Canadian Nurse Practitioners Lead Advanced Prostate Cancer Follow-Up

Treatments called androgen receptor pathway inhibitors, or ARPIs, have improved survival for patients with advanced prostate cancer. That good news creates a busier clinic. More people now need long-term monitoring, which increases demands on staff time and resources. A regional academic cancer center in Canada responded with nurse practitioner-led prostate cancer clinics. The clinics were designed to provide follow-up care for patients receiving androgen deprivation therapy, or ADT, together with ARPIs.

Researchers at the center conducted a retrospective review of electronic medical records. The review covered adults with confirmed prostate cancer who attended the nurse-led clinics from December 2018 through November 2024. They examined patient numbers, visit volume, and orders involving prescriptions, laboratory tests, and referrals. This gave a detailed picture of both the clinic workload and the duties handled by nurse practitioners.

Across the full review period, 531 patients received care through the nurse practitioner clinics. Two full-time nurse practitioners took part, with each setting aside one weekday for this work. During a one-year period, one followed 167 patients while the other followed 162. The clinics delivered 990 follow-up visits over 12 months. This shifted ongoing monitoring away from physician clinics and toward nurse-led care. Nurse practitioners also completed ARPI prescriptions for 91.1% of patients. Genetic testing was ordered for 35.3% of the group, while 39% received medicines to help with symptoms or treatment-related toxicity.

The review identifies nurse-led follow-up as a practical way to manage the repeated monitoring required by ADT and ARPI treatment. However, its retrospective and descriptive design cannot settle every clinical question. It does not directly test comparative safety, effectiveness, or economic impact. Future studies can use this operational profile as a baseline for examining those issues.