Promoting and enhancing survivorship are cornerstones of our mission as navigators. From community outreach efforts to improving quality of life, from managing efficiency throughout the cancer care continuum to implementing strategies to extend life, navigation efforts are primarily intended to improve the patient experience across the continuum of care.
Participating in a national conversation on improving cancer care is a great honor. We are being asked to reconsider how we address cancer from prevention through survivorship. It’s a huge undertaking, but a very exciting one. I’m delighted to be a part of it.” - Danelle Johnston, MSN, RN, ONN-CG, OCN
Although the field of immunotherapy continues to evolve and has led to unprecedented survival in many patients, the effects of these treatments on quality of life are still largely understudied, according to Morganna Freeman, DO, from City of Hope Comprehensive Cancer Center in Duarte, CA.
The role of the oncology nurse navigator in women's health is "education, education, and more education," according to Kristina Rua, BSN, RN, Gynecology Oncology Nurse Navigator at Baptist Health South Florida in Miami.
Patient navigators are increasingly recognized for their critical role in helping patients make their way through complex healthcare systems, all the way from screening to treatment adherence. Clinical trials are a vital part of high-quality cancer care, and navigators have become invaluable in facilitating patient awareness and access to trials, while also normalizing the clinical trial process and dispelling myths.
The nurse navigator, the oncology social worker, the financial navigator, and the lay navigator all provide critical guidance to patients throughout the cancer continuum, but effective communication between departments, well-defined pathways, and role delineation are crucial to prevent the duplication of services and wasted time.
Clearly, immunotherapy has come of age in multiple tumor types, as described in the main article in this publication. The question now is how to develop more personalized immunotherapy and use biomarkers to identify patients most likely to benefit from this therapy.
In the main article of this publication, the current state of programmed-cell death-1 and programmed-cell death ligand-1 (PD-L1) testing, evasion by tumors of the immune system, and the study and use of immune checkpoint inhibitors across multiple tumor types are expertly summarized.
PD-L1 expression is a rational biomarker to predict response to PD-1/PD-L1 ICI therapy, and has been studied extensively in clinical trials. A recurring theme emerging from available clinical data is that high levels of tumor cell membrane PD-L1 expression correlate with better outcomes with PD-1/PD-L1 blockade.