Emma Spangler

Mentor: Ning Wang, PhD

Institution: UVa-Wise

Current Status: Pikeville College of Medicine

Cancer Resources and Patient Navigation in Southwest Virginia

Cancer is a term used to describe diseases in which abnormal cells uncontrollably divide. There are more than 100 different types of cancer, therefore, cancer is not just one disease but instead many diseases (National Cancer Institute, 2013). According to the American Cancer Society (2012), half of all men and one-third of all women in the United States will develop cancer in their lifetime. Southwest Virginia is known as a cancer health disparity population (National Cancer Institute, 2013). In 2000, the Minority Health and Health Disparities Research and Education Act, also known as United States Public Law 106-525, provided a legal definition of health disparities:
         “A population is a health disparity population if there is a significant disparity in the overall rate of disease incidence, prevalence, morbidity, mortality or survival rates in the population as compared to the health status of the general population.” Minority Health and Health Disparities Research and Education Act United States Public Law 105-525 (2000), p. 2498
Thus, due to the high cancer rates in Southwest Virginia this study examined what resources cancer patients, cancer survivors, caregivers, and their family members find most helpful before, during, and after cancer treatment. It is our hope that this information will be utilized for the training purposes of patient navigators who will guide patients through health care system barriers and facilitate timely access to medical treatment and psychosocial care (National Cancer Institute, 2012).
     Southwest Virginia is located in Central Appalachia. Appalachia spans across portions of thirteen states including New York, Maryland, West Virginia, Virginia, Kentucky, Tennessee, North Carolina, South Carolina, Georgia, Alabama, Pennsylvania, Ohio, and Mississippi. Shockingly, not only Southwest Virginia but all of Appalachia is considered to be a cancer disparity population. Investigations into what makes the Appalachian region a cancer disparity population have been conducted. For example, in 2010 the Appalachia Community Cancer Network released a publication entitled “Addressing the Cancer Burden in Appalachian Communities”. This study proposed that socioeconomic characteristics of Appalachia relate to the increased cancer risk. The socioeconomic characteristics mentioned in this publication include lower incomes, higher poverty rates, lower level of educational attainment, and a slightly higher unemployment rate. This study also showed that the mortality rate in Southwest Virginia was greater than that of the other counties in Virginia. Specifically, on average from 2002-2006 195.3 per 100,000 persons diagnosed with cancer died in Southwest Virginia in comparison to 188.7 per 100,000 persons diagnosed with cancer in other Virginian counties (Fisher, Hill, & Plascack, 2010).
     To combat cancer health disparities patient navigation programs are being implemented in Southwest Virginia. Patient navigation programs assist cancer patients with their diagnosis by recognizing and addressing barriers that might impact ones access to health care. According to Freeman et al. (as cited in Hendren et al., 2010) after an abnormal cancer screening 87% of inner-city patients completed the recommended biopsy with patient navigation counseling whereas only 57% did so without navigation. Furthermore, patient navigation also increases communication between cancer patients and their health care providers. This communication is essential for quality care; poor communication could result in the inability of a patient to make informed decisions, cope with their diagnosis, adhere to their treatment, and understand his/her treatment options. Patient navigators can enhance this type of communication by teaching patients how to ask their providers questions that will lead to a greater understanding of their disease and treatment (Hendren et al., 2010).
     The goal of this research was to examine the needs of local cancer patients, caregivers, and their family members. Ultimately, we hope this information will be utilized in the training of cancer patient navigators and will ensure that they are capable of providing the services that Southwest Virginians need.