Navigation As Support

CURE, Special Issue 2007, Volume 6, Issue 3

Some breast cancer patients are finding help with their diagnosis in patient navigators—a person who has been trained to serve as a personal guide through cancer.

For some women across the country, a breast cancer diagnosis brings with it a patient navigator, a former patient or hospital patient educator who has been trained to serve as a personal guide through the psychological, emotional and financial challenges of cancer.

Started in 1990 by Harold Freeman, MD, founder and medical director of Harlem’s Ralph Lauren Center for Cancer Care and Prevention, the patient navigator program has expanded to 60 sites across the country through the American Cancer Society, which launched a program in 2005 to specifically reach underserved populations. In early 2007, the drug company AstraZeneca donated $10 million to the ACS to add at least another 50 patient navigator sites over the next five years. In other settings, psychosocial support may be provided by an oncology social worker, oncology nurse, nurse practitioner or chaplain.

In Denver, Sandra Walters, RN, left her hospital position to open the Andre Center for Breast Cancer Education and Navigation, a community-based outreach program. Serving as an educator and care coordinator to help guide women through breast cancer, Walters sees her role as critical in providing women with an educated medical professional who is not providing treatment but has an in-depth understanding of breast cancer and treatment.

"The biggest hindrance to getting through a breast cancer diagnosis intact is anxiety and fear,” she says. “You address those issues by reaching out and saying, ‘I am going to help you understand and get through this."

The biggest hinderance to getting through a breast cancer diagnosis intact is anxiety and fear. You address those issues by reaching out and saying, ‘I am going to help you understand and get through this.'

In the eight years before beginning the Andre Center, Walters helped develop two hospital-based breast cancer programs, where she worked with hundreds of patients. “I know the value of timely, upfront education and the benefit it brings in decreasing anxiety through one-on-one education and compassion,” she says.

Walters also knows the challenges of creating and maintaining a patient navigator position in hospitals because of the pressures of managed care and time, but “if it’s done right, it will pay for itself through downstream revenue. It’s making the commitment to the process that has to happen.”