Breast Cancer Nurse Navigator on Keeping Pace With New Therapies

As targeted therapies and oral agents continue to reshape breast cancer care, no single clinician can master every new option, according to Ellery Palanuk, MSN, RN, CN-BN, a breast cancer nurse navigator at Compass Oncology, a practice in The US Oncology Network, in the Portland, Oregon, and Vancouver, Washington, area. In an interview with Oncology Nursing News, Palanuk said navigators can best serve patients by understanding enough to explain their care, answering what they can, and knowing when to bring in colleagues with more specialized expertise.

How is the pace of change affecting breast cancer navigation?

"I think the pace of change in breast cancer treatment is really incredible," Palanuk said. "There are so many new targeted therapies, oral medications, different treatment options."

Recent Oncology Nursing News coverage reflects that shift. In October 2026, the FDA approved oral tucatinib (Tukysa) with trastuzumab and pertuzumab as maintenance therapy for HER2-positive advanced breast cancer, an at-home regimen that calls on nurses to monitor liver function, manage diarrhea, and support adherence.¹ An oncology nurse practitioner also recently described how nurses' roles are expanding to include oral therapy adherence and monitoring for antibody-drug conjugate toxicities as treatment becomes more tailored to tumor subtype.²

What does a nurse navigator need to know about new therapies?

Palanuk, who has worked as a nurse in the Portland area for more than 10 years, said the navigator role does not require mastery of every agent.

"I'm lucky as a nurse navigator, I don't need to be the expert on every medication or every new treatment," she said. "I just need to understand enough to help my patients understand what's happening, answer the questions that I can for them, and know when and where to connect them for more specialized expertise."

Who is on the multidisciplinary breast cancer team?

Palanuk described relying on a broad team of specialists.

"I rely a lot on our multidisciplinary team that includes medical oncologists and APPs and also oral chemo nurses, our research team, patient education nurses and pharmacists," she said. "Everybody's going to bring a different level of expertise to that picture."

How do internal tumor boards support individualized care?

"One thing that I am passionate about is our internal tumor boards," Palanuk said.

The format allows the team to review "a patient who has a very complex case and bring it to the multidisciplinary care team, talk it through, hear the different perspectives, and come to a consensus about what makes the most sense for that individual patient," she explained.

"And I think there's a lot of value in doing that," she added. "And the patients really appreciate having their cases reviewed as well."

Palanuk summarized her role simply: "My job is just about kind of connecting the dots for people."

What are the key takeaways for oncology nurses?

• Know enough to explain: Navigators can focus on helping patients understand their treatment plan rather than mastering every new agent.
• Know when to refer: Route questions that call for oral chemotherapy nurses, pharmacists, APPs, or research staff to the right colleague promptly.
• Use the full team: Patient education nurses and pharmacists can reinforce teaching on oral regimens and new therapies.
• Bring complex cases forward: Internal tumor boards offer a venue for multidisciplinary consensus on individualized plans.
• Let patients know their case was reviewed: Palanuk noted that patients appreciate having their cases reviewed by the team.

References

1. Biese A. Tucatinib maintenance for HER2+ breast cancer: what nurses, PAs should know. Oncology Nursing News. October 20, 2026. Accessed October 23, 2026. https://www.oncnursingnews.com/view/tucatinib-maintenance-for-her2-breast-cancer-what-nurses-pas-should-know
2. Biese A. Breast cancer awareness: an APN on personalized care and survivorship. Oncology Nursing News. October 12, 2026. Accessed October 23, 2026. https://www.oncnursingnews.com/view/breast-cancer-awareness-an-apn-on-personalized-care-and-survivorship