adena oncology annual reportrobin primer . navigator support jana eldridge, rn colorectal patient...
Post on 01-Aug-2020
4 Views
Preview:
TRANSCRIPT
ADENA ONCOLOGY ANNUAL REPORT2013 | Adena Health System
Department of: Adena Regional Medical Center
ADENA ONCOLOGY ANNUAL REPORT PAGE - 3
TABLE OF CONTENTS
Chairman’s Letter
Cancer Committee Members
Lung Report
Free Lung Screening Program
Patient Navigators
Medical Oncology
Radiation Oncology
Adena’s Cancer Experience
Clinical Research Trials
Pharmacy
Social Work
PAGE - 5
The Cancer Committee of Adena Health System is pleased to present our 21st Annual Report of the Cancer Committee of
Adena Health System. This report includes our cancer treatment data and updates from 2013.
In this report, you will find information about the many services and initiatives at the Adena Cancer Center, including a new
initiative that Adena Regional Medical Center has undertaken to address the high rates of tobacco abuse and lung cancer
in our community. Our new free lung cancer screening program incorporates a tobacco cessation program and is meant
to help in the early detection of lung cancers as well as to offer assistance to patients who are contemplating leading a
tobacco-free lifestyle.
At the Adena Cancer Center, we are proud that our care is coordinated among many oncology specialists, including surgeons,
pathologists, pulmonologists, radiologists, gastroenterologists, and medical and radiation oncologists. We continually strive to
give our patients the best, most up-to-date care. Our specialists meet up to four times weekly in a multidisciplinary tumor
board to discuss new treatment updates and collectively review patient information and craft individualized patient care plans.
The Adena Cancer Center is an active participant in the Columbus Community Oncology Program, giving patients the added
opportunity to participate in clinical trials with newer therapies and treatment options.
As part of our ongoing efforts to maintain the most up-to-date care possible, we were pleased to welcome Dr. Gordana
Vlahovic from the Duke Cancer Institute, who gave an update on lung cancer and new discoveries in the realm of cancer
genetics and treatments. We are also active with our graduate medical education program and the Adena Continuing Medical
Education Committee to help provide accredited programs in conjunction with the PACCAR Medical Education Center.
At the heart of our treatment plans are our patient navigators and physician nurses who help coordinate cancer care for our
patients. They are a lifeline for our patients and help them navigate the health system and make sure our patients understand
their treatments.
In addition to the support from our nursing team, we have a truly state-of-the-art infusion and radiation center staffed with
experienced, well-trained nurses who help provide care for our patients. Additionally, we provide many ancillary services,
including social work, a new outpatient pharmacy, nutrition counseling, physical therapy, pastoral services, and hospice and
palliative care that create an added layer of support for our cancer patients and their families. These services are further
supported by generous contributions from the Adena Health Foundation and many community partners, including many
volunteers from the community as well as the American Cancer Society, Southern Ohio Cancer Survivors, and many more
year-round initiatives and donations that support the patients and efforts of the Adena Cancer Center to provide the best care
possible for our community. Our world-class center is recognized and accredited by the American College of Surgeons’
Commission on Cancer (CoC). I hope you find the enclosed report helpful and informative!
Sincerely,
Jeffrey VanDeusen, MD, PHD
Cancer Committee Chairman, 2013
ADENA CANCER COMMITTEE 2013 REPORT —CHAIRMAN’S LETTER
2013 CANCER COMMITTEE MEMBERS
Jeffrey Vandeusen, MD, PHD
Medical Director of Oncology Services
Thomas Lewis, MD
Dermatology
Michael Levey, MD Radiology
Ralph Roach, MD Medical Oncology
Ganapathy Krishnan, MD Medical Oncology
Jeyanthi Ramanarayanan, MD Medical Oncology
David Adam Jones, MD Radiation Oncology
Carl Szczesniak, MD Pathology
Byron Smith, MD Pathology
W. Bill Sever, DO Surgery
William Mitchell, MD Radiology
Michael Fealk, MD Surgery
Lana Uhrig, RN, MS, MBA Director Of Oncology Services
Brenna Eldridge, BSN, OCN, RN Medical Oncology Manager
Carolyn Hice Excecutive Assistant
Erin Trapp, RN Radiation Oncology Manager
Debbie Bihl, MSN, AOCN, CNP Medical Oncology
Doug Smith, MA, MS, CNS, CNP Medical Oncology
Tammy McManus, RN, BSN, OCN Patient Navigator, Lung
Ray Seitz, RN Medical Oncology RN
Linda Kight RN, BSN, OCN Clinical Trials Nurse
Stacie Daugherty, CTR Cancer Registrar
Mike Pugh, RPH, BCOP Pharmacy
Kristin Williamson, RPH Pharmacy
Lindsey Kemper, RN Patient Navigator, Breast
Cathy Costillow, RD, LD Dietician
Karen Jenkins, MA, CCC-SLP Rehab
Rev. Paul Ray Pastoral Services
Sharon Wills, RN Hospice
Becky Emerine, LSW Social Worker
Beth Krouse American Cancer Society
Lynne Ayers, MBA American Cancer Society
Robin Primer Navigator Support
Jana Eldridge, RN Colorectal Patient Navigator
Ruth Mcroberts Radiation Oncology
Tonya Mckee, RN, BSN, OCN Patient Navigator, Head and Neck
Elizabeth Whitt, BSN,RN Physician Nurse
Candice Kennedy, RN, BSN System Director for Cardiothoracic,
Pulmonary and Oncology Service
Kate Shane, MS, LGC OSU Genetic Counselor
Heather Hampill, MS, LGC OSU Genetic Counselor
ADENA ONCOLOGY ANNUAL REPORT PAGE - 7
LUNG REPORT
There have been many changes in the past two years in the manner in which we diagnose and treat lung cancer. As a result of
these changes, patients can now be diagnosed at earlier stages in their diseases, leading to potentially curative treatment
options. The Adena Cancer Center is at the forefront of these changes. We use a multidisciplinary team approach that
coordinates the expertise of all our cancer specialists. Our patients receive the best care possible from screening and diagnosis
through treatment.
In November 2013 Adena was one of the first hospitals in the area to implement a successful low-dose CT lung screening
program that has been recognized as a screening center of excellence by the National Lung Cancer Alliance. Adena’s lung
cancer screening CT is free and is recommended for individuals 55 – 74 years old who have a history of smoking at least one
pack a day for 30 years or at least two packs a day for 15 years and are either a current smoker or have quit within the past 15
years. Those who are currently smoking are also offered smoking cessation intervention and counseling. In the first year of the
highly successful program, we have screened over 600 individuals and identified 12 cases of lung cancer.
The Adena Cancer Center staff works very closely in collaboration with our pulmonologists Drs. Haval Saadlla, Vishal Patel and
Emilia Anigbo. Adena uses state-of-the-art diagnostic tools, including bronchoscopy with endobronchial ultrasound and
superDimension navigational bronchoscopy to help diagnose lung cancer accurately and quickly with minimally invasive
diagnostic biopsies. In addition to our team of pulmonologists, we also rely heavily on Adena’s Interventional Radiology
Department staff and physicians. They are able to offer not only CT and ultrasound-guided biopsies for diagnostic purposes,
but also for various cancer treatment measures as well. These minimally invasive procedures include cryotherapy and
radiofrequency ablation, which can destroy smaller tumors without the need for surgery.
Our Radiation Oncology Department and physicians are also on the cutting-edge of cancer treatment with their spacious
9,000-square-foot unit housing two linear accelerators. This state-of-the-art equipment allows the radiation oncologists to
precisely target tumors while sparing healthy tissue. The radiation oncologists here are highly skilled at using intensity-
modulated radiation therapy (IMRT), which is a very sophisticated approach to the planning and delivery of radiation therapy.
Unlike conventional techniques, IMRT utilizes computerized programs to generate treatment plans that highly conform the
prescription dose to the shape of the tumor in three dimensions, thereby decreasing the amount of normal tissues irradiated.
Another newer radiation treatment available at the Adena Cancer Center is stereotactic body radiotherapy (SBRT). This
procedure is performed utilizing our Trilogy Linear Accelerator
and is similar to cyberknife therapy in that it is a method of
targeting tumors very precisely. The result of this method is that
the cancer receives a lethal dose of radiation while the
surrounding healthy tissue is spared. This method of treatment
usually requires only one to five total treatments.
We have also kept pace with new scientific developments in the
arena of lung cancer. New evidence demonstrates that
treatments for lung cancer are more effective when treatment is
personalized based on the individual genetics of the cancer.
Understanding what genetic changes have occurred inside a
tumor can help physicians identify and utilize new treatments that target these specific changes. These newer therapies are
not only less toxic, but also more effective in the fight against lung cancer. At Adena, we utilize next-generation sequencing to
profile our lung cancer patients and then utilize this information to pick from many new therapeutic options available for
patients with lung cancer. These new “targeted therapies” are all being utilized successfully at the Adena Cancer Center.
In summary, all of the Adena Cancer Center staff, including physicians, patient navigators, office nurses, infusion nurses,
radiation staff, technicians and clerical personnel are here to provide compassionate, comprehensive care to our patients and
their families. We coordinate our efforts in a team-based approach that provides state-of-the-art cancer care close to home at
the Adena Cancer Center.
OUR RADIATION ONCOLOGY DEPARTMENT AND PHYSICIANS ARE ALSO ON THE
CUTTING-EDGE OF CANCER TREATMENT WITH THEIR SPACIOUS 9,000-SQUARE-FOOT
UNIT HOUSING TWO LINEAR ACCELERATORS. THIS STATE-OF-THE-ART EQUIPMENT
ALLOWS THE RADIATION ONCOLOGISTS TO PRECISELY TARGET TUMORS WHILE
SPARING HEALTHY TISSUE.
Tammy E. McManus BSN, RN, OCN
Lung Cancer Patient Navigator
IN NOVEMBER 2013 ADENA WAS
ONE OF THE FIRST HOSPITALS
IN THE AREA TO IMPLEMENT A
SUCCESSFUL LOW-DOSE CT LUNG
SCREENING PROGRAM THAT HAS BEEN
RECOGNIZED AS A SCREENING CENTER
OF EXCELLENCE BY THE NATIONAL
LUNG CANCER ALLIANCE.
ADENA ONCOLOGY ANNUAL REPORT PAGE - 9
PATIENT NAVIGATORS
JANA ELDRIDGE, RNColorectal/GI Navigator
TONYA MCKEE, RN, BSN, OCNHead and Neck Navigator
ROBIN PRIMERPatient Navigator Support
TAMMY MCMANUS, RN, BSN, OCNLung Navigator
LINDSAY KEMPER, RNBreast Navigator
FREE LUNG SCREENING PROGRAM
In its first year, Adena Health System’s free lung cancer screening program has saved lives, while becoming a national model
for excellence. In the past year, 595 people have been screened. Of those, a dozen have been diagnosed with lung cancer,
one was diagnosed with breast cancer, and other patients have been found to have heart aneurysms, tumors and other
conditions they may not have known about until it was too late, thanks to the free CT scan.
Adena’s free lung cancer screening program provides CT scans for people at high risk for lung cancer at no cost. The program
began last November, and was initially meant to last just one month. However, due to overwhelming response, and Health
System and physician leader’s recognition of the benefits of free lung cancer screening, it was extended indefinitely.
In just one year, Adena’s free lung screening program has gained a reputation in the industry as one of the nation’s best. The
program has been designated a “Screening Center of Excellence” by The Lung Cancer Alliance, the nation’s leading lung
cancer advocacy group. The Alliance recently invited Adena Cancer Center’s Medical Director Dr. Jeffrey VanDeusen to be one
of its featured speakers at its recent national conference.
“FOR CENTERS LOOKING TO OFFER FREE LUNG CANCER SCREENINGS, ADENA IS
BEING HELD UP AS THE NATIONAL MODEL ON HOW TO ACCOMPLISH THAT,” SAID
DR. VANDEUSEN, “WE’VE DONE IT BETTER THAN ANYONE ELSE. WE’RE PROBABLY THE
NEWEST KID ON THE BLOCK, AND THE MOST SUCCESSFUL. WE ARE PRETTY PROUD
OF THAT.”
The program’s one-year anniversary marks the next big step in the program, and one of the most important – the annual
follow-up. While a patient’s first screening may not identify cancer, it serves as a powerful tool with which to compare
subsequent screens, and to determine if there have been any changes. People who were screened last year are encouraged
to schedule a follow up screening by calling (740) 542-LUNG (5864).
Additionally, new patients at high risk for lung cancer are also encouraged to have a lung cancer screen. The test is a non-
invasive, CT scan which easily identifies tumors or lesions that may need medical attention. Those eligible for the free
screening are: between 55-74 years old; have 30 or more “pack years” of smoking in their past (a pack year=1 pack a day for 30
years, 2 packs a day for 15 years, 3 packs a day for 10 years, etc.); a current smoker or someone who has quit smoking in the
past 15 years. Patients meeting the criteria should schedule a free lung cancer screening by calling (740) 542-LUNG (5864).
ADENA ONCOLOGY ANNUAL REPORT PAGE - 11
RADIATION THERAPY
Radiation therapy is one of the most common cancer treatments for cancer. It uses special equipment to aim high doses of
radiation at cancer cells. This damages the cancer cells and causes them to die. It can be given alone or used with other
treatments, such as surgery or chemotherapy.
Unlike chemotherapy, which exposes the whole body to cancer-fighting drugs, radiation therapy is usually a local treatment. It
targets only the part of the body being treated. The goal of radiation treatment is to damage as many cancer cells as possible,
with little harm to nearby healthy tissue.
There are two basic types of radiation therapy: external beam radiation therapy (EBRT) and internal radiation therapy, also
called brachytherapy. With EBRT, the radiation is delivered from outside of the body using one of several different types of
radiation systems. For patients undergoing brachytherapy, a radioactive source is temporarily or permanently implanted inside
the body, either in the tumor site or in a cavity left by a tumor that has been surgically removed.
The Adena Cancer Center has expanded the radiation treatment options available to patients. These new radiotherapy
techniques include partial breast irradiation and stereotactic body radiotherapy.
Partial breast irradiation (PBI) is performed utilizing brachytherapy targeted specifically for breast cancer treatment. This
treatment technique involves the placement of radioactive iridium using a multi-lumen catheter directly to the area where a
breast tumor has been surgically removed via lumpectomy.
Stereotactic body radiotherapy (SBRT) is a technique that utilizes precisely targeted radiation to a tumor while minimizing
radiation to adjacent normal tissue. This targeting allows treatment of small- or moderate-sized tumors in either a single or
limited number of fractions.
FOR QUESTIONS REGARDING CANCER TREATMENT OPTIONS, CONTACT THE ADENA CANCER CENTER.
DAVID ADAM JONES, MDRadiation Oncology
MEDICAL ONCOLOGY
The Medical Oncology program at the Adena Cancer Center is made up of a
well-integrated multidisciplinary care team of professionals, including physicians,
nurse practitioners, nurses, patient navigators, a clinical trials nurse, tumor registrar,
pharmacists, social workers, dieticians, a financial counselor, and clinical and
administrative staff.
The vision of the Adena Cancer Center is to provide compassionate, quality,
comprehensive cancer care for patients, families and our communities. Our staff
of highly qualified and board-certified physicians has completed training and
fellowships in some of the most prestigious cancer programs in the United States.
Their skill and expertise allow our patients to receive cutting-edge treatment close
to home in our new freestanding state-of-the-art cancer center.
Our priority is to meet the needs of our patients during each step of their cancer
journeys. Besides availability to the most advanced chemotherapy and radiation
regimens, we have a tightly woven care delivery model that includes regular
face-to-face care conferences with our oncologists, interventional radiologists,
pharmacists, pathologists, surgeons and patient navigators, who collaboratively
tailor individualized treatment plans for our patients. Additional services include
chemotherapy education, breast health clinics and advanced care planning clinics
led by our nurse practitioners, diet counseling by licensed dieticians, and a palliative
and hospice care program. We are also dedicated to providing daily availability on
our schedule for walk-in appointments for our patients’ urgent needs so trips to the
emergency room can be avoided when possible.
To address the long-term needs of our patients, we offer a variety of survivorship
programs, including American Cancer Society’s “I Can Cope” and “Look Good Feel
Better” programs led by trained facilitators from our staff as well as a breast cancer
support group. We also host a Survivor Celebration with the Paints and a Breast
Cancer Tree Lighting ceremony. Our Cancer Center social work team provides a wide
variety of services to our patients, including help with medication assistance
programs, access to community resources, transportation and psychosocial support.
The comprehensive cancer care team at the Adena Cancer Center takes pride in the
compassionate and quality care we provide, and we find it a privilege to serve our
community with the best cancer care right here at home.
ADENA ONCOLOGY ANNUAL REPORT PAGE - 13
AGE AND SEX
(60 > yrs. of age account for 65% of all cancer diagnosed)
AGE MALE FEMALE TOTAL
10-19 0 0 0
20-29 1 2 3
30-39 2 12 14
40-49 14 46 60
50-59 64 69 133
60-69 89 90 179
70-79 70 68 138
80-89 31 34 65
90+ 2 5 7
COUNTY AT DIAGNOSIS
ROSS 268
PIKE 87
JACKSON 53
PICKAWAY 41
FAYETTE 38
HIGHLAND 36
VINTON 25
OTHER 51
CLASS OF CASE
00-Diagnosed at Adena and all first course of therapy elsewhere10-14-Diagnosed at Adena and all or part of first course of therapy here
20-22-Diagnosed elsewhere and all or part of first course of therapy at Adena
CLASS OF CASE 00 34 5.7%
CLASS OF CASE 10-14 453 75.6%
CLASS OF CASE 20-22 112 18.6%
CITY AT DIAGNOSIS
CHILLICOTHE 195
WAVERLY 46
WASHINGTON CH 36
JACKSON 34
CIRCLEVILLE 28
PIKETON 26
GREENFIELD 22
FRANKFORT 21
BAINBRIDGE 18
KINGSTON 10
WELLSTON 14
OTHER 149
Adena Cancer Center Information from 2013599 Analytic Cases 610 Accessioned Cases
All of the Analytic statistics are based from the analytic cases, unless otherwise specified. Analytic cases are those cases that are either diagnosed at Adena Health System or receive their first treatment at Adena.
SEX
FEMALE 326 54%
MALE 273 46%
TOP 5 SITESTop 5 sites account for 63% of all cancers seen at Adena
SITE # OF CASES %
LUNG 132 22%
BREAST 124 21%
HEAD & NECK 49 8%
COLORECTAL 48 8%
LYMPHOMA 26 4%
TOP 5 SITES BY SEX
Adena Medical Center remained steady in the number of analytical cases for 2013. Compared to 2012 statistics of 599 breast cancer continues to hold the highest
incidence among women. Lung cancer remains the highest type of cancer for males.
FEMALE MALE
SITE # OF CASES SITE # OF CASES
BREAST 124 LUNG 70
LUNG 62 PROSTATE 37
COLON/RECTUM 25 HEAD & NECK 35
HEAD & NECK 14 COLORECTAL 23
LYMPHOMA 13 LYMPHOMA 13
ADENA’S CANCER EXPERIENCE
ADENA ONCOLOGY ANNUAL REPORT PAGE - 15
CLINICAL STUDIES REPORT
In 2013 we accrued to both cancer treatment studies and cancer control studies and biorepository. Patients were accrued to
both phase II and phase III studies. We accrued to study groups National Surgical Adjuvant Breast and Bowel Project, Southwest
Oncology Group, Ohio Colorectal Cancer Prevention Initiative and the American College of Surgeons Oncology Group. We
accrued to breast, renal, quality of life and biorepository studies, with a total of 11 patients with eight substudies.
The types of studies patients have been accrued to include a stage II new drug for progression of stage IV breast cancer, mTor
inhibitor versus placebo for high risk renal cancer, removing a drug from a group of three drugs given for breast cancer, text
messaging for medication compliance, and tumor and blood samples for Lynch syndrome.
We continue to work with Columbus Community Clinical Oncology Program, which provides the studies we have available to
offer, clinical support services and the internal review board.
ALL ANALYTIC CASES FOR 2013
LUNG 132
BREAST 124
COLON/RECTUM 48
HEAD & NECK 49
LYMPHOMA 26
BLADDER 32
PROSTATE 37
GYN 17
THYROID 8
KIDNEY 15
PANCREAS 12
MELANOMA 7
OTHER 92
ADENA CANCER EXPERIENCE CONTINUED
ADENA ONCOLOGY ANNUAL REPORT PAGE - 17
People diagnosed with cancer encounter a wide range of concerns related to finances, medical worries and emotional
issues. When someone is diagnosed with cancer, the focus is on the person’s physical well being, treatments, side effects,
doctor visits, tests, etc. We also know there are other parts of a patient’s life that are affected by cancer, such as self-image,
work, family and the approach to living.
The American College of Surgeons and NCCN have set standards of care for distress management with standard 3.2,
Psychosocial Distress Screening, which will be phased in by 2015. The Adena Cancer Center’s social workers are currently
working with other staff on this tool for screening and referrals to community resources for provision of services.
The licensed social worker is there to help patients and significant others navigate through the complexities of the
treatment process by serving as a knowledgeable, objective and unbiased resource. The licensed social worker assists
patients and significant others with a wide array of problems and issues, including but not limited to:
– Understanding insurance coverage and following up on insurance statements and rulings.
– Help finding assistance with the rising cost of medications, especially costs that aren’t covered by insurance, and seeking foundations for co-pay assistance and pharmaceutical programs providing free medication.
– Adjusting to and coping with a cancer diagnosis as well as the social, emotional, financial and professional issues that arise from such a diagnosis.
– Linking cancer patients and their significant others to helpful community resources.
– Advance directives information and completion.
– Serving as a sounding board, helping patients and significant others sort through confusion, myths and misconceptions so they can make reasonable, informed decisions about their care.
– Referral to support groups and other organizations that can help cancer patients and their significant others.
Social work services are a highly valued component of the Adena Cancer Center program. The licensed social worker
provides input and insight into the Adena Cancer Center program through involvement in the Cancer Committee and
is available to assist patients and their significant others when needed.
The Adena Foundation Cancer Center Fund continues to be a resource for many of the patients and their families, from
assistance with gas vouchers and medication to the wig fund.
SOCIAL WORK SERVICESPHARMACY
The Adena Cancer Center Pharmacy, located within the Adena Cancer Center, provides all cytotoxic and immunobiological
products required by our patients as well as any adjuvant and supportive therapies that may be prescribed. In 2013 the Adena
Cancer Center Pharmacy prepared and dispensed 6,695 chemotherapy doses and 18,296 doses of adjuvant and supportive
medications, with patient safety first and foremost in consideration.
Additional services provided by the oncology pharmacists include maintaining patient profiles for all chemotherapy patients,
clinical monitoring and intervention, patient education materials regarding medication side effects and proper use and care,
and pharmacokinetic consultation. In addition, the Adena Cancer Center Pharmacy serves as a clinical pharmacy teaching site
for Ohio Northern University, University of Findlay, Ohio State University and University of Charleston.
The Adena Cancer Center Pharmacy will be opening its retail pharmacy in the beginning of 2014. This dispensing pharmacy
will serve Adena Cancer Center patients by filling prescriptions for oral chemotherapy drugs as well as prescriptions for support
medications needed by those patients. The pharmacy will be able to fill most prescriptions in a fraction of the time other
pharmacies require.
THE ADENA CANCER CENTER PHARMACY STAFF CONSISTS OF THE FOLLOWING:
Mike Pugh, RPh, BCOP, Lead Oncology Pharmacist
Kristen Williamson, RPh, Oncology Pharmacist
Jackie Huiss, CPhT, Pharmacy Technician
Nikki Elkins, CPhT, Pharmacy Technician
Sarah Robinette, CPhT, Pharmacy Technician
ADENA CANCER CENTER4435 St. Rte. 159
Chillicothe, Ohio 45601740-542-3030
WWW.ADENA.ORG
top related