Evaluating MELCARE, a nurse-led survivorship program

Melanoma Institute Australia, in partnership with Melanoma Patients Australia and Psycho-oncology Co-operative Research Group (PoCoG), recently conducted a pilot study of MELCARE, to access the feasibility, acceptability and benefits of a nurse-led survivorship program for advanced melanoma patients.

The participants in the survivorship program study were people with stage III and stage IV melanoma which was unresectable (not able to be removed by surgery), and the support was provided by a nurse via telehealth.

We would like to thank the participants and their families for their time and generosity in participating in this study.

The summary below outlines the study and provides an understanding of the key results.

What was this study about?

People diagnosed with unresectable stage III and stage IV melanoma are living longer because of effective treatments like immunotherapy and targeted therapy.

We now know this group of people can face physical, psychological, and social difficulties from the treatment they have had. Some people worry about what will happen to them in the long-term.  However, there are no programs to support this group of people.

This study investigated whether a nurse-led survivorship program (MELCARE) is appropriate and helpful to people who are doing well on immunotherapy or targeted therapy.

Who participated in the study?

This study included people with unresectable stage III and stage IV melanoma who had a good response to immunotherapy or targeted therapy.

What support did the participants receive?

All participants received the nurse-led survivorship program (MELCARE).  This involved two one-hour phone appointments with a specialist melanoma nurse from Melanoma Patients Australia and creation of a Survivorship Care Plan.

During the first appointment, the nurse assessed participants’ physical, emotional, and social needs.  The nurse provided them with information and resources regarding any issues.  This was then summarised in a report called a Survivorship Care Plan.  This plan also had general information about skin checks, sun protection, vaccinations, and screening for other cancers.  This plan was shared with participants’ melanoma doctors and nurses, as well as their general practitioner.

Three months after the first appointment, participants had a follow-up telephone appointment with the same nurse.  Any issues seen during the first appointment were revisited to see if they had resolved.

Participants then completed a survey about how they found the program.

All participants continued to see their usual melanoma doctors and nurses for ongoing treatment and/or monitoring of their melanoma.

What were the results of the study?

31 people decided to participate. They were mainly male with an average age of 67 years. Most people were not on active treatment.

Of those who decided not to participate, the main reason was that they felt well and didn’t feel they required the program.

The program was feasible to run.  30 of the 31 people completed MELCARE.  The nurse was able to deliver the program, spending around 90 minutes with each participant.

The program was shown to be appropriate based on a 4-question survey. Around 80% of participants said MELCARE improved their overall satisfaction with their melanoma care.  All the participants said they would recommend MELCARE to other people with melanoma.

It was also shown that people’s levels of distress reduced from 1^st appointment to the 2^nd appointment.

How has this study helped patients and researchers?

This is the first survivorship program developed for people with unresectable stage III and stage IV melanoma.

We showed that MELCARE was appropriate and helpful to patients and may help them feel less distressed over time.

We hope to run a larger study to offer MELCARE to more patients.  We will also try to understand the best time in a person’s melanoma journey to deliver the program, and the resources and costs associated with delivering this program.

Where has this study been presented/ published?

We shared these results at the European Oncology Nursing Society conference (EONS15), the Australasian Melanoma Conference and the Victorian Cancer Survivorship Conference.  We are hoping to publish this study in a cancer journal later this year.  A link to the final publication will be provided on this website.

Where can I learn more about the study?

If you have any questions about this study, please email Dr Julia Lai-Kwon.