E-poster Presentation 2014 World Cancer Congress

The changing landscape of advanced melanoma and its impact for cancer nurse specialists (#901)

Christine Archer 1 , SAyed Ali 1
  1. Canberra Hospital, ACT Health, Canberra, ACT, Australia

Background:  Ipilumumab and BRAF inhibitors are changing the landscape for management of advanced melanoma. Prior to the availability of these therapies gaining PBS approval, patients were referred to academic centres with clinical trials for treatment. These treatments have unique side effects requiring close monitoring. Since 2012, a dedicated melanoma team has been established at the Canberra Hospital, improving access and monitoring of these treatments for regional patients.

Aim: To analyse changes in service delivery for advanced melanoma patients in a regional centre.

Methods: Six months of data was analysised for the Melanoma and Skin Cancer NCC patient contact time, including visit reasons, for three patient sub-groups; those receiving immunotherapy, targeted therapy or neither.

Results: Immunotherapy had the highest number of visits per patient, (19) of all the treatment types in 2014. Despite the radiotherapy and targeted therapy groups having high total visits, (82 and 79 respectively for 2013 and 10 and 54 for 2014), their visits per patient remained relatively low. One quarter of all patient visits in 2014 were associated with symptom management. Within this category, 49% were patients receiving ipilumumab, 12% were patients receiving targeted therapy. The care requirements for these groups have resulted in a shift in emphasis of service delivery, highlighting the importance of symptom management, follow up and monitoring for patients receiving these therapies.

Conclusions: The data provides insights into the impacts of new cancer treatments on service delivery. There is an increase in contact time with any new therapy until their patterns of toxicity and ways on managing these are understood. The patients’ multidisciplinary team need to be aware of the resulting changes these therapies have on traditional care provision for advanced melanoma and develop strategies for ensuring that service delivery continues to meet changing patient needs.