Navigating Through Cancer Treatment

911

By Gretchen C. Van Benthuysen

“You’ve got cancer.”
Three little words that will rock your world as you sit in a doctor’s office getting your test results.
It happened to Marla Laken of Allenhurst when she learned she had breast cancer in 2012.
“I was totally blown away,” Laken said. “I was in shock.”
At the time she considered herself the healthiest she had been in ages. Nine months earlier she was diagnosed with a stomach ulcer and had adjusted her diet and lifestyle to deal with it.
“I was active, I coached gymnastics. I didn’t smoke. I was a social drinker.”
Making things worse, the divorced mom with two sons (now age 14 and 18), has no health insurance.
Her doctor kept talking but Laken didn’t hear a thing as her mind started spinning. She didn’t know where to turn. She didn’t have a primary care physician who could guide her.
She started making phone calls. One receptionist laughed when she heard Laken had no insurance. She called Mary’s Place by the Sea in Ocean Grove, a respite home for women who are receiving cancer treatment, and they told her to call Debra E. Camal, M.D., medical director for breast oncology at Riverview Medical Center in Red Bank and Bayshore Community Hospital in Holmdel. Her offices are in Tinton Falls.
She made an appointment with Camal. But what Laken didn’t know until she arrived at Riverview was she also would meet with Corinne DeSevo, one of the hospital’s four nurse navigators in the oncology department who guide cancer patients through their care from Day One and stay in touch, sometimes for years after recovery. Think job coach.
“It’s a new approach,” said DeSevo, an oncology nurse for 20 years before becoming a breast cancer navigator three years ago. “There are not many (hospitals) that do it.
“Patients are overwhelmed with information that they are trying to make sense of and understand,” she explained. “The navigator explains what the different tests are and what’s needed and does so in a way (the patient) can understand.
“They facilitate the appointments, they find the needed support,” she added. “They are the glue that holds everything together.”
Patients meet surgeons, medical oncologists, radiation oncologists, plastic surgeons, maybe a genetic counselor if there is a family history of cancer. Social workers may get involved to help the patient and family deal with the situation, as well charity care representatives if money is an issue.
But before that happens, the navigator helps coordinate a meeting attended by all of the patient’s doctors-to-be and support staff to discuss the treatment plan. The patient is encouraged to bring family or friends for support and DeSevo helps interpret anything confusing.
As part of this holistic approach to medical care, the oncology surgeons and support personnel also meet weekly to discuss current cases. While some cases are routine, others are difficult and the meeting enables the staff to brainstorm best treatment practices. Cutting edge treatments, new research, recent studies are shared.
“It’s very helpful when all the minds get together and come up with a plan, especially for the difficult cases,” DeSevo said.
After surgery and chemotherapy, palliative care kicks in with all new faces. A multidisciplinary approach for people with serious illnesses, the focus is on providing patients with relief from the symptoms, physical and mental stress resulting from a serious illness. Nutritionists and physical therapists may join the team.
“You will have a team to manage symptoms like pain, nausea, and other treatable side effects,” explained DeSevo who, again, makes all the arrangements.
The free service is not a moneymaker for Riverview, DeSevo said, but it helps patients follow through so they receive the best service and get the best results.
“The illness takes over (a patient’s) life for a year or more,” DeSevo said. “Not everybody uses it but those who do, say they never could have done it without the help.”
That’s how Marla Laken feels about her experience with DeSevo.
“From the very beginning she took charge. She coordinated all my care; all my doctor appointments,” Laken said. “When I went to Riverview for my biopsy, Corinne met me at the door and came with me. She always explained what was going on, what was happening, and was very comforting.”
When Laken’s boyfriend broke up with her two weeks after her double mastectomy, it was DeSevo’s shoulder she cried on. When Laken’s hair started falling out, DeSevo attended the gal-pal party held at her hairdresser’s shop.
It will be two years this May Laken ended her chemotherapy treatment. She is on maintenance medications and returns to the hospital every six months for checkups and she always stops by to say hello and ask about her sons. Laken is back at work coaching at ACE Gymnastics in Ocean Township and has moved to a small carriage house apartment in Allenhurst. Her two sons have moved in with their father several blocks away. She doesn’t like being separated from them, but said it is temporary while she continues to get back on her feet.
“It’s the same thing I kept telling myself as I was fighting this, especially during the eight- and nine-hour chemo sessions: ‘It’s temporary.’”