Program pairs patients with dedicated nurse navigator for diagnostic journey

August 11, 2014

Receiving a cancer diagnosis is a difficult time for patients and their families. The fear, confusion and pressure can be overwhelming.

David Newman, a 52-year-old Kingston man, knows that feeling all too well – he’s had the conversation no one wants to have not once, but twice.

“In 2006 and 2007, David had recurring knee pain and we couldn’t figure out what was wrong,” said Anne, his wife of 30 years. “He had a second MRI that showed persistent bone marrow abnormalities, which were very unsettling results.”

As his family physician was retiring, David no longer had a primary care provider to refer him to specialists to get to the root of the problem. Every week, Anne would attempt to reach various contacts asking for David to be referred to a hematologist.

“It was a constant challenge. You feel really helpless because you don’t know where to go for help or who you can call next. It took nearly a year, but finally we met with a hematologist in 2008.”

Four days later, David was diagnosed with lymphoma. David began treatment in 2009, successfully completing nine cycles of chemotherapy and two years of maintenance treatments, which finished in July 2011.

Diagnostic Assessment Programs – or DAPs – are designed to coordinate patient care from referral for a suspicion of cancer to a definitive diagnosis.

Once referred into a DAP by their care provider, patients have access to a multidisciplinary care team, which includes a nurse navigator who is the patient’s main contact for coordination of care, diagnostic services and timely diagnosis.

In addition of having the support of a dedicated nurse navigator, patients also have access to the DAP-Electronic Pathway Solution, a web portal that provides patients and their families with access to upcoming appointments, test results, information on upcoming procedures and contact information for the patient’s care team.

“The feedback from patients and their families has been overwhelmingly positive,” said Julia Niblett, Regional Director of the South East Regional Cancer Program. “Since we began with the DAPs, patients have felt better informed and supported every step along the diagnostic journey.”

In 2013, David took a Fecal Occult Blood Test (FOBT) because he was worried about blood in his stool. He was then fast-tracked for a colonoscopy, during which a 3 cm polyp was removed. Pathology tests found that he had signet-ring cell colon cancer, an aggressive colorectal cancer.

“What are the odds, right?” adds his wife, Anne. “It seemed impossible for someone so young and otherwise healthy, and the prospects of beginning the entire process of dealing with new specialists and finding our way through the medical system again was daunting.”

The difference this time was that David was referred to the Colorectal DAP and met Patty Halligan, David’s Nurse Navigator.

“It was like night and day,” said David.

“Just having someone that we could call at any time to ask questions and tell us what we could expect was such a comfort, “added Anne. “It would’ve taken so much longer if we tried to navigate it all ourselves. Patty was fantastic.”

“I feel privileged to be in this role,” said Patty Halligan, Nurse Navigator. “It’s a very vulnerable time for patients and their families. I have an opportunity to provide patients and their families the supportive care needed to cope with a potential cancer diagnosis. Ultimately, the goal is to improve the patient experience and satisfaction by increasing their access to tools and resources, expediting appointments and preparing patients for the next step of care.”

David quickly underwent surgery to remove 15 cm of his colon and the 12 surrounding lymph nodes – the risk area for spread from the site of the polyp. Earlier this summer, David had his one-year follow-up and is doing well.

“We’re very fortunate. We know that. We know how lucky we are. I feel probably better than most 52-year-olds and it’s thanks to the great work of our doctors, nurses and the seamlessness of the DAP, which made everything easier,” said David.

Though his doctors are keeping a close eye on him, David and Anne now look forward to spending time with family and enjoying an active lifestyle.

“We had a really special day recently when our daughter Emily graduated from Queen’s University,” says Anne. “At one point David looked at us and said he was just so happy to be there to mark that important day with his family. He was grateful to just be there. It was really big for us.”

For more information on referring your patients to a Diagnostic Assessment Program, please e-mail


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