National Maori Cancer

Forum 2009

Revolution of Cancer Care

Anna Ruri

Maori Cancer Nurse Coordinator

Te Kupenga O Hoturoa PHO

Kaitiaki Nursing ServicesTAURANGA

Case Study 1.

• Hine is a 62 y.o maori woman with newly diagnosed

Ca Endometrium.

• She has had a TAH/BSO, omenectomy in June 2009.

• Single – 6 grown up children in Auckland who are all

very supportive.very supportive.

• She is a cleaner – but has decided to give up working

as she requires further treatment.

• She is independent with all her cares. All wounds are

well healed.

Case Study 2

• Mrs X is 34 y.o Pacific Island woman who was initially

diagnosed with cervical cancer in August 2008.

• She underwent a simple hysterectomy, partial lymph

node dissection. She received adjuvant combined

weekly cisplatin/irradiation to the pelvis followed by weekly cisplatin/irradiation to the pelvis followed by

internal radiotherapy. She completed treatment in

December 2008.

• In June 2009 she presented with PV bleeding again. An

EUA and biopsy have confirmed recurrence of her

cervical cancer.

• In July I accompanied Mrs X to a gynaecology oncology

follow up appointment.

• She has declined the surgical treatment that she

requires at this stage.

• She has a good understanding of her

diagnosis/prognosis and implications of her decision

• Independent with all cares

Case 3

• Mr x is 62 years old.

• Newly diagnosed with metastatic colon cancer to liver,

wide spread bone disease. His most pain is in his lower

back.

• Married – 6 children in total. 1 daughter + 1 moko at • Married – 6 children in total. 1 daughter + 1 moko at

home

• He has a good relationship with his GP. He is known to

hospice.

• He is mobile with a walking frame. His wife assists with

bathing cares only.

Case 4

• Mr X is 63 y.o. Maori male.

• He had a radical prostatectomy in June 2009 for

Prostate Cancer.

• Post operatively he was troubled by urinary

incontinence, but as time has gone by this has greatly incontinence, but as time has gone by this has greatly

improved.

• He lives by himself – he has a supportive partner.

• Prior to his surgery he was a long haul truck driver. He

hopes to return to work quite shortly

Numbers by Gender

(n=100)

68

50

60

70

80

32

0

10

20

30

40

Male Female

Numbers by Ethnicity

Pacific Island26%

European1%

Chart Title

Maori73%

26%

Numbers by Age

20

26

24

1415

20

25

30

N

u

m

b

e

r

o

f

01

4

6

14

5

0

5

10

15

0-9 Jan-00 20-29 30-39 40-49 50-59 60-69 70-79 80+

f

P

a

t

i

e

n

t

s

Age

Types of Cancer

• Breast Cancer Pancreatic

• Lung Hepatocellular

• Gastric Prostate

• Colon Head & Neck• Colon Head & Neck

• Leukaemia Renal Cancer

• Lymphoma Gynaecological

• Brain Tumours Unknown Primary

Where did Referrals come

from?

Secondary Care

Tertiary Care

Cancer Society

Te Kupenga

O Hoturoa

Internal

Care Society

Hospice

Maori Cancer Service

Who are we?

• 1 experienced registered Nurse

• 1 cultural adviser

• Community health worker• Community health worker

Referral Criteria

• Maori patients and their whanau

• Diagnosed with Cancer

• And live within the Counties ManukauDHBDHB

Counties Manukau District

Boundary MapBoundary Map

Services Provided

• Inpatient support visits

• Community home visits

• Support for whanau

• Education about cancer and its • Education about cancer and its

treatments

• Coordinate referrals to other appropriate

community services

• Advocacy and support at clinic

appointments

• Transport and travel allowance

• Liaising with Kuia and Kaumatua for

whanau support

• Liaising with GP and MDT

•Referring to counselling

• Bereavement follow up support• Bereavement follow up support

BARRIERS TO SERVICE

•Demand exceeds resources

• Ideally would like to have a patient case-

load of 30-35.

•More often there is 50-60 patients•More often there is 50-60 patients

•Geographical area

• Service 4 medical wards