When Sushila Nair was diagnosed with invasive breast cancer in spring of 2013, her mind was spinning after each appointment. “There were so many questions to be answered. So many decisions to be made. You try to remember it all, but invariably you leave confused,” she recalls.
The overwhelming nature of the situation — when normal women are suddenly thrown into abnormal circumstances — is precisely why the GW Cancer Institute patient navigation program was created.
“There’s always some concern when women have been diagnosed with breast cancer,” says Monica Dreyer, M.A., who served as Nair’s patient navigator throughout her diagnosis, surgery, and recovery. “They’re concerned about what to tell their job, how to talk to their family about it,” she explains. “Sometimes they just need someone to talk to. And even if I don’t have an answer for them, I’m someone who is going to pick up the phone when they call and can find someone who will have an answer.”
Nair recollects the comfort she felt upon being introduced to Dreyer as her breast care navigator during her initial meeting with Christine Teal, M.D., assistant professor of surgery at the George Washington University School of Medicine and Health Sciences (SMHS), who provided Nair’s care at George Washington University Hospital. “I knew my surgeon was going to be busy, so it was wonderful to know there was someone I could go to with questions that came up between appointments,” says Nair. These questions ranged from ‘When do I begin my physiotherapy?’ to ‘How do I access the online patient portal?’ “Monica was like a traffic signal for me,” recalls Nair. “If I was having an issue, she would tell me to ‘turn left’ or ‘go right’. She truly helped me navigate the process.”
Dreyer also helped connect Nair to GW’s buddy program, which matches breast cancer patients with women who have been through treatment. “There’s nothing quite like talking to someone who’s been through the exact procedure with the exact doctor,” says Dreyer. Nair found the program so helpful that, upon completing her treatment, she signed up to be a buddy for other patients. “Sushila was so grateful for what we had done for her,” Dreyer recalls. “She wanted to pay that forward and help women going through a similar situation.”
Dreyer, who studied art therapy and is in the process of becoming a licensed professional counselor, has worked with the GW Cancer Institute for the past year and a half. She screens all newly diagnosed patients for distress following a protocol approved by the GW Cancer Committee, a leadership group that guides the cancer program and ensures its ongoing accreditation. The distress screening process “gives us a chance to see how they’re taking in all this information, and to see if there are either practical barriers to care — things like transportation, housing, nutrition — or emotional barriers to care,” she says.
The GW Cancer Institute has been a leader in patient navigation since 2005, seeking to improve cancer outcomes, with special attention to uninsured, underinsured, vulnerable, and minority populations. In 2010, it launched a Citywide Patient Navigation Network, working with community based organizations, primary care centers and other cancer centers to eliminate in excess of 26,000 barriers to care for more than 8,000 patients along the cancer continuum. “The GW Cancer Institute aims to set the standard for patient-centered care and eliminate cancer health disparities,” says Mandi Pratt-Chapman, director of the GW Cancer Institute. “Patient navigation is a key strategy in ensuring patient centered care at GW and throughout the D.C. region,” she adds.
Nair, now eight months out from her treatment, remains grateful for the support that Dreyer offered as her patient navigator. “It’s not about just choosing a doctor who is going to rescue you,” Nair says. “You’re choosing a team of people, and the patient navigator is an exceptionally critical member of that team.”