Nurse Navigators Light the Way to Clinical Trials

September 18, 2020

When confronting cancer, it can be overwhelming to consider treatment options and discover clinical trial

When confronting cancer, it can be overwhelming to consider treatment options and discover clinical trial opportunities. That’s where a KU Cancer Center nurse navigator can help. As trained oncology nurses, they help guide patients and their families through their cancer journeys. Nurse navigators are often at the heart of a multidisciplinary team caring for someone with cancer.

Teri Banman, RN, is director of The University of Kansas Cancer Center’s nurse navigator program, one of the most extensive such programs in the U.S., with 30 disease-specific nurse navigators and 19 intake coordinators.

Clinical trials, including those that take place at the Johnson County Education Research Triangle (JCERT)-funded KU Clinical Research Center, are critical in new treatments and therapies. We chatted with Banman to learn how nurse navigators play a role in clinical research.

How do nurse navigators help patients?

Our navigators are nurse experts in specific cancer groups. For example, if someone has breast cancer and is referred to us,  regardless of treatment location, we’ll partner the patient with  a breast cancer nurse navigator. That nurse will help the patient connect with the right provider, whether that is a surgeon, medical oncologist, radiation oncologist or all of  these professionals.

We help make sure all the appropriate tests are done to diagnose or stage the cancer. We also work with patients to address any barriers they may be facing in their cancer treatment, such as transportation, lodging or financial concerns. Nurse navigators also ensure patients are taking advantage of support services like nutrition, social work, onco-psychology or genetic counseling.

Finally, our nurse navigators manage tumor conferences – meetings of the interdisciplinary team to discuss specific patients. The navigator prepares all patient information in advance so the team can have a productive discussion. Navigators also document discussion outcomes and recommendations and then make sure those are carried out so the patient can start treatment as soon as possible.

What is a nurse navigator’s role in a clinical trial?

We partner with our clinical research team in several ways. We put together a clinical picture of how the patient presented, produce a timeline of when the patient was diagnosed and identify if they’re coming to us for a second opinion or disease progression. We make sure we have all treatment records. That information is sent to the clinical trial coordinators for each specific disease area. The trial coordinators prescreen patients, align them with appropriate clinical trial options and inform the physician. Everyone is in the loop on the patient’s treatment plan.

Our goal is to improve timeliness to care, and our navigators help make that happen. With our multidisciplinary team approach, when patients come for their first physician visit, they can leave with a care plan – including any clinical trial options – that day.

Nurse navigators also help patients living outside of the region who are interested in clinical trials. I’ll never forget a young woman who was going to lose her arm because of sarcoma. Her physicians told her they had no choice but to amputate. She was calling every NCI-designated cancer center to see if there was a clinical trial that would allow her to keep her arm. I immediately put her in touch with our clinical trials coordinator and an oncologist. While we didn’t have a trial for her, she had the peace of mind that she was doing everything she could in such a short time.

What are some of the misconceptions you’ve heard about clinical trials?

First, many people assume some participants receive a placebo in a cancer clinical trial and that’s not the case. In a randomized study, where participants are assigned to the experimental group or control group, those in the control group may not receive the new medicine, but they will get the best standard of care available. Placebos are never used in place of standard of care.

Some people wonder if they’re allowed to drop out of their clinical trials. Of course, they can! Sometimes there are concerns about the cost of treatment, and in those cases, our nurse navigators explain that costs are often covered by the company sponsoring the trial.

Finally, there’s the myth that clinical trial participants are treated like guinea pigs. We never treat our patients like test subjects. I addressed this concern with my own father-in-law, who was diagnosed with a very rare cancer and had run out of treatment options. When we broached the subject of clinical trials, he said he didn’t want to be a part of any “experiments.” We sat down with him and discussed his clinical trial perceptions versus the facts. For some cancers, we are still learning the best way to cure or treat them.

What does it mean to have a National Cancer Institute-designated cancer center in our region?

First, I am very proud to be a part of this organization. Being an NCI-designated cancer center means we have opportunities to provide novel therapies that aren’t available elsewhere. In terms of physicians, nurses, specialists and staff, we have the best of the best. Physicians across the country want to work at the KU Cancer Center because of our NCI designation. Without this designation, we wouldn’t have such a robust, multidisciplinary team.

This research designation enables us to get more funding to develop clinical trials and help cure cancer. Patients have better outcomes when they come here.

Learn more about The University of Kansas Cancer Center’s Nurse Navigator program.

opportunities. That’s where a KU Cancer Center nurse navigator can help.