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Canonsburg General Hospital Launches Breast Cancer Nurse Navigator Programs
By Nancy Kennedy

Shivani Duggal, D.O.

In the nautical world, a navigator is the person who manages the passage of a ship throughout its journey. The navigator knows the territory, plans the trip, keeps the crew informed and guides the ship, around hazards and obstacles and through rough waters. He is constantly vigilant, monitoring and shepherding the ship until it reaches its destination, safe and sound

That concept has been borrowed by innovative oncology professionals as a metaphor for their efforts to guide a patient through the journey that is cancer. Recognizing the complexity and the anxiety of the cancer experience, these specially trained, expert level professionals, known as nurse navigators or patient navigators, serve in many of nation’s hospitals, providing this deeply humane service that is responsive to the entire range of the patient’s medical and emotional needs.

At Canonsburg General Hospital (CGH), a Nurse Navigator Program has been created to better serve women with breast cancer. Colleen Presken, RN, OCN, a radiation oncology nurse with more than 30 years of cancer care experience, is the program’s first Nurse Navigator and manages the service. Presken sees every patient who needs to have a breast biopsy, and follows every patient with a cancer diagnosis, from initial diagnosis through treatment and follow-up. The program is designed to streamline the continuum of care and ensure that patients have access to all the services and resources they may need.

According to Shivani Duggal, D.O., a breast surgeon with the CGH Center for Women’s Health, women who are newly diagnosed with breast cancer are overwhelmed by the news and by the complex mix of medical specialists and services they need. “When a woman receives a diagnosis of breast cancer, she has to see a lot of specialists – the surgeon, radiologist, radiation oncologist, medical oncologist and plastic surgeon. It’s a lot to take in, and it can be overwhelming to sort it all out. That’s where the Nurse Navigator is valuable – she guides the patient through it.”

The program at CGH will be similar to one that has been successful since March 2012 at Allegheny General Hospital (AGH), which is, along with CGH, part of Allegheny Health Network. Nurse navigators provide education, counseling and referrals to support services. They make appointments and facilitate the flow of communication among members of the patient’s team; perhaps most importantly, they provide a supportive, consistent relationship with the patient. That relationship, in which the navigator acts as advocate, teacher and resource, is the key to the program.


“After a woman has a mammogram, she may be told that she needs a biopsy,” Presken explains. “That’s where I step in: I meet the patient on the day of biopsy, before the procedure. I introduce myself and spend time with them, chatting to ease their anxiety. After the biopsy, I contact the referring physician with the results and discuss the next steps with them.” Presken facilitates the first appointment with the surgeon, and prepares the patient for it. “I walk the patient through the process – surgery, radiation, maybe chemotherapy – and tell her what to expect. I let them know they can call me at any time if they have questions or need support. Essentially, I become her go-to person, to get her through the entire experience. If the woman comes to Peters Outpatient Center for radiation, I attend every single appointment with her.”

Dr. Duggal says that the Nurse Navigator program has proven to be beneficial to patients. “Colleen is the perfect person for this role. She has a wealth of experience and is a nurturing, caring person. With Colleen, the patient always comes first. Patients are always telling me, ‘Colleen did this or that for me.’ It takes a burden off the patient’s shoulders at a time when she is anxious and vulnerable.”

Dr. Duggal arrived at CGH in March and is the only fellowship-trained breast surgeon in the area. She is a graduate of Ohio University College of Osteopathic Medicine and completed her residency in general surgery at Summa Health System in Akron, Ohio. She completed a fellowship in Breast Surgical Oncology at AGH. Duggal serves as a fellow for the National Surgical Adjuvant Breast and Bowel Project and is involved in clinical trials that focus on the future treatment of breast cancer.

Presken, a graduate of West Penn Hospital School of Nursing, has worked in radiation oncology, caring for patients undergoing radiation therapy, for most of her nursing career. “We’ve come so far in this field. When I started practice, most women needed a mastectomy; now, with the many advances most can have a lumpectomy with radiation or even partial breast radiation, which has shortened the time needed to complete their treatment. My patients inspire me with their strength. We see patients five days a week, for six weeks, so we develop relationships and it’s often hard to say goodbye. But when we see them at follow-up and they say, ‘I am cancer free’ - nothing compares to that.”

To contact Dr. Duggal or schedule an appointment, call (724) 271-3300. For more information on the Nurse Navigator Program, call (724) 745-3904 or email nursenavigator@wpahs.org.

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