local recurrence. The number of patients seen in the nurse-led clinic varied but no patient failed to attend or asked to be referred back to a doctor.

Conclusions: Nurse-led colorectal cancer follow-up clinic has been successfully initiated in our hospital. Our study demonstrates the effectiveness of this new concept in patient care.