Navigating Cancer

Improving health and equity through Cancer Patient Navigators

By: Elizabeth Chorney-Booth

None of us know what to do in the moments or days after receiving a cancer diagnosis. Moreylle Resurreccion was diagnosed with locally advanced sarcoma this past September, and she could barely process the news. Only 22 years old, the biochemistry student went to the doctor complaining of pain in her leg and the last thing she expected was to be told she would need to start a course of cancer treatment. The diagnosis affected Resurreccion — originally from the Philippines and currently living in Banff with her parents — differently as someone who was just entering adulthood and beginning a career.

“I was devastated when I got the news,” Resurreccion says. “My family and I were really glad when we met April and she started to guide us on where to go and who to talk to.”

The “April” in question is April Boychuk, a Cancer Patient Navigator from the Tom Baker Cancer Centre in Calgary where Resurreccion is receiving her treatment. Boychuk met with the young woman and her parents a few days after her diagnosis and helped them figure out how to manage appointments, set her up with a counsellor to address her emotional needs and now continues to work with her to provide other necessary supports. Boychuk’s role is part of a provincewide navigation program designed to help patients who may have trouble accessing cancer care.

Cancer Patient Navigators weren’t always available to patients like Resurreccion — the current program was launched in 2012, first as a service to rural Albertans with cancer who needed help with transportation, housing and financial support to travel to Calgary or Edmonton for treatment. Cancer Care Alberta (CCA) recruited experienced oncology nurses to take on the Cancer Patient Navigator roles at the province’s 15 regional and community cancer centres, where they provide a personcentred approach to care, supporting the unique needs of the patient after a diagnosis of cancer is received. The Cancer Patient Navigators work to remove unique barriers experienced by rural cancer patients so they can get the same level of care as those who live close to the province’s major cancer centres.

“Navigation is really a health-equity tool,” says Debora Allatt, manager of education and patient experience for CCA. “The whole idea of Cancer Patient Navigation is to support people who may have a number of barriers in terms of accessing care and having a reasonable quality of life.”

After introducing Navigators to the community and regional centres, CCA looked at other populations that were facing different, but equally challenging barriers that may benefit from specialized navigation supports. In 2014, through funding provided by the Alberta Cancer Foundation, CCA extended specialized Cancer Patient Navigation services to patients who are between 18-39, referred to as adolescent and young adults (AYA). Evidence shows this group of patients are more likely to face complications because of employment or family obligations and face more complex emotional distress than older adults undergoing cancer treatment. In 2016, the Navigation program was further expanded to support Indigenous cancer patients who feel the cancer-care system doesn’t address their unique cultural needs or has created barriers from systemic racism and historical events. Today, the program continues to receive support from donors, including a recent donation of $2 million from Calgary-based oil producer Crescent Point Energy.

While those specialized Cancer Patient Navigators who work with these two unique groups may be helping cancer patients in different ways, the intent to support more vulnerable patients to access equitable care is the same as the rural Navigators.

“I think the most important aspect of navigation is the introduction to cancer care,” says Keith Siemens, a rural Cancer Patient Navigator at the Grande Prairie Cancer Centre. “We have the opportunity to flavour the journey with a positive first experience. We strive to be welcoming, as this is a place that no one wants to be. We want people to understand that we will walk with them and support them as much or little as they need. We invite them to hold us accountable for ensuring plans are followed up and come to fruition.”

Most importantly, Cancer Patient Navigation seems to be making a real impact on patient care. Allatt says that, in 2022, approximately 7,000 Albertans will access the help of a Cancer Patient Navigator. Anecdotally, both Allatt and Dr. Linda Watson, who was the lead of person-centred care integration for CCA when the Cancer Patient Navigation program was implemented, say patients have been grateful for the guidance, but there’s also evidence the program is providing better outcomes and even saving lives.

“We know that cancer patients who live in rural Alberta, and in the north zone in particular, have had some of the poorest outcomes because it’s often too complicated to get the care they need, so they are more likely to decline or withdraw from treatment or miss appointments,” Watson says. “The data shows that, since we started implementing the rural Cancer Patient Navigation program, rural cancer patients’ satisfaction with the coordination and integration of their cancer care has improved by about 20 per cent.”

Resurreccion is relieved she doesn’t feel alone during such an unexpected and stressful experience. She may not have known Cancer Patient Navigation existed before she needed a Navigator, but taking tasks like playing phone tag with her oncologist’s office or searching for emotional support off her to-do list has allowed Resurreccion to focus on her treatment and mental well-being.

“April is a really bubbly and cheerful kind of nurse, which makes talking to her easier,” she says. “If I tell her about how my chemo went, she helps lighten things up for me. It’s helpful knowing that someone is on my side and knows my story.”

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