After breast cancer diagnosis, these navigators can help

After breast cancer diagnosis, these navigators can help

For Cape Cod breast cancer patients, the Breast Navigator program offers both coordination of post-surgical treatment and follow-up screenings, plus individualized support in the Cape Cod Hospital and Falmouth Hospital health system and out in the community.

"It's all about collaborating, supporting and giving patients hope. It's personalizing their care," said Patricia Ryan-Blanchard, a nurse practitioner who is a certified clinical navigator at Cape Cod Healthcare's Cuda Women's Health Center in Hyannis, who helped establish the program.

A nurse practitioner for 30 years, Ryan-Blanchard worked in oncology and primary care. She had ovarian cancer in 1989 and "extremely advanced" melanoma in 2005. Her combined work and personal experiences made her a natural for the role of navigator.

"There wasn't a dedicated person to navigate for me" back then, she said. "I can truly understand what a patient is going through."

For a patient first hearing a diagnosis of breast cancer, "life changes at that moment," she said.

After diagnosis, many things must be well-coordinated through treatment and follow-up, she explained.

What Navigators Do

Navigators connect patients to programs including:

• Support groups, run by navigators and those out in the community.
• Alternative and integrative therapies (including acupuncture, massage and reflexology), plus nutritional and emotional support available through the Cape Wellness Collaborative. Local cancer patients receive $750 of credit toward services from affiliated practitioners.
• Financial assistance for imaging and diagnostic testing costs not covered by insurance. In 2025, the Cape Cod Women's Cancer Prevention and Early Detection Fund distributed $68,771.80 toward bills of 58 patients. "We would never want patients not to return because of cost," Ryan-Blanchard said. The fund gets its monies from fundraisers and donations through Cape Cod Healthcare Foundation.
• Help with childcare, housekeeping, groceries, prepared meals, transportation to medical appointments and integrative therapies for Massachusetts breast cancer patients via the Ellie Fund.
• Delivered cooked meals through the Meals on Wheels program, plus provision of in-home services and more, through Elder Services of Cape Cod and the Islands, which serves people over 60 and those with disabilities.
• When needed, connecting patients to services at Dana-Farber Cancer Institute in Boston. Cape Cod Hospital has been a member of the Dana-Farber Cancer Care Collaborative since 2019.

Supportive contact with patients lasts about five years after diagnosis, but many continue longer within support groups, she said. "We are always willing to help our cancer survivors."

Every member of the team has distinct job descriptions and responsibilities, Ryan-Blanchard said. "Each of us performs to their level of expertise to assure patients get excellent service and care every day.

"Radiologists need to dedicate their time to interpret mammograms, perform biopsies and pre-surgery intervention with the goal of diagnosing breast cancer at its earliest stage." 

At Falmouth's Seifer Women's Health and Imaging Center

Nicole Salter worked as a nurse practitioner in primary care for 15 years before transferring to the Cuda center in Hyannis about three years ago. She's been a certified navigator for about 18 months and now works at the Seifer Women's Health and Imaging Center in the Falmouth Hospital Medical Office Building.

"We all have to work together to do it well," Salter said. In addition to the breast cancer surgeons, the navigators work with radiologists, ultrasound and mammogram technicians.

"You learn how to give bad news in a good way; you don't want to sugarcoat it. What we're giving patients is the knowledge in their decision-making going forward."

The navigator system is needed because one in eight women will be diagnosed with breast cancer during their life, Salter said.

"It can be scary, and I can be their home base."

Navigators offer support to patients and their family members, she said.

"It's something I feel I was meant to do," she said.

As an NP navigator, Salter takes on many roles throughout any given day, such as setting patients up for additional imaging, coordinating biopsies, assisting in biopsy procedures, giving pathology results, and coordinating care with breast surgeon offices.  

"We are involved with a patient's breast journey from the moment they have an abnormal mammogram through surgery and beyond," she said. 

Making Life Easier for Patients

Ann Coggeshall works as a certified patient navigator and breast health advocate at Cape Cod Healthcare Breast Surgery in Hyannis and Falmouth, working closely with both Ryan-Blanchard and Salter.

"I mostly help surgeons after they've seen patients newly diagnosed with breast cancer. It's six to eight cancer (cases) a week, supporting and getting referrals to oncology."

Navigators are certified through the National Consortium of Breast Centers. Certification can be for clinical navigators, such as Ryan-Blanchard and Salter, or patient navigators, like Coggeshall. Both require completing a course and passing a test.

Coggeshall said she tries to make life easier for patients by making appointments more convenient to their schedules, such as lining up radiology and chemotherapy visits on the same day.

"I'll point you in the right direction, get an answer for you," she said.

Much of her work is done during the first year following diagnosis, but it continues through follow-up visits.

"Everyone is extremely grateful" for the help and support, Coggeshall said.