tiles of inspiration · awareness month 3:30p helping hands 6p ovarian cancer 3:30p helping hands...

Nobody under-

stands the quote

above more than

the Art Therapy

department at the

Cancer Care Center

of Decatur. Under

the direction of

Assistant Professor of Art Annette Russo

and Millikin University’s art therapy stu-

dents, the Tiles of Inspiration project was

created to provide an artistic outlet.

Individual clay tiles are used to express

an emotion or thought about cancer. Two

structures flank the water wall in the lobby

of the Cancer Care Center of Decatur. These

structures display completed tiles and hope-

fully provide inspiration and recognition to

the thousands of local heroes who have

participated in a clinical trial.

Due to an overwhelming response,

the Tiles of Inspiration project has been

expanded to include all cancer patients,

researchers, medical staff and volunteers.

As you view the tiles in this calendar,

we hope you will be reminded of the

journey we take together with the hope

of arriving at the ultimate destination:

a cure for cancer. Clinical trials provide

hope that we will reach our destination,

sooner rather than later.

Materials and project oversight was

made possible through funding by the

Lance Armstrong Foundation to the

Education Network to Advance Cancer

Clinical Trials (ENACCT).

In 2006, ENACCT selected our communi-

ty from among 70 applications to receive a

$450,000 three-year grant to educate com-

munity leaders, oncology staff, and other

health professionals on how to increase

awareness, access to, and acceptability of

cancer clinical trials. Data has shown that

communities understand the need to dis-

cover new medicines but do not understand

how clinical trials can move research from

the laboratory to advanced treatments for

the patient.

Liz Swords, MS, Clinical Research

Tiles of Inspiration“Artists are just as important as doctors and nurses.

People need nourishing of their souls as well as their bodies.” —Marni California

These structures display completed Art For Therapy tiles. These tiles provide inspiration

for all and well deserved recognition to the thousands of local heros who have participat-

ed in a clinical trial.

Art For Therapy funded by—

He who has hopehas everything.

—Arabian proverb

1 New Year’s Day 2

3 4 5 6 7 8 9

10 11 12 13 14 15 16

17 18 Martin Luther King Day 19 20 21 22 23

24

31

25 26 27 28 29 30

1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 1920 21 22 23 24 25 2627 28 29 30 31

1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728

JANUARY2010

DECEMBER

FEBRUARY

3:30p Helping Hands

Cervical Cancer Awareness Month

3:30p Helping Hands

3:30p Helping Hands6p Ovarian Cancer

6:30p Renewal 4:30p Us TOO Prostate 3:30p Helping Hands

1p Facing Cancer Together 6p Komen Breast Cancer 10a Brain Tumor

S u n d a y M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a yJanuary

The best and most beautiful things in this

world cannot be seen orheard, but must be felt

with the heart.—Helen Keller

1 2 Ground Hog Day 3 4 5 6

7 8 9 10 11 12 13

14 Valentine’s Day 15 President’s Day 16 17 18 19 20

21 22 23 24 25 26 27

28

1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728

FEBRUARY2010

JANUARY

MARCH

3:30p Helping Hands

National CancerPrevention Month

6p Look Good Feel Better

6p Ovarian Cancer

6:30p Renewal 4:30p Us TOO Prostate 11a Growing Through Grief

11a Bereavement Class 1p Facing Cancer Together 6p Komen Breast

10a Brain Tumor3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

S u n d a y M o n d a y Tu e s d a y Th u rs d a y Fr i d a y S a t u rd a y

1 23 4 5 6 7 8 910 11 12 13 14 15 1617 18 18 20 21 22 23

24 25 26 27 28 29 3031

FebruaryWe d n e s d a y

The joy that you give others isthe joy that comes back to you.—John Greenleaf Whitteier

1 2 3 4 5 6

7 8 9 10 11 12 13

14 Daylight Savings 15 16 17 St. Patrick’s Day 18 19 20

21 22 23 24 25 26 27

28 29 30 31

1 2 34 5 6 7 8 9 1011 12 13 14 15 16 1718 19 20 21 22 23 2425 26 27 28 29 30

MARCH2010

APRIL

1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728

FEBRUARY

3:30p Helping Hands

6p Komen Breast

Lymphedema “D” Day6p Ovarian Cancer

3:30p Helping Hands

Kidney CancerAwareness Month

3:30p Helping Hands

3:30p Helping Hands

10a Growing Through Grief

4:30p Us TOO Prostate

6:30p Renewal


1p Facing Cancer Together

10a Brain Tumor

M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a y

National ColorectalCancer Awareness Month

MarchS u n d a y

Life isn’t about

waiting for the storm

to pass, it’s learning

to dance in the rain.

—anonymous

12 3 4 5 6 7 89 10 11 12 13 14 1516 17 18 19 20 21 2223 24 25 26 27 28 2930 31

1 2 Good Friday 3

4 Easter 5 6 7 8 9 10

11 12 13 14 15 16 17

18 19 20 21 22 Easth Day 23 24

25 26 27 28 29 30

APRIL2010

MAY

1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728 29 30 31

MARCH

3:30p Helping Hands

6p Komen Breast


6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

4:30p Us TOO Prostate6:30p Renewal

1p Facing Cancer Together 10a Brain Tumor

M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a yAprilS u n d a y

Head and Neck CancerAwareness Month

And in the end it’s not the years in yourlife that count. It’s the life in your years.

—Abraham Lincoln

1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 1920 21 22 23 24 25 2627 28 29 30

1

2 3 4 5 6 7 8

9 Mother’s Day 10 11 12 13 14 15

16 17 18 19 20 21 22

23

30

24

31

25 26 27 28 29

MAY2010

JUNE

APRIL

6p Komen Breast

6p Renewal

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands4:30p Us TOO Prostate

Memorial Day


10a Brain Tumor

1 2 34 5 6 7 8 9 1011 12 13 14 15 16 1718 19 20 21 22 23 2425 26 27 28 29 30


National Skin CancerAwareness Month

National Cancer ResearchMonth

MayS u n d a y

The only differencebetween a good day and a bad day is your attitude.—Author Unknown

1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 1920 21 22 23 24 25 2627 28 29 30

1 2 3 4 5

6 7 8 9 10 11 12

13 14 15 16 17 18 19

20 21 22 23 24 25 26

27 28 29 30

JUNE2010

JULY

6p Komen Breast


6p Renewal

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands6p Growing Through Grief

6:30p Growing Through Grief



Race for the Cure

National CancerSurvivors Day


10a Brain Tumor

12 3 4 5 6 7 89 10 11 12 13 14 1516 17 18 19 20 21 2223 24 25 26 27 28 2930 31

S u n d a y M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a y

MAY

June

Life should not be lived, it should be celebrated.

—author unknown

1 2 3 4 5 6 78 9 10 11 12 13 1415 16 17 18 19 20 2122 23 24 25 26 27 2829 30 31

1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 1920 21 22 23 24 25 2627 28 29 30

1 2 3

4 5 6 7 8 9 10

11 12 13 14 15 16 17

18 19 20 21 22 23 24

25 26 27 28 29 30 31

JULY2010

AUGUST

JUNE 6p Komen Breast


6p Renewal

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands




Independence Day

1p Facing Cancer Together 10a Brain Tumor

S u n d a y M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a ySarcoma CancerAwareness Month

American Cancer Society-Macon County Relay for Life

July

In all things, the supremeexcellence is simplicity.

—Henry Wadsworth Longfellow

1 2 3 4 5 6 78 9 10 11 12 13 1415 16 17 18 19 20 2122 23 24 25 26 27 2829 30 31

1 2 3 4 56 7 8 9 10 11 1213 14 15 16 17 18 1920 21 22 23 24 25 2627 28 29 30

1 2 3 4 5 6 7

8 9 10 11 12 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29 30 31

AUGUST2010

SEPTEMBER

JULY 6p Komen Breast6p Look Good Feel Better

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

6:30p Renewal

3:30p Helping Hands

3:30p Helping Hands4:30p Us TOO Prostate


10a Brain Tumor

M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a yAugustS u n d a y

Everything can be taken from man but one thing: The last of human freedoms—to choose one’sown attittude in any given set ofcircumstances,to choose one’s own way. —Victor Frankel, survivor, Auschwitz Concentration Camp

1 2 3 4 5 6 78 9 10 11 12 13 1415 16 17 18 19 20 2122 23 24 25 26 27 2829 30 31

1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 17 18

19 20 21 22 23 24 25

26 27 28 29 30

AUGUST6p Komen Breast6p Look Good Feel Better

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

6:30p Renewal

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

Labor Day


10a Brain Tumor

1 23 4 5 6 7 8 910 11 12 13 14 15 1617 18 19 20 21 22 23

24 25 26 27 28 29 3031

OCTOBER

SEPTEMBER2010


National AwarenessMonth for these cancers:Prostate, Ovarian,Childhood,Leukemia,Lymphoma and Thyroid

SeptemberS u n d a y


A good sense of humor makes all things tolerable.—Author Unknown

1 2 3 45 6 7 8 9 10 1112 13 14 15 16 17 1819 20 21 22 23 24 2526 27 28

1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728 29 30

1 2

3 4 5 6 7 8 9

10 11 12 13 14 15 16

17 18 19 20 21 22 23

24

31

25 26 27 28 29 30

SEPTEMBER

6p Komen Breast6p Look Good Feel Better

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands


4:30p Us TOO Prostate6:30p Renewal

National Mammography Day

Early Detection Connection

Columbus Day


10a Brain Tumor

Halloween

NOVEMBER

OCTOBER2010


National Breast CancerAwareness Month

OctoberS u n d a y

Be thankful for what you do have, not the things you do not have.—Author Unknown

1 2 3 45 6 7 8 9 10 1112 13 14 15 16 17 1819 20 21 22 23 24 2526 27 28 29 30 31

1 2 3 4 5 6

7 8 9 10 11 12 13

14 15 16 17 18 19 20

21 22 23 24 25 26 27

28 29 30

6p Komen Breast

6p Ovarian Cancer

3:30p Helping Hands

3:30p Helping Hands

3:30p Helping Hands

Veteran’s Day

Thanksgiving Day

1p Facing Cancer Together10a Growing Through Grief

10a Brain Tumor

1 23 4 5 6 7 8 910 11 12 13 14 15 1617 18 19 20 21 22 23

24 25 26 27 28 29 3031

DECEMBER

NOVEMBER2010

OCTOBER


6:30p Renewal

S u n d a y M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a y

National AwarenessMonth for these cancers:Lung, Pancreas, Brain,and Bone Marrow

National Hospice Month

November

May you have the gladness of Christmas, which is hope;the spirit of Christmas, which is peace;

and the heart of Christmas, which is love.—Author Unknown

12 3 4 5 6 7 89 10 11 12 13 14 1516 17 18 19 20 21 2223 24 25 26 27 28 2930 31

1 2 3 4 5 67 8 9 10 11 12 1314 15 16 17 18 19 2021 22 23 24 25 26 2728 29 30

1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 17 18

19 20 21 22 23 24 25

26 27 28 29 30 31

Combined SupportGroup HolidayGathering, TBA

3:30p Helping Hands

3:30p Helping Hands

Christmas

10a Brain Tumor

JANUARY 2011

DECEMBER2010

NOVEMBER

6:30p Renewal

M o n d a y Tu e s d a y We d n e s d a y Th u rs d a y Fr i d a y S a t u rd a yS u n d a y

3:30p Helping Hands

December

DMH Clinical Research is the largest com-

ponent of the Central Illinois Community

Clinical Oncology Program and provides

clinical trials access to many patients in

surrounding communities. There are a total

18 DMH Research staff, which includes

clinical research associates, nurses, regula-

tory and support staff. Our accrual remains

strong and we continually look for new

opportunities to collaborate with research

bases and pharmaceutical companies to

bring the latest trials to the area.

Participation remained steady in 2009;

317 patients participated with 153 patients

enrolled in treatment trials and 164

enrolled in cancer symptom management

trials. We are seeing increased interest and

patient enrollment. Our collaboration,

process and

communica-

tions have

improved

with Cancer

Care

Specialists of

Central Illinois

now that we

are all housed

in the new

Cancer Care

Center of

Decatur.

Program leaders meet weekly to assess

the status of active trials and to review

new opportunities promptly. When a trial

closes in any disease site, the staff immedi-

ately searches for a replacement trial.

We evaluate trial availability from nine

different sources from across the country:

Southwest Oncology Group

National Surgical Breast and Bowel Project

Eastern Cooperative Oncology Group

MD Anderson Cancer Center

University of Rochester Cancer Center

Wake Forest Cancer Center

Clinical Trials Support Unit

Gynecology Oncology Group

University of Chicago Cancer Center

Partnerships with pharmaceutical com-

panies present even more opportunities to

provide innovative therapy. There are on

average 90 to 100 clinical trials available at

any one time during the year from all these

available resources.

In the past 12 months, the research

program has activated several Phase I

pharmaceutical trials allowing us to provide

ground-breaking new drugs. These trials

are difficult to coordinate due to all the

restrictions and constraints of the protocol,

but in the end, the efforts are worthwhile.

Patient satisfaction surveys continue to

indicate that patients are very happy with

the care they have received while enrolled

on a clinical trial. More than 90 percent of

volunteers would participate in another

clinical trial if offered to them.

Karen Cheek, RN, BS, CCRP

Director, Clinical Research

Clinical Research ReportCancer Registry ReportOur Mission: To accurately collect

and report verifiable data in a timely and ethical manner.

The Cancer Registry is a component of the

DMH Cancer Care Institute and is located in

the Cancer Care Center

of Decatur. Maintaining

a Cancer Registry

ensures that health offi-

cials have accurate and

timely information,

while ensuring the

availability of data for

treatment, research and education.

The Cancer Registry is an information sys-

tem designed to collect, manage and analyze

data on persons with a cancer diagnosis.

Registrars abstract, report, and maintain data

on all patients diagnosed and/or treated at

Decatur Memorial Hospital.

In 2009, a total 1,009 newly diagnosed

cases were abstracted using the METRIQ

Software System. This confidential data base

is reported to the Illinois Department of

Public Health and the National Cancer Data

Base. The data is then used for a wide vari-

ety of public health decisions and provides

rich information for cancer diagnosis and

treatment education. DMH Cancer incidence

data reports are displayed in this report.

In addition, the registry monitors Cancer

Program Standards of Care required by the

American College of Surgeons, Commission

on Cancer Approvals Program. Our staff

works closely with physicians, administra-

tors and other health care planners to pro-

vide support for cancer program develop-

ment to ensure compliance of reporting

standards, and serves as a valuable

resource for cancer information with the

ultimate goal to prevent and control cancer.

This past year, the cancer registry staff

attended several educational meetings to

enhance knowledge and skills to facilitate

accurate data collection. These meetings

were supported by Cancer Registrars of

Illinois (CRI), National Cancer Registrars

Association (NCRA), and the American

Cancer Society (ACS). Members of our staff

also serve on the Board of Directors for the

Cancer Registrars of Illinois organization,

allowing us to network with other regis-

trars across the state.

Nikki Damery, CTR, Cancer Care InstituteCoordinator

Jamie Clark, BS, CTR

Brook Moberly, BS, CTR

Michelle Whitehead, BS

A special thank you to Katie Bellows, a

DMH Auxiliary Volunteer, who donates

many hours to the DMH Cancer Care

Institute.

With great pleasure we present to you the

DMH Cancer Care Institute 2011 Calender,

Cancer Program Annual Report. It includes

information about our supportive services.

Inserted into this calendar are many pic-

tures of art tiles that were designed and

sculpted by some of our cancer patients,

families and staff. We hope you are

inspired by them all.

The DMH cancer program is an accred-

ited program by the American College of

Surgeons Commission on Cancer. This is a

voluntary obligation that helps to ensure

that our patients have access to the full

scope of services required to diagnose,

treat, rehabilitate and provide support to

cancer patients and their families. This

continuous accreditation reaffirms our

commitment to provide the highest quality

cancer care.

To help acheive this mission, a multidis-

ciplinary team of physicians and other

health care professionals form our Cancer

Committee. The Cancer Committee is

responsible for developing program goals,

planning, implementing, evaluating and

improving all cancer-related activities at

DMH. The Cancer Committee also supports

and assures our compliance with the stan-

dards set forth through the American

College of Surgeons-Commission on Cancer

for the cancer program. In addition to the

Cancer Committee, the Clinical and

Physician Oncology Service Line Committee

provides leadership and expertise for the

Cancer Program.

Clinical Research remains a strong com-

ponent of the DMH Cancer Care Institute

and continues its commitment to improving

and preserving quality of life through can-

cer symptom manage-

ment trials and devel-

opment of effective

new therapies. For

more than 22 years,

DMH has brought the

advantages of state-of-

the-art treatment and

cancer control research

to individuals in our

community. This has

been achieved by the

collaborative efforts of

the Central Illinois

Community Clinical

Oncology Program

(CICCOP). DMH,

which is part of the

CICCOP, continues to

receive funding from

the National Cancer

Institute to benefit

Central Illinois

patients and families

for innovative cancer treatment trials.

Support Services and Community

Outreach programs are a prominent part of

our cancer program and provide a real

strength to our program. All these services

are available in the DMH CCI Resources

and Services brochure and are posted on

the DMH website. Additional information is

also available in the resource area located

in the front lobby of the Cancer Care Center

of Decatur.

Professional Education and Cancer con-

ferences are frequent and of high quality.

Weekly cancer conferences provide a forum

for multidisciplinary evaluation of cancer

patients. Detailed discussions are conducted

using a team approach and result in the

development of the most appropriate treat-

ment options for individual cancer patients.

The Cancer Registry is a valuable

resource and assists with the coordination

of the Commission on Cancer requirements.

In 2009, the registrars abstracted and

reported 1,009 cases to the Illinois

Department of Public Helath, State Cancer

Registry. The most frequent sites includes

lung, breast, prostate, colon and non-

hodgkins lymphoma. Cancer incidence

graphs are detailed on the following pages.

A special thank you to those who worked

diligently to develop this calendar and to all

of the dedicated staff who served on the

DMH Cancer Committee. In keeping with

the mission of Decatur Memorial Hospital,

all efforts are made to provide a full range

of comprehensive diagnostic and therapeu-

tic services for cancer patients in the com-

munity and to continuously improve the

health of the people of Central Illinois.

Edward C. Elliott, MD, Radiation

Oncologist, Cancer Committee Chairman

John Ridley, Executive Director

DMH Cancer Care Institute

Cancer Committee Report

PRIMARY SITE# % MALE FEMALE 0 I II III IV 88* UNK**

101 10% 50 51 HEAD & NECK 2 49 6 14 27 1 238 32 6 Lip, Oral Cavity, Pharynx 0 10 2 6 18 1 114 11 3 Larynx 2 4 0 2 6 0 049 7 42 Thyroid 0 35 4 6 3 0 1

146 14% 81 65 DIGESTIVE SYSTEM 4 30 40 20 36 9 765 28 37 Colon, Rectosigmoid Junction 2 16 24 11 10 1 121 15 6 Rectum 1 4 7 2 4 0 310 10 0 Esophagus 0 1 3 2 4 0 09 5 4 Stomach 0 3 0 0 5 0 19 5 4 Pancreas 0 0 3 0 5 0 132 18 14 Other digestive 1 6 3 5 8 8 1

206 20% 105 101 LUNG/BRONCHUS 0 55 8 59 76 4 443 4% 18 25 SKIN (EXCLUDING BASAL & SQUAMOUS) 9 17 4 3 0 1 940 17 23 Melanoma -- Skin 9 16 3 3 0 0 93 1 2 Other Nonepithelial Skin 0 1 1 0 0 1 0

149 15% 2 147 BREAST 39 60 31 9 10 0 032 3% 0 32 FEMALE GENITAL SYSTEM 1 16 2 6 5 2 02 0 2 Cervix Uteri 0 0 0 1 0 1 016 0 16 Corpus & Uterus, NOS 0 11 2 0 2 1 010 0 10 Ovary 0 3 0 4 3 0 04 0 4 Other Female Genital Organs 1 2 0 1 0 0 0

116 11% 116 0 MALE GENITAL SYSTEM 0 3 87 9 10 1 6112 112 0 Prostate 0 0 87 9 10 1 54 4 0 Testis 0 3 0 0 0 0 1

67 7% 45 22 URINARY SYSTEM 12 33 6 6 8 0 235 29 6 Urinary Bladder 10 19 4 2 0 0 029 15 14 Kidney & Renal Pelvis 0 14 1 4 8 0 23 1 2 Ureter 2 0 1 0 0 0 0

35 3% 11 24 BRAIN & CNS 0 0 0 0 0 35 06 4 2 Brain 0 0 0 0 0 6 029 7 22 Other Nervous System 0 0 0 0 0 29 053 5% 28 25 LYMPHOMAS 0 8 12 12 17 0 42 1 1 Hodgkin Lymphoma 0 0 2 0 0 0 051 27 24 Non-Hodgkin Lymphoma 0 8 10 12 17 0 423 2% 11 12 HEMATOPOETIC SYSTEM 0 0 0 0 0 19 313 7 6 Leukemia 0 0 0 0 0 10 310 4 6 Multiple Myeloma 0 0 0 0 0 9 030 3% 19 11 OTHER 0 2 3 0 0 19 68 1% 4 4 UNKNOWN 0 0 0 0 0 8 0

1,009 490 519 TOTALS 67 273 199 138 189 99 4349% 51% 7% 27% 20% 14% 19% 10% 4%

*88: AJCC STAGING FOR THAT PARTICULAT PRIMARY SITE

**UNK:

Distribution by Primary Site and AJCC Stage at Diagnosis2009 Analytical Cases

AJCC STAGE AT DIAGNOSIS

AJCC STAGING SCHEME IS NOT AVAILABLE FOR THIS PRIMARY SITE OR THE MORPHOLOGY OF A CASE EXCLUDES IT FROM THE

INFORMATION AVAILABLE IS NOT SUFFICIENT TO ASSIGN STAGE

DMH 2009 Cancer Incidence Analytical Cases

ic & Non Analytic: 1,064 Cases

65.88%

6.20%

6.67%

5.45%

3.76%

3.57%1.32%

0.47%

0.56%

0.66%

0.66%

Not pictured: Fayette 0.47%

Not pictured: Champaign 1.13%

2009 Cancer Incidence Comparison by Local, State, and National

IL NAT'LLUNG/BRONCHUS 20.4% 15.1% 14.8%COLON/RECTUM 8.5% 10.5% 9.9%BREAST (female) 14.6% 12.5% 13.0%PROSTATE 11.1% 12.5% 13.0%Site case Population 60,960 1,479,350

R

Resource:2009 ACS Facts & Figures

DMH

1,009

D

DMH 2009 Cancer Incidence Comparision by Local, State and National

DMH 2009 Cancer Patients Geographical LocationAnalytic and Non-analytic: 1,064 cases

DMH 2009 Cancer Incidence

Focus Report on Breast CancerBy General Surgeon Timothy Bailey, MD

Cancer Liaison Physician

The incidence of invasive breast cancers in

women in the United States is estimated to

be 192,370 in 2009 and 62,280 additional

cases of in situ breast. Approximately

40,170 women died from breast cancer,

second only to lung cancer.

The female incidence is trending upward

nationally and locally. The explanations

for this are wider use of mammograms

detecting breast cancer before it is palpable

and symptoms develop. Other factors

include delaying childbearing until they

are older. Obesity is much more prevalent

and previous post menopausal hormones

use also may have contributed to the rise

in breast cancer.

RISK FACTORS

Biological age, family history, age at first

full-term pregnancy, early menarche, late

menopause and breast density are all

unmodifable risk factors. Modifiable risk

factors are post menopausal obesity, physi-

cal inactivity, alcohol consumption and the

combined use of estrogen and progestin.

The lifetime risk of developing breast

cancer is 12 percent. Increasing age is the

most important risk factor besides being

female. Family history is also important in

predicting a risk. An estimated 5 to 10 per-

cent of breast cancers are believed to be

inherited mutation or alterations of genes,

such as BRAC1 and BRAC2. Women with

one of these genes, are rare in the general

population but these women are at very

high risk of developing breast cancer at 57

percent and 49 percent respectively by age

70. (Graph A)

PREVENTION

There is no clear way to prevent breast

cancer but risks can be lowered by avoid-

ing obesity, participating in regular exer-

cise, minimizing alcohol intake and

decreasing estrogen and progestin intake

for post menopausal symptoms. Taking

tamoxifen or raloxifene can reduce the

high-risk patient’s risk; however, side

effects and risks must be considered.

Obviously prophylactic mastectomy is an

option for very high-risk patients and low-

ers their risk to below 90 percent.

Prophylactic oophorectomy for BRAC muta-

tion carriers reduces risk for ovarian and

breast cancers.

SIGN AND SYMPTOMS

A painless mass is the most common com-

plaint, although an enlarged lymph node

can cause pain. Heaviness, swelling, red-

ness or change in nipple with tenderness,

inversion, erosion, or spontaneous dis-

charge may signal breast cancer.

SCREENING

Women age 40 and older should have a

screening mammogram every year. Women

in their 20s and 30s should have a clinical

breast exam as part of a periodic (regular)

health exam by a health professional, at

least every three years. After age 40,

women should have a breast exam by a

health professional every year. Women at

moderate to high risk should get an mag-

netic resonance imaging (MRI) of the

breast and a mammogram every year.

Since 1991, the Mammography Initiative

Program has offered free screening mam-

mograms to women who qualify (medically

underserved or unable to gain access to

healthcare). This program is funded by the

proceeds from the Decatur Area Race for

the Cure. From 1991 to 2010, a total of

11,600 mammograms were performed

through the Mammography Initiative.

Since 1991, a total of 74 cancers have

been identified; 73 percent among

Caucasian women; 27 percent among

African American women. The numbers of

early stage breast cancers have increased,

and numbers of late stage cancer have

decreased. This indicates the success of

educational and awareness efforts.

TREATMENT

Treatment options include surgery, lumpec-

tomy and sentinel lymph node biopsy with

possible axillary dissection. Also modified

radical mastectomy plus reconstruction

with implants or tissue flaps are available.

Depending on the type of surgery and

stage of the cancer, radiation therapy,

chemotherapy and hormonal therapy are

current treatments for breast cancer.

Genetic expression analysis and molecular

biology research are also used in targeting

different types of breast cancers.

According to the data graphs, DMH is

very similar in AJCC Stage at Diagnosis

and surgical treatment when compared

with the National Cancer Data Base.

(Graphs B, C, D)

SURVIVAL OUTCOMES

An estimated 40,230 breast cancer deaths

(39,840 women; 390 men), are expected

in 2010. Death rates for breast cancer have

steadily decreased in women since 1990,

with larger decreases in women younger

than 50 (a decrease of 3.2 percent per

year) than in those 50 and older (two per-

cent per year). This decrease represents

progress due to earlier detection and

improved treatment.

The five-year relative survival for female

breast cancer patients has improved from

63 percent in the early 1960s to 90 percent

today. The observed survival by AJCC Stage

at diagnosis at DMH is consistent with the

data compared to the American College of

Surgeons Commission on Cancer, National

Cancer Database. (Graph E)

0

5

10

15

20

25

30

35

40

%

0 1 2 3 4 un/88

Graph B: 2009 Stage at Diagnosis (AJCC 6th Ed.)

DMH NCDB

0

10

20

30

40

50

60

70

80

%

Conservation Surgery Mastectomy No surgery

Graph D: 2009 Surgical Comparison

DMH NCDB

Graph E: Observed Five Year Survival by StageCases Diagnosed in 2003; Data from 1327 National Programs

0

10

20

30

40

50

60

70

80

90

100

Stage 0 Stage 1 Stage 2 Stage 3 Stage 4

Cum

ulat

ive

Surv

ival

Rat

e

DMH NCDB

0

5

10

15

20

25

30

35

%

0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+

Graph A: 2009 Age at Diagnosis

DMH NCDB %

0

5

10

15

20

25

30

35

%

d,s d,s,c d,s,h d,s,r,c d,s,r,c,h d,s,r,h s,h other no 1st courserx

Graph C: 2009 Initial Treatment

DMH NCDB

DMH 2009 Breast Cancer Incidence

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