Introduction
One of the main concerns expressed by cancer patients and their family members is uncertainty about the pathways of care. Many have indicated in needs assessment surveys that they do not understand the way their care will be organized or how they are to access services and supports. Navigation has been described as an intervention that can assist patients and families in understanding the cancer system and how to move through the various settings and providers.

Purpose
Our work was designed to understand the differences in professional, peer/lay and self navigation approaches in cancer care and understand the competencies needed for each.

Methods
Through literature review, focus groups and implementation of demonstration programs, evidence was gathered regarding how to best implement cancer patient navigation approaches, navigator roles and responsibilities, and support the development of navigator competencies.

Results
Key lessons emerged from the implementation of patient navigation projects: the importance of engaging leadership, the need for a clear vision and program elements, and the critical contribution of education and evaluation. Patient satisfaction with navigation was high although health care professionals struggled with clarity of roles and responsibilities as a new member of the cancer care team was introduced. Education ought to be developed in order to achieve the defined competencies for professional, peer and self navigation.

Conclusions
Cancer patient navigation can be an effective augmentation to the existing cancer care delivery system. It is critically important to select the correct type of navigation approach to fill the identified gaps in care delivery in a jurisdiction.