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April 2009 Issue

Gevetta Cunningham was a single mother to four children, including Jamar (pictured), when she found out she had stage 2 breast cancer. Since then, she has taken full advantage of UC’s breast health navigator program.
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'Navigator Program' Helps Breast Cancer Patients Manage Difficult, Confusing Treatment Process

By Amanda Harper
Published April 2009

For patients dealing with a serious illness, often what makes the most impact is having someone there to help you navigate the change and adapt—a personal coach, of sorts, to keep you focused on the goal.

Breast cancer survivor Gevetta Cunningham, 45, of North College Hill, found her “coach” in Gail Johnson, an advance practice nurse at the UC Barrett Cancer Institute at University Hospital’s breast health navigator program.

Cunningham was diagnosed with breast cancer on May 23, 2008, after a routine screening mammogram and biopsy confirmed stage 2 breast cancer.

“When I found out I had breast cancer, I nearly lost my mind. I felt hurt and betrayed,” Cunningham recalls.

“Gail helped me in ways I never thought a person in a hospital could. I commend that lady. She was always there for me to talk to and she kept everything straightforward with me. She didn’t treat me just like another patient—she treated me like a friend.”

Established in April 2008, the breast health navigator program is intended to connect patients with the resources they need to complete standard of care treatment and recover both physically and mentally.

All new patient referrals are funneled through Johnson and the breast health navigator program. This allows her to speak to every patient before they begin treatment to explain what to expect, answer treatment questions and provide information about general breast health.

“Our primary goal is to ensure that at-risk patients don’t fall through the cracks and fail to receive standard of care treatment,” explains Elizabeth Shaughnessy, MD, PhD, a surgical oncologist and breast surgeon with UC Physicians and University Hospital.

“People don’t retain a lot of information around the time of diagnosis, so the breast navigator is there to guide the patient through the process.”

For Cunningham, that included facilitating meetings with a social worker and a breast cancer survivor, among other things.

“Establishing at the very beginning of treatment that the patient has a go-to person to answer questions really seems to allay a lot of fear,” adds Johnson, who has more than 33 years of experience in oncology nursing.

“It also gives a little more reassurance to the referring provider that there is someone on the other end that is making sure follow-up happens.”

Almost a year away from her mastectomy, Cunningham says dealing with cancer has made her stronger. “When I came to treatment, I was so angry with the world—both with the cancer and my personal life—and Gail helped me focus on what was important, which was getting my treatment and getting better.

“I trusted her implicitly, and I wasn’t afraid to ask her questions,” says Cunningham. Those questions ranged from things like side effects of treatment and whether she would lose her hair to fears about intimacy, selfimage and recurrence after treatment was over.

A single mother of four, Cunningham had the challenge of reassuring her family and herself that everything would be OK. She lost weight and hair, but says dealing with the diagnosis mentally was the most challenging.

“Anything I needed, Gail would refer me to a person who could answer my questions. It took a lot of stress off of me,” adds Cunningham.

The breast navigator concept is not new, but its importance has become more recognized in recent years.

The first navigators were social workers who targeted a specific patient population with a certain set of risk factors and made sure patients got from point A to point B in their treatment plan in a timely manner.

Johnson says it’s not necessarily race, education or socioeconomic factors that determine need. “People who seem to need me the most are people with high anxiety levels associated with having breast cancer—that trumps everything. A close second is the type of support system patients bring with them to the situation,” says Johnson.

She follows some patients more closely than others, but she is always there monitoring the patient’s progress to ensure treatment is completed.

“Many patients are not aware they need assistance initially, but I still try to get a feel for people to see how much support they want and be there when I’m needed,” she adds.

For more information on the breast health navigator program, call Johnson at (513) 584-0447.

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