This story originally appeared in the Fall 2015 issue of Brigham and Women’s Magazine.
Nearly 300,000 women in the U.S. receive a breast cancer diagnosis each year. More than 2.8 million are either being treated or have completed treatment for it. Still, no two cases are the same. The Patient Navigator Program at the Brigham and Women’s Faulkner Hospital (BWFH) Breast Center, co-directed by Samantha Morrison-Ma, RN/NP, and Eileen Joyce, MSW, ensures patients with breast cancer receive care uniquely suited to their needs.
The Patient Navigator Program is open to every patient of the Breast Center, and is an extension of the care that oncologists and other specialists provide. Morrison-Ma and Joyce meet with 75 patients each month and field another 150 phone calls per week on average, giving each patient an intimate look at her case and practical help through the entire medical process. Their offerings include:
• Explaining how screenings and diagnoses are performed
• Translating medical terminology about the disease and its progression into plain language
• Reviewing recommended treatment options and explaining relative benefits and risks
• Discussing procedures for any proposed surgery, as well as pre- and post-operative care
• Providing psycho-social counseling
• Identifying additional external resources to assist the patient’s recovery and continued health
“We want to increase our patients’ knowledge and reduce their level of uncertainty,” says Morrison-Ma. “Knowledge gives them a greater sense of control over the process, helps them feel more confident in their decision-making, and enables them to be more comfortable emotionally as they progress through treatments and recovery.”
“Our aim is to eliminate any factor that interferes with, delays, or interrupts a patient’s care,” Joyce adds. “We recognize the financial impact of cancer—if you can’t afford reliable transportation, will you be able to get to your treatment appointments? Here in the Breast Center, we have the ability and the privilege to get to know each individual and consider all aspects of that person’s life—and how that will possibly help or hinder that person’s care.”
Patients diagnosed with breast cancer understandably face a number of concerns ranging from the practical to the more personal. Some concerns include questions about surgery, the side effects of treatment, and how loved ones’ will react to the diagnosis. Others worry about inadequate transportation, lost income during treatment and recovery, or insurance coverage gaps. The Patient Navigator Program helps each patient navigate each of these uncertainties.
“Having a nurse like Samantha as a navigator changes the dynamic, and Eileen does much more than social work—she dissects all the barriers patients may experience,” says Peggy Duggan, MD, chief medical officer at BWFH. “Their high level of understanding about medical, psychological, and logistical challenges makes this program unique. Other patient navigation programs focus on enhanced scheduling support, but this one goes far beyond.”
Bridget Larrabee found support in the program when she needed it most. Larrabee’s therapeutic journey took her from diagnosis to chemotherapy and surgery to radiation and medication—all in the same year. Meanwhile, her husband’s job moved them and their two small children from Massachusetts to Texas.
“In the middle of this period of extreme change and challenge, I thought I had it together, but there were times when I really needed to talk to someone with a deep understanding of what I was going through,” Larrabee says. “The time, care, and information Samantha and Eileen provided were essential to my being ready—mentally and emotionally—to undergo treatment. In retrospect, it is astounding how much they helped me and my family.”
Forming lasting bonds
Research shows this high level of support has a lasting effect. Breast cancer patients who receive dedicated education and counseling have improved five-year survival rates. New studies are pinpointing how these services make a difference to underserved patients.
“Allowing patients and families to tell us their stories of who they are—and how their cultural and familial nuances might play into their cancer care —allows us to serve everyone who come through our doors in the best way possible,” says Joyce.
With hundreds of patients who have benefitted from the program, its leaders are determined to keep up the momentum.
“We hope future investments in the program will enable us to add staff, serve more patients, and collect more evidence on patients’ short- and long-term outcomes through research,” says Duggan.
“One reason we know the Patient Navigator Program is successful,” Joyce says, “is that even when patients move on, they continue to call us because they feel well cared for and know they will get the information and support they need.”