2017 Oncology. St. Vincent HEALTHCARE SCL Health. Annual Report FRONTIER CANCER CENTER

Transcription

1 2017 Oncology Annual Report St. Vincent HEALTHCARE SCL Health FRONTIER CANCER CENTER

2 Table of Contents Chairman s Report 3 Survivorship Story 4 Accreditations 5 Yellowstone Breast Center 6 Screening Event 6 Clinical Trials and Research 7 Patient Navigator 8 Quality Study and Improvement 9 Tumor Board 9 St. Vincent Low-Dose Lung Screening 10 Cancer Registry 11 Analytical Case 12 Leading Sites by Gender 14 Leading Sites of New Cancer Cases and Deaths 16 2

3 Cancer Committee Chairman s Report Even a casual observer has to take notice of the great advances that are occurring in the world of cancer treatment. The rise of immunotherapy as a potent weapon in the war on cancer has resulted in responses we could only imagine a few years ago. We at St. Vincent Healthcare are working hard to stay at the forefront of this rapidly changing oncology environment. The hospital made a significant commitment to improving the oncology pharmacy at the cancer center. We ve finished a major construction project to bring the pharmacy into compliance with the most current USP800 safety regulations, expanded the research pharmacy space, and brought in new, specialty-trained pharmacists to work there. These pharmacists are key to ensuring patients receive the best care available anywhere. Patrick Cobb, MD, FACP The American Society for Clinical Oncology sets strict criteria for certification in the Quality Oncology Practice Initiative (QOPI), an intensive, on-site review of policies and procedures of the top cancer centers in the country. St. Vincent Frontier Cancer Center was recertified in 2017, joining only 306 cancer centers in the United States to receive the highest award. To keep on top of the rapid changes in oncology, our center continues to expand our portfolio of cancer clinical trials. Last year we enrolled patients on multiple trials, from first-in-human phase I studies to randomized phase III trials that will set new standards for treatment. We also laid the groundwork to join the Colorado Cancer Research Program in 2018, which will give our patients access to the latest trials sponsored by the National Cancer Institute. Our cancer patients are blessed by the love and enthusiasm of the staff at St. Vincent Healthcare. We remain committed to providing world-class oncology care close to home. Patrick Cobb, MD, FACP Chairman, St. Vincent Healthcare Cancer Committee Oncology Research Director, St. Vincent Healthcare Medical Director, St. Vincent Frontier Cancer Center 3

4 On her road to remission, Artie never walked alone. See the story at sclhealth.org/mt It s the people behind the medicine. All the people who care for you that bring you to a healing state. Every chance Artie gets, she spends time with the people she loves. Being with family means everything to her. So when Artie discovered she had Stage 2 breast cancer, what scared her most was the possibility that she might not be around for all the moments yet to come. That s why Artie chose an SCL Health hospital that truly understands just how important it is to deliver cancer treatment in a way that inspires hope. During her treatment, Artie s care team would give her the circle of support she and her family needed to believe that she could win this fight. Now that she s in remission, Artie savors every moment that has followed this one very special victory. 4

5 Accreditations St. Vincent Frontier Cancer Center has been continuously accredited by the American College of Surgeons Commission on Cancer (CoC), National Accreditation Program for Breast Cancer (NAPBC), and The Quality Oncology Practice Initiative (QOPI). The goals of these accreditations are for cancer centers to demonstrate commitment to quality care, to improve patient outcomes across all domains of cancer care, dedicate resources to provide screenings, prevention treatment and support services, and to use data to serve as the basis for quality improvement. We are excited to announce we received re-accreditation for QOPI in 2017 for 3 more years. American College of Radiology Accreditation Breast Imaging Center of Excellence The American College of Radiology (ACR) recognizes the Breast Care Center as a Breast Imaging Center of Excellence (BICOE) for seeking and earning accreditation in all of the ACR s extensive breast-imaging accreditation programs and modules in addition to the mandatory Mammography Accreditation Program. ACR Mammographic Imaging Services ACR Stereotactic Breast Biopsy Imaging Services ACR Breast Ultrasound Imaging Services ACR Computerized Tomography (CT) ACR Ultrasound ACR Magnetic Resonance Imaging (MRI) Clinical Laboratory Improvement Amendment (ALIA) College of American Pathologists (CAP) AABB (an international, not-for-profit association representing individuals and institutions involved in the field of transfusion medicine and cellular therapies) US Department of Health and Human Services Certified Mammography Facility 5

6 Yellowstone Breast Center Recognized as a Breast Imaging Center of Excellence by the American College of Radiology for demonstrating excellence in breast imaging by successfully achieving accreditation in mammography, stereotactic breast biopsy, breast ultrasound and ultrasound-guided breast biopsy, the Yellowstone Breast Center is dedicated to total breast health. The Yellowstone Breast Center served over 10,000 women in 2017, diagnosing 160 women with breast cancer. The Yellowstone Breast Center s Mobile Mammography coach traveled within a 300 mile radius in 2017 to reach 3000 women. 52 sites were visited, with many being rural areas, bringing Screening Mammography to patients that otherwise would not be able to have the opportunity to have their mammograms. In 2017 the Mobile Mammography coach screened 14 women who were found to have breast cancer. Screening Event Our 2017 screening event focus was on women in need of a mammogram in rural Native American areas. According to the Comprehensive Cancer Control Plan, cancer presents a significant burden to American Indians throughout Montana. On average, there are 262 newly diagnosed cancers and 80 cancer deaths each year among Montana American Indians. Four types of cancer accounted for 54% of all cancers diagnosed among Montana American Indians: lung, breast, colorectal, and prostate. Over 4 days in June, the St. Vincent Mammo bus traveled to Lame Deer and Crow Agency to offer onsite mammograms to women. Over the four days, 57 women were screened, 4 had an abnormal screening, and 1 had a positive biopsy for breast cancer and was referred to an oncologist for care. Location Date Patients Screened Abnormal Screening Biopsy Positive for Breast Cancer Negative Workup Crow Agency 6/7/ Crow Agency 6/21/ Lame Deer 6/13/ Lame Deer 6/27/ Annual screening mammograms are recommended for women beginning at the age of 40. To schedule your appointment, please call

7 Clinical Trials and Research St. Vincent Frontier Cancer Center s research program is proud to offer patients the opportunity to participate in state-of-the-art cancer clinical trials as part of their cancer treatment. Clinical trials play a key role in the development of new ways to prevent, detect and treat cancer. Clinical trials allow patients access to the latest cutting-edge and innovative cancer therapies not found anywhere else in the world. Most all cancer treatments used today are the results of past clinical trials. At St. Vincent Frontier Cancer Center, we understand that a successful research program requires a multidisciplinary team approach and engagement. A team of medical professionals, including medical oncologists, radiation oncologists, surgeons, radiologists, pathologists, pharmacists, nurses, research coordinators, regulatory coordinators, social workers, patient navigators, and genetic counselors work together to provide high-quality care to all patients who participate in clinical research studies. Tina Erhardt, MSc, CCRP Regional Director of Research Montana Region SCL Health St. Vincent Frontier Cancer Center s dedicated Clinical Research team discusses clinical trials with patients as part of their treatment options. The team provides general information about participating as well as study-specific information to patients who are interested in taking part in clinical trials. The research coordinators work closely with the patient s physician to coordinate care, enrollment, and treatment. research Clinical Trial Enrollment 2017 has been an exciting year for St. Vincent Frontier Cancer Center as we had 35 available pharmaceutical sponsored clinical trials open to accrual this year and were awarded 20 new exciting studies. In 2017, 31% of patients seen at St. Vincent Frontier Cancer Center participated in a clinical trial. There is much to be enthusiastic about in Oncology and we look forward to exciting research programmatic changes occurring in For more information about our clinical trials please call Analytical Case Load (total new patients diagnosed) Patients Enrolled on Clinical Trial 7

8 Patient Navigation Based on our Community Needs Assessment, in 2017 the St. Vincent Cancer Committee focused our Patient Navigation Process on patients with housing needs. Many oncology patients travel to Billings for doctor appointments as well as treatments. Some treatments require patients to stay in town for days or weeks. In 2017: 60 oncology patients stayed at Meadowlark House 3 patients stayed at Pierce Home 9 hotel vouchers were provided by Tough Enough to Wear Pink Central Montana 22 patients utilized American Cancer Society Hotel vouchers 64 nights were free or reduced Additional assistance provided: The Oncology Patient Navigator for Lung and Head/Neck at St. Vincent s was able to provide the following resources to patients in 2017: 13 Financial Assistance applications were processed totaling $ 4, covering gas expenses and gift cards to help with food and utilities. The ACS Navigator at St. Vincent Frontier Cancer Center was able to provide the following resources to patients in 2017: 71 Financial Assistance applications were processed, totaling $25, gas cards were provided ($30 each), totaling $9, wigs provided 8

9 Quality Study and Improvement Pharmacist-Managed Chemotherapy-Induced Nausea and Vomiting Protocol and Collaborative Practice Agreement In 2017, a collaborative practice agreement between the oncology pharmacists and oncologists at the St. Vincent Frontier Cancer Center was implemented that authorized the pharmacists to manage the medication therapy and provide education for patients at risk for chemotherapy-induced nausea and vomiting. The medication therapy management is based on evidence-based protocols and algorithms from published national guidelines such as the National Comprehensive Cancer Network (NCCN) Practice Guidelines in Oncology. Following the implementation of the Collaborative Practice Agreement, the number of patients with moderate or high risk of developing nausea who received a steroid as part of their chemotherapy regimen increased to 68%. 86% of patients at the highest risk of developing nausea received a steroid to help prevent nausea and vomiting associated with chemotherapy. This collaboration between the pharmacists and the oncologists at the St. Vincent Frontier Cancer Center increased the compliance of patients receiving the medications they needed for preventing and managing nausea and vomiting which then contributes positively to patient care and outcomes. Tumor Board: St. Vincent Healthcare offers regular multidisciplinary tumor conferences to review cases of newly diagnosed cancer patients. In accordance with National Comprehensive Cancer Network (NCCN) guidelines, clinic physicians then render a second opinion to guide care. The medical teams that participate in this multidisciplinary approach are dedicated to continued improvement in the quality, efficacy and efficiency of patient care and services at St. Vincent Healthcare. Tumor Conference Hosted at St. Vincent Healthcare in 2017: The multidisciplinary tumor conference includes but is not limited to: medical oncologists, radiation oncologists, surgeons, pathologists, and radiologists. The tumor conference team reviewed 327 cases in 2017 (99% of prospective cases). General Tumor Conference: Wednesday s at 7 a.m. Breast Tumor Conference: Wednesday s at 7:30 a.m Tumor Board Cases Presented 102 Breast Colon / Rectal All Other Disease Types 9

10 St. Vincent Low-Dose Lung Screening St. Vincent Healthcare offers low-dose lung CT scans as a screening test for lung cancer with the intent to catch lung cancer early before symptoms occur. The lung screens are intended for individuals that are: * years old Have at least a 30- pack year history of smoking- (a pack year is calculated by multiplying the number of packs smoked per day by the number of years an individual has smoked). Still actively smoking or someone that has quit in the last 15 years. Individuals must be asymptomatic of lung cancer to be screened * Insurance coverage varies- most insurances cover this as a preventative screen, and some private insurances will allow facilities to screen patients up to 80 years of age In 2017 St. Vincent Healthcare screened 201 patients and 118 of those patients were new to the screening program. Of those screened, 3 patients were diagnosed with lung cancer and were treated with surgery and/or Cyber knife. Also, 1 patient from the screening was diagnosed with metastatic breast cancer Low-Dose Lung Screening 201 Total Patients Screened 1 Patient with Other Cancer 3 Patients with Lung Cancer 197 No Cancer Detected As a benefit to the lung screenings we also have a Multidisciplinary Lung Nodule Committee that meets every 2 weeks to ensure best treatment options for patients. This team consists of skilled surgeons, pulmonologists, radiation oncologists, radiologists, staff from the research team, and lung nurse navigator. Some advantages of this multidisciplinary committee are: Fostering collaboration of physicians during treatment planning Expeditious referral process for the patients Patients are then provided with clear information about their diagnosis, treatment and possible outcomes To learn more about Lung Cancer Screening you may contact our Lung Nurse Navigator at (406) or lung-thoracic/ 10

11 Cancer Registry The Cancer Registry at Saint Vincent Healthcare abstracted 746 analytical cases for the year Our 2016 analytical case volume has increased from 2015 as the Cancer Registry has included SVH Urology and Dermatology Clinics. Analytical cases are newly diagnosed cancer cases that meet the following criteria. The cancer was: 1 diagnosed 2 diagnosed and treated 3 diagnosed elsewhere and treated at Saint Vincent Healthcare. The top five cancers in 2016 were: Prostate Breast Lung Colon Hematopoietic Cancers The Cancer Registry database is a rich source of clinical cancer data information at St. Vincent Healthcare since The data fields include patient demographics, histology, tumor grade, AJCC stage of disease at diagnosis, tumor markers, tumor size, regional lymph node status, first course of therapy, annual follow-up, vital status, and more. Over the past year, SVH cancer registry converted to CRStar cancer registry software, a web-based program. The SCLHS Cancer Registry team has been able to provide support for all SCLHS Colorado/Montana Hospitals. 11

12 St. Vincent Healthcare 2017 Analytic Cases Primary Site Total Class Sex AJCC Stage A N/A M F 0 I II III IV Unk N/A All Sites Oral Cavity Lip Tongue Oropharynx Hypopharynx Other Digestive System Esophagus Stomach Colon Rectum Anus/Anal Canal Liver Pancreas Other Respiratory System Nasal/Sinus Larynx Other Lung/Bronc-Small Cell Lung/Bronc-Non Small Cell Other Bronchus & Lung Blood & Bone Marrow Leukemia Multiple Myeloma Other Bone Connect/Soft Tissue

13 Primary Site Total Class Sex AJCC Stage A N/A M F 0 I II III IV Unk N/A Skin Melanoma Other Breast Female Genital Cervix Uteri Corpus Uteri Ovary Vulva Other Male Genital Prostate Testis Other Urinary System Bladder Kidney/Renal Other Brain & Cns Brain (Benign) Brain (Malignant) Other Endocrine Thyroid Other Lymphatic System Hodgkin s Disease Non-Hodgkin s Unknown Primary Other/Ill-Defined

14 Leading Sites of New Cancer Cases by Gender 2017 US Estimate & 2016 St. Vincent Healthcare Cases This report includes estimated numbers from the ACS for the US in 2017 and actual 2016 new diagnoses for SVH. SVH cases are analytical cases; those diagnosed only, or diagnosed and/or treated at St. Vincent Healthcare. MALE FEMALE BODY SITE SVH % SVH # US SVH % SVH # US BODY SITE Prostate 38% % 37% % Breast Lung & Bronchus 9% 34 14% 14% 50 12% Lung & Bronchus Colon & Rectum 9% 36 9% 8% 29 8% Colon & Rectum Urinary Bladder 8% 30 7% 1% 3 7% Uterine Corpus Melanoma of the Skin 5% 19 6% 4% 14 5% Thyroid Kidney, Renal Pelvis 4% 14 5% 5% 17 4% Melanoma of the Skin Non-Hodgkin Lymphoma 3% 12 5% 3% 10 4% Non-Hodgkin Lymphoma Leukemia 4% 15 4% 1% 5 3% Leukemia Oral Cavity/Pharnyx 3% 10 4% 3% 10 3% Pancreas Liver & Bile Ducts 2% 8 3% 3% 10 3% Kidney, Renal Pelvis All Sites , ,630 All Sites Data Source: American Cancer Society: Cancer Facts and Figures

15 Leading Sites of New Cancer Cases and Deaths 2017 Estimates Estimated New Cases* Estimated Deaths* MALE FEMALE MALE FEMALE Prostate 161,360 (19%) Lung & Bronchus 116,990 (14%) Colon & Rectum 71,420 (9%) Urinary Bladder 60,490 (7%) Melanoma of the Skin 52,170 (6%) Kidney & Renal Pelvis 40,610 (5%) Non-Hodgkin Lymphoma 40,080 (5%) Oral Cavity & Pharynx 35,720 (4%) Leukemia 36,290 (4%) Liver & Intrahepatic Bile Duct 29,200 (3%) All Sites 836,150 (100%) Breast 252,710 (30%) Lung & Bronchus 105,510 (12%) Colon & Rectum 64,010 (8%) Uterine Corpus 61,380 (7%) Thyroid 42,470 (5%) Melanoma of the Skin 34,940 (4%) Non-Hodgkin Lymphoma 32,160 (4%) Leukemia 25,840 (3%) Pancreas 25,700 (3%) Kidney & Renal Pelvis 23,380 (3%) All Sites 852,630 (100%) Lung & Bronchus 84,590 (27%) Colon & Rectum 27,150 (9%) Prostate 26,730 (8%) Pancreas 22,300 (7%) Liver & Intrahepatic Bile Duct 19,610 (6%) Leukemia 14,300 (4%) Esophagus 12,720 (4%) Urinary Bladder 12,240 (4%) Non-Hodgkin Lymphoma 11,450 (4%) Brain & Other Nervous System 9,620 (3%) All Sites 318,420 (100%) Lung & Bronchus 71,280 (25%) Breast 40,610 (14%) Colon & Rectum 23,110 (8%) Pancreas 20,790 (7%) Ovary 14,080 (5%) Uterine Corpus 10,920 (4%) Leukemia 10,200 (4%) Liver & Intrahepatic Bile Duct 9,310 (3%) Non-Hodgkin Lymphoma 8,690 (3%) Brain & Other Nervous System 7,080 (3%) All Sites 282,500 (100%) Estimates are rounded to the nearest 10, and cases exclude basal cell and squamous cell skin cancers and insitu carcinoma except urinary bladder. 2017, American Cancer Society, Inc. Surveillance Research 15

16 B MED ARTS NORTH MED ARTS NORTH MED ARTS SOUTH C VALET VOLUNTEERS SPECIALTY CLINICS NORTH 30TH STREET FREE VALET MARILLAC A MARILLAC AUDITORIUM ENTRANCE HOSPITAL MAIN ENTRANCE H MENTAL HEALTH CENTER ST. VINCENT HEALTHCARE HOSPITAL RIMROCK FOUNDATION ED/SURGERY+ ENTRANCE 12TH AVENUE NORTH MSU-E N POLY DRIVE R MED ARTS POLY K MED ARTS POLY L NORTH 27TH STREET RONDALD MCDONALD HOUSE WEST YMC SVH YELLOWSTONE BREAST CENTER MANSFIELD HEALTH EDUCATION CENTER YELLOWSTONE MEDICAL CENTER EAST YMC PATIENT/VISITOR YELLOWSTONE SURGERY CENTER M SHIRLEY S PLACE VALET ONLY MANSFIELD D SVH OUTPATIENT REHAB E GARAGE F SVH GI CENTER HILLTOP NORTH 28TH STREET YELLOWSTONE SURCERY CENTER M SVH FOUNDATION 11TH AVENUE NORTH St. Vincent HEALTHCARE SCL Health FRONTIER CANCER CENTER