When you’re battling breast cancer, worrying about how to navigate the healthcare system is one of the last things you want to think about. “It’s this complex maze of screening for the cancer, then confirming it’s cancer, and then actually treating it,” says Marc Hurlbert, Ph.D, executive director of the Avon Breast Cancer Crusade.
Enter: breast cancer patient navigators, people (such as nurses) who help patients ensure they get timely and high-quality care by steering them through issues that arise, whether they’re financial, language-related, logistical, or even just making sure patients understand what their treatment involves.
A Patient Navigator’s Role
“Conceptually, they hold the patient’s hand through the whole process,” says Hurlbert. If a woman is concerned about missing work for treatment, for example, a patient navigator might help her formulate a plan.
And if a patient is confused and overwhelmed right after a diagnosis, a patient navigator might sit with her and talk through all of the information she’s just received. “My role is to step in and assist with empowering that woman with information, helping her understand and give her perspective on what this cancer is,” says Deborah Stewart, BSN, RN, CBCN, CBPN, a nurse navigator at the Johns Hopkins Breast Center (her position is supported by a grant from the Avon Foundation for Women). "The doctor may say things the patient only hears once. I can repeat. I can see if she really understands. In addition to contacting the doctor, she can call me at any time and say, ‘I need more information,’ or, ‘Did I understand this correctly?’”
How It Started
Patient navigation was the brainchild of Harold P. Freeman, M.D., formerly the director of surgery at Harlem Hospital in New York. He developed the first patient navigation program there in 1990 so low-income and uninsured women could better cope with breast cancer diagnosis and treatment. And the benefits weren’t just psychological: The five-year survival rate for breast cancer patients at Harlem Hospital between 1964 and 1986 was 39 percent. Between 1995 to 2000—after Freeman’s program was implemented (along with some other new programs)—it jumped to 70 percent.
Patient navigation programs now exist all across the country. The Avon Foundation for Women currently funds 64 active patient navigation programs, for example.
An Available Resource
While these programs are oftentimes geared toward underserved populations, Hurlbert says any patient can see if her treatment center has one and, if so, request their help.
“Cancer care is becoming more and more complex,” he says. “As science advances and medicine advances, it just is going to become more complex, and so the role for a navigator becomes even more important.”