Download Annual Progress Report for Cancer Center-2012

Annual Report 2011
Incorporating 2010 Statistical Data
Julie & Ben Rogers Cancer Institute
3555 Stagg Drive
Beaumont, Texas 77701
409-212-5922
[email protected]
Charline & Sidney “Chief” Dauphin
Cancer Screening & Prevention Center
740 Hospital Drive, Suite 140
Beaumont, Texas 77701
409-212-7950
[email protected]
MISSION STATEMENT
The Cancer Committee of the Baptist Cancer Center at Baptist
Beaumont Hospital provides operational oversight for the provision of
patient care related to inpatient and outpatient oncology services. It is
the mission of the Cancer Committee to ensure patient care is provided
in a manner consistent with the needs of the communities we serve and
in keeping with the mission of Baptist Hospitals of Southeast Texas…
Performing Sacred Work Every Day. The Cancer Committee is developed
with multidisciplinary structure to review patient care practices and
treatment protocols with consideration for the continuum of needs of the
patient and their family. Excellence will be achieved and sustained
through accreditation as a Community Hospital Comprehensive Cancer
Program, adapting to the changing needs of the community, on-going
review of established quality metrics, setting and achieving operational
goals, engaging in research initiatives and adopting the latest
advancements in cancer treatment and technology.
ANNUAL REPORT
2011
TABLE OF CONTENTS
2011 Cancer Committee Members…………………………………………………………………3
Cancer Program Services…………………………………………………………………………..4
Chairman’s Report………………………………………………………………………………….5
Administrator’s Report……………………………………………………………………………..6
Year in Review: A Foundation for the Future……………………………………………………..7
Quality Assurance………………………………………………………………………………….10
Cancer Registry Report…...…………………...………………………………………………….11
Breast Cancer Analysis……………………………………………………………………………14
Lung Cancer Analysis……………………………………………………………………………..15
Community Involvement………………………………………………………………………….16
The Future of Cancer Care………………………………………………………………………..22
2011 CANCER COMMITTEE MEMBERS
Committee Co-Chairs:
Reconstructive Surgery
Oncology Navigator:
Pastoral Care:
Dr. Garrett Peel
Dr. Mark Larson
Jaylene Carr
David Cross
Dr. Gwen Lavalais
Pathology:
Oncology Nurse:
Psychiatry:
Physician Liaison:
Dr. Jason Matherne, Group
Asela Balingit
Dr. Lisa Doguet
Dr. Gwen Lavalais
Administrator:
Social Worker / Case Manager:
Rehabilitative Medicine:
Radiologist:
Todd Senters
Katara Goings
Bryan Caillier
Dr. Dan Karnicki / Group
Operations Director:
Tumor Registrar:
Marketing:
General Surgeon:
Kristen Lindsey
Jennifer Janise
Mary Poole
Dr. Kevin Dean
Community Involvement:
Foundation:
Medical Oncology:
Jim Rich, Kristen Barrs
Quality /
Performance Improvement:
Dr. Sanjay Ayirookuzhi
American Cancer Society:
Dr. Ashok Malani
Tammy Droste, Kathy Chessher
Dr. Rama Chandran
JBRCI Clinical Director:
Dr. John Field, Laurel Shrontz
Radiation Oncology:
Pam Caldwell
Dietitian / Nutrition:
Dr. Mark Bonnen
Inpatient Oncology
Mary Ellen Vivrett
Dr. Dan Garlitos
Clinical Director
Pharmacy:
Surgical Oncology:
Pat Morrell
Dr. Theresa Waugh
Dr. Garrett Peel
Erin Domingue
Dr. Bonnie Labdi
Lisa Torok, Mary Tate
Pain Management /
Palliative Care:
Sacred Work In Action….
Kristie Young
Genetic Counseling /
Community Education:
Dr. Gwendolyn Lavalais
Irene Ramirez
Hospice / Long-Term Care:
Tammy Hanson, Joe Chapman
Committee Secretary:
Brandy Walling
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BAPTIST CANCER CENTER PROGRAM SERVICES
Baptist Cancer Center offers comprehensive services at
the Julie & Ben Rogers Cancer Institute, the Charline &
Sidney “Chief” Dauphin Cancer Screening & Prevention
Center, and Baptist Hospitals of Southeast Texas. The
Cancer Center houses medical and radiation oncology,
physician offices, infusion and treatment areas,
mammography, cancer prevention
and screening
education, and inpatient oncology including access to an
oncology social worker and oncology patient navigators.
Genetic Counseling
Inpatient Oncology
The Radiation Oncology Department offers a full range of
cutting edge services under the expert direction of board
certified radiation oncologists. Treatment is delivered using a
variety of modalities.
Located on the 2nd floor at Baptist Beaumont Hospital, the
inpatient unit offers a calm, quiet setting. The unit is staffed
with experienced oncology nurses who work closely with the
Julie & Ben Rogers Cancer Institute to promote ready access
to patient cancer services offered on site.
Breast Health
The Charline & Sidney “Chief” Dauphin Cancer Screening &
Prevention Center offers a coordinated approach to breast
health with services in preventative care, early detection,
diagnostic mammography utilizing digital technology,
ultrasound, breast MRI, stereotactic biopsy, ultrasound –
guided biopsy, sentinel node biopsy, digital done
densitometry, and personalized genetic testing and
counseling.
Baptist Breast Cancer Navigator
A certified oncology professional and patient advocate works
with each patient who has a suspicious mammogram. She
consults with the patients and families to allay their fears and
explains further testing or studies that might be needed. She is
a shoulder to lean on for support and comfort, reassuring our
patients.
Dedicated Breast Surgeons
The Baptist Cancer Center collaborates a detailed,
individualized plan of care with highly trained and dedicated
breast surgeons who specialize in minimally invasive
technology.
4
Available at the Charline & Sidney “Chief” Dauphin Cancer
Screening & Prevention Center, our genetic program offers
cancer risk assessment, and genetic testing for those at high
risk of breast, ovarian, colorectal, melanoma and numerous
other related cancers.
Radiation Oncology
and decreasing any surrounding tissue damage. With SBRT
we can deliver a single, high-dose radiation treatment so
patients are often able to complete their therapy in a shorter
time-frame than traditional radiation therapy.
Seed Brachytherapy
Prostate seed implants deliver a high dose of radiation to
malignant prostate tissue and limit exposure to surrounding
organs. Tiny radioactive pellets called “seeds” are implanted
directly into the prostate, minimizing the dose of radiation to
the bladder and rectum. The use of ultrasound guidance
ensures accurate seed implantation and effective distribution.
PET/CT
Intensity-Modulated Radiation Therapy (IMRT)
A computer-controlled x-ray technology to deliver precise
radiation doses to tumors with minimal complications for
surrounding healthy tissue.
Image-Guided Radiation Therapy (IGRT)
Provides an image by the use of cone beam CT just before the
delivery of radiation, which enables radiation oncologists to
verify the exact location of the tumor, allowing higher and
precise dosing of radiation to the tumor site.
High Dose Rate Brachytherapy
HDR treatments offers a substantial reduction in overall
treatment time combined with the ability to treat cancers from
within specific tumor sites, as opposed to delivery of external
radiation therapy. This technique translates to lower toxicity
to normal structures and organs and is a proven benefit for
certain patient’s with breast, cervical, and lung cancer. HDR
is commonly used to treat women who are candidates for
breast conservation therapy through the use of a balloon
catheter, administering radiation over a significantly reduced
time period.
Stereotactic Body Radiation Therapy (SBRT)
Is a form of radiation therapy treating tumors in the lungs,
liver, pancreas, spine and other areas of the body with
pinpoint accuracy. SBRT uses custom mapping to account for
a patient’s anatomy, breathing, and organ motion pinpointing
the exact location of even the smallest tumor, sparing organs
For convenience of care, the Julie & Ben Rogers Cancer
Institute offers on-site wide bore computed tomography (CT)
for the radiologists to customize patient treatment positions
for radiation therapy. Diagnostic imaging is also offered onsite.
Outpatient Chemotherapy Infusion
Located at the Julie & Ben Rogers Cancer Institute, the
outpatient chemotherapy infusion suite offers chemotherapy,
blood transfusions, IV fluid and administration along with
education to meet a variety of needs for our cancer patients
and families. Our facility is staffed with experienced
oncology nurses and nationally certified (OCN) nurses.
Clinical Research
Baptist Cancer Center partners with research experts to
provide our patients the option to participate in clinical trails.
Clinical trials offer access to FDA approved medication for
tumor sites.
Cancer Registry
Baptist Cancer Center has dedicated personal and a certified
cancer registrar that collect and analyze statistical data
including the report of cancer incidence, treatment method
and the quality of survival. This registry data is acquired
through the medical record following state and national
guidelines.
CHAIRMAN’S REPORT
The Cancer Center at Baptist Beaumont Hospital continues to offer its patients modern and up-to-date treatments in cancer care. Cancer care
policies and standards are directed through our Cancer Committee, formed in January 2011. This year was an inaugural year for us on our
path toward accreditation through the American College of Surgeons Commission on Cancer, and the National Accreditation Program for
Breast Centers.
This year the Committee has also set forth a comprehensive set of policies and standards for our cancer programs to ensure full compliance
and accreditation.
Patients and families are treated using a multi-disciplinary approach. This includes specialists in medical oncology, cancer surgery, radiation
oncology, radiology and palliative care and pain management. In addition dedicated staff members in nursing, pharmacy, nutrition, quality
improvement, rehabilitation, palliative care, administration and marketing, research, genetic counseling, chaplain services and pediatrics play
a vital role in caring for the physical, emotional and spiritual needs of our patients.
The 2011 Annual Report outlines the accomplishments and activities of our Cancer Center Program for the year, and provides statistical
information about our patient’s treatment during the year 2010. Several notable accomplishments marked our successful year:
Establishment of a comprehensive breast cancer diagnostic, treatment and genetic counseling center at the Charline & Sydney “Chief”
Dauphin Cancer Screening & Prevention Center.
Establishment of a Cancer Navigator Program with the addition of two new clinical certified nurse navigators
Voluntary participation in the Quality Oncology Practice Initiative through the American Society of Clinical Oncology
Recruitment of three new board-certified medical oncologists
Recruitment of a new breast cancer surgeon
Establishment of a palliative care program
Growth of the most comprehensive and modern radiation oncology program in Southeast Texas, to include recruitment of an additional board- certified radiation oncologist
Expansion of cancer surgical services at Baptist Beaumont Orange Hospital
Expanded community outreach through partnerships with community agencies to raise cancer awareness, promote screening activities and encourage and foster prevention
Ongoing financial support to increase access to screening mammography
As our Cancer Center Program continues to grow, the Cancer Committee at Baptist Beaumont Hospital strives to ensure our patients receive the highest quality care in a patient-first
environment.
Garrett K. Peel, MD, MHS
Chairman
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ADMINSTRATOR’S REPORT
2011 was an incredibly active year
for the Baptist Cancer Center. The
year started off with a ribbon-cutting
ceremony to launch the opening of
the breast special procedures suite at
the Charline & Sidney “Chief”
Dauphin Cancer Screening &
Prevention Center. With this
addition, the Dauphin Center added a
second
mammography
suite,
equipped with GE’s state-of-the-art
Essential mammography platform. For the first time at
Baptist Hospitals, women are able to receive
comprehensive breast care “under one roof,” including
digital mammography, breast ultrasound, ultrasoundguided and stereotactic breast biopsy and genetic
counseling. This event marked a transformational shift
for the Dauphin Center and launched a truly
comprehensive breast imaging department.
At the end of January, Baptist Hospitals hosted our
annual black-tie Gala, La Soiree, with proceeds wholly
dedicated to enhancing technology and services at the
Baptist Cancer Center. This event was truly special, as
former-Mayor, Evelyn M. Lord, was recognized with the
inaugural Baptist Hospitals of Southeast Texas
Humanitarian of the Year Award, which was named in
her honor.
Mayor Lord, and her husband Dr. Sam Lord, have been
very active on many civic boards and have developed a
Foundation and trust to carry on their works well into
the future. Most specifically, Mayor Lord has served as
the spokesperson for the Dauphin Center, since its
inception. I have had the honor and privilege of cohosting numerous media and public forum events with
her, as she has passionately advocated for annual cancer
screening. With a voice that commands attention and
respect, Mayor Lord has implored women, in particular,
to lead the find against cancer. She is a true champion
for the cause and a very worthy recipient of this
recognition.
Baptist Hospitals of Southeast Texas was pleased to
continue our relationship in 2011 with the Julie Rogers
“Gift of Life” Program. Through our partnership, we
were able to provide over 1,200 mammograms for
uninsured and under-insured women. The significance of
this partnership was enhanced through the development
6
of a partnership with the University of Texas Medical
Branch at Galveston and the Jasper-Newton Health
Authority; both grant recipients through the Texas
Breast and Cervical Medicaid Program. These
relationships provided us with the opportunity to
diagnose and treat women with breast and GYN cancers,
who would otherwise have had to travel a significant
distance to receive care.
In February, the physicians and staff of the Baptist
Cancer Center in conjunction with “Gift of Life,”
volunteered to perform PSA lab tests and general health
screenings, which included blood pressure checks and
fasting blood sugar analysis. Over 200 men participated
in this event which was held throughout the month at
Baptist Beaumont Hospital, Baptist Orange Hospital and
Lamar State College – Port Arthur. We also held these
events in June, in recognition of Father’s Day, and in
September for Prostate Cancer Awareness Month. In
total, over 600 men were screened for prostate cancer in
2011, through these efforts.
In early 2011, cancer services leaders were gathered
around the table to plan the strategic direction for our
service line. A key initiative was the formation of a
breast cancer support group. This vision took shape over
the course of several months and in August; the Pink
Power Network was launched, in partnership with a
steering committee of breast cancer survivors from the
“Gift of Life.” A launch party was held at the Eleganté
Hotel, where over 500 civic leaders, dignitaries, cancer
survivors, family members and care-givers gathered to
celebrate life and survivorship. Dr. Garrett Peel,
chairman of the Cancer Committee at Baptist Hospitals
and a breast surgeon, and Dr. Mark Larson, a
reconstructive surgeon, delivered the keynote addresses.
A moment not soon forgotten was a spirited address by
cancer patient, Carrie Bud Naas. Though she would soon
lose her battle with Stage IV, Triple-Negative breast
cancer, Carrie spoke about the importance of living for
today and being an advocate for those diagnosed with
cancer. Her words were emotional and full of life. Her
passion to pursue a cure for cancer lives on in everyone
she touched. This was truly a monumental event for our
program and for the people of Southeast Texas.
breast cancer awareness. We attend 5K walk/runs
screening events, mammography day celebrations and
spoke to thousands of individuals across the region
about the importance of being screened for cancer. As
exhausting as this two-month stretch can be, it is
incredibly rewarding to know you may have reached
someone who would otherwise have been unaware they
were at risk for developing cancer. Even one life saved,
makes the effort worthwhile.
With the year drawing to a close, we marked the oneyear anniversary of implementing the Breast Patient
Navigator Program at the Dauphin Center. Our certified
breast navigator, Jaylene Carr, who was a finalist for
Baptist Beaumont Hospital Employee of the Year for
2011, was so successful in implementing this program,
that we began discussions on how to expand the program
to include all diagnosed malignancies. Jaylene’s role
was expanded to include breast and GYN cancers.
Veteran oncology nurse, Julia Dugan, transitioned from
being a nurse in the medical oncology clinic to
becoming the nurse navigator for all other cancer
patients.
The Baptist Cancer Center at Baptist Beaumont Hospital
is continuing our commitment to the men and women of
our community who are diagnosed with cancer. As we
head into 2012, we are moving forward by providing a
patient and family-friendly healing environment at the
Cancer Institute. New furniture, art work and wood
flooring greet you as you walk through our doors. The
compassionate cancer care you receive will let you know
you made the right choice to receive your care at Baptist
Hospitals. In early 2012 we will become the first facility
in the region to offer body stereotactic radiosurgery.
Deemed the future of radiation oncology, this
technology will allow more precise treatment of tumors
than ever before. Later in the year, we plan to add breast
tomosynthesis at the Dauphin Center. This technology
will aid the detection of breast cancer by providing the
most sensitive 3-dimensional mammographic imaging
available. At the Baptist Cancer Center, we remain the
regional leaders in cancer care services. The reason why
is clear… our patients. The care we provide today helps
ensure you are here to see many more tomorrows.
Todd A. Senters, FACHE
As the blue of September transitioned to the pink of
October, our staff and physicians canvassed the
community and the airwaves to talk about prostate and
The Year in Review:
A Foundation for the Future
The world of cancer care is ever-changing and
Southeast Texas is no exception. The Baptist Cancer
Center has seen a year of many changes. In late 2010,
we welcomed two new medical oncologists to the
center, Dr. Sanjay Ayirookuzhi, who is board-certified
in medical oncology and hematology and Dr. Ashok
Malani, who is board-certified in medical oncology.
We also said goodbye to three highly-regarded
oncologists, Dr. Gloria Castro-Zappia, Dr. Gwendolyn
Lavalais and Dr. Subbayah T. Ramachandran, who all
retired from full-time practice. We were fortunate that
Dr. Gwen Lavalais agreed to remain involved as the
program’s Commission on Cancer Liaison Physician
and Co-Chair of the Cancer Committee. She also
oversees the genetics program at the Charline & Sidney
“Chief” Dauphin Cancer Screening & Prevention
Center.
In 2011 Dr. Garrett K. Peel, a Mayo Clinic-trained
surgeon, assumed the role of Co-Chairman of the
Cancer Committee, Division Chief of Surgical
Oncology and Medical Director of the Charline &
Sidney “Chief” Dauphin Cancer Screening &
Prevention Center. Dr. Peel was trained at the Mayo
Clinic to provide state-of-the-art breast and colorectal
cancer surgery and is the only surgeon in the region
who performs skin-sparing and nipple-sparing
mastectomies and partners with local plastic surgeons
to perform immediate reconstruction. Under Dr. Peel
and Dr. Lavalais’ leadership, the Cancer Committee at
Baptist Beaumont Hospital laid the foundation to bring
the oncology program into the twenty-first century.
The beginning of 2011 also saw changes in nursing
leadership with the addition of Pamela Caldwell at the
Julie & Ben Rogers Cancer Institute and Erin
Domingue on the inpatient oncology unit. Pam brings
years of experience in both inpatient and outpatient
cancer care to her role as clinical director of the Cancer
Institute. She has both a Bachelor’s and Master’s in
nursing, and possesses dual certification in oncology
nursing and in pain management. Erin has a Bachelor’s
Degree in nursing and has a wealth of knowledge and
experience in cancer care and palliation.
In a world of transition and change it is essential to
evaluate where the program has been and, more
importantly, where the program is going. At the
beginning of 2011, the Baptist Cancer Center
implemented a patient navigation program focused on
providing support for patients who have a suspicious
mammogram or have been diagnosed with breast
cancer. The Dauphin Cancer Screening & Prevention
Center welcomed Jaylene Carr, a certified breast
patient navigator and registered mammographer, who
assumed responsibility for developing this program.
Jaylene worked to develop relationships with local
physicians to establish a care network for newly
diagnosed breast cancer patients, which enables
patients with a cancer diagnosis to be seen by a surgeon
and oncologist and begin treatment as soon as possible.
In looking towards the future, the Baptist Cancer
Center established a comprehensive breast care
program at the Dauphin Center. This expansion
included the addition of a breast special procedure suite
equipped with GE’s Essential mammography platform
and stereotactic breast biopsy unit. The “Essential”
platform will be upgradable to provide Breast
Tomosynthesis, once this technology is approved by
the FDA.
Baptist Beaumont Hospital resides in a primary and
secondary market totaling over 500,000 people. Many
of these individuals reside in communities underserved
with health care services. To better provide cancer care
for these individuals, The Baptist Cancer Center
developed referral relationships with the JasperNewton Health Authority and the University of Texas
Medical Branch at Galveston to provide care for
patients who are recipients of Breast and Cervical
Medicaid through the State of Texas. Additionally, we
have expanded our relationship with our long-time
community partner, the Julie Rogers “Gift of Life”
Program, to provide treatment for underserved women
diagnosed with breast cancer. The growth of breast care
volume led to the need for a dedicated, certified breast
ultrasonographer to accommodate the increase in
demand for breast ultrasound and ultrasound-guided
breast biopsies.
With the changes at the Baptist Cancer Center, our
vision remains focused on providing technologicallysophisticated cancer care for the communities we serve.
In keeping with our mission, we strive to educate,
empower and support our patients and their families
throughout their cancer journey. The journey towards
survivorship is a walk filled with strength, courage and
hope. The investments we have made to be at the
forefront of technology are an investment in the health
and wellbeing of our community. Every step along the
way we will continue our commitment to Performing
Sacred Work Every Day.
Background photo: Baptist Cancer Center staff
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OUR NATIONALLY CERTIFIED ONCOLOGY NURSES (OCN)
Baptist Cancer Center recognizes that nurses demonstrate commitment and
specialized knowledge in cancer patient care. Oncology Certification through the
National Oncology Nursing Society enhances professional practice and patient care.
Certification validates our oncology nurse’s knowledge and skills while increasing
self-confidence. In turn, patients recognize that certification in oncology is diverse
and challenging, requiring highly knowledgeable, dedicated and motivated nurses. A
patient’s level of trust and confidence in their nurse’s ability to care for them is
essential to their treatment plan and outcome.
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OUR ONCOLOGY PATIENT NAVIGATORS
Because the staff at Baptist Cancer Center understands how overwhelming a diagnosis of
cancer can be, our Center offers the compassionate expertise of Oncology Patient
Navigators; dedicated medical professionals who assist patients and their families in
finding their way through the complex health care system. The Charline & Sidney “Chief”
Dauphin Cancer Screening & Prevention Center at the Baptist Cancer Center is fortunate
to have a highly skilled Navigator, who has succeeded in obtaining national certification
through the National Consortium of Breast Centers, Inc. She is also responsible for
assisting patients who have been
diagnosed with a gynecological
cancer. In late 2011, the Baptist
Cancer Center added a nurse
Navigator dedicated to assisting
patients who have been diagnosed
with all other forms of cancer.
Fully committed to eliminating
barriers to diagnosis and treatment,
our Navigators ensure that every
person with a suspicious finding
receives a timely diagnosis, begins
appropriate treatment as early as
possible, and fully understands their
treatment options and personalized
plan of care.
During this challenging time in a
patient’s life, our Oncology Patient
Navigators offer numerous vital
services for the newly diagnosed
patient and their family, which
incl udes provi di ng educati on,
initiating referrals, scheduling biopsies
and other procedures, updating
patients on test results, and facilitate
access to support groups.
Baptist Hospitals recognize that
encouragement and emotional support
are essential to survivorship.
Combining specialized knowledge and
expertise with focused support and
compassion, our Oncology Patient
Navigators truly embody our “Sacred
Work”. Embracing a caring Christian
e n vi r o n me n t , o ur N a v i g a t o r s
completely redefine the oncology
patient experience and ensure quality
outcomes by skillfully nurturing the
patient and walking alongside them on
their cancer journey.
9
QUALITY ASSURANCE
Quality is one of the most critical elements of
reaching a successful treatment outcome. In order to
remain the regional leader in cancer care, it is
necessary we focus our efforts on evidence-based
practices in our pursuit of excellence.
Focus on Cancer-related Pain:
In 2011, the Baptist Cancer Center focused on
assessment, evaluation, documentation and
management
of
cancer-related pain.
Performance
Rating
Performance was
Metrics
evaluated through
Description of Pain
an audit of patient
Documented on
91.0%
pain assessments,
Initial Assessment
with the findings, as
follows:
0-10 Pain Scale
Documented on
Initial Visit
Pain Documented
on Follow Up Visit
83.0%
86.0%
The Baptist Cancer Center, in late 2011, developed a
relationship with the National American Society of
Clinical Oncology (ASCO), through the Quality
Oncology Practice Initiative (QOPI) program, in an
effort to further ensure the delivery of the highest
quality of care. QOPI enables our cancer team to
intensely examine the quality of care we provide for
our patients and to make certain our protocols and
practices are founded on evidence-based guidelines
and established through evaluation of quality
measures.
At the Baptist Cancer Center, trust is at the pinnacle
of all we do. Our patients entrust us with their lives
when they are at their most vulnerable. For this
reason, it is imperative that we achieve and sustain
the highest quality of care.
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QOPI was developed by world-renowned practicing
oncologists and quality experts, using clinical
guidelines and published standards, such as the
National Initiative on Cancer Care Quality (NICCQ),
ASCO/NCCN Quality Measures, and ASTRO/
ASCO/AMA PCPI Oncology Measures.
QOPI standards are evaluated by the Cancer
Committee at Baptist Beaumont Hospital based on
the ASCO/Oncology Nursing Society (ONS)
Chemotherapy Administration Safety Standards,
which address:
Treatment planning
Excellence in staff training and education
Chemotherapy orders and drug preparation
Patient consent and education
Safe chemotherapy administration
Monitoring and assessment of patient well-being
QOPI is a commitment to the patient, by
participating in QOPI, our practice demonstrates we
are striving to improve the medical and psychosocial
care our patients receive. QOPI promotes excellence
in cancer care by helping the Baptist Cancer Center
create a culture of self-examination and
improvement.
2012 Quality Goals
Established by the Baptist Cancer Committee:
Implement a patient treatment summary to help
improve documentation and coordination of
cancer treatment and survivorship care and to
facilitate provider-to-provider and provider-topatient communication of care provided during
patient treatment.
Incorporate increased tobacco cessation
education for patients.
Implement standardized education for
chemotherapy including oral regimens.
Expand oncology patient navigation program to
include an integrated patient survivorship care
plan.
CANCER REGISTRY
The Cancer Registry Department at Baptist Hospital of Southeast Texas has cancer data back to
2002. The function of the cancer registry is to collect data on occurrence of cancer (incidence),
types of cancer (site and histology), disease spread (stage), treatment rendered and outcomes/
survival. The accuracy of data is ensured through quality reviews under the supervision on the
Cancer Committee.
INCIDENCE
For the calendar year 2010 there were 726 newly diagnosed cancer cases at Baptist Cancer
Center. The most common malignancies diagnosed was lung cancer, with 17.9 percent. This
was followed closely by breast cancer with 15 percent. Prostate cancer ranked third with 14.3
percent, colorectal was fourth with 11.5 percent., pancreatic cancer was fifth with 14.2 percent.
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SUMMARY OF 2010 CANCER CASES
Sex
Status
Stage Distribution-Analytical Cases Only
Total (%)
M
F
Analy
NA
Alive
Expired
0
I
II
III
IV
88
Unk
ORAL CAVITY & PHARYNX
19 (2.6%)
16
3
12
7
12
7
0
2
1
1
6
0
2
Lip
1 (0.1%)
1
0
1
0
1
0
0
1
0
0
0
0
0
Tongue
6 (0.8%)
5
1
4
2
5
1
0
1
1
0
1
0
1
Floor of Mouth
1 (0.1%)
0
1
1
0
1
0
0
0
0
1
0
0
0
Gum & other Mouth
2 (0.3%)
2
0
1
1
2
0
0
0
0
0
0
0
1
Nasopharynx
1 (0.1%)
1
0
0
1
1
0
0
0
0
0
0
0
0
Tonsil
3 (0.4%)
3
0
3
0
2
1
0
0
0
0
3
0
0
Oropharynx
1 (0.1%)
1
0
1
0
0
1
0
0
0
0
1
0
0
Hypopharynx
2 (0.3%)
2
0
1
1
0
2
0
0
0
0
1
0
0
Other Oral Cavity & Pharynx
2 (0.3%)
1
1
0
2
0
2
0
0
0
0
0
0
0
150 (20.7%)
88
62
114
36
98
52
4
18
15
25
33
3
16
Esophagus
6 (0.8%)
5
1
5
1
4
2
0
0
1
0
2
0
2
Stomach
9 (1.2%)
7
2
4
5
4
5
0
1
0
1
2
0
0
Small Intestine
1 (0.1%)
1
0
1
0
1
0
0
0
0
1
0
0
0
Colon Excluding Rectum
57 (7.9%)
31
26
50
7
47
10
2
12
8
14
12
0
2
Cecum
10
2
8
9
1
10
0
0
2
3
4
0
0
0
Ascending Colon
8
4
4
8
0
6
2
0
1
0
4
3
0
0
Hepatic Flexure
8
6
2
7
1
8
0
0
2
2
3
0
0
0
Transverse Colon
6
4
2
6
0
6
0
1
2
1
0
2
0
0
Splenic Flexure
3
1
2
3
0
3
0
1
1
0
1
0
0
0
Descending Colon
5
4
1
5
0
3
2
0
1
1
0
3
0
0
Sigmoid Colon
11
8
3
10
1
8
3
0
3
0
2
3
0
2
Large Intestine, NOS
6
2
4
2
4
3
3
0
0
1
0
1
0
0
Rectum & Rectosigmoid
26 (3.6%)
14
12
15
11
24
2
2
2
3
3
3
0
2
Rectosigmoid Junction
7
5
2
5
2
7
0
0
1
2
2
0
0
0
Rectum
19
9
10
10
9
17
2
2
1
1
1
3
0
2
Anus, Anal Canal & Anorectum
3 (0.4%)
1
2
3
0
1
2
0
0
0
1
0
0
2
Liver & Intrahepatic Bile Duct
9 (1.2%)
6
3
3
6
3
6
0
1
1
0
0
0
1
Gallbladder
1 (0.1%)
0
1
1
0
0
1
0
0
0
0
0
1
0
Other Biliary
5 (0.7%)
4
1
4
1
1
4
0
0
0
1
0
2
1
Pancreas
30 (4.1%)
18
12
25
5
10
20
0
0
2
4
14
0
5
Retroperitoneum
2 (0.3%)
1
1
2
0
2
0
0
2
0
0
0
0
0
Peritoneum, Omentum & Mesentery
1 (0.1%)
0
1
1
0
1
0
0
0
0
0
0
0
1
135 (18.6%)
79
56
108
27
71
64
0
10
10
20
59
0
9
5 (0.7%)
5
0
3
2
2
3
0
0
1
0
2
0
0
130 (17.9%)
74
56
105
25
69
61
0
10
9
20
57
0
9
1 (0.1%)
1
0
1
0
0
1
0
0
0
0
1
0
0
DIGESTIVE SYSTEM
RESPIRATORY SYSTEM
Larynx
Lung & Bronchus
SOFT TISSUE (including Heart)
12
Class of Case
Primary Site
SUMMARY OF 2010 CANCER CASES CONTINUED
SEX
Class of Case
Status
Stage Distribution-Analytical Cases Only
Primary Site
Total (%)
M
F
Analy
NA
Alive
Expired
0
I
II
III
IV
88
Unk
SKIN, Exluding Basal & Squamous
8 (1.1%)
6
2
3
5
6
2
0
0
0
1
1
0
1
8 (1.1%)
6
2
3
5
6
2
0
0
0
1
1
0
1
BREAST
109 (15.0%)
3
106
87
22
99
10
7
32
19
13
8
0
8
FEMALE GENTIAL SYSTEM
29 (4.0%)
0
29
15
14
24
5
0
3
2
3
2
0
5
Cervix Uteri
8 (1.1%)
0
8
5
3
4
4
0
0
3
0
0
0
2
Corpus Uteri
8 (1.1%)
0
8
4
4
8
0
0
2
2
0
0
0
0
Corpus Uteri
4
0
4
3
1
4
0
0
1
2
0
0
0
0
Uterus, NOS
4
0
4
1
3
4
0
0
1
0
0
0
0
0
12 (1.7%)
1 (0.1%)
0
0
12
1
6
0
6
1
11
1
1
0
0
0
1
0
0
0
0
0
2
0
0
0
3
0
108 (14.9%)
107
0
83
25
98
10
0
10
54
10
6
0
3
104 (14.3%)
4 (0.6%)
103
4
0
0
80
3
24
1
94
4
10
0
0
0
8
2
54
0
10
0
6
0
0
0
2
1
Melanoma-Skin
Ovary
Vulva
MALE GENITAL SYSTEM
Prostate
Testis
41 (5.6%)
26
15
35
6
35
6
11
10
2
4
7
1
0
Urinary Bladder
URINARY SYSTEM
17 (2.3%)
15
2
15
2
15
2
10
1
1
1
2
0
0
Kidney & Renal Pelvis
Ureter
23 (3.2%)
1 (0.1%)
10
1
13
0
19
1
4
0
19
1
4
0
0
1
9
0
1
0
3
0
5
0
1
0
0
0
10 (1.4%)
7
3
3
7
9
1
0
0
0
0
0
3
0
4 (0.6%)
6 (0.8%)
4
3
0
3
1
2
3
4
3
6
1
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
10 (1.4%)
3
7
9
1
9
1
0
4
1
0
0
3
1
7 (1.0%)
3 (0.4%)
0
3
7
0
6
3
1
0
7
2
0
1
0
0
4
0
1
0
0
0
0
0
0
3
1
0
BRAIN & OTHER NERVIOUS SYSTEM
Brain
Cranial Nerves, Other Nerves
ENDOCRINE SYSTEM
Thyroid
Other Endocrine
27 (3.7%)
10
17
19
8
21
6
0
2
0
3
11
0
3
Hodgkin Lymphoma
LYMPHOMA
1 (0.1%)
0
1
1
0
1
0
0
0
0
1
0
0
0
Non-Hodgkin Lymphoma
26 (3.6%)
10
16
18
8
10
6
0
2
0
2
11
0
3
20
6
8
2
12
4
14
4
6
2
16
4
4
2
0
0
0
2
0
0
2
0
9
2
0
0
3
0
0
NHL-Nodal
NHL-Extranodal
MYELOMA
12 (1.7%)
5
7
5
7
8
4
0
0
0
0
0
5
LEUKEMIA
19 (2.6%)
12
7
10
9
14
5
0
0
0
0
0
10
Lymphocytic Leukemia
13 (1.8%)
10
3
5
8
10
3
0
0
0
0
0
5
0
Acute Lymphocytic Leukemia
4
4
0
1
3
4
0
0
0
0
0
0
1
0
Chronic Lymphocytic Leukemia
9
6
3
4
5
6
3
0
0
0
0
0
4
0
Myeloid & Monocytic Leukemia
6 (0.8%)
2
4
5
1
4
2
0
0
0
0
0
5
0
Acute Myeloid Leukemia
4
0
4
3
1
3
1
0
0
0
0
0
3
0
Acute Monocytic Leukemia
Chronic Myeloid Leukemia
1
1
1
1
0
0
1
1
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
TOTAL
MESOTHELIOMA
1 (0.1%)
1
0
1
0
0
1
0
0
0
0
0
0
MISCELLANOUS
47 (6.5%)
25
22
30
17
27
20
0
0
0
0
0
30
0
726
389
387
535
191
531
195
22
91
104
80
135
55
48
13
SUMMARY OF 2010 BREAST CANCER CASES
14
SUMMARY OF 2010 LUNG CANCER CASES
15
Recognizing the need to improve access to
comprehensive quality health care for all, Baptist Cancer
Center invests significant time and resources to network
with our local communities, including the underserved
population, to educate and promote best practices that
enable healthy living.
Annually, through a close, collaborative relationship
with the Julie Rogers “Gift of Life” Program, the Baptist
Cancer Center provides access to quality healthcare,
including education and screening, to an underserved
population that would otherwise receive limited care.
Over the course of three successive weekends in
February, June and September, the Baptist Cancer
Center offers annual prostate screenings to uninsured or
underinsured men in our community. Volunteer
phlebotomists, nurses, and medical oncologists from the
Baptist Cancer Center provided PSA’s (prostate specific
antigen) and education to approximately 600 men
throughout the Golden Triangle at events held in
Beaumont, Port Arthur and Orange.
The Charline & Sidney “Chief” Dauphin Cancer
Screening & Prevention Center in conjunction with our
sister hospital in Orange, offers mammograms to those
uninsured or underinsured, and performed over 1,200
mammograms in 2011.
Throughout the year, the Baptist Cancer Center
participates in numerous educational outreach programs,
on a variety of cancer- related topics, to diverse
community groups including schools, civic and
government organizations, businesses and industry. To
facilitate learning, educational presentations are highly
interactive, and utilize an assortment of resources
including open discussion, simulators, visual aids,
anatomical models, hands-on demonstrations and printed
literature.
A small sampling of 2011 activities includes:
Tobacco cessation classes, facilitated by a certified
tobacco cessation specialist, were offered throughout the
year at the Dauphin Center. Based upon the American
Cancer Society’s “Fresh Start” Program, four
interactive, one-hour weekly classes are available to
patients and their families, employees and the Southeast
Texas community at large.
A tobacco awareness educational program, linking
various forms of cancer and diseases to tobacco use, was
presented to students at Smith Middle School.
Prevention and avoidance strategies are a major focus of
these types of tobacco awareness programs.
The Kick Butts Campaign, an annual community-wide
American Cancer Society anti-tobacco educational
program which encourages tobacco cessation, was held
at Lamar University.
An annual prostate cancer awareness presentation
educated employees of the City of Port Neches Public
Works Department regarding risk factors, screening
guidelines and treatment modalities.
Baptist Cancer Center nurses conducted numerous
interactive breast cancer awareness presentations to a
variety of civic organizations focusing on risk reduction,
various screening methods, cancer treatment modalities
and survivorship. Open discussion, visual aids and
educational literature were utilized to facilitate learning.
The Orange County and Chambers County Health Fairs,
annual events for county employees provided another
opportunity to educate participants about different types
of cancer, risk reduction and treatment modalities.
At a health fair setting, Spindletop MHMR employees
were educated about various forms of cancer, risk
reduction and cancer treatment options.
The Baptist Cancer Center team also participated in:
American Cancer Society
Strides 5K Walk
American Cancer Society
Golf Tournament
16
American Cancer Society
Bark for Life
American Cancer Society
Relay for Life
Julie Rogers Gift of Life
Program -Julie Richards Proctor
5K Run/Walk
2.
1.
3.
5.
6.
7.
4.
9.
8.
10.
11.
From left to right: 1. Gift of Life Breast Cancer Awareness event 2. BRA-vo! 3. Prostate cancer screening event 4. BRA-vo! 5. Julie Proctor 5K Run/Walk
6. Gift of Life Champagne & Ribs event 7. Julie Proctor 5K Run/Walk 8. BRA-vo! 9. Pink Power Network breast cancer support group
10. “Pink Heals” pink fire truck tour 11. Prostate cancer screening event
17
LEGLISLATIVE ADVOCACY FOR CHANGE
Recognizing the importance that
our voices be heard for the future
of cancer care, the Baptist Cancer
Center is actively involved in
State and National Legislation.
Having previously been very
active and instrumental in the
successful passage of a city-wide
tobacco ordinance, Baptist
Cancer Center has since been eager to achieving even more
tangible changes to advance the health of our community. In
2011, in conjunction with the American Cancer Society, by
testifying before the Texas State Senate, Baptist Cancer Center
nurses lobbied for passage of House Bill 438 (which supports
equal funding care for those patients that could be eligible for
oral chemotherapy).
Clinical Director, Pam Caldwell, R.N., at Nation’s Capitol, lobbying Congress for support of
cancer research, education and prevention.
18
Additionally, we
participated in AntiTobacco Lobby Day in
Austin, as well as
supporting future funding
for cancer research by
lobbying elected officials
as members of the
American Cancer
Society’s Cancer Action
Network (ACS CAN) during Washington DC Lobby Day.
SUPPORT GROUPS
“MAN TO MAN” PROGRAM is the Prostate Cancer Support Group
affiliated with the American Cancer
Society. “Man to Man” patient
volunteers/facilitators are prostate cancer survivors trained by Baptist Cancer Center
RN’s, the “Us Too” International Prostate Cancer Education and Support Program, and
the Julie Rogers Gift of Life Program. The group meets monthly to help men and their
families cope with and understand prostate cancer treatment options and quality of life
issues after treatment. Professional speakers are invited each month to talk about prostate
cancer and quality of life issues.
PINK POWER NETWORK is a breast cancer support group
is a collaborative effort between the Baptist
Cancer Center and the Julie Rogers Gift of
Life Program. The group meets monthly
(twice on the same day) to help women and
their families cope with and understand breast cancer treatment options and quality of life
issues after treatment. Professional speakers are invited each month to talk about breast
cancer, quality of life issues and survivor stories of hope and inspiration
LOOK GOOD...FEEL BETTER is a national
American Cancer Society program at Baptist
Cancer Center that teaches beauty techniques to
cancer patients to help them manage the
appearance-related side effects of cancer treatment
and bolster their self-esteem. Look Good…Feel
Better group programs are open to all women with
cancer who are undergoing chemotherapy,
radiation, or other forms of treatment. Each monthly presentation includes educational
video, demonstrations and written materials. Participants receive free makeup supplies in
a personal kit.
I CAN COPE is a free educational program and support group
for adults facing cancer. Classes are led by trained, Baptist
Cancer Center professionals who provide educational
information on various topics including, diagnosis and
treatment, side effects of treatment, self-esteem and intimacy,
communicating concerns and feelings, community resources,
financial concerns, pain management, nutrition and physical
activity, cancer-related fatigue, and keeping well in mind,
body, and spirit.
19
It is difficult to know what the future of cancer care will hold. However, it will
continue to be essential that these programs are supported by Foundation and
philanthropic events such as La Soiree, the annual hospital golf tournament
and the employee giving campaign. At Baptist Hospitals, we remain resolved
to provide leading edge cancer care for the communities we serve. It is
through the support of the community and our civic leaders that this mission is
possible. For all of those affected by cancer, we are forever dedicated to
Performing Sacred Work...Every Day.
Philanthropic effects lay a solid FOUNDATION for advancements of cancer
education, community cancer screening and education events, and the
implementation of leading edge cancer care technology. Our premier event,
La Soirée, has lead to the development of a breast ultrasound program and the
genesis of comprehensive breast care services, at the Charline & Sidney
“Chief” Dauphin Cancer Screening and Prevention Center, the creation of a
family-centric care environment on the inpatient oncology unit, and the
reinvention of the entrance at Julie & Ben Rogers Cancer Institute.
20
1.
2.
3.
4.
5.
6.
7.
8.
11.
10.
9.
From left to right: 1. La Soirée black tie fundraiser 2. Donation by Employees of AT&T 3. Cirque de La Soirée 4. Dauphin Center new GE mammography unit
dedication & ribbon cutting 5. Medical oncology inpatient family room 6. Art donation to Julie & Ben Rogers Cancer Institute 7. Ribbon cutting of new medical
oncology inpatient family room 8. Renovated flooring at Julie & Ben Rogers Cancer Institute 9. Fundraiser at Howell furniture 10. Baptist Hospital “Cajun Classic”
golf tournament 11. Installation of new “GE Essential” mammography unit with stereotactic biopsy capabilities.
21
THE FUTURE OF CANCER CARE...
The future of cancer care can be divided across four
primary areas of specialization: medical oncology,
radiation oncology, surgical oncology and cancer
screening and prevention.
Medical Oncology
Cancer Genomics
The immediate future of medical oncology will be
focused on genomics. Current pathology standards group
malignancies according to location, lymph node
involvement, general appearance and description of
other physical characteristics such as size, shape, color
and tissue margins.
Medical Oncology research is moving towards
identifying genetic sequencing for each specific
malignancy. Though there are a finite number of
identified and categorized cancers, each individual
tumor can have characteristics which indicate
responsiveness of a specific cancer to first-line
treatment, the tendency towards metastases and where
the cancer is likely to metastasize.
Genetic sequencing will enable the development of truly
customized treatment plans with greater tumor response
rates. Many cancer researchers believe this will
significantly improve the effectiveness of
chemotherapeutic agents that are currently available.
Cancer Vaccine
Cancer genomics research is also focused on the
development of cancer vaccines. Cancer vaccines take
two forms, 1) vaccines that promote the development of
antibodies to fight an existing cancer and 2) vaccines
developed to prevent cancer formation. Provenge is the
first “cancer vaccine” to promote the formation of
targeted antibodies for the treatment of late-stage
prostate cancer. The “HPV” vaccine has been available
for several years, targeting a specific virus which can
lead to cancer. Several vaccines currently in trials are
targeting other tumor sites, including breast, ovarian and
lung cancers. Current vaccine trials are continuing to
examine the role of vaccines in combination with or in
place of chemotherapy. Over the course of the next five
years, this work will transition to preemptive vaccine use
22
for the prevention of specific cancers, rather than
exclusive adjunct use to improve immune response to
tumor cells.
Light-Reactive Chemotherapy
Researchers are working to develop light reactive
chemotherapies (photodynamic therapy) which are
engineered to collect around malignant tumor cells.
These molecules are impregnated with concentrated
chemotherapy which is not released until the light
activates the molecule. This permits the delivery of
higher concentrations of chemotherapeutic agents while
limiting the bio-toxic effects prevalent with most
chemotherapies.
Medical Oncology Summary
The immediate future of medical oncology is fairly
clear, but the waters remain murky. The direction of
cancer care is based in cancer genomics and the
completion of the genome of various tumor types. This
will guide the development of new first and subsequent
line chemotherapeutic agents, selection of stand-alone
and combination chemotherapy treatment (by individual)
and adjunctive and preventive cancer vaccines.
Over the next five years, cancer type-specific genetic
markers and vaccines will become commercially
available, off-trial. As an organization, we will continue
to evaluate each as either an addition to our formulary
(vaccines and chemotherapies), similar to Provenge
which is currently in use, or inclusion as new cancer
testing (tumor genetic identifiers.) We will also evaluate
participation in Stage II FDA trials which may be of
particular benefit to our patient base. Photodynamic
therapy will present a viable option for most forms of
cancer treatment; however, commercial availability is
likely to be several years away.
Radiation Oncology
There is a multi-focal move occurring in radiation
oncology, all geared towards administering the highpossible radiation dose while preserving the healthy
tissues immediately surrounding the cancerous tumor.
Interventional Radiology
Interventional Radiology advances will continue to be a
focal point in tumor destruction techniques. Microwave
Ablation and Radio Frequency Ablation are ideal
approaches for certain specific tumors. Cryotherapy has
now been deemed an appropriate technique for certain
malignant tumors.
Hypofractionation
Many tumors are not accessible through interventional
radiology. For these tumors, other approaches must be
considered.
The future trend in radiation oncology is towards
increasing the radiation dose at the tumor site,
selectively. The precision required to accurately
administer high radiation doses necessitates tumor
movement tracking through stereotaxis
(hypofractionation) or intra-cavity radiation
Brachytherapy.
The radiation dose must move with the natural
movement of the body (i.e. respiration). This is
accomplished through stereotactic administration of
radiation, which can be delivered in high doses very
quickly, with the ability to instantly stop and restart the
dose based on body movement.
Linear Accelerators currently in use can be retrofitted to
accommodate this technology, with the addition of
“SBRT” or stereotactic body radiation therapy. Newer
generation linear accelerators will be capable of
delivering a higher dose quicker and more accurately
than previous generations of radiation technology.
These technologies are currently available at most
academic medical centers and some community
hospitals. Over the next five years there will be
penetration of these technologies into more community
hospitals and regional cancer centers.
Radiation Oncology Summary
The newest generation linear accelerators are equipped
for 3-Dimensional tumor imaging for image-guided
radiation, IGRT and tracking of body movement, SBRT.
Additionally, the newest generation is capable of
delivering higher doses of radiation in an extraordinarily
accurate beam.
Cutting-edge radiation therapy delivery will be
accomplished with true beam technology, which
pinpoints the radiation dose with true laser accuracy.
This is the future of radiation therapy and
hypofractionation.
Tumor GPS
There’s cutting edge technology, and then there is
bleeding edge technology. The use of global positioning
systems in the treatment of cancer has arrived.
Researchers are working with implanted microchips
which will relay real-time as to tumor positioning. The
radiation beam is synchronized to the microchip and the
treatment beams tracks with the precise position of the
tumor. This is new generation technology for
radiosurgery, but also permits adjustment in beam
position as the tumor shrinks over the course of
treatment, which is absolutely a desired outcome. This
technology is commercially available now for treatment
of prostate cancer. It is certain that this technology will
be available for other tumor sites within the next five
years.
Tomo Therapy and Brain Radiosurgery
There are some tumors which will not be able to be
treated with brachytherapy or stereotactic radiosurgery.
Tomo Therapy involves the administration of radiation
slice by slice, guided by CT images. Brain Radiosurgery,
involves the precise administration of radiation to
critical viscera, including the brain.
As an organization, we are ahead of the curve in
radiation oncology. We have invested in both
Brachytherapy (HDR) and Stereotactic Body
Radiosurgery (SBRT). Both technologies provide for
hypofractionation radiation dosing, which is truly the
future of radiation treatment. From a technology
standpoint, we will need to invest in new generation
linear accelerators. The linear accelerator platform that
will drive our program over the next decade will be true
beam. This technology will allow for beam accuracy that
will be comparable to any radiation program across the
country. However, this technology is first generation. It
is reasonable to wait two to three years for second
generation true beam technology to come on the market.
We will have the advantage of offering state-of-the-art
care, without facing some of the “newness” issues
involved in implementing technology that is new to the
market.
Tumor GPS will need to prove to be more valuable than
SBRT in order to be widely adopted. In theory, this is a
method of treatment that should be superior to any
presently available. However, with improved
sophistication in imaging technology, we are able to
produce a near-virtual image of the tumor being treated.
It is likely that SBRT on new generation true beam will
prove to be equivocal with tumor GPS.
Surgical Oncology
The future of surgical oncology continues to be robotics
and minimally-invasive surgery. This will be essential in
moving towards a surgical sub-specialty program in
gynecology, urology and thoracic cancer surgery. The
use of intraoperative peritoneal chemotherapy will also
become more prevalent over the next five years,
especially in GYN, urological and GI likelihood of
survival.
Cancer Screening and Prevention
Cancer Screening
Cancer screening and prevention is on the verge of a
giant leap forward; a real breakthrough in the future of
cancer care. Cancer treatment begins with detection and
diagnosis. Researchers at MD Anderson are working on
a blood test that will detect cancer down to the level of
one single cell. Once the test is proven effective it is
certain to be fast-tracked by the FDA. It could well be
available within the next five years. The test is so
promising that Johnson & Johnson has signed-on to
support the research and approval process. This will
truly revolutionize cancer care, second only to the
development of pre-emptive vaccines. Within the next
decade, it will be commonplace to be screened for
cancer as part of the annual physical exam.
Genetic Counseling
Advancements in Cancer Genomics is breathing new life
into genetic screening and counseling. It is expected that
over the next five years new genetic markers will be
discovered which will enable more sophisticated testing
for a larger array of genetically-related cancers.
Currently there is only one laboratory, Myriad, who
holds the patents on genetic testing for cancer. Genetic
testing will evolve to the point to where it can be
performed at any regional reference laboratory and
eventually at the community hospital laboratory.
23
Turnaround time can be essential in the presence of an
existing cancer diagnosis. The likelihood of cancer
recurrence or development of secondary associated
cancer will be a significant factor in deciding to have a
hysterectomy or mastectomy, versus other lesserinvasive procedures in the absence of a positive finding.
As cancer care becomes more dependent upon
genomics, it will be essential that genetic testing moves
to a regional level in order to facilitate care and
treatment decisions.
Breast Imaging
Mammography has been the gold standard in breast
cancer screening for decades. In the past ten years,
mammography has been revolutionized by the
transformation from analog film images to digital
images. Over the next decade, the move will be towards
3-dimensional breast imaging and nuclear breast
imaging.
Tomosynthesis has the ability to produce a 360-degree
view of the breast tissue. This is especially helpful in the
presence of dense breast tissue, which can hide .
malignancies. It is likely that, over the next decade,
tomosynthesis will replace traditional screening
mammography as a first-line screening technology.
Nuclear imaging of the breast is focused on one thing,
producing an image that approximates breast MRI,
without the inconvenience of scheduling a breast MRI.
Breast PET (PEM – Positron Emission Mammography)
is able to produce an MRI-like image in a compact
mammography unit that is a reliable, reproducible image
for biopsy. This is especially important when clinical
indicators suggest that a mass is present, but is cannot be
identified through other modalities. It is equally
important when looking for the presence of contralateral in a patient with a confirmed malignancy. PEM
will become a critical diagnostic tool for destination
breast cancer centers.
In late 2012, the Charlene & Sidney “Chief” Dauphin
Cancer Screening and Prevention Center will be
unveiling breast tomosynthesis as the first facility in this
region to offer this technology.
Whole Body Imaging
Currently PET/CT is being utilized in patients with a
confirmed diagnosis of cancer. PET will eventually
transition to PET/MR, offering enhanced image
capability and detection of cancers not identifiable with
other screening modalities.
It is highly likely that PET/
MR will be utilized for
cancer screening, much as
colonoscopy is today.
Additional screening on the
horizon includes Chest CT
as a diagnostic tool to
screening for lung cancer.
There is a recommendation
coming out of research
from MD Anderson that
periodic Chest CT is far
more
sensitive
at
identifying early lung
c a nc e r s , w h i c h c a n
accelerate diagnosis and
treatment, improving the
overall likelihood of
survival.
SUMMARY
Medical Oncology –
Genomic identifiers will be
key to individualized
chemotherapy regimens.
Cancer vaccines are the
24
future of cancer prevention and treatment
Radiation Oncology – Beam fractionation will be the
future of radiation oncology to maximize radiation
dosage while sparing healthy surrounding tissue
Surgical Oncology – Robotics and minimally-invasive
surgery / field visualization will be essential for a
successful surgical oncology program
Screening and Prevention – Enhanced genetic
screening capabilities, improved breast imaging
modalities to include tomosynthesis and nuclear breast
imaging and sophisticated whole-body cancer screening
with PET/MR and CT. Ultimately screening and
prevention will be driven by the early detection of
cancer through laboratory testing.
Background photo: Breast Cancer Survivor
confetti release to kick off October Breast
Cancer Awareness Celebration, downtown
Beaumont.
25
6
“My name is Kathy Lee and I
was diagnosed with invasive
ductal carcinoma in May of
2011. I had a radical
mastectomy in June, began
chemotherapy in August and 6
weeks of daily radiation
treatments beginning in midDecember. My faith in God
sustained me and His Spirit led
me to the medical team at
Previty Clinic, The Charline &
Sidney “Chief” Dauphin Cancer
Screening & Prevention Center
and the Julie & Ben Rogers
Cancer Institute. I had the
best care from the doctors,
nurses and even the office
staff, that I could have ever
asked for. When faced with a
devastating situation, a smile
or a hug and the feeling that
you are viewed as a person
and not a patient number goes
a long way in providing
comfort and an atmosphere of
healing.”
Background photo: Breast Cancer Survivor
confetti release to kick off October Breast
Cancer Awareness Celebration, downtown
Beaumont.
This first annual report is dedicated to the memory of and in honor of
Dr. Mark A. Wilson
and all of our patients who have fought the battle and lost.
We rededicate ourselves to creating survivors and finding a cure.
Baptist Hospitals of Southeast Texas
3080 College Street
Beaumont, Texas 77701
409-212-5000
www.bhset.net