when someone has cancer · physicians—oncologists, radiation oncologists, radiation therapists,...
TRANSCRIPT
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When Someone Has Cancer
When Someone Has CancerWhen someone has cancer, his healthcare team has to look at him very closely. They have to determine his specific type of cancer. They must stage the cancer for how large the tumor is, and everywhere it may exist in the body.
In planning treatment, an oncologist must determine the precise medications or combinations of drugs that show the most promise for the best outcome. The radiation oncologist must calculate the optimum dosage with pinpoint accuracy for delivery of radiation.
A dietitian has to watch the patient’s weight, pound by pound, week by week, to make sure his body has the nourishment it needs to stay the course of treatment. Infusion nurses must monitor patients during chemotherapy, watching for any signs of complication.
Everyone on the healthcare team has a defined, critically important role to play in giving the patient his greatest platform for recovery and the best possible quality of life. They must scrutinize an immense volume of clinical data and coordinate care down to the smallest detail.
And when they’ve done all this, they still haven’t looked closely enough.
To truly care for a cancer patient, you have to look beyond the chart to see a person. A grandmother who has a vacation planned with her grandchildren. A father who wants to walk his daughter down the aisle. A mother who needs to make sure her own mother is safe and happy. A sister who is the heart of her entire family. Every single patient is someone with a life. A story. A unique way of impacting the world.
In the pages of this report, you’ll meet clinicians at Baptist Cancer Services who bring a wealth of professional expertise to their patients. But they bring a lot more than that, too. They bring the ability to truly SEE our patients as individuals with intrinsic dignity, made in the image of God, connected to their families and friends by their shared love and experiences.
When patients come to Baptist for cancer care, we do indeed look at them very closely. They deserve no less.
01
Tonya Ball, RN, BSN, OCNCancer Services Navigator
“I basically just steer patients through the whole cancer process in the Cancer Center.” So says Cancer Services Navigator Tonya Ball, now in her fifteenth year at Baptist.
That steering can take patients down any number of paths as they access the abundant variety of resources available to them. “We have a dietitian, we have a clinical psychologist, there’s a multitude of services within Baptist Cancer Services,” Tonya explains. “The team is rather large; it consists of many physicians—oncologists, radiation oncologists, radiation therapists, and many oncology nurses. I also work with physical therapists in our lymphedema program. We also offer cancer rehab. It’s just astounding the services and the people that are all connected here.”
In her role, Tonya has an opportunity to connect with many patients. Someone who recently made a lasting impact is Adam. “He has an extraordinary faith,” Tonya says. “I met Adam and his dad when Adam was starting radiation at the Cancer Center. I got to find out more about him and his story, and it’s just been amazing getting to follow him through. But the more I found out about him, the more I felt connected with him. It was all related to his faith.”
“In 2007 I was diagnosed with a Grade II oligodendroglioma, which is in essence a brain tumor,” says Adam. “I have had four surgeries since then. I have done, overall, about nine chemo sessions. I can’t remember how many radiation sessions I did -- 32 or 36—it was lot.” Adam’s seizures and headaches persisted, and finally led to surgery in which Adam’s entire frontal lobe was removed.
“He makes me think of what it’s really all about,” Tonya shares. “It’s not about all the worldly stuff – and status and position. It’s about what Adam has and that’s faith – like real faith.”
“He does inspire me everyday to not only do a better job, but to make sure that I hear the voice of the Lord, and I do the things that I’m supposed to do,” Tonya concluded. “I don’t feel like this is just my job that I get a check for. I actually feel like it is my calling.”
Adrienne Russell, RN, MSN, CN-BNBreast Health Navigator at the Center for Breast Health
Breast Health Navigator Adrienne Russell, who describes herself as a “resource person,” is based in the Center for Breast Health. There, she is readily available to help from the moment a patient first discovers she has an abnormal mammogram.
“I am there for our patients from the beginning all the way through treatment,” she says. “I connect them to other resources. I do a lot of education, and a lot of follow up. I also work with our surgeons in the Center for Breast Health surgery clinic as well.”
03
05
In addition to Adrienne’s services as Navigator, the Center for Breast Health offers patients an on-site, dedicated radiologist. This means that, with her previous studies on file, a patient can know her screening mammogram results before she leaves the Center. And should she need additional views, a diagnostic mammogram, or even breast ultrasound, in many cases those tests can be done right away. Also, a surgical biopsy typically can be performed the next business day. Navigating women along these courses is Adrienne’s forte. Breast cancer survivor Angie Brewer, recently treated at Baptist, is someone who especially inspires Adrienne. “I felt there were a lot of similarities between us,” Adrienne explains. “She is a mother and a spouse. She said to me, ‘I don’t care what you have to do to me, I just need to be there and to be OK for my family.’ And that really resonated with me.”
“When I came in Adrienne’s office, I just felt like I couldn’t see light at the end of the tunnel,” Angie shares. “But she truly has been such a blessing for me throughout my entire journey of breast cancer. She has taken a difficult situation and made it not so scary. If it’s possible, by her follow up phone calls, her encouraging words, and literally being by my side if I had any questions, she’s opened my eyes to what’s really important in life, which is being there for other people.”
“Patients like Angie inspire me every day,” Adrienne says. “I’m privileged to get to know these women diagnosed with cancer and to see them, initially upset, of course, but then showing this strength and faith in God through the whole process, even after surgery, and chemo when they’re sick. These women, and men, have such faith and strength that I think, ‘If they can do that, then what more can we all do?’”
Baptist’s Girl Friend’s Guide for Breast CancerWhen someone has cancer, he or she isn’t the only one affected. The patient’s family, friends, church, workplace, and entire circle of relationships are also affected.
For women who are undergoing breast cancer treatment, Baptist Cancer Services has developed “Baptist’s Girl Friend’s Guide to Breast Cancer,” a free resource designed to equip a woman’s friends with tools they need to provide meaningful support.
Filled with information about everything from treatments to side effects to practical ideas for what really helps, the publication is a guide to help breast cancer patients as they travel the challenging path that leads from breast cancer diagnosis to recovery and beyond.
Some topics include:What to Cook, Gift Ideas, Ways to Help, What’s Going On Inside, Lend a Listening Ear
Download a free electronic copy Baptist’s Girl Friend’s Guide to Breast Cancer at:mbhs.org/powerofpink
Cases by County (1,971)
n More Than 400 Patients
n 200-399 Patients
n 50-199 Patients
n 20-49 Patients
n 19 and under
n No Patients
2014 Cancer Cases
MADISON
RANKINHINDS
TISH
OMIN
GO
QUITMAN
STONE
PONTOTOC
CLAY
MARSHALLTIPPAH
TUNICA TATE PRENTISS
ITAWAM
BA
HANC
OCK
BENTON
GEORGE
CALHOUN
DESOTO
JACKSON
PANOLA
ALCORN
CHICKASAW
WEBSTER
WAYNE
LAFAYETTE
KEMPER
LEE
TALLAHATCHIE
CHOCTAW
NOXUBEE
WILKINSON
WALTHALL
GREENEPERRY
ISSA
QUEN
A
UNION
COAHOMA
YALOBUSHA
AMITE
JEFFDAVIS
HARRISON
MONROE
LOWNDES
MARION
PEARL RIVER
CLARKE
SUNF
LOW
ER
CARROLL
MONTGOMERY
GRENADA
OKTIBBEHAHU
MPHRE
YS
WINSTON
SHAR
KEY
NESHOBA
NEWTON
CLAIBORNE
JEFFERSON
FRANKLIN
LAMAR
COVINGTON
JASPERSMITH
JONES
LAUDERDALE
ADAMS
LEFLORE
LAW
RENC
E
FORR
EST
WARR
EN
LINCOLN
HOLMES
BOLIVAR
WASHINGTON
ATTALA
PIKE
COPIAH
YAZOO
SCOTT
SIMPSON
LEAKE
OUT-OF-STATE CASES
Alabama - 3California - 1Georgia - 2Iowa - 1Louisiana - 19Nevada - 1N. Carolina - 1Tennessee - 1Texas - 1
More than 200
MISSISSIPPI CASES BY COUNTY
60 - 199
26 - 59
25 and under
None
Out-of-State Cases (27)
Alabama - 1Arkansas - 3Florida - 1Louisiana - 17
Tennessee - 1Texas - 3Virginia - 1
07
Primary Site Study – Breast Carcinoma in Situ The American Cancer Society estimates during 2015 there will be 60,290 new cases of female breast carcinoma in situ which is about 20% of all reported U.S. breast cancers. (1) The term “carcinoma in situ” also known as “pre-cancer” or “pre-malignant” is used to describe abnormal epithelial cells that have not invaded nearby tissues but look similar to cells with invasion under the microscope. More recent research indicates that the transition of cells from normal to carcinoma in situ to invasive carcinoma involves a series of molecular changes that are complex and more subtle than the older view based on microscope appearances. In situ breast cancers may involve ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS).
If left untreated, some DCIS lesions become invasive cancers, while others remain non-invasive. Despite decades of effort, there is no way for doctors to know which lesions will progress and which ones will not. As a result, breast specialists recommend that all DCIS be treated with surgery, often followed by radiation and hormone therapy. Many women treated for DCIS are likely to have not needed treatment at all, but there is no way to predetermine which patient’s disease will progress to invasive cancer. (2)
PURPOSE The purpose of this review is to look at patterns of care and outcomes of breast cancers treated at Baptist Medical Center (BMC) as well as to review United States statistics from the National Cancer Data Base (NCDB). NCDB is a nation-wide oncology database of over 1500 hospitals from 50 states, a joint project between the Commission on Cancer of the American College of Surgeons and the American Cancer Society. Criteria used for this review will be from NCDB data from comprehensive community cancer centers in the Mid- South division (61 hospitals) for patients diagnosed during the years 2003-2013. The Mississippi data used in this review is from 11 hospitals in Mississippi. (3)
INCIDENCEFor this review (2003 – 2013), the NCDB regional data reported 9,946 or 21% patients with breast carcinoma in situ and 36,635 or 79% with invasive breast cancer. Mississippi has 2,347 (17%) patients with breast carcinoma in situ and 11,753 (83%) patients with invasive cancer and BMC has 543 (19%) patients with breast carcinoma in situ and 2,343 patients with invasive breast cancer. (Graph 1) The percent of carcinoma in situ cases per year for each data set are similar except BMC had a higher percentage of in situ cases in 2012 and 2013. This may be due to early detection on screening mammograms. (Graph 2) The histology for in situ cases will be about 83% ductal carcinoma in situ (DCIS) and 12% will be lobular carcinoma in situ (LCIS) or lobular neoplasia. (1)
BREAST CANCER: THE 2015 SITE STUDY
07
0
20
40
60
80
100InvasiveIn situ
NCDBMSBMC
Breast Cancer Histology 2003 - 2013Graph 1 pe
rcen
t
BREAST CANCER: THE 2015 SITE STUDY
RISK FACTORS FOR DCISIn general, the risk factors for carcinoma in situ and invasive disease are similar. Mammography screening can be considered a “risk factor” for DCIS because the incidence is much lower in woman not screened but screening mammography detects DCIS lesions and does not cause the disease. In a recent study, which included 1.2 million postmenopausal women in the United Kingdom, the risk of DCIS was higher for women with “fewer” or no children, “old” at first childbirth, or reaching menopause after age 50, women with high breast density and menopausal women on hormonal therapy. A study found high breast density for women under age 55 with associated increased risk. (1) For this review, women between the ages of 50 to 69 years old accounted for 54% to 56% of each data set. (Graph 3)
0 2 4 6 8 10 12 14
NCDBMSBMC2013
YEAR
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
Incidence Carcinoma In Situ by yearGraph 2
0
5
10
15
20
25
30NCDBMSBMC
80+70-7960-6950-5940-49under 39
Age at DiganosisGraph 3
perc
ent
09
EARLY DETECTIONMammography is valuable as an early detection tool, often identifying breast cancer before physical symptoms develop. DCIS would be a rare diagnosis without mammogram. Most DCIS is detected by microcalcifications (clusters of calcium) on a mammogram. Rarely does DCIS turn into a lump. In the 1970s and early 1980s with mammography introduced as a screening tool, DCIS diagnoses began to rapidly increase. Numerous studies have shown early detection saves lives and increases treatment options. In October 2015, the American Cancer Society (ACS) released updated breast cancer screening guidelines that recommend women at average risk have the opportunity to begin annual screening with mammography between the ages of 40 - 44 years; start regular annual screening with mammography at age 45 (if not previously) and transition to screening biennially at age 55 or have the opportunity to continue screening annually. Women should have the opportunity to continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer. The guidelines were published in the Oct. 20, 2015 issue of the Journal of the American Medical Association (“Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society”. )(4) Recommendations for women at high risk for breast cancer are pending. Annual screening using magnetic resonance imaging (MRI), in addition to mammogram, is recommended only for women at high risk starting at age 30. All suspicious findings on physical exam or mammogram should be further investigated.
STAGE OF DISEASEBreast carcinoma in situ is noninvasive (premalignant) or Stage 0 according to the American Joint Committee on Cancer (AJCC), the very earliest stage of disease for breast cancer and most often picked up by screening mammograms. (5)
TREATMENT Treatment options for DCIS include surgery, radiation, hormonal treatment either alone or in combination, as well as no therapy. Age at diagnosis is strongly associated with the type of treatment given. Surgery is the most common treatment which includes breast conserving surgery (lumpectomy or partial mastectomy) with or without sentinel lymph node biopsy or mastectomy. Radiation therapy is often recommended as part of breast conserving therapy, after lumpectomy. The three data bases reveal similar treatment modalities: percent of surgery alone at BMC (44%), MS (41%), and NCDB (43%) followed by combination of surgery, radiation and hormonal therapy for BMC (23%), MS (23%) and NCDB (19%). The next combination therapy is surgery and radiation BMC (10%), MS (14%) and NCDB (21%). Combination of surgery and hormone therapy is BMC (12%), MS (15%) and NCDB (9%). No therapy given is BMC (4%), MS (4%) and NCDB (3%). (Graph 4) About 40% of patients receive radiation as part of their first course of therapy. Radiation therapy following breast conserving surgery may include external beam radiation or brachytherapy. Brachytherapy has become more available since 2008. For this review, external beam radiation was given - BMC (32%), MS (35%) and NCDB (36%) and brachytherapy - BMC (3%), MS (4%) and NCDB (5%) - revealing similar patterns of care.
BREAST CANCER: THE 2015 SITE STUDY
0 5 10 15 20 25 30 35 40 45
NCDBMSBMC
None
Other
S/R/H
S/H
S/R
Surgery
First Course TreatmentGraph 4
percentS = Surgery R = Radiation H = Hormonal Therapy
DISTANCE TRAVELED FOR BREAST CANCER TREATMENTReview of the data for the miles traveled to treatment reveals 28% of BMC patients travel more than 50 miles each way for treatment which is further than MS or NCDB. (Graph 5) Baptist can assist patients and their care providers in finding temporary lodging during cancer treatment. The American Cancer Society Hope Lodge is coming soon to the Jackson area, and the Hope House is already providing lodging for qualified patients.
SUMMARYThe incidence of invasive cancer and carcinoma in situ breast cancer for all the data sets is comparable. BMC had a higher percentage of in situ cases in 2012 and 2013 which reveals early detection on screening mammograms. BMC data compares favorably with MS and NCDB data with incidence, age and first course treatment. The treatment for carcinoma in situ is primary surgery, radiation and hormonal therapy. BMC has a slightly higher “surgery only” rate. The types of radiation therapy given are all similar between the data sets.
BAPTIST CANCER SERVICESBaptist Center for Breast Health is a comprehensive, multidisciplinary accredited center that offers a full complement of services in a private, personal and comfortable setting. The Center for Breast Health provides easy access to a wide range of services as well as education, information and support. Services include screening mammography with same-day results (if prior films available at time of appointment); digital diagnostic mammography performed by certified radiological technologists and interpreted by on-site board-certified dedicated radiologists and a Certified Breast Care Navigator. Our team is supported by a full range of physician specialists including Surgeons, Medical and Radiation Oncologists, Pathologists, and Plastic and Reconstructive Surgeons. Baptist Cancer Services includes oncology nurses, registered dietitians, chaplains, a board certified Clinical Psychologist, and a certified physical therapist in lymphedema management. All are dedicated to caring for women with breast health problems. Screening and diagnostic digital mammography, stereotactic biopsies, sentinel lymph node mapping, up-to-date radiation therapy equipment, genetic testing, a multitude of chemotherapy drugs, and clinical trial availability help make Baptist a leader in treating breast cancer. To further enhance patient care, weekly multidisciplinary patient care conferences are held. Specialists in all disciplines discuss the patient’s case, review pathology and radiology findings and discuss the plan of care. “The Positive Ones” is an ongoing breast cancer support group to help connect patients with others whom are sharing the breast cancer journey. “Caregivers Support Group” for care givers meets monthly at the Hederman Cancer Center. “Standing Strong”, is a free, supervised exercise program offered to cancer patients. Appearances, a boutique which carries wigs, hats, scarves and skin care products for patients undergoing chemotherapy and radiation therapy helps patients with their physical appearance needs. It is located on the ground floor of the Hederman Cancer Center.
0
10
20
30
40
50
60NCDBMSBMC
>100 miles50-99 miles25-49 miles5-24 miles<5 miles
Distance Traveled forBreast Cancer Treatment (one way)
Graph 5
BREAST CANCER: THE 2015 SITE STUDY
Baptist has established a fund called, “fund for the girls” which helps women who need financial assistance for breast care services at Baptist. The fund works by providing payment for breast health services, including screening and diagnostic mammograms, ultrasounds, biopsies and other services as medically indicated. Funding begins when requested by physicians on staff at Baptist Health Systems. This built-in accountability ensures two important goals of “fund for the girls”: 1) Patients can obtain necessary medical care without financial stress and concern. Working with a patient’s physician means that the services provided are driven by what the physician and patient determine, as necessary as opposed to a predefined set of services. 2) Funds are directed to the people
with the greatest financial need. Physicians’ offices can determine a person’s ability to pay, while preserving privacy and dignity. All services available through the fund are offered at the Center for Breast Health at Baptist Health Systems.
NATIONALLY RECOGNIZED FOR QUALITY OF CARE THROUGH ACCREDITATIONSSince June 2011, Baptist Center for Breast Health has maintained accreditation from the National Accreditation Program for Breast Cancer (NAPBC), a national accreditation program for breast centers. Baptist Center for Breast Health was the first facility in Mississippi to achieve this! Baptist is the only hospital in Mississippi to earn The Joint Commission’s Gold Seal of Approval for Breast Cancer which demonstrates compliance with The Joint Commission’s National standards for health care quality and safety in breast care. Our physicians and staff members provide the highest quality evaluation and management for people with breast disease. Healthgrades has awarded Baptist Medical Center the Outstanding Patient Experience Award for 2015 and Patient Safety Excellence Award for 2015. Healthgrades evaluated 3,558 hospitals across the United States in BOTH areas of patient safety and patient satisfaction /experience. Baptist is one of only 93 hospitals, out of the 3,558 hospitals evaluated in the United States, to win both awards putting Baptist in the Top 2% of hospitals in the country.
For more information about Baptist Cancer Services, call 1-800-948-6262 or visit our website www.mbhs.org and Baptist Center for Breast Health 1-601-973-3180 or visit our website www.mbhs.org/breasthealth for services, programs, education podcasts etc. For more information or support for “fund for the girls”, www.mbhs.org/baptist-health-foundation/areas-of need/support-fund-for-the-girls. For information on cancer in general visit our website or www.cancer.org, or www.nci.nih.gov. Prepared by Richard B. Friedman, M.D. and Pam Barlow, CTR
REFERENCES1. American Cancer Society: Cancer Facts and Figures 2015.Atlanta, Ga. Online www.cancer.org/research/cancerFactsFigures. pages 26 -35. 2. Cancer Today, Summer 2015. “The DCIS Dilemma” by Sue Rochman, page 24-29.
3. Commission on Cancer, American College of Surgeons. NCDB Hospital Comparison Benchmark Reports, Cases 2003 – 2013. Chicago, IL, 2015 4. Journal of the American Medical Association. “Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society”. Oct. 20, 2015 issue
5. American Joint Committee on Cancer 2010, 7th Edition, Springer-Verlag New York, page 323
CANCER REGISTRY The Cancer Registry is an important part of the cancer program at Baptist with the primary goal to maintain an accurate comprehensive database for patients diagnosed and/or treated with cancer or a reportable tumor since January 1982. The registry collects cancer related data from diagnosis through treatment as well as lifetime follow-up. The Baptist database includes more than 62,000 cases. Registry data is used for reporting the incidence of cancer seen at Baptist, educational purposes, and evaluating the patient care provided as well as treatment outcomes and survival results. The registry data is submitted to the National Cancer Data Base (NCDB), Mississippi Cancer Registry and Rapid Quality Reporting System. Annual patient follow up is essential to accurately assessing treatment outcomes. The Baptist Cancer Registry exceeds the standard for follow up with 91% for the patients in last 5 years and 84% for patients since the reference year of 1982.
BREAST CANCER: THE 2015 SITE STUDY
11
Summary of 2014 CasesTotal new cancer registry cases 1971Analytic (diagnosed and treated at Baptist) 1764Non-Analytic (1st seen at Baptist on recurrence) 207
TOP FIVE SITES LAST 5 YEARSSite 2010 2011 2012 2013 2014Breast 263 264 357 340 284Lung 267 256 295 289 254Colorectal 171 175 148 173 173Prostate 165 162 149 193 204Kidney 55 42 85 81 102
200 400 600 800 1000 1200 1400 1600 1800 2000
1764
1876
1794
1663
1701
1530
1539
1688
1563
1551
1604
New Cancer Registry Cases (analytic) 2004-2014
0
46%54%
Females
Males
Sex
14%
58%
31%
under 59
over 80
60-79
Age at Diagnosis
Reviewing the 2014 analytic primary sites for Baptist Medical Center (BMC) reveals the top five to be breast, lung, prostate, colorectal and kidney. Data from the NCDB reveals the major sites in the U.S. to be lung, breast, colorectal and prostate which correlates with the major sites for Mississippi and BMC.
STAGE OF DISEASEThe AJCC Stage of Disease for primary sites for BMC 2014 and NCDB 2003-2013 cases have been reviewed with very similar stage of disease between the two data sets. See graphs for details.
13
0
5
10
15
20
25
30
35
40NCDBBMC
UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE ISTAGE 0
Breast
0
10
20
30
40
50
60
70
80NCDBBMC
UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE I
Prostate
perc
ent
perc
ent
0
5
10
15
20
25NCDBBMC
UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE ISTAGE 0
Colon
0
10
20
30
40
50
60
70
80NCDBBMC
UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE ISTAGE 0
Kidney & Renal Pelvis
perc
ent
perc
ent
15
Primary Site Measure Type Measure Specifications 2010 2011 2012 2013BreastBCSRT Accountability (NQF #219) Radiation therapy is administered within 1
year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer.
100% 98% 97% 97%
MAC Accountability (NQF #0559) Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or stage II or III hormone receptor negative breast cancer.
100% 100% 97% 98%
HT Accountability (NQF #0220) Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1cN0M0, or stage II or III hormone receptor positive breast cancer.
100% 99% 99% 98%
MASTRT Surveillance Radiation therapy is considered or administered following any mastectomy within 1 year (365 days) of diagnosis of breast cancer for women with ≥ 4 positive regional lymph nodes.
100% 100% 100% 100%
nBx Quality Improvement Image or palpation-guided needle biopsy (core or FNA) is performed to establish diagnosis of breast cancer.
86% 89% 85% 85%
ColonACT Accountability (NQF #0223) Adjuvant chemotherapy is considered or
administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer.
100% 100% 100% 95%
12RL Quality Improvement (NQF #0225) At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer.
85% 76% 84% 86%
Quality DataThe Rapid Quality Reporting System (RQRS) was developed to assist CoC-accredited cancer programs in promoting evidence-based cancer care at the local level. It is a Web-based, systematic data collection and reporting system that advances evidence-based treatment through a prospective alert system for anticipated care that supports care coordination required for breast and colorectal cancer patients.
Baptist has been participating with the Cancer Program Practice Progam (CP3R) program since 2004 and the RQRS in 2013. See below for details.
Prim
ary S
ite Ta
ble - 2
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ll cas
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Stag
e Dist
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Anal
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Case
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y Site
Tota
l (%
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FAn
alNA
Alive
Exp
Stg 0
Stg I
Stg I
ISt
g III
Stg I
VNA
/Unk
ORAL
CAVI
TY &
PHA
RYNX
17 (0
.9%
)14
317
016
10
43
35
2
Tong
ue6 (
0.3%
)4
26
06
00
12
02
1
Saliv
ary G
lands
3 (0.2
%)
21
30
30
01
01
10
Naso
phar
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1 (0.1
%)
10
10
10
00
00
10
Tons
il5 (
0.3%
)5
05
04
10
10
21
1
Orop
hary
nx1 (
0.1%
)1
01
01
00
01
00
0
Hypo
phar
ynx
1 (0.1
%)
10
10
10
01
00
00
DIGE
STIV
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TEM
399 (
20.2
%)
197
202
371
2828
811
116
5370
9110
041
Esop
hagu
s10
(0.5%
)7
310
06
40
10
13
5
Stom
ach
30 (1
.5%)
1515
291
237
011
47
34
Small
Intes
tine
24 (1
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1410
231
213
02
212
61
Colon
Exclu
ding R
ectu
m13
7 (7.0
%)
6473
125
1211
522
916
3136
312
Cecu
m28
1315
280
226
31
86
100
Appe
ndix
83
58
07
10
31
22
0
Asce
nding
Colon
3014
1630
027
33
65
97
0
Hepa
tic Fl
exur
e3
21
30
21
01
11
00
Trans
verse
Colon
136
711
212
10
03
44
0
Splen
ic Fle
xure
65
16
05
11
02
20
1
Desce
nding
Colon
61
55
15
10
11
03
0
Sigm
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lon34
1717
313
304
24
912
31
Larg
e Int
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S9
36
36
54
00
10
20
Rectu
m &
Recto
sigm
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(2.4%
)25
2348
040
86
127
88
7
Recto
sigm
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67
130
121
11
35
30
Rectu
m35
1916
350
287
511
43
57
Anus
, Ana
l Can
al &
Anor
ectu
m9 (
0.5%
)3
69
09
01
13
21
1
Liver
& Int
rahep
atic B
ile Du
ct21
(1.1%
)14
717
47
140
11
46
5
Liver
1511
411
45
100
11
42
3
Intrah
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Duct
63
36
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2
Gallb
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45
05
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10
22
0
Othe
r Bilia
ry9 (
0.5%
)4
59
05
40
04
11
3
Panc
reas
90 (4
.6%)
4941
8010
4545
08
179
3412
Retro
perit
oneu
m1 (
0.1%
)1
01
00
10
00
01
0
Perit
oneu
m, O
men
tum
& M
esen
tery
15 (0
.8%)
015
150
123
00
19
41
RESP
IRAT
ORY S
YSTE
M28
0 (14
.2%
)14
413
626
020
175
105
179
1943
104
14
Lary
nx6 (
0.3%
)4
24
25
10
40
00
0
Lung
& Br
onch
us27
2 (13
.8%)
139
133
254
1816
810
41
7519
4310
412
Trach
ea, M
edias
tinum
& Ot
her R
espir
atory
Orga
ns2 (
0.1%
)1
12
02
00
00
00
2
BONE
S & JO
INTS
2 (0.
1%)
11
20
20
01
10
00
SOFT
TISS
UE6 (
0.3%
)2
46
04
20
22
02
0
**SK
IN EX
CLUD
ES B
ASAL
& SQ
UAM
OUS
62 (3
.1%
)41
2159
358
411
357
30
3
Melan
oma -
- Skin
56 (2
.8%)
3818
533
524
1133
52
02
Othe
r Non
-Epit
helia
l Skin
6 (0.3
%)
33
60
60
02
21
01
BASA
L & SQ
UAM
OUS S
KIN
7 (0.
4%)
61
77
52
00
00
00
BREA
ST31
3 (15
.9%
)2
311
283
3029
122
6010
668
2715
7
FEM
ALE G
ENITA
L SYS
TEM
172 (
8.7%
)0
172
126
4616
012
268
1324
154
# Cer
vix Ut
eri43
(2.2%
)0
4318
2540
31
84
41
0
Corp
us &
Uteru
s, NO
S76
(3.9%
)0
7674
272
40
566
47
1
Corp
us Ut
eri74
074
722
704
055
64
61
Uteru
s, NO
S2
02
20
20
01
00
10
Ovar
y31
(1.6%
)0
3122
927
40
02
125
3
Vagin
a5 (
0.3%
)0
52
34
10
01
10
0
Vulva
14 (0
.7%)
014
77
140
14
00
20
Othe
r Fem
ale Ge
nital
Orga
ns3 (
0.2%
)0
33
03
00
00
30
0
MAL
E GEN
ITAL S
YSTE
M24
7 (12
.5%
)24
70
215
3224
43
119
129
4618
2
Pros
tate
236 (
12.0%
)23
60
204
3223
33
013
127
4518
1
Testi
s7 (
0.4%
)7
07
07
00
41
10
1
Penis
4 (0.2
%)
40
40
40
12
10
00
URIN
ARY S
YSTE
M18
9 (9.
6%)
106
8317
514
166
2332
8416
2815
0
Urina
ry Bl
adde
r72
(3.7%
)45
2769
358
1428
209
57
0
Kidne
y & Re
nal P
elvis
113 (
5.7%
)59
5410
211
105
82
646
228
0
Urete
r3 (
0.2%
)1
23
02
11
01
10
0
Othe
r Urin
ary O
rgan
s1 (
0.1%
)1
01
01
01
00
00
0
BRAI
N &
OTHE
R NE
RVOU
S SYS
TEM
44 (2
.2%
)26
1842
228
160
00
00
42
Brain
22 (1
.1%)
148
211
913
00
00
021
Crania
l Ner
ves O
ther
Nervo
us Sy
stem
22 (1
.1%)
1210
211
193
00
00
021
ENDO
CRIN
E SYS
TEM
60 (3
.0%
)11
4958
260
00
393
51
10
Thyro
id50
(2.5%
)9
4149
150
00
393
51
1
Othe
r End
ocrin
e inc
luding
Thym
us10
(0.5%
)2
89
110
00
00
00
9
LYM
PHOM
A69
(3.5
%)
4722
5910
4821
08
711
321
Hodg
kin Ly
mph
oma
9 (0.5
%)
45
81
72
01
12
40
Hodg
kin - N
odal
83
57
17
10
11
23
0
Hodg
kin - E
xtran
odal
11
01
00
10
00
01
0
Non-
Hodg
kin Ly
mph
oma
60 (3
.0%)
4317
519
4119
07
69
281
NHL -
Nod
al 40
2911
346
3010
02
58
181
NHL -
Extra
noda
l20
146
173
119
05
11
100
MYE
LOM
A25
(1.3
%)
1510
241
214
00
00
024
LEUK
EMIA
34 (1
.7%
)14
2029
522
120
00
00
29
Lym
phoc
ytic L
euke
mia
10 (0
.5%)
46
64
91
00
00
06
Chro
nic Ly
mph
ocyti
c Leu
kem
ia9
36
54
81
00
00
05
Othe
r Lym
phoc
ytic L
euke
mia
11
01
01
00
00
00
1
Myelo
id &
Mono
cytic
Leuk
emia
22 (1
.1%)
1012
211
1111
00
00
021
Acut
e Mye
loid L
euke
mia
115
611
02
90
00
00
11
Chro
nic M
yeloi
d Leu
kem
ia10
55
91
82
00
00
09
Othe
r Mye
loid/
Mono
cytic
Leuk
emia
10
11
01
00
00
00
1
Othe
r Leu
kem
ia2 (
0.1%
)0
22
02
00
00
00
2
Othe
r Acu
te Le
ukem
ia1
01
10
10
00
00
01
Aleu
kem
ic, Su
bleuk
emic
& NO
S1
01
10
10
00
00
01
MES
OTHE
LIOM
A1 (
0.1%
)0
10
10
10
00
00
0
MIS
CELL
ANEO
US44
(2.2
%)
1826
386
2222
00
00
038
Tota
l1,
971
891
1,08
01,
764
207
1,61
036
112
349
833
828
130
721
7
** Th
is ex
clude
s all l
ocali
zed b
asal
and s
quam
ous c
ell ca
rinom
a of t
he sk
in. #
Exclu
des 2
4 carc
inom
a in s
itu of
the c
ervix
.
Sex
Clas
s of C
ase
Stat
usSt
age D
istrib
utio
n ( An
alyt
ic Ca
ses O
nly)
Prim
ary S
iteTo
tal (
%)
MF
Anal
NAAl
iveEx
pSt
g 0St
g ISt
g II
Stg I
IISt
g IV
NA/U
nk
ORAL
CAVI
TY &
PHA
RYNX
17 (0
.9%
)14
317
016
10
43
35
2
Tong
ue6 (
0.3%
)4
26
06
00
12
02
1
Saliv
ary G
lands
3 (0.2
%)
21
30
30
01
01
10
Naso
phar
ynx
1 (0.1
%)
10
10
10
00
00
10
Tons
il5 (
0.3%
)5
05
04
10
10
21
1
Orop
hary
nx1 (
0.1%
)1
01
01
00
01
00
0
Hypo
phar
ynx
1 (0.1
%)
10
10
10
01
00
00
DIGE
STIV
E SYS
TEM
399 (
20.2
%)
197
202
371
2828
811
116
5370
9110
041
Esop
hagu
s10
(0.5%
)7
310
06
40
10
13
5
Stom
ach
30 (1
.5%)
1515
291
237
011
47
34
Small
Intes
tine
24 (1
.2%)
1410
231
213
02
212
61
Colon
Exclu
ding R
ectu
m13
7 (7.0
%)
6473
125
1211
522
916
3136
312
Cecu
m28
1315
280
226
31
86
100
Appe
ndix
83
58
07
10
31
22
0
Asce
nding
Colon
3014
1630
027
33
65
97
0
Hepa
tic Fl
exur
e3
21
30
21
01
11
00
Trans
verse
Colon
136
711
212
10
03
44
0
Splen
ic Fle
xure
65
16
05
11
02
20
1
Desce
nding
Colon
61
55
15
10
11
03
0
Sigm
oid Co
lon34
1717
313
304
24
912
31
Larg
e Int
estin
e, NO
S9
36
36
54
00
10
20
Rectu
m &
Recto
sigm
oid48
(2.4%
)25
2348
040
86
127
88
7
Recto
sigm
oid Ju
nctio
n13
67
130
121
11
35
30
Rectu
m35
1916
350
287
511
43
57
Anus
, Ana
l Can
al &
Anor
ectu
m9 (
0.5%
)3
69
09
01
13
21
1
Liver
& Int
rahep
atic B
ile Du
ct21
(1.1%
)14
717
47
140
11
46
5
Liver
1511
411
45
100
11
42
3
Intrah
epati
c Bile
Duct
63
36
02
40
00
04
2
Gallb
ladde
r5 (
0.3%
)1
45
05
00
10
22
0
Othe
r Bilia
ry9 (
0.5%
)4
59
05
40
04
11
3
Panc
reas
90 (4
.6%)
4941
8010
4545
08
179
3412
Retro
perit
oneu
m1 (
0.1%
)1
01
00
10
00
01
0
Perit
oneu
m, O
men
tum
& M
esen
tery
15 (0
.8%)
015
150
123
00
19
41
RESP
IRAT
ORY S
YSTE
M28
0 (14
.2%
)14
413
626
020
175
105
179
1943
104
14
Lary
nx6 (
0.3%
)4
24
25
10
40
00
0
Lung
& Br
onch
us27
2 (13
.8%)
139
133
254
1816
810
41
7519
4310
412
Trach
ea, M
edias
tinum
& Ot
her R
espir
atory
Orga
ns2 (
0.1%
)1
12
02
00
00
00
2
BONE
S & JO
INTS
2 (0.
1%)
11
20
20
01
10
00
SOFT
TISS
UE6 (
0.3%
)2
46
04
20
22
02
0
**SK
IN EX
CLUD
ES B
ASAL
& SQ
UAM
OUS
62 (3
.1%
)41
2159
358
411
357
30
3
Melan
oma -
- Skin
56 (2
.8%)
3818
533
524
1133
52
02
Othe
r Non
-Epit
helia
l Skin
6 (0.3
%)
33
60
60
02
21
01
BASA
L & SQ
UAM
OUS S
KIN
7 (0.
4%)
61
77
52
00
00
00
BREA
ST31
3 (15
.9%
)2
311
283
3029
122
6010
668
2715
7
FEM
ALE G
ENITA
L SYS
TEM
172 (
8.7%
)0
172
126
4616
012
268
1324
154
# Cer
vix Ut
eri43
(2.2%
)0
4318
2540
31
84
41
0
Corp
us &
Uteru
s, NO
S76
(3.9%
)0
7674
272
40
566
47
1
Corp
us Ut
eri74
074
722
704
055
64
61
Uteru
s, NO
S2
02
20
20
01
00
10
Ovar
y31
(1.6%
)0
3122
927
40
02
125
3
Vagin
a5 (
0.3%
)0
52
34
10
01
10
0
Vulva
14 (0
.7%)
014
77
140
14
00
20
Othe
r Fem
ale Ge
nital
Orga
ns3 (
0.2%
)0
33
03
00
00
30
0
MAL
E GEN
ITAL S
YSTE
M24
7 (12
.5%
)24
70
215
3224
43
119
129
4618
2
Pros
tate
236 (
12.0%
)23
60
204
3223
33
013
127
4518
1
Testi
s7 (
0.4%
)7
07
07
00
41
10
1
Penis
4 (0.2
%)
40
40
40
12
10
00
URIN
ARY S
YSTE
M18
9 (9.
6%)
106
8317
514
166
2332
8416
2815
0
Urina
ry Bl
adde
r72
(3.7%
)45
2769
358
1428
209
57
0
Kidne
y & Re
nal P
elvis
113 (
5.7%
)59
5410
211
105
82
646
228
0
Urete
r3 (
0.2%
)1
23
02
11
01
10
0
Othe
r Urin
ary O
rgan
s1 (
0.1%
)1
01
01
01
00
00
0
BRAI
N &
OTHE
R NE
RVOU
S SYS
TEM
44 (2
.2%
)26
1842
228
160
00
00
42
Brain
22 (1
.1%)
148
211
913
00
00
021
Crania
l Ner
ves O
ther
Nervo
us Sy
stem
22 (1
.1%)
1210
211
193
00
00
021
ENDO
CRIN
E SYS
TEM
60 (3
.0%
)11
4958
260
00
393
51
10
Thyro
id50
(2.5%
)9
4149
150
00
393
51
1
Othe
r End
ocrin
e inc
luding
Thym
us10
(0.5%
)2
89
110
00
00
00
9
LYM
PHOM
A69
(3.5
%)
4722
5910
4821
08
711
321
Hodg
kin Ly
mph
oma
9 (0.5
%)
45
81
72
01
12
40
Hodg
kin - N
odal
83
57
17
10
11
23
0
Hodg
kin - E
xtran
odal
11
01
00
10
00
01
0
Non-
Hodg
kin Ly
mph
oma
60 (3
.0%)
4317
519
4119
07
69
281
NHL -
Nod
al 40
2911
346
3010
02
58
181
NHL -
Extra
noda
l20
146
173
119
05
11
100
MYE
LOM
A25
(1.3
%)
1510
241
214
00
00
024
LEUK
EMIA
34 (1
.7%
)14
2029
522
120
00
00
29
Lym
phoc
ytic L
euke
mia
10 (0
.5%)
46
64
91
00
00
06
Chro
nic Ly
mph
ocyti
c Leu
kem
ia9
36
54
81
00
00
05
Othe
r Lym
phoc
ytic L
euke
mia
11
01
01
00
00
00
1
Myelo
id &
Mono
cytic
Leuk
emia
22 (1
.1%)
1012
211
1111
00
00
021
Acut
e Mye
loid L
euke
mia
115
611
02
90
00
00
11
Chro
nic M
yeloi
d Leu
kem
ia10
55
91
82
00
00
09
Othe
r Mye
loid/
Mono
cytic
Leuk
emia
10
11
01
00
00
00
1
Othe
r Leu
kem
ia2 (
0.1%
)0
22
02
00
00
00
2
Othe
r Acu
te Le
ukem
ia1
01
10
10
00
00
01
Aleu
kem
ic, Su
bleuk
emic
& NO
S1
01
10
10
00
00
01
MES
OTHE
LIOM
A1 (
0.1%
)0
10
10
10
00
00
0
MIS
CELL
ANEO
US44
(2.2
%)
1826
386
2222
00
00
038
Tota
l1,
971
891
1,08
01,
764
207
1,61
036
112
349
833
828
130
721
7
** Th
is ex
clude
s all l
ocali
zed b
asal
and s
quam
ous c
ell ca
rinom
a of t
he sk
in. #
Exclu
des 2
4 carc
inom
a in s
itu of
the c
ervix
.
The Tumor Board and Comprehensive Breast Patient Care conferences are held in the Hederman Cancer Center Conference Room every Monday at 5:00 p.m. and Neurology/Neurosurgery/Spine/Radiology meetings are held every Tuesday at 7:30 a.m. These patient care conferences offer multidisciplinary consultative services for patients and an educational opportunity for the cancer support professionals. The discussions include the use of AJCC stage of disease, prognostic indicators and evidence-based national treatment guidelines in planning for optimal treatment strategies and expected outcomes. In 2014, 294 cases or 23% of analytic cases, were discussed at the meetings with 96% of the discussion for prospective treatment options
and management. The major primary sites discussed were breast, CNS tumors, lung, colon and rectum, lymphoma and melanoma cases.
Baptist is accredited by the Mississippi State Medical Association to provide continuing medical educational (CME) for physicians. Participation in the conference earns one hour of Category I Continuing Education credit. Conferences are open to all the medical staff and appropriate ancillary personnel. Anyone interested in presenting a case or receiving a weekly agenda, may contact the Cancer Registry at 601-968-1339.
Eric Amundson, MDVinod K. Anand, MDJustin T. Baker, MDEric L. Balfour, MDGeorge Copeland, MDRichard B. Friedman, MDAlexander J. Haick, MDKeith O. Jones, MDA. Michael Koury, MDPhillip B. Ley, MDNathan Maples, MDJames L. Moore, MDJason Murphy, MDGerald P. Randle, MD
Grace G. Shumaker, MDDavid Steckler, MDW. Lynn Stringer, MDDavid A. Wahl, MDRichard E. Weddle, MDBob S. Wilkerson, MDTammy H. Young, MD
Pathologists:Steven Bigler, MDKathryn Brown, MD James Cavett, MDNanette Pinkard, MDWilliam Payne, MD
Radiologists:E. J. Blanchard, MDJames L. Burkhalter, MDLarkin Carter, MDGary A. Cirilli, MDJ. Mack Haltom, III, MDR. Houston Hardin, MDJason R. Hosey, MDEdward K. Phillips, MDCharles K. Pringle, MDC. Dallas Sorrell, MDWilliam E. Studdard, MDJ. Dean Tanner, MDTimothy G. Usey, MD
Physicians Presenting at Cancer Conferences in 2014
Cancer Conferences
2015 Cancer Committee
Richard B. Friedman, MDRadiation Oncology Chairman
A. Michael Koury, MDThoracic SurgeryAmerican College of SurgeonsCancer Liaison Physician
Justin Baker, MDMedical Oncology
Eric Balfour, MDRadiation Oncology Scott Berry, MDSurgery
Steven Bigler, MDPathology
Alexander Haick, MDSurgery
Jason Hosey, MDDiagnostic Radiology
Michael Maples, MDChief Medical Officer
James Moore, MDGynecologic Oncology
William Payne, MDPathology
Charles Pringle, MDDiagnostic Radiology
Grace G. Shumaker, MDMedical Oncology
Margaret Wadsworth, MDRadiation Oncology
David Wahl, MDRadiation Oncology
Bob Wilkerson, MDMedical Oncology
Tammy Young, MDMedical Oncology
Tonya Ball, BSN, RN, OCNCancer Center Patient Navigator
Pam Barlow, CTRCancer Registry CoordinatorQuality of Cancer Registry Data Coordinator
Cara Chandler, BSN, RN Nurse Manager, Oncology
Teresa Davis, BSN, RN, OCNClinical Trials Coordinator
Kelly Gettings, BSN, RN, OCN Outpatient Infusion Clinic Nurse Manager
Harold Gore, PharmDBryan Miller, PharmDOncology Pharmacists
Dana Price, RD Clinical Dietitian
Brenda Howie, Ph.D., RN, NE-BCVice President of Nursing
Wanda Lett, CTR Cancer RegistrarCancer Conference Coordinator
Donna Lustig, RT, (R) (M)Director, Radiation OncologyQuality Improvement Coordinator
Bufkin Moore, PsyDOncology Counselor
Deniece Ponder, MHSA, BSN, RN, OCNDirector of Oncology ServicesCommunity Outreach Coordinator
Mark Roth, LMSW Social Worker/Discharge Planning
Solon Smith, MDivChaplain
Ginger Stover, PT, DPT, CLTLymphedema Coordinator
Bobbie Ware, MHSA, BSN, RN, FACHE, NEA-BC Vice President/Chief Nursing Officer
19
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