hall-perrine cancer center community report...as a surgical oncologist, i’d be remiss if i...

2019

Hall-Perrine Cancer Center Community Report

2 2019 HALL-PERRINE CANCER CENTER COMMUNITY REPORT

A Note for the Community From the Medical Director of Hall-Perrine Cancer Center

Dear Friends,

I’m sure you’re familiar with the phrase “20/20 vision.” Yes, it represents a good eye exam outcome but, figuratively speaking, it’s also something valued by wise decision-makers.

As my colleagues and I usher in 2020 at Mercy’s Hall-Perrine Cancer Center, we do so with a clear vision for providing innovative cancer care right here in Cedar Rapids. The path to achieving that vision is paved by treatment advancements and leading-edge technologies, like the ones you’ll read about here in our 2019 annual report.

As a surgical oncologist, I’d be remiss if I didn’t share with you one such innovation from the operating room: Lymphoseek®. Introduced at Mercy Medical Center in 2019, this technology is the newest in an arsenal of tools for fighting breast cancer and uses nuclear-medicine mapping to locate probable cancer-harboring lymph nodes. When combined with current technology that lowers the likelihood for a second surgery, like SaviScout® that precisely finds tumors and the MarginProbe® system, which detects remaining cancerous tissue surrounding a tumor, Lymphoseek is another strong medical advancement available at Hall-Perrine Cancer Center to improve patient outcomes.

Speaking of strong medical advancements, immunotherapy is proving to be a breakthrough treatment in medical oncology for several types of cancers, especially melanoma (historically a difficult cancer to cure). Immunotherapy — a gentler treatment than chemotherapy — stimulates the body’s immune system to recognize cancer as an invader, essentially training the body to attack cancerous cells the way it would attack other illnesses. Because immunotherapy only kills cancerous cells, patients don’t experience the side effects often associated with chemotherapy, such as hair loss or nausea. At Hall-Perrine Cancer Center, we’re using immunotherapy options in the treatment of some lung, kidney, bladder, head/neck and skin cancers, as well as lymphoma.

Guided by our legacy of innovative medicine provided by compassionate experts, coupled with advancements like the ones highlighted in this report, along with four different types of radiation treatment options — more than any other cancer-care provider in Cedar Rapids — Hall-Perrine Cancer Center remains at the forefront of life-improving and life-saving care. With the unparalleled Mercy Touch® spurring us along, it’s clear 2020 will continue to move the fight against cancer forward in inspirational ways.

Sincerely,

Vincent Reid, MD, FACSDirector of Surgical OncologyMedical Director, Hall-Perrine Cancer Center

Vincent Reid, MD, FACSMedical DirectorHall-Perrine Cancer Center

32019 HALL-PERRINE CANCER CENTER COMMUNITY REPORT

On Behalf of the 2019 Cancer Committee

The Cancer Committee is a multidisciplinary committee of Hall-Perrine Cancer Center Medical Staff. The committee meets quarterly to provide leadership for the cancer activities at the medical center and oversee the operations of the Cancer Registry. The Cancer Committee is involved in evaluating new technologies, establishing new programs and making recommendations for improving cancer care within the healthcare community.

CHAIRMAN

Vincent Reid, MD, Surgical Oncologist, Hall-Perrine Cancer Center Medical Director

COMMITTEE MEMBERS

Vincent Reid, MD, Chair, Surgical Oncologist

Julie Netser, MD, Pathologist

Janet Merfeld, MD, Radiation Oncologist

Ann Stroh, DO Cancer Liaison, Medical Oncologist

Jasmine Nabi, MD, Medical Oncologist

Arnold Honik, MD, Radiologist

Penny Glanz, Cancer Program Administrator

Jeanne Noble, Clinical Research Coordinator

Raelyn Debner, Community Outreach Coordinator

Lauren Hansen, Cancer Registry Quality Coordinator, Certified Tumor Registrar

Teresa Coker, Palliative Care Team Member

Peg Weston-Kolarik, Social Worker, Psychosocial Services Coordinator

Alissa McEowen, Nurse Oncology Manager

Sallie Buelow, Cancer Conference Coordinator

Amy Yoder, Quality Improvement Coordinator

Amie Hass, ARNP, Genetic Counselor

Matthew Smith, MD, Urologist

Shane Gailushas, MD, ENT Surgeon

Deborah Wilbur, MD, Medical Oncologist

Wook Lee, MD, Radiation Oncologist

Nora Royer, MD, General Surgery

Michelle Cooley, MD, Pathologist

Eduardo Celis, MD, Pulmonologist

Aimee Bell, Manager, Clinic Operations

Nicole Sorge, Hall Radiation Center

Jessica Pearson, Rehab Services

Jessica Steffens, Nurse Navigator

Gwen Herder, Nurse Navigator

Nancy Jolliffe, Oncology Dietitian

Tammy Buseman, Pastoral Care

Shelly Walker, Amer. Cancer Society

Lisa Zwanziger, Clinical Research

Kathie Churchill, Cancer Registrar

Kim Salzbrenner, Hall Radiation Center

Lisa Shaffer, ARNP, OCN

Molly Flynn, Director, Specialty Clinics

Becky Prier, Zone 41


MALE:

Prostate

Lung and Bronchus

Bladder

Colon

Melanoma

Hematopoietic (cancers of the blood, bone marrow and lymph systems)

2019 Top 5 Hall-Perrine Cancer Center Sites By GenderSource: HPCC Registry Note

FEMALE:

Breast

Lung and Bronchus

Colon

Uterine

Hematopoietic (cancers of the blood, bone marrow and lymph systems)

Melanoma

* Based on number of cases from January 1, 2019 – August 1, 2019

“I never felt bad. I never got sick. It’s just so amazing.” – John Tigan, cancer survivor

5

By early December, John learned he had much more than an M&M-size cyst — he had Stage 4 melanoma.

“That all sounded just horrid to me,” John remembers. “I was thinking, ‘Geez. Skin cancer? On my ear?’ Skin cancer wasn’t really in my thoughts. That was not the way I thought I was going to get sick when I got sick.”

Further tests uncovered the cancer had spread to his chest. John began seeing Hall-Perrine Cancer Center oncologist Samuel Wood, MD, who recommended a new, cutting-edge treatment.

“The stage and type of cancer John was dealing with, melanoma, has historically been challenging to treat,” explains Dr. Wood. “At the time of John’s diagnosis, a new treatment was on the horizon called immunotherapy, which basically trains the human immune system to recognize cancer as a foreign invader in the body and attack it. Research was pointing to immunotherapy as an emerging opportunity for melanoma treatment, and I felt John would be a prime candidate if he wanted to pursue it as an option.”

After giving it some thought and weighing his choices, John decided to give it a try. He visited Hall-Perrine

Cancer Center to receive an hour-long infusion of Yervoy® immunotherapy medicine once a month for three months in 2014. The following year, he started Keytruda® immunotherapy infusions every three weeks until his last treatment in April 2017.

“I’d come over to Hall-Perrine on an extended lunch and do these infusions.” says John, a proud member of CarePro’s warehouse team. “I came over, I got the infusion, they taped me up, and I went back to work and just kept working through the whole thing.”

In fact, many of John’s coworkers didn’t even realize he was battling cancer. Aside from some time off around his surgeries and some moments of discomfort now and then, he never experienced the symptoms that sometimes come with chemotherapy treatment.

That’s because immunotherapy is very different.

“While chemotherapy kills cancerous tissue, it can also damage healthy cells.” Dr. Wood says. “Patients might see the common symptoms associated with

chemotherapy when those healthy cells are damaged, like

hair loss or nausea. Immunotherapy, on

the other hand, only homes in on cancerous tissue. Healthy cells are far less likely to

be damaged in the course of treatment. That means people who are on immunotherapies often don’t experience those commonly identifiable side effects.”

“Nothing ever changed as far as I was concerned,” John says about the more than four years he spent battling melanoma. “I never felt bad. I never got sick. It’s just so amazing.”

More than two years after his last immunotherapy infusion, John is living life cancer-free. His days are filled by a job he enjoys, video games that challenge his mind, and cheering on the successes of wife Leigh and son Robert. He checks in with Dr. Wood every six months and still has routine PET scans.

“Things have worked out really well for us,” John reflects. “I know I’m fortunate. I just keep moving forward. That’s all I can do. I listen to the doctors more than I used to, and I don’t push off appointments anymore.”

He encourages others to stay on top of their own health issues.

“Go to the doctor; listen to the doctor,” he says. “The staff here at Hall-Perrine has been awesome. I appreciate the professionalism of people who know their jobs and do them well. I have nothing but positive things to say about everything that’s happened here.”

Training the body to fight cancer with immunotherapyJohn Tigan noticed what he thought was a cyst on his left earlobe in the summer of 2013. The knot grew as weeks passed and his dermatologist recommended it be removed.

Samuel Wood, MDHematology and Oncology

For more information about immunotherapy at Hall-Perrine Cancer Center, visit hallperrinecancercenter.org/immunotherapy.

One Visit – Multiple PhysiciansHall-Perrine Cancer Center’s Multidisciplinary ClinicsWith many advances in cancer treatments, we feel it’s important to have a collaborative approach to ensure each patient’s treatment plan is comprehensive and effective.

The goal of the Hall-Perrine Cancer Center’s Multidisciplinary Clinic is to move patients from diagnosis to treatment faster – that’s why our patients see all their doctors in one day, during one appointment. The team is tailored to each patient’s needs and may include a medical oncologist, radiation oncologist, oncologic surgeon, oncology nurse navigator, oncology genetic counselor and other specialists. The patient’s treatment plan is evaluated together as a team to ensure quality care.

BENEFIT TO PATIENTS –✓ See all their oncology physicians during one single visit✓ Specially designed rooms for examination and consultation✓ Shorter time between diagnosis and treatment✓ Faster treatment

Lung Clinic: This clinic is for newly diagnosed lung cancer patients. The specialists providing care in this clinic include a medical oncologist, radiation oncologist, surgical oncologist and a pulmonologist.

Breast Clinic: During Breast Clinic, surgical, medical and radiation oncologists will meet with a newly diagnosed breast cancer patient. A specific treatment plan will be outlined with the patient at the end of the appointment.

GI Clinic: The GI Multidisciplinary Clinic is for new gastrointestinal cancer patients. This clinic brings together a surgical oncologist, medical oncologist and radiation oncologist. Collaboratively, these specialties provide the best comprehensive approach for management of the patient’s cancer.

Thyroid Clinic: Dedicated to the diagnosis and comprehensive care of thyroid cancer, thyroid nodules and other complex thyroid disorders. Our physicians specialize in surgical oncology, endocrinology, radiation oncology and medical oncology.

Advanced Skin Cancer ClinicWith many advances in skin cancer treatments, such as biologics for advanced melanoma, it’s important to have a collaborative approach to ensure each patient’s treatment plan is comprehensive and effective. This clinic provides comprehensive care for those who have suspicious skin lesions/moles. Concerns include a change in the color or size of the lesion, bleeding or large-sized lesions.

CLINICS ARE HELD ON THE FOLLOWING DAYS:Lung Clinic: Thursday afternoons

Breast Clinic: Tuesday afternoons

GI Clinic: Thursday afternoons

Thyroid Clinic: Tuesday mornings

Skin Cancer Clinic: Thursday afternoons



Radiation Oncology: Hall Radiation CenterSince 1956, Mercy’s Hall Radiation Center has been a leader in cancer treatment and the first to offer radiation treatment technology west of the Mississippi River. That legacy continues as the radiation center offers the most comprehensive and advanced technology, including the Varian Trilogy and Truebeam linear accelerators, Tomotherapy, large bore CT Simulator, intensity modulated radiation therapy, high dose rate brachytherapy, and prostate brachytherapy implants.

Radiation Oncology of Cedar RapidsRadiation Oncologists at Hall-Perrine Cancer Center

Janet Merfeld, MD Medical Director

Michael Marquardt, MD

Wook Lee, MD

FISCAL YEAR 2019 OVERVIEWHall Radiation continues to be Eastern Iowa’s only ACRO accredited radiation facility, which ensures that the clinical processes, quality assurance programs, and treatment procedures are independently reviewed.

FISCAL YEAR 2019 HALL RADIATION TREATMENT STATISTICS:

Varian Linear Accelerators: 6130TomoTherapy: 4663Thyroid i-131: 15Brachytherapy Procedures - Gynecological HDR: 23 Mammosite HDR: 20 Prostate seed implants: 2

In 2019, 10915 radiation therapy treatments were administrated, 467 new patient consultations, 379 new patients starting treatment and 109 patients returned for additional radiation therapy treatments.

Oncology Associates at Mercy Medical Center

Medical Oncologists at Hall-Perrine Cancer Center

Leila Kutteh, MD

Jasmine Nabi, MD

Deb Wilbur, MD Medical Director

Samuel Wood, MD

FISCAL YEAR 2019 HEMATOLOGY /ONCOLOGY STATISTICS:HPCC Clinic New Patients: 1160HPCC Established Clinic Visits: 13786HPCC Infusion Treatments: 10466

FISCAL YEAR 2019 OUTREACHCLINIC STATISTICS:Outreach Clinic New Patients: 92Outreach Clinic Established Patient Visits: 969Total Outreach Clinic Patients: 1061Outreach Infusions (Manchester, IA) 297

Ann Stroh, DO

Medical Oncology

Medical oncology services at Hall-Perrine Cancer Center provide high-quality, expert cancer care and chemotherapy treatment by the practicing physicians of Oncology Associates at Mercy Medical Center. The goal is to provide comprehensive and personalized cancer care to patients using a variety of the latest, most effective therapies. The practice includes five oncologists who also offer services for patients with blood disorders (hematology). Along with their dedicated staff, the physicians work to ensure that patients receive individualized treatment planning, therapy and follow-up care. Oncology Associates at Mercy Medical Center works together with the patient’s support system of family and friends, while providing excellent medical care in the comfort of, or close to, their home community. With that in mind, the oncologists travel to outreach clinics in the surrounding areas, including Anamosa, Independence, Manchester and Vinton. Chemotherapy infusions are provided at the practice’s Manchester Outreach Clinic which enables the continuity of high-quality oncology care for patients with limited access or limited transportation to oncology health services.

In 2019, Oncology Associates at Mercy was recognized by the Quality Oncology Practice Initiative (QOPI®) Certification Program, an affiliate of the American Society of Clinical Oncology (ASCO). This program provides a three-year certification for outpatient hematology-oncology practices that meet standards for quality cancer care. Oncology Associates prides itself on providing the highest quality patient care. This re-certification reinforces that excellent cancer care is consistently offered close to home, at the Hall-Perrine Cancer Center.

Lisa Shaffer, ARNP


Surgical OncologyHall-Perrine Cancer Centers Surgical Oncology Department offers the highest level of cancer care underthe direction of the only fellowship-trained oncologic surgeon in Cedar Rapids, Dr. Vincent Reid. Dr. Reidhas advanced training in surgical oncology and is skilled in the latest surgical procedures, offering patientswith cancer the best possible outcomes.

MARGINPROBE®

Hall-Perrine Cancer Center was the first hospital in Iowa to use MarginProbe® technology to detectany remaining cancerous tissue during breast cancer surgery. MarginProbe delivers clarity in real-time,reducing doubt and the likelihood of a second surgery. Margin Probe reduces the surgicalre-excision rate by 75%. National Average is 18-24% Dr. Reid’s rate is 6%.

SAVI SCOUT®

SAVI SCOUT is an FDA-cleared device used by surgeons and radiologists to precisely locate anddirect the removal of a tumor during a lumpectomy or surgical biopsy procedure. SAVI SCOUT usesnon-radioactive, radar technology to provide real-time surgical guidance during breast surgery. Ratherthan placing a wire immediately before surgery, a reflector is placed in the target tissue up to sevendays prior to surgery. During surgery, the technology accurately detects the location of the reflector —and the tumor. The new technology also allows for the incision to be more strategically placed by breastsurgeons, and helps reduce the discomfort associated with needle localization lumpectomy, resulting inbetter cosmetic outcomes. Mercy is the first hospital in Iowa to offer this technology as a standard ofcare for breast cancer surgery patients. Dr. Reid has completed 214 cases using Savi Scout technology.

Surgical Oncology at Mercy Medical Center

Surgical Oncologist at Hall-Perrine Cancer Center

HIDDEN SCAR™

Hidden Scar Breast Cancer Surgery is an advanced approach in which breast surgeons remove cancerous tissue through a single incision made in inconspicuous areas to minimize visible scarring. By utilizing this approach, surgeons are able to preserve a natural-looking breast by sparing the nipple, areola and surrounding tissue. The Hidden Scar approach may also ease the emotional impact of breast cancersurgery, in that patients have little to no visible reminder of the surgery, and experience a more natural looking breast reconstruction. Patients who undergo this approach are also at no higher risk of recurrence than patients who undergo any other type of technique.

ERAS (Enhanced Recovery After Surgery)Pectoralis nerve (Pecs) and serratus plane blocks are newer ultrasound guided regional anesthesia technique that can be effectively utilized for analgesia during mastectomy procedures thereby decreasing the need for oral and injectable narcotics. For instance, the Pec Block was devised to anesthetize the medial and lateral pectoral nerves which innervate the pectoralis muscles. This is accomplished by an injection of local anesthetic in the fascial plane between the pectoralis major and minor muscles.

LYMPHOSEEK®

Dr. Reid brought Lymphoseek technology to Mercy in May of 2019. Lymphoseek [technetium Tc 99 tilmanocept] injection is a radioactive diagnostic agent indicated with or without scintigraphic imaging for lymphatic mapping and guiding sentinel node biopsy. This injection allows for precise and confident identification of the primary tumor-draining lymph node for accurate staging and more informed treatment decisions. Lymphoseek is detectable within 10 minutes and up to 30 hours following injection. ENHANCED RECOVERY AFTER SURGERY [ERAS] BREAST PAIN MANAGEMENTThe goal of ERAS is to focus on improving patient outcomes without increasing the use of narcotics. ERAS processes can reduce complications by supporting evidence based practice and include protocols that facilitate the optimization of post-operative analgesia by using pectoralis block procedures prior to breast conservation surgery.

MEMBER OF NATIONAL QUALITY MEASURES FOR BREAST CENTERS (NQMBC)The NQMBC - Surgeon Program identifies quality care measures that allows participating surgeonsto compare performance with other participating surgeons across the United States. Dr. Reid is theonly surgical oncologist in Iowa that is a member of the NQMBC Surgeon program.

SURGICAL ONCOLOGY STATISTICS:JANUARY 1, 2013 - AUGUST 31,2019Total number of surgeries: 3240Lumpectomies: 602Mastectomies: 308

Vincent Reid, MD, FACSMedical DirectorHall-Perrine Cancer Center


Source: https://shri.public-health.uiowa.edu/wp-content/uploads/2019/03/Cancer-in-Iowa-2019-report.pdf

The cancer registry information is submitted to the State Health Registry of Iowa and the National Cancer Database (NCDB)for research and statistical purposes. The Cancer Registry complies with data standards regulated by the American College ofSurgeons Commission on Cancer (ACOS or ACoS)) and the Surveillance Epidemiology and End Results (SEER) program of theNational Cancer Institute (NCI). Iowa is a population-based registry established by SEER and NCI as a source for cancer incidenceand survival data for 28% of the U.S. population. The development, ongoing growth and support of the registry shows thecommitment of the Hall-Perrine Cancer Center as it continues to provide high-quality, comprehensive care for its cancer patients.

CANCER REGISTRY The Hall-Perrine Cancer Registry was established in 1988 to collect data for all hospital patients diagnosed and treated at the facility for cancer. To date, the Hall-Perrine Cancer Registry has more than 22,000 patient records in its database. Data collection of cancer diagnosis and treatment is an important part of a successful cancer program to monitor patient care outcomes. A Certified Tumor Registrar (CTR) collects demographics, pathology, radiology and treatment information on each cancer patient diagnosed and treated at Hall-Perrine Cancer Center. This information is reportable by the Iowa State Health Department regulations. The data provides medical staff and administrators with statistical information for research investigation, facility utilization assessments, the allocation of resources and patient care outcome improvements.

RESEARCHFor nearly 30 years, Oncology Associates at Mercyhave been participating in clinical research studiesfunded through the National Cancer Institute.Clinical trials are an important step in finding newand better ways of treating cancer. Hall-PerrineCancer Center is dedicated to advancing cancercare by leading and participating in many clinicaltrials that test the safety and efficacy of new ormodified cancer treatments. As a member of theIowa-Wide Oncology Research Coalition NCORP,Oncology Associates at Mercy and Mercy MedicalCenter participate in clinical trials offered throughthe Alliance for Clinical Trials in Oncology, theEastern Cooperative Oncology Group (ECOG), NRGOncology, Wake Forest NCORP Research Base, andthe Cancer Trials Support Unit (CTSU). In 2019,research conducted at Oncology Associates at Mercyand Mercy Medical Center included participation inbiorepository, prevention and treatment studies.Quality of life, observation and pre-registrationstudies were conducted there as well. These studieswere conducted via the NCI’s National Clinical TrialsNetwork and pharmaceutical based research.

CANCER CONFERENCEHall-Perrine Cancer Center held 72 cancer conferences in the past year. These conferences provide physicians with the opportunity for discussion of diagnosis, tumor staging, treatment and outcomes of cancer patients. Treatment recommendations are made to provide the highest quality of care. Representatives from the major disciplines including medical oncology, radiation oncology, surgery, pathology, specialty clinics, radiology and nurse navigators participate in discussing diagnostic and therapeutic alternatives for the cancer patient.

Top 10 Types of Cancer in Iowa Estimated for 2019

3

LYON

65OSCEOLA

40DICKINSON

145EMMET

75KOSSUTH

120

WINNEBAGO

70WORTH

50MITCHELL

65HOWARD

55 WINNESHIEK

110ALLAMAKEE

90

CLAYTON

120FAYETTE

135

CHICKASAW

75BREMER

150

FLOYD

120CERROGORDO

365HANCOCK

80PALO ALTO

85CLAY

105O’BRIEN

95SIOUX

155

PLYMOUTH

160CHEROKEE

85BUENA VISTA

95POCAHONTAS

55HUMBOLDT

65WRIGHT

75FRANKLIN

80BUTLER

110DUBUQUE

585DELAWARE

120BUCHANAN

120BLACK HAWK

750GRUNDY

85HAMILTON

110WEBSTER

240CALHOUN

80SAC

65IDA

50WOODBURY

545

MONONA

75CRAWFORD

95CARROLL

160GREENE

75BOONE

170STORY

380MARSHALL

245TAMA

120BENTON

155LINN

1,230JONES

125JACKSON

135CLINTON

320CEDAR

120JOHNSON

610IOWA

100POWESHIEK

115JASPER

225POLK

2,200DALLAS

350GUTHRIE

75AUDUBON

45SHELBY

85HARRISON

80

POTTAWATTAMIE

550CASS

110ADAIR

55MADISON

95WARREN

255MARION

200MAHASKA

125KEOKUK

70WASHINGTON

145

MUSCATINE

255LOUISA

60HENRY

125JEFFERSON

95WAPELLO

230MONROE

50LUCAS

50CLARKE

65UNION

85ADAMS

30MONTGOMERY

80MILLS

95FREMONT

60PAGE

120TAYLOR

40RINGGOLD

50DECATUR

55WAYNE

45APPANOOSE

80DAVIS

50VAN BUREN

55 LEE

230

SCOTT

950

DES MOINES

275

HARDIN

130

In 2019, data will be collected on an estimated 18,100 new, invasive cancers (and in situ bladder cancers) among Iowa residents. Estimates of new cancers are given by county with shading by urban/rural status as well as the top 10 by sex, below.

New Cancers in Females TYPE # OF CANCERS % OF TOTAL

Breast 2,500 28.1

Lung 1,100 12.4

Colon & Rectum 780 8.8

Uterus 630 7.1

Skin Melanoma 450 5.1

Thyroid 360 4.0

Non-Hodgkin Lymphoma 330 3.7

Leukemia 270 3.0

Kidney & Renal Pelvis 260 2.9

Pancreas 250 2.8

All Others 1,970 22.1

Total 8,900

New Cancers in Males TYPE # OF CANCERS % OF TOTAL

Prostate 2,050 22.3

Lung 1,280 13.9


Bladder 640 7.0




Leukemia 400 4.3

Oral Cavity 330 3.6

Pancreas 270 2.9


Total 9,200

Estimates for New Cancers in 2019

Based on the 2013 Rural-Urban Continuum Codes, Iowa counties were classified as:

RURAL = Completely rural or less than 2,500 urban population, adjacent or not adjacent to a metro areaSMALL URBAN = Urban population of 2,500 to 20,000 or more, adjacent or not adjacent to a metro areaLARGE URBAN = Counties in metro area of fewer than 250,000 or up to 1 million population

RURAL SMALL URBAN LARGE URBAN

LYON

25OSCEOLA

15DICKINSON

45EMMET

30KOSSUTH

40

WINNEBAGO

25WORTH

20MITCHELL

25HOWARD

20 WINNESHIEK

35ALLAMAKEE

25

CLAYTON

45FAYETTE

50

CHICKASAW

30BREMER

50

FLOYD

45CERROGORDO

100HANCOCK

20PALO ALTO

30CLAY

40O’BRIEN

35SIOUX

55

PLYMOUTH

55CHEROKEE

35BUENA VISTA

35POCAHONTAS

20HUMBOLDT

25WRIGHT

30FRANKLIN

20BUTLER

40DUBUQUE

195DELAWARE

35BUCHANAN

45BLACK HAWK

255GRUNDY

35HAMILTON

35WEBSTER

80CALHOUN

25SAC

30IDA

20WOODBURY

205

MONONA

25CRAWFORD

35CARROLL

60GREENE

25BOONE

60STORY

125MARSHALL

90TAMA

45BENTON

55LINN

415JONES

45JACKSON

40CLINTON

115CEDAR

45JOHNSON

170IOWA

35POWESHIEK

50JASPER

90POLK

765DALLAS

105GUTHRIE

30AUDUBON

10SHELBY

30HARRISON

30

POTTAWATTAMIE

200CASS

40ADAIR

25MADISON

30WARREN

100MARION

85MAHASKA

55KEOKUK

25WASHINGTON

60

MUSCATINE

90LOUISA

25HENRY

50JEFFERSON

35WAPELLO

85MONROE

25LUCAS

25CLARKE

20UNION

30ADAMS

10MONTGOMERY

25MILLS

35FREMONT

20PAGE

35TAYLOR

15RINGGOLD

20DECATUR

20WAYNE

20APPANOOSE

35DAVIS

15VAN BUREN

25 LEE

95

SCOTT

345

DES MOINES

105

HARDIN

55

5

In 2019, an estimated 6,400 Iowans will die from cancer. Heart disease and cancer are the leading causes of death in Iowa. These projections are based upon mortality data the Iowa Cancer Registry receives from the Iowa Department of Public Health. Estimates of cancer deaths are presented by county with urban/rural shading as well as the top 10 by sex, below.

Cancer Deaths in Females TYPE # OF CANCERS % OF TOTAL

Lung 730 24.3

Breast 390 13.0


Pancreas 230 7.7

Ovary 160 5.3

Leukemia 110 3.7


Uterus 110 3.7

Brain 80 2.7

Multiple myeloma 70 2.3

All Others 740 24.6

Total 3,000

Cancer Deaths in Males TYPE # OF CANCERS % OF TOTAL

Lung 900 26.5

Prostate 350 10.3


Pancreas 240 7.1

Leukemia 170 5.0

Esophagus 150 4.4


Bladder 120 3.5


Liver 110 3.2

All Others 820 24.1

Total 3,400

Estimates for Cancer Deaths in 2019


3

LYON

65OSCEOLA

40DICKINSON

145EMMET

75KOSSUTH

120

WINNEBAGO

70WORTH

50MITCHELL

65HOWARD

55 WINNESHIEK

110ALLAMAKEE

90

CLAYTON

120FAYETTE

135

CHICKASAW

75BREMER

150

FLOYD

120CERROGORDO

365HANCOCK

80PALO ALTO

85CLAY

105O’BRIEN

95SIOUX

155

PLYMOUTH

160CHEROKEE

85BUENA VISTA

95POCAHONTAS

55HUMBOLDT

65WRIGHT

75FRANKLIN

80BUTLER

110DUBUQUE

585DELAWARE

120BUCHANAN

120BLACK HAWK

750GRUNDY

85HAMILTON

110WEBSTER

240CALHOUN

80SAC

65IDA

50WOODBURY

545

MONONA

75CRAWFORD

95CARROLL

160GREENE

75BOONE

170STORY

380MARSHALL

245TAMA

120BENTON

155LINN

1,230JONES

125JACKSON

135CLINTON

320CEDAR

120JOHNSON

610IOWA

100POWESHIEK

115JASPER

225POLK

2,200DALLAS

350GUTHRIE

75AUDUBON

45SHELBY

85HARRISON

80

POTTAWATTAMIE

550CASS

110ADAIR

55MADISON

95WARREN

255MARION

200MAHASKA

125KEOKUK

70WASHINGTON

145

MUSCATINE

255LOUISA

60HENRY

125JEFFERSON

95WAPELLO

230MONROE

50LUCAS

50CLARKE

65UNION

85ADAMS

30MONTGOMERY

80MILLS

95FREMONT

60PAGE

120TAYLOR

40RINGGOLD

50DECATUR

55WAYNE

45APPANOOSE

80DAVIS

50VAN BUREN

55 LEE

230

SCOTT

950

DES MOINES

275

HARDIN

130

In 2019, data will be collected on an estimated 18,100 new, invasive cancers (and in situ bladder cancers) among Iowa residents. Estimates of new cancers are given by county with shading by urban/rural status as well as the top 10 by sex, below.

New Cancers in Females TYPE # OF CANCERS % OF TOTAL

Breast 2,500 28.1

Lung 1,100 12.4


Uterus 630 7.1


Thyroid 360 4.0


Leukemia 270 3.0


Pancreas 250 2.8


Total 8,900

New Cancers in Males TYPE # OF CANCERS % OF TOTAL

Prostate 2,050 22.3

Lung 1,280 13.9


Bladder 640 7.0




Leukemia 400 4.3

Oral Cavity 330 3.6

Pancreas 270 2.9


Total 9,200

Estimates for New Cancers in 2019

Based on the 2013 Rural-Urban Continuum Codes, Iowa counties were classified as:

RURAL = Completely rural or less than 2,500 urban population, adjacent or not adjacent to a metro areaSMALL URBAN = Urban population of 2,500 to 20,000 or more, adjacent or not adjacent to a metro areaLARGE URBAN = Counties in metro area of fewer than 250,000 or up to 1 million population


LYON

25OSCEOLA

15DICKINSON

45EMMET

30KOSSUTH

40

WINNEBAGO

25WORTH

20MITCHELL

25HOWARD

20 WINNESHIEK

35ALLAMAKEE

25

CLAYTON

45FAYETTE

50

CHICKASAW

30BREMER

50

FLOYD

45CERROGORDO

100HANCOCK

20PALO ALTO

30CLAY

40O’BRIEN

35SIOUX

55

PLYMOUTH

55CHEROKEE

35BUENA VISTA

35POCAHONTAS

20HUMBOLDT

25WRIGHT

30FRANKLIN

20BUTLER

40DUBUQUE

195DELAWARE

35BUCHANAN

45BLACK HAWK

255GRUNDY

35HAMILTON

35WEBSTER

80CALHOUN

25SAC

30IDA

20WOODBURY

205

MONONA

25CRAWFORD

35CARROLL

60GREENE

25BOONE

60STORY

125MARSHALL

90TAMA

45BENTON

55LINN

415JONES

45JACKSON

40CLINTON

115CEDAR

45JOHNSON

170IOWA

35POWESHIEK

50JASPER

90POLK

765DALLAS

105GUTHRIE

30AUDUBON

10SHELBY

30HARRISON

30

POTTAWATTAMIE

200CASS

40ADAIR

25MADISON

30WARREN

100MARION

85MAHASKA

55KEOKUK

25WASHINGTON

60

MUSCATINE

90LOUISA

25HENRY

50JEFFERSON

35WAPELLO

85MONROE

25LUCAS

25CLARKE

20UNION

30ADAMS

10MONTGOMERY

25MILLS

35FREMONT

20PAGE

35TAYLOR

15RINGGOLD

20DECATUR

20WAYNE

20APPANOOSE

35DAVIS

15VAN BUREN

25 LEE

95

SCOTT

345

DES MOINES

105

HARDIN

55

5

In 2019, an estimated 6,400 Iowans will die from cancer. Heart disease and cancer are the leading causes of death in Iowa. These projections are based upon mortality data the Iowa Cancer Registry receives from the Iowa Department of Public Health. Estimates of cancer deaths are presented by county with urban/rural shading as well as the top 10 by sex, below.

Cancer Deaths in Females TYPE # OF CANCERS % OF TOTAL

Lung 730 24.3

Breast 390 13.0


Pancreas 230 7.7

Ovary 160 5.3

Leukemia 110 3.7


Uterus 110 3.7

Brain 80 2.7

Multiple myeloma 70 2.3

All Others 740 24.6

Total 3,000

Cancer Deaths in Males TYPE # OF CANCERS % OF TOTAL

Lung 900 26.5

Prostate 350 10.3


Pancreas 240 7.1

Leukemia 170 5.0

Esophagus 150 4.4


Bladder 120 3.5


Liver 110 3.2

All Others 820 24.1

Total 3,400

Estimates for Cancer Deaths in 2019



DIETITIANNutrition plays an important role in the care and healing of individuals with cancer. Individualized nutrition assessment and education is offered to each patient during their cancer treatment. The nutrition services are provided by a Board-Certified Specialist in Oncology Nutrition (CSO). Board certification as a specialist in oncology helps to identify a registered dietitian with a specialized skill set as a nutrition expert for patients who are seeking timely, accurate and reliable information on eating well before, during or after cancer treatment. In fiscal year 2019, the Hall-Perrine Cancer Center dietitian completed 1211 nutrition visits and presented 3 community outreach programs.

SOCIAL WORKERCancer treatment and care involves not only medical care but attention to the emotional and psychosocial issues of the patient and family. At the Hall-Perrine Cancer Center, the social worker can provide assistance through ongoing supportive care, practical issues, community resources and referrals.

Hall-Perrine Cancer Center Support ServicesCANCER PATIENT REHABILITATION Hall-Perrine Cancer Center offers a full range of rehabilitation and support services for cancer patients, including physical therapy, lymphedema and axillary web syndrome therapy for patients with breast cancer, occupational therapy and speech therapy, with the goal of maximizing and enhancing the quality of cancer survivorship.

✓ Physical therapy provides specially trained clinicians to develop interventions to improve/maintain maximum strength, range of motion, balance and mobility, including the use of individualized exercises, caregiver education, anodyne therapy, assistive devices, and connecting patients to long term exercise options and community resources.

✓ Breast cancer therapy offers support and treatment to patients with lymphedema and axillary web syndrome.

✓ Occupational therapy provides specialized services in breast cancer rehabilitation, exercise instruction to prevent limitations in upper extremities, lymphedema prevention and treatment, scar massage and patient/caregiver training in adaptive equipment to maximize independence.

✓ Speech/swallowing therapy provides specialized services to head and neck cancer patients, optimizing the safety and efficiency of oral intake and development of assistive communication devices and prescription exercises to inhibit fibrotic tissue changes following surgery and radiation therapy.

INFRARED LIGHT THERAPYInfrared Light Therapy is used to treat patients with neuropathy, pain and poor circulation caused by a range of factors including chemotherapy, diabetes, acute injuries and vascular disease. This non-invasive, evidence-based therapy emits monochromatic infrared light, which increases circulation and triggers the local release of nitric oxide to promote healing and decrease pain and inflammation. This therapy provides symptomatic relief while avoiding systemic side effects.

SYMPTOMS INCLUDE:✓ Tingling, burning, coldness, weakness or

numbness in the hands or feet.

✓ Pain or difficulty walking.

✓ Difficulty picking up small objects, buttoning, typing, etc.

NURSE NAVIGATORThe role of the Nurse Navigator is to ease the burden of cancer treatment on both the patient and family. They coordinate the efforts of the medical team, help patients and families understand their diagnosis and assist them through the healthcare system. They also participate in weekly multidisciplinary clinics and cancer conference. There is no cost to utilize the services of the Nurse Navigator as it is part of the Hall-Perrine Cancer Center’s comprehensive cancer care.

THRIVE FITNESS AND WELLNESS PROGRAMThrive Fitness and Wellness is a program designed toimprove a patient’s functional strength and exerciseability during and following the course of their cancertreatments. A physical therapist will perform aninitial assessment to determine any weakness indaily activities, balance or walking stability issues,as well as measure the patient’s exercise ability.An individualized program is developed and thenimplemented by specially trained exercise instructors.


PALLIATIVE CAREPalliative Care is specialized care for those experiencing a serious, progressive or life-limiting illness. The goal of Palliative Care is to relieve the pain, symptoms and stress of a serious illness to achieve the best quality of life, while supporting patients and their families, regardless of treatment goals and life expectancy. The Palliative Care Program is an integral part of Hall-Perrine Cancer Center’s comprehensive cancer care.

GENETICS AND CANCER RISK ASSESSMENT Approximately ten percent of cancers are hereditary. This means that individuals are born at a higher than average risk to develop cancer due to inherited changes in a person’s DNA . Breast, ovarian, prostate, colorectal, uterine and pancreatic cancers- are a few of the cancers that have been associated with hereditary cancer. Cancer genetic testing has changed over the past five years. In the past- just two or three genes were analyzed for DNA changes. Today- gene panels of 30 to 40 genes are analyzed as part of a genetic test for hereditary cancer. By identifying individuals and families that have a hereditary cancer syndrome, we can discuss additional cancer surveillance and preventative strategies. Cancer genetic testing may also play a role in the personalized treatment of an individual’s cancer. The Genetics and Cancer Risk Assessment Program helps patients assess, understand, and manage their risk of developing cancer. During the consultation, individuals meet with our High Risk Genetics Nurse Practitioner, who will guide the individual and family through the process of genetic assessment, counseling and testing. Cancer risk assessment is beneficial to estimate individuals’ risks for cancer in their lifetime. Women may be at risk for breast cancer solely based on a family history of breast cancer even when genetic test is negative. Breast cancer risk assessment and estimating risk for breast cancer may change an individual’s breast cancer screening recommendations. Additional services, such as DNA banking, participation in research studies, and providing support and resources to patients and families are also available. The majority of genetic tests are covered by health insurance. Since its inception, the program has served more than 2200 individuals. The High Risk Genetics Nurse Practitioner participates in Multidisciplinary Clinics within our cancer center. We have worked to educate the public and other healthcare professionals on issues related to cancer genetic counseling and genetic testing through educational presentations.

MERCY WOMEN’S CENTER Mercy Women’s Center is designated by the American College of Radiology (ACR) as a Breast Imaging Center of Excellence. The center provides breast care screening and diagnostic services, including Digital Mammography, Digital Breast Tomosynthesis (3-D Imaging), which offers the latest state of the art imaging, diagnostic mammography, ABUS Automated Breast Ultrasound; nonsurgical breast biopsies, 3D stereotactic breast biopsies, DEXA bone analysis, dietitian counseling, therapeutic massage services and education about early detection of breast cancer. Specially-trained Registered Nurse offers education, resources and support to individuals newly diagnosed with breast cancer. A dedicated breast nurse navigator acts as a case manager for each newly diagnosed breast cancer patient from diagnosis through treatment and beyond. Since 1991, free mammograms and other breast care services have been provided to area women in need through the Especially For You® Race Against Breast Cancer. In 2013, Mercy’s Women’s Center became a participant in the National Quality Measure for Breast Centers Program (NQMBC). This program identifies quality core measures, and provides immediate access to information and allows breast centers to compare their performance with others across the U.S.

SUPPORT GROUPSHall-Perrine Cancer Center offers monthly support groups for patients. The support group meetings provide patients with a time and place to connect with others facing the same challenges. These meetings provide a forum to educate, share thoughts and address issues related to cancer treatment and survivorship. Learn more at www.hallperrinecancercenter.org/cancer/support-resources/support-groups/


Community Events & Education 2019Sponsorship and involvement in cancer-related community events allow Hall-Perrine Cancer Center to give back to the community while raising awareness and funding for cancer research. In conjunction with the American Cancer Society and other community agencies, Hall-Perrine Cancer Center sponsors annual cancer screenings and programs for the community at large. The programs for 2017 included:

SUPPORT GROUPS:

✓ Especially For You® Breast Cancer Support Group

✓ Prostate Support Group

EDUCATIONAL AND COMMUNITY EVENTS:

✓ Breast Cancer Education

✓ Dental Cancer Conferences

✓ Cancer Care Update Conference

✓ Dr. Martin Weisenfeld Lecture Series

✓ Especially For You® Race Against Breast Cancer

✓ Mercy Medical Center’s Power of Pink

✓ Hall-Perrine Cancer Center Survivor’s Day

PROGRAMS:

✓ Especially For You® Women’s Health and Well-being Events

✓ Gems of Hope –Daffodil Days

✓ Baskets of Hope – In partnership with Aiming for a Cure

✓ Back To School Back Packs – In partnership with Aiming for a Cure

✓ “Dish it Up” – Nutrition for Cancer Survivors

SCREENINGS:

✓ Skin Cancer Screening

✓ Low Dose Ct Lung Cancer Screening

* The Support Group and Community Events and Education section meet the requirements for the Commission on Cancer standards 4.1 and 4.2.

CONNECT, SHARE & LEARN WITH USHall-Perrine Cancer Center

701 10th Street SE Cedar Rapids, IA 52403

(319) 365-HOPE

www.hallperrinecancercenter.org

hall-perrine cancer center community report...as a surgical oncologist, i’d be remiss if i...

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