The Need for a Complete Cancer Care Team Is Critical as We Move Out of the Pandemic

May 2021 Vol 12, No 5


Christian Downs, JD, MHA
Executive Director, Association of Community Cancer Centers
Linda Fleisher, PhD, MPH
Academy of Oncology Nurse & Patient Navigators, Cranbury, NJ
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
Co-Founder, AONN+; Editor, JONS; University Distinguished Service Professor of Breast Cancer, Professor of Surgery, Johns Hopkins University School of Medicine; Co-Developer, Work Stride-Managing Cancer at Work, Johns Hopkins Healthcare Solutions
Mandi Pratt-Chapman, MA, PhD, HON-OPN-CG
Associate Center Director,
Patient-Centered Initiatives & Health Equity,
GW Cancer Center
Washington, DC
Rani Khetarpal, MBA
Vice President, Provider Partnerships
New Century Health

Without question, the COVID-19 pandemic has had a crippling effect on our nation’s healthcare system.1 Revenues have declined, and expenses continue to go up at practices, hospitals, and health systems across the country.

As a service line, our cancer programs and practices have also been significantly impacted. Many patients have delayed testing or treatment, and staff have been pulled in multiple directions to address the immediate needs of responding to the pandemic.2

While our nation and healthcare system slowly begin to move out of the COVID-19 pandemic, it is critical that long-term investments made in our cancer delivery infrastructure are not cut to address short-term financial stress. Indeed, these long-term investments are critical to address the pandemic of inequities in the United States.

This is particularly true as it relates to our cancer program navigators, social workers, and financial counselors who are vital to our patients and their families and caregivers. Following are several key reasons to protect our cancer care team:

  1. We will have significant volume of newly diagnosed patients as well as more patients with advanced disease. A clear impact of the pandemic has been the delay in screening and treatment of cancer patients.3 In fact, it is believed that this delay impact could affect cancer care delivery for years.4 Our oncology navigators and social workers will be essential in both managing and supporting this influx of patients as well as addressing the social inequities that exist in our community.
  2. Our revenues and expenses will be impacted if we do not have a streamlined and efficient care organization. Years of research indicate that navigation and social work in cancer care greatly improve the patient and caregiver experience and clinical outcomes, and control costs.5 In fact, navigation and social work are key to controlling costs such as no-shows, readmissions, cancellations, and nonadherence to the treatment plan. Revenue will be enhanced because bottlenecks in care delivery and efficiencies can be identified by our navigators and social workers.
  3. It will be very difficult to reassemble the navigation team. As it relates to the pandemic, evidence exists that trying to cut staff and then bring them back can be more costly and time-consuming.6 This is particularly true in highly trained support staff, such as navigators and social workers, who are integral to most cancer programs.
  4. Navigation has been proved to address cancer disparities. Navigation is a core evidence-based strategy to address health inequities across racial and ethnic minority populations. To build community trust in our health systems and to move the needle on cancer outcome disparities, navigation is a critical tool in our toolbox.

With new testing and mitigation strategies being implemented and improved access to vaccines on the horizon, now is the time to proactively plan for the near future. With proper and realistic planning, we can be well positioned to serve our cancer patients and their families as the pandemic begins to subside.


  1. Kaufman, Hall & Associates, LLC. The Effect of COVID-19 on Hospital Financial Health. July 2020.
  2. Hutchins Coe E, Enomoto K, Finn P, et al. Understanding the hidden costs of COVID-19’s potential impact on US healthcare. September 4, 2020.
  3. Fillon M. Cancer treatment delays caused by the COVID‐19 pandemic may not hinder outcomes. CA Cancer J Clin. 2021;71:3-6.
  4. McGinley. Nation’s cancer chief warns delays in cancer care are likely to result in thousands of extra deaths in coming years. June 18, 2020.
  5. Sheinfeld Gorin S, Haggstrom D, Han PKJ, et al. Cancer care coordination: a systematic review and meta-analysis of over 30 years of empirical studies. Ann Behav Med. 2017;51:532-546.
  6. Schnurman M. Another pandemic casualty: Baylor Scott & White will lay off about 1,200 and furlough others. May 26, 2020.
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Last modified: August 10, 2023

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