Opbygning af sygeplejedrevet senfølgecenter med fokus på behandling af senfølger efter kolorektal- og analkræft

Resumé
Baggrund
Tarmkræft er en af de hyppigste kræftformer i Danmark. Grundet stigende overlevelse ses flere patienter med senfølger, hvilket nødvendiggør systematisk opsporing, så patienterne kan tilbydes behandling.
Formål
I artiklen belyses de hyppigste senfølger efter behandling af kolorektal- og analkræft og det beskrives, hvordan et målrettet senfølgetilbud med sygeplejersker som primær kontakt, kan understøtte behandlingen af senfølger.
Metode og Design
Prospektive data omkring hyppighed af senfølger indsamlet i Københavns Senfølgecenter CARE (Colon, Anal og REctum cancer) præsenteres deskriptivt. Opbygningen af Københavns Senfølgecenter CARE beskrives med centrering omkring opsporing, sygeplejerskens rolle som primær kontakt samt behandling af senfølger.
Resultater
Mere end halvdelen af patienterne ønsker kontakt med Senfølgecenteret og de hyppigste senfølger er afføringsproblemer og urindysfunktion. Sygeplejerskerne varetager den indledende konsultation og opstarter behandling med mulighed for at viderehenvise til specialiseret behandling. De fleste patienter kan afsluttes efter 1-2 konsultationer, som ofte foregår over telefon.
Konklusion
Mange patienter oplever senfølger efter kolorektal- og analkræft, såsom afføringsproblemer og urindysfunktion. Der kan tilbydes behandling for senfølger, hvor sygeplejersker fungerer som primær kontakt. Systematisk opsporing, retningslinjer og tværfagligt samarbejde betyder, at de fleste patienter kun behøver få konsultationer, hvoraf de fleste kan foregå telefonisk.

English Abstract

Establishing a nurse‑led late effects clinic focused on managing late effects after colorectal and anal cancer

Background
Colorectal cancer is one of the most common cancer types in Denmark, and increasing survival means that more patients live with late effects, which necessitates systematic identification so that patients can be offered treatment.
Aim
To describe the most frequent late effects after treatment for colorectal and anal cancer and to show how a targeted late effects service with nurses as the primary contact can support the management of late effects.
Method and design
Prospective data on the frequency of late effects collected at Copenhagen Late Effects Centre CARE (Colon, Anal and REctum cancer) are presented descriptively. The establishment of Copenhagen Late Effects Centre CARE is described with a focus on systematic identification, the nurse’s role as primary contact, and the treatment of late effects.
Results
More than half of patients wish to be in contact with the Late Effects Centre, and the most frequent late effects are bowel problems and urinary dysfunction. Nurses conduct the initial consultation and initiate treatment, with the option of referring patients for specialised interventions when needed. Most patients can be discharged after 1–2 consultations, which most often take place by telephone.
Conclusion
Many patients experience late effects after colorectal and anal cancer, particularly bowel problems and urinary dysfunction, for which targeted treatment can be offered with nurses as the primary contact. Systematic identification, clear guidelines, and interdisciplinary collaboration mean that most patients require only a few consultations, the majority of which can be conducted by telephone.

Keywords: Late effects, colorectal cancer, anal cancer, nurse‑led clinic, bowel dysfunction, urinary dysfunction, survivorship, interdisciplinary care.