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Posted: Monday, January 5, 2015

Nurse navigator a constant for breast cancer treatment

“Sometimes when people hear ‘cancer,’ they think it’s a death sentence,” said Blount Memorial Cancer Center nurse navigator Denia Lash. “The diagnosis itself is overwhelming. A person can only absorb so much information at once.”

It’s undeniable that a cancer diagnosis is a life-changing event, affecting not only your daily routines for however long you’ll receive treatment, but also your general outlook on the future. Simply finding out you have cancer can lead to a host of questions, many of which don’t have easy answers.

“I tell them ‘My role is to help with any problem or any barrier that you might have so that all you have to focus on is getting well,’” Lash said.

In mid-2014, Blount Memorial launched its first nurse navigator program. Put simply, a nurse navigator is a person who serves as a touchstone for cancer patients as they progress from diagnosis to treatment to recovery. Lash meets with patients at their post-diagnosis MRI. She continues on with them through appointments with various members of their cancer care team, including oncologists and surgeons, and helps them use the resources that are available to them. The first cancer to benefit from the program is breast cancer.

“A lot of hospitals will do navigator programs for all cancer sites,” Lash said. “When you do that, it’s typically not very comprehensive. Our radiation oncologist and Cancer Center medical director Dr. Albert Petty wanted us to start with breast cancers, so that’s what we’ve done.”


“For a number of years, we’ve recognized the need for a nurse navigator,” Petty said. “The idea was to have someone there who could assist patients through their entire course of care. Treatment is multidisciplinary these days. Patients are dealing with a lot of different treatments, doctors and offices. It’s helpful to have someone there who is a constant who can help you through the process and work on your behalf,” Petty explained.


“My role is really a patient advocate,” Lash said. “I’m available for any questions they may have. I’ve had patients call me with lingering questions from their physician visits and questions about their options. At my first meeting with patients, we talk about what’s stressing them and what they’re worried about. Sometimes it’s housing and bills, and other times it’s the cancer itself and their anxieties or worries. We help get them resources and provide support for them so that, hopefully, those problems are minimized or in some cases resolved,” she explained.

Lash has helped navigate 40 breast cancer patients – men and women – since the program’s full launch in October. One of those patients is Nancy Scott, who coincidentally enough found out she had breast cancer after a routine mammogram that same month.


“It’s a shock to get that diagnosis,” Scott said. “I was really happy to meet Denia. She’s answered questions, gone over my reading materials and just explained everything to me. People tell you things and it goes in your ear, but when you get home, you can’t remember what you heard. It’s nice to have someone who can tell you again in more simplified terms. I really think it’s a wonderful thing,” she added.

Though Scott now is well on the road to beating breast cancer, her time with Lash isn’t over. At some point, the two will meet to go over Scott’s survivorship care plan.

“Once patients are finished with all of their treatment, surgery, chemotherapy and radiation, they meet with me for about an hour or so,” Lash said. “I give them their care plan, which is almost like a medical record. It includes their diagnosis, their pathology report, the surgery that they’ve had, the chemotherapy they had, the radiation they had and the dates of everything that they’ve gone through. It also includes information about what they have to do going forward, such as how often they need to follow up with their surgeon, medical oncologist and radiation oncologist for the rest of their lives. It’s already very overwhelming, and now they have at least three specialists that they’ll have to see essentially forever. With the survivorship care plan, they have a whole packet of information to help guide them. If a patient moves to California, they have everything they’ll need to continue their appointments with their new doctors there,” Lash explained. “The name fits – the survivorship care plan helps you survive not only the treatments, but life after the treatments,” she added.

“The nurse navigator program absolutely is good for patients,” Petty said. “It helps them get through the program and their treatment, and helps them know about the resources that are available. A breast cancer diagnosis is very difficult for someone to take it all at once. It’s a very stressful time and a very stressful situation to have to deal with. As soon as they get that diagnosis, a lot of patients are looking for as much information as possible. The nurse navigator can be a big help with that. It’s not to take the place of the patient’s doctor or the nurses in the doctors’ offices. It’s to help the patient get what they need for their best care,” he added.

For her part, Lash says she’s happy to be helping people navigate what can be one of the most challenging times of their lives. “I’ve seen the whole scope,” she said. “I’ve had patients say ‘It is what it is. I’ll take it one day at a time.’ I’ve had other people who literally have burst into tears and were just devastated. So far, the response has been great. I’ve had patients tell me that just knowing someone was there and that they had a name and a phone number to call, gave them peace of mind. They did not feel that they were all alone,” Lash said.

Blount Memorial has begun the process of setting up a navigator program for prostate cancer patients, as well, with hopes of expanding it to help many other cancer patients in the future.

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