Download Cancer Program Annual Report - Salina Regional Health Center

2008
Cancer Program Annual Report
Comprehensive
Cancer Care
Close to Home
A publication reviewing the 2008 Cancer Program Activities and Data
2008 Cancer Program Report
2008 marked four years of providing cancer services at Tammy Walker Cancer Center. The future poses more challenges, including increasing competition from cancer
centers in surrounding areas, increasing costs of delivering cancer care, decreasing
reimbursement for services delivered, difficulties recruiting and retaining staff and
difficulties participating in clinical trials. It is important that we face these challenges
with renewed vigor and see solutions rather than resign ourselves to defeat. We must
be willing to think “outside the box” in out search for solutions.
We can be proud of our accomplishments this past year. Our Avon grant was renewed, allowing us to continue cancer prevention and detection services in the region. The Cancer Center once again sponsored a Breast Cancer Forum for the public
W.F. Cathcart-Rake
with speaker, Kim Carlos, author of “Nordies at Noon”. We also provided the public
M.D.
free skin cancer screening and prostate cancer screening clinics and worked with the
Kansas Department of Health and Environment (KDHE) to provide information and
hemoccult kits to the public during the month of March. Tumor conferences continue
to be held twice monthly, year-round. Educational opportunities provided included an Oncology Fair for nurses
and Quarterly ONS chemo certification classes at Wesley Hospital in Wichita, Kansas.
A great deal has been accomplished in the first 4 years of existence of Tammy Walker Cancer Center but much
remains to be done. It is important that all members of the team remain united in the fight against the scourge of
cancer.
Respectfully,
William Cathcart-Rake, MD
Cancer Registry
The cancer registry of Salina Regional Health Center collects, manages and analyzes cancer information on
all cancer patients, which have been diagnosed and/or treated at our facility. Since 1994 the Salina Regional
Health Center cancer registry has developed a data base of 9, 850 tumors in 9,331 patients.
In 2008 the registry entered 649 new cancer cases into the database. Of the 649 cases 358 (56%) were male and
275 (43%) were female. The top five cancer sites for this year were: Prostate, Breast, Lung, and Colon/Rectum.
(See graphs for more information on the 2008 cases).
Colon/Rectal Cancer
Colorectal cancers are the fourth most common cancer treated in our area. Salina Regional Health Center has
seen the number of colorectal cases decline until the present year at 56 cases. The average number of colorectal
cancers treated and reported in the cancer registry is 58 cases per year.
Colon/Rectal Cancer ct’d
The American Cancer Society estimates in
2009 that 106,100 new cases of colon cancer will be diagnosed and 40,870 new cases
of rectal cancer will be diagnosed. Death
will occur for 49,920 persons. This cancer
affects both men and women. In our data
base in the years 2003 – 2008, it has equally
affected men and women. The American
Cancer also states this is a cancer which occurs equally in men and women.
Colorectal Cases
C olorec tal C as es
80
72
70
66
60
56
56
53
50
46
40
Number of Cases
30
20
10
0
2008
2007
2006
2005
2004
2003
ex of P atient
Sex Sof
patients
173
Male
Female
178
In comparing staging with the National Cancer
Data Base (NCDB) we see in 2003, Salina Regional Health Center staged more Stage 1 and Stage 3
cancers than those diagnosed elsewhere. Stage 2
and Stage 4 cases were lower than the average in
the NCDB data. Using the latest staging information 2006 from NCDB, our 2008 cases were very
much in line with NCDB except for the Stage 4
cases for which we have fewer cases.
Each March, the Tammy Walker Cancer Center
provides free hemoccult kits to area pharmacies for
persons to check their stools for hidden blood. We
have collaborated with the American Cancer Society and Kansas Department of Health and Environment (KDHE) to provide these free kits to the public. Also included in the kits is information about prevention
of colon/rectal cancers. KDHE provides advertising about colon/rectal cancers through the media with help
from a CDC (Center for Disease Control) grant.
Stage
at Diagnosis - 2008
S tage at Diagnos is 2008 (2006)
Stage
of Diagnosis - 2003
S tage at Diagnos is (2003)
35
30
30
25
25
20
20
SRHC
NCDB
Percent
15
SRHC (08)
15
NCDB (06)
Percent
10
10
5
5
0
0
Stage 0
Stage 1
Stage 2
Stage 3
Stage 4
Unknown
Stage 0
Stage 1
Stage 2
Stage 3
Stage 4
Unknown
Colon/Rectal Cancer ct’d
Screening for colon/rectal cancer is recommended to
begin at 50 years of age, or earlier if there is a family
history of colon/rectal cancer.
Greater than 90% (93%) of the patients diagnosed
with colon/rectal cancer from 2003-2008 were diagnosed over the age of 50. Seven percent (7%) of the
patients were in there 30s and 40s.
Signs and Symptoms of colorectal cancer:
• A change in bowel habits such as diarrhea,
constipation or narrow stool that lasts
for more than a few days
• A feeling that you need to have a bowel
movement that doesn’t go away after
doing so
• Rectal bleeding, dark stools or blood in the stool
• Cramping or stomach pain
• Weakness and tiredness
Age at Diagnosis
- 2003-2008
Age at Dx( 2003-2008)
120
113
100
80
60
54
Number of cases
40
21
18
20
4
0
30-39
40-49
50-59
60-69
70-79
80-89
90+
Survival of colon/rectal cancer depends on
many factors including stage at diagnosis, age
of the patient, and adequacy of surgical resection and administration of chemotherapy.
Survival
Comparison
with NCDB
S urvival
C omparis on 2003 with2003
NC DB
90
80
70
60
50
SRHC
NCDB
percent
40
71
70
Survival data for 2003 from NCDB and
SRHC are very comparable as shown in the
graph at left.
30
20
10
0
1year
2 year
3 year
4 year
5 year
In summary, our comparisons to NCDB are very comparable. We will continue to offer colon/rectal cancer
education to promote early detection of colon/rectal cancers. We will promote this information at health fairs
and every March for colon/rectal cancer screening month. We will also encourage participation in clinical trials
when appropriate.
Summary of all 2008 Cases
Age at
Diagnosis
- 2008
Age at
Diagnos is - 2008
PrimaryP rimary
Sites
(SRHC - SSH) 2008
s ites 2008 (S R HC & S S H)
250
Prostate
135
Breast
4
105
4
200
200
Lung
103
0
172
Colon/Rectum
56
Pancreas
35
Bladder
31
Bone Marrow
30
Kidney
18
Head & Neck
16
Thyroid
16
7
150
0
SRHC
12
SSH
106
0
0
50
37
2
All Other
104
20
40
60
80
100
15
12
5
1
16
0
0-19
0
101
100
0
120
140
20-29
30-39
40-49
50-59
60-69
70-79
80-89
90+
160
S ite
Top 5 Sites
- 2008
Top 5 S itesComparison
C omparis on - 2008
Stage at Diagnosis - 2008
S tage at Diagnos is - 2008
35
450
402
30
400
28.7
26
350
25
22.3
21.9
300
20
20
SRHC - 2008
14.4
15
Percent of Cases
14.9
250
KCR - 2006
16
15
NCDB - 2007
14
200
11.9
10.9
150
135
10
7.4
100
5
2.2
50
2.5
37
35
40
Distant
Unknown
0
0
Prostate
Breast
Lung
Colon/Rectum
In Situ
Pancreas
Localized
Regional
2008 Tumor Conference Cases = 77
Patient County of Origin
2
6
10
19
3
2
18
23
41
4
7
6
16
26
1
1
3
2
3
4
16
2
21 248
5 47
5
1
9
7 3
1
76
2
3
1
1
Out of State = 4
Breast
11
Unknown Primary
2
Head & Neck
1
Cervix
1
Bone Marrow
9
Renal Pelvis
2
Lung
8
Stomach
1
Lymph Nodes
3
Soft Tissue
2
Blood
2
Thyroid
2
Bladder
4
Bone
1
Kidney
1
Esophagus
2
Colon/Rectum
6
Liver
2
Prostate
3
Uterus
2
Myeloproliferative Disease
1
Small Bowel
2
Pancreas
2
Ampula
1
Ovary
3
Abdomen
2
Common Bile Duct
1
Brain
1
Skin
1
511 S. Santa Fe • Salina, KS 67402-3617
Cancer Committee Members – 2008
Larry Beck, MD – Chairman – Medical Oncology
William Cathcart-Rake, MD – Medical Oncology
Phillip Munoz, MD – Pathology
Arnold Cabrera, MD – Diagnostic Radiology
Claudia Perez-Tamayo, MD – Radiation Oncology
Jody Neff, MD. – Surgery
Brian Smith, MD – Physician Liaison – Urology
Richard Gomendoza, MD – Internal Medicine
Allied Health Members:
Linda Goodwin, RN – Administration
Rebecca Troyer – Radiation Therapy
Sr. Mary Augustine – Chaplain
Pam Ehlts, CTR – Cancer Registry
Lorraine Meyer – Quality Improvement
Terry Hauschel, RT – Diagnostic Radiology
Jill Smith-Barker, LBSW – Cancer Care Coordinator
Mary Quinley, RN – Medical Oncology
Steve Blanner, Rph – Pharmacy
Charlotte Craig, RHIA – Cancer Registry
Lesli Schrader, RN – Hospice of Salina, Inc.
Jeanne Byquist, LD – Dietary
Janet Ingram, RN – Outreach Services
Ruth Cathcart-Rake, PT – Physical Therapy
Joel Phelps – Administration