Talking About Prostate Cancer: Why Trust Between Patients and Nurse Practitioners Matters Most
A leading nurse practitioner in oncology breaks down prostate cancer and how providers can build trust to improve outcomes.
This year, the National Cancer Institute (NCI) estimates that the U.S. will see 313,780 new cases of prostate cancer, and 35,770 men will die from the disease. While the NCI reports that “in general prostate cancer has excellent survival rates,” they note that not every person is at equal risk: “Prostate cancer occurs only in men, and it is more common in older men than younger men. It is more likely to occur in men with a family history of prostate cancer and non-Hispanic Black men.”
Nurse practitioners (NPs) and their colleagues can help their male patients understand risk factors, when to begin screening for prostate cancer and what options they have if they are diagnosed. In observation of Prostate Cancer Awareness Month, the American Association of Nurse Practitioners®
(AANP) spoke with Susy Varghese, DNP, APRN, NP-C — the newest co-chair of AANP’s Oncology Community — about what NPs need to know about prostate cancer and the importance of working collaboratively to achieve the best outcomes for patients.
Testing and Screening
Born in India, Susy Varghese migrated to the U.S. in 2006 and worked as a nurse while she earned her graduate degrees, including her Doctor of Nursing Practice degree from the University of Texas Medical Branch in 2019. She practiced as an NP at MD Anderson for 17 years, working in pain medicine, GI oncology and breast oncology. About prostate cancer in particular, she says: “There are several critical insights that all NPs should understand about prostate cancer to enhance early detection, guide them in appropriate management and provide holistic support to patients — because prostate cancer frequently presents without symptoms in its early stages. Making a risk-based screening is very essential.”
A few testing options are available to screen for prostate cancer, including a prostate specific antigen test (PSA), a digital rectal exam (DRE) and others. Health care providers should be aware of some of the limitations of the tests, however, and the PSA, “while useful, is not a cancer-specific test,” says Varghese.
“Elevated PSA levels can result from benign prostatic hyperplasia (BPH), a non-cancerous condition.” With this in mind, NPs should concentrate on “focus screening,” for “high-risk populations, including African American men…those with genetic mutations like BRCA1, BRCA2,” and more.
“The NP plays a key role in educating these patients, finding out the difference between the symptoms of BPH and potential cancer-related symptoms,” Varghese explains. “We know that screening guidelines are evolving because prostate cancer screening recommendations are not one-size-fits-all. NPs should initiate individualized, shared decision-making conversations, especially for men aged 45 to 60, with high-risk patients and a family history of prostate cancer. Early detection is very important.”
Connecting With Patients
Varghese, when speaking about screening and treatment, makes it clear that the first goal is to build a foundation of trust between provider and patient. This belief is borne out by research: in an article published by the journal Cancer Nursing™ entitled How African American Men Decide Whether or Not to Get Prostate Cancer Screening, the authors conclude that among other factors, for those who had screening, “it was necessary for the men to have a trusting relationship with their health care provider.”
Varghese suggests NPs approach a patient by saying something like, “because of your age and health history, it is a good time to talk about screening for prostate cancer. “We’ll start with a simple blood test called a PSA. The results give us a better sense of your personal risk for prostate cancer. Together with your overall health, this helps us create a screening plan that’s tailored just for you. The goal is to catch anything early if it’s there, but also to give you peace of mind and avoid unnecessary procedures whenever possible.”
Asked how NPs can reach higher-risk populations, she says, “You know, it is very important to build trust by developing a long-term, respectful relationship.” NPs, she says, can meet these patients where they are, “and be an advocate for them to screen early and provide educational materials. We need to address the social determinants of their health. We can use counselors. We can use navigation services. We can empower them to make informed decisions about their screening and treatment options. What is the key here? Education.”
Join the AANP Oncology Community
Varghese, a new co-chair of AANP Oncology Community, says “I believe this community has the potential to shape different conversations, promote best practices and improve outcomes for our patients and families who are affected by cancer.” AANP Communities are designed to support discussion, document sharing, collaboration and networking, and each AANP Community maintains a dedicated online forum where members can instantly connect with like-minded NP colleagues and share information.
AANP is also offering the continuing education (CE) activity, Cancer Screening 2025, which covers detection, prevention and social determinants of health. This activity offers 0.88 contact hours of CE credit and is available through July 16, 2026.