Scott Webb (Host): A diagnosis of breast cancer is never easy for medical providers or patients. But at Emerson Health, patients are joined on their journey to survive breast cancer by a breast cancer nurse navigator. And I'm joined today by registered nurse Kim Choquette. She's here today to tell us about her role at Emerson Health and how surviving breast cancer herself inspired her to be there for women and couples as they face their diagnosis and look to defeat cancer.

Host: This is the Health Works Here Podcast from Emerson Health. I'm Scott Webb. Kim, so nice to have you here today. We're going to learn more about you and what you do and encourage women to get their screening mammograms and all that good stuff. So as we get going here, what do you do? Like what is a breast cancer nurse navigator? What does that mean?

Kim Choquette: What that means is it's typically a registered nurse specializing in breast cancer care and helps guide the patient through their breast cancer treatment. And what that essentially is, I like to meet with the patient when they get the news from their surgeon. So typically with breast cancer, you'll hear from the surgeon first. And at that visit, they kind of go through what the cancer treatment is going to look like for you potentially. Before we know all the other tests that come down the line, they kind of hit you with, "Here's everything that's probably going to happen." And, as you can imagine, that's extremely overwhelming. So, I'm at that appointment with the patient so I can kind of bring it down to terms that are a little more palatable, "Don't worry. Everything's going to be fine. We'll take one step at a time." And that's really important at that moment, because this has all been laid out in front of them. It's extremely stressful, very overwhelming. And then, I let them know I'm going to be their point person. I'll be at appointments with them. I'm going to be able to help guide them through, answer any questions they have, educate them on something the doctor mentioned that they didn't quite understand. So, really, my goal is to be their guide through this treatment to help alleviate any fear and know that they have someone to turn to.

Host: Yeah, that's awesome. And it does seem like nurse navigators have become so prominent in medicine over the last few years. Really being with the patients, in this case, women who are newly diagnosed with breast cancer and certainly scared and perhaps other things, right? So being with them throughout this journey, throughout this process, breaking it down in lay terms that, you know, they can sort of get their minds around. I want to have you just share what do you love most about what you do? And maybe you can share some of your personal experiences here, but what motivates you to go to work every day and try to help people and save lives and all that good stuff?

Kim Choquette: Well, what drew me to this position to begin with is that I am also a breast cancer survivor. So, I've been that patient sitting across the desk from the doctors, they're telling me, "You have cancer. Here's what kind of cancer you have. Here's everything we're going to do to treat you." And it's a terrifying experience. So, it was a hard time in my life, as it is for every woman who gets this diagnosis. But I got through it, and I had certain people there to help me through it. One of them was my sister. She's actually also a breast cancer survivor. And I had a conversation when I was thinking about taking this kind of position. I said, you know, "Debbie, is this a job that I want to be doing every single day, being there at a time in a woman's life when she's getting the worst news possible? Is that what I want to fill my days with?" And she made up a really great point to me. She said, "Do you remember that one person within the people that treated you, that one person that helped you the most through that?" She said, "You get to be that person for other women and you'll never forget that person. You get to be someone who walks through the fire with them, brings them through the other side." And honestly, I am so privileged to have a position that I can be that person for other people.

Host: Well, that just brought a big smile to my face. You know, it seems like such a common thread at Emerson that so many of the nurses that I speak with, they had a personal experience there, whether it's that they had their baby delivered there, and then they became a labor and delivery nurse, or in your case, being a breast cancer survivor, your sister as well. It's just so cool. And wondering from you and your sense, like, why do women choose Emerson for their breast cancer care?

Kim Choquette: Well, you know, obviously, we're a community hospital with a great reputation, so people around here are very comfortable with Emerson getting their care here. It's more personalized because we have less people here because we're smaller, so we're able to give that personalized care. And as far as the breast cancer treatment goes, we have a collaboration with Mass General Hospital, so we are considered Mass General Cancer Care at Emerson Hospital.

So with that, that means we have medical and radiation oncologists that are from Mass General. So, we have that connection where they're able to draw with the amazing care from Mass General and bring it right here into Concord. And we also have highly trained surgical specialists for any surgical needs that are necessary. And then beyond all the doctors, we have physical therapists, nutritionists, counselors, support groups, pretty much a comprehensive breast center where everything you need is right here in a place that you're comfortable. And another thing that's amazing is that we have national accreditations. We have one for breast centers itself and for radiology. And that pretty much means that we're a medical center that's proven to meet the highest standards of care on a national level. So, that's an amazing thing to have in a community hospital in an area where people are very comfortable and don't have to drive all the way into Boston to get their care.

Host: Right. It's like Mass General's coming to them and Concord, right?

Kim Choquette: Exactly. And it's so much more convenient and it's a place people have been coming their whole lives, most likely. And it relieves some stress. They don't need more stress than they already have going through this to begin with. And if we can alleviate any of that stress, that is the goal.

Host: Yeah, it absolutely is the goal. And speaking of stress, let's talk a little bit more about screening mammograms and what you would say to a woman who's just afraid to get theirs, whether it's because she believes she has dense breast tissue and she's afraid that the mammogram won't go well or will diagnose something. How do you help them, to encourage them to get those mammograms?

Kim Choquette: Well, it's normal to be afraid and I think everyone is, especially when they're either having their first one or then they know what to expect and they know that it's nerve wracking waiting for those results. So, what I would just say generally is this can save your life. Early detection, there's been studies that show 10-year survival rate for cancers that have been detected by mammograms are 95%. So, that's an unbelievable rate of success in treating breast cancers that are found early. Because if you're not feeling a lump and you just happen to find it on a mammogram, then that means it's early, it's treatable, and turns into something that is a few months worth of treatment as opposed to could be years, could be chemotherapy, and you can avoid all that if you get some early detection.

So, you know, generally women who are 40 to 44 should start their screening mammograms every year. Around 45 to 54, they should definitely be getting their mammograms every year. And then, women who are 55 and older, they can switch to every other year, if that's what their providers decide is right for them. Even women 35 years old are eligible to have a mammogram if they have a strong family history of cancer or if they're considered high risk because of any genetic factors.

Host: Yeah. And that seems to be the case, and fortunately insurance seems to be playing ball for us folks who do have a strong family history, genetic component or at higher risk. So being screened for mammograms, get those screening mammograms earlier, as you say, as early as 35 perhaps, or colonoscopies, you know, all of that type of stuff that many of us drag our feet about. But as you say, early diagnosis, early detection, early treatment doesn't guarantee survival, but it's a good start, right?

Kim Choquette: Absolutely. It gives you the best chance of if something happens to be there, getting it taken care of early and easier than it would be later on. If something's there, it'll grow, whether you know it's there or not. So, it's better to find out early and take care of it and have a much better outcome than if you just pretend, "Oh, no, I'm fine, not going to worry about it."

Host: Yeah. Burying our heads in the sand is never recommended, never prescribed by medical professionals. Well, Kim, this has been great today. Great learn more about you and what you do and how women and couples there are in such good hands, you know, having you as their navigator, taking them through this process and, as always, trying to encourage all women to get those screening mammograms, know their risk factors, whether they need to get started early, all that good stuff. So, thank you so much. You stay well.

Kim Choquette: Thank you, Scott. You too.

Host: For more information, visit emersonhealth.org/breasthealth or call 978-287-3547. And thanks for listening to Emerson's Health Works Here podcast. I'm Scott Webb. And make sure to catch the next episode by subscribing to the Health Works Here Podcast on Apple, Google, Spotify or wherever podcasts can be heard.