Cancer care requires startling changes in understanding the place of the patient as a partner in care. Currently, there is a trance from the physician to the patient and his/her family, a steady expectation that the patient has little to do other than follow instructions. Patients seeking to exercise their voices to seek answers to questions, often very hard questions, are too often met with a doubling down of the trance. Patients are paralyzed as much by the physician’s behavior as they are by the fears about the cancer. What can happen if the trance is broken is amazing for both the patient and the doctor, and maybe for the ways in which the patient’s lives their lives with a disease and its uncertainties. We can find new ways to educate for compassion that will replace the trance; we can practice empowerment with the patients and encourage a vulnerable but authentic discussion of alternatives.
In Cincinnati for the past two years the Peace Village Cancer Project has worked with agencies that serve the poor and minorities to create a Cancer Justice Network. Our belief is that a new kind of relationship is essential in cancer care. Using a navigator, a person educated to be resourceful and compassionate, the patient can have an ally to face the obstacles in both their personal life and the difficulties in working with the health care system. Most importantly, it may be the critical factor in saving lives. Our navigator program is focused on bringing patients to early screening for cancer and then, if necessary, rapid treatments. Helping people to understand the basics of cancer, the warning signs, and the necessary steps to screening, requires a caring communication, a trusted relationship, and action that releases the patient from the trance of low expectations for survival. Based on a pioneering program created by Harold Freeman, MD, a former president of the American Cancer Society, a surgeon, and an African American, in New York City, we expect navigators to be placed or hosted by community agencies where cancer education has been limited and where cancer mortality is greatest. The navigator, along with a physician, will respond to questions about cancer while the navigator will be available to help a person overcome any obstacles to getting screened. In the Fall we plan on having cancer education at Churches Active in Northside, Christ Church Cathedral, Madisonville Education and Assistance Center, Southern Baptist Church, the FreeStore Food Bank, St. Vincent de Paul, St. Francis Seraph, Center for Independent Living, Santa Maria Center, Peaslee Center, and Caracole.
Breaking the trance opens new possibilities for the patient: they are now partners in being educated and in taking action to have their cancer, if they have cancer, reviewed and acted upon. The navigator stays with the person as long as they would like them to be a part of the treatment process. The navigator emphasizes following a “road map” to success through screening and treatment. The navigator is an educator, a guide through barriers, an ally, and even a friend. The navigator-person team is the new cancer health education model for prevention and treatment. Over time we expect that once the trance is broken throughout the city, the person with cancer, irrespective of their zip code, regardless of their color or economic ability, will be a survivor that can educate the community to a new kind of partnership.
(You can reach Steve via email Steve.c.sunderland@icloud.com)
