Quality standard

Quality statement 4: Managing adverse effects of treatment

Quality statement 4: Managing adverse effects of treatment

Quality statement

People with adverse effects of prostate cancer treatment are referred to specialist services.

Rationale

Treatments for prostate cancer have various adverse effects that can continue after the treatment is completed. Adverse effects include sexual dysfunction, loss of libido, impotence, urinary incontinence, radiation‑induced enteropathy, hot flushes, osteoporosis, cardiovascular complications, gynaecomastia and fatigue. These adverse effects can also have an emotional and psychological impact on people. Specialist services that provide interventions such as counselling, drug therapy, radiotherapy, physiotherapy and aerobic exercise can help to manage adverse effects of treatment and substantially improve the person's quality of life.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local pathways that allow people with adverse effects of prostate cancer treatment to be referred to specialist services.

Data source: Data can be collected locally from information recorded locally by healthcare professionals and provider organisations, for example, from service specifications. The National Prostate Cancer Audit includes information on whether cancer service providers have specialist services on site.

Process

Proportion of people with adverse effects of prostate cancer treatment referred to specialist services.

Numerator – the number in the denominator referred to specialist services.

Denominator – the number of people with adverse effects of prostate cancer treatment.

Data source: Data can be collected locally from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.

What the quality statement means for different audiences

Service providers (such as hospitals, specialist urological cancer multidisciplinary teams and specialist prostate cancer services) ensure that systems are in place for people with adverse effects of prostate cancer treatment to be referred to specialist services.

Healthcare professionals refer people with adverse effects of prostate cancer treatment to specialist services.

Commissioners (such as integrated care systems, clinical commissioning groups and NHS England) have pathways in place to ensure that people with adverse effects of prostate cancer treatment are referred to specialist services.

People who have side effects from prostate cancer treatment are referred to specialist services (such as erectile dysfunction or continence services) to help stop or ease the side effects.

Source guidance

Prostate cancer: diagnosis and management. NICE guideline NG131 (2021), recommendations 1.3.36, 1.3.39, 1.3.42, 1.4.3, 1.4.8, 1.4.13, 1.4.14, 1.4.16, 1.4.18 and 1.4.19

Definitions of terms used in this quality statement

Adverse effects

Adverse effects include:

  • sexual dysfunction

  • loss of libido

  • impotence

  • urinary incontinence

  • radiation‑induced enteropathy

  • hot flushes

  • osteoporosis

  • cardiovascular complications

  • gynaecomastia

  • fatigue

  • weight gain

  • metabolic syndrome.

[Adapted from NICE's guideline on prostate cancer]

Specialist services

The specialist services include erectile dysfunction services, continence services and psychosexual counselling. [Adapted from NICE's guideline on prostate cancer]

Equality and diversity considerations

Older people may need encouragement to engage with specialist services as they tend not to use the health service as much as other people.

People who are gay, bisexual or transgender have a risk of developing prostate cancer. Healthcare professionals should be aware of their psychosexual needs, lifestyle and the impact of different treatment options.