Navigating a brand-new cancer diagnosis

Members of the Fred Hutch Nurse Navigation team gathered on top of the Arnold Building to celebrate the recently expanded program. Photo courtesy of Kasey Hnateyko

A cancer diagnosis isn’t just scary. It can also be incredibly confusing.

Not only do new cancer patients need blood tests and biopsies, they may also need scans and other imaging tests to stage the cancer and/or genetic or genomic tests (along with interpretation of the results) to determine the best types of care.

Whether it’s a blood cancer like leukemia or a solid tumor like breast, lung or ovarian cancer, this can mean a raft of appointments at Fred Hutch Cancer Center – South Lake Union Clinic or other clinic locations. And juggling all that while wrapping your brain around the fact that your body has seemingly betrayed you can be, well, overwhelming.

Now, thanks to a recent expansion of the Fred Hutch Nurse Navigation Program, newly referred cancer patients have more help than ever getting to the appropriate provider.

“When patients are first diagnosed, they now talk to a nurse navigator upon referral to Fred Hutch,” said Janelle Wagner, RN, senior director of the program. “The nurse will go over the diagnosis in full detail and provide education. They’ll also talk about probable next steps and help coordinate the diagnostic procedures, place orders and connect the patient with the scheduling team.”

Photo of Janelle Wagner, senior director of the Nurse Navigation Program

‘We have navigation at five different locations. And you don't need to be referred to nurse navigation. Everybody gets it. If you are referred to Fred Hutch by a provider, or if you call on behalf of yourself, a nurse navigator will be your first point of contact.’

— Janelle Wagner, RN, senior director, Fred Hutch Nurse Navigation Program

A free service for patients

Nurse navigators help to streamline the process, Wagner said, making sure patients receive all the necessary testing and connect with all the proper clinicians. It’s a concept the organization first used at Fred Hutch at UW Medical Center – Northwest more than five years ago.

“We started with nurse navigation for breast cancer patients in 2017,” Wagner said. “We had two people — myself and another navigator — and we’ve grown the program from that.”

By the end of 2025, Wagner said the Fred Hutch program will have 50 nurse navigation team members throughout the entire Fred Hutch system.

And the service is free to all Fred Hutch patients, no matter where they’re treated.

“We have navigation at five different locations — Fred Hutch at Overlake Cancer Center; the Peninsula Clinic in Poulsbo; UW Medical Center — Montlake; Fred Hutch at UW Medical Center — Northwest and at South Lake Union,” Wagner said. “And you don't need to be referred to nurse navigation. Everybody gets it. If you are referred to Fred Hutch by a provider, or if you call on behalf of yourself, a nurse navigator will be your first point of contact.”

And that same nurse navigator will be the patients’ point of contact until they’ve had first visit with their cancer provider.

“The navigator is their person until they arrive at a clinic,” Wagner said. “Whether they are getting surgery at UW Medicine at Montlake or getting chemotherapy at our Northwest campus or elsewhere, they have the same navigator. They will coordinate all of it. The patient can communicate with the nurse via My Chart, phone or e-mail.”

This streamlined approach ensures patients not only receive faster access to life-saving care but also that they’re given the guidance and support they need every step of the way, making their entry into the cancer care system a little less overwhelming.

Faster appointments, help with resources

Navigators will also conduct psychosocial screening, asking about family history and identifying barriers to care such as transportation issues, socioeconomic concerns, language barriers, etc. Patients dealing with any of these hurdles will then be connected to another vital Fred Hutch service, patient navigation.

“Patient navigators focus on the psychosocial needs of the patient,” Wagner said. “Whether that’s housing insecurity, food insecurities, transportation, financial toxicities, just to list a few. They’re really good at finding and providing internal or community resources.”

Nurse navigators can also connect patients to registered dieticians, genetic testing and clinical trials.

But the main goal of the program, Wagner said, is to “get patients to their first line of treatment faster.”

Toward that end, the program has cut wait times down significantly.

According to Wagner, Fred Hutch strives to have a patient receive a call from their nurse navigator within one day of referral, and then speak with a scheduler that same day or the next to receive their schedule.

“In many of our disease groups, the average turnaround time for a referral is now one day,” Wagner said. “The patient now gets a call from a nurse the day they’re referred and are sent to a scheduler. Within two days, they’re given an appointment. They may not be seen within two days, but they're given a schedule.”

Wagner said the care provided by navigators has proven to be such a success, there are currently discussions about expanding it in the next fiscal year.

“Patients are constantly calling the nurses back saying thank you so much for this program,” she said. “We’re getting really positive feedback from both patients and family members.”

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