MD Anderson’s ABC Program: Meeting the Unique Needs of Patients with Advanced Breast Cancer

TON - April 2023 Vol 16, No 2
St. Elizabeth Cancer Center, Edgewood, KYThe University of Texas MD Anderson Cancer Center, Houston.
© The University of Texas MD Anderson Cancer Center

The Nellie B. Connally Breast Center at The University of Texas MD Anderson Cancer Center, Houston, is among the largest in the country. MD Anderson’s team of breast cancer oncologists and subspecialists address all diagnoses, medical complications, and symptoms associated with the disease. The Advanced Breast Cancer (ABC) Program is uniquely situated to set the standard of care because it was created by patients for patients, and it is guided by a multidisciplinary steering committee in which patient advocates have a major voice.

The Oncology Nurse-APN/PA (TON) recently interviewed Abbey Kaler, MS, APRN, FNP-C, Nurse Practitioner and Patient Navigator in the ABC Program, who discussed why she chose a career in nursing, the types of services offered to patients in the program and her role in providing those services, the most rewarding and challenging aspects of her job, and what she is currently excited about in the field of breast cancer treatment.

TON: What inspired you to pursue a career in nursing?

Ms Kaler: When I was 9 years old, I was found to have a brain tumor. I had 2 brain surgeries to remove the tumor. It was completely removed after the second surgery, and I recovered in the hospital over the course of 2 weeks. I was then discharged from the hospital and followed by the MD Anderson Child and Adolescent Center for 11 years. My goal was to return to the institution that had cared for me and my family during such a vulnerable time in our lives. I wanted to provide the same level of care that was shown to us.

After graduating from nursing school, I was a bedside nurse on a telemetry floor for 5 years. It was during this time that I truly learned how to care for and guide my patients, and I had the extreme pleasure of working with patients during this difficult time in their lives. This is where I discovered my passion for patient education; I believe that knowledge is power. Working with patients and helping them to understand more about their unique situations and next steps has been one of the highlights of my career.

In 2022, I was a finalist for the Brown Foundation Award, MD Anderson’s highest award to celebrate excellence in oncology nursing. It was truly an honor to be recognized for my love of patient education and compassionate care.

TON: Tell us about the types of services that patients are able to receive through the ABC Program.

Ms Kaler: The ABC Program provides integrated care for patients by combining the ABC Clinic and the vast resources of MD Anderson, allowing patients to access these services to improve their health and quality of life. The ABC Clinic features nurse practitioner navigators, which are part of the healthcare team. These highly skilled professionals guide patients through the MD Anderson system and offer emotional support, access to clinical trials and specialty clinics, tailored patient education, advanced treatment, innovative care projects, and quality-of-life protocols.

TON: What are your primary responsibilities at the clinic?

Ms Kaler: I love being an advanced practice registered nurse navigator. I work with patients as well as the primary oncology team. I meet with patients via video visits on an ongoing basis to discuss the following:

  • ABC diagnosis and treatment education
  • Personalized therapy education (eg, clinical trials, genetics, genomics)
  • Care coordination
  • Goals of care
  • Psychosocial support
  • Resource utilization assessment
  • Other items as clinically indicated.

TON: What is the most rewarding aspect of your job?

Ms Kaler: I meet with patients at their most vulnerable moments, to understand their unique challenges and barriers to care and brainstorm solutions and options for paths to move forward. This work may be challenging, but seeing patients move beyond their most difficult moments to a place of peace is truly a privilege.

TON: What is one of the greatest challenges?

Ms Kaler: As metastatic breast cancer is a terminal illness with no known cure, it is a harsh reality when patients pass away. There is no amount of time or success of medications that makes the loss of a patient any easier to process.

TON: What advances in breast cancer treatment are you particularly excited about right now?

Ms Kaler: I am excited about the future of oral anticancer medications. These agents allow our patients to receive treatment at home without frequent visits to infusion centers. It creates a great opportunity for navigators to educate patients about oral medications and how to take them safely at home.

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