Much of the research about the causes of cancer health disparities identifies lack of access as a primary factor. People from difficult socioeconomic circumstances often do not know where to go or who to turn to - and in many cases, do not have the resources - to respond appropriately when they receive a cancer diagnosis. In other cases, people live in isolated communities 100 miles or more from the nearest clinic or hospital. One approach to closing this access gap is NCI's Patient Navigator Research Program, which relies on personal guides to shepherd disadvantaged cancer patients into standard care.

The Patient Navigator Program assigns guides to help cancer patients and their families navigate the treatment process, steering them around obstacles that may limit their access to quality care. They help the patient choose a doctor, arrange transportation, assess treatment options, and see that the patient follows the prescribed care regimen.

Patient navigators can be social workers, nurses, or volunteers who are familiar with the health care system and the cancer care process. Their goal is to ensure that cancer patients from disadvantaged backgrounds get high-quality treatment; patient navigators can make the difference between these patients becoming cancer survivors or dying from the disease.

The Patient Navigator Program is part of a group of initiatives that NCI developed to address cancer health disparities. Variations on the program are in place in several communities, and NCI is expanding the program through a new series of grants. About $24 million in grants will be awarded over the next 5 years as part of the program.

NCI supports a number of Patient Navigator Program pilot projects in minority communities: two in Native American communities at Indian Health Service sites in the Portland, Ore., area and one each in Rapid City, S.D., and Laredo, Tex., the latter of which serves 50 "colonias," communities that are home to an extremely poor segment of the Hispanic population, as well as sites in Mississippi, North Carolina, California, and Pennsylvania.

Recently, NCI held a workshop designed to enhance navigators' knowledge about clinical trials. In the 3-day workshop on April 10-13 in Bethesda, Md., patient navigators from NCI-funded projects across the country participated in sessions dealing with the clinical trials process and how to assess trials for their respective communities.

The patient navigator concept was developed by Dr. Harold Freeman, director of NCI's Center to Reduce Cancer Health Disparities. Dr. Freeman developed the concept when he served as director of surgery at Harlem Hospital in New York City. Dr. Freeman found that the program was successful in saving lives and educating the larger population about cancer prevention and treatment.

"Receiving a cancer diagnosis is traumatic, even though there is more hope today for cancer patients than at any other time," says Dr. Freeman. "But to be faced with that news and to also lack the resources, knowledge, and confidence to follow through appropriately to get quality care is a tragedy. For these patients, patient navigators are a true lifeline."

For more information about the Patient Navigator Program, go to http://crchd.nci.nih.gov/initiatives/#Navigator.