Download 2016 Cancer Annual Report – 2015 data

2016 Cancer Annual Report – 2015 data
The Froedtert & the Medical College of Wisconsin
Kraemer Cancer Center at St. Joseph’s Hospital Campus
MK12166316
Kraemer Cancer Center Cancer Annual Report – 2015 data
Table of Contents
Welcome................................................................................................................ 3
Cancer Committee. . .................................................................................. 5
Cancer Registry Report............................................................................ 7
Cancer Conferences.. ............................................................................... 9
Cancer Care Team.................................................................................... 10
Cancer-Related Services.......................................................................... 11
Primary Sites.. .......................................................................................... 13
Glossary................................................................................................... 16
Skin Cancer Screening ............................................................................ 17
Photo on cover: Froedtert & the Medical College of Wisconsin Small Stones Wellness Center
supports the healing process by helping cancer patients enhance their appearance, boost
self-esteem and promote optimal health and well-being. Small Stones provides carefully selected
products and resources, wigs and other hair coverings and educational classes. Professional staff
offer their guidance and expertise. Learn more: froedtert.com/cancer/small-stones
The Froedtert & the Medical College of Wisconsin Cancer Network delivers a coordinated system of high-quality cancer care
anchored by the specialty expertise of Medical College of Wisconsin physicians and the extensive resources of eastern
Wisconsin’s only academic medical center.
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Welcome
We proudly present the 2016 cancer annual report for the Froedtert & the Medical
College of Wisconsin Kraemer Cancer Center at St. Joseph’s Hospital campus, a member
of the Froedtert & MCW Cancer Network. Highlighted in this report are resources
and services available at St. Joseph’s Hospital. We also examine the overall statistics of
newly diagnosed cancer patients benchmarked against state and national data.
Our energetic cancer care team continues to grow rapidly, strengthening current
programs as well as new offerings. We are excited by the breadth and quality of support
and services now available to the residents of Washington County and surrounding areas.
Colin Mooney, MD
The following highlights advances and achievements over the past year at the Kraemer Cancer Center.
• National recognition for quality care at St. Joseph’s Hospital continues.
e maintained accreditation through the Commission on Cancer and National Accreditation Program for
o W
Breast Centers and have upcoming surveys in 2017.
e initial application for accreditation by the Quality Oncology Practice Initiative of American Society
o Th
of Clinical Oncology has been submitted.
o The Joint Commission survey was successful.
• New cancer experts have joined the team, enhancing cancer care.
o Clinical pharmacist Becky Stark delivers coordinated care to physicians in clinic and supports patients
receiving oral chemotherapeutics. Her addition completes a 2016 Commission on Cancer goal.
o Financial counselor Kyle Gaesslin navigates patients through the cost of cancer care.
o Survivorship coordinator Chawndel Nelson gives patients a summary of care delivered and a roadmap of
post-treatment care.
• A new inpatient palliative care program was implemented with plans for outpatient integration.
• Clinical trial enrollment has expanded significantly.
• Tissue banking consent is available to expand clinical research in our community.
• .Screening events for skin and prostate cancer were held May 25, 2016, and Nov. 1, 2016, respectively.
• Community outreach continued with promotion of colon cancer awareness, screening and education at the
Celebrate Families Resource Fair held Feb. 14, 2016.
• Efforts toward prevention continue with upcoming events focusing on cervical, breast and colon cancers.
• Radiation oncology achieved tier-one status for staff engagement.
• Implementation of a new clinic check-in process now allows tracking of wait times for patients to firstchemotherapy-drug to exam and optimizes patient movement through the cancer center.
• Quality improvement efforts focused on developing a new scheduling process for patients receiving
chemotherapy to maximize valuable infusion space throughout the day.
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Kraemer Cancer Center Cancer Annual Report – 2015 data
• Fertility preservation is the subject of a new study for eligible breast cancer patients going through treatment.
• .Early lung cancer detection was the focus of a screening study to evaluate eligible individuals using
computed tomography (CT) scans, which will be the foundation of a new community CT lung cancer
screening program.
• .Th
e Centers for Medicare and Medicaid Services (CMS) accepted the Kraemer Cancer Center as an official
participant in the Oncology Care Model.
Colin Mooney, MD
Colin Mooney, MD
Hematologist/Oncologist
Chair, Cancer Committee
Medical Director, Hematology and Oncology
Froedtert & MCW St. Joseph’s Hospital
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Kraemer Cancer Center Cancer Annual Report – 2015 data
2015 Cancer Committee
Cancer Committee members meet regularly to review and evaluate the quality and direction of the cancer
program and make recommendations for improvement.
Physician Members
Colin Mooney, MD
Chair, Cancer Committee; Medical Director, Hematology and Oncology, Kraemer
Cancer Center
Roxanna Aldstadt, MD
Obstetrics and Gynecology
Mark Bosbous, MD
Plastic and Reconstructive Surgery
William Bradley, MD
Gynecologic Oncology
John Burfeind, MD
Cancer Liaison Physician, Hematology and Oncology
Patrick Gardner, MD
Pathology
William Hall, MD
Radiation Oncology
Candice Johnstone, MD, MPH
Medical Director, Froedtert & the Medical College of Wisconsin Cancer Network;
Medical Director, Radiation Oncology, Kraemer Cancer Center; Radiation Oncology
David Johnstone, MD
Thoracic Surgery
John Lacey, MD
Urology
Peter Langenstroer, MD, MS
Urologic Oncology
Kirk Ludwig, MD, FACS, FACRS
Colorectal Surgery
Kaizad Machhi, MD
General Surgery
Jared Robbins, MD
Radiation Oncology
April Shera, MD
Otolaryngology
Jeffery Smale, MD
Pulmonology
Eric Soneson, MD
Surgery
John Tomashek, MD
Diagnostic Radiology
Brian Wolter, MD
Family Medicine
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Kraemer Cancer Center Cancer Annual Report – 2015 data
2015 Cancer Committee
Kraemer Cancer Center and Hospital Operations
Sandra Bach, APNP
Supervisor, Women’s Services
Carol Barczak, BSN, RN, OCN
Manager, Hematology and Oncology
Nurse Coordinator, Thoracic Cancer Program, Prostate
Julie Bluma, BSN, RN
and Urologic Cancer Program
Lisa Bruesch, PTA, CMT
Cancer Rehabilitation
Kristi Caddock, ANP-BC, APNP
Nurse Practitioner
Karen Ferkans-Rupert, MS, RTT
Manager, Radiation Oncology
John Fuchs
Chaplain
Jackie Grams, LCSW, OSW-C
Oncology-Certified Social Worker
Nedra Johnson, BSN, RN, CCRP
Nurse, Clinical Research
John Koenig
Executive Director, Community Division, Froedtert & MCW Cancer Network
Sue Knuth
PT Director, Community Physicians Rehabilitation
Tracy Lilach, CCS-P, CCA
Oncology Data Management Technician, Cancer Registry
Luanne Murray
Aesthetics Wellness Coordinator, Small Stones Wellness Center
Leslie Loftis, CTR, RHIT
Certified Tumor Registrar, Quality Coordinator, Cancer Registry
Amy Maurer
Program Specialist, Community Engagement
Tracy Morales-Diaz, RN, BSN, OCN
Nurse, Hematology and Oncology
Debra Nevels
Representative, American Cancer Society
Debbie Przedpelski, MSW, APSW
Palliative Care Representative, Social Work
Nancy Roecker, BSN, RN, OCN
Nurse, Radiation Oncology
Karl Schultz
Director of Operations, St. Joseph’s Hospital
Heidi Stark, BSN, RN, OCN
Nurse Coordinator, Prostate and Urologic Cancer Program
Alexandra Verbeten, MSN, RN, ACNS-BC, AOCNS
Clinical Nurse Specialist
Wendy Weiss, RN, BSN
Performance Improvement/Quality Management
Gina Wilson, RN, BSN, CBCN
Breast Care Navigator
Heather Wittnebel, MS, RTT
Radiation Therapist
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Cancer Registry Report
Hospital-based cancer registries serve as the nation’s primary source of oncology statistics. The Cancer
Registry’s comprehensive collection of patient data facilitates comparisons between individual facilities and
the state or the nation as a whole. As with all cancer registries, the role of the Cancer Registry at Froedtert &
the Medical College of Wisconsin St. Joseph’s Hospital continues to grow and evolve. With advances in
cancer-related research, technology and treatments, the Cancer Registry collects more detailed information
than ever before. Information is collected and analyzed from many aspects, including from demographics,
personal and family histories, risk factors, diagnostic procedures, cancer site and histology, tumor markers,
prognostic indicators, staging, treatment, follow-up and survival data for each patient.
The Cancer Registry is an integral part of our cancer program and functions in accordance with guidelines
set by the American College of Surgeons Commission on Cancer and the Wisconsin Cancer Reporting
System. The Cancer Registry has a beginning reference date of Jan. 1, 2008, and is under the management
and direction of St. Joseph’s Hospital and its cancer committee. In 2015, the number of patient cases in our
Cancer Registry database totaled 3,477. Of the 581 newly reported cases added in 2015, 422 were analytical
patient cases. The Cancer Registry works with the Wisconsin Cancer Reporting System, submitting and
updating data each month. Patient cases are submitted to the National Cancer Database in January each
year. The Cancer Registry maintains the confidentiality of private health information and does not release
personal patient information in any cancer data statistics.
The Cancer Registry works with hospital physicians, administrators and health care planners to provide
coordination and support for cancer program development. It also tracks quality of care and treatment by
monitoring compliance with national, evidence-based guidelines. Data is also used by the hospital for
cancer conference presentations and administrative reports, as well as to evaluate staffing and equipment
needs and guide the development of educational and screening programs for patients and the community.
Cancer Registry staff maintains and submits required documentation to ensure the cancer program complies
with all standards established by the Commission on Cancer to maintain its accreditation as a Community
Cancer Program and ensure compliance with Wisconsin reporting standards.
Staffing
The Cancer Registry serves as a valuable resource for cancer information with the ultimate goal of
preventing and controlling cancer. Since 2012, we have partnered with nThrive (formerly Precyse)
Oncology Data Management Division to manage and staff the Cancer Registry at St. Joseph’s Hospital.
The Cancer Registry is staffed by two registrars (1.5 full-time equivalents) who maintain certified tumor
registrar credentials. They are assisted by an oncology data management technician (.5 full-time
equivalent). Cancer registrars are members of the National Cancer Registrars Association and participate
in educational conferences provided by this organization, as well as by their state affiliate organizations.
Oncology data management technicians participate in educational opportunities offered by nThrive and
have the option of obtaining certified tumor registrar credentials.
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Cancer Registry Report (continued)
Follow-up
Follow-up helps promote optimum patient care and provides a valuable record of patient outcomes. The primary
purposes of follow-up are to ensure continued medical surveillance, determine outcomes of treatment and to provide
documentation of continued disease-free status, residual disease or its spread and recurrence. The Commission on
Cancer standard requirement is 80 percent yearly follow-up on all patients diagnosed and/or treated at St. Joseph’s
Hospital since the Cancer Registry reference date of Jan. 1, 2008. The Commission on Cancer standard also requires
90 percent follow-up for patients diagnosed in the last five years. The Cancer Registry maintains ongoing data
collection and continued lifetime observation on 2,247 patients. The current follow-up rate is 98.3 percent for patients
diagnosed since the Cancer Registry reference date and 98.9 percent for patients diagnosed in the last five years.
Follow-up information is obtained by reviewing patient medical records and/or by gathering updated information
from the managing physician.
Data Requests
The Cancer Registry fulfills requests for cancer data from staff physicians, allied health professionals, other hospitals or
institutions and requests for treatment and follow-up information from other Wisconsin cancer registries. All data
requests are handled with the utmost care for the patient’s confidentiality. Data can be used in the process of
determining the incidence and etiology of malignant neoplasms and/or evaluating measures designed to eliminate,
alleviate or reduce the impact of cancer. In 2015, the Cancer Registry received 41 data requests.
For More Information
Cancer Registry: 262-836-7218
Registry Staff
Samantha Conrad, CTR, MBA
Lead Certified Tumor Registrar, Quality Coordinator/Oncology Data Management Consultant
Tracy Lilach, CCS-P, CCA
Oncology Data Management Technician
Leslie Loftis, RHIT, CTR
Lead Certified Tumor Registrar, Quality Coordinator/Oncology Data Management Consultant (2015)
Jill McAndrew, CTR
Certified Tumor Registrar, Oncology Data Management Consultant
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Cancer Conferences
Cancer conferences are a key component to the multidisciplinary approach for an American College of Surgeons
Commission on Cancer accredited program. The conferences allow the cancer team – including surgeons, medical
oncologists, radiation oncologists, pathologists and diagnostic radiologists – to consult and discuss recently diagnosed
patients, challenging cases and cases of interest. A synoptic report is presented to the team, and pathology slides and
imaging studies are reviewed for each patient when applicable. Nurses, navigators, genetic counselors and clinical
research nurses also attend. In this way, patients benefit from the collective expertise and experience of multiple
physicians and health care specialists who discuss treatment options for their patients and share information on current
developments and studies available in cancer diagnosis and treatment. Discussions include patient history, diagnostic
testing, surgical procedures, stage of disease at diagnosis, treatment options including clinical trials, evidence-based
guidelines and survival outcomes. Cancer conferences are also used to educate the medical staff in new techniques and
technology in the field of cancer diagnosis and treatment.
In 2011, a dedicated breast cancer conference was started at the Froedtert & the Medical College of Wisconsin St.
Joseph’s Hospital. Holding frequent, regularly-scheduled meetings allows the opportunity for more cancer patient cases
to be discussed in real-time to assist in the management of patients. In 2015, 224 patients were discussed at the general
cancer conferences and 162 patients were discussed at breast cancer conferences. Breast cancer patients are usually
discussed pre- and post-operatively. General cancer conferences are held on Friday mornings and breast cancer
conferences are held on Monday mornings.
Summary of Multidisciplinary Cancer Conferences
Conference
Sessions
Case Discussions
Breast Cancer
General
Total
35
42
77
162
224
386
2015 Cancer Conferences by Site
Lymphoid, 6
Gynecologic, 7
Musculoskeletal/
Soft Tissue, 4
Thyroid, 3
Unknown, 1
Head and Neck, 12
Skin, 12
Hematopoietic, 26
Breast, 162
Thoracic, 44
Breast
Digestive System
Genitourinary
Gynecologic
Head and Neck
Hematopoietic
Lymphoid
Musculoskeletal/Soft Tissue
Skin
Thoracic
Thyroid
Unknown
Digestive System, 44
Genitourinary, 65
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Cancer Care Team
From diagnosis through treatment and recovery, our dedicated cancer specialists work together to deliver the
most effective treatment for our patients and their individual needs.
Anesthesiologist
The physician who administers medicine to put patients to sleep or to numb the area on which patients will be operated.
Breast Care Navigator
Experienced oncology nurse with advanced training in cancer care who works closely with breast cancer patients and
families to coordinate all aspects of care.
Cancer Specialists
Physicians who diagnose and treat specific cancers such as breast, colorectal, lung or prostate cancers.
Case Manager
The social worker or nurse who discusses what to expect during a patient’s hospital stay and sets up support services
for when patients return home.
Clinical Pharmacist
The pharmacist who works with the medical oncologist to plan chemotherapy and other infused therapy regimens
for cancer patients.
Dietitian
A health care professional who assesses individual dietary and nutritional needs to keep cancer patients healthier
during and after treatment and reduce the overall risk of cancer.
Genetic Counselor
A certified genetic counselor provides personalized consultations regarding a person’s risk for genetically-linked
disease, how genes are linked to disease, how disease is inherited, guidance for genetic testing and options for
early disease detection and prevention.
Infusion Nurse
A registered nurse who is an experienced and skilled professional with extensive training in infusion therapy and
administering chemotherapy.
Medical Oncologist
The physician who plans chemotherapy and other infused treatments, directs care and monitors each patient’s ongoing status.
Oncology Nurse Practitioner
A registered nurse who has completed advanced training that allows him or her to provide direct patient care,
including physical exams and ordering medications, lab tests and X-rays.
Pathologist
The physician who examines tissue removed during a colonoscopy or a procedure to evaluate malignancies and
assists in making the diagnosis.
Radiation Oncologist
The physician who plans and oversees radiation therapy treatment, directs care and monitors each patient’s ongoing status.
Radiation Therapist
An experienced, skilled professional who has extensive training in administering prescribed doses of radiation to
specific areas of the body.
Surgeon
The physician who performs surgical procedures and helps coordinate care. For breast cancer patients, board-certified
plastic and reconstructive surgeons are available to perform breast reconstruction if needed.
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Cancer-Related Services
Our cancer program has been recognized by the American College of Surgeons Commission on Cancer as offering the
highest-quality cancer care. Since 2003, we have been proud to bring comprehensive, multidisciplinary cancer care
close to home.
Diagnostic Radiology
Board-certified, specialty-trained radiologists use state-of-the-art advanced imaging technologies, which result in more
accurate and comprehensive diagnoses. These medical imaging technologies include:
• Advanced digital technology for screening and diagnostic mammograms, including 3D mammography
(Tomosynthesis)
• Dual-source, multidetector computed tomography (CT)
• Nuclear medicine, including positron emission tomography/computerized tomography (PET CT) fusion imaging
• Magnetic resonance imaging (MRI), including breast MRI and biopsy
• Advanced ultrasound technologies
• Interventional radiology, including image-guided biopsy and treatment
• Fluoroscopy and conventional X-ray services
Surgery
Board-certified surgeons have the clinical expertise to deliver cancer-related specialty care in multiple areas. Additional
surgical specialties are available through the Froedtert & the Medical College of Wisconsin Cancer Network at
Froedtert Hospital campus.
• Breast surgery
• Colorectal surgery
• Ear, nose and throat surgery
• Thoracic surgery
• Vascular surgery
• Laparoscopic surgery, including gynecologic
• Urologic surgery
• Plastic and reconstructive surgery
Hematology and Oncology
Board-certified medical oncologists plan treatment and direct care for hematologic malignancies and benign blood
disorders using expertise in multiple areas in collaboration with physicians, pharmacists, social workers, genetic
counselors, oncology nurses and other members of the patient’s care team.
• Biological response modifiers
• Chemotherapy
• Hormonal therapy
• Clinical trials
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Cancer-Related Services (continued)
Radiation Oncology
Board-certified radiation oncologists deliver therapy that uses high-energy X-rays to kill cancer cells. Radiation
therapy technology at the Kraemer Cancer Center includes:
•
•
•
•
•
•
•
•
•
IMRT (Intensity-modulated radiation therapy)
IGRT (Image-guided radiation therapy)
3D conformal radiation therapy
Electron beam
External beam radiation therapy
Sterotactic body radiation therapy
Systemic radioisotopes
Clinical trials
Additional radiation therapy technologies are offered at Froedtert & MCW Froedtert Hospital when needed, such as
brachytherapy, Gamma Knife®, Radixact™ and Tomotherapy®
Rehabilitation Services
A wide range of rehabilitation therapies are available on an inpatient/outpatient basis for patients of all ages, including:
•
•
•
•
•
•
Pain rehabilitation
Lymphedema management
Occupational therapy
Physical therapy
Speech therapy
Stomal services/wound care
Support Services
A variety of resources is available to help patients cope with the stressors of cancer and the treatment process.
•
•
•
•
•
•
•
•
Breast cancer navigator
Clinical therapist
Financial counselors
Genetic counselors
Home health agency
Hospice
Social workers (oncology-certified)
Small Stones Wellness Center
•
•
•
•
•
•
•
Palliative care
Nutrition services
Nursing
Psycho-oncology
Spiritual services
Support groups
Survivorship education
Community Education Programs
Patients and others can learn about topics such as: cancer risk factors, signs and symptoms, screening guidelines,
prevention and control strategies, new treatments and living with cancer. Examples include:
•
•
•
•
•
Breast health
Cancer nutrition
Prostate cancer screening
Skin cancer prevention and screening
Smoking cessation
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Primary Sites
STATISTICAL SUMMARY
In 2015, 581 new cancer patient cases were added to the
Cancer Registry database for the Froedtert & the Medical
College of Wisconsin Kraemer Cancer Center at St.
Joseph’s Hospital campus. Of these, 422 (73 percent) were
classified as analytical.
Analytical refers to patients who have had their diagnosis
made and/or have received all or part of their first course of
treatment at St. Joseph’s Hospital. It could also mean
patients who are diagnosed elsewhere but choose to have
all or part of their treatment at St. Joseph’s Hospital. The
top 10 sites of analytical cases in order of decreasing
frequency were: breast (103), lung/bronchus-non-small cell
(52), prostate (27), non-Hodgkin lymphoma (24),
leukemia (22), bladder (22), colon (19), pancreas (15),
kidney/renal pelvis (12) and rectum/rectosigmoid (10).
Of all analytical cancer patients diagnosed and/or treated at
St. Joseph’s Hospital, 43.6 percent were male and 56.4
percent were female.
In 2015, patients seen at St. Joseph’s Hospital for diagnosis
and/or treatment of cancer ranged in age from younger
than 20 (.5 percent) to 90 and older (2.6 percent). The
majority of patients were older than 50. Most of our
patients were clustered around the age range of 60-69 (32
percent), followed by patients in the 70-79 age range (24.4
percent). Patients younger than age 50 constituted 11.2
percent of all patients.
Review of analytical patient cases by race showed that 421
of our patients were Caucasian (99.8 percent). One patient
was African-American (.2 percent).
The American Joint Commission on Cancer (AJCC)
staging system is a classification system describing the
extent of disease progression in cancer patients. It uses
the TNM scoring system: Tumor size, Lymph Nodes
affected, Metastases.
The distribution by the AJCC stage at diagnosis chart
demonstrates that for analytical cases, more than half of
patients had stage 0, I or II cancers (51.9 percent). Patients
with stage III disease represented 13.7 percent of the
analytic cases, and 17.3 percent had stage IV cancers.
AJCC staging was not applicable for 10.7 percent of
analytical cases, and 6.4 percent of patients had an
unknown stage of cancer.
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GENDER (Analytical Patient Cases)
Number
Percent
Male
184
43.6
Female
238
56.4
TOTAL
422
100
AGE AT DIAGNOSIS (Analytical Patient Cases)
Number
Percent
Under 20 years
2
0.5
20-29 years
3
0.7
30-39 years
15
3.6
40-49 years
27
6.4
50-59 years
71
16.8
60-69 years
135
32.0
70-79 years
103
24.4
80-89 years
55
13.0
90-99 years
11
2.6
TOTAL
422
100
RACE (Analytical Patient Cases)
Caucasian
African-American
TOTAL
Number
Percent
421
99.8
1
0.2
422
100
AJCC STAGE AT DIAGNOSIS (Analytical Patient Cases)
Number
Percent
Stage 0
44
10.4
Stage I
103
24.4
Stage II
72
17.1
Stage III
58
13.7
Stage IV
73
17.3
Not Applicable
45
10.7
Unknown
27
6.4
TOTAL
422
100
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Primary Sites
Top 10 Analytical Sites
Rectum and Rectosigmoid, 3%
Kidney and Renal Pelvis, 4%
Pancreas, 5%
Colon, 6%
Bladder
Breast
Colon
Kidney and Renal Pelvis
Leukemia
Lung/Bronchus-Non-Small Cell
Non-Hodgkin Lymphoma
Pancreas
Prostate
Rectum and Rectosigmoid
Breast, 34%
Bladder, 7%
Leukemia, 7%
Non-Hodgkin Lymphoma, 8%
Lung/BronchusNon-Small Cell, 17%
Prostate, 9%
Top 10 Cancer Sites by Gender
Rectum and Rectosigmoid
8
2
Kidney and Renal Pelvis
11
1
Pancreas
6
9
8
Colon
Bladder
Male
Female
11
17
5
Leukemia
9
13
12
12
Non-Hodgkin Lymphoma
27
Prostate
21
Lung/Bronchus - Non Small Cell
31
2
Breast
0
101
10
20
30
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40
50
60
70
80
90
100
Numbers per Gender
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Site Group
Total Cases
Class
Gender
Primary Cancer Sites Using AJCC Staging
Analytic
Non-Analytic
M
F
Stage
Other
Stage 0
Stage I
Stage II
Stage III
Stage IV
Unknown
N/A
HEAD AND NECK
LIP
1
1
0
0
1
0
1
0
0
0
0
0
0
TONGUE
5
4
1
4
1
0
0
0
0
1
3
0
0
SALIVARY GLANDS, MAJOR
1
1
0
1
0
0
0
0
0
0
1
0
0
GUM
2
1
1
1
1
0
0
0
0
0
1
0
0
FLOOR OF MOUTH
2
1
1
1
1
0
0
1
0
0
0
0
0
TONSIL
1
1
0
1
0
0
0
0
0
0
1
0
0
OROPHARYNX
1
1
0
1
0
0
0
0
0
0
1
0
0
HYPOPHARYNX
1
1
0
1
0
0
0
0
0
0
1
0
0
DIGESTIVE SYSTEM
ESOPHAGUS
12
8
4
9
3
0
0
0
1
2
3
2
0
STOMACH
6
5
1
4
2
0
0
0
0
1
3
1
0
SMALL INTESTINE
2
2
0
2
0
0
1
0
0
1
0
0
0
COLON
22
19
3
10
12
0
4
5
1
2
3
4
0
RECTUM & RECTOSIGMOID
13
10
3
8
5
0
1
3
0
4
0
2
0
ANUS, ANAL CANAL, ANORECTUM
1
1
0
0
1
0
0
0
0
1
0
0
0
LIVER
5
4
1
4
1
0
0
0
1
1
1
0
1
GALLBLADDER
2
2
0
1
1
0
0
0
1
0
1
0
0
BILE DUCTS
2
1
1
2
0
0
0
0
0
0
0
0
1
PANCREAS
23
15
8
14
9
0
0
2
4
2
7
0
0
RESPIRATORY SYSTEM AND THORAX
NASAL CAVITY, SINUS, EAR
2
2
0
1
1
0
0
0
2
0
0
0
0
LARYNX
1
1
0
1
0
0
0
1
0
0
0
0
0
LUNG/BRONCHUS-SMALL CELL
13
10
3
5
8
0
0
1
0
3
6
0
0
LUNG/BRONCHUS-NON SMALL CELL
66
52
14
28
38
0
1
14
5
8
21
3
0
19
HEMATOPOIETIC
LEUKEMIA
24
22
2
14
9
1
0
0
0
1
1
1
MYELOMA
8
6
2
5
3
0
0
0
0
0
0
0
6
OTHER HEMATOPOIETIC
10
7
3
4
6
0
0
0
0
0
0
0
7
4
2
2
2
2
0
0
1
0
0
0
1
0
16
10
6
13
3
0
0
6
2
2
0
0
0
120
103
17
2
118
0
22
37
27
12
5
0
0
BONE AND SOFT TISSUE
SOFT TISSUE
SKIN
MELANOMA OF SKIN
BREAST
BREAST
GYNECOLOGIC SITES
CERVIX UTERI
1
1
0
0
1
0
0
0
1
0
0
0
0
CORPUS UTERI
14
8
6
0
14
0
0
4
0
1
2
1
0
OVARY
10
8
2
0
10
0
0
1
2
2
2
1
0
VAGINA
1
1
0
0
1
0
0
0
0
0
1
0
0
VULVA
2
1
1
0
2
0
0
1
0
0
0
0
0
PROSTATE
74
27
47
74
0
0
0
5
13
2
3
4
0
TESTIS
3
1
2
3
0
0
0
0
0
0
0
1
0
GENITOURINARY SITES
BLADDER
30
22
8
24
6
0
14
4
2
0
0
2
0
KIDNEY AND RENAL PELVIS
18
12
6
15
3
0
0
6
2
2
2
0
0
URETER
2
1
1
1
1
0
0
1
0
0
0
0
0
BRAIN AND CENTRAL NERVOUS SYSTEM
BRAIN
10
5
5
5
5
0
0
0
0
0
0
0
5
OTHER NERVOUS SYSTEM
3
2
1
1
2
0
0
0
0
0
0
0
2
THYROID
11
10
1
0
11
0
0
2
3
2
0
3
0
OTHER ENDOCRINE
1
1
0
0
1
0
0
0
0
0
0
0
1
THYROID AND OTHER ENDOCRINE GLANDS
LYMPHOID NEOPLAMS
HODGKIN DISEASE
2
2
0
2
0
0
0
0
2
0
0
0
0
NON-HODGKIN LYMPHOMA
27
24
3
14
13
0
0
8
3
8
4
1
0
UNKNOWN OR ILL-DEFINED
UNKNOWN OR ILL-DEFINED
TOTAL
6
3
3
4
2
0
0
0
0
0
0
0
3
581
422
159
282
298
1
44
103
72
58
73
27
45
M = male; F = female; N/A=not applicable, UNK = unknown.
PLEASE NOTE: Tabulations for stage distribution include analytical cases only.
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Kraemer Cancer Center Cancer Annual Report – 2015 data
Glossary
Analytical
Cancer patients diagnosed and/or receiving all or part of the first course of treatment at Froedtert & MCW
St. Joseph’s Hospital.
Non-Analytical
Cancer patients at St. Joseph’s Hospital who receive care for recurrent or persistent disease, those who seek second
opinions or patients who receive care for other reasons (who cannot be classified as analytical).
Stage of Disease
Determination of the extent of disease at time of patient’s diagnosis.
TNM stage: American Joint Commission on Cancer Staging System, Seventh Edition.
• T = Size and extent of tumor
• N = Involvement of regional lymph nodes
• M = Distant metastasis
Please note: Tabulations for stage distribution include analytical cases only.
First Course of Treatment
The initial plan for tumor-directed treatment or series of treatments, usually initiated within four months after
diagnosis.
In situ
Confined to site of origin.
Abbreviations
A = analytical
N/A = non-analytical (includes patients seen for second opinion consultations)
M = male
F = female
N/A, Non-Appl/Unk = not applicable or unknown
NOS = not otherwise specified
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16
Kraemer Cancer Center Cancer Annual Report – 2015 data
A Report on Skin Cancer Screening: St. Joseph’s Hospital
More than two million cases of skin cancer will be diagnosed in the United States this year. While
melanoma is the rarest form of skin cancer, it is also the deadliest, causing more than 75 percent of skin
cancer deaths. The American Cancer Society (2015) estimated almost 74,000 new melanoma patients
would be diagnosed and about 10,000 would die from melanoma in the U.S.
Melanoma rates have increased during the last 30 years. The disease is 20 times more common in
Caucasians than in African-Americans, and the risk increases with age — the average age of onset is 62.
Melanoma incidence in Wisconsin has also increased in the past 20 years. The Wisconsin Interactive
Statistics on Health organization states, that of all the major cancers, melanoma rates increased most
dramatically from 1995 to 2012:
•. The age-adjusted melanoma incidence rate for females more than doubled from 8.5 to 20.4 per 100,000.
•. Males had higher incidence rates of melanoma, but less of an increase, from 14.7 to 25.9 per 100,000.
Skin cancer screening recommendations vary from organization to organization:
• The American Cancer Society recommends skin checks every three years between ages 20 and 40 and
yearly after age 40.
• The American Medical Association recommends that patients talk with their physicians about the
frequency of skin screening and do skin self-exams monthly.
• The U.S. Preventive Services Task Force recommends that doctors:
o B
e aware that fair-skinned individuals ages 65 and older and people with atypical moles or more than
50 moles are at greater risk for melanoma.
o L
ook for skin abnormalities when performing physical exams.
A concern with the U.S. Preventive Services Task Force guidelines is that it is based on studies done from
1999 to 2005 — when cancer rates were lower. More recent studies show the benefits of physician-directed
total body skin exams and skin self-exams.
The American Cancer Society recommends regular skin checks because with these exams, most skin cancers
can be found early. Early detection makes skin cancer easier to treat. Regular exams are most important for
people at high risk of skin cancer such as those with:
• Reduced immunity
• A personal history of skin cancer
• A family history of skin cancer
Early detection is especially important for melanoma patients because when caught early, it has a very high
survival rate. When discovered late, survival can be low as 15 percent. Survival is directly related to the
depth of the cancer at diagnosis, so the earlier it is found, the better. Skin cancers present on the skin and
are often visible to patients and providers.
Based on this data, Froedtert & the Medical College of Wisconsin St. Joseph’s Hospital offered a skin
cancer screening to the community. The two-hour screening was held in May 2016 at the Froedtert &
MCW Kraemer Cancer Center at St. Joseph’s Hospital campus. Free screenings were provided for
individuals who did not have a prior history of skin cancer and were not under the care of a physician or a
dermatologist at the time of screening. Dermatologists staffed the event and examined skin lesions such as
moles, birth marks or scaly patches for signs of cancer or pre-cancerous conditions. Based on findings,
patients were referred for additional care or biopsy.
Of the 88 participants screened, 28 were referred for follow-up and seven were referred for biopsy. The
majority of participants were ages 55 and older and Caucasian. Additional demographic data and
evaluation of the event are included in tables 1-6.
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Kraemer Cancer Center Cancer Annual Report – 2015 data
This skin cancer screening drew a large number of patients. Patients who did not have current dermatologic
care and individuals who would otherwise not have been seen were able to receive the screening. The
Froedtert & MCW health network will continue to offer skin screening and other opportunities to improve
the community’s awareness about skin cancer and other cancers.
Patients identified for further screenings have shared their appreciation for community events like skin cancer
screenings. The free screenings have been described as “lifesavers” by several patients who needed subsequent
treatment. While education surrounding the dangers of sun exposure is valuable, early detection is key and
has the added benefits of minimizing morbidity from surgery and decreasing health care costs. Cancer
screening events in local communities make it possible for more people to participate in lifesaving, early
detection initiatives.
Table 1: AGE
Percent
25-34 years
3
35-44 years
6
45-54 years
22
55-64 years
35
65 years +
34
Total
100
Table 2: RACE OR ETHNICITY
Table 4: SOURCE OF EVENT INFORMATION
Percent
Newspaper
41
Website: froedtert.com
16
Flyer
12
Other
26
No data
5
Total
100
Table 5: HOUSEHOLD INCOME
Percent
Percent
African-American
97
Less than $25,000
4
Caucasian
1
$25-50,000
29
Hispanic-American
1
$50-75,000
20
No data
1
$75-100,000
25
$100,000+
13
No data
9
Total
100
Table 3: EDUCATION LEVEL
Total
100
Percent
8th grade or less
1
High school or GED
28
Some college
36
Four-year college
22
More than four-year college
11
No data
2
Total
Table 6: SCREENING MET EXPECTATIONS
Percent
Yes
13
No
0
No data
87
Total
100
100
Froedtert Health complies with applicable federal civil rights laws and does not
discriminate on the basis of race, color, national origin, age, disability or sex.
Attention: If you speak another language, assistance services, free of charge, are
available to you. Call: 414-805-3000 (TTY: 1-800-947-3529)
Español (Spanish): ATENCIÓN: si habla español, tiene a su disposición servicios
gratuitos de asistencia lingüística. Llame al: 414-805-3000 (TTY: 1-800-947-3529)
Hmoob (Hmong): LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus,
muaj kev pab dawb rau koj. Hu rau: 414-805-3000 (TTY: 1-800-947-3529)
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18