Nurses Play Key Role in Susan G. Komen's Goal to Address Breast Cancer Disparities

While Susan G. Komen Greater New York City looks to address disparities among underserved patient populations, nurses also play a vital role in educating patients about breast cancer.

Oncology Nursing News® spoke with Linda Tantawi, CEO of Susan G. Komen Greater New York City, about the organization’s patient navigation program, and the specific areas nurses can help to address.

Oncology Nursing News®: Part of Komen’s mission is helping individuals to understand breast cancer. What are some misconceptions about the disease?

Tantawi: Misconceptions start at the very beginning where women think because they have no family history of breast cancer that they are not at risk of breast cancer. My sister was one of those women. Shortly after I started at Susan G. Komen, I asked my sister, who was 43 at the time, when the last time was that she had a mammogram, and she said, “Well, I’ve never had a mammogram.” And I said, “I can’t be the CEO of Susan G. Komen if you haven’t had a mammogram. Go get your mammogram.” So, she went and got her mammogram and was diagnosed with breast cancer. It’s a common misconception. But know, in fact, that most women who are diagnosed with breast cancer — I think 80 percent – have no family history of breast cancer.

With that, what role can oncology nurses play to help educate patients and their families?

In the oncology space now, there are so many options and so many pathways. Oncology nurses really work hard to reduce the fear (associated with a breast cancer diagnosis).

We also have to know and educate patients about their recurrence rate and the importance of adherence to medication. We know that tamoxifen and the other hormone blockers have a significant impact on a woman’s life. They cause some joint pain, they put premenopausal women in to menopause. So, the adherence rate can drop off significantly and that of course increases your recurrence rate. So, really helping patients to understand the importance of therapeutic adherence and knowing what women can do to decrease their risk of recurrence (will help).

In addition to the medication, we know that obesity compounds your risk of recurrence. We know that exercise reduces your risk of recurrence. So, just making sure that patients really understand all that they can do to reduce their risk.

And then also to know that just because you had a double mastectomy doesn’t mean that you can’t have a recurrence. Just because you don’t have breasts doesn’t mean you can’t get a recurrence of breast cancer. So, really helping patients, without frightening them. Wo do need to be aware of which breast cancers are apt to recur than others, and what patients can do to reduce recurrence, and then medication adherence and what can you do to reduce the effects of medication through yoga, other exercise, nutrition, mindfulness. All of the things that can help mitigate.

Komen also focuses on “some of the most ethnically, financially, and geographically diverse communities in America.” Can you expand on some of the unique breast cancer risks in these populations?

Our grants process is very competitive and the process ensures that the programs are serving the populations that we know are most at need. We conduct our annual community needs assessment every five years. Through our community needs assessment, we can identify the populations that are most at risk and then target the programs that we think could meet those needs, and then if they can submit a qualified grant, then we will fund them. The community needs assessment also pointed out that the metastatic community had needs, and then our patient navigation program was designed to ensure that women are getting the care that they need.

Is there anything that nurses and health care providers should consider when treating underserved populations?

The biggest thing that we hear from patients that is not discussed is their sex lives, especially with metastatic patients or patients currently in treatment. They don’t want to be told put on a camisole and use lubrication. They don’t feel well. So, doctors and nurses really need to address those concerns in a very thoughtful and compassionate way so women don’t feel uncomfortable and their partners don’t feel uncomfortable. Sex is not a dirty thing. We know some women live a very long life, and tamoxifen and other estrogen suppressors wreak havoc on a woman’s body. So, doctors really need to talk with their patients about their treatment goals and about their life goals and really understand so they can guide women and their partners so they can be helped and not just left on their own to be unhappy and not feel good about themselves.