How Navigation Has Affected My Cancer Patients

Bright fluorescent lights, cold waiting room seats, no family, and a diagnosis of cancer....

Mr Smith has just arrived for chemo teaching in preparation for his first infusion tomorrow. He’s been diagnosed with stage IV pancreatic cancer. At 78 years old, Mr Smith finds himself alone and unsure how he will get through this. A widower with no children; his only brother passed away from cancer just a year ago. He wants to be strong, but reality overtakes his thoughts: “I have no one.” As he listens for his name, fear begins to set in.

Unfortunately, Mr Smith is not alone. Patients throughout our country share this experience every day. Ordinary people living their lives find themselves in a bubble of uncertainty. Cancer is scary. Cancer is a thief. Cancer is cruel. When receiving a cancer diagnosis, patients are met with an insurmountable amount of fear and angst for what their outcome will be. Many don’t know what they need; they simply know they’re in need. That is why we prioritize navigation and supportive care services in our facility. It is our belief that no one should face cancer alone. It is our promise that no one ever will.

In providing navigation services, we recognize the importance of addressing the whole patient. Our navigation program consists of a 4-point process including social work, financial toxicity, nutritional support, and nurse navigation, a personal concept I’ve coined as The 4Ms of Oncology—Mind, Money, Meals, and Medical. When these 4 areas are addressed, patients gain the opportunity to positively impact the trajectory of their story. What does that look like? Every patient entering the oncology service line is assigned a navigator for the listed specialties. Their care team comes equipped with a social worker, certified financial navigator/patient navigator, registered dietitian, and certified oncology nurse navigator. Patients are introduced to the navigation team and notified that their care will be followed throughout their time with us. On this journey, current barriers to care are addressed. Likewise, anticipated barriers may be identified, affording patients an opportunity to make necessary adjustments to improve their outcomes.

Patients report overwhelmingly positive feelings concerning navigation services. They share feelings of relief, joy, understanding, but most importantly, hope. Our goal is to anticipate every question and every limitation to care. With that, we strive to equip navigators to respond with solutions, and with hope. Whether it’s explaining lymphedema or coinsurance, patients are empowered to make educated decisions about their care with our support. Patients and families report feelings of aspiration where despair once lived. To me, that is the testament of a navigator’s work. It is the driving force to persevere for patients.

Navigation is an integral part of oncology services. In my opinion, it is the backbone to positive experiences. No matter what a patient faces, navigators are there every step of the way.

Navigation is an integral part of oncology services. In my opinion, it is the backbone to positive experiences. No matter what a patient faces, navigators are there every step of the way. Effective navigation programs anticipate and assess all barriers to care. This includes financial, clinical, psychosocial, physical, and dietary limitations that inevitably affect a cancer patient’s journey. Whether it’s Mr Smith or a single mom unable to work while undergoing surgery and subsequent chemotherapy, there’s a place for navigation. That’s the beauty of our role. We aren’t just medical professionals. We aren’t just nice people who meet you at appointments. We are hidden heroes who readily stand in the gap on behalf of our patients. We are listeners. We are advocates. We are tissue passers, and fist bumpers. No matter where a patient is, or what a patient faces, we will be there to hold their hand and see them through.

As for Mr Smith, he has us.