When we think about a cancer diagnosis, the focus centers primarily on clinical treatment, as it should. Patients need to be educated about their diagnosis, treatment, and how to manage the journey ahead. While this is key, another important role is taking care of the human being while going through treatment. The patient’s practical needs—family, finances, travel, home living essentials, nutrition, and community—are vital.
A systematic review of patient navigation programs in cancer care demonstrated that navigators significantly improved referrals, screening rates, and completion of diagnostic procedures.
For people who have access, the practical needs are an afterthought because they are the given, but certain populations—people who are Black, Brown, LGBTQAI, poor, or living in rural communities, to name just a few—do not have the privilege of focusing only on their cancer care. They face multiple levels of disparities that sometimes supersede their ability to access and/or adhere to treatment recommendations. Below are a few of the health determinants that impact their quality of life:
According to the National Academies of Sciences, Engineering, and Medicine, the most harsh and common health inequities are reported where poverty, systematic racism, and discrimination occur. Furthermore, some of the most prevalent and well-studied health inequities correlate with socioeconomic status, race and ethnicity, sexual orientation and gender expression, and geographic location.1
Research shows that nearly as many deaths are caused by social factors as by behavioral or pathophysiological factors. Researchers found that in the year 2000, more than 244,000 deaths could be attributed to low education (less than some college education); more than 133,000 deaths could be attributed to individual poverty (household annual income of ≤$10,000); and more than 39,000 deaths could be attributed to area poverty (live in a county where ≥20% of the population lives below the poverty line).
This is where people need an intercessor (defined by the Merriam-Webster Dictionary as one who goes in between). Spiritually, an intercessor is someone who mediates or intervenes on behalf of others, who bridges the gap and supports them in getting their needs. The patient navigator’s role, while sometimes overlooked, is an integral bridge between the patients’ clinical needs and what their human needs are while living with cancer. When someone is vulnerable, the right navigation, the bridge, can pull those patients off the ledge and can have a tremendous benefit on quality of and life itself.
In populations that are vulnerable, the patient navigator’s role can mean life or death for the communities and people it serves. In these communities, a navigator isn’t just “nice to have.” Without that bridge, people fall through the cracks, and the collateral damage is staggering.
Yet, the state of health equity in America is at a devastating point in our nation’s history. With executive orders dismantling health equity2 and the dissemination of a list of flagged words that cannot be used on government websites and documents—among them women, female, Black, BIPOC, Hispanic minority, disabilities, diverse, equity, inclusivity, inclusiveness, bias, LGBT, marginalized, racial justice, socioeconomic, status, trauma, underrepresented, underserved, victim, advocate, antiracist, barrier, disabilities, discrimination, vulnerable, and more.3,4
As we continue to push for health equity, if we cannot identify people in need and create pathways to give them support through navigation, how can they be assured of just care in the hands of a healthcare system that has historically betrayed and failed marginalized populations?
If the structures to protect patients that have been put in place—especially with the heightened focus on health equity—over the past 5 years are being dismantled, who is standing in the gap for those who can’t protect themselves while dealing with a chronic or potentially terminal illness?
It is crucial to integrate patient navigators into healthcare systems as essential components of care delivery. Patient navigation is not just a service; it is an intervention that has the power to save lives by addressing disparities at multiple levels.
Patient navigators serve as the bridge that connects patients with the broader healthcare system, ensuring continuity of care, advocacy, and holistic support. These navigators work at the micro level by assisting patients in overcoming individual barriers, such as understanding treatment options or navigating appointments. Navigators can tease out patients’ needs and collaborate with social service providers and community organizations to improve access to care. At the macro level, they can contribute to systemic change by influencing policy and institutional practices.5
The role of patient navigators is particularly crucial in ensuring timely diagnosis and treatment, as delays in care are one of the primary drivers of poor health outcomes. Research has shown that patient navigators help improve access to services, reduce wait times, and increase adherence to follow-up.6
A systematic review of patient navigation programs in cancer care demonstrated that navigators significantly improved referrals, screening rates, and completion of diagnostic procedures. In addition, patient navigation programs have been linked to reduced emergency department visits and lower hospital readmission rates, highlighting their effectiveness in promoting continuity of care.6
Historically marginalized communities, particularly those facing socioeconomic disadvantages, experience disproportionately high barriers to accessing healthcare services. Vulnerable populations, including racial and ethnic minorities, uninsured individuals, and those with limited health literacy, often struggle to receive timely and appropriate cancer care. As a result, they suffer from higher disease burden and poorer health outcomes.7
Patient navigators are instrumental in addressing these disparities by providing culturally competent guidance, improving communication between patients and healthcare providers, and advocating for necessary resources. Research has demonstrated that patient navigation programs lead to earlier treatment initiation, shorter diagnostic delays, and better adherence to treatment regimens.6 These findings underscore the need for widespread implementation of patient navigation services in cancer care settings.
One of the most successful models of patient navigation is the Tigerlily Foundation’s ANGEL Advocate Program, a grassroots community-driven initiative aimed at addressing disparities in cancer care. Tigerlily creates opportunities for patients to connect, share experiences, and offer support. This sense of community helps individuals realize they are not alone in their journey.
By coming together, patients amplify their voices on critical issues, sharing their stories to drive awareness and influence policy changes. This collective action is a powerful form of advocacy.
Reflecting on this work, I often think about how transformative it would have been to have had a supportive network during my own journey—which is why I developed the ANGEL program—that is driven for patients by patients. The beauty of this program is that patients who were once in vulnerable positions but who were supported by Tigerlily now have the opportunity to help other patients navigate after getting rigorous and certified navigation training. The greatest gift for our patients today is that they have each other, and that they understand the micro and macro resources and limitations in their communities, and know how to guide patients to what they need in a timely fashion. This community not only provides emotional support but also inspires individuals to show up for themselves and advocate for their health. It gives people a space where their voices are heard, and their experiences are validated. Together, they cultivate a culture of empowerment that encourages active participation in care and a shared commitment to improving health outcomes for all.
ANGEL Advocates have engaged in more than 1000 outreach activities, including distributing educational materials, conducting policy reviews, and collaborating with stakeholders in high-disparity areas. The program has recruited more than 400 patient navigators across 21 high-risk regions who have engaged with more than 3500 clinical and nonclinical stakeholders to improve cancer care access.
The impact of the ANGEL program is undeniable. In 2023 alone:
This model of empowering patients through navigation fosters self-advocacy, community involvement, and systemic engagement. By equipping patients with the knowledge and resources needed to advocate for their health, the ANGEL program exemplifies how patient navigation can transform cancer care.
Despite the proven effectiveness of patient navigators, many programs struggle with sustainability due to a lack of funding, limited institutional buy-in, and fragmented implementation. Too often, these programs exist as fragile lifelines, fighting for survival in a system that has yet to fully recognize their worth. Like the tiger lily, a resilient flower that flourishes in even the most adverse conditions, patient navigation programs persist, determined to break through the cracks of inequity and bloom into fully integrated pillars of healthcare.
Healthcare systems must recognize patient navigation not as an auxiliary service but as a fundamental component of patient-centered care. True progress demands bold investment: policy initiatives that ensure funding, institutional support that fosters workforce expansion, and partnerships that embed patient navigation into standard oncology practice.
A major obstacle to expanding these programs is the need for stronger collaboration between healthcare providers and patient advocacy organizations. Imagine the strength of a garden where all flowers thrive together, nurtured by shared resources and a unified vision. Partnerships between hospitals, policymakers, and patient organizations should not be transactional; they must be transformational. These relationships, built on mutual trust, shared goals, and transparent communication, can cultivate groundbreaking improvements in cancer care delivery.
By cocreating educational resources, promoting health equity initiatives, and expanding access to clinical trials, these collaborations can empower patients and improve overall health outcomes.
By cocreating educational resources, promoting health equity initiatives, and expanding access to clinical trials, these collaborations can empower patients and improve overall health outcomes. When we invest in patient navigation, we invest in the very fabric of equity, ensuring that every patient, regardless of background or socioeconomic status, has access to the support and advocacy they need to navigate their cancer journey with confidence.
The future of oncology health equity and patients’ lives depends on our collective commitment to patient navigation. Healthcare professionals, hospital administrators, and policymakers must rise to the challenge and prioritize navigation services as an essential part of cancer care. The evidence is clear: patient navigators improve access, enhance care coordination, and ultimately save lives. The time for passive acknowledgment is over; the time for action is now.
By integrating patient navigators into healthcare systems, expanding workforce training, and fostering meaningful partnerships, we can move closer to a future where health equity is not just an ideal but a reality. Just as the tiger lily stands resilient, unwavering in its growth, we too must be steadfast in our mission. The lives of millions depend on it.
As Dr Martin Luther King Jr once said in one of my favorite quotes, “Whatever affects one directly, affects all indirectly. I can never be what I ought to be until you are what you ought to be. This is the interrelated structure of reality.”
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