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2009 Rutherford Hospital Inc.Cancer Program

Annual Reportfeaturing 2008 statistics

Finding Hope for aBrighter Tomorrow.

has been a year of exciting opportunities for growth and more effectively meeting needs of our

cancer patients. The Open House for our new Cancer Resource Center was a great success. Not only does the county

now have a central location where cancer patients can receive information about their particular type of cancer,

but cancer screenings and support groups are also held in the building. Through the excellent leadership of Jamie

Ingraham and Dee Allen, our patients are able to get the necessary information to make informed decisions about

their care and get much-needed support.

Rutherford County is an economically depressed area and has an unemployment rate of approximately 17 percent,

one of the highest rates in North Carolina. With the economy suffering, the number of uninsured people in the

community continues to increase. Two local businesses, Covenant Advisory Group and Doncaster, joined with

Rutherford Hospital, Inc. (RHI) to provide a fund-raising event. In February,

“Fashion with a Passion” was held to raise money to provide mammograms for

patients who are uninsured. To have a program that provides mammograms for

these patients is quite remarkable for a hospital our size.

The Patient Navigation program, which began in 2008 through funding from

the Duke Endowment, has been highly successful with over 100 patients served

since its beginning. The program began serving only breast cancer patients

but in 2009 grew to also incorporate all gynecologic malignancies. The program

continues to receive excellent feedback from both patients and physicians.

Determining an individual’s risk of developing cancer and cancer screening is an

important part of individualized medical care. Dr Matt Rees and the Cancer

Program leadership felt having a computerized program to help determine

cancer risk factors is a tremendous need. A group of graduate students from the

UNC School of Public Health met with the Cancer Program leadership in 2009

and is working to develop a cancer risk assessment that can be used throughout

the state of North Carolina. Not only will the individual completing the

assessment know his or her risk factors but will also be given information about

cancer screenings that are needed. Rutherford Hospital is proud to be involved

in this tremendous endeavor.

Because of her care and concern for our cancer patients, Katie Miller, a Patient/Family Support Liaison, worked

diligently to obtain donations to improve the décor of a patient room on our Oncology Unit. Patient surveys indicated

the change was a very positive one and made a difference in the overall experience of our patients. Katie exemplifies

the commitment of our staff to the Rutherford Hospital, Inc. vision “to provide an excellent patient care experience

every time.”

The Rutherford Hospital, Inc. Cancer Program continues to strive for excellence in providing quality patient care

every day. We are committed to maintaining our status as an approved cancer program that has the experienced

hearts, hands, and minds to care for you close to home.

‘More effectively meeting needs of cancer patients’

David M. Bixler,

President and CEO

Rutherford Hospital, Inc.

2

The year 2009

The Patient Navigation

program, which began in

2008 through funding

from the Duke

Endowment, has been

highly successful with

over 100 patients served

since its beginning.

The program continues

to receive excellent

feedback from both

patients and physicians.

The Cancer Committee is a multidisciplinary committee made up of physicians from various diagnostic and treatment

specialties and non physicians from administrative and support services. The Cancer Committee provides oversight of

quality improvement activities, the Cancer Registry, and Cancer Conference (Tumor Board), and community outreach.

The Cancer Committee meets quarterly and is responsible for all Cancer Program activities at Rutherford Hospital. The

Committee is also responsible for appointing coordinators to be responsible for the four primary

functions of the Cancer Program. The coordinators for 2009 were:

• Cancer Conference – Dr. Matt Rees

• Quality Control of Registry Data – Dr. Scott Roberts

• Quality Improvement – Peggy Baumgartner and Nancy Boffemmyer

• Community Outreach – Dr. Matt Rees and Jamie Ingraham

Reports are given at each meeting highlighting the activities of each area. This provides a global

view of the status of compliance with the standards set by the American College of Surgeons

(ACoS) Commission on Cancer. Reports from each area providing supportive care are also

given at the quarterly committee meetings. The Committee takes the information and identifies the needs of the program.

Each year the Cancer Committee sets goals designed to meet the identified needs. All goals have a major purpose of

enhancing care given to our cancer patients. The goals encompass 4 areas: community outreach, programmatic, quality

A Word About the Cancer Committee

continued ...

2009 Annual R

eport

Applying for and maintaining Commission on Cancer (CoC) approval is a voluntary commitment by a cancer program that

ensures its patients will have access to the full scope of services required to diagnose, treat, rehabilitate, and support patients

with cancer and their families. A cancer program is able to continually evaluate its performance and take proactive corrective

action when necessary. This continuous evaluation reaffirms the commitment of the program to provide quality cancer care.

In 2001 Rutherford Hospital first received approval as a Community Hospital Cancer Program. The most recent survey was

in June of 2007 when the program again received approval with 7 areas of commendation. An upcoming survey is scheduled

for June 2010. For our patients and Community, the quality standards established by the CoC for

cancer programs ensure that Rutherford Hospital provides:

• Comprehensive care including a complete range of state-of-the-art services and equipment

• A multidisciplinary team approach to coordinate the best available treatment options

• Information about ongoing cancer clinical trials and new treatment options

• Access to prevention and early detection programs, cancer education, and support services

• A cancer registry that offers lifelong patient follow-up

• Ongoing monitoring and improvements in cancer care, and

• Quality care, close to home

Approval of the RHI Cancer Program

3

The most recent surveywas in June of

2007 when the program

again received approval with

7 areas of commendation.

Dr. Bill Haden,

Cancer Committee Chair

improvement, and clinical. The goals approved by the Cancer

Committee for 2009 were as follows:

• Programmatic – To search for and identify the availability of a

computer program that allows the input of specific data by an individual

to determine their risk for cancer and what they need to be doing for

screening and prevention. – UNC-Chapel Hill students who are

managing a project to develop this program have completed the tool.

During the spring of 2010 it will be available for a pilot study on

volunteers in our county at the Cancer Outreach Center.

• Clinical –

1. A revision and staff education of the bowel protocol for Oncology patients

will be accomplished. – Goal was attained.

2. The chemotherapy flow sheet will be revised. – The flow sheet has been

developed and changes made. It has been given to hospital’s MIS department

to put into its Meditech system.

• Community Outreach – To increase awareness of the community of the

Cancer Resource Center and resources available to cancer patients and their families through RHI’s Cancer Outreach and

Navigator Programs. – Goal was attained. Numerous articles about the program have appeared in the Daily Courier.

Physician referral and word of mouth have greatly increased the visibility of both the Cancer Outreach Center and the

patient navigation program. The program was expanded to include gynecological cancers for 2010.

• Quality Improvement –

1. To review 2008 colon cancer cases using ASCO criteria. – Two ASCO criteria have been used in evaluation of colon

cancer cases.

• Adjuvant chemotherapy is considered and/or administered within 4 months for patients under 80 who have Stage III

lymph node positive colon cancer

• At least 12 lymph nodes are removed and pathologically examined for resected colon cancer. – Pathologist Bob

Stallings, M.D. reported that in 2009 12 or more lymph nodes were removed in 94% of cases where there was

a resection. This is a dramatic improvement from 57.1% in 2004.

2. The following goals from 2009 are ongoing and will be a major focus of 2010. The American Cancer Society has

provided a grant that will allow us to meet these goals in 2010 with the assistance of the Duke Oncology Network.

• Develop quality measures for reviewing the care of lung cancer patients.

• Have a recognized expert in the field of lung cancer review the data on patients diagnosed and/or treated at RHI

and make recommendations for improvement.

• Have a multidisciplinary team develop and finalize a Lung Cancer Protocol to be used by Physicians providing

care to lung cancer patients.

Cancer Committee, continued

The Cancer Committee is a

multidisciplinary committee

made up of physicians from

various diagnostic and

treatment specialties

and non physicians

from administrative

and support services.

4

William Haden, MD

General Surgeon

Rutherford Surgical Associates, PA

Cancer Committee Chair

Dean Backstrom, MD

Medical Staff Director


Peggy Baumgartner, RN, CPHQ

Director, Quality Resources ManagementRutherford Hospital, Inc.

David M. Bixler

President and CEO


Nancy Boffemmyer, BSN, RN, CNA, LNHA, MHAVice President, Patient Care Services & CNORutherford Hospital, Inc.

Lynn Hensley, RN

Nurse Manager, Second Medical UnitRutherford Hospital, Inc.

Lena Higgins, RNC

Nurse Manager, Behavioral Health Rutherford Hospital, Inc.

Ann Hutchins

Cancer Survivor

Community Support

Jamie Ingraham, RN, BSN

Cancer Outreach Coordinator


Don Ledbetter, M.Div., APCE

Chaplain, Spiritual Care DepartmentRutherford Hospital, Inc.

Ronda Patton, RN

Director of Palliative Care

Hospice of Rutherford County

Luther Person, MD

Diagnostic Radiologist

Rutherford Hospital Inc.

Maggie Perry, RD, LDN

Dietician


Anita Phillips, RN, BSN

Patient Education


Stewart Powell, MD

Urologist

Foothills Urology

Matthew M. Rees, MD

Medical Oncologist/Cancer Liaison Physician

Rutherford Internal Medicine Associates

Scott Roberts, MD

Radiation Oncologist

21st Century Oncology

Lynn R. Ross, RN, MSN, CTR

Oncology Program Director


Robin Pendleton, MD

OB/GYN

Rutherford OB/GYN Associates, PA

Barbara Simpson, PT, MHA

Director, Rehabilitation Services

Rutherford Hospital, Inc

Robert Stallings, MD

Clinical Pathologist


Members of the 2009 Cancer Committee 2009 Annual R

eport

The individuals on the Cancer Committee are constantly seeking ways to provide our patients with the best care

possible. Because of this commitment by each member of the Cancer Committee, the program is continuously

evaluated and changes made as needs are identified at each meeting.

5

An essential way of providing optimum care to cancer patients is to present them with the very best treatment options

available. This allows the patient to choose the treatment that is right for them. Tumor Board is a meeting where cancer

cases are discussed and input from various medical specialties is received.

Patients presented at Tumor Board receive information from their physician

about treatment choices discussed at Tumor Board. This results in informed

treatment decisions by the patient because he/she is given options that seem

most likely to benefit them. Tumor Board was held 18 times in 2009.

A requirement of the Commission on Cancer is that 75 percent of cases

presented at Tumor Board are “prospective.” Prospective cases are:

• Newly diagnosed and treatment is to be determined;

• Newly diagnosed and treatment has started but discussion of additional

treatment is needed;

• Previously diagnosed and initial treatment is complete but discussion of additional

treatment or treatment for recurrence or progression is needed;

• Previously diagnosed, and discussion of supportive or palliative care is needed.

In 2009 there were 109 cases presented at Tumor Board. All of the cases but three were

prospective. Those cases were presented to provide follow-up information regarding

treatment decisions and outcomes. At each meeting staging at the time of diagnosis and

national treatment guidelines were discussed during the presentations. Frequently the

presenting physician

talked about the different

options available to patients

within the NCCN guidelines.

Cases presented at Tumor Board during 2009 included the

major sites diagnosed at Rutherford Hospital, Inc. as well as

some of those infrequently seen.

The team of physicians attending Tumor Board represented 12

different specialties. An average of 11 physicians attended

each conference. An average of 4 Nurses and staff from other

disciplines also attended each conference.

The goal of Tumor Board continues to be offering the best

treatment options to our patients in a way that he or she

understands and can make an informed decision about the

care they wish to receive.

TUMOR BOARD (CANCER CONFERENCE)

Physicians at tumor board

discussing details of a

cancer case.

6

Tumor Board is a meeting where cancer cases are discussed and

input from various medical specialties is received. Patients presented

at Tumor Board receive information from their physician about

treatment choices discussed at Tumor Board. This results in informed

treatment decisions by the patient because he/she is given options that

seem most likely to benefit them.

AnusBrainBreastColonEpiglottisGallbladderGerm CellTumorHodgkin LymphomaKidneyLeukemiaLungLymphomaPancreasMelanoma

MouthNeckOvaryParotidProstateRectumSarcomaSkinTesticleThyroidTonsilUterus

CANCER SITES PRESENTED AT TUMOR BOARD – 2008

There have been 3,160 patients placed in the Cancer Registry since it started in 1997. In 2008, 312 new cases of cancer

were diagnosed and/or treated at Rutherford Hospital. The reason Cancer Registries are a part of any Cancer Program is for

the collection, management, analysis and distribution of data about cancer cases. By tracking incidence and stage of these

cases and the effectiveness of common cancer treatments, the care of our cancer patients can be evaluated and improved.

Data in the Cancer Registry allows Rutherford County statistics to be compared with statewide and national statistics. The

following overview is based on statistics taken from 2008 data.

A projected 42,451 people in North Carolina were newly diagnosed with cancer in 2008 and 1,437,180 in the United States.

In 2008 there were 301 patients diagnosed and/or treated at Rutherford Hospital with 312 new cancers. Of the 312 new

cases, there were 137 males and 175 females. The most prevalent site of cancer for females was breast, followed by

bronchus and lung. In males, the most prevalent sites were bronchus and lung, followed by prostate.

Age/Sex of All Cancer Cases Entered Into the Cancer Registry in 2008:

MALE FEMALE TOTAL

20 - 29 2 3 5

30 - 39 0 2 2

40 - 49 7 8 15

50 - 59 25 31 56

60 - 69 45 50 95

70 - 79 33 41 74

80 - 89 20 37 57

90 - 99 5 3 8

Total 137 175 312

CANCER Registry

There have been

3,160 patients placed

in the Cancer Registry

since it started in 1997.

In 2008, 312 new cases

of cancer were diagnosed

and/or treated at

Rutherford Hospital.

The reason Cancer

Registries are a part

of any Cancer Program

is for the collection,

management, analysis

and distribution of

data about cancer cases.

2009 Annual R

eport

70

10

20

30

40

50

60

20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99

Male

Female

The top 5 sites of cancer diagnosed and/or treated at RHI in 2008 are reflected in chart #1. Of note is the percentage of

meningeal tumors diagnosed in 2008.

In reviewing cases entered into the Cancer

Registry the most common types of cancer

diagnosed at Rutherford Hospital were compared

with the estimated cancer cases in both North

Carolina and the United States. It was found that

Rutherford County had a higher incidence of

men diagnosed with lung and bronchus cancer

and women with breast cancer. Colorectal cancer

was also seen to be higher in both men and

women than estimated cases in both North

Carolina and the United States. The incidence of

breast cancer in women, lung cancer in men and

colorectal cancer in both men and women is

compared to state and national estimates in chart

#2. (National estimates for lung/bronchus and

colorectal cancers were not available broken

down by sex.)

Incidence of lung and breast cancer in Rutherford

County is a major concern to Rutherford

Hospital. The Patient Navigator Program that

started in October of 2008 still has a primary

focus of breast cancer patients. It continues to

grow with gynecologic cancer patients being

added in 2009. In 2009 several opportunities for

community members to donate money to provide

financial assistance to patients who could not

afford mammograms were available. (These

events are highlighted later in this report.)

Because of the high incidence of lung cancer in

Rutherford County, tobacco cessation is a key

component of our Cancer Education Program.

Smoking cessation programs have been offered

to the community free of charge. In an effort to

help our patients stop using tobacco, all patients

who are admitted as inpatients or outpatients are given information about tobacco cessation and counseling is available for

patients who are hospitalized. Tobacco prevention programs for youth are also presented in local schools.

Cancer Registry, continued

8

21.8%

17.6%

13.5%

6.7% 6.4%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

Type of Cancer 21.80% 17.60% 13.50% 6.70% 6.40%

Breast Lung Colorectal Prostate Meninges

0%

10%

20%

30%

40%

50%

RHI 39% 19% 15% 13%

NC 31% 14% 11% 13%

US 13% 15% 10% 10%

Breast Lung/Bronchus Colorectal Colorectal

Chart #1

Chart #2

2009 Annual R

eportAt Rutherford Hospital:

Summary by body system and sex

Oral Cavity & Pharynx - 3 (2%)

Lung and Bronchus - 35 (26%)

Pancreas - 5 (4%)

Kidney & Renal Pelvis - 4 (3%)

Urinary Bladder - 8 (6%)

Colon & Rectum - 20 (15%)

Prostate - 21 (15%)

Non-Hodgkin Lymphoma - 1 (1%)

Melanoma of the skin - 2 (1%)

Leukemia - 5 (4%)

All other sites - 33 (24%)

Thyroid - 1 (1%)

Lung and Bronchus - 20 (11%)

Breast - 68 (39%)

Kidney & Renal Pelvis - 3 (2%)

Ovary - 7 (4%)

Uterine Corpus - 6 (3%)

Colon & Rectum - 22 (13%)

Non-Hodgkin Lymphoma - 3 (2%)

Melanoma of the skin - 1 (1%)

Leukemia - 0 (0%)

All other sites - 44 (25%)

Images reprinted by the permission of the American Cancer Society Inc.

from www.cancer.org. All rights reserved.

Males137

Females175

9

Colon cancer is a concern in Rutherford County. There were 1,745 colonoscopies done at Rutherford Hospital in 2008 with

the large majority done for screening purposes. Three Physicians are credentialed to perform colonoscopies. The majority

of Physician offices have screening guidelines posted in areas where they are easily seen by patients. Screening guidelines

are also given to patients as they are admitted to Rutherford Hospital.

Quality Control is a large part of the Cancer Registry. Each year several indicators are chosen to be used in review of cases

being entered in the Cancer Registry. In 2009 four indicators were used to monitor the quality of Cancer Registry Data:

1. The size of the tumor size was coded correctly;

2. The site of the tumor site was coded correctly;

3. Chemotherapy was considered and/or administered within 4 months for patients under 80 who have stage III

lymph node positive colon cancer;

4. At least 12 lymph nodes were removed and pathologically examined for

resected colon cancer.

Improvement in gathering these data items was noted throughout the year. Registry

data was also reviewed by a Physician member of Cancer Committee, Dr Scott

Roberts. Fifty-nine records were reviewed for accuracy which is well above the

required 10% of cases to meet the standards of an approved cancer program.

Quality of data is vital in making sure the Cancer Registry accurately portrays the

types and numbers of cancer cases seen in Rutherford County.

Our goal is to have the Cancer Registry provide the most accurate and

comprehensive data possible so that changes can be made in providing care

for the cancer patients in Rutherford County.

Cancer Registry, continued

In reviewing cases

entered into the Cancer

Registry the most

common types of cancer

diagnosed at Rutherford

Hospital were compared

with the estimated

cancer cases in both

North Carolina and the

United States. It was

found that Rutherford

County had a higher

incidence of men

diagnosed with lung and

bronchus cancer

and women with breast

cancer. Colorectal

cancer was also seen to

be higher in both men

and women than

estimated cases in both

North Carolina and the

United States.

Patients often have fears about participating in clinical trials. These fears can be the biggest barrier to participating

in these cancer treatment options. Many of these fears are unfounded but are strong enough in the general

population to slow down the pace of cancer research. Some of the myths that are often talked about are:

• Patients in clinical trials are treated like guinea pigs.

When asked in a survey about their care and treatment, 97 percent of patients state they were treated with dignity

and respect and received excellent care.

• You need to be near a big hospital to take part in a clinical trial.

Under the direction of Dr. Matt Rees patients are offered the option of

participating in a clinical trial when one is available for their particular type

of cancer. Treatment is given right here in Rutherford County.

• Once I sign a consent form that’s it; I can’t back out.

Any patient who is in a clinical trial is able to change their mind AT ANY TIME

without giving up access to other treatment options.

Why should a cancer patient consider a clinical trial? Cancer treatment clinical

trials are organized research studies involving people who have cancer. They try to

answer specific questions to find better ways to prevent, detect, treat or improve

care for our cancer patients. In many cancer treatment trials, one treatment is compared with another. When one

treatment is compared with another, patients receive either the most advanced and accepted treatment for the kind of

cancer they have (the standard treatment) or a new treatment that has shown promise of being at least as good as the

standard treatment, if not better. We don’t know which treatment is better when the study starts. In almost all cancer

treatment clinical trails, patients receive treatment for their cancer. Patients do not receive a placebo (sugar pill) for

their treatment unless there is no standard treatment for that particular cancer.

Everything we know about cancer treatment today is because of people who have participated in previous clinical

trials. The more people who participate in clinical trials, the faster we can get the answers we need to cure cancer.

One area of discussion at Tumor Board may be the potential for a patient to be

enrolled in a clinical trial. Since 1999 Rutherford Hospital has partnered with Upstate

Carolina CCOP to provide opportunities for patients to be involved in clinical trials.

This gives patients the

opportunity to receive

cutting edge treatment. In

2009, nine patients chose

to participate in a clinical

trial. With all of the

changes that are occurring

in cancer care we are

hopeful many more will

participate in 2010.

Clinical Trials

Everything

we know about cancer

treatment today is

because of people who

have participated

in previous

clinical trials.

10

Lung cancer remains a major medical problem in the United States. It is the leading cause of cancer death in the US.

Approximately 220,000 people will be diagnosed with lung cancer this year. Of those 40 – 50 will be from Rutherford

County. The incidence of lung cancer and mortality rates in men have dropped over the last 10 years, but this has not been

true for women.

Cigarette smoking is the primary cause of lung cancer. Approximately 85 – 90% of all cases of lung cancer are caused by

smoking or exposure to “second hand smoke.” Smoking cessation starts the process of gradual reduction in the risk of lung

cancer. Through individual initiative, various medications, and programs such as

the free smoking cessation program offered through Rutherford Hospital, we are

starting to see more success in smoking cessation, and this is expected to decrease

the risk of lung cancer.

Patients diagnosed with lung cancer generally present with symptoms of cough,

shortness of breath, chest pain and weight loss. Other symptoms that cause someone

to seek medical attention are appetite loss, coughing up blood or the development

of pneumonia. The diagnosis is suspected by the finding of a mass on X-rays,

followed by a biopsy showing non-small cell lung cancer. Subtypes of non-small

cell lung cancer include adenocarcinoma, large cell, squamous cell and

broncho-alveolar cell carcinoma.

Lung cancer starts in the lung tissue but very often is able to migrate into the lymph

nodes in the center of the chest or to metastasize through the blood stream to distant

parts of the body. Contrary to popular belief, lymph node involvement is not

necessarily a sign of incurability. The lymph nodes act as filters of infection and of

cancer, and can trap cancer cells. Cancer, which is limited to the site of origin and

the lymph nodes is potentially still curable.

Staging

There are four “stages” in lung cancer. Stage I describes cancer which is in the lung tissue but has not yet migrated to the

lymph nodes or distant areas. Stage II lung cancer has migrated into the first station of lymph nodes. Stage III lung cancer

has migrated into more centrally or distantly located lymph node areas in the chest. Stage III lung cancer is also defined as

when the primary lung cancer has invaded into the mediastinum or chest wall. Stage IV lung cancer indicates metastatic

disease which has spread through the blood system to distant parts of the body.

We speak of 5-year survival rates, which indicate the percentage of patients who are

alive 5 years after the time of diagnosis. In the early Stage I patient, we can expect a

5-year survival rate of 80%. This drops down to 40% in Stage II patients, and down

to 15% in Stage III patients. Stage IV patients, with metastatic disease, have roughly

a 15% chance of survival at 2 years, rather than 5 years.

2009 Annual R

eport

A Brief Overview of Non-Small Cell Lung Cancer

11

continued ...

by Matt Rees, M.D., and Scott Roberts, M.D.

Matt Rees, M.D.

Scott Roberts, M.D.

lung cancer cell

12

Medical Care

When a patient is newly diagnosed with lung cancer, it is important to obtain a biopsy to determine what cell type of

lung cancer has developed. Often a bronchoscopy is performed to obtain this biopsy. Most patients will then undergo

various x-rays and scans. Often, the newer PET scan will be utilized to determine the extent and stage of disease. In

some settings, a surgical procedure to biopsy the lymph nodes in the center of the chest will be required.

Treatment

Treatment for lung cancer is multidisciplinary, and involves a team

approach. The type of treatment depends on the stage of disease.

Earlier stage cancers are often treated with surgery. Other stages

are treated with various combinations of surgery, chemotherapy, and

radiation. Other common treatment options now include oral agents

with minimal toxicity that benefit a subset of patients, as well as

antibodies that prevent new blood vessel growth to tumors.

In patients with Stage III disease, surgery is usually not feasible.

The general rule is that surgery is not recommended when it has not

been shown to have a favorable impact on survival. In these Stage

III patients, combining chemotherapy and radiation therapy has

been shown to improve both quality and quantity of life. Likewise,

Stage IV is usually treated with a combination of chemotherapy

with or without radiation therapy.

The use of both chemotherapy and radiation therapy has greatly

improved over the past decades. Both treatments are effective at

killing cancer cells and reducing the amount of cancer in the body.

For early Stage III disease, combined chemotherapy and radiation

therapy is potentially curative. For more advanced disease, therapy

does not cure the cancer but can reduce the amount of cancer in the

body, thereby prolonging survival and improving symptoms. Side

effects due to cancer therapy are measurable but with modern

techniques are significantly less than in years past.

When eligible, patients are often offered the opportunity to participate in clinical trials. Clinical trials are available for

patients with lung cancer. These studies offer the newest research based treatments for patients, with potential benefit not

just to the patient, but for other patients down the road. We are pleased to be able to offer several clinical trials locally.

One of the recent advances in lung cancer has been the discovery that the subtypes of non-small cell lung cancer respond

differently to various treatments, and precision in subtyping has become a major focus of evaluation. We are very excited

about he recent advances in lung cancer diagnosis and treatment. Lung cancer research seems to have blossomed, and as

more discoveries are made we expect to see a continued increase in options available for our patients.

Site Specific Study: Non-Small Cell Lung Cancer (continued)

2009 Annual R

eport

13

Duke Oncology Network Affiliation

New MRI Successfully Delivered in December 2009

In the fall of 2009, several members of Administration and the Cancer committee met with the leadership of the Duke

Oncology Network to discuss the feasibility of establishing an affiliation. The purpose of the relationship would be to

improve the quality of selected components of the cancer program at Rutherford Hospital. Some strategies that were

discussed included providing oncology-related educational opportunities for

healthcare practitioners in the community at large, enhancing the effectiveness and

efficiency of cancer care delivery in Rutherford County, and building relationships

between physicians in Rutherford County and Duke Physicians. Duke has a long

history of working with communities and currently provides tailored affiliation services in twenty one organizations

throughout the southeast. The components of an affiliation between Duke and Rutherford Hospital will be determined and,

if approved, will be implemented in 2010.

Installation of the new MRI at Rutherford Hospital is progressed according to plan in late 2009. The magnet was

successfully delivered at the end of December and installed shortly thereafter. Applications were scheduled to begin

in January 2010 with a goal of operating at full schedule full schedule by February 1, 2010.

The new MRI offers many advantages over the old system:

• The fixed base, in-house location of the scanner will provide safer and

better access for inpatients;

• Advancements in computer technology will provide better quality

images for most MRI imaging studies;

• New dedicated coils will enhance the resolution of our orthopedic

imaging;

• The new detachable tables will make it easier to transport inpatients

directly into the scanner, reducing the number of transfers from bed to

stretcher to scan table and back;

• Motion correcting software will dramatically improve our ability to

perform brain MRIs for agitated or non-cooperative patients;

• New non-contrast vascular imaging (MRA) sequences will expand

our ability to assess the arteries of patients with renal failure or other

contraindications to dye;

• Improved imaging of peripheral arteries using new contrast enhanced MRA techniques;

• Abdominal and pelvic imaging, including better resolution for MRCPs;

• The ability to perform breast MRIs and MR guided stereotactic biopsies.

We are looking forward to offering these improved and new imaging services at Rutherford

Hospital. Many people have invested a lot of time and energy into this project and our patients will benefit.

Luther Person, MD

Rutherford Radiological Associates, PA

Workers install

Rutherford Hospital’s

new MRI magnet in

late December

14

“Relay for Life” continues to be an important part of the Cancer Program. RHI employees donated over $6,668.45

in 2009 for cancer research and programs supported by the American Cancer Society (ACS). During the event

opportunities to sign up for various cancer screenings and receive educational material about cancer were

available.

A major premise of the ACS programs is that learning to live with cancer involves

discovering new knowledge, exploring new potentials, and experiencing the

fellowship of other people who have cancer. This principle is seen in each of

the programs offered in Rutherford County. The following ACS programs were

available for our patients in 2009:

• Reach to Recovery is a program that offers one-on-one support for women

recently diagnosed with breast cancer. A breast cancer survivor contacts the

individual who has been recently diagnosed and provides her materials and

emotional support.

• Road to Recovery assists any patient undergoing cancer treatment with

transportation to doctor’s appointments or for treatment

• Look Good… Feel Better offers training by a licensed cosmetologist on how

to take care of their skin and apply makeup. Instruction is given on wigs and

other head accessories

• Dietitian on Call offers free, personalized nutrition counseling for cancer patients.

• Cancer Survivors Network is a telephone and web based support service created

by and for cancer survivors, their families, caregivers and friends.

Several fund raising activities were held at the hospital to raise money for cancer

research and education including a barbecue dinner, basket auction, and ice cream

was sold at the event which also helped to raise funds. The impact that cancer has on

the lives of our team members was very evident in the amount of money

raised for the event.

The American Cancer Society

“Relay for Life” continues to be an important part of the

Cancer Program. RHI employees donated over $6,668.45 in

2009 for cancer research and programssupported by the

American Cancer Society (ACS). During the event

opportunities to sign up for various cancer screenings

and receive educational material about cancer

were available.

2009 Annual R

eport

15

Rutherford Hospital and Dr. Matt Rees, oncologist, have partnered with graduate students from the University of North

Carolina School of Public Health and Walter Shepherd, Executive Director of the North Carolina Comprehensive Cancer

Program, in the fight against cancer.

A joint project to develop a computerized cancer risk assessment tool began in 2009. The computer program will provide

individuals with a personalized report outlining their risk of being diagnosed with the six most common types of cancers.

The level of an individual's risk is based on their answers to questions about their family history and health practices. Along

with the capability to provide a personalized cancer risk assessment, the program will provide an individualized plan of how

to reduce the risk of being

diagnosed with cancer and ways to

find cancer in its earliest stages

when treatment is most effective.

The UNC Graduate School of

Public Health students

participating in the project are

Laura Calderon, Raphael Louie,

Mohamed Jalloh and Peyton

Purcell. Their completion of the

project will fulfill the university's

Capstone requirement for a graduate degree in Public Health. Along with representatives from the university, state and

hospital a panel of local cancer survivors are participating in the project to ensure the

computer program is user-friendly.

According to the National Cancer Institute, deaths from cancer could be cut in half through simple lifestyle changes. Jamie

Ingraham, of Rutherford Hospital’s Cancer Outreach Program, states, "This project will be a very effective means to

increase awareness of the known risk factors for cancer and the benefits of lifestyle changes and early detection through

cancer screenings."

The Cancer Outreach Program plans to offer the personalized cancer risk assessment to the community free of charge at the

Cancer Resource Center located in Forest City, at community health fairs and on the hospital's website. Rutherford County

will be the pilot county for the project and there are plans to launch the project statewide through the NC Comprehensive

Cancer Program. The computer program should be available for use in Rutherford County in the spring of 2010.

RHI, UNC Partner In Fight Against Cancer

Doris “Dee” Allen, RN, was named as RHI’s Cancer Care Patient Navigator to offer support

with educational, practical, emotional, or logistical issues surrounding the diagnosis of breast

cancer. Dee’s passion comes from her heart. “I am a cancer survivor and several of my family

members have also experienced cancer as well. I have great empathy for those whose lives have

been forever changed by this diagnosis.” The Patient Navigator is a free service offered to patients

by Rutherford Hospital.

New Cancer Navigator Joins RHI

Dee Allen

16

He sat in the Cancer Resource Center and told me he had been feeling well and expected good news when he returned to

see his doctor after the biopsy. The blood work was abnormal but he hoped it was just one of those things that didn’t mean

much. When he heard his doctor say “prostate cancer” he couldn’t quite believe it. Whatever the doctor had said after that,

he either didn’t hear or didn’t understand, but he did remember the doctor telling him about the Cancer Resource Center

and here he was looking for information about prostate cancer.

Jamie Ingraham, RN, BSN, Cancer Outreach Coordination, states, “As an oncology nurse that works in the Cancer

Resource Center, I help patients find the information they need to learn about their diagnosis and the treatment options that

they have. I’ve learned that being diagnosed with cancer is an overwhelming experience, and that once people have the

information that they need, they are more confident and can face just about anything.”

The Cancer Resource Center, located in the OneSource Building next to Belk in

Forest City, offers cancer patients and their families’ information about their

diagnosis, Internet access and searches. Wigs, hats and prosthesis provided by

the American Cancer Society and Heavenly Hats are available free of charge.

An experienced oncology nurse is available to answer questions about what to

expect during treatment and where to find the most up to date information.

Support services and educational programs from national cancer organizations

like the American Lung Association, Cancer Care, the American Cancer Society

and LiveStrong are also offered. Support groups like the Pink Ladies help

connect survivors to others who have experienced similar diagnosis and

treatments.

The center is also the home of the Cancer Care Patient Navigator program. Dee Allen, RN, Patient Navigator, assists

patients and their families from the point of diagnosis through treatment and follow up care. The Cancer Resource Center

and Cancer Care Patient Navigator Program were made possible by a grant to the Rutherford Hospital Foundation from

the Duke Endowment. The 2008 grant matched capital funds from the hospital to expand the space for the new cancer

programs. The grant provided partial funding for the navigator position for the current year. Donations to sustain the cancer

navigator program may be made through the Rutherford Hospital Foundation.

Cancer Resource Center

"The Pink Ladies" enjoying a moment

together at "Fashion With A Passion," a

Valentine's Luncheon to support

mammograms for uninsured women.

Arlene Coberg is a breast cancer survivor and member of the Pink Ladies Cancer Support

Group. Arlene was saddened to hear that many women in our county forgo having their annual

mammogram because they do not have medical insurance and cannot afford the cost of a

mammogram. She purchased a dozen ceramic piggy banks, spray painted them pink, dressed

them up with pink ribbons and hit the road. Along with the kindness of local businesses, she has

made it possible for everyone to donate their change and help women who need a mammogram.

The proceeds go to the Rutherford Hospital Foundation’s Mammogram Program and 100 percent

of the funds are used to provide mammograms for women in our community. “In just two weeks

Arlene’s pink piggy banks collected over $100. What a difference this will make for women in

our county!” said Jamie Ingraham, RN, BSN, Cancer Outreach Coordinator for Rutherford

Hospital.

Pink Pigs Program Helps Women With No Insurance

Arlene Coberg

2009 Annual R

eport

Meet Haley Givens. She is the 12-year-old grand daughter of Freda Ledford of Forest City.

Haley isn’t like most 12 year olds; her mission in life is to help women in our community

find cancer in its earliest stages.

Haley learned the value of detecting cancer early when her grandmother was diagnosed

with ovarian cancer four years ago. Haley remembers when her grandmother lost her hair

as she was going through chemotherapy. But most of all, Haley remembers how being

diagnosed with cancer never stopped her grandmother from dancing with the seniors group

and volunteering to help others at the shelter.

Since then Haley has worked hard to make a difference. She started by donating 10 inches

of her hair to the Locks of Love program. This program makes wigs from donated hair for

women and children who are undergoing treatment for cancer. But Haley did not stop there;

her next project was to collect aluminum pop-tops to raise money for the Mammogram

Program sponsored by the Rutherford Hospital Foundation. This Cancer Outreach Program

helps women, who might not otherwise be able to afford it, obtain a mammogram.

Haley decided there was still more she could do. Along with her grandmother and mother,

Haley started to collect yard sale items. Just when she was ready to have the yard sale,

Haley broke her arm roller-skating. This might have stopped most people, but not Haley.

She was there in her bright pink cast working as planned. Haley and her grandmother Freda

proudly presented $200 to the Pink Ladies Cancer Support Group of Rutherford Hospital at

one of the group’s recent meetings.

When asked what she would like to accomplish with her donation, Haley stated, “I want my

donation to help ladies here in our community, to help them get mammograms.”

“It is truly inspiring to see Haley’s commitment to the women in our community. I promised her that 100 percent of her

donation would stay right her in our community to help those that need it most,” said Jamie Ingraham, Cancer Outreach Co-

ordinator for Rutherford Hospital.

Haley remembers when her

grandmother lost her hair as she

was going through chemother-

apy. But most of all, Haley re-

members how being diagnosed

with cancer never stopped her

grandmother from dancing with

the seniors group and volunteer-

ing to help others at the shelter.

Since then Haley has worked

hard to make a

difference.”

17

“I Want My Donation To Help”

Meet “Team Mashed and Splashed,” a group of breast cancer survivors

that competed in its first Dragon Boat Race on August 29th and placed

third in their division. The motivation for these survivors to hit the water

and paddle their hearts out was to raise money to support Rutherford

Hospital Foundation’s Mammogram Program. The program helps women

who are medically uninsured and unable to afford a screening mammogram

obtain one free of charge. Jill Miracle, Executive Director of Rutherford

Hospital’s Foundation, said, “Each year the Foundation provides screening

mammograms for 80-100 women in our county and the majority of the

funding comes from individuals or groups of women committed to helping

others.”

Breast Cancer Survivors Raise Money for Screenings

Men’s Health Fair

18

In the automotive world the phrase "preventative maintenance" is often used. In the

real world, that statement is, unfortunately, not applied by men when it comes to their

bodies. Men usually take better care of their vehicles than they do themselves.

However, in Rutherford County, the award-winning hospital here offers more concern,

more caring and more opportunity for everyone to take care of themselves - especially

men. Usually what drives a man to the doctor is fear. Something goes wrong with their

body and that's when they go.

Preventative maintenance is what every man in Rutherford County needs to begin.

Your loved ones will be proud of you and grateful for your beginning to care about

your health. An outstanding example of what we are referring to is the Cancer

Outreach Program of Rutherford Hospital. It offered a men's health fair including

prostate, skin and blood pressure screenings at the Cancer Resource Center in

September. September is Prostate Cancer Awareness Month. Each year 186,000

American men have prostate cancer. It is the second most common for men, skin

cancer being the first. Want to look in the mirror and love what you see? This is a

great opportunity to ensure your health and begin your personal "preventative

maintenance" program.

Prostate screenings are offered several times a year. Men, 50 years old, should have

this test every year. Men with a cancer history in their family and African-Americans

should have the test every year starting at age 45. The rarity of what Rutherford

Hospital offers is not only the Cancer Resource Center's availability for information,

but a place where families can come to learn about their diagnosis and have caring

people to guide them through the process.

To participate in the programs offered, all you have to do is call to register. What is

offered for just a $20 would cost the average citizen from $100 to $150 elsewhere.

The beauty of this is that they share the results of the tests with your family physician

and make it a part of your health care record. Actually, the screening is free. The $20

is for lab work. The support services offered by Rutherford Hospital through this

ongoing program is very rare.

Through a great number of cancer survivors volunteering, the program helps in

support groups. The volunteers help this outreach program work very efficiently.

"We are so fortunate to have a hospital like ours and volunteers to help!" Jamie

Ingraham, RN, BSN, the Cancer Outreach Coordinator will tell you. She and Dee

Allen, RN, the Patient Navigator, love what they do and are there to help, guide you

and help you better understand. This is an amazing health program and is not often

found in any community the size of Rutherford County. How very fortunate we are.

by M.A. Andrews, Rutherford Weekly reporter

Men, 50 years old,

should have this test

every year. Men with

a cancer history in their

family and African-

Americans should have

the test every year starting

at age 45. The rarity of

what Rutherford Hospital

offers is not only the

Cancer Resource Center's

availability for information,

but a place where families

can come to learn about

their diagnosis and have

caring people to guide

them through the

process.

(This article originally appeared in the Rutherford Weekly on August, 27, 2009.)

2009 Annual R

eport

19

Brent Washburn, Rutherford Hospital Foundation Chairman, has announced the beginning of the Foundation’s “Touching

Lives” campaign. “Our Foundation has been in existence for many years. We have raised over $3 million in the past five

years for vital health services for the people in our county. You will recognize many of them:

• Lifeline service for seniors who are unable to pay, allowing them to stay in their homes instead of in nursing facilities.

• Camp WheezKnot – a camp for children with asthma held by the hospital each summer.

• Mammograms for uninsured women and a cancer patient navigator for women diagnosed and treated for breast cancer.”

The Rutherford Hospital Foundation is divided into different

segments to raise money in this campaign:

• Corporate Honor Roll chaired by Paul McIntosh.

• Special Gifts Committee chaired by Dr. Tom Jaski.

• Planned Giving committee chaired by Connie Bunch.

A special reception honored members of the 1906 Club,

named for the year that the hospital was founded. Rutherford

Hospital Foundation’s newest family – the forty-nine 1906

Club members and their guests – were invited to the special

evening.

Anyone wishing to join the 1906 Club effort to help make these programs and activities possible, please call Jill Miracle at

828-286-5070.

Foundation’s Campaign Supports Cancer Navigator, Mammograms

The 1906 Club

Cancer screening is looking for cancer before a person has any symptoms. By the time symptoms

appear, the cancer may have grown and spread. This can make the cancer harder to treat or cure.

Screening tests can help find cancer at an early stage, before symptoms appear. When abnormal

tissue or cancer is found early, it may be easier to treat or cure. It is important to remember that

when your doctor suggests a screening test, it does not always mean he or she thinks you have

cancer. There are different kinds of screening tests. Screening tests include the following:

• Physical exam and history: An exam of the body to check general signs of health, including

checking for signs of disease, such as lumps or anything else that seems unusual. A history

of the patient’s health habits and past illnesses and treatments will also be taken.

• Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other

substances in the body.

• Imaging procedures: Procedures that make pictures of areas inside the body.

Currently, screening tests exist for breast, prostate, and colon cancer. It is important to talk to your

doctor at least once a year about screening tests that you may need. The earlier cancer is detected,

the more easily it can be treated. More information can be found at http://www.cancer.gov/cancer-

topics/pdq/screening/overview/Patient.

Screenings: early detection means easier treatment

It is important to

remember that when

your doctor suggests

a screening test, it

does not always

mean he or she

thinks you have

cancer.


Founded in 1906 by Drs. Henry Norris and Montgomery H.

Biggs, Rutherford Hospital is a not-for-profit hospital

governed by a local Board of Trustees licensed for 143

private acute care beds.

Rutherford Hospital has been selected by Thomson Reuters

Top Hospitals as a four-time recipient of the 100 Top

Hospitals Award. The hospital received the Thomson

Reuters 100 Top Performance Improvement Leader award

for 2005, 2006, 2007 and 2008.

This past year, for the first time, the hospital was the

recipient of two national benchmark (highest performance)

awards: the 2008 Thomson Reuters 100 Top Hospitals

National Benchmarks Award, and the 2008 Thomson Reuters

100 Top Hospitals Everest Award for National Benchmarks,

awarded to only 23 hospitals nationally. The Everest Award

for National Benchmarks recognizes hospital leaders whose

work led to high rates of long-term improvement.

The National Benchmarks Award recognizes hospitals

with the highest hospital-wide performance compared with

the national peers, based on an overall score on the 100

Top Hospitals National Balanced Scorecard. This award

acknowledges the organizational achievement Rutherford

Hospital has made by aligning its board, management team,

employees, and medical staff in a concerted effort to achieve

balanced excellence.

IMPORTANT RHI PHONE NUMBERS:

Information/Switchboard 286-5000

Administration 286-5200

Behavioral Health 286-5515

The Birth Place 286-7620

Business Office 286-5303

Cancer Resource Center 245-4596

Cardiac and Pulmonary Rehab 286-5053

Cardiopulmonary Services 286-5442

Carolina Community Care 245-3575

Case Managers 286-5432

Chaplain 286-5050

Companion Services 245-3575

Diabetes Education 286-5501

Dietary Consultant 286-5523

Education 286-5502

England and Godfrey Family Practice 245-7626

Foundation 286-5070

Gift Shop 286-5149

Great Expectations,

Childbirth/Women’s Health Coordinator 286-5065

Human Resources 286-5334

Insights Psychiatric Resources 287-3928

James Medical Clinic 657-5371

Joint Solution 286-5024

Lifeline 286-5673

The Mammography Place 286-5670

Marketing/Community Relations 286-5071

Nursing Administration 286-5333

Occupational Medicine Center 286-5508

OneSource Rehab 247-1588

Outpatient Receptionist 286-5030

Outpatient Services 286-5310

Patient Representative 286-5505

Radiology 286-5335

Rutherford East Medical Services 453-0703

Rutherford Orthopaedics 287-9260

Rutherford Surgical Associates 286-1743

Volunteer Services 286-5338

20

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