Patient Navigators to Help Breast Cancer Survivors
Have you heard the term “patient navigator?” In cancer world, a patient navigator is a trained volunteer who helps cancer patients figure out their treatment, particularly those classified as underserved due to socioeconomic status, cultural or language barriers, or lack of health insurance.
While disparate organizations sponsor patient navigator training programs, one of the most active is that of the American Cancer Society. The ACS’s program, launched in 2005, operates at 60 sites around the country. In addition, thanks to a $10 million gift from drug giant AstraZeneca, the ACS is scheduled to create 50 more operating sites, including three that have already opened this year. (On the other hand, Congress passed a federal Patient Navigator Act in 2005, but it has yet to receive any funding. Thank God for private organizations like the American Cancer Society.)
And what, exactly, do patient navigators do? According to the ACS, navigators are “licensed clinical social workers who serve as personal guides to help patients confront the psychological, emotional, and financial aspects of diagnosis, treatment, and care… Navigators are full-time ACS employees with rigorous training in collaboration with the National Cancer Institute Patient Navigation Research Program… The navigators help patients tackle a range of needs, from arranging transportation to and from treatment or providing referrals to physical therapy or nutrition counseling to getting patients information on financial assistance programs.”
While this burgeoning breast cancer support program is making strides towards smoothing the road for those in active treatment, it occurs to me that this same type of program would be a boon to cancer survivors, as well. With more than 10 million Americans classified as cancer survivors – and the number growing every year – it’s becoming clear that this is a large enough group to demand some attention from the medical community.
Patient navigators could be a critical part of the “survival plans” and “survivorship prescriptions” currently being developed in the oncology community. And not just for medically underserved patients, but for all of us mystified by how to handle the special health issues that characterize survivorship.
At a recent meeting of ASCO, the American Society for Clinical Oncology, four “queries of interest” regarding survivorship were discussed:
• Who’s responsible for identifying possible symptoms of recurrence in cancer survivors, and then watching out for them: the patient, the oncologist, the primary care physician… or all three? What if, due to lack of communication, each thinks the other is responsible?
• What are the main survivorship issues for any particular patient? Financial, emotional, physical, or some combination?
• Which treatment side effects could most affect survivorship in this patient? For instance, with breast cancer, patients taking Herceptin may have an increased risk of heart damage. Or those having had chemo may experience severe menopausal issues.
• What, exactly, should each patient’s survivorship prescription plan look like?
How do we, as survivors, answer these questions? And even after we identify our own particular survival issues – how do we deal with them effectively? Hello, patient navigator… Maybe I’m just being a wimp, but personally, I’d love to have someone upon whom I could call to answer questions I have about long-term survivorship. Like, are these treatment side effects I’m still experiencing, five years later, going to go on for the rest of my life? Are there any insurance companies who’ll offer me life insurance, with my cancer history? Are my sleepless nights related to cancer, to menopause, to treatment… or to some combination of the above?
Perhaps once the American Cancer Society’s patient navigator program for the medically underserved is firmly in place on a nationwide basis, it could examine a similar program for those of us navigating the uncharted waters of survivorship.