Although considerable gains have been made in the treatment of metastatic breast cancer (mBC) it remains incurable.1 Responding to the multifaceted complexity of patients’ experiences of mBC presents unique challenges for health and supportive care services. Emotional support and quality of life improvements have consistently been identified as two key unmet needs.2-7 Despite international guidelines recommending all women with mBC have access to a nurse experienced in the treatment of mBC,8 this remains an identified gap in service provision in Australia.6 In this exploratory qualitative study, our aim was to explore women’s experiences of care provided by breast care nurses, drawing on data from semi-structured interviews with 38 women with mBC.
Consensus existed around the value and benefit of a dedicated mBC nurse. Participants who currently had access to a mBC nurse (n=15) commented that they valued knowing that the nurse was available if and when they needed that support. For these women, knowing the nurse was there to help with issues such as living with uncertainty, emotional and existential distress, social isolation, work and care responsibilities, treatment failures, disease progression and advanced care planning provided reassurance even if they did not expect or require support currently. Attributes most valued by those who had accessed the mBC nurse included the nurse’s knowledge, availability, responsiveness and ability to coordinate care and advocate on their behalf.
However, although most participants talked about breast care nurses, many were actually reporting an absence of care with some reporting that they had not been contacted by or received support from a breast care nurse (n=15) or if they had the support offered was minimal or tokenistic (n=8).
Access to an mBC nurse, although not yet available to all patients with mBC in Australia, has the potential to improve care of women with mBC.