Download The Power of Community-Based Cancer Care: Live

The Power of Community-Based Cancer Care:
Live Life Well
CANCER PROGRAM ANNUAL REPORT 2011-2012
The full circle of health and wellness dedicated to excellence.
Cancer Program at a Glance
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For more information about the Cancer Center at CentraState, call 1-855-411-CANCER or visit
www.centrastate.com/cancercenter.
Our Mission
To enhance the health and well-being of our communities through the compassionate delivery of
quality healthcare.
President’s Message
At CentraState Medical Center, we are looking at cancer care as an all-encompassing array of services designed
to fulfill the patient’s needs and offer all the treatment options for the best possible outcomes. From prevention
through survivorship, The Cancer Center at CentraState Medical Center provides a coordinated approach by
primary care physicians and cancer care specialists, nurses and nurse navigators, counselors and therapists
to guide patients and their families through every step of their journey.
With advanced treatment options leading to increased survivor rates, cancer is beginning to resemble a
chronic disease. CentraState’s primary care physicians, experienced in attending to the needs of cancer
survivors, can help guide patients toward continued wellness by keeping cancer under surveillance, screening
for other cancers, providing general preventive health, and managing any ongoing health issues. Plus,
CentraState patients have access to cancer rehabilitation and wellness services such as integrative therapies like
yoga and meditation; specialized occupational, speech and physical therapies, including lymphedema and aquatic
therapies; and a medically supervised Fitness and Wellness Center.
Driving hours to a specialized center for a cancer diagnosis and for frequent treatments can take a toll on a cancer patient
and family members during an already stressful time. CentraState’s cancer patients can stay in their own community and
with the physicians they’re familiar with for their treatment—saving them undue stress, without sacrificing clinical quality
and expertise. It also allows them to receive an unmatched level of customized, personal care that’s hard to match at a distant
cancer center.
In the spring of 2012, CentraState, in collaboration with ProCure Treatment Centers and Princeton Radiation Oncology,
brought the first and only proton therapy center to the New Jersey/New York area. This $160-million, 60,000-square-foot
ProCure Proton Therapy Center in Somerset, New Jersey is one of only 10 centers in the United States. Proton therapy, an
FDA-approved alternative to traditional X-ray radiation, is an advanced form of radiation treatment to combat several types
of cancerous tumors. The treatment is performed using proton beams directed precisely to the cancerous tumor, only with
fewer damaging side effects to nearby tissue than occurs with traditional radiation therapy.
At CentraState, community-based cancer care is provided by world-class oncologists who are trained at renowned national
cancer centers, including Harvard, Memorial Sloan-Kettering, and the Hospital of the University of Pennsylvania. Our skilled
surgeons are trained in the latest minimally invasive procedures, including two thoracic surgeons who were among the first
in the world to perform groundbreaking, video-assisted, thoracic surgery. It’s also advanced treatments like robotic surgery
and proton therapy, and the latest clinical trials with promising new developments—all right here in our community at
CentraState.
The Power of Community-Based Cancer Care: LIVE LIFE WELL
Sincerely,
John Gribbin, FACHE
President and CEO; CentraState Healthcare System
CentraState Healthcare Foundation — Cancer Campaign
To help support our growing cancer center, the CentraState Healthcare Foundation Board of Trustees
approved a campaign that will run through the end of 2013 with a goal to raise $5 million. The funds
raised will be used for:
• New construction and equipment for the expansion of our radiation oncology and Women’s Health
Center.
• Seed funding for new programs such as the Melanoma and Skin Cancer Center and colorectal cancer
program.
• An endowment to provide a stable source of revenue for cancer services that operating revenues
alone can’t sustain or that are provided free to patients and families.
• An endowment to provide a stable source of revenue for our Family Practice Residency Program with
its survivorship training.
Community support of this campaign is an investment that assures that the most comprehensive cancer
care is available close to home.
2
Cancer Committee:
The Cancer Committee is a standing committee of CentraState Medical Center’s (CSMC) Medical and Dental
staff. The mission of the committee is to enhance the health and well-being of our communities through the
compassionate delivery of quality health care. The committee is responsible for ensuring compliance with the
American College of Surgeons (ACoS) Commission on Cancer standards and promoting the best possible
standard of care for cancer patients treated at CentraState Medical Center. The committee meets quarterly to
plan, assess and implement all cancer-related programs and activities at the hospital. The committee’s goal is to
ensure CentraState offers a coordinated, multidisciplinary approach to cancer prevention and treatment supported
by state-of-the-art technology and specially trained staff. The committee strives to continually improve patient
survival and outcomes to enhance the quality of life for all cancer patients, regardless of diagnosis.
2012 Cancer Committee Goals:
Each year, the Cancer Committee establishes, implements, and monitors clinical, programmatic, quality
improvement and community outreach goals for the improvement of cancer-related care.
These goals are accomplished with an emphasis on wellness, education, prevention, survivorship, research and
stringent monitoring of comprehensive, quality cancer care. Each goal is evaluated and discussed at least twice
per year by the Cancer Committee.
The following are examples of clinical and programmatic goals:
Clinical Goals:
1. To offer early, palliative care on all appropriate patients by optimally utilizing palliative care resources offered
through the Cancer Center at CSMC.
2. To ensure all biopsies, generated within physician offices for patients receiving definitive surgery at CSMC,
are made available to the pathology department and are scanned into the electronic health information
record.
Programmatic Goals:
To continue to support new and upgraded services implemented within the medical center that directly or
indirectly relate to cancer care:
1. Recruitment of tumor site specific surgeons
2. A new and technologically upgraded Radiation Oncology suite
3. ProCure Proton Therapy Center strategic partnership
3
Programmatic Achievements
(For the period of July 2011 through June 2012)
Kim Kelly, RN, MS, NEA-BC, FACHE
Vice President, Clinical Services
Robert Braun, MA, M.Ed., RN, OCN,
RT (T)(R)
Assistant Vice President,
Cancer Services
Physician Recruitment
Thomas Kayal, MD, a board-certified colorectal surgeon
has joined the surgical team of CentraState Healthcare
System.
Princeton Brain & Spine: Mark McLaughlin MD, Nirav
K. Shah, MD, Dani Bidros, MD, and Seth Joseffer MD,
have joined the surgical team of CentraState
Healthcare System.
Cancer Navigator:
An Advanced Practice Nurse (APN) has been hired for
the further development of the cancer service line. Her
capacity is multifunctional with a role as a surgical
oncology APN, as well as a cancer navigator.
ProCure/Proton Therapy:
Underscoring a united commitment to advancing
patient care for the treatment of cancer, ProCure
Treatment Centers and Princeton Radiation Oncology,
in collaboration with CentraState, have brought the first
and only proton therapy center to the New Jersey/New
York area. The center is the third to open in a national
network of proton centers being developed by
ProCure. It is one of only 10 centers that offer proton
therapy nationwide. On March 20, 2012, ProCure
hosted a ribbon cutting ceremony to officially open the
new Proton Therapy Center. Testimonials were
provided by proton therapy patients regarding the need
for proton therapy within the community.
Website Revised:
In order to more clearly demonstrate to patients the
comprehensive services of the Cancer Center at
CentraState Medical Center, the cancer service line
launched a new website:
www.centrastatecancercenter.com. This new website
provides a list of all services offered through the
Cancer Center, including radiation oncology, infusion
therapy, surgical services, diagnostic services, patient
navigation, rehabilitative services, physician contacts,
survivorship and alternative complementary services.
Survivorship Program Development: Survivor Care
Plan—A Roadmap for the Patient’s Future Health
and Well-being:
Survivorship Care Plan, of the American College of
Surgeons Commission on Cancer Standard 3.3 states,
“The cancer program of an accredited facility must
‘develop a process to disseminate a comprehensive
care summary and follow-up plan to patients with
cancer who are completing treatment’.” The Cancer
Committee developed focus groups to review existing
survivorship plans within the marketplace to develop a
customized plan to be used within the CentraState
Medical Center Cancer Program. In addition, surveys
were sent to patients to elicit feedback from survivors
themselves, to better understand the survivor’s needs.
The program will be phased in beginning in 2015.
E-Share Document (Dietary, Radiation Oncology,
Palliative Care)
An e-share document was developed with the
assistance of an outside vendor to better facilitate the
exchange of information between entities within the
cancer service line. The e-share document is an
electronic intake form which shares patient information
between ProCure, CentraState and radiation oncology.
Other areas of the service line are in the process of
implementing the use of the e-share document,
including nutrition and palliative care.
• All patients receiving radiation therapy now receive
a social work consult as part of their comprehensive
care.
• The Manor at CentraState Healthcare System
opened two dedicated hospice beds for patients
requiring such services.
• CentraState Medical Center hosted the Annual
Lymphedema Certification Course and a clinical
course on edema management for breast cancer
patients. More than 50 physical and occupational
therapists attended.
• CentraState Medical Center, along with the
American Cancer Society (ACS), developed a
program to allow CentraState volunteers to be used
for the ACS Road to Recovery Program.
• The American College of Surgeons, Commission on
Cancer, has posted CentraState’s “2010-2011
annual report” and the “cancer committee policy”
under their “Best Practice Repository” section.
• Uzma Rizwan successfully delivered a lecture on
“Registry Experience: On Rapid Quality Reporting
System” at the annual meeting of the New York
and New Jersey Chapter for ACoS on September
17, 2011.
4
Clinical Achievements
(For the period of July 2011 through June 2012)
Jeffrey Silberberg, MD, FACP
Chair, Cancer Committee
Enrollment of Subjects in Research Studies:
In 2011, more than 40 subjects were enrolled in
research studies offered at CentraState Medical Center
or by referral, which exceeded the cancer committee’s
clinical compliance goal.
Thoracic Symposium:
A Lung Symposium was held on June 7, 2011.The
symposium’s speakers included Drs. Caccavale,
Spector, Croce, Bocage, Balar and Tsai. The goal of the
program was to provide an in-depth discussion for
primary care physicians regarding the diagnosis and
treatment of lung cancer. CMEs and CEUs were
provided.
PAC-3 Research with ACS:
CSMC partnered with the ACS on a research study
known as Cancer Prevention Study-3 (CPS-3). We were
the first health care organization within Monmouth
County to enroll participants. The study is an
Epidemiology Research Program that invites men and
women, between the ages of 30 and 65 who have no
personal history of cancer, to participate. The purpose
of CPS-3 is to better understand the lifestyle,
behavioral, environmental and genetic factors that
cause or prevent cancer, and to ultimately eliminate
cancer as a major health problem for this and future
generations. CSMC hosted the event on July 24th and
25th; 176 people were enrolled.
Physician Honors:
Jarrod Kaufman, MD, FACS, board-certified surgeon on
staff at CentraState Medical Center, was selected by
the American College of Surgeons Commission on
Cancer (CoC) Cancer Liaison Program as a recipient of
the Commission on Cancer State Chair Outstanding
Achievement Award for 2010-11, for his cancer liaison
work throughout the state. He was presented the
award at the CoC Annual Meeting held in San
Francisco.
Chinese Physician visit:
In May, a group of eight radiologists from China visited
CentraState to learn new techniques in interventional
radiology for breast cancer. The group of physicians
trained with internationally distinguished interventional
radiologist, Ken Tomkovich, MD, medical director of
Interventional Radiology at CentraState and with
Freehold Radiology Group. The visit marked the first
time that a program for education on breast imaging
and minimally invasive biopsy has taken place between
the United States and a group of doctors from China.
During their visit to CentraState, the physicians from
China were thoroughly instructed in breast cancer
diagnosis and ultrasound and stereotactic biopsy—
procedures that are not widely used in China. “We
reviewed cases together, shared thoughts with one
another and, through mutual respect and trust, built
friendships that will last forever,” Dr. Tomkovich says.
“Most importantly, they will return to China with a new
knowledge and ability to treat their patients that they
did not have before. My hope is that they will be able
to share this knowledge with other doctors in China
and ultimately save more lives.”
“My positive attitude about cancer comes from my doctors who have always encouraged me.
Patients should have confidence in their CentraState doctors and never give up hope”
– Carol Murphy
5
Clinical Trials Offered at CSMC
(2011 - 2012)
Janice Breen, PhD, PHCNS-BC
Manager, Clinical Research
The comprehensive Cancer Program at CentraState Medical Center offers eligible patients the opportunity to
participate in promising new developments in cancer treatment and prevention through clinical trials. CentraState
Medical Center participates in pharmaceutical company trials and is a clinical research affiliate of the Eastern
Cooperative Oncology Group (ECOG) and the Cancer Institute of New Jersey’s Oncology Group (CINJOG).
CentraState Medical Center currently has open clinical trials/research studies in the areas of breast,
gastrointestinal, lung, pancreatic, prostate and renal cancer. To find information on available clinical trials and the
eligibility criteria, please visit CentraState Medical Center’s website at www.centrastatecancercenter.com.
6
Tumor Board/Cancer Conference Coordinator Report:
Henry K. Tsai, MD, FACP
Radiation Oncology
The Tumor Board Conference at CSMC provides a
multidisciplinary forum to discuss a patient's diagnosis
and the most appropriate treatment options available.
Physicians participate in regularly scheduled Tumor
Board Conferences where cancer specialists discuss
the best treatment plans for new and existing cancer
patients at CentraState. This specialized team consists
of board-certified medical oncologists, radiation
oncologists, surgeons, diagnostic radiologists,
pathologists, nurses, research coordinators and a
cancer registrar.
At each Tumor Board Conference, the discussion
involves the review of individual patients’ medical
histories, imaging studies, pathology reports and
current methods of treatment. Appropriate staging is
discussed for applicable cases. National
Comprehensive Cancer Network (NCCN) treatment
guidelines or other appropriate guidelines are
referenced to ensure treatment plans are in line with
nationally recognized standards. In addition, any
applicable clinical trials are reviewed and discussed.
Treatment recommendations are formulated based on
a multidisciplinary consensus and presented to the
patient’s managing physician. Final therapeutic
decisions rest with the managing physician and the
patient. Ninety-five percent of cases presented at the
conference are prospective case discussions. All
information presented at these conferences is
confidential and considered part of the quality
improvement process. Attendees who complete an
evaluation form can receive continuing medical
education credit.
The Tumor Board activities’ grids are used to monitor
the discussion of staging, treatment guidelines,
prognostic indicators and the availability of applicable
clinical trials.
The General Tumor Board (GTB) meets bimonthly. One
meeting convenes either the first or second Tuesday
and the other is held on the third Friday of the month.
A combination of different cancer sites is discussed at
each meeting.
In 2011, a total of 20 General Tumor Board meetings
were held. Total sites/cases presented from January to
December = 86 cases. The prospective case
presentation = 97%.
In 2011, total lung Tumor Board meetings = 20
Total sites/cases presented from January to December = 51 cases.
Prospective case presentation = 97%
In addition to regular cancer conferences, the cancer program offered eight lectures to medical staff and other
allied health professionals.
The required physician attendance at the Tumor Board Conference is 80% per specialty. General Tumor
Board Conference physicians’ attendance from the period of January to December 2011 is as follows.
7
YEAR
Category
Medical
Oncology
Attendance
Radiation
Oncology
Attendance
Surgery
Radiology
Attendance
Pathology
Attendance
Diagnostic
Attendance
2011
GTB
100%
100%
96%
100%
96%
Community Outreach
COMMUNITY EVENT: (For the period of July 2011 through June 2012)
Maryann Roper, RN, MSN
Director, Star and Barry Tobias Health Awareness Center
Free Spa Day held on Dec. 6, 2011:
The ABC Spa provided a one-day, free spa treatment to
30 patients that were treated at CentraState. The
services included manicures, facials and massages.
Taste of the Towns:
Was held on March 26 at the American Hotel. Taste of
the Towns is a fundraising event organized by the
Noontime Optimist Club of Freehold and CentraState
Associated Auxiliaries. Money raised from the Taste of
the Towns supported the children and families’ housing
needs at the ProCure Treatment Center in Somerset,
NJ; Camp Quality NJ, a camp for children with cancer;
and youth activities and scholarships sponsored by the
Noontime Optimist Club of Freehold.
CentraState Celebrates Cancer Survivorship with
Current and Former Patients-June 10, 2012:
An estimated 325 cancer survivors, family and friends
joined CentraState Medical Center staff on June 10 for
an afternoon of sharing, encouragement and education
to celebrate National Cancer Survivors Day. A survivor
is anyone living with a diagnosis of cancer. Keynote
speaker, Aubrey Barr, survivor of childhood acute
lymphocytic leukemia (ALL) and an avid runner, along
with several CentraState cancer survivors, inspired the
audience with their personal stories.
All visitors received complimentary materials including
the book “Complete Guide to Nutrition for Cancer
Survivors” (American Cancer Society). The day’s events
also included music, a healthy cooking demonstration,
luncheon and mini health fair.
Skin Cancer Awareness and Screening Efforts:
MoleSafe Program: MoleSafe was introduced to
CentraState in June 2010.
This program uses advanced technology for the early
detection of melanoma, thereby identifying skin cancer
at a treatable stage. The process begins with a
comprehensive, full-body exam, digital imaging and
dermoscopic scan. Images are examined and reviewed
by a MoleSafe dermatologist. In 2011, more then 200
people were examined, compared to the first two
quarters of 2012, when 100 people were examined.
Choose Your Cover:
On July 21, 2012, CentraState’s Star and Barry Tobias
Health Awareness Center (HAC) partnered with the
Monmouth County Cancer Coalition to participate in a
statewide event called Choose Your Cover, a skin
cancer awareness, education and screening program.
Choose Your Cover brings free skin cancer screenings
and complimentary sunscreen, along with vital skin
safety information, to an at-risk population of people
who spend extended periods of time in the sun.
CentraState participated and sponsored the event at
Belmar Beach. There were 134 participants screened.
Screenings and Community Lectures:
In the area of prevention and education, CentraState
Medical Center is a leader in the central New Jersey
service area.
Screenings and lectures offered include:
July through December 2011, more than 100 people
received free skin cancer screenings and attended
prevention lectures.
January through June 2012, more than 120 people
received free skin cancer screenings and attended
prevention lectures.
On April 26, 2012, there was an oral cancer screening
and lecture–8 individuals were screened; 12 attended
the lecture.
CentraState partnered with the Monmouth Ocean
Cancer Coalition to offer a Living with Chronic Disease
seminar for the community with 35 in attendance.
Support Groups:
• Bereavement
• Breast Cancer
• Colorectal Cancer Self-Help Group
• Leukemia/Lymphoma/Multiple
Myeloma/Myelodysplasia
• Lymphedema
• Patient and Family Cancer Support
• Prostate Cancer
Psychosocial Support:
Between the months of July and December 2011,
more than 165 new radiation patients were seen by a
social worker. They were assessed for a variety of
needs, with appropriate referrals made at that time.
8
Quality Improvements & Physician Liaison Report
Amit Kharod, MD, FACS
Board-Certified Surgeon
Each year, the Cancer Committee conducts several
quality improvement (QI) reviews in an effort to ensure
that a high-quality standard of care was provided to our
patients. The QI review involved representation from
physicians and non-physician members of the Cancer
Committee. Multiple departments were represented
including cancer registry, cancer navigator, Outpatient
Infusion, 4-East oncology, palliative care, pharmacy and
Radiation Oncology. In 2012 alone, more than 22 QI
activities were reported to the Cancer Committee.
CoC, ACR, OCN or oncology dashboard measures from
the advisory board. Some of the QI activities were
selected from the Press Ganey scores.
The QI activities also provide an opportunity to improve
upon quality care and outcomes. In addition, the
Cancer Committee continues to participate in the Rapid
Quality Reporting System. This involves concurrent
reporting on breast, colon and rectal cases to the
National Cancer Data Base.
QI indicators were selected based on compliance with
national standards of care including NCCN guidelines,
Cancer Registry/Commission on Cancer (CoC)
Supervisor Report
Uzma Rizwan, BS, CCS, CTR
Commission on Cancer Program Supervisor
The Cancer Registry (CR) continues to provide timely
statistics and quality improvement studies to the
Cancer Committee and the Cancer Service Line
Committee. This reporting aids in identifying trends and
opportunities for improved patient care, and ensures
compliance with national cancer care and treatment
guidelines. Cancer registry also requires that
CentraState Medical Center submit cancer data to the
New Jersey State Cancer Registry (NJSCR) and
National Cancer Data Base (NCDB).
In addition, the registry supplies statistics to the Facility
Information Profile System (FIPS), which is part of the
American College of Surgeons. The FIPS is a datasharing project that benefits consumers and providers
of cancer care. FIPS Level II data is information
composed of cancer caseload data, which includes
cancer cases diagnosed and treated at the hospital
within a specified year (by site and stage).
9
This data is also available to the public.
To ensure the accuracy of collected data, the CoC
program supervisor, quality improvement coordinator
and Cancer Committee physicians and CoC surveyor
performed a quality review on cancer registry data. In
2011, 15 percent of all analytical cases were reviewed
for accuracy.
Cancer Registry Data Requested/Presented
Cancer site demographics were presented to the
Community Outreach Committee to assist in
identifying unique patient population needs. This
information is utilized to develop screening programs
that will be of most benefit the community. In addition,
the cancer registry continues to assist the research
department in identifying patients who meet the
eligibility criteria for a specific clinical trial or study.
Statistical Summary of Cancer Registry Data
Primary Site Table: Newly Diagnosed and/or Treated Cases Seen at CSMC — 2011
Sex
Primary Site
Total (%)
M
Status
F
Stage Distribution - Analytic Cases Only
Alive Exp
Stg 0
Stg I
Stg II Stg III Stg IV Stg N/A 88
Unknown
ORAL CAVITY & PHARYNX
13 (1.5%)
7
6
12
1
1
5
2
1
3
0
1
Lip
Tongue
Salivary Glands
Floor of Mouth
Gum & Other Mouth
Tonsil
Oropharynx
3 (0.3%)
2 (0.2%)
1 (0.1%)
2 (0.2%)
2 (0.2%)
1 (0.1%)
2 (0.2%)
1
1
1
0
2
1
1
2
1
0
2
0
0
1
3
2
1
2
1
1
2
0
0
0
0
1
0
0
0
1
0
0
0
0
0
2
1
0
2
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
DIGESTIVE SYSTEM
141 (16.3%)
73 68
123
18
9
26
32
25
28
4
17
Esophagus
6 (0.7%)
4
2
5
1
1
1
3
0
0
0
1
Stomach
Small Intestine
Colon Excluding Rectum
Cecum
Appendix
Ascending Colon
Hepatic Flexure
Transverse Colon
Descending Colon
Sigmoid Colon
Large Intestine, NOS
Rectum & Rectosigmoid
Anus, Anal Canal & Anorectum
Liver & Intrahepatic Bile Duct
Gallbladder
Other Biliary
Pancreas
Retroperitoneum
Peritoneum, Omentum
& Mesentery
Other Digestive Organs
17 (2.0%)
1 (0.1%)
67 (7.8%)
15
5
20
1
4
2
13
7
15 (1.7%)
1 (0.1%)
3 (0.3%)
3 (0.3%)
10 (1.2%)
14 (1.6%)
1 (0.1%)
1 (0.1%)
9
1
34
6
3
7
1
1
2
9
5
10
0
0
1
7
5
1
0
8
0
33
9
2
13
0
3
0
4
2
5
1
3
2
3
9
0
1
14
1
59
15
5
17
1
3
2
11
5
13
1
3
3
9
11
1
1
3
0
8
0
0
3
0
1
0
2
2
2
0
0
0
1
3
0
0
2
0
4
1
0
2
0
0
0
1
0
2
0
0
0
0
0
0
0
2
0
19
2
3
8
1
1
0
4
0
2
0
1
0
0
1
0
0
1
1
15
4
2
5
0
2
0
1
1
5
0
0
1
1
5
0
0
3
0
16
5
0
2
0
1
1
6
1
2
1
0
2
0
1
0
0
6
0
8
3
0
2
0
0
0
1
2
4
0
0
0
4
5
1
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
3
0
4
0
0
1
0
0
1
0
2
0
0
2
0
4
2
0
1
2 (0.2%)
1
1
2
0
0
0
0
0
0
2
0
RESPIRATORY SYSTEM
98 (11.4%)
50 48
72
26
1
15
7
26
40
2
7
Nose, Nasal Cavity
& Middle Ear
Larynx
Lung & Bronchus
1 (0.1%)
0
1
0
1
0
0
0
0
0
1
0
3 (0.3%)
94 (10.9%)
3 0
47 47
2
70
1
24
1
0
1
14
0
7
0
26
1
39
0
1
0
7
BONES & JOINTS
1 (0.1%)
0
1
1
0
0
0
0
0
1
0
0
SOFT TISSUE
5 (0.6%)
3
2
5
0
0
3
2
0
0
0
0
SKIN EXCLUDING BASAL
& SQUAMOUS
33 (3.8%)
14 19
31
2
14
9
3
1
1
0
5
Melanoma—Skin
Other Non-Epithelial Skin
29 (3.4%)
4 (0.5%)
13 16
1 3
28
3
1
1
14
0
9
0
2
1
0
1
0
1
0
0
4
1
BREAST
176 (20.4%)
1 175
173
3
39
76
33
16
7
0
5
10
Statistical Summary of Cancer Registry Data
Primary Site Table: Newly Diagnosed and/or Treated Cases Seen at CSMC — 2011
Sex
Primary Site
Total (%)
M
Stage Distribution - Analytic Cases Only
Alive Exp
Stg 0
Stg I
Stg II Stg III Stg IV Stg N/A 88
Unknown
FEMALE GENITAL SYSTEM
39 (4.5%)
0 39
37
2
0
18
2
6
4
1
8
Cervix Uteri
Corpus & Uterus, NOS
Ovary
Vulva
4 (0.5%)
31 (3.6%)
2 (0.2%)
2 (0.2%)
0 4
0 31
0 2
0 2
4
29
2
2
0
2
0
0
0
0
0
0
0
17
0
1
1
1
0
0
1
5
0
0
1
2
0
1
0
1
0
0
1
5
2
0
MALE GENITAL SYSTEM
133 (15.4%)
133 0
130
3
0
62
57
9
4
0
1
Prostate
126 (14.6%)
126 0
123
3
0
56
57
9
4
0
0
Testis
7 (0.8%)
7
0
7
0
0
6
0
0
0
0
1
URINARY SYSTEM
98 (11.4%)
65 33
94
4
15
52
12
3
8
0
8
Urinary Bladder
Kidney & Renal Pelvis
Ureter
Other Urinary Organs
64 (7.4%)
32 (3.7%)
1 (0.1%)
1 (0.1%)
46
17
1
1
18
15
0
0
60
32
1
1
4
0
0
0
14
0
0
1
36
15
1
0
9
3
0
0
0
3
0
0
3
5
0
0
0
0
0
0
2
6
0
0
BRAIN & OTHER
NERVOUS SYSTEM
10 (1.2%)
5
5
8
2
0
0
0
0
0
10
0
Brain
Cranial Nerves
Other Nervous System
8 (0.9%)
2 (0.2%)
4
1
4
1
6
2
2
0
0
0
0
0
0
0
0
0
0
0
8
2
0
0
ENDOCRINE SYSTEM
21 (2.4%)
1 20
21
0
0
9
1
6
1
0
4
Thyroid
21 (2.4%)
1 20
21
0
0
9
1
6
1
0
4
LYMPHOMA
41 (4.8%)
17 24
38
3
0
17
4
5
8
2
5
Hodgkin Lymphoma
8 (0.9%)
2
6
8
0
0
3
3
1
1
0
0
Hodgkin - Nodal
7
2
5
7
0
0
3
2
1
1
0
0
Hodgkin - Extranodal
1
0
1
1
0
0
0
1
0
0
0
0
Non-Hodgkin Lymphoma
33 (3.8%)
15 18
30
3
0
14
1
4
7
2
5
NHL - Nodal
21
9 12
20
1
0
8
1
4
5
0
3
NHL - Extranodal
12
6
6
10
2
0
6
0
0
2
2
2
MYELOMA
3 (0.3%)
3
0
3
0
0
0
0
0
0
3
0
LEUKEMIA
14 (1.6%)
9
5
10
4
0
0
0
0
0
14
0
Lymphocytic Leukemia
3 (0.3%)
2
1
3
0
0
0
0
0
0
3
0
1
0
1
1
0
0
0
0
0
0
1
0
Chronic Lymphocytic Leukemia 2
Acute Lymphocytic Leukemia
11
Status
F
2
0
2
0
0
0
0
0
0
2
0
Myeloid & Monocytic Leukemia 11 (1.3%)
7
4
7
4
0
0
0
0
0
11
0
MESOTHELIOMA
3 (0.3%)
3
0
3
0
0
0
0
0
0
1
2
MISCELLANEOUS
34 (3.9%)
14 20
27
7
0
0
0
0
0
34
0
Total
863
398 465
788
75
79
292
155
98
105
71
63
Please note that in 2011 there were 55 cases that were clinically and/or radiologically diagnosed. Out of 55 cases, 30 cases were
diagnosed @ CSMC and went elsewhere for treatment. Nine cases were with unknown primary sites; all of which were reviewed for
quality assurance purposes.
2011 Cancer Registry Case Reporting
In 2011, the American Cancer Society estimated* around 1,596,670 new cancer cases would be diagnosed in the
U.S., including 49,080 in New Jersey, and 571,950 cancer deaths would occur in the U.S., including 16,370 in
New Jersey
In 2011, the cancer registry at CentraState abstracted and/or accessioned 863 new analytical cases. These
statistics do not reflect localized basal and squamous cell carcinoma of the skin, follicular neoplasm of the thyroid
and positive urine cytology cases.
156
246
461
(0) Diagnosis @ CS all 1st course treatment
elsewhere
(1) Diagnosis @ CS, all or part of 1st course
treatment @ CS
(2) Diagnosis @ another facility, part or all of
1st course treatment@ CS
Analytical cases: Patients were diagnosed and/or received treatment for their newly diagnosed cancer at CSMC.
In addition to newly diagnosed cases, approximately 530 patients (non-analytical) utilized CSMC services for
consultation, diagnostic workup, transient care, management of recurrent disease or for treatment of benign
conditions (with active cancer diagnosis).
Data was compiled by Uzma Rizwan, BS, CCS, CTR and reviewed and critiqued by Drs: Amit Kharod, MD, FACS, Henry K. Tsai, MD, JeanPhilippe Bocage, MD, FACS, Bhavesh Balar, MD, Robert Braun, MA, M.Ed., RN, OCN, RT (T)(R), Janice Breen PhD, RN, PHCNS-BC
12
Newly Diagnosed and/or Treated Cases
Seen at CSMC
By First Year of Contact (2001-2011)
DIAGNOSED YEAR
806
635
674
661
691
814
836
813
863
685
486
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Five Body Systems Comparative Analysis
of Newly Diagnosed Cases Seen at CSMC 2009–2011
Table 1:
BODY SYSTEM
DIGESTIVE SYSTEM
RESPIRATORY SYSTEM
BREAST
MALE GENITAL SYSTEM
URINARY SYSTEM
2009
2010
2011
152
92
187
99
72
153
96
161
118
78
141
98
176
133
98
In 2011, there was a significant increase in the number of urological cancer cases compared to the preceding
year. This case mix includes prostate, kidney and bladder cancers.
Top Five Primary Sites Comparative Analysis
of Newly Diagnosed Cases Seen at CSMC 2009-2011
Table 2:
PRIMARY SITES
Breast
Colon & Rectal
Bronchus & Lung
Prostate Gland
Urinary Bladder
2009
2010
2011
187
103
86
93
61
161
98
85
114
52
176
82
95
126
63
According to the ACS, the top four cancer sites represent 51.8% of all new cases and 48.5% of all new cancer
deaths within Monmouth County. These sites include lung, breast, colorectal and prostate cancers.
13
Newly Diagnosed and/or Treated Cases
Seen at CSMC continued
By First Year of Contact (2001-2011)
At CSMC, there was continued growth in the number of prostate cancer patients in 2011 compared to 2009
and 2010. This increase was attributed to CentraState offering the full spectrum of care, which includes a
surgical treatment option (da Vinci S™ Surgical System), as well as advanced radiation therapy—two of the
most commonly utilized treatments for prostate cancer.
In 2011, CentraState demonstrated an increase in the number of total breast cancer diagnoses; however there
was a decrease in the number of colorectal patients diagnosed and treated. In 2012, Thomas Kayal, MD, boardcertified and fellowship-trained colorectal surgeon was recruited to join the medical staff to add additional
surgical expertise in the area of colorectal surgery at CSMC.
2011 Top Five Cancer Sites at CSMC
by Best Collaborative/AJCC Stage
STAGE
COLON
LUNG
BREAST
PROSTATE
Stg 0
4
0
39
0
Stg I
19
14
76
56
Stg II
15
7
33
57
Stg III
16
26
16
9
Stg IV
8
39
7
4
Stg N/A
0
2
0
0
Unknown
4
7
5
0
COUNT
66
95
176
126
The table above reflects CSMC diagnosed and treated predominantly early stage cancers. This is attributed to
individuals within the community having access to CentraState’s screening and healthy lifestyle programs
offered through the Star and Barry Tobias Health Awareness Center.
14
Breast Cancer Comprehensive Care at CSMC
Breast cancer represented the largest percentage of all cancer diagnoses and treatments at CSMC. The graph
below demonstrates a comparative analysis of the total number of breast cases diagnosed at CSMC vs. The
National Cancer Data Base (NCDB).
Comparative analysis of Number of Breast Cancer cases Diagnosed from 2000- 2010.
Reported to NCDB by CSMC vs. Comprehensive Hospitals in State of New Jersey
14%
12%
10%
CSMC
8%
NCDB
6%
4%
2%
0%
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
In 2011, the American Cancer Society estimated female breast cancer accounted for 14.6% of all cancer cases
and 8.3% of all cancer deaths. In 2011, CentraState Medical Center diagnosed and/or treated 176 new patients.
The Cancer Center at CentraState provides comprehensive breast cancer services from diagnosis through
survivorship, utilizing a dedicated multidisciplinary team approach composed of breast and general surgeons,
radiation oncologists, medical oncologists, pathologists and diagnostic radiologists.
The table below reflects a breast cancer treatment compliance measure of CSMC compared to the National
Cancer Data Base (NCDB) of facilities participating in the Rapid Quality Reporting System (RQRS) study.
Measure: Radiation therapy is administered within one year (365 days) of diagnosis for women under
age 70 receiving breast conserving surgery for breast cancer.
Facility Comparison Groups
15
Performance Rates
2008
2009
2010
CentraState Healthcare System
95%
92%
94%
Comprehensive Cancer Program (36)
92%
92%
91%
NJ (15)
84%
83.2%
86%
CINJ Affiliate Hospitals
88%
80%
85%
Breast Cancer Comprehensive Care at CSMC continued
The current clinical trials that are available for breast
cancer at CSMC include:
Women’s Health Center:
2) Study Title: A Randomized Study to Prevent
Lymphedema in Women Treated for Breast Cancer
The Women Health Center (WHC) at CentraState has
been named a Breast Imaging Center of Excellence
for digital mammography and other diagnostic
procedures. In addition, the WHC was designated as
a certified Pink Ribbon Facility by HologicTM, the
makers of digital mammography. This designation is
a distinction awarded only to an elite group of health
care facilities who offer the latest, state-of-the-art,
digital technology for breast cancer detection.
3) Study Title: Effect of DNA Variations on Breast
Cancer Risk.
Breast Cancer Screenings and Lectures:
1) Study Title: A Phase III Clinical Trial Comparing
Trastuzumab Given Concurrently with Radiation
Therapy and Radiation Therapy Alone for Women
with HER2-Positive Ductal Carcinoma In Situ
Resected by Lumpectomy
For details about available clinical trials and eligibility
criteria, please visit www.centrastatecancercenter.com
Lymphedema Program:
Ocean First Rehabilitation Center has eight certified
therapists, four of which are members of the
Lymphedema Association of North America (LANA).
CentraState’s Lymphedema Program is one of only a
few programs in New Jersey that is recognized by the
National Lymphedema Network. In 2011, more than
200 lymphedema patients were referred and treated
within the program.
During the Susan G. Komen grant cycle, in October
2011, free mammographies and lectures were
provided. CSMC collaborated with the Visiting Nurse
Associations of America (VNAA) through the Cancer
Education and Early Detection (CEED) Grant. The
screening program provided a breast exam and a
prescription for a free mammogram. There were 19
participants who benefited from the grant, which
focuses on uninsured and underinsured women.
An annual “manicure and mammogram” campaign
was kicked off in October at the WHC, where CSMC
provided a gift certificate for a free manicure to every
woman who came in for a digital mammography during
the month of October (National Breast Cancer
Awareness month).
“Everyone I encountered at CentraState was
clearly part of team- from the receptionist to the
technicians to Dr. Cahlon- and they took time to
get to know me. I became a part of the team, not
just a patient walking in the door periodically.
You don’t see that kind of care everywhere.”
– Angela Cali, a breast cancer patient
16
Prostate Cancer Care at CSMC
In 2011, the American Cancer Society estimated Prostate Cancer accounted for 14.4% of all cancer cases and
4.1% of all cancer deaths. Prostate cancer is the most common cancer after skin cancer in men and can be cured
if detected early.
The comparative data below reflects CSMC diagnosed and treated prostate cancers which were primarily early
stage cancers compared with the cases diagnosed in New Jersey reported to NCDB.
Comparative analysis of Prostate Carcinoma by AJCC Stage Diagnosed in 2010.
Reported to NCDB by CSMC vs. Comprehensive hospitals in NJ
70%
60%
50%
CSMC
40%
NCDB
30%
20%
10%
0%
Stg I
Stg II
Stg III
Treatment: The majority of patients diagnosed with
prostate cancer at CSMC in 2010 had early-stage,
localized disease and received either surgery or
radiation as their initial therapy which is in line with
National Comprehensive Cancer Network (NCCN)
guidelines. Treatment options vary depending on stage
and grade of the cancer as well as the patient’s age and
other medical conditions. Appropriate patients may be
counseled regarding active surveillance or “watchful
waiting.” The Cancer Center at CentraState offers all
potential treatment options including surgery (open,
laparoscopic, or robot-assisted), intensity modulated
radiation therapy, radioactive seed implantation (lowdose and high-dose brachytherapy), and now proton
17
Stg IV
Stg Unknow n
therapy through the hospital’s partnership with
ProCure. Other treatment options may include
hormonal therapy and/or chemotherapy for more
advanced cases.
In 2011, CentraState diagnosed and treated 126 newly
diagnosed cases. Approximately 90% of CSMC
patients were diagnosed with early stage cancer. Early
detection and accurate diagnosis gives patients the
best chance to survive the diagnosis. Prostate
screenings and lectures were offered throughout the
year through CentraState’s Star and Barry Tobias Health
Awareness Center. The Center not only reaches out to
the local community but also extends the screening
efforts to the neighboring counties.
Prostate Cancer Care at CSMC continued
2011 Prostate cases by AJCC Stage
60
N0; OF CASES
50
40
30
20
10
0
Stg 0
Stg I
Stg II
Stg III
Stg IV
AJCC STAGE
Clinical Trial:
Support Group:
The current clinical trials available at CSMC include:
Prostate cancer is not just a man’s disease, but also
involves the family and friends of everyone affected by
it. CSMC, in collaboration with the American Cancer
Society (ACS), provides an on-site, man-to-man support
group that meets regularly.
1) Study Title: A Phase III Prospective Randomized
Trial of Dose-Escalated Radiotherapy With or
Without Short-Term Androgen Deprivation Therapy
for Patients With Intermediate-Risk Prostate Cancer
2) Study Title: A Phase III Trial of Short-Term Androgen
Deprivation with Pelvic Lymph Node or Prostate
Bed Only Radiotherapy (SPPORT) in Prostate
Cancer Patients With a Rising PSA After Radical
Prostatectomy
For more information about support group, visit
www.centrastatecancercenter.com.
For details about available clinical trials and eligibility
criteria, visit www.centrastatecancercenter.com
18
Lung Cancer Care at CSMC
According to the National Cancer Institute, lung cancer
is the second most common cancer among both men
and women. The American Cancer Society estimates
lung and bronchus cancers accounted for 12.8% of all
cancer cases and 25.8% of all cancer deaths in 2011.
The Comprehensive Lung Program at CentraState
Medical Center offers advanced services, expertise,
and technology for diagnosing, treating and helping
patients recover from lung cancer. Because
CentraState’s focus is on the whole person, not simply
the disease, we also offer guidance on maintaining
lung health and complementary therapies to support
self-healing and emotional well-being, while patients
maximize the benefits of conventional treatment.
The Comprehensive Lung Program at CentraState
Medical Center includes:
• A dedicated, multidisciplinary tumor board
• Patient navigation services
• Advanced, diagnostic imaging technology, including a
low-dose lung CT screening program
• Treatment options including state-of-the-art, imageguided radiation therapy, infusion therapy and
advanced surgical options including video-assisted
thoracic surgery (VATS) performed by board-certified
thoracic surgeons who were pioneers in the
procedure and have performed more than 6,000
procedures.
In 2011, the Cancer Center at CentraState diagnosed
and treated 95 new patients. More than 75% of these
patients were reviewed at the multidisciplinary Lung
Tumor Board meetings. The tumor board reviews the
patient’s medical history, imaging studies, pathology
and current methods of treatment. This specialized
team consists of board-certified medical oncologists,
radiation oncologists, surgeons, diagnostic radiologists,
pathologists, cancer navigator nurses, palliative nurses,
a cancer registrar and research coordinators.
Comparative data between cases reported to the
NCDB by CentraState vs. New Jersey hospitals reflects
more patients have been seen at CSMC with earlier
stage cancers; this may show improvement in survival.
Comparative analysis of Non- Small Cell Lung Carcinoma by AJCC Stage Diagnosed in 2010
Reported to NCDB by CSMC vs. Comprehensive hospitals in NJ
45%
40%
35%
30%
25%
CSMC
NCDB
20%
15%
10%
5%
0%
Stg I
Stg II
Stg III
Stg Unknow n
Clinical Trials:
Prevention Program:
(For details about available clinical trials and eligibility
criteria, visit www.centrastatecancercenter.com
The leading cause for lung cancer is smoking and
exposure to industrial toxins such as asbestos. The
best prevention however, is not to smoke. The Star and
Barry Tobias Health Awareness Center at CentraState
offers a comprehensive smoking cessation program.
CentraState Medical Center, in collaboration with
Freehold Radiology offers a low-cost screening
program for high-risk individuals. For more information,
call 855-411-CANCER.
1) Study Title: A Phase III Randomized Trial of Adjuvant
Chemotherapy with or without Bevacizumab for
Patients with Completely Resected Stage 1B (less than
or equal to 4cm)-IIIA Non-Small Cell Lung Cancer
(NSCLC).
19
Stg IV
Colorectal Cancer Care at CSMC
In 2011, the American Cancer Society estimated colorectal cancer accounted for 9.9% of all cancer cases
and 10.4% of all cancer deaths. Colorectal cancer is
one of the top four cancers diagnosed and treated at
CentraState.
The graph below reflects the number of newly
diagnosed colon cancer cases treated at CentraState
Medical Center compared to the number of cases
diagnosed in other New Jersey comprehensive cancer
programs, as reported to National Cancer Data Base.
Comparative analysis of Number of Colon Cancer cases Diagnosed from 2000- 2010.
Reported to NCDB by CSMC vs. Comprehensive Hospitals in State of New Jersey
12%
10%
8%
CSMC
NCDB
6%
4%
2%
0%
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
In 2011, CSMC diagnosed and treated 82 new colorectal cases. The American Joint Committee on Cancer (AJCC)
staging data below shows that CSMC provided treatment to patients of all stages.
CSMC 2011 COLON CASES BY AJCC STAGE
19
16
NO: OF CASES
15
8
4
4
Stg 0
Stg I
Stg II
Stg III
Stg IV
Stg Unknow n
The Cancer Center at CentraState provides comprehensive care to patients diagnosed with colorectal cancer. This
comprehensive care is multidisciplinary and includes a dedicated team of surgeons, medical oncologists, radiation
oncologists, pathologists and diagnostic radiologists.
In early 2012, Thomas Kayal, MD, board-certified colorectal surgeon, joined the surgical team of CentraState
Healthcare System. CentraState is one of only a few hospitals in the United States that provides daVinci Robotic
colorectal surgery.
20
Colorectal Cancer Care at CSMC continued
Colon Cancer Treatment Meeting National
Guidelines to Improve Disease Survival Rates:
In the fourth quarter of 2011, the Cancer Committee
conducted a quality improvement study based upon
an article published in the Journal of the American
Medical Association (JAMA). The article suggested
induction of adjuvant chemotherapy in a timely manner
to eligible colon cancer patients to assist in improving
survival rate. Adjuvant chemotherapy is routinely
recommended after curative surgical resection of
stage III (node-positive) colon cancer, and/or stage II
(node-negative) colon cancer in high-risk patients.
Community Outreach and Prevention Efforts:
According to the American Cancer Society (ACS), New
Jersey statewide data reflects lower screening and
early detection rates for colon cancer.
CentraState provides colon cancer screening and
lectures throughout the year. March is designated as
Colorectal Cancer Awareness Month. The following
were activities held at CentraState during the month
of March:
March 1st – Paint the Town Blue
March 2nd – Wear Blue to Work Day
National guidelines, including the American College
of Surgery’s Commission on Cancer, recommend
patients be evaluated or begin chemotherapy within
120 days of surgery.
New data published within JAMA recommended
initiation of chemotherapy within four weeks to
improve disease survival rates.
Retrospective and concurrent reviews were performed on
newly diagnosed chemotherapy eligible stage III colon
cancer patients at CentraState. It was noted that all eligible
patients were referred to medical oncologists for
chemotherapy consultations, thus meeting 100%
compliance with the treatment guidelines.
Dr. Balar commented, “This represents the strong
commitment by The Cancer Center at CSMC to provide the
best care possible to our community”
Clinical Trials:
1) Study Title: Phase III Trial of Irinotecan/5FU/Leucovorin or Oxaliplatin/5-FU/Leucovorin with
Bevacizumab, or Cetuximab (C225), or with the
Combination of Bevacizumab and Cetuximab for
Patients with Untreated Metastatic Adenocarcinoma
of the Colon or Rectum
2) Study Title: A Randomized Phase II Study of
Irinotecan and Cetuximab with or without the AntiAngiogenic Antibody, Ramucirumab, in Advanced,
K-ras Wild-type Colorectal Cancer Following
Progression on Bevacizumab-Containing
Chemotherapy
For details about available clinical trials and eligibility
criteria, visit www.centrastatecancercenter.com
21
March 18th – 3rd Annual Paulette Steps Toward
Cancer Wellness 5k Run/Walk
In order to raise awareness about the importance of
colorectal cancer screenings in the community, a
colorectal cancer self-help group is available and led by
a colorectal cancer survivor, diagnosed and treated at
CentraState. The group provides a supportive
environment and is a resource for survivors and
caregivers.
2011 - 2012 Cancer Committee Members
Physician Members:
Bhavesh Balar, MD
Medical Oncologist
Jarrod Kaufman, MD, FACS
General Surgeon
Amit Kharod, MD, FACS
Cancer Liaison
General Surgeon
Michael McGinnis, MD, FCAP, FASCP,
DLM (ASCP), CHCQM
Director—Pathology
Jeffrey Silberberg, MD, FACP
Medical Oncologist
Chair—Cancer Committee
Kenneth Tomkovich, MD, FACP
Diagnostic and Interventional Radiologist
Henry Tsai, MD, FACR
Radiation Oncology
Donna Keehn
Quality Improvement
Kim Kelly, RN, MS, NEA-BC, FACHE
Vice President—Clinical Services
Rev. Lisa Lancaster, MDiv, ThM, BCC
Chaplain—Pastoral Care
Michele Langevin, RN, MSN
Oncology—Orthopedics Nurse Manager
Sharon Lorfing, RN, MSN, APN-CNurse Practitioner—Cancer Navigator
Brian Mason
Clinical Director—Rehabilitation
Services—Physical Therapy
Trudy Mercurio, CCS
Financial Data Coordinator—HIM
Dan Messina, PhD, FACHE, LNHA
Sr. VP/Chief Operating Officer
Yvonne Elsey, RN, BSN (VNA)
Director of Hospice
Clinical Staff Members
Guests:
Jack Dworkin, MD, MBA, FACC
Vice President—Chief Medical Officer
Molly Gabel, MD
Director, CINJ Network
Mark Kroll, MD
Medical Oncologist
T. Rose, MD
Medical Oncologist
Edward Soffen, MD, FACP
Radiation Oncologist
Jennifer Beukers, BSN, RN
Research Nurse
Cathy Janzekovich, RNC, MA, NEA-BC
AVP Nursing
Justin Leighton
Genetic Counselor
Valerie Pratz
Marketing Manager-Public Relations
& Marketing
Robert Braun, MA, M.Ed., RN, OCN, RT
(T)(R)
Assistant Vice President—Cancer Services
Terry Beck, RN, MPA, CHPN
Chief Mission Officer
Vice President—Communication
Initiatives: VNACJ
Janice Breen, PhD, RN, PHCNS-BC
Manager—Clinical Research
Barbara Yuhas, BSN, RN-BC, NE-BC
Director of Nursing—Med/Surg Division
Nicole Buccino, RN, BS, CCRN
Nurse Manager—Ambulatory Services
Uzma Rizwan, BS, CCS, CTR
CoC Program Supervisor
Janice Breen, PhD, RN, PHCNS-BC
Diana Chiaro, RN, MSN, AOCN,
APN, C.
Oncology Nurse
Maryann Roper, RN, MA
Director—Star and Barry Tobias Health
Awareness Center
Kim Kelly, RN, MS, NEA-BC, FACHE
Mary Ann Cole, RNC
Palliative Care Nurse
Leonard Thomas, RN
Director—Patient/Family Services: ACS
John DiMatteo, MS, RPH
Clinical Director—Pharmacy
Deb Turi-Smith, BA, CSW
Support Service Social Work
Jan Dragotta, BS, RT (R,T)
Clinical Director—Radiation Oncology
Mandi Wortman
Clinical Director—Radiology
References: American Cancer Society, Cancer Facts & Figures, 2011
** Estimate based on average annual cases and deaths 2004-2008
NJ DOH & SS, State Cancer Registry, 2011
NJ State Cancer Plan:
http://www.state.nj.us/health/ccp/ccc_plan.htm
NCCN guidelines, National Cancer Data Base
2011 - 2012
Contributing Efforts
Robert Braun, MA, M.Ed, RN, OCN, RT
(T)(R)
Patricia Cullen
Maryann Roper, RN, MA
Mandi Wortman
Amit Kharod, MD
Uzma Rizwan, BS, CCS, CTR
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