st. john medical center cancer program · 2014. 4. 21. · lafortune cancer center at st. john 2012...

St. John Medical CenterCancer Program2012 ANNUAL REPORT

L A F O R T U N E C A N C E R C E N T E R A T S T . J O H N 2 0 1 2 A N N U A L R E P O R T

TABLE OF CONTENTS

Report from the Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Report of Cancer Committee Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Report from the Cancer Liaison Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Cancer Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Cancer Registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Primary Site Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Report of Cancer Census . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Lung Cancer Site-Specific Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Cancer Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Support Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14


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ST. JOHN HEALTH SYSTEM AND LAFORTUNE CANCER CENTER MISSION, VISION AND VALUES

MissionRooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable . Our Catholic health ministry is dedicated to spiritually centered, holistic care that sustains and improves the health of individuals and communities . We are advocates for a compassionate and just society through our actions and our words .

VisionWe envision a strong, vibrant Catholic health ministry in the U .S ., which will lead to the transformation of healthcare . We will ensure service that is committed to health and well-being for our communities and that responds to the needs of individuals throughout the life cycle . We will expand the role of the laity, in both leadership and sponsorship, to ensure a Catholic health ministry of the future .

ValuesWe are called to:• Service of the poor: generosity of spirit, especially for persons most in need• Reverence: respect and compassion for the dignity and diversity of life• Integrity: inspiring trust through personal leadership• Wisdom: integrating excellence and stewardship• Creativity: courageous innovation• Dedication: affirming the hope and joy of our ministry


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REPORT FROM THE DIRECTORThe pace of new advances in the treatment and cure of cancer is staggering . New chemotherapeutic agents are being produced at a rapid pace, as well as remarkable therapeutic radiation delivery systems such as our CyberKnife and TomoTherapy systems . The LaFortune Cancer Center at St . John Medical Center is positioned to fully participate in these advances in research and technology in our mission to deliver compassionate care and medical excellence .

Support services continue to be an integral component of our program, which includes dedicated social service support, an education resource center, sponsorship of multiple support groups and medical nutritional counseling . The Cancer Center is an active participant in numerous community activities that promote public education, screenings and disease prevention; fundraising; and celebration of survivorship .

Clinical research is available through sponsoring institutions, which include the National Cancer Institute, Eastern Cooperative Oncology Group, Radiation Therapy Oncology Group, National Surgical Adjuvant Breast and Bowel Program, and Clinical Trials Support Unit . Eligible patients who choose to participate may have an opportunity to receive cancer treatment that represents the most current science in cancer care .

The Cancer Registry abstracted 1,810 new cases during 2012, growing the database to more than 40,000 cases .

The Cancer Center team is dedicated to providing patient-centered care adhering to our mission and values and looks forward to the exciting challenges and opportunities in the delivery of cancer care .

Sincerely,

Phil Ames Director, Radiology Services LaFortune Cancer Center


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REPORT OF CANCER COMMITTEE ACTIVITIESThe St . John Cancer Committee is proud of the role it played in the successful operation of St . John Medical Center in 2012 .

In the area of improving the delivery of efficient and competent oncological care to our patients, the pharmacy department again had a dedicated pharmacist responsible only for the oncology department . Working with MD Anderson, we added a series of chemotherapy audits designed to further minimize chemotherapy order mistakes . Chemotherapy orders and regimens are being standardized and will eventually be digitized into our electronic medical records . The goal is seamless communication from physician to pharmacy to nursing for every chemotherapy order administration . The process would be transparent, with multiple safety mechanisms built in to further minimize mistakes . Additionally, internal quality improvement processes were constantly reviewed and updated to minimize patient wait time in the chemotherapy infusion room .

To help with the quality of life of our patients undergoing cancer treatment, the St . John rehabilitation department took a major step forward when it was awarded the STAR (Survivorship Training and Rehabilitation) Program certification. This program is proven to help cancer survivors cope with their debilitating side effects caused by treatments .

St . John Medical Center continued its public outreach program to help educate and support patients and their families receiving treatment or who received treatment in the past . The annual Holiday Heart and Hope party was again a great success, with good attendance by past and present patients and much community involvement . St . John also continued to participate actively in other community functions, such as Relay for Life and the Susan G . Komen Race for the Cure . At Christmastime St . John participated in the Angel Tree Program to provide less fortunate and financially strapped families with gifts for their children.

The Cancer Center continued to hold weekly Tumor Board conferences and expanded to include a breast cancer conference once a month . The conferences were well-attended by our multidisciplinary team of medical oncologists, radiation oncologists, surgeons and pathologists .

Patients treated at the LaFortune Cancer Center continued to have access to the most advanced equipment and specialized care . The medical staff included dedicated medical oncologists, hematologists, a breast surgeon, radiation oncologists, radiologists, neurosurgery oncologists, orthopedic surgeons, gynecologic oncologists, colorectal surgeons, plastic surgeons and ENT . Patients have access to PET/CT scanners, CyberKnife technology and robotic urological procedures . The Cancer Center welcomed its second radiation oncologist, Reginald Westmacott, MD . He has been providing much-needed additional radiation oncology coverage for our expanding Cancer Center patient population .

Our patients continued to have access to clinical trials from large corporative groups, including NSABP and RTOG .

Sincerely,

Coty Ho, MD Co-Chair, 2012 Cancer Committee Medical Director, Hematology and Oncology LaFortune Cancer Center


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REPORT FROM THE CANCER LIAISON PHYSICIANThe cancer liaison physician provides a connection between the Commission on Cancer of the American College of Surgeons and the LaFortune Cancer Center of St . John Medical Center . The cancer program at St . John underwent a survey in 2010, and its accreditation was renewed until 2013 .

The Cancer Center continues to provide assistance with the management of patients suffering from many types of cancer . Patients with both hematologic malignancies and solid tumors are treated at the Cancer Center . Patients have access to a wide variety of different medical subspecialties for treatment of oncological problems . We have a dedicated medical oncology team, as well as radiation oncology and breast surgical oncology . Our surgical service is further supported by a well-staffed neurosurgery team, with expertise in dealing with primary CNS tumor resection . We also have dedicated colorectal surgeons . We collaborate closely with our large group of urologists . Our radiation oncology department provides state-of-the-art CyberKnife technology, and our urology staff can provide robotic surgery expertise . Our interventional radiology staff continues to provide excellent service for all types of biopsy examinations and minimally invasive procedures to aid in new cancer diagnoses and palliative measures during treatment .

Our programs continue to promote up-to-date medical treatment with support for the whole patient — mind, body and spirit . We have dedicated social workers, nutritionists, rehabilitation specialists, physical therapists and home health nurses assigned to the Cancer Center . We are proud to report that the St . John rehabilitation department was awarded the STAR (Survivorship Training and Rehabilitation) Program certification. The program was designed to help cancer survivors treat and cope with the possible debilitating side effects caused by cancer treatments . The St . John hospice program, along with our chaplain service, remains active with the care of our terminally ill patients and provides much support to their families .

The Cancer Center remains active within the community with projects, such as free new wigs for patients with hair loss while undergoing chemotherapy . Another important program for the community is Tulsa Project Woman . This program provides free mammographies and, if needed, breast biopsies, for the indigent population with financial needs. The Charity Fund makes available financial support to uninsured patients undergoing cancer treatment . The annual Tulsa Komen Race for the Cure and the local Relay for Life raised funds to help support cancer research activities at St . John . Other St . John-sponsored activities, such as the Art of Healing, bring together cancer survivors and their families in an annual celebration of their continued health and courage . Our St . John physicians routinely take turns putting together annual symposiums on different topics of cancer to educate and update their colleagues and hospital staff on various new treatments and advances in cancer care . The Cancer Center continues to work closely with the local American Cancer Society chapter to provide temporary housing for patients from afar undergoing treatment here .

St . John remains a community leader in healthcare and cancer treatment . We have four satellite hospitals in the surrounding communities, allowing us to deliver excellent medical care to the growing Tulsa area and its suburbs . We were voted again by the greater metropolitan population as the No . 1 hospital in the area for 2012 . A great number of cancer patients throughout northeastern Oklahoma are impacted by the broad-reaching and supportive care of our doctors, nurses and staff . We will continue in our endeavors to provide medical excellence and compassionate care to the cancer patient .

Sincerely,

Coty Ho, MD 2012 Cancer Liaison Physician Medical Director, Hematology and Oncology LaFortune Cancer Center


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CANCER COMMITTEEThe St . John Cancer Committee is composed of representatives from various medical disciplines and support services involved with the care of cancer patients . The committee met six times in 2012 under the leadership of acting co-chairs Richard Ruben, MD, and Coty Ho, MD .

The committee is concerned with the entire spectrum of care for cancer patients seen at St . John Medical Center . Committee responsibilities include:

• Developing and evaluating annual goals and objectives for the clinical, educational and programmatic activities related to cancer .

• Promoting a coordinated, multidisciplinary approach to patient management .

• Ensuring educational and consultative cancer conferences cover all major sites and related issues .

• Ensuring an active, supportive care system is in place for patients, families and staff .

• Monitoring quality management and improvement through completion of quality management studies that focus on access to care and outcomes .

• Promoting clinical research .

• Supervising the cancer registry and ensuring accurate and timely abstracting, staging and follow-up reporting .

• Performing quality control of registry data .

• Encouraging data usage and regular reporting by planning and conducting a minimum of two patient care evaluation studies annually, one to include survival and comparison data, if available .

• Ensuring that content of the annual report meets requirements .

• Publishing the annual report on the St . John Health System MedWeb by Nov . 1 of the following year .

• Upholding medical ethical standards .

COMMITTEE MEMBERSRichard Ruben, MD . . . . . . . . . . . . . . Acting committee co-chair,

Medical Oncology

Coty Ho, MD . . . . . . . . . . . . . . . . . . . Acting committee co-chair and cancer liaison physician, Medical Oncology

Melissa Wood, RN . . . . . . . . . . . . . . . Nursing manager, Inpatient Oncology

Polly Robinson, PharmD . . . . . . . . . . Pharmacy

Heidi Macha, PharmD . . . . . . . . . . . Pharmacy

Michael Harvey, MD . . . . . . . . . . . . . Pathology

Jack Mocnik Jr ., MD . . . . . . . . . . . . . Radiology

Phil Ames . . . . . . . . . . . . . . . . . . . . . . Administrative director, LaFortune Cancer Center

Julie Kinzie, LCSW . . . . . . . . . . . . . . Social Services

Candida Barlow, RN . . . . . . . . . . . . . Manager, Clinical Research

Carol A . Lane, CTR . . . . . . . . . . . . . . Cancer Registry

Fred Willison, MD . . . . . . . . . . . . . . . Radiation Oncology

John L . Eckenrode, MD . . . . . . . . . . Medical Oncology

Kathy Smarinsky . . . . . . . . . . . . . . . . Vice president, St. John Medical Center

Doris Ghazal . . . . . . . . . . . . . . . . . . . Medical Staff Services

Denise Rable . . . . . . . . . . . . . . . . . . . Surgery

Mark Genesen, MD . . . . . . . . . . . . . . Gynecologic Oncology

Joyce George, RN . . . . . . . . . . . . . . . . Director, Medical Records and Admissions

JoAnn Rushenberg, RN . . . . . . . . . . Quality Assurance

Brenda Frank, RN . . . . . . . . . . . . . . . Nursing manager, Hospice

Jodi Hudson . . . . . . . . . . . . . . . . . . . . ACS representative

Kelly Berry, MPT . . . . . . . . . . . . . . . . Manager, Rehabilitation Services

Ronald Distefano, DO . . . . . . . . . . . . Pathology

Suzanne Forsberg . . . . . . . . . . . . . . . Nutrition

Donna Longfield, RN . . . . . . . . . . . . . Nursing manager, Radiology/Radiation Oncology

Sister Julie Manternach . . . . . . . . . . Pastoral Care

Tanyanika Towe, MD . . . . . . . . . . . . Medical Oncology

Douglas Shram, MD . . . . . . . . . . . . . Palliative Care

Sandra Walker, RN . . . . . . . . . . . . . . Nursing director, Outpatient Oncology

Andrew Crawford, DO . . . . . . . . . . . . Gastroenterology

Jeff Delo, MD . . . . . . . . . . . . . . . . . . . Medical Oncology


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14

12

11

8

2

38

28

44

6

110

65

8

15

1

5

1

4

32

1062

11

38

35

37

17

2

153

21

1

8

3

2

2

1

2

1

1

1

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CANCER REGISTRYThe St . John Cancer Registry maintains a complete database of all cancer cases diagnosed and/or treated at St . John . More than 23,119 cases have been accessioned since the registry’s new reference date of 2000 . In addition, 10,082 non-analytic cases and 1,143 cases of cervical carcinoma in situ have been registered . Three full-time cancer registrars and one follow-up secretary are responsible for collecting and maintaining complete and accurate data, including annual follow-up information for all cancer patients diagnosed or treated at St . John .

During 2012, the Cancer Registrars:• Abstracted 1,811 cases into the database .

• Abstracted the required 90 percent within the required six-month time frame .

• Registered 25 cases of cervical carcinoma in situ and 1,100 NRs .

• Completed follow-up on 90 percent of the 11,996 cases under follow-up .

• Reviewed and re-abstracted 10 percent of 2012’s accessioned cases .

• Prepared for the weekly Cancer Conference presentation .

• Prepared for the Cancer Committee .

• Prepared the annual report .

• Participated in the Tulsa Community College student program .

• Responded to 12 requests for studies or information from various departments, physicians and administrators .

DISTRIBUTION OF ANALYTIC CASES BY COUNTYThere were 1,811 analytic cases diagnosed at St . John in 2012 . Of them, 1,785 were from Oklahoma, and 26 were from other states . The case totals for Oklahoma counties are shown below:

OTHER STATES

Kansas . . . . . . . . . . . .18Louisiana . . . . . . . . . . .2Missouri . . . . . . . . . . .2Alabama . . . . . . . . . . . .1Arkansas . . . . . . . . . . .1California . . . . . . . . . . .1Tennessee . . . . . . . . . . .1

Total . . . . . . . . . . . . . .26


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2012 FREQUENCY COUNTS FOR PRIMARY SITECode Frequency Percent Cum. Freq. PercentTONGUE 1 1 0.1 1 0.1

TONGUE OTH 2 2 0.1 3 0.2

PALATE 5 2 0.1 5 0.3

MOUTH 6 1 0.1 6 0.3

PAROTID GL 7 2 0.1 8 0.4

TONSIL 9 5 0.3 13 0.7

OROPHARYNX 10 2 0.1 15 0.8

PYRIFORM S12 1 0.1 16 0.9

ORAL CAVITY 14 2 0.1 18 1.0

ESOPHAGUS 15 18 1.0 36 2.0

STOMACH 16 14 0.8 50 2.8

SM INTESTINE 17 5 0.3 55 3.0

COLON 18 105 5.8 160 8.8

RECTOSIGM 19 17 0.9 177 9.8

RECTUM 20 33 1.8 210 11.6

ANUS 21 12 0.7 222 12.3

LIVER 22 19 1.0 241 13.3

GALLBLADDER 23 6 0.3 247 13.6

BILIARY TR 24 2 0.1 249 13.7

PANCREAS 25 51 2.8 300 16.6

DIGESTIVE 26 3 0.2 303 16.7

NASAL CAVITY 30 1 0.1 3.4 16.8

SINUS 31 1 0.1 3.5 16.8

LARYNX 32 11 0.6 316 17.4

LUNG 34 273 15.1 589 32.5

PLEURA-MED 38 2 0.1 591 32.6

BONE LIMBS 40 1 0.1 592 32.7

BONE 41 2 0.1 594 32.8

BLOOD SYS 42 48 2.7 642 35.5

SKIN 44 111 6.1 753 41.6

PERITONEUM 48 3 0.2 756 41.7

CONNECTIVE 49 10 0.6 766 42.3

BREAST 50 378 20.9 1,144 63.2

VULVA 51 7 0.4 1,151 63.6

VAGINA 52 1 0.1 1,152 63.6

CERV UTERI 53 16 0.9 1,168 64.5

CORP UTERI 54 57 3.1 1,225 67.6

UTERUS 55 2 0.1 1,227 67.8

OVARY 56 38 2.1 1,265 69.9

FEM GENIT 57 3 0.2 1,268 70.0


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Code Frequency Percent Cum. Freq. PercentPENIS 60 2 0.1 1,270 70.1

PROSTATE 61 85 4.7 1,355 74.8

TESTIS 62 4 0.2 1,359 75.0

KIDNEY 64 96 5.3 1,455 80.3

REN PELVIS 65 2 0.1 1,457 80.5

URETER 66 4 0.2 1,461 80.7

BLADDER 67 69 3.8 1,530 84.5

URINARY 68 1 0.1 1,531 84.5

EYE 69 6 0.3 1,537 84.9

MENINGES 70 36 2.0 1,573 86.9

BRAIN 71 50 2.8 1,623 89.6

CENT NERVE 72 35 1.9 1,658 91.6

THYROID 73 52 2.9 1,710 94.4

ENDOCRINE 75 21 1.2 1,731 95.6

OTHER 76 1 0.1 1,732 95.6

LYMPH NODE 77 37 2.0 1,769 97.7

UNKNOWN 80 42 2.3 1,811 100.0

TOTAL 1,811 100.0 1,811 100.0

Mean = 47.66Standard error of mean = 0.42Frequency mode = 378

Code = 50Standard deviation = 17.93


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REPORT OF CANCER CENSUSDuring 2012, St . John Medical Center continued to be busy with the growth of its cancer care service . LaFortune Cancer Center continued to treat a wide variety of cancer diagnoses . The bulk of the cases comprised of the following four major types of cancer: lung, breast, colorectal and lymphoma . There were 273 cases of newly diagnosed lung cancer in 2012 . There were 378 cases of breast cancer . There were 201 cases of colorectal cancer and 37 cases of lymphoma diagnosed at the hospital in 2012 .

The total of newly diagnosed cancers in Oklahoma continues to increase every year . In 2012, the state had 20,160 new cases .

PRIMARY SITE FOR 2012

MaleLung . . . . . 164Skin . . . . . . 71Colon . . . . . . 68Pancreas . . . 31Rectum . . . . 26Lymphoma . . 20Breast . . . . . . 5

FemaleBreast . . . . 373Lung . . . . . 109Colon . . . . . . 83Skin . . . . . . 40Lymphoma . . 29Rectum . . . . 24Pancreas . . . 20


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LUNG CANCER SITE-SPECIFIC STUDY St. John Medical Center, Tulsa, Okla. Tanyanika Phillips, MDLung cancer remains the leading cause of cancer-related deaths in the U .S . According to the American Cancer Society, new cases of lung cancer represent 14 percent of all new cancer diagnoses; it is primarily a disease of the elderly, with more than 80 percent of cases over age 60 . At St . John, lung cancer was the second most common cancer diagnosed in 2012, with 78 percent of cases over age 60 .

The number of cases of lung cancer is shown below . Stage IV cases among national data (NCDB) are included in parentheses in the first chart and compared with local data at our hospital.

2008 2009 2010 2011 2012ST. JOHN 272

57% IV

NATIONALLY 126,035 (35.9%) IV

127,788(36.7%) IV

126,204 (40%) IV

124,289 (39.9%) IV

N/A

St. John lung cancer cases by demographics, histology and stage of disease in 2012:

GENDER Male Female

N=272 164 (61%) 108 (39%)

AGE <60 61–79 >80

65 (22%) 175(64%) 40 (14%)

RACE/ETHNICITY White Non-white

246 16

HISTOLOGY NSCLC Small cell lung CA

N=272 242 30

STAGE Localized/regional disease Distant

N=272 115 (42%) 157 (57%)

Our data was compared to NCDB data to identify the number of cases that present with early-stage disease and receive first course of surgery. Surgery remains the gold standard for initial treatment in patients with early-stage disease .

The 2011 NCDB data among NSCLC cases included 44,031 diagnosed with stage I or II lung cancer . There were 31,883 persons with stage I in 2011 and 12,148 diagnosed with stage II . Among stage I, 10,161 did not receive surgery . Among stage II, 4,821 did not receive surgery . Thus, 21,722 stage I lung cancer patients received at least some form of surgery, 17 of whom it was unknown whether surgery was performed in 2011 . And 7,327 patients with stage II received surgery, and only four cases were unknown whether surgery was performed .


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A snapshot of the last year of our cases reveals that in 2012 most persons diagnosed with lung cancer were white, male, between the ages of 61 and 79 and histologically NSCLC adenocarcinoma predominant (62 percent) .

We compared our data with the NCDB’s, and 57 percent of total cases in 2012 had stage IV disease, compared with 39 .9 percent nationally . Among the 125,230 diagnosed with lung cancer nationally, 88,806 (70 percent) received no surgery of the primary site .

Among the 42 percent (115 cases) with the localized disease defined as stage I or II, a random 10-percent sample was abstracted to identify those who received some form of surgery . Fifteen cases were randomly selected, and about half of the cases received surgery. Sixty-five percent of stages I and II lung cancer patients received surgery nationally .

Stages I and II (localized disease) St. John (115) 10% sample National NCDB (44,031)

Surgery 50% 7 65% 29,049

No surgery 50% 8 35% 14,982

Our demographic data mirrors national data, but the number of persons who present with advanced disease is slightly higher, with nearly 60 percent of our cases stage III or greater at diagnosis compared to 40 percent nationally . It appears that fewer patients nationally are receiving surgery as the first course of treatment. If reviewed by early stage alone, however, there is still a greater percentage of patients (65 percent) receiving surgery as the first course of treatment.

Patients who present to St . John with early-stage disease received surgery in 50 percent of cases, which is lower than the national data . When surgery was not performed, the majority of reasons identified were linked to co-morbidities, particularly COPD, making patients less optimal candidates for surgery . Thus, radiation such as stereotactic radiosurgery was performed .

In summary, although lung cancer is a challenging disease, our institution is following guidelines by offering surgery as a first choice for early-stage patients. When not eligible for surgery, patients are offered radiation as a chance to aggressively treat it . National efforts in early detection are under way to identify a greater number of persons with early-stage disease . We are actively engaging in discussions to provide screening for patients at high risk for lung cancer to provide effective treatment sooner for patients in need .


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CANCER CONFERENCEThe goal of the St . John Cancer Conference is to improve the care of the community’s cancer patients through the exchange of information . The weekly conference is open to all physicians, residents, medical students and nursing personnel . The third Wednesday of every month is dedicated to breast cases .

There were 51 conferences for 2012 . A total of 215 cases were presented for prospective treatment .

BREAST CENTERThe St. John Breast Center was the first fully digital, comprehensive breast center in northeastern Oklahoma and provides state-of-the-art digital mammography services, minimally invasive biopsies, breast ultrasounds, breast MRIs, free breast self-examination training, educational materials and help with access to medical specialists for consultative services . St . John Breast Center at St . John Medical Center is the only breast center in northeastern Oklahoma designated a Breast Imaging Center of Excellence by the American College of Radiology and is ACR-accredited . Mammography services are offered at St . John Outpatient Radiology at 81st Street

and Memorial Drive in Tulsa, as well as St . John Sapulpa, St . John Owasso and St . John Broken Arrow . Statistics on the number of cancers found are documented and may be obtained from the Breast Center .

CANCER PROGRAMS

DiagnosticRadiology. State-of-the-art equipment and computers enable a highly trained staff to offer screening and diagnostic procedures for all types of cancer . Digital radiographic evaluation, nuclear medicine, mammography, CT, MRI, ultrasound, interventional radiology and PET are available .

Pathology. The pathology department provides a complete range of rapid, reliable, state-of-the-art testing services to diagnose cancer, determine prognostic factors and monitor the results of treatment . The department has 22 board-certified pathologists and a Ph.D. immunologist experienced in the diagnosis of all forms of cancer, with specific areas of interest and expertise in the diagnosis of cancer of the breast, skin, lymph nodes, hematopoietic system, GI tract, GU tract and lungs . Physicians maintain subspecialty board certifications and/or special training in breast pathology, hematopathology, cytopathology, medical microbiology, dermatopathology, chemical pathology, medical immunology, molecular pathology and toxicology . In addition, there is expertise in fine needle aspiration and bone marrow biopsy and aspiration . Pathology consultations are available 24/7 .

Treatment ModalitiesMedical Oncology. Medical oncology is a subspecialty of internal medicine in which physicians receive special training in the diagnosis and treatment of cancer . At St . John Medical Center, treatment may be given in the outpatient facilities of the LaFortune Cancer Center, at St . John’s


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Outpatient Hematology Services or at a designated inpatient oncology unit . In all locations, certified oncology nurses deliver cancer therapy with great attention to patient comfort and education .

Radiation Oncology. Indications for the use of radiation therapy in the treatment of disease processes continue to expand, both as a single modality or in a combined format . Methods of treatment include conventional external beam radiation therapy, IMRT, superficial radiation therapy, CyberKnife robotic radiosurgery, brachytherapy, TomoTherapy and radiolabeled monoclonal antibodies. Two board-certified radiation oncologists provide direction and oversight of these complex treatment processes .

Respiratory Therapy . Sputum inductions for cytology are obtained . A variety of pulmonary function studies, including spirometry and diffusion capacity, are used to evaluate patients . Treatment includes such modalities as supplemental oxygen, humidity therapy and hand-held nebulization of bronchodilators . Incentive spirometry and chest physiotherapy are used for treatment of retained secretions, pneumonia, atelectasis and pleural effusion .

SUPPORT PROGRAMSCancer Registry. The Cancer Registry monitors all types of cancers diagnosed and/or treated at St . John . More than 40,000 cases have been registered since the reference date 1967, making St . John’s registry the oldest approved program in Oklahoma . The registry uses Rocky Mountain Cancer Data Systems, a software program containing all data points required by the American College of Surgeons and Surveillance, Epidemiology and End Results (SEER) program . Three full-time cancer registrars (abstractors) and one full-time follow-up secretary are responsible for collecting and maintaining complete and accurate data for all cancer patients registered at St . John . Nearly 14,000 patients are followed yearly .

Clinical Research Department. The St . John Health System Institutional Review Board meets monthly to review clinical research trials . The IRB incorporates active and passionate members comprised of facility members, physicians, nurses and community members . Dr . Coty Ho serves on the IRB to support expert evaluation of oncology studies submitted for IRB review . The foundation of the IRB is guided by the core values of service, presence, human dignity and wisdom, with commitment to the mission of service and day-to-day interactions with those who serve and are served .

St . John has centralized research resources by creating the clinical research department to coordinate and conduct clinical trials by providing investigators with an efficient infrastructure, committed research staff and operational expertise to attain, perform and manage trials . Clinical Research has full-time nurse coordinators and research nurses with 100 percent of their time dedicated to clinical trials . The Clinical Research Center clinical staff is specifically trained to perform research procedures and collect data as mandated by study protocol and federal, state and local regulations and guidelines . Clinical Research and the LaFortune Cancer Center have a designated oncology pharmacist, Matt Taliaferro, PharmD . Taliaferro has completed human subject protection and CITI training and is registered through CTSU as the investigational pharmacist for the Cancer Center . Clinical research physicians, nurse coordinators and nurses are registered through CTSU and complete human subject protection and CITI training on an annual basis .

The Cancer Center participates in clinical research trials by the National Institutes of Health’s National Cancer Institute by enrolling participants in clinical trials through the Cancer Trials Support Unit . Active and long-term follow-up clinical trials at the Cancer Center include Eastern Cooperative Oncology Group (ECOG), National Surgical Adjuvant Breast and Bowel Project (NSABP), North Central Cancer


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Treatment Group (NCCTG), Cancer and Leukemia Group B (CALGB) and Radiation Therapy Oncology Group (RTOG), affording access via the Main Cooperative Groups through the Cancer Trials Support Unit affiliation. The Cancer Center also provides active referrals for participants to clinical trials through the MD Anderson Clinical Research Network, Mayo Clinic and Baylor Medical Center .

St . John and the Cancer Center afford multiple institutional resources to conduct high-quality multidisciplinary cancer control, prevention and treatment trials throughout our comprehensive cancer center for our oncology patients . The Cancer Center’s robust network allows our oncology patients to stay home and maintain active lifestyles supported by their family, friends and community . Engagement in clinical trials provides our oncology patients access to potential advanced treatment options . The Alliance network would provide an immeasurable multidisciplinary clinical trial support system to our oncology patients if membership is granted to the Cancer Center. We are hopeful you will find our comprehensive Cancer Center committed and dedicated to excellence to support the work needed to implement and improve oncology patients’ lives through clinical trials .

Enterostomal Therapy. An enterostomal therapy (ET) nurse provides services for people who have undergone surgery or who are anticipating surgery resulting in an ostomy . The ET nurse also assists inpatients who have problems with surgical drains, fistulae or draining wounds. Outpatients are seen depending on the inpatient census of the ET nurse; however, phone consults with the patient or the patient's home health nurse are always available .

Home Health Care. Home Health Care at St . John Medical Center provides health services to promote, maintain and restore health to individuals and families in their homes . Home Health Care can also increase the level of patient independence while reducing the effects of disability and illness .

Hospice. St . John Hospice, one of the oldest hospices in Tulsa, provides expert, loving care to people with a limited life expectancy . The patient, family members and physicians work together with the St . John Hospice interdisciplinary team to establish a plan for care that enhances the patient’s quality of life . The hospice team of professionals and volunteers support that plan by responding to the unique needs of the terminally ill and their families .

Nutritional Counseling. A clinical dietitian assists oncology patients in making the correct dietary choices . Nutrition screenings by dietitians help manage optimal nutrition .

Pastoral Care. The St . John Medical Center pastoral care department provides chaplain services that are consistent with Ascension Health’s goal of providing spiritual care that supports holistic care and healing . To that end, chaplains (priests, sisters and ministers), pastoral care volunteer visitors and nursing spiritual support team members are available to meet the spiritual/emotional needs of patients, families and associates . Patients’ ministers, rabbis and spiritual counselors are recognized as integral partners with the chaplains in providing spiritual care to a diverse patient population .

Pharmacy. The pharmacy department offers a wide range of services to support the


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cancer program . These include providing and maintaining current information on chemotherapeutic and related drug products; storage, preparation and dispensing of these products; storage and distribution of investigational chemotherapy drugs; and chemotherapy order verification. The pharmacist plays a key role on the team in managing the treatment of cancer patients .

Great American Smokeout. The Great American Smokeout is a program of the American Cancer Society in which supportive services and the St . John Siegfried Health Club participate every year .

Healthy Lifestyles . The Healthy Lifestyles programs at St . John were designed to help individuals achieve their optimal level of health . A dedicated team of physicians, nurses, dietitians, exercise physiologists and clinical psychologists provide the congenial atmosphere needed for changing unhealthy lifestyle habits into healthy ones . Weight control and smoking cessation programs are offered .

Rehabilitation Services. St . John Rehabilitation Services, accredited by The Joint Commission, offers the most complete line of rehabilitation programs available in northeastern Oklahoma . Inpatient rehabilitation provides services including physiatry, physical therapy, occupational therapy, rehabilitation nursing, rehabilitation social work, speech-language pathology and therapeutic recreation .

Outpatient rehabilitation provides physical, occupational and speech therapy services to a varied caseload, including oncology patients . Outpatient rehabilitation currently has three physical therapists certified in manual lymphatic drainage and complete decongestive therapy for patients with lymphedema . Currently, 25 to 30 new patients are admitted per month for pre/post-breast cancer surgery, lymphedema prevention training and lymphedema management .

Resource Center. The LaFortune Cancer Resource Center provides comprehensive educational material for patients and families . The center offers free information from the National Cancer Institute, American Cancer Society and Leukemia Society of America, as well as other sources . Also available at the center are new wigs, hats and turbans for loan to chemotherapy patients .

Supportive Services. The LaFortune Cancer Center’s Supportive Services social worker meets with patients and families to help evaluate needs and lend assistance when necessary. The five most frequently identified areas of need are financial counseling, transportation, family relations, medications and lodging . Free educational and support programs are available to adult cancer patients and their families and friends .

Reach to Recovery. The American Cancer Society provides the program for mastectomy patients .

Look Good Feel Better. A trained cosmetologist provides skin care advice, as well as tips for wearing wigs and scarves, on a monthly basis . The program is co-sponsored by the LaFortune Cancer Center, American Cancer Society, National Cosmetology Association and CTFA Foundation .

US TOO. The educational support group with a survivor-steering committee is led by a licensed clinical social worker . The meeting is typically attended by prostate cancer survivors and their spouses and guests .

Myeloma Support Group. The Myeloma Support Group is co-sponsored by the Leukemia & Lymphoma Society for anyone affected by myeloma .

Celebrating the Art of Healing. This annual community event, sponsored by the Leukemia & Lymphoma Society, Monte Cassino, Saint Francis Hospice, Grace Hospice and St . John Medical Center, includes professional speakers and breakout sessions to provide local cancer survivors with a day of learning, healing and fun .


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The staff of the Cancer Registry extends its sincere appreciation for the support of the Cancer Committee, Medical Records, Pathology, Radiology and the St. John medical staff for its cooperation and assistance.

Holiday Heart and Hope. A yearly celebration for patients, families and caregivers, Holiday Heart and Hope is a day of fun, hope and therapeutic connections . Participants receive free chair massages, manicures, pictures with Santa Claus and lunch . The activities afford survivors the opportunity to celebrate and make important therapeutic connections with other survivors .

St. John Mini Relay for Life. The Mini Relay for Life is co-sponsored by the American Cancer Society and St . John Medical Center . More than 45 survivors and their families participated in the first annual event. A reception took place in honor of survivors, allowing each to share his or her story with others . The event raised more than $10,000 for the American Cancer Society and honored the Cancer Center’s survivors .

Susan G. Komen Race for the Cure. Every year St . John sponsors a breast cancer survivor team, paying for every survivor’s registration, at the yearly fundraiser for the Komen foundation . In 2012, more than 145 participated on the St . John Survivor Team .

The ACS Day. The ACS Day is a collaborative effort between the American Cancer Society and LaFortune Cancer Center . Every month, an ACS patient services manager is on site to visit with patients regarding ACS services and resources, including disseminating personal health managers to every patient .

1923 S. Utica Ave.Tulsa, OK 74104

st. john medical center cancer program · 2014. 4. 21. · lafortune cancer center at st. john 2012...

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