Living What You Do: A Conversation with Idalina Colburn

Don S. Dizon and Idalina Colburn

There are people where I work whose presence in the clinic pretty much guarantees a smooth day—for both patients and for clinicians. They respond to the calls, coordinate care between specialties, seem to know about what troubles people are having on their medications, and even where you left your stethoscope. They coordinate with medical assistants, schedulers, and the infusion team, and without them, the place would seemingly grind to a halt (or at least, stutter on awkwardly). They are our navigators, and we employ both lay and nurse positions. Both are important and here, they work as a team. Idalina is one of our best nurse navigators. She is so good at what she does she has been recognized multiple times for her skills and for her compassion, most recently as the 2021 Oncology Nursing Society’s Nurse of the Year in our region. What she brings to us is a sense of what we should all aim for: as if she wants us all to work the way we would if she had cancer. And she does. Idalina is the face of life with metastatic breast cancer here in Providence, and each day I am amazed by all she puts into her work. I’ve often wondered how our clinics impact her personally. Instead of wondering, I approached Idalina to chat with me in this month’s column and it’s an honor that she enthusiastically agreed.

Why did you choose a job as a navigator?

At a very young age I watched my grandmother battle breast cancer, and from that point on, I knew that I needed to help others experiencing serious illness. Throughout my career I have been in oncology—as a social worker, a bedside oncology nurse, an outpatient chemotherapy treatment nurse, and a navigator. I really love any role I can play, but of them all, I feel that in navigation I can really impact the cancer journey of someone I have met. I have the privilege of meeting patients early on and can make sure that any potential barrier to their care is addressed and eliminated, so that my patient is well prepared for their cancer journey. I get to follow my patients throughout, and am there when some transition to end of life. I feel honored and humbled to be allowed into the lives of my patients and their families. In navigation, I feel that I am often the glue between the patient and that health care system. I can really make a difference.

Can you share a bit about your own breast cancer journey?

When I was first diagnosed with breast cancer it was 2006, I was a bone marrow transplant nurse and was diagnosed with ductal carcinoma in situ (DCIS). The prognosis was excellent. I underwent a mastectomy and thought I’d be fine afterwards. Years later, I transitioned to oncology and in 2018, and I was working in my current role as a breast/GYN nurse navigator. That’s when I was diagnosed with metastatic breast cancer (MBC).

Suddenly, I was in the exact same place as so many patients I treated who were struggling with the uncertainty and fear that comes with a metastatic diagnosis. However, it might be surprising to say, but I think that being in this role probably made this more tolerable for me. I was surrounded by a group of amazing colleagues that quickly navigated every little detail of my work up and treatment plan. It was scary and overwhelming to know what it all meant, but at the same time, very empowering. I knew what questions to ask and how to advocate for what I needed. Still, I felt extremely supported but also vulnerable and, quite honestly, a little guilty because I didn’t want special treatment. In that way, I see my diagnosis as both a blessing and a curse.

As soon as I was diagnosed, my colleagues started to question if I should consider a different area of oncology and distance myself from treating people with breast cancer. The oncologists that I support tried to protect me; they would often try to shelter me from discussions of patients with MBC who were doing poorly. I remember that around this time, many were not doing well and thinking that maybe my colleagues were right. Perhaps I did need to step away from what I loved to do to protect my own mental health? I decided that maybe it was best and left my position.

I was gone for a year and that additional time allowed me the space to adjust to my own diagnosis. I realized I really missed my old job and then it struck me: perhaps having the same diagnosis as my patients was actually a blessing. Living with MBC myself meant I could really understand what they were going through. I really get it. I can use my experience to be even more effective in my role. I know firsthand the anxiety when you are waiting to schedule a scan, waiting for a test result, when the tumor marker goes up a bit, or when you are experiencing a side effect and worry that you might not be able to stay on the treatment. I get it. But I am also a very positive person and can show them it’s possible to live your very best life with metastatic cancer. In doing so, I can try to empower my patients to do the same.

Knowing all that you do, as a cancer provider and as one receiving services for cancer herself: did it prepare you for what you've also experienced in your family?

In addition to my grandmother, others have had to hear those words, “you have cancer”. My youngest sister, Nelia, tells me that I saved her life. She had experienced some abnormalities on her mammograms and had a couple biopsies that did not show any malignancies. However, given my knowledge and my own experience with breast cancer, I was not satisfied with that work-up and worried that we were missing something. I advocated to get her seen in the high-risk breast clinic, which resulted in closer monitoring with MRI. On her first MRI she was diagnosed with breast cancer. She has had surgery and is currently going through her radiation for early-stage disease. I didn’t really save her life, but this is another reason why I am spending my career exactly where I should be. Having MBC has made me a stronger person, a better advocate, a better sister, and a better nurse navigator.

What do you want people living with MBC to know about navigators (some wish to be more involved in cancer centers, for example)?

I have been very fortunate to know what to ask for and how to utilize my navigators in this institution. My message to anyone diagnosed with cancer would be to request that you have a navigator to help you through this complex journey. Every patient deserves to have one—whether a nurse or a lay navigator. There is nothing worse than trying to figure out the complex health care system on your own. I should know—even working within the system, there are times that it is very overwhelming to get where and what you need. No one should walk it alone. No one.

How does this job impact you emotionally?

I won’t lie. There are some moments, some “patient encounters,” when I am with a patient with the very same type of breast cancer and very similar features, but perhaps is turning the corner and not doing well, when I have to take a breath and refocus. Those moments require me to look deep down and find my strength. However, most days I am thankful and humbled by the strength, courage, and determination that I see in so many women that are going through this experience. My patients give me the strength that I need. I know that I can make a difference. When I counsel a patient who is struggling with symptoms or with the emotional impact of this diagnosis, I really get it. I hope that this comes through, and that my patients feel supported when they allow me into their experience.