2016 Oncology Institute Annual Report
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1 2016 Oncology Institute Annual Report
2 Message from the Cancer Committee: On behalf of the Cancer Committee of The Methodist Hospitals, we are pleased to present to you our 2016 Oncology Institute Annual Report which reflects 2015 data. This report provides an overview of the Methodist Hospitals Cancer Program, and reflects the clinical outcomes for several tumor sites which are tracked through our Tumor Registry. Some of our programs highlights for 2015 include an expansion of Nurse Navigation, an expansion of our Clinical Trial outreach to include radiation oncology patients, and our oncology social worker who assesses cancer patients for psychosocial distress. We are also proud of our long standing commitment to quality cancer care as demonstrated by our 9 th year running as an American College of Surgeons accredited cancer program with commendation. We look forward to continuing to provide our community with the highest quality cancer care as demonstrated by our outcomes reflected throughout this report. B.H. Barai, M.D. Cancer Committee Chair Dennis Streeter, D.O. Cancer Committee Cancer Liaison Physician
3 Nurse Navigation Methodist Hospitals oncology nurse navigators help patients find their way through the complex maze of cancer treatment. Navigators work with referring physicians to design individual treatment plans based on the type, stage, and aggressiveness of the cancer. Furthermore, our navigators redefine the patient experience and promote quality outcomes by combining extensive knowledge and skill with the support and compassion our patients deserve. Navigation services include: v Providing education related to the diagnosis and treatment plans v Identifying and remove barriers v Screening for nutrition and genetic counseling referrals v Scheduling appointments v Providing education on and access to community and support services v Facilitating communication across the care continuum v Providing symptom management, education, and support Our nurse navigators are the patient s partners in guiding them through their cancer treatment journey. Our nurses direct, advise, and answer questions to help navigate patients through the labyrinth of cancer care.
4 Our Community The Methodist Hospitals continues to make the community we serve a priority for prevention, education, and when needed, high quality care. Annual cancer screenings include skin and prostate along with promoting annual screening mammograms by our highly touted Breast Care Center and colorectal assessments and physician recommended colonoscopies. In 2010, Lake County had a total population of 496,01 people (U.S. Census Bureau, 2010) and in 2015 it is estimated that the population will decline by 1.7% to 487,865. Of the total population, 75.6% are adults (meaning 18 years of age or older). The incidence rate of cancer within the county is estimated to be about 2,624 new cancers per year. Prostate, breast, lung, and colon cancers are the most prevalent cancers within Lake County. (Periods of the data are from 2008 through 2012 and are reported by the National Cancer Institute (NCI) along with the Centers for Disease Control (CDC) 2016.) Lake County Cancer Incidence Rates Cancer Site Lake County Indiana United States Avg. Annual Count County Prostate Breast Lung Colon All Sites ,624 Lake County Cancer Mortality Rate Cancer Site Lake County Indiana United States Meet Healthy People Objective Avg. Deaths per Year County Prostate No (-.4) 50 Breast No (-1.9) 84 Lung No (-0.8) 04 Colon No (-2.4) 111 All Sites No (-1.7) 1,088
5 The Methodist Hospitals top five cancer sites for new analytic* cases in our Cancer Registry data base for 2015 were breast, colon, lung, prostate and hematopoietic (lymphoma, multiple myeloma, and leukemia). The distribution of these reported cases are shown on the chart below Analytic Primary Sites* Breast 21% Prostate 10% Lung 18% Hematopoietic (lymphoma & leukemia) 5% Colon/Rectum 16% All Other 0% *Analytic cases: Diagnosed at Methodist and received all or part of 1st course of treatment at Methodist, or diagnosed elsewhere and received all or part of 1st course of treatment at Methodist. Excludes benign brain and CNS tumors. The frequency comparison by selected sites between Methodist and National data demonstrates for males, that Methodist is below national estimates for Prostate, Oral Cavity and Pharynx, Bladder and Kidney. Methodist is above national estimates for Lung, Colon and Rectum, and Liver. Frequency Comparison by Selected Sites: *Methodist & National Data. Percentage of Estimated vs Actual New Cancer Cases 2015 Male Cancer Prostate Lung Oral cavity & pharynx Bladder Colon/Rectum Liver Kidney All Other National Estimated Methodist Actual 24
6 The data demonstrates for females that Methodist is below national estimates for Non-Hodgkin Lymphoma, Uterus, and Pancreas. Methodist is above or equal to national estimates for Breast, Lung, Colon/Rectum, and Kidney. Frequency Comparison by Selected Sites: *Methodist & National Data. Percentage of Estimated vs Actual New Cancer Cases 2015 Female Cancer Breast Non Hodgkin Lymphoma Lung Uterus National Estimated Methodist Actual Colon/Rectum Pancreas Kidney All Other *Source of national data: Cancer Facts and Figures 2015, American Cancer Society (estimated new cancer cases 2015). Does not include basal and squamous cell skin cancers and carcinoma in situ except of urinary bladder. Excludes benign brain and central nervous system tumors. Source of Methodist data: Cancer Registry (newly diagnosed cases 2015). Does not include carcinoma in situ except of urinary bladder. Excludes benign brain and central nervous system tumors. Outcomes Methodist Hospitals continues to deliver high quality cancer care for the entire Northwest Indiana community. The American College of Surgeons (ACoS) Commission on Cancer (CoC) tracks certain quality metrics to measure accredited programs quality of cancer care. The 201 CPr Colon Cancer data reflected in the graph below, demonstrate how Methodist Hospitals quality of colon cancer care compares to other Community Comprehensive Cancer Programs (CCCP) accredited nationwide and to the State of Indiana accredited cancer programs. In 2014, the Cancer Committee identified a problem with retrieving at least 12 regional lymph nodes for patients having colon surgery. As recommended by the Cancer Committee, the committee drafted and sent recommendation letters citing the National Comprehensive Cancer Network (NCCN) guidelines in 201 and Additionally, the Cancer Liaison Physician (CLP) met with Methodist Hospitals surgeons in mid-2014 and discussed the issue with the surgeons. Methodist Hospitals acted upon the 201 metrics which resulted in appreciable increases in the two subsequent years. As detailed by the post intervention results graph below, Methodist Hospitals increased the percentage to 89% in 2014 and to 100% in 2015 both above the 85% standard.
7 COLON CANCER 7% 90% 91% Methodist CCCP State of IN - At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. Standard 85% Methodist Hospitals cancer program is 17% lower than other Community Comprehensive Cancer Programs across the country and 18% lower than the State of Indiana cancer programs for colon cancer. Methodist Hospitals is below the 85% standard at 7%. Post Intervention Results Colon Surgical Lymph Node Analysis: 12 Regional Lymph Nodes Retrieved. Percentage of cases compliant Standard: 85% *89 * *2014 * data reported from COC CPR. * projected data from Cancer Registry.
8 Clinical Trials The Methodist Hospitals Cancer Program is at the leading edge of developing the most effective new cancer treatments. Clinical trials are research studies that investigate new ways to prevent, diagnose, and treat diseases. By participating in a wide range of clinical trials, Methodist Hospitals are committed to helping the research of today develop the best cancer treatments of tomorrow. Those who choose to participate in clinical trials may benefit from access to treatments not yet available to the public. Additionally, patients who enroll in clinical trials often play an active role in their own care while helping others by contributing to medical research.
9 Technology For those patients who have the misfortune of being diagnosed with cancer, Methodist Hospitals use state of the art technology to attack, shrink and kill cancer cells. Our Medical Oncologists utilize targeted therapies by determining the genetic make-up of a cancer tumor allowing the ability to treat the cancer more effectively and efficiently with the best chemotherapy drugs available. Further, our Radiation Oncologists use up to date Radiation Therapy along with utilizing Brachytherapy (one of only a couple in NW Indiana) to treat all tumors wherever they exist. Psychosocial Services Psychosocial services are offered to patients on request or through cancer distress screening. A licensed clinical social worker (LCSW) meets with the patients and provides support and offers services to help them cope with their disease and the disease process. The social worker oversees cancer support groups and refers patients to available community resources. Summary In summary, the Cancer Committee is pleased to provide you with an overview of our clinical outcome data and achievements in our 2015 Oncology Patient Annual report. We appreciate you choosing Methodist for your health care needs, and remain available to provide you with the most advanced high quality cancer care for our community.
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