A guide for the journey

JOLIET – You have cancer.

Those emotionally charged words – and the ominous thoughts that may follow – often result in the patient remembering little else from the conversation.

Then come the major decisions patients have to make about the course of their treatment – if they even want treatment – and sudden, often drastic, changes in their daily lifestyles of work, child-rearing and finances.

That’s why Presence Cancer Care in Joliet recently began a breast cancer nurse navigator program. A nurse navigator is assigned to newly diagnosed breast cancer patients to help them and their families through the treatment – and often post-treatment – process.

“We help get them through the system, keep them informed and keep them on track,” said Jennifer Yanak, Presence Cancer Care nurse navigator. “One big part of what we do is assess patients for barriers to care.”

Yanak said services to patients include discussing possible hair loss during chemotherapy, sorting through financial matters relating to their illness, ensuring tests get scheduled and finding resources for breast prostheses.

“It’s about helping patients get through being diagnosed and then getting them through everything else,” Yanak said, “because they’re so overwhelmed.”

Previously, chemotherapy nurses, other hospital staff or the patient’s primary physician and nurse might provide that assistance, but Yanak said having a nurse navigator whose specialty is breast cancer and who is on-site is a big advantage to the patients.

Yanak said her first interaction with the breast cancer patients is at their first appointment with the medical oncologist. From there, Yanak said she is available for questions and support.

She checks in during chemotherapy and radiation therapy, makes periodic phone calls, talks to families about what to expect and how help, and acts as a bridge between the patient and physician or lab.

“Sometimes [patients] just need someone to hold their hand and get them through it,” Yanak said.

In August, Shirley Koscik of Channahon learned in she had Stage 2 breast cancer that had spread to her lymph nodes. Koscik would require four weeks of chemotherapy (with three weeks of breaks in between each treatment) and six weeks of radiation therapy.

“When you find out you have cancer,” Koscik said, “your world stops.”

In September, Koscik began chemotherapy at Presence Care Center, and Yanak – whom Koscik called “the girl to go to with answers” – was there to help her.

“Sometimes, you don’t want to bother the doctor,” Yanak said, “but you know something’s going on with your body.”

From the beginning, Yanak let Koscik know she would have side effects, but that Yanak would also help her through each negative reaction. During one chemo cycle, Koscik said she became dizzy and felt strange. She called Yanak, who discovered Koscik was dehydrated and needed IV fluids to recover.

“I’ve had a particularly rough time. I’ve had just about everything happen to you that can happen,” Koscik said. “She’s somebody to talk to who knows what she’s doing.”

Other oncology fields also have nurse navigators. Yanak said most hospitals have navigators for inpatients who begin working with them at diagnosis.

According to the Oncology Nursing Society at www.ons.org, the first breast cancer patient navigation program in the nation was begun in 1990, aiming to expand cancer screening and follow-up with medically underserved women.

Research, the ONS also said, clearly shows improved patient outcomes with an oncology nurse navigator involved. Five-year cancer survival rates can be improved with better screening and help through insurance issues, fear and distrust of the medical community and cultural and communication barriers.

In 2012, the American College of Surgeons released standards requiring that new cancer programs establish a navigator position.

Yanak said a nurse navigator can clinically assess patients, as well as manage complex treatment and lab test schedules. She reviews charts to be sure tests are ordered and completed on time.

Furthermore, Yanak said nurse navigators also can get quick physician answers or directions when a patient calls, as she is in the same clinic as the physicians.

Koscik said she is on schedule to have her last chemotherapy treatment in January, after which she will begin radiation therapy.

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KNOW MORE

Presence Care Center Nurse Navigator Jennifer Yanak sees patients at the office at 2614 Jefferson St., Joliet, and Skypes with patients at the office at 1600 W. Route 6, Morris. For information, call 815-725-9861(Joliet) or 815-942-2791(Morris). See also www.presencehealth.org/services/cancer-care?r=206 and www.jolietoncology.com.