INDIANAPOLIS CARMEL MOORESVILLE

Transcription

1 2015 Cancer Report

2 I am pleased to share the Franciscan St. Francis Health Cancer Center 2015 annual report, which presents a summary of our activity and services in In this issue, we highlight the success of our Aspire Tobacco-Free Program and our plans to expand the program to help more Hoosiers quit smoking. Lung cancer accounts for about 27 percent of all cancer deaths and is by far the leading cause of cancer death among both men and women. The American Cancer Society reports that, each year, more people die of lung cancer than of colon, breast and prostate cancers Peter Garrett, MD combined. With our Aspire program, we have introduced a comprehensive approach to helping our residents quit smoking and, in turn, lower their risk of developing lung cancer, as well as cancer of the mouth, trachea, esophagus and other organs. This low-cost, multi-faceted program is yielding promising results. Franciscan St. Francis Health is also proud to be a charter member of the Lung Force professional women s cabinet, formed by the American Lung Association in 2014 to bring attention to lung cancer in women. Other 2014 highlights include: We welcomed breast and melanoma surgeon Juliana Meyer, MD, and medical oncologist Meghana Raghavendra, MD, to the program and Franciscan Physician Network. Thanks to a grant from the Livestrong Foundation, we implemented the Vital Hearts Program, a secondary trauma resiliency training program for cancer caregivers including both nurses and physicians. We opened an Interventional Pulmonology Clinic, staffed by Faisal Khan, MD, and a Prostate Cancer Multidisciplinary Clinic. We opened a Supportive Care Clinic for cancer patients and physicians. This clinic is designed to provide helpful health resources, including psychological and social services, either on an ongoing basis or as single-visit needs. It is staffed with a nurse practitioner, licensed therapist, registered dietitian and speech therapist. We have expanded our services by creating partnerships with Putnam County Hospital, Decatur County Memorial Hospital, Rush Memorial Hospital and Major Hospital. We formed an affiliation with the National Institutes of Health s Office of Research Services and became main members of the Alliance for Clinical Trials in Oncology and NRG Oncology, two primary organizations involved in the facilitation of research funded by the federal government. We built on our existing partnership with the Cancer Support Community by adding licensed therapists, support groups and education sessions to the network s outreach efforts. We implemented a specific multidisciplinary tumor board for melanoma cancer cases. Patient-centered care is a priority at the Franciscan St. Francis Health Cancer Center. We believe with these additions, and advancements to our staff and programs, we continue to position ourselves to provide exemplary cancer care to our patients, now and in years to come. Sincerely, Peter Garrett, MD Chairman, Cancer Committee Medical Director, Cancer Services Franciscan St. Francis Health Letter from the Cancer Committee Chairman PRIMARY SITE TABLE (2014 Analytic Cases*) Total Sex AJCC Stage 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 Lung/Bronchus Other Blood & Bone Marrow Leukemia Multiple Myeloma Other Bone Connect/Soft Tissue 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 Number of cases excluded: 0 *This report EXCLUDES CA in-situ cervix cases, squamous and basal cell skin cases, intraepithelial neoplasia cases 2015 Cancer Report 03

3 2014 TOTAL CASE DISTRIBUTION BY COUNTY OF RESIDENCE (at time of diagnosis) 2014 TOP NEW CANCER CASES BY SEX Males Females 1-5 Cases 6-9 Cases Cases Cases > 300 Cases Note: There were 14 out-of-state cases Source: Franciscan St. Francis Tumor Registry ST JOSEPH LA GRANGE STEUBEN ELKHART LA PORTE PORTER LAKE MARSHALL NOBLE DEKALB STARKE KOSCIUSKO NEWTON WHITLEY JASPER PULASKI FULTON ALLEN WABASH WHITE CASS MIAMI HUNTINGTON WELLS ADAMS BENTON CARROLL GRANT HOWARD BLACKFORD JAY TIPPECANOE WARREN CLINTON TIPTON DELAWARE MADISON RANDOLPH FOUNTAIN BOONE HAMILTON MONTGOMERY HENRY VERMILLION WAYNE HANCOCK HENDRICKS MARION PARKE PUTNAM RUSH FAYETTE UNION VIGO JOHNSON SHELBY MORGAN CLAY FRANKLIN OWEN DECATUR BARTHOLOMEW MONROE BROWN SULLIVAN RIPLEY DEARBORN GREENE JENNINGS OHIO JACKSON LAWRENCE JEFFERSON SWITZERLAND KNOX DAVIESS MARTIN SCOTT WASHINGTON ORANGE CLARK PIKE DUBOIS GIBSON CRAWFORD FLOYD Primary Site FSFH National Primary Site FSFH National Lung 20.1 % 13.6 % Breast 22.8 % 28.7 % Rectum 7.7 % 2.7 % Lung 15.4 % 13.4 % Colon 6.9 % 5.7 % Corpus Uteri 8.7 % 6.5 % Prostate 6.6 % 27.2 % Colon 5.9 % 6.0 % Leukemia 6.3 % 3.5 % Brain & CNS 5.6 % 1.3 % Bladder 4.6 % 6.6 % Rectum 3.9 % 2.0 % Kidney/Renal/Pelvis 4.2 % 4.6 % Thyroid 3.8 % 5.9 % Brain & CNS 4.2 % 1.5 % Leukemia 3.3 % 2.7 % Other Oral Cavity 3.9 % 0.2 % Non-Hodgkin Lymphoma 3.3 % 4.0 % Melanoma 3.8 % 5.1 % Ovary 3.1 % 2.7 % *Rounded to nearest tenth. National data is based on the Estimated New Cancer Cases by Sex in the U.S., Cancer Facts & Figures American Cancer Society, Inc., Surveillance Research. Estimated new cases are based on cancer incidence rates reported by the North American Association of Central Cancer Registries (NAACCR), representing about 89 percent of the U.S. population. WARRICK VANDERBURGH POSEY SPENCER PERRY HARRISON Cancer Report 2015 Cancer Report 05

4 Lung Cancer: Aspiring to quit smoking In 2011, more than 25 percent of Hoosiers smoked or used smokeless tobacco products (Centers for Disease Control, 2011 statistics). Franciscan St. Francis Health responded to the clinical health issue and adopted the Aspire Tobacco-Free Program in This low-cost, behavior-changing program was specifically designed for tobacco cessation and relapse prevention for those within the communities we serve ASPIRE COMMUNITY BY AGE Total Patients 233 Age PATIENTS Age PATIENTS Age PATIENTS 100% 80% 60% 40% 20% 0 Age PATIENTS 69% 1 month Age PATIENTS 51% 3 months Age PATIENTS Age PATIENTS ASPIRE COMMUNITY SUCCESS RATES (as of 12/31/14) 37% 6 months 18% 1 year The Aspire program is patient-centered and customized to individual needs. Treatment guidelines involve four to six individual counseling sessions led by our Mayo Clinic-trained tobacco treatment specialists. During these weekly or biweekly sessions, patients develop their own unique quit plans through coaching, medication management and motivational interviewing. Patients also attend group classes, held in Indianapolis and Mooresville, and receive a year of follow-up support. When a participant cannot attend sessions in person, the specialists follow up with a phone call. Due to the highly-addictive quality of the drug nicotine present in tobacco products and its availability, it is very difficult for individuals to quit, and the relapse rate is high. In 2012, the Centers for Disease Control reported that 68.8 percent of adult smokers wanted to quit, and that 48 percent of high school smokers had tried to quit. 2 The combination of physical symptoms of nicotine withdrawal and psychological dependency increases that challenge. Research has shown that counseling and medication together, as offered by programs like Aspire, leads to better outcomes than either approach alone. In 2014 alone, 233 patients participated in the Aspire program, and 35 percent completed all program sessions. Sixty percent of participants were 50 to 79 years of age, 64 percent were female and 75 percent were Caucasian. Success rates for quitting tobacco were 51 percent three months after completion of the Aspire program and 18 percent a full year post-completion which is more than double the rate of individuals who attempt to quit on their own. 1 At Franciscan St. Francis Health, the Aspire program has been shown to be effective in helping individuals not only quit smoking, but enjoy better health and quality of life. In the future, the hope is to expand the hospital s program to more underserved areas of Indiana, especially where tobacco use is high. 1 Fiore et al, Centers for Disease Control and Prevention. Quitting Smoking, (16 October 2015). Cheryl Streeval, RN, BSN, Lung Cancer Nurse Navigator Multidisciplinary Lung Clinic The management of patients with suspected or known lung cancer from smoking or second-hand smoke is becoming increasingly complex, but the time from diagnosis to the start of treatment doesn t need to be. The Franciscan St. Francis Health Cancer Center Lung Clinic is designed to bring our nationally recognized team of physicians together to meet with a patient during the same office visit. This includes leading cancer experts in pulmonology, medical oncology, radiation oncology, cardiothoracic surgery, pathology, radiology and many others. By meeting with our entire team in one visit, patients save several weeks of waiting and traveling to multiple office appointments and locations. This approach also ensures the best possible treatment plan is designed quickly in partnership with the patient and his or her family. Patients also have access to our dedicated lung cancer nurse navigator through each phase of treatment. The nurse navigator serves as a point person to coordinate the best care possible, while helping patients maintain control and maximize the quality of their life. Our research coordinators also participate on the Lung Clinic team to facilitate access to advanced treatment options not yet available with standard care. As a leading research center, Franciscan St. Francis Health participates in cutting-edge cancer research studies and clinical trials, including multiple trials for lung cancer. DETECTING LUNG DISEASE EARLIER Early detection is the key to beating lung cancer. Most lung cancers are first diagnosed based on symptoms. Unfortunately, symptoms often don t occur until the disease is in a late stage when treatment options are limited. Franciscan St. Francis Health offers a variety of screenings and interventional pulmonology procedures that expand care beyond diagnostic into advanced therapies to treat lung cancer that are less invasive than traditional surgical options. LUNG SCAN Franciscan St. Francis Health was the first in Indiana and one of the first in the nation to offer a lung CT screening program for the early detection of lung cancer. The lung screening is safe, simple and non-invasive with a minimal amount of radiation exposure. The screening is recommended for men and women who are either a current or former smoker between the ages of 55 and 75 and for those who have averaged smoking one pack of cigarettes a day for thirty years (two packs a day for fifteen years, three packs a day for ten years, etc.). ELECTROMAGNETIC NAVIGATIONAL BRONCHOSCOPY Franciscan St. Francis Health was the first hospital in central Indiana to use Electromagnetic Navigational Bronchoscopy (ENB), an innovative procedure to diagnose lung cancer, quickly and safely without surgery. Using GPS-like technology to navigate a unique set of tools deep into the lungs, pulmonologists can access suspicious areas that usually are hard to reach. This technology helps physicians detect lung cancer earlier, even before patients experience symptoms. Before ENB, a patient with a suspicious spot on his or her lung had the options of major surgery to remove a section of the lung or a watch-and-wait approach to see if the spot was cancerous and grew. ENDOBRONCHIAL ULTRASOUND (EBUS) is a more precise, less invasive way of assessing a patient s lymph nodes and determining if lung cancer has spread to other parts of the body. EBUS offers an alternative to surgery and leads to quicker diagnosis and staging of lung cancer, and early treatment. RIGID BRONCHOSCOPY is a procedure used to treat lung cancer to gain better access to a patient s airway, and permits the passage of larger instruments and cameras in order to diagnose and treat airway disease. It also allows for larger biopsies and for placing airway devices, such as tracheobronchial stents to keep airways open. It is estimated that less than six percent of pulmonologists in the United States are trained to perform rigid bronchoscopy Cancer Report 2015 Cancer Report 07

5 INDIANAPOLIS 8111 S. Emerson Ave. Indianapolis, IN (317) CARMEL B N. Meridian St. Carmel, IN (317) MOORESVILLE 1215 Hadley Road, Suite 105 Mooresville, IN (317) FranciscanStFrancis.org/cancer