For older men, a diagnosis of prostate cancer doesn't automatically mean immediate treatment is the best solution.

Sometimes it's better to monitor the growth rather than immediately operate or use radiation therapy. Many men with prostate cancer are not aware of this "watchful waiting" option, which avoids the many complications that can come with invasive procedures. That is one of the reasons that Meredith Wallace, Ph.D., RN, was moved to write a book about the illness.

Wallace, a New Haven resident and an assistant professor of nursing at Fairfield University, co-edited "Prostate Cancer: Nursing Assessment, Management, and Care," (Springer Publishing Co. 2002) with Lorrie L. Powel, Ph.D., RN, a research health scientist at Boston University School of Public Health. In January, the American Journal of Nursing awarded the book one of its prestigious book awards.

"This text compiles a breadth of information about prostate cancer into one comprehensive source," the January issue of AJN stated about the book.

The book does not advocate "watchful waiting" over any of the other treatment options, but seeks to make sure nurses are informed about all of them, Dr. Wallace said. While the book's target audience is nurses who might be treating patients with prostate cancer, it is written clearly and concisely enough for a general audience, Dr. Wallace said.

"I pride myself on the clarity of the writing," Dr. Wallace said.

Prostate cancer is the second leading cause of cancer death in men, according to the book. However modern instruments enable healthcare workers to screen for it cheaply and quickly, Dr. Wallace said.

Temporary or permanent urinary incontinence and sexual impotence are side effects in up to 90 percent of cases in which prostate cancer is treated with radiation or surgery. Prostate cancer is actually a slow-growing tumor, Dr. Wallace said. Men in their late 70s who have other diseases and no symptoms may prefer monitoring the tumor and taking no immediate invasive action if they were informed of that alternative. "They don't think it's an option not to do it," Dr. Wallace said of invasive procedures.

Prostate cancer is complex because there are so many uncertainties. "While nurses are particularly skilled in providing information and emotional support about diagnoses and treatment, they have been ill prepared to help men face prostate cancer," Dr. Powel said. "'Prostate Cancer: Nursing Assessment, Management and Care' arms the generalist nurse with the information that is so critically needed when caring for patients who are diagnosed and treated for the most common noncutaneous malignancy in American men."

Dr. Wallace has contributed to several other works, including the text book "Gerontology Nursing Care of The Older Adult," and "Geriatric Nursing Research Digest," which she edited along with Joyce Fitzpatrick, Ph.D., FAAN and Terry Fulmer, Ph.D., FAAN and which also won an AJN book award. Dr. Wallace is currently working on an updated, abbreviated version of a gerontology text.

AJN is the official journal of the American Nurses Association, and as such, its book awards are some of the most prestigious book awards in the nation, said Jeanne Novotny, Ph.D., FAAN, dean of the School of Nursing at Fairfield.

"Meredith is one of the leading nursing researchers in prostate cancer and geriatric nursing," Dr. Novotny said, adding that Fairfield was pleased to recruit Dr. Wallace, who just joined the University in September. "We are so fortunate to have attracted a key nursing researcher in gerontology."

Dr. Wallace is available for interviews.

Posted On: 02-03-2003 09:02 AM

Volume: 35 Number: 167