When a woman finds out she has breast cancer, in many cases she needs someone to “hold her hand” through this unanticipated and frightening journey into the unknown. Women face a confusing maze of questions and often become overwhelmed very quickly. As physicians, we do our best to provide as much support and information as possible, but often we rely on a breast cancer navigator to fill in the gap for us to make sure patients have the resources they need throughout their entire cancer journey. A breast cancer navigator literally helps patients navigate the seemingly endless barrage of medical appointments, tests and treatments. They provide an invaluable service for breast cancer patients.
Breast care navigators guide patients through their entire journey – from diagnosis, surgery and treatment, to life after treatment. They educate, advocate, provide resources and support, help with financial and insurance-related problems, resolve issues and remove obstacles patients face along the way – from understanding their diagnosis, to telling family members about their illness, answering questions about insurance coverage, or finding the right post op bra.
During The Breast of Everything podcast, Marsha Schmit, RN, breast care navigator at Hurley Medical Center in Flint, Michigan, talks in depth about the role of a breast care navigator and the services she offers patients. She knows from experience what it is like to navigate a breast cancer journey. Marsha is a 12-year breast cancer survivor.
When a woman finds out she has breast cancer, in many cases she needs someone to “hold her hand” through this unanticipated and frightening journey into the unknown. Women face a confusing maze of questions and often become overwhelmed very quickly. As physicians, we do our best to provide as much support and information as possible, but often we rely on a breast cancer navigator to fill in the gap for us to make sure patients have the resources they need throughout their entire cancer journey. A breast cancer navigator literally helps patients navigate the seemingly endless barrage of medical appointments, tests and treatments. They provide an invaluable service for breast cancer patients.
Breast care navigators guide patients through their entire journey – from diagnosis, surgery and treatment, to life after treatment. They educate, advocate, provide resources and support, help with financial and insurance-related problems, resolve issues and remove obstacles patients face along the way – from understanding their diagnosis, to telling family members about their illness, answering questions about insurance coverage, or finding the right post op bra.
During The Breast of Everything podcast, Marsha Schmit, RN, breast care navigator at Hurley Medical Center in Flint, Michigan, talks in depth about the role of a breast care navigator and the services she offers patients. She knows from experience what it is like to navigate a breast cancer journey. Marsha is a 12-year breast cancer survivor.
Unknown Speaker 0:01
Welcome to the breast of everything podcast your trusted resource for breast health information support and encouragement. Your host today is Dr. Lindsay gold of comprehensive breast care. Welcome.
Unknown Speaker 0:14
Welcome to the breast of everything podcast. I'm your host today Dr. Lindsay gold of comprehensive breast care. Today I will be talking with breast cancer navigator Marsha Schmitt. Marsha and I have known each other personally for boy well over a decade now. And I know that and she knows when a woman finds out that she has breast cancer in most cases, she needs somebody to hold her hand or guide her through this unanticipated and often frightening journey into the unknown. women face a confusing maze of questions often become overwhelmed a very quickly. as physicians, we do our best to provide as much support and information as possible. But often we rely on a breast cancer navigator to fill in the gap for us to make sure patients have the resources they need throughout their entire cancer journey. A breast cancer navigator literally helps patients navigate through the seemingly endless barrage of medical appointments, tests and treatments. They provide an invaluable service for our patients. During this podcast, Marshall will talk about her role as a breast cancer navigator and the services she offers. Marsha has been a registered nurse for 35 years, she has served as a breast cancer navigator for Hurley Hospital in Flint, Michigan since 2008. working to support women through their breast cancer journey, she knows from experience what that journey is all about because Marsha is a 12 year breast cancer survivor. Welcome, Marsha. So happy to have you on the podcast today.
Unknown Speaker 1:59
Oh, thank you. It's great to be here.
Unknown Speaker 2:01
So Wow, there's gonna be a lot we can talk about. But if you don't mind, would you mind sharing your own personal story about breast cancer with our listeners? Sure. Um,
Unknown Speaker 2:13
that was kind of I actually started as a breast cancer navigator in 2008. And ironically, in 2009, it was just a little over a year after I started, I was convinced to go to regional medical imaging where I might get the very best mammogram ever. And I went and did the mammogram. And it wasn't too long after that they suggested maybe a little more in depth imaging. There was a spot that looks suspicious. And so I did at the time, it was kind of an interesting bsti something that isn't Oh, yeah. But the screening mammogram has kind of taken its place. But it gave a little more in depth view of what was happening in a very dense breast. And right away, my breast tissue just lit up like a Christmas tree. And it wasn't within moments that the doctor came in and said, we really need to do an MRI and a biopsy. And just from looking at the films and after having sat in tumor boards for over a year. I knew right that moment that I had breast cancer, I was not in the slightest bit surprised, but shocked, overwhelmed, almost, you know, like I took off my navigator hat and immediately became a patient and things move very, very quickly as we attempted to diagnose. And it was really because I had been a navigator for a year, I realized that I too would be able to get on the other side of this. But had I not experienced the previous year and leading support groups and working with women. I can't imagine if I wouldn't have had that platform ahead of time. Just stepping in blindly into being a breast cancer patient. You know, you go from life as you knew it to all of a sudden, you just were hit over the head with something that just almost seems unfathomable, you know? So I enlisted the support of some of my nursing friends to go to appointments with me, because it is overwhelming. You know, and even with all of my experience and being a nurse, it's hard to process and take in and you know, so that's where I started as well.
Unknown Speaker 4:27
So, in case there are people listening to the podcast who aren't familiar with the role of a navigator, can you talk about some of the services and resources you provide and what your role is in the patient's journey?
Unknown Speaker 4:45
Sure, navigators are becoming much much more popular in cancer centers, and they enter at different points in people's care and in facilities use navigators differently but the primary role of a navigator To step in, whether it's at the diagnosis, or in chemo radiation surgery, I enter at the beginning of a diagnosis and help the patient understand all the information after they sit with the doctor, sometimes they heard you have cancer, you need surgery, you need chemo, they get bits and pieces, but understanding what their tumor type is the extent of the disease, what why they would qualify for different types of treatment. Those things all are easier understood sometimes after they've had a little minute to walk away from their first visit with a doctor and a woman set with them in their pathology report and just help them understand in another setting when they've had time to process that initial diagnosis. And so my role is to educate. I advocate for women who, you know, if women don't have insurance, or men sometimes get breast cancer, I have people enter at a point where they don't have any health insurance and they have a palpable mass and they don't know what to do. So I might be the very first step in helping get insurance getting imaging biopsy, and then get them carefully placed in the hands of a physician to take the next steps. navigators can help with, you know, finding someone find a post op bra, or there's just honestly, I don't think in any given day, there is anything that I haven't helped navigate, you know, I have dental issues, you know, that becomes important if someone's in chemotherapy, right. So we're trying to help the patients find the necessary resources, the support, they need, the emotional comfort and support, maybe how do I tell my children? When should I tell my children? How do I break the news to family? You know, so there's so many different levels that a navigator can play in a woman's life, and along that journey to help just be a support?
Unknown Speaker 6:57
Absolutely, I mean, from the clinicians perspective, I can't imagine what it would be like for women who are being treated by a specialist, or more likely not by a specialist that is not providing resources and all of that information, I don't know, I don't know what what they would do. So I've been known to say that, if you are being treated in a facility that does not offer navigational services, you should probably go to another facility. Because I mean, really, to me, it's an absolute necessary part of a person's journey, it's 100% needed to have those resources.
Unknown Speaker 7:46
I agree. I tell women all the time, I'm a part of your care team. So while you'll have a surgical oncologist, medical oncologist, possibly a radiation oncologist, I'm also an important part of that. I always tell women, we're going to develop a friendship now. Because I want you to feel like you can lean on me, you know, if your family doesn't get how you're feeling, I will always be able to understand how you're feeling having walked in your shoes, and I'm a safe place, you know, if you feel like oh, I don't want my family to know, I'm struggling. I'm a sales person to share that struggle with and I can kind of dust them off and you know, get them back on their way and, you know, hopefully offer support. And just information, you know, be that extra person in the team.
Unknown Speaker 8:34
Yes. And so from a navigators perspective, I would think that the majority of people who are navigators begin as nurses, but perhaps that's is that always the case? Or what is the sort of Is there a certification process? How does one become navigator?
Unknown Speaker 8:55
You know, I understand there are some lane navigators that American Cancer Society has offered, I'm not entirely certain the capacity, but they might be able to help point and direct and lead people to necessary resources. But in most institutions, they do hire a registered nurse who is capable of understanding like I see my patients postoperatively I go for care. I provide you know, resources at the time of surgery such as pillows, cameras, halls, squeeze bottles, you know, to help them do arm exercises, help them understand the possibility of developing lymphedema, or why those post topics or sizes are important getting up moving, not overdoing it, but also just sitting still for you know, seven to 10 days. We don't want you to develop pneumonia or blood clots. So I do a lot of nursing education alongside of just helping them cope with the whole diagnosis and information.
Unknown Speaker 9:57
Absolutely. And even more nurses, there's various oncology certifications. And a lot of times people don't think of nurses as specializing, per se. But they do, right. They have their own specialties.
Unknown Speaker 10:14
They do. And I went for a special CBC and certified breast care navigators. So I actually have a very extensive certification to do this particular role. And it's it's very timely, you know, it's much like your board certification right? Before a nurse, you know, where you go, and you specialize in that area so that you have the necessary information and resources and understanding of how to properly navigate someone.
Unknown Speaker 10:40
Absolutely. So, you know, you do a lot more obviously, than provide, you know, just quote unquote, breast cancer navigation services, like Like you said, you form a friendship with these ladies. So how does your services? I mean, can they efficiently end per se? Or do you do you maintain some long term relationships with these with your patients,
Unknown Speaker 11:07
I myself, I kind of navigate them to a level of wellness. And they always know they can call me back, I kind of do a closure phone call once they've completed treatment. But I always tell them, I love to hear good news. So if you have a normal mammogram, never hesitate to call me back, if you just want to let me know you're doing well. But I also work so closely with the women that if I do have a patient who has metastatic disease, and it's more extensive, I will also be with patients in end of life care as well, I do a lot of advanced care planning, I encourage people at the time of diagnosis that they should prepare for their ending, I always say we have to do a little homework, and that's making sure you have somebody who can help represent you, if you ever got to a point and I said that could be 20 years, 30 years, it could be a month from now, who knows, you know where our lives going to go. But everybody should have a person to advocate for them. So I do advanced care planning, but I build a relationship with women with metastatic disease. And I always encourage them to trust me to be their friend, that should they get to a point where there is no longer a lot of options in terms of helping take them to a level of wellness, that they would trust me to help them have a peaceful serene ending. And so I tried to develop that relationship. So people know that when we get to that point, they can trust me when I come in, and I say, you know, we've really exhausted all of our treatment options, it's time to start thinking about hospice and comfort care. And I work very closely, and I've had many, many patients, you know, tell me that they were tired, and it was time and, and then to help the family understand that, you know, patient isn't giving up and they haven't stopped trying, but that the disease has taken over. And that, you know, there's little more medicine can possibly do to help them. And so I in my setting, have the ability to work with women, you know, in all the happy times, but I can also be there at the end and create a happy ending as well,
Unknown Speaker 13:12
which is hard. Yeah, you know, when I first started practice, I was, in my mind, sometimes critical, if you will, of sometimes my medical oncology colleagues who you I would have thought you guys should be really good at death and dying and doing that, but but in the end, just like, just like me, as a surgeon, I mean, sometimes you just don't have time in the office, to have these type of conversations that require certain settings, and they require patience. And they require, you know, quiet, I mean, you just, you just don't have time to, to do it. And sometimes to deliver the news, especially end of life discussions, you know, basically choosing how you want to die, right? And like you say, communicating with the family that, you know, they want their loved one around forever, no matter what, but the patient is tired. Those are so important. And you know, the doctor doesn't often have the time to do that. So I can't imagine what women would do if they didn't have somebody like you a navigator to go to.
Unknown Speaker 14:32
And I do think it's important. I think that patients develop a good relationship with their physician but like you say, you're seeing patients in and out, you're in the operating room, having that time and a lot of times what has allowed me to develop that relationship is that they may have been admitted multiple times, for very, if complications, you know, from their cancer. And so over a period of time I've really gotten to know people better and better for longer periods of time and Through my role and because I am based in the hospital setting, it gives me an opportunity to be able to be that person for an individual, should they come to that position or point in time where they need that relationship to help get get to the end safely. I always say we certainly way more patients that do well, I don't want that to be Yes, of course, you know, but
Unknown Speaker 15:24
but these are their important issues for sure. For sure. I'm sure the hospital or health systems, you know, really rely on navigators for a lot of other things other than direct patient care. So for example, fundraising activities, other community initiatives, what kind of projects have you been involved with,
Unknown Speaker 15:48
you know, I have been blessed to be able to go out and community and churches and go and educate women, we've done things alongside of the American Cancer Society creating resources. But at Hurley Medical Center, where I work, we determined early on that having a financial resource for our patient was going to be imperative to the success of them clean completing treatment, and most facilities tried to create that type of a situation, because patients may have to drive distances, they may have to go day after day after day. And so having gas cards, grocery cards, I have patients who have to stop work, you know, young women who are part of the monthly nut, shall we say, all of a sudden find themselves in a situation where if they can't work for a significant period of time, their contribution to the family is deficient. And so trying to supplement that. So part of my role, I kind of say I put my Social Work hat on at that point, try to help determine financial stressors, and we don't want people focusing on that we want them focusing on their level of wellness, and getting better so that they can return to life as they knew it. So I do a financial assessment. And I help determine what we can help do to help carry those patients through those difficult times and make sure they have the resources financially, as well as other areas. To get through that, you know, some people might just need a post op bra, some people might need their rent or mortgage paid, or they're going to have a shutoff notice, can you imagine trying to go through cancer without running water or heat or those types of things. And, and you know, we've had some difficult challenging years behind and ahead of us, you know, where people haven't been able to work regularly. And maybe the spouse hasn't either. So our community has been so incredibly generous. And we have a tremendous number of community fundraisers, we call them our community partners, along with community fundraisers, so I do a lot a lot of fundraising, I work closely with our community to help
Unknown Speaker 17:54
create that, you know, I I find in talking to people, just people in general, many people are very surprised to find out how little bit of the dollar from Nash, the huge national organizations, how little bit of that money trickles down to the community level. Right. So look, you know, there's, I won't mention any particular organizations, because they're all doing well, and they're doing their own things. But the point is, you know, you're raising money to do this walk and to do that, and from national organizations, and you're like, Well, I mean, I don't understand I raised you know, $5,000 to do that, where is this money, and very, very little of it will trickle down to the individual patient at the community level. So what you're describing is so, so, so important, it's basically where hospitals health systems get get their resources to do this for patients, right?
Unknown Speaker 19:09
Yes, and 100% of the funds that we raise or that are donated to our foundation fund, we call it our breast cancer navigation fund. We also have a general Cancer Fund for our other cancer patients. But 100% of that money is used for patients benefits, you know, what if they, you know, I've paid taxes on a home because they were going to lose their home? Well, people can't be successful in completing treatment if they don't have a place to stay. So we have, you know, we look at the area of need and, and we also collaborate with other funds that are available in the community, but 100% of what we raise goes directly to impact patients. So
Unknown Speaker 19:50
yeah, which is definitely a big deal. So are there any final messages that you would want to share with the audience? To let them know if they were looking for more information, how they might go about doing it. Any advice?
Unknown Speaker 20:08
You know what if patients find out or feel a lump or a bump, I always tell people give something two weeks unless it's, you know, protruding out of your skin. But if you have something that's abnormal two weeks is a reasonable amount of time to determine if this is something that's going to become something or it up and disappears. But they should seek out and they can always call their hospitals, they can ask, do they have a navigation program? And if so, connect them to that program, because a lot of times, you know, in my particular role, I can get the ball rolling and help get people streamlined for insurance if they don't have that or get them immediately into a physician's office. So I would like patients to not be immobilized by fear or be afraid that I felt something, I would rather have them call me, we can either go rule something in or rule it out. But don't let fear immobilize you. And, by all means, call your hospital system and ask if they have a navigator. And if you don't get an answer there, you might call another hospital system, even if that's not where you normally go, because the navigator at a different hospital might still be able to direct you in your insurance and where they should begin or go. And so I think that's an important piece for people to pursue. And I think I think the important thing is to realize the sooner you get treatment, the better your outcome will be. It's when you leave in glad things for prolonged periods that it creates a bigger challenge for a more favorable outcome and a long term survival advantage. So, you know, you want to get on top of things just as quickly as you can. And don't let not having insurance become your stopping point. You know, make sure you pick up the phone, you call, you know, hospitals and find out where you can go because oftentimes there are resources that can actually help people. And you know, you may not be aware of it, but there are people inside of hospitals that can help plug those holes for you and
Unknown Speaker 22:10
patch the gaps. Absolutely. And if somebody is being treated at a facility that does not have navigation services, great advice to maybe, you know, call another facility, Crosstown, wherever, because you're willing to drive a half hour for a good restaurant, you ought to be willing to drive a half hour right for care that can make the difference between life and death are a good experience and a bad experience. Right? Yeah, sometimes we have to help people see the forest through the trees like that. But thank you so much, Marsha, for joining me and sharing so much valuable information and for sharing your story for patients in their families. I always enjoy talking to you.
Unknown Speaker 22:59
Oh, likewise, it was my pleasure.
Unknown Speaker 23:02
So everybody, thank you for listening to the breast of everything Podcast. I am your host, Dr. Lindsay gold of comprehensive breast care. We want to hear from you. If you have a topic you'd like us to talk about. We welcome your suggestions, you can send them to compro breast care. com. That's compbreastcare.com till next time
Unknown Speaker 23:29
you've been listening to the breast of everything podcast with your host and board certified breast surgeon, Dr. Lindsay gold of comprehensive breast care. If you have a subject you would like the surgeons to discuss, please email your suggestions online at comp breast care.com. That's compbreastcare.com the doctors want to hear from you. The views thoughts and opinions shared in this podcast are intended for general education and informational purposes only and should not be substituted for medical advice, treatment or care from your physician or healthcare provider. Always consult your healthcare provider first.
Transcribed by https://otter.ai