Karen Poole trained as a nurse at University of Wales College of Medicine in 1994, graduating with a Bachelor of Nursing First Class Honours Degree. She became the first nursing student to be awarded the Lord Merthyr Medical Research scholarship to fund her PhD, which she completed in 1998. Her doctoral studies investigated the psychological impact of undergoing investigations for breast disease and formed the basis for her career in cancer clinical research.
Since then, Karen has worked across academic, industry and NHS settings. After establishing the Surrey, West Sussex & Hampshire Cancer Research Network (2002-2007), Karen became the Research Delivery Director for the National Institute of Health Research (NIHR) Clinical Research Network (formerly National Cancer Research Network) responsible for the delivery of the national portfolio of over 500 cancer clinical research studies, across all disease types in the NHS (2007-2014). Karen has extensive experience of working across NHS organisations and networks, and coordinating large scale initiatives.
From 2015 to 2017, Karen returned to academic research as a Research Fellow with Professor Sara Faithfull on the True NTH Exercise & Diet project developing a pharmacy-led lifestyle intervention for men after treatment for prostate cancer. More recently she was appointed as a Lecturer in Cancer Care (2017) teaching on the undergraduate programme and CPD modules, with leadership responsibility for the Systemic Anti Cancer Therapy Nursing Practice Module.
Areas of specialism
Affiliations and memberships
Invited observer (2006 to 2012)
In the media
- Family/dyad interventions to support people affected by cancer
- Innovations to support people undergoing systemic anti-cancer treatments
- Lifestyle behaviours to prevent cancer and mitigate against the consequences of cancer treatment
- Patient and public involvement in research
- Initiatives to support and develop the cancer workforce
Professor Andy Jones (University of East Anglia)
Professor Karen Lyons (Boston College, William F.Connell School of Nursing, Boston, USA)
Dr Karen Milton (University of East Anglia)
Dr Ainslea Cross (University of Derby)
Dr Richard Pulsford (University of Exeter)
Dr Kajal Gokal (University of Coventry)
I teach on cancer care and research methods on the undergraduate programmes and CPD modules (including Return to Practice, Introduction to General Practice and Cancer in Society). As Module Lead for the Systemic Anti-Cancer Therapy Nursing Practice: Issues in Care and Management I combine a range of pedagogical approaches including simulation to help practitioners develop their skills, competence and confidence in supporting patients receiving systemic anti-cancer therapies. This course is supporting the implementation of the UK Oncology Nursing Society Systemic Anti-Cancer Therapy Competency Passport.
Courses I teach on
CPD and Short courses
of cardiometabolic complications of androgen deprivation therapy
for prostate cancer, Nutr Res Rev 30 (2) pp. 220-232 Cambridge University Press
also been associated with the development of cardiometabolic complications that can increase mortality from cardiovascular events. There is
emerging evidence to suggest that ADT-related cardiometabolic risk can be mitigated by diet and lifestyle modification. While the clinical
focus for a nutritional approach for achieving this effect is unclear, it may depend upon the timely assessment and targeting of dietary changes
to the specific risk phenotype of the patient. The present review aims to address the metabolic origins of ADT-related cardiometabolic risk,
existing evidence for the effects of dietary intervention in modifying this risk, and the priorities for future dietary strategies.
Social support is acknowledged as important in cancer survivorship, but little is known about change in support after cancer diagnosis and factors associated with this, particularly in colorectal cancer. The CREW cohort study investigated social support up to 2 years following curative intent surgery for colorectal cancer.
A total of 871 adults recruited pre?treatment from 29 UK centres 2010 to 2012 consented to follow?up. Questionnaires at baseline, 3, 9, 15, and 24 months post?surgery included assessments of social support (Medical Outcomes Study?Social Support Survey, MOS?SSS) and health?related quality of life (HRQoL). Socio?demographic, clinical and treatment details were collected. Longitudinal analyses assessed social support over follow?up, associations with participant characteristics, and HRQoL.
Around 20% were living alone and 30% without a partner. Perceived social support declined in around 29% of participants, with 8% of these reporting very low levels overall from baseline to 2 years (mean MOS?SSS overall score
Levels of social support decline following colorectal cancer diagnosis and treatment in nearly a third of patients and are an important risk factor for recovery of HRQoL. Assessment of support early on and throughout follow?up would enable targeted interventions to improve recovery, particularly in the more vulnerable patient groups at risk of poorer social support.
Manage Problems Predict Recovery
Trajectories of Health and Wellbeing in the
First Two Years following Colorectal Cancer:
Results from the CREW Cohort Study, PLoS ONE 11 (5) e0155434 Public Library of Science
This paper identifies predictors of recovery trajectories of quality of life (QoL), health status
and personal wellbeing in the two years following colorectal cancer surgery.
872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires
at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing,
confidence to manage illness-related problems (self-efficacy), social support, comorbidities,
socio-demographic, clinical and treatment characteristics. Group-based trajectory
analyses identified distinct trajectories and predictors for QoL, health status and
Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently
well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health
status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2%
wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing).
Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors
including disease characteristics, stoma, anxiety and social support.
Psychosocial factors including self-efficacy and depression before surgery predict recovery
trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent
of treatment or disease characteristics. This has significant implications for colorectal
cancer management as appropriate support may be improved by early intervention
resulting in more positive recovery experiences.
It is well established that exercise and lifestyle behaviours improve men's health outcomes from prostate cancer. With 3.8 million men living with the disease worldwide, the challenge is creating accessible intervention approaches that lead to sustainable lifestyle changes. We carried out a phase II feasibility study of a lifestyle intervention delivered by nine community pharmacies in the United Kingdom to inform a larger efficacy study. Qualitative interviews explored how men experienced the intervention, and these data are presented here.
Community pharmacies delivered a multicomponent lifestyle intervention to 116 men with prostate cancer. The intervention included a health, strength, and fitness assessment, immediate feedback, lifestyle prescription with telephone support, and reassessment 12 weeks later. Three months after receiving the intervention, 33 participants took part in semistructured telephone interviews.
Our framework analysis identified how a teachable moment can be created by a community pharmacy intervention. There was evidence of this when men's self?perception was challenged and coupled to a positive interaction with a pharmacist. Our findings highlight the social context of behaviour change with men identifying how their lifestyle choices were negotiated within their household. There was a ripple effect as lifestyle behaviours made a positive impact on friends and family.
The teachable moment is not a serendipitous opportunity but can be created by an intervention. Our study adds insight into how community pharmacists can support cancer survivors to make positive lifestyle behaviour changes and suggests a role for doing rather than just telling.
Assessing fitness and promoting regular physical activity can improve health outcomes and early recovery in prostate cancer. This is however, underutilised in clinical practice. The cardiopulmonary exercise test (CPET) is increasingly being used pre-treatment to measure aerobic capacity and peak oxygen consumption (VO2peak - a gold standard in cardiopulmonary fitness assessment). However, CPET requires expensive equipment and may not always be appropriate. The Siconolfi step test (SST) is simpler and cheaper, and could provide an alternative.
The aim of this study was to evaluate the validity and reliability of SST for predicting cardiopulmonary fitness in men with prostate cancer. Men were recruited to this two-centre study (Surrey and Newcastle, United Kingdom) after treatment for locally advanced prostate cancer. They had one or more of three risk factors: elevated blood pressure, overweight (BMI Ã 25), or androgen deprivation therapy (ADT). Cardiopulmonary fitness was measured using SST and cycle ergometry CPET, at two visits three months apart. The validity of SST was assessed by comparing it to CPET. The VO2peak predicted from SST was compared to the VO2peak directly measured with CPET. The reliability of SST was assessed by comparing repeated measures. Bland-Altman analysis was used to derive limits of agreement in validity and reliability analysis.
Sixty-six men provided data for both SST and CPET. These data were used for validity analysis. 56 men provided SST data on both visits. These data were used for reliability analysis. SST provided valid prediction of the cardiopulmonary fitness in men Ã 60 years old. The average difference between CPET and SST was 0.64 ml/kg/min with non-significant positive bias towards CPET (P = 0.217). Bland-Altman 95% limits of agreement of SST with CPET were ± 7.62 ml/kg/min. SST was reliable across the whole age range. Predicted VO2peak was on average 0.53 ml/kg/min higher at Visit 2 than at Visit 1 (P = 0.181). Bland-Altman 95% limits of agreement between repeated SST measures were ± 5.84 ml/kg/min.
SST provides a valid and reliable alternative to CPET for the assessment of cardiopulmonary fitness in older men with prostate cancer. Caution is advised when assessing men 60 years old or younger because the VO2peak predicted with SST was significantly lower than that measured with CPET.
Prehabilitation is increasingly being used to mitigate treatment?related complications and enhance recovery. An individual's state of health at diagnosis, including obesity, physical fitness and comorbidities, are influencing factors for the occurrence of adverse effects. This review explores whether prehabilitation works in improving health outcomes at or beyond the initial 30 days post?treatment and considers the utility of prehabilitation before cancer treatment.
A database search was conducted for articles published with prehabilitation as a pre?cancer treatment intervention between 2009 and 2017. Studies with no 30 days post?treatment data were excluded. Outcomes post?prehabilitation were extracted for physical function, nutrition and patient?reported outcomes.
Sixteen randomised controlled trials with a combined 2017 participants and six observational studies with 289 participants were included. Prehabilitation interventions provided multi?modality components including exercise, nutrition and psychoeducational aspects. Prehabilitation improved gait, cardiopulmonary function, urinary continence, lung function and mood 30 days post?treatment but was not consistent across studies.
When combined with rehabilitation, greater benefits were seen in 30?day gait and physical functioning compared to prehabilitation alone. Large?scale randomised studies are required to translate what is already known from feasibility studies to improve overall health and increase long?term cancer patient outcomes.
Purpose: Primary care nurses can contribute to cancer early diagnosis. The objective of this systematic review was to identify, appraise and synthesise evidence on primary care nurses? contribution towards cancer early diagnosis in developed countries.
Method: The following databases were searched in September 2017: MEDLINE, PsychINFO, CINAHL, SCOPUS, and EMBASE. Data were extracted on nurses?: knowledge of cancer; frequency of 'cancer early diagnosis-related discussions' with patients; and perceived factors influencing these discussions. Studies were appraised using the Mixed Methods Appraisal Tool.
Results: Twenty-one studies were included from: United States, United Kingdom, Ireland, Spain, Turkey, Australia, Brazil and Middle East. Studies were mostly of low quality (one did not meet any appraisal criteria, 15 met one, four met two, and one met three). Nurses? knowledge of cancer, and their frequency of ?cancer early diagnosis-related discussions?, varied across countries. This may be due to measurement bias or nurses? divergent roles across healthcare systems. Commonly perceived barriers to having screening discussions included: lack of time, insufficient knowledge and communication skills, and believing that patients react negatively to this topic being raised
Conclusions: Findings suggest a need for nurses to be adequately informed about, and have the confidence and skills to discuss, the topic of cancer early diagnosis. Further high-quality research is required to understand international variation in primary care nurses? contribution to this field, and to develop and evaluate optimal methods for preparing them for, and supporting them in, this.
To assess the feasibility and acceptability of a community pharmacy lifestyle intervention to improve physical activity and cardiovascular health of men with prostate cancer. To refine the intervention.
Phase II feasibility study of a complex intervention.
Nine community pharmacies in the UK.
Community pharmacy teams were trained to deliver a health assessment including fitness, strength and anthropometric measures. A computer algorithm generated a personalised lifestyle prescription for a homebased programme accompanied by supporting resources. The health assessment was repeated 12 weeks later and support phone calls were provided at weeks 1 and 6.
116 men who completed treatment for prostate cancer.
The feasibility and acceptability of the intervention and the delivery model were assessed by evaluating study processes (rate of participant recruitment, consent, retention and adverse events), by analysing delivery data and semi-structured interviews with participants and by focus groups with pharmacy teams. Physical activity (measured with accelerometry at baseline, 3 and 6 months) and patient reported outcomes (activation, dietary intake and quality of life) were evaluated. Change in physical activity was used to inform the sample size calculations for a future trial.
Out of 403 invited men, 172 (43%) responded and 116 (29%) participated. Of these, 99 (85%) completed the intervention and 88 (76%) completed the 6-month follow-up (attrition 24%). Certain components of the intervention were feasible and acceptable (eg, community pharmacy delivery), while others were more challenging (eg, fitness assessment) and will be refined for future studies. By 3 months, moderate to vigorous physical activity increased on average by 34 min (95% CI 6 to 62, p=0.018), but this was not sustained over 6 months.
The community pharmacy intervention was feasible and acceptable. Results are encouraging and warrant a definitive trial to assess the effectiveness of the refined intervention.
Faithfull S, Burton C, Clarke S, Kirby M, Lyon A, Levitt G, Poole K, Walter F (2017) Mitigating the risk of cardiovascular disease in cancer survivors. Cancer Nursing Practice 16 (1) 18-23 https://journals.rcni.com/doi/full/10.7748/cnp.2017.e1352
Turner L, Poole K, Faithfull S, Griffin B (2017) Current and future strategies for the nutritional management of cardio-metabolic complications of androgen deprivation therapy for prostate cancer. Nutrition Research Reviews 30 (2) 220-232 https://doi.org/10.1017/S095442241700008
Haviland J, Sodergren S, Calman L, Corner J, Din D, Fenlon D, Grimmett C, Richardson A, Smith P.W, Winter C, members of Study Advisory Committee, Foster C (2017) Social Support following diagnosis and treatment for colorectal cancer and associations with health-related quality of life: results from the UK ColoREctal Wellbing (CREW) cohort study. Psycho-Oncology 26 (12): 2276-2284 https://doi.org/10.1002/pon.4556
Foster C, Haviland J, Winter C, Grimmett C, Chivers Seymour K, Batehup L, Calman L, Corner J, Din A, Fenlon D, May C.M, Richardson A, Smith P.W, members of Study Advisory Committee Pre-surgery Depression and confidence to manage problems predict recovery trajectories of health and well-being in the first two years following colorectal cancer: results from the CREW cohort study. PLOS One 11(5):e0155434 https://doi.org/10.1371/journal.pone.0155434
Egan B, Gage H, Hood J, Poole K, McDowell C, Maguire G, Storey L (2012) Availability of CAM for people with cancer in the British NHS: the results of a national survey. Complementary Therapies in Clinical Practice 18, 75-80 https://doi.org/10.1016/j.ctcp.2011.11.003
Cameron D, Stead M, Lester N, Parmar M, Haward R, Maughan T, Wilson R, Spaull A, Campbell H, Hamilton R, Steward D, O’Toole L, Kerr D, Potts V, Moser R, Cooper M, Poole K, Darbyshire J, Kaplan R, Seymour M & Selby P (2011) Research-intensive cancer care in the NHS in the UK. Annuals of Oncology 22 (supplement 7): vii29-viii35. https://doi.org/10.1093/annonc/mdr423
Gage H, Storey L, McDowell C, Maguire G, Williams P, Faithfull S, Thomas H, Poole K (2009) Integrated care: utilisation of complementary and alternative medical therapies within a conventional cancer treatment centre. Complementary Therapies in Medicine 17, 84-91. https://doi.org/10.1016/j.ctim.2008.09.001
Poole K (2004) Commentary on Kloinerg IL, Fridlund B, Engholm G-B, Holmberg Nurse-led follow-up on demand on by a physician after breast cancer surgery: a randomised study. European Journal of Oncology Nursing 8, 118-120. https://doi.org/10.1016/j.ejon.2004.04.003
Poole K, Froggatt K (2002) Loss of weight and appetite in advanced cancer: a problem for the patients, the carer or the health professional? Palliative Medicine 16, 499-506. http://doi/10.1191/0269216302pm593oa
Froggatt K, Poole K, Hoult E (2002) The provision of palliative care in nursing homes and residential care homes: a survey of clinical nurse specialist work. Palliative Medicine 16, 481-487. http://doi/10.1191/0269216302pm592oa
Poole K & Froggatt K (2002) Weight loss in advanced cancer: a literature review. Report of a study for Macmillan Cancer Relief. London: Macmillan Cancer Relief
Poole K & Fallowfield L J (2002) The psychological impact of post-operative arm morbidity following axillary surgery for breast cancer: a critical review. The Breast 11 (1), 81-87. https://doi.org/10.1054/brst.2001.0369
Coster S, Poole K & Fallowfield L J (2001) The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively. Breast Cancer Research & Treatment 68, 273-282.
Jenkins V, Fallowfield L J, Poole K (2001) Are members of multidisciplinary teams in breast cancer aware of each other’s informational roles? Quality in Health Care 10 (2), 70-75.
Poole K, Lyne P A (1999) The ‘cues’ to diagnosis: describing the monitoring activities of women undergoing diagnostic investigations for breast disease. Journal of Advanced Nursing 31, 752-758.
Poole K, Hood K, Davis B D, Monypenny I, Sweetland H, Webster D J T, Lyons K, Mansel R E (1999) The psychological distress associated with waiting for the results of diagnostic investigations for breast disease. The Breast 8, 334-338.
Poole K (1997) The emergence of the ‘waiting game’: a critical examination of the psychosocial issues in diagnosing breast cancer. Journal of Advanced Nursing 25, 273-281.
Poole K, Jones A (1996) A re-examination of the experimental design for nursing research. Journal of Advanced Nursing 25, 273-281.
Poole K (1996) The evolving role of the clinical nurse specialist within the comprehensive breast cancer centre. Journal of Clinical Nursing 5, 341-349.
Poole K (1996) The most significant ‘nothing’: a concept analysis of personal space. In Maggs C, Biley F (Ed) Contemporary Issues in Nursing. Churchill Livingstone, Edinburgh (pp 233-271)
Poole K (1995) Death of a patient 1: a personal reflection. British Journal of Nursing 4 (4) 197-200.
Poole K (1995) Death of a patient 2: a personal reflection. British Journal of Nursing 4 (5) 259-262.