Patient Navigation May Offer Solutions

Dr. Brawley said that he sees patient navigation as key to addressing disparities in access to care. Pioneered by Harold P. Freeman in 1990, patient navigation seeks to eliminate barriers to timely screening, treatment, and supportive care in cancer patients.3

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Dr. Brawley said that he thinks that navigation could help patients in underserved communities get access to health care resources enjoyed by better-served communities. “Socioeconomic and racial integration is only going to work if you’ve got patient navigation to educate the patient and get them involved in the health care process,” he said. “I’m a big fan of navigation.”

“Doctors and health care providers who are aware of these patterns and are consciously looking to ensure these things don’t happen can be very helpful in preventing them,” said Dr. Brawley. “I think that patient navigation is very important in trying to prevent these types of unfortunate things from occurring.”

Dr. Trinh agreed. “I think [patient navigation] is important, especially for prostate cancer as there are a lot of decisions that need to be made by the patient,” he said. “There’s a lack of central direction to treating prostate cancer, and the problem is compounded by the fact that providers have their own biases and their own incentives and the patient can get lost in the system.”

RELATED: Prostate Cells Undergo Epigenetic “Reprogramming” in Tumorigenesis

“Ultimately this contributes to disparities because some patients can be better informed for all sorts of reasons, and if we’re trying to achieve equitable health care for everyone we need to level the playing field,” Trinh said.


  1. Schmid M, Meyer CP, Reznor G, et al. 2015. Racial differences in the surgical care of Medicare beneficiaries with localized prostate cancer [published online ahead of print October 22, 2015]. JAMA Oncol. doi:10.1001/jamaoncol.2015.3384.
  2. Brawley O. The meaning of race in prostate cancer treatment [published online ahead of print on October 22, 2015]. JAMA Oncol. doi:10.1001/jamaoncol.2015.3615.
  3. Freeman, HP. Patient navigation: a community based strategy to reduce cancer disparities. Journal of Urban Health83(2), 139-141.