Navigating Cancer Survivors Through the Continuum of Care With Darcy Burbage, DNP, RN, AOCN®, CBCN®

The Evolving Definition of Survivorship

“Survivorship is a lifelong journey that begins at diagnosis and continues throughout and beyond treatment,” Dr. Burbage explains. Advances in early detection and treatment have transformed survivorship, expanding the focus from post-treatment care to a comprehensive approach that includes surveillance, risk reduction, health promotion, and management of long-term and late effects—both physical and psychosocial.

Navigating Unique and Invisible Challenges

Survivors face a range of challenges, many of which are deeply personal and often invisible to others. “Even the word ‘survivor’ can be empowering for some, but triggering for others, especially those living with advanced or metastatic cancer,” Dr. Burbage notes. Well-intentioned comments like “You look great” or “Aren’t you glad it’s all behind you?” can inadvertently invalidate ongoing struggles such as fatigue, anxiety, or fear of recurrence.

Triggers may include anniversaries of diagnosis or treatment, and the anxiety of waiting for test results, termed “scanxiety.” Reintegration into daily life, work, and relationships can also be fraught with stress, as survivors navigate shifting roles and expectations. “Survivors may feel a disconnect between external expectations and what they’re internalizing themselves,” Dr. Burbage says, emphasizing the importance of clinicians asking open, empathetic questions to uncover these hidden challenges.

The Critical Role of Nurse Navigation

Nurse navigators are essential in the survivorship journey, serving as consistent points of contact and advocates for patients. “We help ensure that survivors don’t feel abandoned at the end of treatment,” Dr. Burbage shares. Navigators coordinate follow-up care, address barriers such as financial toxicity, and offer guidance on which provider to contact for ongoing symptoms. “I tell my patients, ‘I work for you, so whatever you need, feel free to call me.’” This ongoing, trusting relationship helps survivors feel supported, even months or years after treatment.

Evidence-Based Support and Motivational Interviewing

Clinicians can further support survivors by using evidence-based tools, such as patient-reported outcomes, to assess ongoing needs. “I call it ‘recognize, reassure, and refer’,” Dr. Burbage says. Validating concerns, providing reassurance, and connecting survivors to resources like rehabilitation or palliative care are key steps.

Motivational interviewing is another powerful approach, empowering survivors to define wellness on their own terms. “It helps guide survivors toward their own solutions, rather than prescribing what they should do,” she explains. This method fosters a sense of control and partnership, making survivors active participants in their care.

MASCC Presentation: Beyond Survivorship 101

At the upcoming Multinational Association of Supportive Care in Cancer (MASCC) Annual Meeting, held from June 26-28, 2025, Dr. Burbage is presenting as part of a half-day program titled “Beyond Survivorship 101,” where she will share insights on implementing motivational interviewing within survivorship programs, highlighting how nurse navigators can effectively use this technique to empower survivors and emphasizing that there is no one-size-fits-all approach; programs should be tailored to the specific needs of their community.

A Message for National Cancer Survivors Month

In honor of National Cancer Survivors Month, Dr. Burbage offers a powerful message to both survivors and clinicians. To survivors, she emphasizes the uniqueness and power of their individual stories, regardless of where they are in their journey. “Your story is powerful. It’s your own experience, and whatever your hopes and fears are, they’re real and valid. Don’t be afraid to share them with your clinicians and with your family, so we can help you get back on track.”

To clinicians, she stresses the importance of teamwork, empathy, and patient-centered care. “We need to continue to show up with empathy, with curiosity, and with humility. We need to let the patients lead, and we need to continue to be their advocate, their guide, and their champion through this part of the journey.”

Key Takeaways

• Survivorship is a lifelong, evolving journey that requires a comprehensive, individualized approach.
• Challenges are often invisible; clinicians should ask open-ended questions and validate survivors’ experiences.
• Nurse navigators play a vital role in providing continuity, advocacy, and support.
• Evidence-based tools and motivational interviewing empower survivors and enhance care.
• Teamwork and empathy are essential: Clinicians should be empathetic and let the patients lead.

About Dr. Burbage

Darcy Burbage, DNP, RN, AOCN^®, CBCN^®, is an Oncology Clinical Nurse Specialist in Newark, Delaware and is passionate about helping individuals with cancer navigate the journey during and after treatment. She has presented and published extensively on topics relating to nurse navigation, cancer survivorship, and palliative care.