Lewis Cancer & Research Pavilion PROSTATE CANCER 2012 REPORT SELECTED A NATIONAL CANCER INSTITUTE COMMUNITY CANCER CENTER PROGRAM.
2 St. Joseph s/candler Mission and Vision Mission Rooted in God s love, we treat illness and promote wellness for all people. Vision To set the standards of excellence in the delivery of healthcare throughout the regions we serve. Nancy N. and J.C. Lewis Cancer & Research Pavilion and the Oncology Service Line Mission and Vision Mission Holistic, multi-disciplinary, patient-centered cancer care provided across the disease continuum for all stages of a patient s journey. Vision To be the premier destination for comprehensive cancer care in the region while providing a superior patient experience.
3 A Message from the Cancer Committee Chairman The Nancy N. and J.C. Lewis Cancer & Research Pavilion (LCRP) continues to broaden its program development to adhere to the Commission on Cancer and the National Cancer Institute standards and initiatives. According to the American Cancer Society s Cancer Facts and Figures 2013, an estimated 7,930 new cases of prostate cancer were diagnosed in Georgia in 2013 and an estimated 790 Georgia men died of prostate cancer. While overall, one in six men will be diagnosed with prostate cancer in their lifetime, African American men have a one in five chance of developing prostate cancer and are more likely to die from prostate cancer than white men. The incidence rate of prostate cancer in Georgia, at 165.7 cases per 100,000 men, is higher than the national average of 143.8 cases per 100,000. The LCRP is responding to this need. We are a regional destination for cancer care and are proud to consistency report higher rates of survivorship among our prostate cancer patients than national rates. To support improved prostate patient outcomes the LCRP offer all prostate cancer patients access to cutting edge technology, robotic radical prostatectomy, personalized medicine, clinical trials, and supportive oncology services including palliative care, navigation services, nutritional services, support groups, and survivorship care. Within the LCRP service area Camden, Clinch, Emanuel, McIntosh, and Jasper South Carolina counties have prostate cancer incidence rates higher than national averages. The community support and collaboration of local urologists with the LCRP multi-disciplinary treatment team is integral to seamless patient transition to cancer treatment and care. Because of this strong collaboration with local urologist and higher incidence rates in outlying areas, the percentage of analytic prostate cancer cases treated at the LCRP from the LCRP s tertiary service area and from outside of our service area grew from 12% in 2011 to 18% in 2012. However, 74% of LCRP patients treated for prostate cancer come four counties within the LCRP primary service area Chatham, Beaufort SC, Liberty, and Bryan. With a total of 210 cases (190 analytic and 20 non-analytic), prostate cancer was one of the most commonly treated cancer sites at the LCRP in 2012, surpassed only by lung and breast cancers. The majority of prostate cases treated at the LCRP were among men diagnosed between ages 60-69 (47% in 2011 and 43% in 2012) while roughly one fourth of cases were in men ages 50-59 and another one fourth in men over age 70. Additionally, in both 2011 and 2012, the majority of prostate cancer cases treated at the LCRP for both African American and white men were stage I and II cancer, indicating that the majority of men are receiving early detection and timely entry into treatment. In 2012, the LCRP conducted a quality study on prostate cancer to ensure the highest level of care for our prostate cancer patients. The LCRP compared its cancer registry data to the American College of Surgeons Commission on Cancer National Cancer Database to examine the LCRP s five year survival rate (2003 to 2006) and stage at time of diagnosis. Men treated at the LCRP showed an overall five year survival rate higher than national rates while prostate cancer stage at time of diagnosis was consistent with Georgia and national rates. Men newly diagnosed with prostate cancer can be confident that, by picking the Lewis Cancer and Research Pavilion for their treatment, they will receive holistic, multi-disciplinary, patient-centered care at a regional destination for comprehensive cancer care. H.A. Zaren, MD, FACS Medical Director, LCRP Cancer Committee Chairman Primary Investigator, NCCCP Professor of Surgery at Georgia Regents University and Distinguished Cancer Scientist
4 Community Need 1 in 6 men will be diagnosed with prostate cancer in their lifetime. Prostate cancer is the most common cancer in American men. 1 An estimated 238,590 U.S. men were diagnosed with prostate cancer in 2013, 7,930 of these men were from Georgia. 2 An estimated 29,720 U.S. men died of prostate cancer in 2013, 790 of these men were from Georgia. 3 African American men have a 1 in 5 chance of developing prostate cancer during their lifetime and are more likely to die from prostate cancer than white men. 4 Prostate Cancer Incidence in LCRP Primary, Secondary, and Tertiary Service Areas 100% State Cancer Profiles, 2012 Annual Incidence Rate per 100,000 Males JENKINS JOHNSON 136.7 SCREVEN 108.5 EMANUEL 150.8 131.9 MONTGOMERY 117.5 EVANS TOOMBS 78.6 183 TATTNALL 115.7 WHEELER 92.5 TREUTLEN 116.2 JEFF DAVIS 96.5 COFFEE 106.4 ATKINSON 106.4 APPLING 102.6 BACON 116.1 WARE 148 CANDLER 97.8 BULLOCH 101.7 PIERCE 109.3 WAYNE 121.4 BRANTLEY 57 BRYAN 91.8 LIBERTY LONG 117.7 77.1 EFFINGHAM 97 McINTOSH 145.7 GLYNN 143 JASPER 178.4 CHATHAM 133.1 BEAUFORT 140.1 LCRP Analytic Prostate Cancer Cases by Service Area 2011-2012, LCRP Cancer Registry Data OUTSIDE SERVICE AREA TERTIARY SECONDARY PRIMARY 82% 79% CLINCH 155.2 CHARLTON 128.3 CAMDEN 182.8 6% 8% 13% 3% 4% 5% 2011 2012
5 Prostate Cancer Death and Incidence Rates per 100,000 State Cancer Profiles, 2012 DEATH RATE ANNUAL INCIDENCE Georgia 27.1 165.7 United States 23 143.8 Five counties in the LCRP service area (Camden, Clinch, Emanuel, McIntosh, and Jasper Counties) have prostate cancer incidence rates higher than national averages. JOHNSON EMANUEL TREUTLEN CANDLER BULLOCH EFFINGHAM BEAUFORT MONTGOMERY EVANS WHEELER TOOMBS BRYAN TATTNALL CHATHAM COFFEE JEFF DAVIS ATKINSON APPLING BACON WARE PIERCE JENKINS WAYNE BRANTLEY SCREVEN LIBERTY LONG McINTOSH GLYNN JASPER CLINCH CHARLTON CAMDEN Lewis Cancer & Research Pavilion Response LCRP Prostate Cancer Cases 2011-2012, LCRP Cancer Registry Data Analytic 250 Non-analytic 200 150 100 50 0 245 2011 190 28 20 2012 Analytic cases: refers to patients who are either initially diagnosed at the LCRP or newly diagnosed elsewhere and are referred to LCRP for all or part of their initial treatment or decision not to treat. Non-Analytic cases: refers to patients who are diagnosed and treated elsewhere, or diagnosed and treated prior to referral to the LCRP. Prostate cancer was one of the most commonly treated cancer sites at the LCRP in 2012, surpassed only by lung and breast cancers.
6 Age Range at Time of Diagnosis (Analytic Cases) 2011-2012, LCRP Cancer Registry Data 50 40 30 20 21% 32% 47% 43% 28% 21% 2011 2012 10 4% 4% 0 40-49 50-59 60-69 70+ The National Comprehensive Cancer Network (NCCN) recommends that men should have a thorough discussion with their healthcare provider about the pros and cons of testing for prostate cancer. Testing is done through the prostate specific antigen (PSA) blood test and a digital rectal exam (DRE). The NCCN recommends that African American men and men with a family history begin prostate cancer screening in their 40 s, while men with an average risk should begin screening in their 50 s. 5 300 250 200 150 100 50 0 Number of Patients by Prostate Cancer Stage at Time of Diagnosis and Race among LCRP Patients 2011-1012, LCRP Cancer Registry Data 44 38 Stage I 154 100 Stage II 20 18 17 11 19 14 Stage III Stage IV Stage UNK 254 Total 181 2011-2012 White 2011-2012 African- American The majority of prostate cancer cases treated at the LCRP for both African American and white men are stage I and II cancer, indicating that the majority of men are receiving early detection and entry into treatment.
7 74 % of LCRP patients treated for prostate cancer come from four counties: Chatham, Liberty, Bryan, and Beaufort, South Carolina. 2012 Analytic Prostate Cancer Cases by Country of Residence at Time of Diagnosis 2012, LCRP Cancer Registry Data DIAGNOSIS COUNTY NUMBER OF CASES PERCENT Chatham 75 39.5% Beaufort, SC 27 14.2% Liberty 26 13.7% Bryan 13 6.8% Effingham 9 4.7% Toombs 7 3.7% Out of State 6 3.2% Appling 3 1.6% Bulloch 3 1.6% Tattnall 3 1.6% Wayne 3 1.6% Candler 2 1.1% Emanuel 2 1.1% Montgomery 2 1.1% Screven 2 1.1% Bacon 1 0.5% Camden 1 0.5% Coffee 1 0.5% Hampton 1 0.5% Jasper, SC 1 0.5% Jeff Davis 1 0.5% Pierce 1 0.5% TOTAL CASES 190 100%
8 CyberKnife Robotic Radiosurgery System The CyberKnife Robotic Radiosurgery System is a pain-free, noninvasive alternative to surgery for the treatment of tumors anywhere in the body. The CyberKnife System delivers maximum doses of radiation to both malignant and benign tumors with unparalleled accuracy sparing surrounding healthy tissues and organs. The CyberKnife allows me to provide a pain-free procedure to treat tumors anywhere in the body, says John A. Pablo, M.D. and Medical Director of Radiation Oncology at the Lewis Cancer & Research Pavilion. With this tool, I can deliver high doses of radiation to small areas with phenomenal accuracy. This technology utilizes real-time tracking, Pablo says. If the patient or the tumor itself moves slightly, the CyberKnife can see where things are moving and correct for that motion. If something is benign but it s next to your optic nerve, for example, it can potentially blind you if it grows, Pablo says. This again shows how advantages of the CyberKnife work together seamlessly. It can track and correct for any slight motion, and deliver the radiation with incredible accuracy. In 2014 the LCRP will add CyberKnife technology as a modality to treat men with prostate cancer. In selected patients this will reduce overall treatment time from 8 to 9 weeks down to 1 week. John A. Pablo, M.D. Medical Director of Radiation Oncology at the Lewis Cancer & Research Pavilion.
9 Results In 2012, the LCRP conducted a quality study on prostate cancer to ensure the highest level of care for our prostate cancer patients. The LCRP compared its cancer registry data to the American College of Surgeons Commission on Cancer National Cancer Database to examine LCRP s 5-year survival rate (2003-2006) and stage at time of diagnosis. Men treated at the LCRP showed an overall five year survival rate higher than national rates while prostate cancer stage at time of diagnosis was consistent with Georgia and national rates. Comparison of LCRP and National Five Year Survival Rates 2003-2006, National Cancer Database (NCDB) of the Commission on Cancer and 2003-2006, LCRP Cancer Registry Data 100% 80% 60% 40% 20% 0% 87.6% 91.2% Overall NCDB LCRP Stage of Prostate Cancer Diagnosed in 2011 LCRP Patients Compared to Georgia and National Rates 2011 National Cancer Database (NCDB) of the Commission on Cancer 80% 70% 60% 50% 40% 30% 20% 10% 0% 22.3 24.2 23.4 Stage I 60.3 60.9 Stage II 57.1 10.2 8.3 6.2 Stage III 6.6 6.1 6.2 Stage IV 2.6 2.5 3.2 Stage UNK LCRP Georgia National
10 The Prostate Cancer Support Group The Prostate Cancer Support Group is a support group for men with prostate cancer and their families and caregivers. Founder and group facilitator John Richardson explains, It s pretty inevitable that 1 out of 6 men will get prostate cancer. So our group is there to provide laymen s information and help men newly diagnosed with prostate cancer find out about available treatments. We share our experiences and help others learn what to expect and realize that it s not just happening to them but to other men as well. After being diagnosed with prostate cancer in September 2007, Mr. Richardson realized that there was nowhere to go, no one to ask questions to, and no support group in the Savannah area. As he explains, It s just not something that men talk about very often with each other. Mr. Richardson was involved in a support group while having treatment out-of-state, which made him realize the benefit of having an informal setting for men to share their treatment and other experiences. Upon his return to Savannah, Mr. Richardson formed a support group for prostate cancer survivors in June 2008. The Prostate Cancer Support Group is held at the Nancy N. and J.C. Lewis Cancer & Research Pavilion the 2nd Wednesday of every even month and at the Anderson Cancer Center on odd months. The group begins at 6 pm and includes light refreshments for participants. All men and their families are welcome to attend from men seeking information to men newly diagnosed with prostate cancer to men who have finished treatment. Mr. Richardson explains that one of the benefits of the group is that there are usually 2-3 newly diagnosed men at every meeting who are trying to decide what to do. They have the opportunity during the group to talk to men who have gone through treatment about their experiences. In addition, allied health professionals will sometimes present on relevant prostate cancer and wellbeing topics. Prior to my diagnosis, I wasn t aware of prostate cancer or its impact on men and their families. The Prostate Cancer Support Group is there to promote self-awareness and to provide information to all men, regardless of if they have prostate cancer. John Richardson, Founding member For additional information, contact John Richardson at: jsrclearwater@aol.com 2014 Meetings at the LCRP: Wednesday February 12 th 6 pm Wednesday August 13 th 6 pm Wednesday April 9 th 6 pm Wednesday October 8 th 6 pm Wednesday June 11 th 6 pm Wednesday December 10 th 6 pm
11 Footnotes 1 American Cancer Society. Cancer Facts & Figures 2013. Atlanta, GA. American Cancer Society, 2013. 2 American Cancer Society. Cancer Facts & Figures 2013. Atlanta, GA. American Cancer Society, 2013. 3 American Cancer Society. Cancer Facts & Figures 2013. Atlanta, GA. American Cancer Society, 2013. 4 American Cancer Society. Cancer Facts & Figures for African Americans 2013-2014. Atlanta, GA. American Cancer Society, 2013. 5 Prostate Cancer Early Detection. May 2012. National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/pdf/prostate_detection.pdf.
SELECTED A NATIONAL CANCER INSTITUTE COMMUNITY CANCER CENTER PROGRAM.