Cancer numbers are increasing in numbers, as are the survival rates. And behind all of these statistics are hundreds of personal stories filled with struggle, endurance, acceptance, and increasingly but not always, recovery.

Therefore, health officials in Malta are paying more attention to the quality of life of people with cancer both during and after their treatment.

Marmarà was driven by a deep concern for the individual experiences of cancer sufferers. This drive led her to seek out and develop approaches that serve the unique needs of patients beyond the essential medical treatment of cancerous tumours.

During her years of studying and training in the UK, Marmarà noticed that the most impressive features of cancer care were timeliness and efficient coordination.

But still, despite the fairly robust systems in place, it was apparent for Marmarà that patients could still fall out of the system. And so, she began researching ways to both prevent or catch people at risk of slipping through gaps in the system.

This led her to her first encounter with the idea of a health system “navigator”, which was being trialled in areas in the US.

This concept lingered in her mind and upon completing a PhD in cancer care at Stirling University, she returned to Malta with a strong vision to improve cancer systems locally.

Through observing and speaking with patients and families during their time affected by cancer, Marmarà noticed certain service gaps that leave patients and survivors feeling lost following their treatment.

It became clear to her that patients needed the health system to have a human face.

“The needs at diagnosis are quite different to those after treatment, which takes a heavy emotional toll. Each person’s needs depend on their context; for example, if it’s a woman who works and has a family, it’s about returning to work, coping with family and relationships, and, of course, her physical, psychosocial, spiritual and emotional needs.”

This is why holistic and continuous care is at the core of the nurse navigator role in Malta. The role is designed based on input from patients about their day-to-day needs, including accessible cancer type-specific information, joined-up care, and dealing with fear of the unknown.

After a lot of hard work, the role was launched in 2017.

A nurse navigator was recruited for colorectal cancer. And since then, recruitments have only grown. Nurse navigators have been signed up to take on gastrointestinal, lung, urological (prostate, bladder, kidneys, penile, testes), gynaecological, head and neck, and most recently, breast cancer.

This new system has proved to have numerous benefits for people diagnosed with cancer. It has resulted in faster diagnosis which is also due to a new fast-track system, shorter time between diagnosis and start of treatment, increased patient and caregiver knowledge, better adherence to recommended care, and reported improvements in quality of life.

“Other countries may take note, as early signs are that this model is providing real improvements and truly embodying patient-centred care,” the WHO concluded.

Congratulations Danika for making waves in the development of cancer care