Christine Hamilton (left), who was diagnosed with breast cancer earlier this year, underwent treatment at Hulston Cancer Center and had regular meetings with Laura Bowles, CoxHealth’s breast care navigator. Bowles helped guide her through the process, offering information and support. “I knew I could call Laura and ask questions, and that she would have the answer,” Hamilton says. The patients spoke, the time was right, and now breast cancer patients at CoxHealth have a new ally in their fight against the disease with the Breast Cancer Navigator program, which began at Hulston Cancer Center this summer.
There has been a movement in cancer care during the last decade to establish navigators for different patient populations. According to June Johnson, administrative director of Hulston Cancer Center, CoxHealth first tried this approach by developing the lung cancer patient coordinator position a few years ago.
“The doctors loved it and the patients loved it, and we knew we had a good thing,” she says. The coordinator, or navigator, is responsible for steering lung cancer patients through the process, from testing and diagnosis through doctor and surgeon visits, treatment and beyond.
The idea to expand that coordinator program to other patient populations came from the first Hulston Cancer Center Survivors Advisory Council. This group of patients gathered to talk about their cancer treatment and to rank what they felt was most important to their care.
“There were things on that list that we knew were important. The best technology; the best doctors; caring, knowledgeable staff – those are givens,” says Johnson. “But the lung cancer patients were amazed to find out that other patients didn’t have a navigator, and we discovered that was by far the most important thing to all our patients – to have someone to guide you, to show you the way, to explain things.”
Johnson says they learned that physicians felt patient navigators were extremely important as well. “We had a situation where all of our patients were telling us ‘This is what we want, this is what we need.’ And we had our caregivers saying ‘This is it. This is the thing,’” she says. “But everything we learned from those groups wouldn’t have made a difference in getting this program off the ground if we hadn’t had the moon, stars and planets align and had the perfect person available at just the right time.”
Hulston Cancer Center is in the process of seeking a Center of Excellence designation through the American College of Surgeons for the breast cancer program. A key part of achieving that designation is having a breast cancer-specific navigator program in place.
“We have the largest mammography facility in the state, and we’ve been a center of excellence in the mind of the community and the medical community forever,” Johnson says. But the lack of a navigator program was seen as a missing piece in Hulston’s services.
Says Johnson: “I’ve seen women come out of the elevator in a daze – they didn’t know they were going to be diagnosed with cancer. Between their diagnosis and their appointment with a surgeon, there’s a gap where it may feel like there’s no one to turn to.”
Because of an organizational change at the CoxHealth Center for Advanced Pain Management this past summer, Laura Bowles, a long-time CoxHealth employee who served as full-time director for that program, experienced a change in her job description. She still oversees the pain center, but on a part-time basis. When the change occurred, Johnson, who is her supervisor, saw an opportunity to meet a patient need. She officially transitioned Bowles into the breast care navigator role after getting the position approved by the position review committee.
“The most important thing we needed was someone with the right personality. Someone who could be a servant to our patients. We needed someone with system-savvy, who knew who to call to get the answers that were needed. Those two things are what made Laura the perfect person for this position,” says Johnson.
For her part, Bowles says she feels like she’s really filling a need not just for Cox and Hulston, but most importantly for the patients. “This is the best job I’ve ever had,” she says. “It is so rewarding.”
Bowles’ goal is to contact every patient diagnosed with breast cancer at Hulston – it is one of the cancer center’s top diagnoses, with more than 300 cases found each year.
“When they are diagnosed, the Breast Care Clinic gives the patient my card. I try to give them 24 hours to absorb the news before I make my phone call. Then I introduce myself and say ‘I understand you’re getting ready to fight a battle. We’re going to do it together,’” she says.
Bowles now spends her days making those introductory calls and sending personalized notes to each patient she speaks with – but most importantly, she serves as a resource and a friend for those patients who need her – patients such as Christine Hamilton.
Hamilton was diagnosed with stage 1 cancer earlier this year, and says the help and support she received from Bowles was invaluable. “She attended some appointments with me, and offered a lot of ideas and suggestions that were incredibly helpful,” Hamilton says.
While Hamilton has a great support system of friends and family, she says she was thankful to have Laura as a resource.
“I knew I could call Laura and ask questions, and that she would have the answer, or know who to call to get it,” she says.
“There are some patients who say ‘no problem, I’ve got this,’” Bowles says. “And there are others who call me morning, noon and night. I can offer an educated opinion without being too emotionally attached, and I can be wherever they need me to be.” Bowles has gone to physician appointments and chemo and radiation treatments with her patients. Some patients have no support system to speak of, and they need a lot of love, care and support. As breast cancer navigator, Bowles is there to provide it.
Says Johnson: “Navigators are our people who carry a big satin pillow around, and our patients can just hop on and ride with them when they need to. They need that care and understanding. Yes, patients need to be accountable and make decisions about their care. Tomorrow, when they aren’t throwing up and shaving their heads, they can be big girls and make these decisions again. But today, they just need that big, pink, satin pillow. And now Laura’s work provides just that kind of support.”
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