Download Leading. Transforming. Innovating.

Leading. Transforming. Innovating.
2012 Annual Report
Cancer Treatment Centers of America®
Hospitals are located in Zion, Illinois; Tulsa, Oklahoma; Philadelphia, Pennsylvania;
Goodyear, Arizona; and Newnan, Georgia; with a clinic in Seattle, Washington.
Seattle
Philadelphia
Zion
Goodyear
Tulsa
Newnan
Table of Contents
01
Message from Steve Bonner
15
Clinical Care Conference Report
02
Cancer Treatment Centers of America
15
Cancer Committee Report
is working to change health care
16
Cancer Conference Report
05
Message from Steve Mackin
17
Cancer Registry Report
06Hospital Consumer Assessment of
18
Quality Outcomes Report
Healthcare Providers and Systems
20
2011 Primary Sites
08HealthGrades
22
2011 Estimated New Cancer Cases
10Innovations
22
2011 Total New Cases By State
12
Comprehensive Services
24
Medical Staff
14
Cancer Committee Membership
29Publications
2012 Annual Report with Cancer Registry Statistical Data from 2011
Message from Steve Bonner:
Leading the Health Care Renaissance
I’m excited to tell you about the record year Cancer Treatment Centers of America® (CTCA) Stakeholders have created at Southwestern
Regional Medical Center in Tulsa! The new heights were led by accelerating patient care innovations at Southwestern, and across the
entire CTCA® enterprise. In this report, you will see many of these innovations and what they add for our patients. As a preamble to
your review, I’d like to take a few moments to look over the horizon together and consider the future of CTCA — a future that is even
brighter than our growing history.
We are a national network for cancer care. We specialize in treating patients with complex or advanced-stage cancer, as we combine
medical expertise and state-of-the-art technology with nutritional counseling, naturopathic medicine, mind-body therapy and spiritual
support…and any other support that cancer patients value. This is done to treat the whole person, not just the tumor. At every CTCA
hospital, we empower patients and their caregivers with the information they need to make decisions about their care. We do this to
help them make the best decisions for their care, and to get back to their lives, families, work and dreams faster.
But caring for our patients is not all we do. We are also helping to lead a Health Care Renaissance in America, as we seek better quality
and cost for all Americans. More consumers want to select their health care providers based on the best information about quality,
costs, and the patient experience. They want the power to make these intimate, personal decisions for themselves. At CTCA, we
welcome the Renaissance because we know patients have the right to make informed choices about where and how they are treated.
So we give them the information they need to decide about their care. And we honor their choices.
We also are educating lawmakers, professionals and thought leaders about the exceptional quality of the care we provide, including
our speed of delivery, superior treatment results and 98 percent patient loyalty scores. Government can help the Renaissance by creating
health insurance portability; premium tax fairness; expanded Health Savings Account options; malpractice reform; and Medicare
choice. Government can reform the FDA to accelerate innovation, and provide responsible choices to those who need help today!
And every American must help drive the Renaissance by adopting healthy lifestyles for themselves and their families. CTCA partners
with each of our Stakeholders and our communities on the wellness journey, too.
We believe that a fully engaged, consumer-driven market is the quickest way to propel valued change in health care. Equipped with
quality and cost information, patients can make choices that align with their own personal values and needs. This will force provider
competition and drive increased efficiency, new innovation, better quality and reasonable-cost care. It is time for the Health Care
Renaissance. Our success will include providing the best possible patient care, and helping to make that type of care available to all
patients, at CTCA and beyond. Now, in the rest of this Annual Report, I hope you will be encouraged by what we have accomplished
and what we are building for the future.
Steve Bonner, President & CEO
Cancer Treatment Centers of America
1
The Patient Empowered Care® Model
Cancer Treatment Centers of America
is Working to Change Health Care
2
The Patient Empowered Care model brings a multidisciplinary
team of oncologists, clinic nurses, registered dietitians,
Naturopathic Physician and nurse care managers to the
patient… as a team.
At Cancer Treatment Centers of America® (CTCA), we work
every day to provide the best possible care to patients and
their families. We provide innovative solutions to improve
treatments and the overall experience across the entire
continuum of care. We believe the status quo in health care
is unsustainable, so each and every day we work to set the
example of how health care must improve. Here are just a
few of the innovations we have implemented to improve
patient care across CTCA®.
Members of these teams listen to patients and provide clear,
comprehensive choices to help develop treatment plans that
are customized to the patient’s personal goals and health
needs. With this approach, CTCA patients remain in one
room for greater comfort, convenience and privacy, where
this team comes to see them. “Doctor, the patient will see
you now!”
The CTCA Integrative Approach
CTCA care teams deliver high-quality cancer treatment and
seek innovations to improve our delivery of care to patients.
At CTCA, patients can receive surgery, chemotherapy,
radiation and immunotherapy. These treatments don’t just
treat the tumor – they treat the whole person. Conventional
treatments are used to remove cancerous tissue, help relieve
pain, maintain dignity, increase comfort, maintain nutritional
status or preserve normal function after treatment.
Transparent Information for Informed Decisions
To promote transparency and enable patients to make
informed decisions, CTCA was one of the first cancer
treatment centers to provide outcomes to patients and the
public. Results are provided on the CTCA website for 10
disease types and include:
Just as important, CTCA combines conventional treatment
with integrative therapies to restore and maintain health,
increase patients’ ability to withstand treatment and have
more strength to fight their cancer battle. These include:
•Acupuncture
• Chiropractic Care
• Mind-Body Medicine, such as Humor Therapy,
Laughter Therapy and Pet Therapy
• Naturopathic Medicine
• Nutrition Therapy
• Oncology Rehabilitation
• Pastoral Care
• Survivorship Support Services
• Symptom Management
You can view these results by visiting www.cancercenter.com/
cancer-statistics.cfm. No other cancer center provides as
much information on quality and outcomes as CTCA.
•
•
•
•
CTCA patient survival results
Quality of life measures
Patient experience statistics
Speed of care results
Innovative Evaluations: CareEdge®
We are committed to providing patients with high quality,
affordable cancer care. That’s why we introduced CareEdge®,
our new patient-centered cancer diagnostic and treatment
plan program. CareEdge provides patients with a complete,
comprehensive diagnostic evaluation and a personalized
treatment plan within three to five business days at a
guaranteed price. And, we back CareEdge with a guarantee:
if CTCA fails to complete the CareEdge diagnostic and
treatment planning process within three to five business
days, we provide a full refund.
At CTCA, all of these aspects of care are brought together
in one comprehensive care team that meets regularly to
discuss the patient’s care plan, symptoms and side effects
and response to treatment from a whole-patient perspective.
Patient Empowered Care: Patients Are At The
Center of All We Do
CareEdge empowers patients and families to make decisions
about their care. The program gives patients and their care
team the clinical evaluation they need and access to stateof-the-art diagnostic equipment and laboratory services,
swiftly, efficiently and at a guaranteed price.
At the core of the CTCA care model is Patient Empowered
Care®. It assembles CTCA medical professionals in fully
integrated teams to educate and empower cancer patients
and their caregivers to actively and meaningfully participate
in their cancer care.
3
At CTCA, our goal is to become the leading provider for
personalized cancer care, offering patients individualized
treatment plans based on their unique molecular and
genomic profile. And we are doing so by making personalized
medicine a top clinical priority across our enterprise.
Improving Quality: Lean Six Sigma to Improve the
Patient Experience
CTCA was one of the first hospital systems to embrace Lean
Thinking principles, a concept that helps us continually
implement treatment and process improvements that benefit
our patients. Whether our improvement projects are large or
small, they always help us deliver better care to our patients
and their families.
Advancing Translational Research through
Collaborations
In 2012, CTCA solidified a collaboration with Merrimack
Pharmaceuticals, Inc. to advance its long-term vision of
individualized treatment – where diagnosis and
therapy is guided by an in-depth understanding
of the underlying mechanism of a patient’s
disease. The collaboration encompasses
minutes
research on diagnostics based on a network
signaling approach to analyzing patients’
tumors as well as clinical trial research.
For example, we recently reduced the amount of time
patients spend in the waiting area for port access
implants. Using Lean Thinking, we made small
changes that made a big difference, including
new scheduling guidelines and better
processes that enabled our lab technicians
to do their jobs more efficiently.
These and other process improvements have
dramatically reduced patient wait time for
chemotherapy infusion from 40 minutes to an
average of 10 minutes – a 75 percent improvement over previous wait times. More important
than the speed and cost components, this takes the
stress and worry out of the equation for patients.
10
40
minutes
Patient Wait Time
Improved by
Lean Thinking
For the diagnostic research, CTCA will
contribute archived tumor biopsies from
our extensive tumor databank as well as
prospectively collected tumor samples. These
samples will be analyzed using Merrimack’s
Network Biology approach to identifying the network
signaling that drives cancer growth with the goal of
understanding each patient’s cancer at the molecular
level. Because many of our patients are battling advanced
cancer and have received prior lines of therapy, the CTCA
tumor archive is particularly unique as we offer an
opportunity for Merrimack to explore how the molecular
characteristics of a tumor change as a result of therapy. This
joint effort could eventually lead to the identification of
novel companion diagnostics to guide treatment decisions.
Genomic Medicine: Truly Personalized Care
There is an ongoing virtual revolution in the understanding
of the fundamental biology of cancer. At CTCA, we anticipate
that within the next two years it will be both scientifically
and economically possible to identify highly specific
(“personalized”) molecular abnormalities present within an
individual patient’s cancer. Understanding how to optimally
manage malignant disease based on this knowledge will
be extremely complex and will evolve over the next several
decades. This coming era will be characterized by truly
spectacular advances in cancer outcomes as these mysteries
are increasingly understood and specific management
strategies are rapidly tested and confirmed beneficial.
The collaboration also encompasses clinical research.
Merrimack will collaborate with CTCA investigators to take
advantage of the rich clinical expertise at CTCA through
participation in and collaboration on clinical studies of
Merrimack therapeutics.
4
Message from Steve Mackin:
New Ideas Come to Life
The story of this hospital has always been one of progress. From the moment we opened our doors more than 22 years ago to today,
we have focused our efforts on providing more options for more patients. As a team, we rapidly complete significant change initiatives,
which enable our ideas and the wishes of our patients to come to life.
To anticipate the needs of our patients, we are thoughtful in our investments of new technologies and treatments. This year, we added
CyberKnife® VSI with Robocouch,® an advanced system that CyberKnife offers. Another addition includes a new Interventional
Radiology (IR) suite consisting of the GE Innova® Image Guided System 540 and the Veran IG4™ Navigation System. Cancer Treatment
Centers of America® (CTCA) at Southwestern Regional Medical Center was one of the first hospitals to obtain these systems,
and the first to have this combination of IR equipment in a suite, which helps our specialists locate and treat tumors throughout the
body. CTCA® at Southwestern has also established partnerships that are advancing our use of genetics in the creation of personalized
treatment plans for our patients.
We are also deeply committed to helping cultivate a new generation of talented physicians in Oklahoma who are passionate about
treating cancer. Evidence of that is our continued partnership with Oklahoma State University to offer fellowship programs focusing
on Gastroenterology, Pulmonology, Medical Oncology, Plastic Surgery, Pain Management and Nephrology. These fellowships are
helping to retain specialized talent in the state.
Hospital growth continues and is evident from our physical structure. We’ve added more than 100,000 square feet since we moved into
our new building. The construction crews have never left our grounds! In addition, our number of Stakeholders has increased—from
450 employees in 2005 to 777 in 2012, with a medical staff of 185.
As we seek to help our hospital evolve with new opportunities, we also maintain a focus on how to do so responsibly. Our first priority
is always to our patients, and in FY2012, 98.5% of patients were satisfied with their overall experience at CTCA. Additionally, our hospital
earned a Net Promoter Score of 96.5. In an industry where a score over 60 is considered stellar, this is something to be quite proud of.
Our Stakeholders who provide the care leading to such exemplary scores are not to be forgotten either, as their loyalty leads to better
care for our patients. Again this year, OKC Biz Magazine named CTCA at Southwestern as one of the “Best Places to Work in Oklahoma.”
This award included input from employees and the survey results indicated that 95% of stakeholders were satisfied with CTCA as an
employer, a 6% increase since 2011. In addition, we were named the top-ranked health care institution among this year’s winners.
Our patients are at the center of our hearts, minds and actions every day. In order to give them exceptional care, we must first make sure
we are taking care of our employees. That’s why we measure employee satisfaction just as closely as patient satisfaction. We want to be a
powerful resource for Oklahoma and a source of pride for the Southwest region.
In the following pages, you will find more information on the innovations discussed above as well as 2011 statistics and results. I hope this
report will help you understand how Cancer Treatment Centers of America continues to win battles daily with the patients we serve, and,
indeed, win the fight against cancer every day.
Steve Mackin, President & CEO
Cancer Treatment Centers of America at
Southwestern Regional Medical Center
5
HCAHPS: Hospital Consumer Assessment of
Healthcare Providers and Systems
HCAHPS is administered by the U.S. Department of Health and Human Services (HHS) and is a national, standardized, publicly
reported survey of patients’ perceptions of their hospital care.
Cancer Treatment Centers of America® (CTCA) hospitals and other U.S. hospitals administer HCAHPS surveys to a random sample
of adult patients every month between 48 hours and six weeks after their discharge from the hospital. Each hospital’s results are then
reported on the HHS Hospital Compare website (www.hospitalcompare.hhs.gov) four times a year.
HCAHPS scores are an important indicator of the overall quality of a hospital and the overall satisfaction of the patients who were
treated there.
6
HCAHPS Results
Patients who reported that their nurses
“Always” communicated well.
Patients who reported that their doctors
“Always” communicated well.
Patients who reported that their pain was
“Always” well controlled.
Patients at each hospital who reported that
“Yes,” they were given information about
what to do during their recovery at home.
Patients who gave their hospital a
rating of 9 or 10 on a scale from
0 (lowest) to 10 (highest).
Patients who reported “Yes,” they would
definitely recommend the hospital.
50%60%
70%80%90%100%
Eastern Regional Medical Center
Midwestern Regional Medical Center
Southwestern Regional Medical Center
National Average
Note: Results above represent a rolling four quarters of data and are reported as of September 10, 2012. CTCA at Western Regional Medical Center, near Phoenix, began use
of the HCAHPS survey with patients discharged after September 1, 2012. Their results will be included in 2013 CTCA HCAHPS results, as will the results of the newest CTCA
hospital, CTCA at Southeastern Regional Medical Center, near Atlanta.
Some of the attributes on the above graph are aggregates of
multiple questions on the HCAHPS survey, including:
•
•
•
•
there was no national standard for collecting and publicly
reporting information that allowed valid comparisons to be
made across hospitals locally, regionally and nationally.
Patients who reported their nurses “Always”
communicated well, defined as: treatment with courtesy
and respect; careful listening; and explaining care in a
way you could understand.
Patients who reported their physicians “Always”
communicated well, defined as: treatment with courtesy
and respect; careful listening; and explaining care in a
way you could understand.
Patients who reported their pain was “Always” well
controlled, defined as: both control of the pain and staff
responsiveness to patient needs.
Patients who gave the hospital a rating of 9 or 10 on a
scale of 0 being the worst hospital possible and 10 being
the best hospital possible.
Three broad goals have shaped HCAHPS
First, the survey is designed to produce data about patients’
perspectives of care that allow objective and meaningful comparisons of hospitals on topics that are important to consumers.
From its onset, researchers behind HCAHPS approached its
development recognizing that many legacy patient satisfaction
tools approached measurement from an institutional mindset.
Conversely, HCAHPS attempts to collect data that are based
largely upon the following four questions:
•
•
•
•
Overview of HCAHPS
The HCAHPS survey is the first national, standardized, publicly
reported survey of patients’ perspectives of hospital care.
HCAHPS is both a survey instrument and data collection
methodology. While many hospitals have collected information
on patient satisfaction for their own internal use, until HCAHPS,
What do patients want?
What do patients value?
What helps or hinders patients’ ability to manage
their health problems?
What aspects of care are most important to patients
and their families?
Second, public reporting of the survey results creates new incentives
for hospitals to improve quality of care. Third, public reporting
serves to enhance accountability in health care.
7
Patient Experience Performance Superiority Study Results
Healthgrades, Inc.
In 2012, Healthgrades®, Inc. performed a study to identify important experience factors in the treatment of cancer patients and caregivers;
to establish national benchmarks for such experience factors; and to compare the perceptions of cancer patients and caregivers of
cancer patients treated in Cancer Treatment Centers of America® (CTCA) hospitals against those of cancer patients and caregivers of
cancer patients treated in other U.S. hospitals. This study included responses from 217 caregivers and 700 patients treated for cancer
within a CTCA hospital between 2009 and 2011. It also included responses from 66 caregivers and 723 patients treated for cancer in a
U.S. hospital (other than a CTCA facility between 2009 and 2011). Results are also shown as compared to the “Top 20 Cancer Treatment
Hospitals” as rated by Modern Healthcare.
Responding patients were asked to rate their cancer treatment experience via a five-point scale question, from “Very Poor” to
“Very Good” on the following 12 factors; responding caregivers were provided the same factors for rating with appropriately
adjusted stem semantics:
•
•
•
•
•
•
Having a compassionate team of care providers
Providing me with a knowledgeable, competent physician(s)
Treating me as a human being and not just a person with
a disease
Treating me with dignity and respect
Involving me fully in decisions about my care
Helping me understand my treatment options
•
•
•
•
•
•
Providing me with information about the likely outcome
of my treatment
Listening carefully to me and my concerns
Giving me access to a well coordinated team of
medical experts
Providing all care services conveniently in one facility
Actively seeking to relieve my pain and discomfort
Helping me handle my insurance and related paperwork
Respondents were also asked to comment on the following factor: “All things considered, please indicate the extent to which
you were satisfied/dissatisfied with the cancer care you received at this hospital.”
• Responses to this question were solicited via a 5-point scale ranging from “Very Dissatisfied” to “Very Satisfied.”
CTCA Patients Rated Their Experience Higher than did a Modest Sample of Non-CTCA Patients Treated
in the Modern Healthcare Top 20 Cancer Hospitals (Average Response by Hospital Group)
CTCA Hospital
Other Hospital
Top 20 Cancer Hospitals
5.0
4.5
4.0
3.5
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CTCA Patients Rated Their Experience Higher on all 13 Factors
(Average Response by Type of Patient)
CTCA Patient
Non-CTCA Patient
5.0
4.5
4.0
3.5
3.0
CTCA Caregivers Rated Their Patient’s Experience Higher on all 13 Factors
(Average Response by Type of Caregiver)
CTCA Caregiver
Non-CTCA Caregiver
5.0
4.5
4.0
3.5
3.0
9
Innovations
CTCA is a health care industry leader with
a steadfast commitment to invest in
advanced medical and surgical diagnostic
technology and potentially lifesaving
medical treatment options for patients
with advanced and complex cancers.
10
Autologous Fat Transfer
This breast reconstruction procedure with Dr. Arch Miller
involves taking the patient’s own fat tissue from a part of the body
where excess exists and transferring it to rebuild the breast after
a mastectomy or lumpectomy. This technique can also help to
recontour the breast after breast implants. Potential advantages
include using the patient’s own tissue and improved cosmetic results
with no visible incision, healthier looking skin, more elasticity and
a resulting breast that looks and feels like a normal breast.
CyberKnife® VSI™
This radiation machine with a robotic arm delivers stereotactic
radiosurgery, a very precise form of radiation. CyberKnife provides
accurate targeting of tumors; a precise, high radiation dose;
less damage to surrounding healthy tissue; and shorter treatment
times. The new technology at Southwestern also features
RoboCouch,® a comfortable, cushioned bench for patients only
found in a handful of CyberKnife machines in the country, and
lung optimization, a program that allows accurate tracking and
treating of lung tumors as the lungs move – a feature also only
found in a handful of machines in the United States.
Deep Tissue Hyperthermia
Deep tissue hyperthermia uses heat combined with either
chemotherapy or radiation therapy to treat tumors deep within
the body. Formerly only offered as a research study, deep tissue
hyperthermia received FDA approval this past year to be used to
treat cervical cancer tumors. With this approval, the usage of
deep tissue hyperthermia expanded, allowing our physicians the
flexibility to use this treatment for other pelvic-region cancers
that otherwise wouldn’t qualify for the research study.
Enzalutamide (formerly MDV3100) Expanded Access Study
Cancer Treatment Centers of America® (CTCA) at Southwestern
Regional Medical Center in Tulsa participated in Astellas’
Expanded Access Study for enzalutamide (formerly MDV3100)
for patients who have been treated with Docetaxel-based
chemotherapy and have castration-resistant prostate cancer.
Enrollment for this study is now closed.
GE Innova® IGS 540 Interventional Radiology Suite
Launched in Spring 2012, the new Interventional Radiology (IR)
Suite consists of the GE Innova Image Guided System 540 and
the Veran IG4™ Navigation System. CTCA® was one of the first
hospitals in the nation to obtain these systems, and the first to have
this combination of IR equipment in a suite. This system helps
locate and guide catheters to tumors with an enhanced resolution
and a smaller dose overall. In addition, this new equipment allows
doctors to see and treat small lesions or metastases that may not
have been detected before.
Integrative Surgical Techniques
Investments in new programs and technologies have expanded
surgical opportunities at Southwestern allowing surgeries with
multiple cross functional teams to occur. These integrative
surgeries may include such physicians as a surgical oncologist,
neurosurgeon, radiation oncologist and plastic surgeon all in the
same surgery. The goal is to increase collaboration, letting each
physician contribute his/her specific skill set, while completing as
many of the patient’s needed procedures at one time.
Nephrology Clinic
Since some chemotherapies can impact a patient’s renal function,
access to a nephrologist to help with any resulting symptoms is
important. In 2012, CTCA brought nephrology services onsite
through its partnership with Nephrology Specialists of Tulsa.
This new partnership allows patients to see nephrologists onsite
at CTCA in order to help patients experiencing kidney damage as
a result of treatment, patients who need dialysis or patients who
have unexpected kidney-related symptoms.
Neurology Clinic
Due to an increase in patient need, CTCA brought neurology
services onsite in 2012. Under the direction of Drs. John D. DeWitt
and Keith Simmons, patients experiencing seizures, neuropathy,
headaches, change in mental status and other neurological-related
symptoms can now receive consults at the hospital. The addition
of the neurology clinic also brought on board the new
electromyography (EMG) service, as well as expanded the existing
electroencephalography (EEG) service.
Novac 7™ Intraoperative Radiation Therapy (IORT)
Initially introduced in 2011, this innovative treatment delivers
a concentrated beam of radiation directly to the tumor bed
immediately after tumor removal in surgery. This helps to increase
the dose of radiation that can be given, shield the surrounding
healthy tissue, and, ideally, lessen the number of radiation
treatments needed. After using the technology for its primary
usage for breast cancer, the CTCA team has expanded the use of
IORT with applications for additional cancer types, including
pancreatic and brain.
Sleep Lab
Designed to address one of the top quality of life challenges that
patients face — fatigue — the Sleep Lab opened in Spring 2012 and
helps patients identify and proactively work on any sleep-related
issues via an overnight sleep study.
Stem Cell Transplant and Cell Therapy Program
With the addition of Dr. Joseph Lynch in October 2012, CTCA
started seeing patients in preparation for the Stem Cell Transplant
and Cell Therapy Program that will open in the spring of 2013.
Through this service, patients with malignant blood cancers will
now be able to complete treatment through blood and marrow
transplant on-site while keeping their continuity of care with CTCA.
This service includes any hematology patients, such as chronic and
acute leukemia, Hodgkin’s and non-Hodgkin’s lymphoma, multiple
myeloma, and any other malignant blood cancers.
11
Comprehensive Services
Facility: 306,937 sq. ft. | Physicians: 185 | Staff: 777 | Inpatient Beds: 43 | Outpatient Accommodations: 153
Medical Oncology
24-hour infusion center
Chemoembolization
•Hepatic arterial
chemoembolization
•Portal vein embolization
•Bland chemoembolization
Fractionated dose chemotherapy
•Metronome
•Chronomodulated therapy
Gastroenterology
High-dose chemotherapy
Hormone therapy
Hospitalist/intensivist services
Inpatient and outpatient services
Intra-arterial chemotherapy
Intraperitoneal chemotherapy
•Intrathecal chemotherapy
Nephrology
Neurology
Pulmonology
Immunotherapy
Hematopoietic growth factors
Interferons
Interleukins
Monoclonal antibodies
Provenge®
Yervoy™
Radiation Oncology
4D CT Sim with gating
Calypso® system
CyberKnife VSI™ system
External beam radiation
High-dose rate brachytherapy
Hyperthermia
•Deep tissue
•Superficial
Intensity Modulated Radiation
Therapy (IMRT)
Novac™ 7 Intraoperative
Radiation Therapy (IORT)
TheraSphere®
TomoTherapy® HI-ART
Varian 2100EX linear accelerator
with Rapid Arc and Cone
Beam CT
Otolaryngoscopy head and
neck surgery
•Neck dissection
•Tracheostomy
Pancreatic surgery
•Choledochojejunostomy
•Gastrojejunostomy
•Partial pancreactomy
•Whipple procedure
Partial liver resection
Sarcoma surgery
Spine surgery
Splenic surgery
Thoracic surgery
Urological
•Bladder surgery
•Nephrectomy
•Stent placement
Vascular access devices
Surgical Oncology
Breast surgery
•Axillary node dissection
•Breast reconstruction
•Breast-sparing procedures
•Modified radical mastectomy
•Segmental breast resection
•Sentinel lymph node biopsy
•Total mastectomy
Cholecystectomy
Endocrine surgery
•Adrenal
•Parathyroid
•Parotid
•Thyroid
Gastrointestinal surgery
•Esophagus
•Rectum /Anus
•Small and large bowel surgery
•Stomach
Gynecological surgery
•Hysterectomy
•Oopherectomy
Hyperthermic Intraperitoneal
Chemotherapy (HIPEC)
Lymphatic System
•Lymph node biopsy
•Lymph node resection
Laparoscopic surgery
•Peritoneal exploration
Liver biopsy
Major liver lobectomy
Melanoma surgery
Neurosurgery
•Craniotomy for tumor
•Ommaya reservoir placement
•Ventriculoperitoneal shunt
placement
Pulmonology
Bronchoscopic procedures
•Argon plasma coagulation
•Autofluorescent bronchoscopy
•Bronchial stent placement
•Electrocautery
•Endobronchial ultrasound
•Flexible and rigid bronchoscopy
•HDR brachytherapy
•Intratumoral chemotherapy
(investigational)
•Navigational bronchoscopy
•Photodynamic therapy
Fiducial marker placement
Indwelling pleural catheter
Medical Pleuroscopy
Gastroenterology
Colonoscopy
Cyanoacrylate sclerotherapy for
gastric varices
Endoscopic Mucosal Resection
(EMR)
12
Endoscopic Retrograde
Cholangiopancreatography (ERCP)
•Cholangioscopy
Endoscopic Ultrasound (EUS)
•Celiac plexus neurolysis
•Fiducial marker placement
•Fine needle aspiration
Enteral nutrition
Esophageal Radio Frequency
Ablation (RFA)
Esophagogastroduodenoscopy
(EGD)
Enteroscopy
Intratumoral chemotherapy for
pancreatic cancer
Photo Dynamic Therapy (PDT)
Stent placement (esophageal,
small intestine, colon, biliary)
Total Parenternal Nutrition
Video capsule endoscopy
Interventional Radiology
Abscess drainage and fluid
collection
Angioplasty/stent placement
Arterial infusion catheter
placement
Arteriography
Biliary drainage - internal and/or
external and stent placement
Biopsy - abdomen, pelvis, lung,
chest, bone, soft tissue
Chemoembolization
Embolization
Inferior vena cava filter
Intra-arterial infusion
Kyphoplasty
Nephrostomy drainage - external
and/or internal
Radiofrequency hyperthermic
tumor ablation
Radioimmunotherapy
Vertebroplasty
Venography
Imaging
Breast needle localization
CT angiography
DEXA bone scan densitometry
Echocardiogram, trans-thoracic
Intra-operative ultrasound
Interventional and diagnostic
multi-detector computed
tomography
Magnetic resonance imaging and
angiography
Mammography
MRI breast imaging
Microwave ablations
Nuclear medicine
•Iodine 131 therapy
•Zevalin®- therapeutic
treatment for non-Hodgkin
lymphoma
PET/CT imaging/molecular
imaging
•NaF PET bone imaging
ProstaScint®
Sentinel node mapping and
imaging
Surgical radiography
Ultrasound
X-Ray/diagnostic radiography
Pathology Services
24-hour laboratory services
Coagulation
General chemistry
Hematology
Immunochemistry
Laboratory administrative services
Microbiology
Pathology Surgical/Cytology
Phlebotomy
Reference testing
Transfusion services
Urinalysis
Integrative Services
Care Management
24-hour nurse on-call services
Anticoagulation clinic
Discharge planning
Medical social work
Nurse concierge services
Nursing case management
Palliative care
Survivorship services
Clinical Research
Investigator initiated trials and
sponsored/pharmaceutical trials:
•Compassionate use drugs
•Chemotherapy
•Device trials
•Expanded access drugs
•Humanitarian device
exemptions
•Intratumoral chemotherapy
•Monitoring safety and efficacy
of study drugs
•Naturopathic medicine
•Nutrition
•Pastoral care
•Radiation
•Treatment databases
•Quality of care
Chiropractic Services
Chiropractic instrument adjusting
Extremity adjusting
Full spine adjusting
Proactive wellness care
Spinal care classes
Individual nutrition assessments
Individual nutrition consults
Metabolic support
Nutrition and cooking classes
Parenteral nutrition
The Nutrition Shoppe
Spiritual outreach program
•Our Journey of Hope®
Naturopathic Medicine
Acupuncture
•Auriculotherapy
•Electroacupuncture
•Moxibustion (Moxa)
•TDP lamp
Assessment and consultation
Assessment of herb/drug and
drug/nutrient interactions
Botanical medicines
Dietary supplements
Environmental medicine and
detoxification
Homeopathic medicines
Hydrotherapy
Low-level energy laser
Natural therapies evaluation
Naturopathic classes
Quality of Life Center
Medical and symptom
management
Oncology Rehabilitation
Auriculotherapy
Cognitive therapy
Endurance and energy
management
Lymphedema clinic
Manual therapy
Occupational therapy
Peripheral neuropathy treatment
Physical therapy
Pulmonary rehabilitation
Speech and language pathology
Swallowing rehabilitation
Image Enhancement
Custom wig fittings
Professional mastectomy services
•Compression garments
•Post-surgical garments/forms
Skin care and makeup
Spa and salon services
Mind Body Medicine
Auriculotherapy
Children and teens support
program
Educational groups
•Humor therapy
•Relaxation and imagery
•Stress management
Individual and family therapy
Smoking cessation
Support groups for caregivers
Support groups for patients
Pain Management
Epidural blocks
Individualized pain assessment
Nerve blocks
Pumps
Trigger point injections
Pastoral Care
Grief and bereavement
counseling
Individual and group prayer
Non-denominational worship
services
Spiritual counseling
Nutrition Therapy
Body composition analysis
Certified diabetes selfmanagement
Drug/nutrient interaction
Education program
Enteral nutrition
Indirect calorimetry
13
Patient Relations
24-hour on-call services
Patient advocacy
Respiratory Therapy
Acute and chronic lung disease
Aridol challenge testing
Airway education and
management
Arterial blood gases
Breathing management
CPR/ACLS responders
EEG
EKG
Electromyogram
High altitude simulation testing
Holter monitors
Mechanical ventilation
management
Nerve conduction studies
Nocturnal pulse oximetry testing
Non-invasive ventilation
management
Oxygen services
Patient assessments
Pulmonary function testing
Pulse oximetry
Respiratory treatments
Six-minute walk testing
Sleep lab
Cancer Committee Membership
Petra Jasmin Ketterl, MD, Chairman // Medical Oncology
Debra Allen, RN, CPHQ // Quality
Laurence H. Altshuler, MD // Intake / Internal Medicine
Katherine Anderson, ND, FABNO // Naturopathic Medicine
Mark Axness, MD // Pain Management / Cancer Liaison Physician
Kalli N. Castille, MS, RD, CSO, LD // Nutrition
Tamara Chaney, MD // Pathology
Pam Doak, RN // Infusion Services
Gerald J. Ellison, PhD // Mind-Body Medicine
Christie Enochs // Cancer Conference Coordinator
Amy Finn // Cancer Registry, Cancer Conference Coordinator
Susan Flores, RN // Infection Control / Employee Health
Denise Geuder, MS, RN, CNOR // Administration, VP of Patient Care Services
Karen Gilbert, PT // Oncology Rehabilitation
Pierre J. Greeff, MD, FACS // Surgery
J.J. Hale, BS, CCRC // Clinical Research
Laurie Harder, CTR // Cancer Registry
Tammi Holden, RN, BSN // Outpatient Oncology Clinic
Davena Howard, RN, BSN, MBA, CNOR // Surgery
Glinda Huitt, RN // Inpatient Services
Simeon Jaggernauth, DO // Medical Oncology
Teri Jennings, MS, RN, OCN // Quality Improvement Coordinator / Cancer Program Administrator
Rev. Michael A. Langham, MCE, CGBC // Pastoral Care
Steve Mackin // Administration, President & CEO
Susan Magill // Patient Relations
Timothy McCay, DO // Diagnostic Radiology
Ed McKay, RT, (R), (N), CNMT, BA, MA // Imaging
Jeff Newhouse, DPh, MBA // Pharmacy
Tena Pagett, RT, (R) (T) // Radiation Oncology
Theodore W. Pollock, DO, FACOI // Oncology
Carla Rausch, RT // Cardiopulmonary
George Lambert River, MD, FACP // Oncology / Hematology
Elena Roman // Administration, COO
Susan Schlesinger, RN, BS, CHC // Compliance
Sagun Shrestha, MD // Oncology / Hematology
Oneita Taylor, MD // Radiation Oncology
Margie Taylor // Psychosocial Services Coordinator
Michael Thomas, MD // General Surgery
Zack Varughese, MS, MSM, DLM // Clinic
Shelly Ware, CTR // Cancer Registry, Quality of Cancer Registry Data Coordinator
Coralean Wilkerson, (ASCP), SBB // Laboratory
Leon Yoder, DO, FACS // Surgery / Gastroenterology
14
Clinical Care Conference Report
During calendar year 2011, Cancer Treatment Centers of America® offered 22 clinical care conferences on a variety of topics related to
clinical care as well as electronic health record optimization. Our programs provided 1,301 support staff hours through the technology
of video-conferencing.
When participants were asked what they liked most about the conferences, the responses were as follows: Multimodality/Multidisciplinary discussion; increasing awareness of technology and diagnostics and the ability to treat complex patients; variety of cases;
informative; and updates in current, conventional therapy.
Cancer Committee Report
The Cancer Committee is comprised of a multidisciplinary team of board-certified physicians and health care professionals. Membership includes representatives from medical oncology, radiation oncology, diagnostic radiology, pathology, surgical oncology, pain
management, and the cancer liaison. Required non-physician members are administration, cancer registry, nursing services, social
services, quality assurance, oncology rehabilitation, naturopathic medicine, nutrition, lab, cardiopulmonary, pastoral care, pharmacy,
and community outreach.
The Cancer Committee is responsible for setting goals, planning, initiating, implementing, and improving all cancer-related activities
in the facility. The Cancer Committee meets monthly on the third Wednesday of each month. Program Activity Coordinators are
designated for each cancer program activity. Coordinators are required for the following categories:
a.) Cancer Conference b.) Quality of Cancer Registry Data c.) Quality Improvement d.) Community Outreach
CTCA® at Southwestern Regional Medical Center (Southwestern) is accredited by the American College of Surgeons Commission on
Cancer. Every three years, the Commission on Cancer (CoC) accredited facilities are audited and awarded accreditation, if applicable.
There are 17 approved CoC programs in Oklahoma. Since 2004, Southwestern has been awarded a three-year accreditation with
commendation and the Outstanding Achievement Award from the American College of Surgeons Commission on Cancer. Southwestern
is one of only four Oklahoma programs to receive the Outstanding Achievement Award consecutively.
1. Community Outreach Goal
a. To educate the Southwestern region on CTCA integrative care model and become part of the community by participating in
10 community events.
b. In 2011, Southwestern participated in the following community outreach prevention events: American Cancer Society,
Our Journey of Hope, free mammograms, cold and flu prevention and Lung Watch, among many others. There were also
several events held in key markets such as Dallas and Kansas City.
2. Quality Improvement Goal
a. To ensure our Breast and Colorectal Cancer Program Practice Profile Report percentages are at or above the American College
of Surgeons Commission on Cancer rates for our same program type.
3. Clinical Goal
a. Development of Symptom Management clinic, Neurosurgery Program and Intraoperative Radiation Therapy (IORT).
4. Programmatic Goal
a. Continue to work on the application process and develop a steering committee to become a Breast Center for Excellence.
15
Cancer Conference Report
During 2011, weekly Cancer Conferences were attended by a multidisciplinary team including medical oncology, radiation oncology,
radiology, pathology and surgery. The nursing and ancillary staff also attended these conferences to ensure comprehensive
representation. Together, they reviewed cases in detail and discussed stage, prognostic indicators, national guidelines and plans for
appropriate diagnostic studies, therapies and clinical trials. These prospective, patient-oriented and multidisciplinary physician care
planning meetings provide free consultations to our patients and education for the medical and hospital staff.
Primary Sites Presented at Cancer Conferences During 2011
Adrenal1
Esophageal9
Leukemia1
Prostate8
Appendix2
Gastrointestional Tract
4
Liver3
Rectum3
Bladder1
Gynecologic15
Lung12
Sarcoma7
Breast22
Head/Neck/Brain16
Lymphoma9
Thyroid1
Cholangiocarcinoma2
Kidney1
Melanoma6
Unknown Primary
Colon9
Larynx1
Pancreas7
Ureter1
15
Total156
16
Cancer Registry Report
Cancer Treatment Centers of America® at Southwestern Regional Medical Center (Southwestern) Cancer Registry maintains a data
system designed for the collection, management and analysis of data on individuals diagnosed with cancer. The Cancer Registry has
entered more than 15,500 cases into the database since its inception in 1991.
During 2011, 1,083 new cases were accessioned into the Cancer Registry database at Southwestern. Of these cases, 464 cases were
analytic (either diagnosed at Southwestern or received all or part of their first course of treatment at Southwestern) and 393 were nonanalytic (diagnosed elsewhere and received their first course of treatment elsewhere) and 226 were non-reportable cases. There were
360 male patients and 497 female patients. We accessioned patients from 40 states, two patients from the Virgin Islands and one patient
from Iraq, with the largest portion of patients residing in Oklahoma.
The American College of Surgeons, Commission on Cancer (CoC) mandates that at least 90% of the analytic patients from the last five
years and at least 80% from the reference year (1991) are followed yearly. The Southwestern Regional Medical Center Cancer Registry
meets this standard with 92% current follow-up on patients seen since 1991 and 95% on patients seen in the last five years.
The Registry staff maintains the daily functions of the Registry and ensures data accuracy with continuous quality improvement reviews
by Cancer Committee physicians. The Registry provides the Cancer Committee with information from which clinical application and
analysis of patient outcomes can be determined.
Cancer Registry Activities for 2011
• Responded to more than 150 requests
for data during 2011
• Submitted all required cases error free
on initial submission to the National
Cancer Data Base
• All staff participated in the Oklahoma
Cancer Registrars Association
Educational Workshop in Oklahoma
City, Oklahoma.
• Submitted all required cases to the
Oklahoma Central Cancer Registry
• Attended the National Cancer
Registrars Association 36th Annual
Educational Conference in Orlando,
Florida
• Two members of the registry staff held
an office in the Oklahoma Cancer
Registrars Association and attended
quarterly executive board meetings
• Coordinated and attended monthly
Cancer Committee meetings
• Attended state purchased North
American Association of Central
Cancer Registries Webinars
• Participated in Clinical Care
Conferences and Staff Education
Meetings
• Maintained membership with the
National Cancer Registrars Association
• Maintained membership with the
Oklahoma Cancer Registrars
Association
• Provided information and assisted in
the completion of the Annual Report
• Began the process to become a Breast
Center of Excellence with the National
Accreditation Program for Breast
Cancer Centers
17
• Participated in the National Cancer
Registrars Association National Cancer
Registrars Week by attending a photo
opportunity with the Governor of the
State of Oklahoma, Mary Fallin
• Participated in the Leukemia and
Lymphoma Society’s Light the Night
fundraiser
• Attended Tuesday Staff Education
meetings
• Attended Friday Clinical Care
Conferences
Quality Outcomes Report
Southwestern at 100% for both
Breast and Colon Measures
All Commission on Cancer accredited hospitals must follow the quality metrics guidelines for collecting necessary data and achieving
high performance with the measures outlined in the CP3R. These standards show performance criteria on critical components of
cancer care applied through the National Cancer Data Base (NCDB). Cancer Treatment Centers of America® (CTCA) hospitals have
invested in systems to ensure that our cancer patients receive high quality, coordinated care that follows evidence-based national
treatment guidelines. Our hospitals also meet and surpass the standards for offering supportive services and resources addressing the
full continuum of care for all our patients. These graphs show CP3R comparisons for breast and colon cancer at CTCA® at Southwestern
with others in our region and nationally.
Select Breast Measures
Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70
receiving breast conserving surgery for breast cancer. [BCS/RT]
Performance Rates
2009
100%
CTCA at Southwestern Regional Medical Center (Tulsa, OK)
84%
Oklahoma
87.4%
All CoC Approved Programs (ALL)
Select Breast Measures
Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for
women under age 70 with AJCC T1c N0 M0, or Stage II or III ERA and PRA negative breast cancer. [MAC]
Performance Rates
2009
CTCA at Southwestern Regional Medical Center (Tulsa, OK)
100%
Oklahoma
85.4%
All CoC Approved Programs (ALL)
88.4%
Select Breast Measures
Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) Performance Rates
2009
of diagnosis for women with AJCC T1cN0M0, or Stage II or III hormone receptor positive breast cancer. [HT]
CTCA at Southwestern Regional Medical Center (Tulsa, OK)
100%
Oklahoma
72.5%
All CoC Approved Programs (ALL)
81.8%
18
Select Colon Measures
Adjuvant chemotherapy is considered or administered within 4 months (120 days) of diagnosis for
patients under the age of 70 with AJCC Stage III (lymph node positive) colon cancer. (ACT)
Performance Rates
2009
100%
CTCA at Southwestern Regional Medical Center (Tulsa, OK)
85%
Oklahoma
89.2%
All CoC Approved Programs (ALL)
Select Colon Measures
At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer.
(12RLN)
Performance Rates
2009
CTCA at Southwestern Regional Medical Center (Tulsa, OK)
100%
Oklahoma
85.2%
All CoC Approved Programs (ALL)
84.8%
19
2011 Primary Sites
Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report
Sex
Class of Case Stage Distribution - Analytic Cases Only
Primary SiteTotalM
FAnalyNA
ORAL CAVITY & PHARYNX
6
18 (2.1%)
12
6
12
Stg 0
Stg I
Stg II
0
2
0
Stg III Stg IV 88/NA
1
2
0
Lip
1 (0.1%)
10100 1 000 0
Tongue
2 (0.2%)
20110 0 030 0
Salivary Glands
2 (0.2%)
11110 1 000 0
Floor of Mouth
1 (0.1%)
1
0
0
1
0
0
0
0
0
0
Gum & Other Mouth
1 (0.1%)
0
1
0
1
0
0
0
0
0
0
Nasopharynx
5 (0.6%)
14140 0 001 0
Tonsil
4 (0.5%)
40220 0 011 0
Oropharynx
1 (0.1%)
10010 0 000 0
Other Oral Cavity & Pharynx
1 (0.1%)
1
0
0
1
0
0
0
0
0
0
222 (25.9%)
124
98
113
109
0
7
16
19
68
3
DIGESTIVE SYSTEM
Esophagus
13 (1.5%)
94
1030 1 243 0
Stomach
16 (1.9%)
976
100 0 006 0
Small Intestine
Colon Excluding Rectum
Cecum
Appendix
3 (0.4%)
64 (7.5%)
03030 0 000 0
27
37
31
33
0
2
2
9
18
0
19
6139
10010170
8
35350 1 101 0
Ascending Colon
6
33240 0 002 0
Hepatic Flexure
1
10010 0 000 0
Transverse Colon
6
33510 0 122 0
Splenic Flexure
2
11020 0 000 0
Descending Colon
3
21210 0 002 0
18
810
108000640
1
01010 0 000 0
Sigmoid Colon
Large Intestine, NOS
Rectum & Rectosigmoid
Rectosigmoid Junction
Rectum
35 (4.1%)
22
13
18
17
0
3
6
2
7
0
12
75390 0 003 0
23
158
1580 3 624 0
Anus, Anal Canal & Anorectum
3 (0.4%)
1
2
2
1
0
0
0
1
0
1
Liver & Intrahepatic Bile Duct
14 (1.6%)
10
4
8
6
0
0
0
1
6
1
Liver
7
61340 0 012 0
Intrahepatic Bile Duct
7
43520 0 004 1
Gallbladder
6 (0.7%)
15420 0 004 0
Other Biliary
2 (0.2%)
20110 1 000 0
62 (7.2%)
4121
32
300062
240
Pancreas
Peritoneum, Omentum & Mesentery
2 (0.2%)
0
2
0
2
0
0
0
0
0
0
Other Digestive Organs
2 (0.2%)
2
0
1
1
0
0
0
0
0
1
RESPIRATORY SYSTEM
Nose, Nasal Cavity & Middle Ear
Larynx
127 (14.8%)
1 (0.1%)
5 (0.6%)
62
65
72
55066
19
401
1
0
1
0
0
0
0
0
0
1
41140 0 100 0
Lung & Bronchus
121 (14.1%)
57
64
70
51
0
6
5
19
40
0
BONES & JOINTS
2 (0.2%)
1
1
0
2
0
0
0
0
0
0
20
Sex
Primary SiteTotalM
SOFT TISSUE (including Heart)
Class of Case Stage Distribution - Analytic Cases Only
FAnalyNA
Stg 0
Stg I
Stg II
Stg III Stg IV 88/NA
8 (0.9%)
5
3
1
7
0
0
1
0
0
0
SKIN EXCLUDING BASAL & SQUAMOUS
20 (2.3%)
12
8
10
10
0
5
1
2
1
1
Melanoma – Skin
18 (2.1%)
11
7
9
9
0
5
1
2
1
0
Other Non-Epithelial Skin
2 (0.2%)
1
1
1
1
0
0
0
0
0
1
BASAL & SQUAMOUS SKIN
3 (0.4%)
2
1
0
3
0
0
0
0
0
0
2
1
0
3
0
0
0
0
0
0
Basal/Squamous cell carcinomas of Skin
BREAST
3 (0.4%)
192 (22.4%)
1
191
11874 637352020 0
FEMALE GENITAL SYSTEM
69 (8.1%)
0
Cervix Uteri
16 (1.9%)
0163
13010200
Corpus & Uterus, NOS
15 (1.8%)
Corpus Uteri
Uterus, NOS
14
0
69
15
21
8
48
7
0
0
8
4
1
0
7
2
4
1
1
1
01477040210
1
01100 0 000 1
Ovary
32 (3.7%)
0329
23021330
Vagina
3 (0.4%)
03120 1 000 0
Vulva
3 (0.4%)
03030 0 000 0
MALE GENITAL SYSTEM
69 (8.1%)
69
Prostate
68 (7.9%)
680
53
150172547 0
1 (0.1%)
10010 0 000 0
30 (3.5%)
264
13
170 1 219 0
8 (0.9%)
62350 0 210 0
Testis
URINARY SYSTEM
Urinary Bladder
Kidney & Renal Pelvis
Ureter
21 (2.5%)
1 (0.1%)
19
0
2
53
10
16
11
0
0
17
1
25
0
4
0
7
9
0
0
10010 0 000 0
BRAIN & OTHER NERVOUS SYSTEM
16 (1.9%)
11
Brain
14 (1.6%)
104770 0 000 7
Cranial Nerves Other Nervous System
2 (0.2%)
1
5
1
8
1
8
1
0
0
0
0
0
0
0
0
0
0
8
1
ENDOCRINE SYSTEM
18 (2.1%)
4
14
135080320
Thyroid
16 (1.9%)
412
124080310
Other Endocrine including Thymus
LYMPHOMA
Hodgkin Lymphoma
2 (0.2%)
0
2
1
1
0
0
0
0
1
0
22 (2.6%)
11
11
139041530
4 (0.5%)
22220 0 020 0
Hodgkin - Nodal
2
11110 0 010 0
Hodgkin - Extranodal
2
11110 0 010 0
Non-Hodgkin Lymphoma
18 (2.1%)
99
1170 4 133 0
13
76850 2 132 0
NHL - Nodal
5
23320 2 001 0
MYELOMA
NHL - Extranodal
6 (0.7%)
33420 0 000 4
LEUKEMIA
11 (1.3%)
47470 0 000 4
Lymphocytic Leukemia
6 (0.7%)
24150 0 000 1
Myeloid & Monocytic Leukemia
5 (0.6%)
2
3
3
2
0
0
0
0
0
3
Acute Myeloid Leukemia
1
01100 0 000 1
Chronic Myeloid Leukemia
3
12120 0 000 1
1
10100 0 000 1
MESOTHELIOMA
Other Myeloid/Monocytic Leukemia
2 (0.2%)
20110 0 001 0
MISCELLANEOUS
22 (2.6%)
TOTAL
857
1111
1480 0 00014
360
497
464
393 6958881
15736
21
2011 Estimated New Cancer Cases
Men
Site
W ome n
United States
Southwestern
Site
United States
Southwestern
Prostate
29%8%
Lung & Bronchus
14%
14%
Colon & Rectum
9%
12%
Urinary Bladder
7%
1%
Melanoma of the Skin
5%
2%
Kidney & Renal Pelvis
5%
3%
Non-Hodgkin’s Lymphoma4%
2%
Oral Cavity & Pharynx
3%
2%
Leukemia
3%1%
Pancreas
3%7%
All Other Sites
18%
48%
Breast
29%22%
Lung & Bronchus
14%
14%
Colon & Rectum
9%
12%
Uterine Corpus
6%
2%
Thyroid
5%2%
Melanoma of the Skin4%
2%
Non-Hodgkin’s Lymphoma4%
2%
Kidney & Renal Pelvis
3%
3%
Ovary
3%4%
Pancreas
3%7%
All Other Sites
20%
30%
Total
Total
100%100%
100%100%
* New Leading Cancer Cases 2012 estimates from the American Cancer Society Cancer Facts and Figures 2012 compared with 2011 Analytic data at Southwestern.
2011 Total New Cases by State
2
1
2
1
1
3
4
1
6
2
5
12
11
6
9
41
2
106
204
4
Alaska = 2
Virgin Islands = 2
Baghdad, Iraq = 1
2
2
23
30
21
11
2
13
19
52
42
22
1
1
20
38
143
4
2
1
1
23
Collaboration Leads to Innovation
The wellbeing of our patients drives all that we do at Cancer Treatment Centers of America® (CTCA) and our desire to foster productive
collaboration among other oncology experts leading to better treatments for patients highlights this mission. In September 2012,
we hosted the Inaugural CTCA® Review, which brought pioneers in the hematologic and medical oncology fields together in Chicago
for an intense, two-day continuing medical education (CME) program. The groundbreaking, collaborative event featured a faculty
of internationally recognized experts from Duke University, Fred Hutchinson Cancer Research Center, Mayo Clinic, MD Anderson,
Sloan-Kettering, UCLA, University of Chicago, and CTCA.
Maurie Markman, MD, Senior Vice President of Clinical Affairs,
National Director of Medical Oncology, Cancer Treatment Centers of America
Medical Staff
Daniel A. Nader, DO, FCCP // Chief of Staff, National Clinical Director and Medical Director of Pulmonary and Critical Care
Dr. Nader serves as Director of the Lung Center at CTCA at Southwestern. Dr. Nader earned a medical degree from the
University of Health Sciences in Kansas City. He completed both a residency and a fellowship in pulmonary medicine at the
Naval Regional Medical Center in San Diego. He is board certified in internal medicine and pulmonary disease. Dr. Nader was
recognized by Castle Connelly as a top doctor in pulmonary medicine the last three years and in 2012, he was named one of
US News and World Report’s “Top Doctors.”
Amer Alkhatib, MD // Gastroenterologist
Dr. Alkhatib received his medical degree from the University of Jordan in Amman. He completed an internal medicine internship and residency at the University of Texas in Houston, and a gastroenterology fellowship at the University of Utah. Board
certified in gastroenterology, he also completed an advanced endoscopy fellowship at the Mayo Clinic in Scottsdale. In addition,
he served as adjunct clinical assistant professor at Washington State University and worked as a liver transplant hospitalist
at the University of Utah. Dr. Alkhatib has had more than 30 research papers published in medical journals, including the
New England Journal of Medicine.
Laurence H. Altshuler, MD // Medical Director of Oncology Intake
Dr. Altshuler earned a medical degree from the University of Oklahoma and then completed an internal medicine residency
at the University of Oklahoma Health Sciences Center in Oklahoma City. He earned his bachelor’s degree from Duke University
in Durham, where he graduated magna cum laude. Board certified in internal medicine, Dr. Altshuler is also certified in
acupuncture, hypnosis and interactive imagery and also has expertise in Western and Chinese herbology. He has authored
several publications including magazines and books.
Mark Axness, MD // Medical Director of Quality of Life Center
A board-certified anesthesiologist with a sub-specialty certification in pain management and palliative care, Dr. Axness earned
a medical degree from the University of California Medical School, followed by an internship and residency at the Mayo Clinic.
He has been practicing anesthesiology for more than 25 years and joined CTCA in 2005.
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Clinton J. Baird, MD // Medical Director of Neurosurgery Services & Neurosurgeon
Dr. Baird earned a medical degree from Saint Louis University, where he also completed bachelor’s degrees in biology and
chemistry and a graduate study in biology. At Johns Hopkins University, he completed an internship in general surgery,
a residency in neurological surgery and the Hunterian Neuro-Oncology Research Fellowship, supported in part by the American
Brain Tumor Association. He also completed a fellowship in endoneurosurgery at the University of Pittsburgh Medical Center.
He has received several awards and has been published in numerous medical journals.
Lisa Baldwin, MD // Hospitalist
Board certified by the American Board of Internal Medicine, Dr. Baldwin earned a medical degree from the University of
Oklahoma College of Medicine, where she graduated with distinction. She went on to complete the university’s internal medicine
residency program. Before pursuing a medical degree, Dr. Baldwin received a bachelor’s degree in radiologic technologysonography from the University of Oklahoma. She is a member of the Tulsa County Medical Society, Oklahoma State Medical
Association and the Alpha Omega Alpha Honor Medical Society.
Samuel C. Bieligk, MD, FACS // Surgical Oncologist
Board certified in general surgery and surgical oncology, Dr. Bieligk joined CTCA in September 2011 after serving at St. John’s
Regional Medical Center in Joplin, Missouri. He received a bachelor’s degree from the University of Oklahoma and a medical
degree from the University of Oklahoma School of Medicine. His post-graduate training includes a general surgery residency
and research fellow/instructor at Tulane University School of Medicine and a surgical oncology fellowship at Memorial SloanKettering Cancer Center. He is a member of the American College of Surgeons, Society of Surgical Oncology and American
Medical Association.
Bette Bischoff, MD, RD // Hospitalist
A Diplomate of the American Board of Internal Medicine, Dr. Bischoff earned a medical degree from the University of Kansas
School of Medicine in Kansas City. She completed an internal medicine residency at the University of Texas Health Science
Center at San Antonio, and a fellowship in integrative medicine at the University of Kansas Medical Center. Dr. Bischoff is
also a registered dietitian. She holds a bachelor’s degree in dietetics from Kansas State University, where she graduated summa
cum laude.
Janet Cheek, DO // Hospitalist
Dr. Cheek primarily cares for the daily medical needs of inpatients. She earned a medical degree from the New York College of
Osteopathic Medicine. She received a bachelor’s degree in chemistry from Howard University in Washington, D.C., where she
also completed a post-baccalaureate program. Board certified in osteopathic internal medicine, Dr. Cheek completed an
internship and residency at St. Barnabas Hospital in New York. She is a member of the American Osteopathic Association,
the American College of Osteopathic Internists and the American Medical Association.
James P. Flynn, MD, FACR // Radiation Oncologist
Before joining CTCA, Dr. Flynn taught radiology and radiation oncology and served for 17 years as an attending physician at
Overlook Hospital in New Jersey. Board certified by the American Board of Diagnostic and Therapeutic Radiology, Dr. Flynn
completed residencies in diagnostic radiation and radiation oncology at New York Hospital, Cornell Medical Center, and
Memorial Sloan-Kettering Cancer Center. He earned a medical degree from the St. Louis University School of Medicine.
He was named a Fellow of the American College of Radiology in 1997. In 2012, Dr. Flynn was named one of US News and
World Report’s “Top Doctors.”
John Frame, MD, FACS // Breast Surgeon
Dr. Frame is a Fellow of the American College of Surgeons and a Diplomate of the American Board of Surgery. Board certified by
the American Board of Surgery, he earned a medical degree from Washington University School of Medicine. He completed a
surgical internship and residency at the University of Oklahoma Health Sciences Center, where he served as Chief Resident in
surgery. He also completed a research fellowship in cardiovascular surgery at Duke University Medical Center. Before pursuing a
medical degree, Dr. Frame obtained a bachelor’s degree from the University of Oklahoma. His work has been published in
renowned clinical publications, including Surgical Forum and the American Journal of Surgery.
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Geoffrey Graham, DO // Hospitalist
Prior to joining CTCA, Dr. Graham served as a hospitalist for Midwest Hospitalist Services in Tahlequah, OK. He completed
his internal medicine residency at Freeman Health System in Joplin, MO where he served as internal medicine chief resident.
Dr. Graham received his biological sciences degree from the University of California and his medical degree at Touro
University of Osteopathic Medicine in Henderson, NV.
Pierre J. Greeff, MD, FACS // Surgical Oncologist
Dr. Greeff ’s background includes running a thriving general surgery and surgical oncology practice. He trained under one
of the most renowned cancer surgeons in the country, John Stehlin, MD. Dr. Greeff earned a medical degree from the Medical
School of the University of Cape Town in South Africa. Board certified in surgical oncology, he completed a residency at
St. Joseph Hospital in Houston, where he was also a member of the surgical teaching staff. During his tenure there, he received
the distinguished “Service to Mankind Award” presented by the Sertoma Club of Houston.
Simeon Jaggernauth, DO // Medical Oncologist & Program Director of Medical Oncology Fellowship
Dr. Jaggernauth earned a medical degree from Oklahoma State University. He then completed an internship at Tulsa Regional
Medical Center, an internal medicine residency at the University of Oklahoma and a fellowship in medical oncology at the
University of Louisville in Kentucky. Dr. Jaggernauth is board certified in medical oncology. He is a member of the Oklahoma
Society of Clinical Oncology, American Society of Clinical Oncology, American Society of Hematology and the American
Medical Association.
Petra Jasmin Ketterl, MD // Medical Oncology / Intake Physician
Before joining CTCA, Dr. Ketterl ran a private practice in Tennessee. Board certified in medical oncology, she completed
a residency in internal medicine and a fellowship in oncology at East Tennessee State University, where she also earned a
medical degree.
Don King, MD, ACP, ACPE // Director of Hospital Medicine
Dr. King works together as part of a team to care for inpatients. Board certified in internal medicine and administrative
medicine, Dr. King completed residencies in internal medicine at Pacific-Presbyterian Hospital in San Francisco and the
University of Illinois. He has held positions as assistant professor of internal medicine, Chief of Hospital Services at the
U.S. Air Force Hospital in Turkey, and Medical Director at City of Faith Hospital in Tulsa.
Joseph P. Lynch, MD, MS // Medical Director of the Stem Cell Transplant and Cell Therapy Program
Board certified in medical oncology and internal medicine, Dr. Joseph Lynch earned master’s and medical degrees from
Georgetown University School of Medicine in Washington, D.C. Dr. Lynch completed an internship at Cleveland Clinic,
an internal medicine residency at West Virginia University in Morgantown and a medical oncology fellowship at Allegheny
General Hospital in Pittsburgh. Additionally, he completed a bone marrow transplantation fellowship at the University of
Louisville in Kentucky and served as a visiting fellow in the bone marrow transplantation program at the Fred Hutchinson
Cancer Research Center in Seattle. He has been performing bone marrow transplants since 1985.
Ritwick Panicker, MD, FACP // Hematologist & Medical Oncologist
Dr. Panicker received his medical degree from Christian Medical College in Vellore, India. He completed an internal medicine
residency at the Mayo Clinic in Rochester, Minnesota, and a medical oncology fellowship at the University of Washington in
Seattle. In addition, Dr. Panicker received hematology training at hospitals in London and Cardiff, England. He is board certified
in medical oncology, hematology and internal medicine.
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Michael S. Payne, Jr., MD // Director of Radiation Oncology
Dr. Payne completed a bachelor’s degree from Northwestern University, a medical degree from Rush Medical College, and an
internship in internal medicine at the University of Illinois. He completed a four-year residency in radiation oncology at the
University of Kansas. He is a member of several professional organizations, including the American College of Radiation
Oncology and the American Brachytherapy Society.
Theodore W. Pollock, DO, FACOI // Vice Chief of Staff, Director of Medical Oncology
Dr. Pollock brings more than 30 years of oncology experience to CTCA. He earned a medical degree from Kirksville College of
Osteopathic Medicine. Dr. Pollock then completed an internship and residency at Doctors Hospital in Columbus, Ohio, as well
as a medical oncology fellowship at Memorial Sloan-Kettering Center in New York. After his fellowship, Dr. Pollock returned to
Columbus, where he spent 25 years providing care to cancer patients in a private practice setting. He is board certified in medical
oncology and hematology.
George Lambert River, MD, FACP // Hematologist & Medical Oncologist
Dr. River earned a medical degree from Loyola University Chicago Stritch School of Medicine. He completed an internship,
a residency in internal medicine, and a fellowship in hematology at Cook County Hospital in Chicago. With nearly 50 years of
experience in practicing hematology, medical oncology, and internal medicine, he has headed the cancer programs at Finley
Hospital in Dubuque, IA, and Freeman Hospital in Joplin, MO. Board certified in medical oncology and hematology, Dr. River
also served as a hematologist/medical oncologist at Mt. Carmel Regional Medical Center/Cancer Center in Pittsburg, KS.
Sagun Shrestha, MD // Hematologist & Medical Oncologist
Dr. Shrestha received her medical education at the Maulana Azad Medical College in New Delhi, India. She was Chief Medical
Resident at the Jamaica Hospital Medical Center in New York and Chief Fellow in the Division of Hematology-Oncology at the
Long Island Jewish Medical Center, Albert Einstein College of Medicine. She is board certified and holds memberships in the
American Society of Clinical Oncology, American Society of Hematology and American College of Physicians.
Oneita Taylor, MD // Radiation Oncologist
Dr. Oneita Taylor attended the University of Kansas and Smith College in Massachusetts, where she earned a bachelor’s degree.
She earned a medical degree from the University of Kansas and completed a residency and fellowship in radiation oncology at
the University of Kansas Medical Center. Board certified by the American Board of Radiology, she is a Diplomate of the National
Board of Medical Examiners, a member of several professional organizations, and a clinical assistant professor at the University
of Oklahoma Medical Center.
Ross M. Taylor, MD // Gastroenterologist
Dr. Taylor earned a medical degree from the University of Manitoba in Winnipeg, Canada, where he also completed training
as Chief Resident in internal medicine. Prior to joining CTCA, he practiced gastroenterology and internal medicine. He also
taught medical students and postgraduate residents at Oral Roberts University School of Medicine. Each year, he performs
approximately 1,000 endoscopy procedures. Board certified in gastroenterology, Dr. Taylor is a Certified Nutritional Support
Physician and a member of the American Medical Association.
Leon J. Yoder, DO, FACP // Gastroenterologist & Program Director of Gastroenterology Fellowship
Board certified in gastroenterology by the American Board of Internal Medicine and the American Association of Physician
Specialists, Dr. Yoder earned a medical degree from Kansas City University of Medicine and Biosciences College of Osteopathic
Medicine. He completed a residency in internal medicine at Veterans Hospital in Dayton, Ohio (Ohio State University affiliated),
followed by a fellowship in gastroenterology at the University of Colorado Medical Center. Dr. Yoder is also an adjunct clinical
associate professor of medicine at Oklahoma State University, which includes gastroenterology fellowship training.
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Integrative Services
Katherine Anderson, ND, FABNO // National Director of Naturopathic Medicine
Katherine Anderson is a Fellow of the American Board of Naturopathic Oncology. She graduated from Simon Fraser University
in British Columbia and completed a naturopathic medicine residency at CTCA. Prior to joining CTCA, she spent several years
as a women’s health educator at the University of Toronto. She has served as the president of the Oklahoma Association of
Naturopathic Physicians and has been a recipient of the Swiss Herbal Remedies Bursary in recognition of “Excellence in the
Promotion of Women’s Health.”
Kalli N. Castille, MS, RD, CSO, LD // Director of Nutritional Support & Culinary
Kalli Castille and her team of clinical oncology dietitians proactively address patients’ nutritional well-being throughout their
care. Castille is a registered and licensed dietitian with a certification in oncology nutrition. She earned bachelor’s and master’s
degrees in nutritional sciences and healthcare administration from Oklahoma State University. In 2008, Castille was named
president-elect of the Oklahoma Dietetic Association (ODA). She served as president in 2009 and as past-president in 2010.
Karen R. Gilbert, PT // National Director of Oncology Rehabilitation
Karen Gilbert and her team of licensed rehabilitation therapists provide a range of individualized programs, including physical
and occupational therapy, speech and language pathology, massage therapy, auriculotherapy, and lymphedema management.
A licensed physical therapist and certified lymphedema therapist, Gilbert earned a bachelor’s degree in physical therapy from the
University of Michigan. She has conducted investigational rheumatology research on fibromyalgia and facilitates a lymphedema
support group for breast cancer survivors.
Reverend Michael Langham // Director of Pastoral Care
Reverend Michael Langham and his team of chaplains, including certified grief/bereavement counselors, strive to create
an atmosphere conducive to healing patients and families. Rev. Langham earned a bachelor’s degree in pastoral care from
Oral Roberts University and received clinical pastoral education from the Association of Clinical Pastoral Education at
Integris Hospital in Oklahoma City. He is certified by the United States Chaplains Association.
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Publications
Published Manuscripts
1. Association Between Changes in Quality of Life Scores and Survival in Non-Small Cell Lung Cancer Patients 2012 European Journal of Cancer Care
2. The Use of Failure Mode and Effect Analysis in a Radiation Oncology Setting: The Cancer Treatment Centers of America Experience 2012
Journal for Healthcare Quality
3. Beliefs and Perceptions of Women with Newly Diagnosed Breast Cancer Who Refused Conventional Treatment in Favor of Alternative
Therapies 2012 The Oncologist
4. Colon Carcinoma with Unusual Metastasis to the Esophagus Manifesting as Multiple Nodules and Dysphagia: Management with Systemic
Chemotherapy 2012 Case Reports in Gastroenterology
5. Role of Nutritional Status in Predicting Quality of Life Outcomes in Cancer – A Systemic Review of the Epidemiological Literature 2012
Nutrition Journal
6. Superficial Hyperthermia Plus External Beam Radiation in the Palliation of Locally Progressive Chemoradiation-Resistant Breast Cancer 2012
Karger Case Report On- Line Journal
7. Effect of Naturopathic and Nutritional Supplement Treatment on Tumor Response, Control, and Recurrence in Patients with
Prostate Cancer Treated with Radiation Therapy 2012 The Journal of Alternative and Complementary Medicine
8. Serum 25-Hydroxyvitamin is Inversely Associated with Body Mass Index in Cancer 2012 Nutrition Journal
9. Can Patient Experience with Service Quality Predict Survival in Colorectal Cancer? 2012 Journal for Healthcare Quality
10. Longitudinal Health-Related Quality of Life Assessment Implications for Prognosis in Stage IV Pancreatic Cancer 2012 Pancreas Journal
Published Abstracts
1. The Role of Electronic Records in Reporting Adverse Drug Reactions 2012 American Society of Clinical Oncology (ASCO) Quality Care Symposium
2. Low Dose Naltrexone 2012 Integrative Health Practitioner Journal
3. Use of Naturopathic Agents in the Context of Immunotherapy for Pancreatic Cancer Patients 2012 Society of Integrative Oncology (SIO)
4. Naturopathic Nutritional Supplements (NNS) Collaborate with Cancer Chemotherapy in the Inhibition of Human Proliferation of Human
Peritoneal Cancers 2012 Society of Integrative Oncology (SIO)
5. Resveratrol Increases Sensitivity of Human Peritoneal Cancer Cells to Macrophage-Mediated Cytolysis 2012
American Association for Cancer Research (AACR)
6. The Impact of Parenteral Nutrition on Clinical Outcomes in Cancer Patients Undergoing Hyperthermic Intraparitoneal Chemotherapy 2012
Clinical Nutrition Week
7. Outcomes of Systemic Nutritional Assessment and Intervention in an Oncology Setting 2012 Clinical Nutrition Week
8. Longitudinal Health-Related Quality of Life Assessment: Implications for Prognosis in Ovarian Cancer 2012
American Society of Clinical Oncology (ASCO)
9. The Relationship Between Patient Experience with Service Quality and Survival in Pancreatic Cancer 2012
American Society of Clinical Oncology (ASCO)
10. Safety and Efficacy of Percutaneous Endoscopic Gastrostomy Tube Placement in Patients with Malignant Peritoneal Carcinomatosis
Induced Bowel Obstruction 2012 American Society of Clinical Oncology (ASCO)
Poster Presentations
1. Stereotactic Body Radiotherapy (SBRT) for Low Risk Prostate Cancer: Plan Comparison with Real Time Tracking By Beacons and Helical
Tomotherapy 2012 American Society for Radiation Oncology (ASTRO) Annual Meeting
2. The Utilization of IV Vitamin C for the Supportive Care in Advanced Malignancies 2012 Society of Integrative Oncology (SIO)
3. Low Level Laser in Oral Mucositis: A Pilot Study 2012 Society of Integrative Oncology (SIO)
Oral Presentations
1. Naturopathic Medicine in End-of-Life Palliative Care 2012 Oncology Association of Naturopathic Medicine (OncANP) Conference
Articles Published
1. The Chiropractor’s Role in Quality of Life for Cancer Patients 2012 The American Chiropractor
2. Life Altering Diagnosis 2012 American Chiropractic Association News
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