Focus on Prostate Cancer

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1 2010 A N N U A L R E P O RT Edwards Cancer Center Focus on Prostate Cancer Union

2 Welcome from the President Letter from the Chairman Carolinas Medical Center-Union and Edwards Cancer Center continue our commitment to provide comprehensive cancer care through a multidisciplinary approach for our patients. We are proud of the highly trained and skilled medical oncologists, radiation oncologists, surgeons, pathologists, and other physicians, nurses, cancer registrars, and other support staff members who work closely together to provide high quality and compassionate cancer care. This past year, Edwards Cancer Center at CMC-Union was granted a three-year full accreditation by the National Accreditation Program for Breast Centers (NAPBC). This accreditation is only given to cancer centers that voluntarily commit to provide the highest quality breast care and undergo a rigorous evaluation process and review of their performance. This accreditation demonstrates our commitment to providing the highest quality diagnosis and treatment of patients with breast disease. Our cancer program is greatly indebted to Carolyn Menendez, MD; Debbie Hummert and Cynthia Mills, our cancer registrars; Donna Little, our patient navigator; and the tremendous work of our Cancer Committee in achieving the high standards required to receive this accreditation. I hope you enjoy reading the highlights of our cancer program in this 2010 Annual Report, including this year s site study on prostate cancer. I would like to thank Gregory Brouse, MD, for his leadership as chairman of the Cancer Committee and his dedication toward improving the quality of life for all cancer patients. Michael Lutes President, CMC-Union Since its inception, Edwards Cancer Center has grown from a small group of dedicated physicians and staff to a comprehensive cancer program accredited by the American College of Surgeons Commission on Cancer. In seven short years, more than 3,000 patients with cancer have been diagnosed and treated at CMC-Union. In 2010, the cancer program at CMC-Union had another successful year. We became one of only 12 hospitals in North Carolina to earn a three-year full accreditation from the National Accreditation Program for Breast Centers (NAPBC). A few additional accomplishments and highlights include: Edwards Cancer Center provided a variety of cancer screenings (skin and prostate), support groups and community outreach programs that were well attended by the local community. Our annual Cancer Survivors Day Celebration drew over 250 attendees, including more than 100 cancer survivors. In addition to our patient navigator, support services for cancer patients now include a full-time dietitian and a certified lymphedema specialist. To improve our diagnostic capabilities, PET/CT imaging is now available twice per month with plans to install a permanent unit in The on-campus mammography center, now in its third year, continued to grow and offer the most advanced mammography technology with access to the region s most qualified breast radiologists. Beginning in 2011, I m also pleased to report that patients will have access to nationally-run cancer research trials through Edwards Cancer Center. This opportunity will allow patients access to novel and emerging cancer therapies right here in Union County. I congratulate the medical staff, nurses, support staff and Cancer Committee on their accomplishments over the past seven years. We will continue to improve and advance the level of care and services we provide to patients and families in Union County. Gregory M. Brouse, MD Cancer Committee Chairman

3 Focus On Prostate Cancer Hormone therapy can be added to radiation therapy for the management of higher-risk disease (PSA > 20, Gleason score eight or greater, or evidence of extraprostatic extension). Left to right: Board-certified urologists Arthur Lim, MD; Theodore Stamatakos, MD; and Richard Sowden, MD Prostate cancer is the most common cancer in American men. In 2009, 35 men were diagnosed and treated for prostate cancer at CMC-Union. These men ranged in age from 53 to 88 years with the average age at diagnosis of 67. As seen in national data, the average age in African American men was four years younger at 63. Twenty of our patients were Caucasian, 14 African-American and one Native American. Prostate cancer was the third most common cancer diagnosed and treated at CMC-Union in The most common methods used to screen for prostate cancer are the prostate specific antigen (PSA) blood test and the digital rectal exam (DRE). If either of these tests is abnormal, biopsy is considered to determine if cancer is present. Twenty-seven patients in our cohort presented with an elevated PSA test found on screening evaluation. Five patients were diagnosed by physicians detecting a nodule by DRE and two were found during work-up for urinary symptoms. Unlike some cancers, after a diagnosis of prostate cancer, patients have multiple options including observation. Surgery and radiation therapy represent the primary treatment modalities for the management of early-stage disease. At Edwards Cancer Center, 27 of our patients received intensity modulated radiation therapy (IMRT) as their primary therapy. Twenty of these patients presented with intermediate and high risk disease and received hormonal therapy in conjunction with radiation. Eight men underwent surgery as their primary treatment modality. Thomas G. Trautmann, MD Radiation Oncologist Five-year survival data is now available on patients diagnosed and treated for Stage II and Stage III prostate cancer in 2003 and Comparison of our survival data for patients diagnosed shows our five-year survival rate is similar to other cancer centers in North Carolina and the United States. PROSTATE CANCER OBSERVED SURVIVAL rates CMC-UNION - NortH CAROLINA - NCDB PERCENT % 85.3% 84.9% CMC-Union NC NCDB 1

4 Prostate Cancer Report Highlights In 2009, prostate cancer was the third most common cancer diagnosed and treated at Edwards Cancer Center, and accounted for approximately 10 percent of all new cancer cases (35 total cases). The preferred treatment for prostate cancer was surgery or radiation therapy. Cure rates were similar with either option. Radical prostatectomy (surgical removal of the prostate gland) is the mainstay of surgical treatment for prostate cancer. Eight patients underwent surgery as their primary treatment modality. Twenty patients received hormonal therapy in conjunction with radiation therapy. Hormonal therapy, also called androgen deprivation therapy, involves lowering the circulating androgens (male hormones) or blocking the binding of androgen to the androgen receptor. In summary, our review shows our five-year survival rates for patients diagnosed and treated for prostate cancer are comparable with other cancer centers in North Carolina and the United States. Twenty-seven patients received Intensity Modulated Radiation Therapy (IMRT). IMRT is a computerized planning and delivery system used to quantitate the radiation dose to the prostate while restricting the dose to the bladder, rectum and other surrounding normal tissues. 2

5 Cancer Registry Report CMC-Union s Cancer Registry has been in existence since 2003 and is managed by a full-time, nationally accredited cancer registrar and a part-time registrar. The registry has entered over 3,000 cases into its database since Of those, 2,544 were analytic cases (newly diagnosed). Top Five Cancer Sites at CMC-Union 2009 Registry data is reported to the State of North Carolina, as required by law, and the Commission on Cancer s National Cancer Data Base, on an annual basis. The cancer registry is also responsible for documentation and compliance with the standards and guidelines as set forth by the American College of Surgeons, Commission on Cancer for an accredited Community Hospital cancer program. The cancer registry electronically collects and stores records on all reportable cases of cancer and reportable cases diagnosed and/or treated at CMC-Union. This information guides patient care by helping to determine the effectiveness of current therapeutic interventions and providing direction for future therapies. 14% 12% 7% 28% 39% Breast Lung Prostate Colorectal Lymphoma Newly Diagnosed Cancer Patients For *National COMPARISON of THE TOP 10 MOST PREVALENT CANCER SITES *Estimated Cancer Cases from: The American Cancer Society Cancer Fact & Figures Newly Diagnosed Cancer Cases by Year at CMC-Union Percent CMC-Union 2009 ACS Projected Figures North Carolina 2010 ACS Projected Figures National BREAST LUNG PROSTATE COLORECTAL BLADDER NH LYMPHOMA CORPUS UTERI MELANOMA LEUKEMIA CERVIX

6 The Cancer Committee The Cancer Committee is comprised of a multidisciplinary team of medical specialists and key supporting individuals. Members include board-certified physicians from surgery, medical oncology, radiation oncology, diagnostic radiology and pathology, along with an American Cancer Society representative, patient navigator, pain control/palliative care specialist and representatives from administration, nursing, social services, cancer registry, community outreach and quality assurance. The committee is charged with facilitating the ongoing operations and direction of CMC-Union s cancer program including adherence to the 36 standards required for accreditation from the Commission on Cancer. Physician Members Medical Oncology Gregory M. Brouse, MD Diagnostic Radiology Robyn Stacy-Humphries, MD Radiation Oncology Thomas G. Trautmann, MD Pathology Kiran Adlakha, MD General Surgery John Cattie, MD, FACS Carolyn Menendez, MD, FACS non-physician Members Oncology Nursing Joette Parker, RN, BSN, CMSRN Patient Navigator Donna Little Quality Improvement Debbie Hummert, RHIT, CTR American Cancer Society Tracie Lewis Mary Szymonski, RN, MBA Palliative Care Dietary Consultant Kathryn Wineland, RD, LDN Cancer Registry Keitha Eddins, RHIT, BHA Administration Dave Anderson, MHA, FACHE Lynn B. Hamilton, RN Cynthia Mills Joyce S. Bates, R.T., (R) 4

7

8 Carolinas Medical Center-Union Edwards Cancer Center For more information about Edwards Cancer Center or for an electronic version of this report, visit

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