Annual Report Cape Cod Hospital and Falmouth Hospital Regional Cancer Network 2013 Expert physicians. Quality hospitals. Superior care.
Cape Cod Hospital s Davenport- Mugar Hematology/Oncology Center and Falmouth Hospital s Clark Cancer Center are multidisciplinary cancer centers located on Cape Cod in Massachusetts.
Cancer Care CAPE COD HOSPITAL The Cancer Program at Cape Cod Hospital is accredited as a Community Comprehensive Program by the American College of Surgeons. The Cuda Women s Health Center at the Wilkens Outpatient Medical Complex is also accredited by the National Accreditation Program for Breast Centers, which is part of the American College of Surgeons and The American College of Radiology. These programs provide multimodality care plans for cancer patients as outlined by national standards of care such as the National Comprehensive Cancer Network (NCCN), American College of Radiology (ACR), American College of Surgeons (ACOS) and College of American Pathologists (CAP). Our staff of dedicated board certified medical and radiation oncologists, as well as nursing, pharmacy, technical, social work, tumor registry, and clerical staff and volunteers provide state-of-the-art care in a bright and emotionally supportive atmosphere. In addition, we have long-standing collaborative relationships with local surgeons, gynecologists, urologists, dermatologists, pathologists, and radiologists. We are affiliated with many distinguished cancer treatment centers and organizations, including the National Cancer Institute, Dana-Farber/Partners Cancer Care, the Dana-Farber Cancer Institute, Brigham and Women s Hospital and Massachusetts General Hospital, through their adult oncology collaboration. CAPE COD HOSPITAL CANCER CENTER S TOP FIVE TREATMENT AREAS In 2013, there were 1,213 analytic patients treated at the CCH Cancer Center. BREAST 25% OTHER 37% LUNG 13% PROSTATE 10% COLORECTAL 8% BLADDER 7% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 1
Some of the benefits of our affiliations include: Multidisciplinary conferences to review cases prospectively Monthly second opinion specialty clinics on site with Dana-Farber Cancer Institute physicians Collaboration to determine best treatment plans Access to up-to-date pharmaceutical options and nursing standards Clinical staff participation in networking conferences and grand rounds Participation in clinical trials for new treatments Cape Cod Hospital has a vigorous clinical trial program with access to National Study Groups protocols and the Dana-Farber Cancer Institute. The Davenport-Mugar Hematology/Oncology Center works closely with our local American Cancer Society chapter to ensure our patients have access to and benefit from their many programs and support systems. 2 Cape Cod Healthcare Regional Cancer Network 2013
CAPE COD HOSPITAL 2013 PRIMARY TREATMENT AREAS TOTAL MALE FEMALE # % # % # % ORAL CAVITY & PHARYNX 41 3.4% 32 5.8% 9 1.4% Tongue 15 1.2% 11 2.0% 4 0.6% Salivary Glands 5 0.4% 4 0.7% 1 0.2% Gum & Other Mouth 7 0.6% 5 0.9% 2 0.3% Tonsil 8 0.7% 6 1.1% 2 0.3% Oropharynx 1 0.1% 1 0.2% 0 0.0% Hypopharynx 5 0.4% 5 0.9% 0 0.0% DIGESTIVE SYSTEM 184 15.1% 99 17.9% 85 12.9% Esophagus 17 1.4% 10 1.8% 7 1.1% Stomach 15 1.2% 7 1.3% 8 1.2% Colon Excluding Rectum 58 4.8% 25 4.5% 33 5.0% Cecum 19 9 10 Appendix 2 1 1 Ascending Colon 12 4 8 Hepatic Flexure 1 0 1 Transverse Colon 9 7 2 Descending Colon 2 1 1 Sigmoid Colon 10 2 8 Large Intestine, NOS 3 1 2 Rectum & Rectosigmoid 35 2.9% 25 4.5% 10 1.5% Rectosigmoid Junction 13 9 4 Rectum 22 16 6 Anus, Anal Canal & Anorectum 9 0.7% 5 0.9% 4 0.6% Liver & Intrahepatic Bile Duct 9 0.7% 7 1.3% 2 0.3% Liver 8 7 1 Intrahepatic Bile Duct 1 0 1 Gallbladder 2 0.2% 0 0.0% 2 0.3% Other Biliary 6 0.5% 2 0.4% 4 0.6% Pancreas 31 2.6% 16 2.9% 15 2.3% Retroperitoneum 1 0.1% 1 0.2% 0 0.0% Other Digestive Organs 1 0.1% 1 0.2% 0 0.0% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 3
TOTAL MALE FEMALE # % # % # % RESPIRATORY SYSTEM 175 14.4% 85 15.3% 90 13.6% Nose, Nasal Cavity & Middle Ear 1 0.1% 0 0.0% 1 0.2% Larynx 14 1.2% 13 2.3% 1 0.2% Lung & Bronchus 160 13.2% 72 13.0% 88 13.3% SOFT TISSUE 4 0.3% 2 0.4% 2 0.3% Soft Tissue (including Heart) 4 0.3% 2 0.4% 2 0.3% SKIN EXCLUDING BASAL & SQUAMOUS 42 3.5% 21 3.8% 21 3.2% Melanoma Skin 40 3.3% 21 3.8% 19 2.9% Other Non-Epithelial Skin 2 0.2% 0 0.0% 2 0.3% BREAST 292 24.0% 2 0.4% 290 43.9% Breast 292 24.0% 2 0.4% 290 43.9% FEMALE GENITAL SYSTEM 49 4.0% 0 0.0% 49 7.4% Cervix Uteri 3 0.2% 0 0.0% 3 0.5% Corpus & Uterus, NOS 32 2.6% 0 0.0% 32 4.8% Corpus Uteri 31 0 31 Uterus, NOS 1 0 1 Ovary 8 0.7% 0 0.0% 8 1.2% Vulva 3 0.2% 0 0.0% 3 0.5% Other Female Genital Organs 3 0.2% 0 0.0% 3 0.5% MALE GENITAL SYSTEM 129 10.6% 129 23.3% 0 0.0% Prostate 127 10.5% 127 22.9% 0 0.0% Testis 1 0.1% 1 0.2% 0 0.0% Penis 1 0.1% 1 0.2% 0 0.0% URINARY SYSTEM 127 10.5% 93 16.8% 34 5.1% Urinary Bladder 91 7.5% 66 11.9% 25 3.8% Kidney & Renal Pelvis 30 2.5% 24 4.3% 6 0.9% Ureter 5 0.4% 2 0.4% 3 0.5% Other Urinary Organs 1 0.1% 1 0.2% 0 0.0% BRAIN & OTHER NERVOUS SYSTEM 22 1.8% 14 2.5% 8 1.2% Brain 16 1.3% 10 1.8% 6 0.9% Cranial Nerves Other Nervous System 6 0.5% 4 0.7% 2 0.3% ENDOCRINE SYSTEM 17 1.4% 6 1.1% 11 1.7% Thyroid 16 1.3% 6 1.1% 10 1.5% Other Endocrine including Thymus 1 0.1% 0 0.0% 1 0.2% 4 Cape Cod Healthcare Regional Cancer Network 2013
TOTAL MALE FEMALE # % # % # % LYMPHOMA 53 4.4% 26 4.7% 27 4.1% Hodgkin Lymphoma 5 0.4% 2 0.4% 3 0.5% Non-Hodgkin Lymphoma 48 4.0% 24 4.3% 24 3.6% NHL Nodal 32 16 16 NHL Extranodal 16 8 8 MYELOMA 18 1.5% 10 1.8% 8 1.2% Myeloma 18 1.5% 10 1.8% 8 1.2% LEUKEMIA 39 3.2% 21 3.8% 18 2.7% Lymphocytic Leukemia 21 1.7% 12 2.2% 9 1.4% Chronic Lymphocytic Leukemia 19 12 7 Other Lymphocytic Leukemia 2 0 2 Myeloid & Monocytic Leukemia 18 1.5% 9 1.6% 9 1.4% Acute Myeloid Leukemia 9 3 6 Chronic Myeloid Leukemia 9 6 3 MESOTHELIOMA 3 0.2% 3 0.5% 0 0.0% Mesothelioma 3 0.2% 3 0.5% 0 0.0% KAPOSI SARCOMA 2 0.2% 2 0.4% 0 0.0% Kaposi Sarcoma 2 0.2% 2 0.4% 0 0.0% MISCELLANEOUS 18 1.5% 9 1.6% 9 1.4% Miscellaneous 18 1.5% 9 1.6% 9 1.4% TOTAL 1,215 554 661 TREATMENT AREAS BY GENDER MALE # % PROSTATE 127 23% LUNG & BRONCHUS 72 13% URINARY BLADDER 66 12% COLON & RECTUM 50 9% ORAL CAVITY & PHARYNX 32 6% KIDNEY & RENAL PELVIS 24 4% NON-HODGKIN LYMPHOMA 24 4% MELANOMA OF THE SKIN 21 4% LEUKEMIA 21 4% PANCREAS 16 3% FEMALE # % BREAST 290 44% LUNG & BRONCHUS 88 13% COLON & RECTUM 43 7% UTERINE CORPUS 32 5% NON-HODGKIN LYMPHOMA 24 4% MELANOMA OF THE SKIN 19 3% LEUKEMIA 18 3% THYROID 10 2% OVARY 8 1% KIDNEY & RENAL PELVIS 6 1% ALL OTHER SITES 101 18% ALL OTHER SITES 123 19% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 5
Cancer Care FALMOUTH HOSPITAL The Falmouth Hospital Cancer Program is accredited as a Community Program by the American College of Surgeons. The Breast Cancer program at the Seifer Womens Health and Imaging Center is accredited by the National Accreditation Program for Breast Centers, a division of the American College of Surgeons, as well as the American College of Radiology. These programs provide multimodality care plans for cancer patients as outlined by national standards of care such as the National Comprehensive Cancer Network (NCCN), the American College of Radiology (ACR), the American College of Surgeons (ACOS), and the College of American Pathologists (CAP). In summary, the Falmouth Hospital Cancer Program offers a full-range of comprehensive medical and surgical specialists who are board certified and work in collaboration to bring personalized, compassionate care to patients. Radiation Therapy consultations and treatments are offered at the Clark Cancer Center in the Falmouth Hospital Medical Office Building. Medical Oncology/Hematology consultations and treatments are offered at the Hematology Oncology Specialists of Cape Cod in North Falmouth. Our clinicians offer interactive consultations on a regular basis, jointly review test results, and work in partnership on treatment plans. We hold weekly tumor conferences which enable our physicians to share information on both complex and common diagnoses and plan the best therapies for patients. Our focus of care is to treat the whole patient by understanding the emotional and physical effects of cancer which our patients experience. To augment this care, Falmouth Hospital has assembled strong support teams who address such issues as pain management, palliative medicine, physical therapy, and social services among others. We initiate numerous screening programs in our community outreach efforts. A recent example includes our low-dose lung screening program that has just been activated. Our belief in a comprehensive cancer program that addresses the individual patient is evident in the exceptional care we provide our patients each day. 6 Cape Cod Healthcare Regional Cancer Network 2013
In 2013, Falmouth Hospital s cancer team diagnosed and/or treated approximately 446 new primary cancers: Of these, 318 were primary cancers diagnosed and/or treated at Falmouth Hospital. 138 of the patients were men (43%) and 180 of the patients were women (57%). In 2013, 42% of new primaries diagnosed at Falmouth Hospital were early stage cancers (i.e. stages 0 and 1). 75% of new cancer patients seen were between the ages of 60 and 89. The top 5 sites for women were Breast, Colon, Lung, Skin, and Uterus. The top 5 sites for men were Prostate, Colon, Skin, Bladder, and Lung. The cumulative total of cases in Falmouth Hospital s cancer database since 2000 grew to 5,659 with 318 new cases added in 2013. 91% of living patients were successfully followed for care during 2013 (dating back to reference year 2005). FALMOUTH HOSPITAL CANCER CENTER S TOP FIVE TREATMENT AREAS 2013 Analytic Case Comparison BREAST 25% LUNG 10% PROSTATE 7% COLORECTAL 15% OTHER 36% BLADDER 9% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 7
Our data is reported to the Massachusetts Cancer Registry as required by state law, as well as the National Cancer Data Base (NCDB) which allows comparison with local, state and national statistics. During 2013, a total of 446 cases were entered into the Cancer Registry of which 318 (71%) were analytic and 128 (29%) were non-analytic. Of the 318 analytic cases, 138 were male and 180 were female. The five major sites continue to be breast, colorectal, lung, bladder, and prostate. There were 79 cases of breast cancer diagnosed which accounts for 25% of the total number of analytic cases in 2013. 48 or 61% of these cases were diagnosed with stage 0 and stage 1 disease. Of note: In comparing the years 2008, 2009, 2010, 2011, and 2012, there was a steady increase in class 0 cases, which were cases diagnosed at Falmouth and treated elsewhere. However, in 2012 and 2013, class 0 cases decreased, and were 21% of the total analytic cases decreasing from 37% in 2011. Colorectal cancer accounted for the second highest incidence of cancer for both sexes with a total of 47 cases or 18% of the total cases. There were 19 males and 28 females. 23% of these colorectal patients were diagnosed with stage 2 and 3 disease. Colorectal cancer replaced Lung cancer as the second highest incidence of cancer for both sexes at Falmouth Hospital. Lung cancer incidence decreased from 17% of analytic cases in 2012 to 10% in 2013. There were 56 cases diagnosed in 2012 and 31 in 2013. We saw a decrease in prostate cancers from 35 cases to 23 analytic cases. There still are a significant number of non-analytic cases that were treated elsewhere. In 2013, 8 patients went elsewhere or 35% of class 0 cases, but in 2012, 19 patients went elsewhere, or 26% of class 0 cases. We are currently studying this trend. We believe that a good portion of prostate cancer cases on the Cape are not diagnosed or treated in our system. Bladder cancer rates have stayed consistent. 8 Cape Cod Healthcare Regional Cancer Network 2013
FALMOUTH HOSPITAL 2013 PRIMARY TREATMENT AREAS TOTAL MALE FEMALE # % # % # % ORAL CAVITY & PHARYNX 11 3.5% 9 6.6% 2 1.1% Tongue 4 1.3% 2 1.5% 2 1.1% Floor of Mouth 1 0.3% 1 0.7% 0 0.0% Tonsil 5 1.6% 5 3.6% 0 0.0% Hypopharynx 1 0.3% 1 0.7% 0 0.0% DIGESTIVE SYSTEM 69 21.8% 34 24.8% 35 19.6% Esophagus 2 0.6% 2 1.5% 0 0.0% Stomach 5 1.6% 3 2.2% 2 1.1% Colon Excluding Rectum 24 7.6% 9 6.6% 15 8.4% Cecum 6 2 4 Ascending Colon 8 2 6 Hepatic Flexure 1 1 Splenic Flexure 1 1 Descending Colon 2 2 Sigmoid Colon 4 2 4 Large Intestine, NOS 2 2 Rectum & Rectosigmoid 22 7.0% 9 6.6% 13 7.3% Rectosigmoid Junction 8 5 4 Rectum 14 4 10 Anus, Anal Canal & Anorectum 5 1.6% 3 2.2% 2 1.1% Liver & Intrahepatic Bile Duct 3 0.9% 3 2.2% 0 0.0% Liver 2 2 0 Intrahepatic Bile Duct 1 1 0 Gallbladder 1 0.3% 0 0.0% 1 0.6% Other Biliary 1 0.3% 1 0.7% 0 0.0% Pancreas 6 1.9% 4 2.9% 2 1.1% RESPIRATORY SYSTEM 36 11.4% 18 13.1% 18 10.1% Larynx 4 1.3% 4 2.9% 0 0.0% Lung & Bronchus 32 10.1% 14 10.2% 18 10.1% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 9
TOTAL MALE FEMALE # % # % # % SOFT TISSUE 1 0.3% 1 0.7% 0 0.0% Soft Tissue (including Heart) 1 0.3% 1 0.7% 0 0.0% SKIN EXCLUDING BASAL & SQUAMOUS 13 4.1% 4 2.9% 9 5.0% Melanoma Skin 40 3.3% 21 3.8% 19 2.9% Other Non-Epithelial Skin 2 0.6% 1 0.7% 1 0.6% BREAST 77 24.4% 0 0.0% 77 43.0% Breast 77 24.4% 0 0.0% 77 43.0% FEMALE GENITAL SYSTEM 16 5.1% 0 0.0% 16 8.9% Cervix Uteri 1 0.3% 0 0.0% 1 0.6% Corpus & Uterus, NOS 11 3.5% 0 0.0% 11 6.1% Ovary 4 1.3% 0 0.0% 4 2.2% MALE GENITAL SYSTEM 27 8.5% 27 19.7% 0 0.0% Prostate 22 7.0% 22 16.1% 0 0.0% Testis 4 1.3% 4 2.9% 0 0.0% Penis 1 0.3% 1 0.7% 0 0.0% URINARY SYSTEM 35 11.1% 24 17.5% 11 6.1% Urinary Bladder 30 9.5% 24 17.5% 6 3.4% Kidney & Renal Pelvis 5 1.6% 0 0.0% 5 2.8% BRAIN & OTHER NERVOUS SYSTEM 5 1.6% 3 2.2% 2 1.1% Brain 5 1.6% 10 2.2% 2 1.1% ENDOCRINE SYSTEM 3 0.9% 2 1.5% 1 0.6% Thyroid 3 0.9% 2 1.5% 1 0.6% LYMPHOMA 13 4.1% 8 5.8% 5 2.8% Non-Hodgkin Lymphoma 13 4.1% 8 5.8% 5 2.8% NHL Nodal 10 7 3 NHL Extranodal 3 1 2 10 Cape Cod Healthcare Regional Cancer Network 2013
TOTAL MALE FEMALE # % # % # % MESOTHELIOMA 1 0.3% 1 0.7% 0 0.0% Mesothelioma 1 0.3% 1 0.7% 0 0.0% MISCELLANEOUS 9 2.8% 6 4.4% 3 1.7% Miscellaneous 9 2.8% 6 4.4% 3 1.7% TOTAL 316 137 179 TREATMENT AREAS BY GENDER MALE # % URINARY BLADDER 24 18% PROSTATE 22 16% LUNG & BRONCHUS 14 10% ORAL CAVITY & PHARYNX 9 7% NON-HODGKIN LYMPHOMA 8 6% PANCREAS 4 3% MELANOMA OF THE SKIN 3 2% LEUKEMIA 0 0% KIDNEY & RENAL PELVIS 0 0% FEMALE # % BREAST 77 43% COLON & RECTUM 28 16% LUNG & BRONCHUS 18 10% UTERINE CORPUS 11 6% MELANOMA OF THE SKIN 8 4% NON-HODGKIN LYMPHOMA 5 3% KIDNEY & RENAL PELVIS 5 3% OVARY 4 2% THYROID 1 1% LEUKEMIA 0 0% ALL OTHER SITES 35 26% ALL OTHER SITES 22 12% EXPERT PHYSICIANS. QUALITY HOSPITALS. SUPERIOR CARE. 11
The Cape Cod and Falmouth Hospitals Cancer Programs are proud that we meet or exceed standards of care levels in all areas when compared to the National Quality Forum indicators. Prevention programs are supported by Cape Cod and Falmouth Hospitals as well as our medical staff and include smoking cessation and weight management, routine mammography, colonoscopy and PSA testing. Screening programs include a new program for lung screening which is available at Falmouth Hospital and Cape Cod Hospital, supported by the hospitals Cancer Committee. Quality Improvement measures are reviewed at Cancer Committee meetings and include the Cancer Profile Performance Report (C3PR) which includes National Quality Forum Indicators. In 2013, the Cancer Registry, in conjunction with members of the Cape Cod Hospital medical staff, completed three studies: EGFR testing for all adenocarcinomas of the lung; incidence and treatment of melanoma; and incidence of oral cavity cancer and related HPV status. These studies were presented to the hospitals Cancer Committee and medical staff. Both Medical Oncology and Radiation Oncology at Cape Cod and Falmouth Hospitals participate in Quality Improvement programs which are included in the Quality Assurance/ Performance Improvement Dashboard Report which is presented quarterly to the Cancer Committee. Some of the indicators monitored are: Consent forms appropriately completed and signed prior to administration of chemotherapy. 100% compliance New patient intake forms are completed by the referring office. 100% compliance Outpatient problem lists are created and updated in the medical and radiation charts. 100% compliance Outpatient medication lists are created and updated in the medical and radiation charts. 100% compliance Radiation treatment machine down time is less than 2%. 98% compliance The Cape Cod and Falmouth Hospitals Cancer Programs are proud that we meet or exceed standards of care levels in all areas when compared to the National Quality Forum indicators. 12 Cape Cod Healthcare Regional Cancer Network 2013
For general information on services available, statistics or information, please contact: CAPE COD HOSPITAL Davenport-Mugar Cancer Center at Cape Cod Hospital: 508-862-7575 FALMOUTH HOSPITAL Clark Cancer Center at Falmouth Hospital: 508-495-8900
Cape Cod Healthcare 88 Lewis Bay Road Hyannis, Massachusetts 02601 CapeCodHealth.org