Types of oncology navigators

We learn about the different types of oncology navigators.

Origin of oncology navigation

Oncology navigation is a relatively new speciality. Though, its history dates back as far as the Middle Ages, where feldshers and barber surgeons were part of the communities. 

A feldsher was a trained healthcare worker who provided various medical services, limited to emergency treatment and ambulance practice. The community would turn to them for encouragement and assistance. The service was mainly provided in rural areas with limited medical services. 

Barber surgeons were medical practitioners assigned to look after soldiers during and after the battle. Their duties expanded from cutting hair to amputating limbs. They were regarded as middle medical workers. Their profession continued until the professional military medical services were established.

The concept was later recognised in China with barefoot doctors who worked bare feet in the rice paddies. They provided education and basic treatment, like preventative care, family planning and hygiene, instead of curative and chronic care. These rural doctors were minimally trained and lived with the community they served. Their purpose was to bring healthcare to rural communities. 

In 1990, Harold Freeman brought health services to the poor communities of North America, by employing lay navigators, who didn’t have medical background, to educate on breast education and breast self-examination. 

The aim was to eliminate barriers of care and ensure timely cancer diagnosis and treatment. Since then oncology navigation has developed across the cancer continuum from outreach and prevention to survivorship and end of life. 

In 2005, US President, George Bush, signed the Patient Navigator and Chronic Disease Prevention Act and community-based navigation programmes were developed. Today, patient navigator programmes exist all over the USA and beyond.

What is an oncology navigator?

An oncology navigator is a healthcare professional who provides patient-centred care by liaising between patients and healthcare providers. They’re uniquely well-positioned to proactively guide the patient and/or family through and around the barriers of care, ensuring they receive a timely delivery of care. 

Oncology navigators are relative newcomers to the multi-disciplinary team. They work to reduce the fragmentation of care in and around the healthcare facility by coordinating clinical services. They can be disease specific or can deal with a wide variety of diseases. A multi-sited navigator works with all types of cancers in different healthcare facilities. 

Types of oncology navigators

There are three types of oncology navigators and their functions are differentiated by their healthcare knowledge and skills. All are regulated by their scope of practice and ethical conduct according to their profession.

  1. Patient navigator
  • Patient navigators are trained/non-professionals, with or without medical background, who provide individualised care to patient, family and caregivers through basic understanding of cancer and the healthcare system.
  • To help overcome healthcare system barriers and facilitate timely access to quality health and psychosocial care throughout all phases of the cancer continuum, patient navigators facilitate awareness and identify patients’ needs. e.g. lay navigator, financial navigator, breast navigator, radiology navigator etc.
  • Lay-, financial-, breast-, and radiology navigator all fall under patient navigators.

2. Nurse navigator

  • Nurse navigators are professional registered nurses with oncology specific knowledge. Using the nursing process, the navigator assists patients by providing education and resources to facilitate informed decision-making and timely delivery of care throughout all phases of the cancer continuum (diagnosis to survivorship, or end-of-life).
  • Novice nurse navigator – two years or less navigation experience.
  • Expert nurse navigator –  has at least three years experience; is proficient in the role and has the education and experience to use critical thinking and decision-making skills pertaining to the evolution of navigation processes. 

3. Social work navigator

  • Licenced social worker with oncology specific clinical knowledge, who offers psychosocial support and psychotherapy to patients, families and caregivers to help overcome healthcare system barriers.
  • Diagnosis to end-of-life.

The benefits of an oncology navigator

Oncology navigators benefits the patient, family and healthcare system alike by improving quality of life and care. The patient gains greater understanding of their condition and access to quality care. Many patients have managed to gain self-management skills and their silent barriers have been addressed. The use of oncology navigators has improved family and caregiver satisfaction by reducing worry and frustration on how to care for their loved ones. Additionally, the healthcare team benefits by efficient and reduction of fragmentation of care.

Alice Banze is a novice nurse navigator at Netcare. She is an oncology trained professional nurse and a former bone marrow transplant coordinator. She is also a member of Academy of Oncology Nurse and Patient Navigators (AONN).


Alice Banze is a novice nurse navigator at Netcare. She is an oncology trained professional nurse and a former bone marrow transplant coordinator. She is also a member of Academy of Oncology Nurse and Patient Navigators (AONN).