Background: Breast cancer is the number one cancer diagnosis in Nigerian women; 100,000 new cases are diagnosed annually. Most are at advanced stages due to factors including a minimal number of diagnostic centers and fear of diagnosis. Death, loss of a breast, and no hope are common first thoughts reported by newly diagnosed breast cancer patients. Patient navigation was an unfamiliar concept for most patients and many healthcare professionals before 2016 and was not supported by the leaders in the Nigerian community. Project Pink Blue is a nonprofit cancer organization in Nigeria that is engaged in raising cancer awareness, patient navigation, advocacy, and free breast and cervical screening for women living in poverty.
Purpose: In 2016, Project Pink Blue launched Nigeria’s first patient navigation program and a toll-free telephone center with the mission of educating the people of Nigeria about breast cancer awareness and detection. The organization hosted The Breast Cancer Navigation & Palliative Program to train nurses, cancer survivors, nonclinical social workers, and retired midwives across Nigeria on how to navigate breast cancer patients. The Union for International Cancer Control requested a breast cancer nurse navigator from the United States to assist with the 2-week launching of this patient navigation training program.
Interventions: During the first week of the navigator’s visit to Abuja, Nigeria’s capital, the US-based nurse navigator and the Project Pink Blue team had meetings and introductions with hospital, community, government, and spiritual leaders to educate them regarding the positive impact of patient navigation in their communities, and to advocate for support. During the second week, 4 days of intensive training was provided to 40 new patient navigators. Courses were taught by the nurse navigator and a diverse multidisciplinary team and included topics on patient navigation, psychology of cancer, and palliative care in advanced breast cancer.
Results: Upon completion of the first training program, 44 patient navigators for 6 area councils of Abuja, FCT, and Enugu and Kebbi states graduated and have been able to navigate over 1153 patients. The training has helped the healthcare workers to build a better rapport and connection with breast cancer patients in their facilities. Through the patient navigation program, a breast cancer support group has been established for the first time in Abuja to connect cancer patients. The program has connected 116 breast health facilities, 58 in Abuja and 58 across Nigeria (diagnostic centers and hospitals), through web-based navigation map application.
The trained patient navigators are currently establishing patient navigation programs in other cities in Nigeria.
Conclusion: The need for patient navigation is universal. Patients are often lost and confused and feel helpless once they are told that they have cancer, no matter what country they live in. The fears, worries, barriers to care, lack of finances, and lack of support are not confined to any borders or countries. The role of the patient navigator is not supported equally across the borders. It takes a team effort to train and support people who can guide and educate, provide emotional support, coordinate appointments, and decrease barriers for cancer patients. This collaboration can transcend borders and is instrumental in a successful patient navigation program.
SourcesInternational Agency for Research on Cancer. Ferlay J, Soerjomataram I, Ervik M, et al, eds. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. http://publications.iarc.fr/Databases/Iarc-Cancerbases/GLOBOCAN-2012-Estimated-Cancer-Incidence-Mortality-And-Prevalence-Worldwide-In-2012-V1.0-2012.
World Health Organization. Breast cancer: prevention and control. www.who.int/cancer/detection/breastcancer/en.