Oncology patient navigation demands a multidisciplinary team, say congress experts


Seeking to improve the experience of patients in cancer treatment, navigation brings together multidisciplinary teams, with doctors, nurses, psychologists, nutritionists and occupational therapists. Whether with a cure or with palliative care, the outcome of the clinical condition is better when the patient has access to different professionals in their trajectory.

The journey of the cancer patient was discussed at one of the tables this Wednesday (28) at the 9th Congress All Together Against Cancer, promoted by Abrale (Brazilian Association of Lymphoma and Leukemia). Organized by Hospital Israelita Albert Einstein, the panel brought together specialists from the Einstein Oncology and Hematology Center and was mediated by Elisa Conte, the center’s care coordinator.

The objective of care with a multidisciplinary team is to welcome the patient and reduce their anguish at all stages of treatment, says navigator nurse Claudia Patricia Villar de Godoy.

Even so, participation in navigation activities should not be restricted to patients and it is essential that caregivers of people with cancer are present at consultation times, so that the entire support network for cancer patients outside the hospital environment knows how to deal with difficulties of treatment, such as side effects, says Godoy.

With friends, family and caregivers active in the process of navigating the cancer patient, the integration between the therapies prescribed in each specialty is also improved, says psychologist Silmara Ferreira Costa Silva.

She explains that successful navigation depends on the multiprofessional team’s knowledge of the patient, their preferences, their family dynamics and the impact that the diagnosis had on their moment of life and who is close to them. With these perceptions, communication between the professional and the patient can be made in a simpler way, to meet the demands of organization and adaptation to a new routine.

In the same vein as Godoy e Silva, clinical oncologist Guilherme Andriatte says that it is up to the doctor to welcome, create a relationship of trust with the patient and know how to guide on different aspects of the journey, as in the case of recommending vaccines to cancer patients. The ideal would be to immunize against influenza and pneumococcal diseases, for example, before starting treatment, to avoid intercurrences during the process, but this is not always the case, he says.

It is also necessary for the doctor to know the correct moments to resort to other specialties, he emphasizes. Faced with pain, it is common for the oncologist to seek to adjust the doses of medication, but there are cases in which physiotherapy sessions would work better both to relieve the complaint and to rehabilitate and strengthen the patient’s muscle mass, explains Andriatte.

At the Einstein Oncology and Hematology Center, the patient also has a nutrition service for evaluation and support in issues such as lack of appetite and even food hygiene, as immunity is lower during cancer treatments, says nutritionist Marcia Tanaka.

Even when the outcome is not a cure, quality of life and comfort are the focus of integrative medicine practices, explains Maria Ester Azevedo, coordinator of this area at Einstein. The proposed activities contribute to the management of symptoms such as pain and stress, and promote well-being with yoga tools, such as meditation and diaphragmatic breathing, to encourage self-care.

Patient navigation is important even in the face of treatments that require less frequency at the hospital, such as hormone therapy, since adherence can be impaired if the patient is not instructed on the proper use of medications, warns nurse Michele Bezerra.

In moments of healing, when the treatment comes to an end, patients also count on the survivorship sector, coordinated by Fábio Romano, which offers help to deal with prolonged physical symptoms, such as fatigue, and to maintain self-care outside the hospital environment.

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