Helpful Definitions

Navigation
The heart of navigation is personalized care. Everyone involved in the patient’s care has some role within the navigation process, whether it is a lay person who is arranging for an oncology appointment or sharing resources, a nurse proactively providing one-on-one education and facilitating communication with the interdisciplinary team, or a social worker facilitating the provision of financial support. It involves personalized assistance and support offered to patients, families, and caregivers to help overcome healthcare system barriers (eg, fragmented care) or personal barriers (eg, cultural, financial, educational, spiritual, psychosocial) and facilitate timely access to quality health and psychosocial care from prediagnosis through all phases of the cancer experience.

  • Navigation is a process whereby a patient is given individualized support across the continuum of care, beginning with community outreach to raise awareness and perform cancer screening, through the diagnosis and treatment process, and on to short- and long-term survivorship or end of life. Although a primary focus of navigation is the identification and elimination of barriers that delay early diagnosis and completion of treatment in keeping with National Comprehensive Cancer Network guidelines and other national accreditation requirements, it also incorporates education and psychosocial support for the patient and their caregivers.
  • A navigator is a medical professional whose clinical expertise and training guides patients and their caregivers to make informed decisions, collaborating with a multidisciplinary team to allow for timely cancer screening, diagnosis, treatment, and increased supportive care across the cancer continuum. A navigator can also be a layperson who fulfills specific administrative tasks to expedite scheduling or access to resources, and carries out other functions appropriate for a nonmedical person to perform.

Identification of the patient’s life goals is incorporated into the navigation and treatment planning process to ensure that treatment is received with measures taken to preserve his/her life goals whenever possible.

 

Survivorship
Survivorship is the process of living with, through, or beyond cancer. By this definition, cancer survivorship begins at the moment of diagnosis. It includes people who continue to receive treatment to either reduce the risk of recurrence or to manage the cancer as a chronic disease.

  • Acute survivorship describes the time when a person is being diagnosed and/or in treatment for cancer with surgery, chemotherapy, radiation therapy, and/or other short-term adjuvant therapy.
  • Short-term survivorship describes the transition period after acute treatment is completed, and although there is no precise time frame, this usually lasts for weeks to months. Patients in this time period may receive chronic or maintenance treatments.
  • Long-term survivorship describes the period that begins following short-term survivorship and lasts for the rest of the patient’s life.

Navigation plays an integral role in survivorship care by helping to ensure that the survivor’s ongoing health needs are met, including screening for recurrence and secondary cancers, managing late and long-term effects of treatment, lifestyle changes to reduce cancer risk, and managing comorbidities.

Cancer diagnosis and treatment is a life-altering experience. Navigators are in a key position to help newly diagnosed patients with cancer understand the importance of self-advocacy and help empower them to participate as a member of the care team, ensuring that the care they receive meets their needs and preferences. Taking such an approach encompasses maintenance and establishment of life goals, applying survivorship care at the moment of diagnosis, and striving to diminish the negative impact cancer care has on an individual physically and emotionally.

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