THE CANCER CENTER 2013 ANNUAL REPORT CONTAINING 2012 STATISTICS
Northside Medical Center Cancer Committee Mission Statement It is the mission of the Cancer Committee to evaluate and monitor the care of cancer patients throughout ValleyCare Northside Medical Center in an effort that will establish, and/or enhance positive outcomes through continuous quality improvement initiatives. Cancer Committee Vision Statement Our vision for tomorrow is seeing the treatment of cancer significantly reduced through preventative lifestyles, more public awareness, free screening programs and new and improved treatment methods, and strive for excellence in meeting the physical, emotional and spiritual needs of our patients and their families. 2
2013 ANNUAL REPORT TABLE OF CONTENTS CONTAINING 2012 STATISTICS Cancer Committee Mission Statement...2 Cancer Committee Vision Statement...2 Acknowledgement...4 Chairman s Report...5 Cancer Committee Members...6 2012 Cancer Conferences Statistics...7 2012 Cancer Conferences...8 ANALYTIC CASES Incidence by Site and Sex...9 Cancer Cases Diagnosed - 2012...10 Patient Outcomes Standard...11 Primary Site Tabulation - 2012... 12-13 Seer Stage and County Codes...14 Age by Sex Graph - 2012...15 Collaborative Group Stage by Sex...16 Treatment...17 Collaborative Group Stage by Sex...18 ANALYTIC LUNG CASES Frequency by Year of Diagnosis...19 Histology...20 AJCC Stage by Sex Graph...21 Seer Stage and County Codes...22 Age by Sex Graph - 2003-2007...23 Five Year Survival by Stage...24 Glossary of Terms...25 3
Northside Medical Center Acknowledgements Our special thanks to the following individuals for their contribution and cooperation in making this publication possible. It would be impossible without them. Kevin Scheetz, MD- Cancer Committee Chairman, ValleyCare Northside Medical Center Karl Wieneke, MD- Cancer Committee Liaison Physician/Vice Chairman, ValleyCare Northside Medical Center Pyongsoo Yoon, MD-Cardiovascular Surgery All Cancer Committee Members All Ancillary Cancer Services Administration ValleyCare Medical Center Marketing & Public Relations Cancer Registry Staff Jacqueline Shannon, CTR This publication is produced annually by the Cancer Registry Department in cooperation with ValleyCare Northside Medical Center Marketing & Public Relations Department. For additional copies please call (330) 884-4269. 4
2013 ANNUAL REPORT Northside Medical Center Cancer Committee Chairman s 2013 Annual Report As Chairman of the Cancer Committee, I am happy to report that Valley Care Health System has continued to excel in cancer care management during 2012. Valley Care Health System s cancer program remains accredited by the Commission on Cancer of the American College of Surgeons. Only 25% of hospitals in the United States have cancer programs approved by the Commission on Cancer and 80% of newly diagnosed cancer patients are treated at these institutions. Approval by the Commission on Cancer is only given to those facilities that are voluntarily committed to providing the highest level of quality cancer care and undergo a rigorous evaluation process and review of their performance. The Cancer Registry of Forum Health Northside Medical Center accessioned 315 analytic cancer cases in 2012. Our hospital system primarily serves a three-county region and over 99% of the new cancer patients reside in this area which includes Mahoning, Trumbull and Columbiana counties. The percentage of female cancer patients registered in 2012 at Northside Medical Center was 57%. This is substantially higher than the national average of 48% female and 52% male cancer patients as reported by the American Cancer Society statistics. There are a few noteworthy differences between state and national statistics and those of Valley Care Health System. Analytic breast cancer cases comprise 23% of our total cancer cases at Northside Medical Center; this is substantially higher than the 14% seen nationwide. This may be due to the highly effective Breast Cancer Program which is one of the busiest programs for screening and diagnostic mammography in the area. Cancer education has also remained a priority at Valley Care Health System. In 2012, our Cancer Committee sponsored our 31 th Annual Cancer Symposium this year focusing on lung cancer. These cancer symposiums are directed toward physicians and other healthcare professionals and bring presentations by nationally known speakers covering new and emerging concepts in the treatment and diagnosis of cancer. Other educational endeavors include a weekly Tumor Conference, which is a multidisciplinary conference where a number of physicians, including surgeons, medical oncologists, radiation oncologists, pathologists, diagnostic radiologists and primary care physicians discuss the diagnosis and management of specific cases of cancer. Kevin L. Scheetz, M.D. Chairman, Cancer Care Committee ValleyCare Health System of Ohio 5
Medical Staff Kevin Scheetz, MD- Chairman, Pathology NORTHSIDE MEDICAL CENTER 2012 CANCER COMMITTEE MEMBERS Karl Wieneke, MD- Vice-Chairman, Liaison, Physician Richard Barr, MD- Diagnostic Radiology Masud Bhatti, MD-Hematology Oncology The Hope Center Chris Knight, MD-Hematology Oncology The Hope Center Thomas d Amato, MD- Cardiothoracic Surgery Daniel Ebert, MD-Surgery Arthur Greenbaum, MD-Radiation Oncology Arvind Padubidri, MD-Plastic Surgery Eugene Tareshawty, MD-Hospice, Pain Management- The Hope Center Ancillary Staff Allyn Booher, RPh- Oncology Pharmacy Deborah Gilbert, LD, RD- Oncology Nutrition Mary Ann Hall, RN- Quality Management Deborah Moore- American Cancer Society Mary Morris, BA, LSW, MSEd- Oncology Social Worker Portia Ingram, CTR- Cancer Registry Jacqueline Shannon, CTR- Cancer Registry Cancer Conference Fellows Internal Medicine Residents Pathology Residents Surgery Residents 6
2013 ANNUAL REPORT 2012 CANCER CONFERENCES STATISTICS SITE PROSPECTIVE RETROPECTIVE ANORECTAL ARISING IN TUMBULOVOUS ADENOMA 1 0 ANUS & ANAL CANAL 1 0 APPENDIX 1 0 BILE DUCT 1 0 BLOOD & BONE MARROW 1 1 BREAST 14 0 BRONCHUS & LUNG 12 0 CARCINOID TUMOR 1 0 CECUM 1 0 CERVIX 1 0 COLON 16 0 COMMON BILE DUCT 1 0 CONNECTIVE SUBCUTANEOUS OTHER SOFT TISSUE 1 0 ESOPHAGUS 4 0 GALLBLADDER 1 0 GE JUNCTION 1 0 GIST 2 0 KIDNEY 2 0 LEUKEMIA 1 0 LIVER & BILE DUCTS 1 0 LYMPH NODES 2 0 MALE BREAST 1 0 MELANOMA 3 0 OTHER BILIARY TRACT 1 0 PANCREAS 2 0 PAROTID GLAND 1 0 RECTOSIGMOID JUNCTION 2 0 RECTUM 2 0 SARCOMA 2 0 SARCOMATOID CA-LUNG 1 0 STOMACH 6 0 THYROID GLAND 2 0 TONSIL 1 0 UNK PRIMARY 1 0 URACAL 1 0 URINARY BLADDER 1 0 Cases Presented 93 1 Percentages 99.55% 0.02% 7
2012 Cancer Conferences Cancer Conferences are held every Thursday at 7:00 a.m. in the Politis Auditorium in the Medical Education Building at Northside Medical Center. The Conferences are open to all medical staff, residents and ancillary personnel. Cases presented are selected by the Cancer Fellows who make all conference arrangements and are moderated by members of the medical staff on a rotating basis. All cases are discussed with representatives from medical and radiation oncology, surgery, pathology, radiology and other medical specialties. Both current and retrospective cases are discussed, and Category 1 CME hours are granted to medical staff for attendance. The Cancer Committee also oversees continuing medical education every year. For 2012, our focus presentation was Colorectal Cancer, which we presented at our Symposium. 8
2013 ANNUAL REPORT Incidence by Site and Sex, 2012 Analytical Cases SITE NAME # Cases Percent MALE Percent FEMALE Percent PAROTID GLAND 1 0.32 1 100 0 0 TONSIL 1 0.32 1 100 0 0 ESOPHAGUS 11 3.49 8 72.73 3 27.27 STOMACH 7 2.22 4 57.14 3 42.86 SMALL INTESTINE 2 0.63 1 50 1 50 COLON 38 12.06 17 44.74 21 55.26 RECTOSIGMOID JUNCTION 2 0.63 1 50 1 50 RECTUM 10 3.17 5 50 5 50 ANUS & ANAL CANAL 1 0.32 0 0 1 100 LIVER & BILE DUCTS 2 0.63 0 0 2 100 OTHER BILIARY TRACT 2 0.63 1 50 1 50 PANCREAS 9 2.86 4 44.44 5 55.56 BRONCHUS & LUNG 79 25.08 43 54.43 36 45.57 HEART MEDIASTINUM PLEURA 1 0.32 0 0 1 100 BLOOD & BONE MARROW 8 2.54 4 50 4 50 SKIN 3 0.95 1 33.33 2 66.67 CONNECTIVE SUBCUTANEOUS OTHER SOFT TISSUE 1 0.32 1 100 0 0 BREAST 73 23.17 2 2.74 71 97.26 VULVA 1 0.32 0 0 1 100 CORPUS UTERI 4 1.27 0 0 4 100 PENIS 1 0.32 1 100 0 0 PROSTATE GLAND 10 3.17 10 100 0 0 TESTIS 2 0.63 2 100 0 0 KIDNEY 6 1.9 4 66.67 2 33.33 KIDNEY, RENAL PELVIS 1 0.32 0 0 1 100 URETER 1 0.32 0 0 1 100 URINARY BLADDER 14 4.44 11 78.57 3 21.43 OTHER & UNSPECIFIED URINARY ORGANS 1 0.32 0 0 1 100 THYROID GLAND 6 1.9 1 16.67 5 83.33 LYMPH NODES 10 3.17 6 60 4 40 UNK PRIMARY 7 2.22 5 71.43 2 28.57 TOTAL CASES 315 100% 134 42.54% 181 57.46% 9
CANCER CASES DIAGNOSED 2012 *NATIONAL COMPARISON OF SELECTED CANCER SITES *Estimated Numbers of New Cases from: The American Cancer Society Cancer Facts & Figures 2012 VALLEYCARE NORTHSIDE OHIO NATIONAL MEDICAL CENTER PRIMARY SITE CASES PERCENT CASES PERCENT CASES PERCENT BREAST 73 23.2% 8,990 7.9% 226,870 13.8% LUNG 79 25.1% 10,270 9.0% 226,160 13.8% PROSTATE 10 3.2% 8,560 7.5% 241,740 14.8% COLORECTAL 46 14.6% 6,020 5.3% 143,460 8.8% BLADDER 14 4.4% 3,160 2.8% 73,510 4.5% NH LYMPHOMA 12 3.8% 2,920 2.6% 70,130 4.3% CORPUS UTERI 4 1.3% 2,110 1.9% 47,130 2.9% MELANOMA 3 1.0% 3,030 2.7% 76,250 4.7% LEUKEMIA 4 1.3% 1,810 1.6% 47,150 2.9% CERVIX 0 0.0% 400 0.4% 12,170 0.7% ALL OTHERS 70 22.2% 66,560 58.5% 474,340 28.9% 10
2013 ANNUAL REPORT The American Cancer Society (ACS), has formed a Collaborative Action Plan with ValleyCare Northside Hospital. With this collaboration the goal setting tool known as SMART (Specific, Measurable, Achievable, Realistic, and Timely) was used. For 2012 the Cancer Committee was to provide 1 prevention program each year to reduce the incidence of skin cancer. In collaboration with the ACS and Healthy Women. ACS was to provide supporting information brochures, fact sheets and easy reading health information in the quantity requested. The results were 60 people with skin cancer were reached for a prevention program. Screening Programs Northside Medical Center and the American Cancer Society continues their collaboration with the B.E.S.T. program that provides funding through the American Cancer Society s Making Strides against Breast Cancer Walk for no cost mammograms for women ages 40-64 who are uninsured or underinsured. Other referral totals for 2012 Sept. 1, 2011 August 31, 2012 were; 17 requests for information 18 women attended Look Good Feel Better 1 patient was served with Road to Recovery 2 rides were provided 1 patient received a gas card for a total of $300. 1 patient received a Personal Health Manager File. The ACS also provided the Cancer Liaison Physician (CLP) with resources of becoming American Cancer Society Liaison webinar information for Health Care Professionals, cancer.org, cancer presentations, easy reading health information, toolkits, Colon, Prostate, Facts and Figures, ACS Journals, Cancer Liaison Information Board. The hospital responsibility was for the CLP to be available as a resource for press release quote and or ACS Conference Presentation if requested. 11
PRIMARY SITE TABULATION FOR 2012-ANALYTIC-CASES PRIMARY SITE TOTAL SEX Collaborative Stage Group N/A Male Female 0 I II III IV UNK N/A ALL SITES 315 0 134 181 29 74 65 42 63 23 19 ORAL CAVITY 1 0 1 0 0 1 0 0 0 0 0 LIP 0 0 0 0 0 0 0 0 0 0 0 TONGUE 0 0 0 0 0 0 0 0 0 0 0 OROPHARYNX 0 0 0 0 0 0 0 0 0 0 0 HYPOPHARYNX 0 0 0 0 0 0 0 0 0 0 0 OTHER 1 0 1 0 0 1 0 0 0 0 0 DIGESTIVE SYSTEM 83 0 40 43 3 22 24 9 14 7 4 ESOPHAGUS 11 0 8 3 1 0 6 1 3 0 0 STOMACH 7 0 4 3 0 2 0 2 0 1 2 COLON 34 0 16 18 1 9 12 5 3 3 1 RECTUM 12 0 6 6 0 8 2 0 1 1 0 ANUS/ANAL CANAL 1 0 0 1 1 0 0 0 0 0 0 LIVER 2 0 0 2 0 1 0 1 0 0 0 PANCREAS 9 0 4 5 0 0 2 0 6 1 0 OTHER 7 0 2 5 0 2 2 0 1 1 1 RESPIRATORY SYSTEM 80 0 43 37 0 12 4 21 35 7 1 NASAL/SINUS 0 0 0 0 0 0 0 0 0 0 0 LARYNX 0 0 0 0 0 0 0 0 0 0 0 LUNG/BRONCHUS 79 0 43 36 0 11 4 21 35 7 1 OTHER 1 0 0 1 0 1 0 0 0 0 0 BLOOD & BONE MARROW 7 0 3 4 0 0 0 0 0 0 7 LEUKEMIA 4 0 2 2 0 0 0 0 0 0 4 MULTIPLE MYELOMA 1 0 0 1 0 0 0 0 0 0 1 OTHER 2 0 1 1 0 0 0 0 0 0 2 BONE 0 0 0 0 0 0 0 0 0 0 0 CONNECT/SOFT TISSUE 1 0 1 0 0 1 0 0 0 0 0 12
2013 ANNUAL REPORT PRIMARY SITE TABULATION FOR 2012-ANALYTIC-CASES (cont.) SKIN 3 0 1 2 0 0 1 0 2 0 0 MELANOMA 3 0 1 2 0 0 1 0 2 0 0 OTHER 0 0 0 0 0 0 0 0 0 0 0 BREAST 73 0 2 71 13 22 20 8 4 6 0 FEMALE GENITAL 5 0 0 5 2 2 1 0 0 0 0 CERVIX UTERI 0 0 0 0 0 0 0 0 0 0 0 CORPUS UTERI 4 0 0 4 1 2 1 0 0 0 0 OVARY 0 0 0 0 0 0 0 0 0 0 0 VULVA 1 0 0 1 1 0 0 0 0 0 0 OTHER 0 0 0 0 0 0 0 0 0 0 0 MALE GENITAL 13 0 13 0 1 1 9 2 0 0 0 PROSTATE 10 0 10 0 0 0 9 1 0 0 0 TESTIS 2 0 2 0 0 1 0 1 0 0 0 OTHER 1 0 1 0 1 0 0 0 0 0 0 URINARY SYSTEM 22 0 14 8 10 4 3 0 3 2 0 BLADDER 14 0 11 3 8 1 3 0 1 1 0 KIDNEY/RENAL 6 0 3 3 0 3 0 0 2 1 0 OTHER 2 0 0 2 2 0 0 0 0 0 0 BRAIN & CNS 0 0 0 0 0 0 0 0 0 0 0 BRAIN (BENIGN) 0 0 0 0 0 0 0 0 0 0 0 BRAIN (MALIGNANT) 0 0 0 0 0 0 0 0 0 0 0 OTHER 0 0 0 0 0 0 0 0 0 0 0 ENDOCRINE 6 0 1 5 0 2 2 1 1 0 0 THYROID 6 0 1 5 0 2 2 1 1 0 0 OTHER 0 0 0 0 0 0 0 0 0 0 0 LYMPHATIC SYSTEM 14 0 10 4 0 7 1 1 4 1 0 HODGKIN'S DISEASE 2 0 1 1 0 1 1 0 0 0 0 NON-HODGKIN'S 12 0 9 3 0 6 0 1 4 1 0 UNKNOWN PRIMARY 7 0 5 2 0 0 0 0 0 0 7 Number of cases excluded: 0 This report EXCLUDES CA in-situ cervix cases, squamous and basal cell skin cases, and intraepithelial neoplasia cases 13
2012 ANALYTIC CASES Seer Stage and County Codes SEER STAGE DESCRIPTION # CASES Percent 1 LOCALIZED 116 36.9% 2,3,4,5* REGIONAL 80 25.2% 7 DISTANT 70 22.3% 9 UNKOWN 11 3.5% Other 38 12.1% TOTAL 315 100% *Note: Seer Stage 2 means Regional by Direct Extension; 3 means Regional to Lymph Nodes; 4 means Regional by Direct Extension; 5 means Regional, NOS COUNTY CODES 2012-ANALYTICAL-CASES COUNTY CODE # of Cases Percent COLUMBIANA 10 3.2% GEAUGA 0 0% MAHONING 217 68.8% PORTAGE 1 0% SUMMIT 0 0% TRUMBULL 83 26.4% OTHTER 4 1.3 OVERALL TOTALS 315 100% CONTROLLING VARIABLES COLUMBIANA is COUNTY CODE 029 GEAUGA is COUNTY CODE 055 MAHONING is COUNTY CODE 099 PORTAGE is COUNTY CODE 133 SUMMIT is COUNTY CODE 153 TRUMBULL is COUNTY CODE 155 14
2013 ANNUAL REPORT 2012 ANALYTIC CASES Age By Sex Graph Age Range Male Female 10-19 0 1 20-29 4 1 30-39 1 2 40-49 4 6 50-59 19 27 60-69 36 46 70-79 33 53 80-89 35 38 90-99 2 7 TOTALS 134 181 Of our 315 analytic cases, the average age is ranges between 60-80 for both males and females patients. With a mean age range for males 60-69 and for females 70-79. 15
2012 ANALYTIC CASES COLLABORATIVE GROUP STAGE BY SEX Stage Male Female 0 9 20 I 26 48 II 25 40 III 19 23 IV 33 30 UNK 9 14 N/A 13 6 TOTALS 134 181 16
2013 ANNUAL REPORT 2012 ANALYTIC CASES Treatment TREATMENT CASES PERCENT NONE 138 43.81% SURGERY 100 31.75% RADIATION 44 13.97% SURGERY/RADIATION 31 9.84% CHEMOTHERAYPY/RADIATION 1 0.3% CHEMOTHERAPY 1 0.3% NONE 18 0.03 TOTAL CASES 315 100.0% 17
2012 ANALYTIC CASES Collaborative Group Stage by Sex Stage Male Female 0 9 20 I 26 48 II 25 40 III 19 23 IV 33 30 UNK 9 14 N/A 13 6 TOTALS 134 181 18
2013 ANNUAL REPORT LUNG CASES Frequency by Year of Diagnosis, Analytic Cases Only YEAR TOTAL CASES LUNG CASES PERCENT 2003 842 97 11.5% 2004 822 70 8.5% 2005 884 84 9.5% 2006 759 60 8% 2007 613 45 7.3% 2008 506 53 10.5% 2009 411 43 10.5% 2010 392 47 12% 2011 379 35 9.2% 2012 315 49 15.5% 19
2012 LUNG CANCER WITH HISTOLOGY In 2012, 49 cases of lung cancers were diagnosed at ValleyCare Northside Medical Center. With 71.4% of the cases with the histology of Non-Small Cell, and 28.6% diagnosed as Small Cell. HISTOLOGY BRONCHUS & LUNG TOTAL VALUES NON-SMALL CELL 35 71.4% SMALL CELL 14 28.6% OTHER NOS 0 0% ANY OTHERS 0 0% OVERALL TOTALS 49 100% CONTROLLING VARIABLES NON-SMALL CELL is HISTOLOGY 80122-80353, 80462-85763 SMALL CELL is HISTOLOGY 80402-80453 OTHER NOS is HISTOLOGY 80002-80113, 85802-95823 20
2013 ANNUAL REPORT 2012 ANALYTIC LUNG CASES AJCC Stage by Sex Graph Stage Male Female I 1 5 II 2 1 III 6 8 IV 14 9 UNK 1 2 TOTALS 24 25 21
2012 ANALYTIC LUNG CASES Seer Stage and County Codes SEER STAGE DESCRIPTION # CASES Percent 1 LOCALIZED 8 16% 2,3,4,5* REGIONAL 17 35% 7 DISTANT 23 47% 9 UNKOWN 1 2% TOTAL 49 100% *Note: Seer Stage 2 means Regional by Direct Extension; 3 means Regional to Lymph Nodes; 4 means Regional by Direct Extension; 5 means Regional, NOS COUNTY CODE COUNTY CODES 2012-ANALYTICAL-LUNG-CASES # of Cases Percent COLUMBIANA 2 4.1% GEAUGA 0 0% MAHONING 29 59.2% PORTAGE 0 0% SUMMIT 0 0% TRUMBULL 18 36.7% OVERALL TOTALS 49 100% CONTROLLING VARIABLES COLUMBIANA is COUNTY CODE 029 GEAUGA is COUNTY CODE 055 MAHONING is COUNTY CODE 099 PORTAGE is COUNTY CODE 133 SUMMIT is COUNTY CODE 153 TRUMBULL is COUNTY CODE 155 22
2013 ANNUAL REPORT 2003-2007 ANALYTIC LUNG CASES Age By Sex Graph Age Range Male Female 30-39 2 0 40-49 6 14 50-59 32 23 60-69 44 46 70-79 65 56 80-89 35 23 TOTALS 184 162 23
ANALYTIC LUNG CASES Five Year Survival by Stage STAGE 0 STAGE 1 STAGE 2 STAGE 3 STAGE 4 2003-2007- ANALYTIC- LUNG BEGIN % 100 100 100 100 100 100 YEAR 1 0 84.3 55.5 50.9 10.9 35.6 YEAR 2 0 74.5 38.8 31.4 6.3 25.1 YEAR 3 0 64.7 33.3 19 4 18.9 YEAR 4 0 60.7 27.7 12 2.3 15 YEAR 5 0 48.7 27.7 10.8 1.1 12.3 24
2013 ANNUAL REPORT GLOSSARY OF TERMS CLASS OF CASE Analytic- Patients who were diagnosed and/or treated as part of their first course of treatment at Northside Medical Center. These are Class of Case 00 through 22. Non-Analytic- Patients diagnosed previously and now with recurrence, patients diagnosed at our facility prior to our reference year (2006) and cancers diagnosed at autopsy. These cases are not included in survival statistics. These are Class of Cases 30 through 38. FIRST COURSE OF TREATMENT The initial cancer-directed treatment or series of treatments, usually initiated within four months of the date of diagnosis. PRIMARY SITE The anatomical location within the human body considered to the point of origin of the malignancy. STAGE OF DISEASE The extent of the cancer spread as determined at the time of first evaluation. In-situ The tumor meets all criteria for malignancy except invasion. Local The tumor is confined to the organ of origin. Regional The tumor has spread by direct extension to adjacent organs and/or has metastasized to regional lymph nodes. Distant The tumor has spread beyond the immediate adjacent organ by direct extension: has developed secondary or metastatic tumors: has metastasized to distant lymph nodes; or has been determined to be systemic in origin. Unknown/Unspecified/Not Applicable There is no AJCC staging available, or cannot be determined from the medical record or medical authority. 25
GLOSSARY OF TERMS (cont.) PROTOCOL GROUPS Local & Institutional Trials REFERENCES American Cancer Society: Cancer Facts & Figures 2012 AJCC Cancer Staging Manuel, Seventh Edition ICD-O, Third Edition International Classification of Disease for Oncology SEER Summary Staging Manual, Revised 2010 Fords Manual Revised 2012 Collaborative Staging-CSv2.04 26
Northside Medical Center Cancer Registry Medical Office Building B 500 Gypsy Lane Youngstown, Ohio 44501 Phone: (330) 884-4269 www.valleycareofohio.net