Summa Cancer Institute 2012 Annual Report/media/Files/pdfs... · Corpus Uteri Lung and Bronchus Breast Bladder Prostate Colorectal Lung and Bronchus Lung and Bronchus 277 196 129

2012 Annual ReportSumma Cancer Institute

S p e c i a l i S t S t e c h n o l o g y c l i n i c a l t r i a l S r e S e a r c h

PROOF 12/12/13

A message from the Medical Director

Summa Cancer Institute is a comprehensive center at the forefront of

cancer care. We fight complex, advanced stages of cancer every day with

advanced, targeted treatment options based on the latest clinical guidelines.

The foundation of Summa Cancer Institute is our talented specialists. They

provide care in a multidisciplinary setting. Many of our physicians were born

in Northeast Ohio and returned here after their training, becoming part of

the community. They provide a level of personalized care that goes beyond

clinical excellence.

Our care includes:

•Radiation oncology specialists who deliver treatment with pinpoint

accuracy that spares healthy tissue and organs

•Hematologists and medical oncologists who provide chemotherapy,

immunotherapy, hormonal therapy, as well as other treatments

•Surgical oncology, including minimally invasive surgical techniques

•Specialized patient support programs and services focused on nutrition,

mental health, pain and symptom management, home care, alternative

medicines and support groups

We also are a national leader in research and clinical trials with more than

100 clinical trials available at any one time. Our cancer specialists serve

on committees for the National Cancer Institute, allowing Summa to offer

groundbreaking treatments, even before they become the standard of care.

Summa has earned prestigious national accreditation and recognition from

numerous national organizations, including American College of Surgeons

Commission on Cancer (CoC), National Accreditation Program for Breast

Centers (NAPBC), the American Society of Clinical Oncology (ASCO) and

the American College of Radiology (ACR), among others.

Our oncology services are available at locations throughout Summit,

Medina and Portage counties. No matter where they choose to access

care within Summa Health System, our patients will be immediately

directed to a cancer specialist at the Jean and Milton Cooper Cancer Center

on the campus of Summa Akron City Hospital, Parkview Center at Summa

Barberton Hospital, Summa Health Center at Lake Medina, or our offices

at Summa Western Reserve Hospital and Robinson Memorial Hospital, an

affiliate of Summa Health System. We also offer inpatient consults at Summa

Wadsworth-Rittman Hospital.

When our specialists and services are combined, Summa Cancer Institute

offers patients a level of compassionate care that is more personalized and

less institutional. Our goal is to cure the cancer, whenever possible, while

improving our patients’ quality of life.

R. Douglas Trochelman, M.D., F.A.C.P.

System Medical Director,

Summa Cancer Institute

Summa Health System summahealth.org/cancer

Cancer Registry Summary 2012

The cancer registry is an essential component of a Commission on Cancer-accredited cancer program. Summa Cancer Institute achieves its goals by collecting and reporting quality cancer data in support of its business planning and outreach initiatives.

Data collected by the cancer registry is an invaluable tool in the fight against cancer. As accredited CoC facilities, our registries collect demographic and disease-specific data elements on each cancer patient presenting for diagnosis or treatment. The information collected is utilized by physicians, administration and other healthcare professionals.

Among the many uses are:•Measuring quality outcomes•Tracking community outreach initiatives•Supporting clinical, diagnostic and treatment research•Evaluating the effectiveness of current treatment modalities•Presenting data for individualized patient treatment planning•Submitting to local and national databases for incidence and

outcome comparison

Summa Cancer Institute

summahealth.org/cancer

C O N T E N T S

cancer registry Summary 2012 1

Statistics 2

•SummaAkronCityand St. Thomas Hospitals 2

•SummaBarbertonHospital 4

•RobinsonMemorialHospital,an affiliate of Summa Health System 6

outcomes Measures 8

•Reducinghealthdisparitiesfor uninsured and underinsured women through mammography, breasthealtheducation 8

•Improvinglymphedema outcomes 10

research 12 •Summaleadswayon CPS-3 enrollment 12

technology 13 •StereotacticRadiosurgery(SRS) andStereotacticBody Radiotherapy(SBRT) 13

S U M M a c a n c e r i n S t i t U t e2 0 1 2 a n n U a l r e p o rt2

2012 Primary Cancer SitesPrimary Site Total Sex Class of Case

M F Analytic Non-AnalyticBreast 277 4 273 271 6

Lung/Bronchus 196 97 99 192 4

Colon 95 50 45 90 5

Corpus Uteri 90 0 90 88 2

Prostate 62 62 0 59 3

Non-Hodgkin's Lymphoma 59 31 28 58 1

Bladder 52 36 16 51 1

Kidney/Renal 43 27 16 41 2

Unknown Primary 39 13 26 39 0

Leukemia 38 20 18 37 1

Ovary 36 0 36 34 2

Rectum 34 21 13 34 0

Thyroid 29 6 23 29 0

Melanoma 27 13 14 24 3

Other Digestive Sites 26 7 19 26 0

Pancreas 22 12 10 22 0

Cervix Uteri 19 0 19 18 1

Multiple Myeloma 17 8 9 16 1

Esophagus 16 14 2 16 0

Brain (Malignant) 16 5 11 15 1

Other Oral Sites 14 8 6 14 0

Anus/Anal Canal 12 2 10 12 0

Vulva 12 0 12 12 0

Testis 10 10 0 9 1

Stomach 9 3 6 9 0

Larynx 9 6 3 9 0

Tongue 8 6 2 7 1

Liver 8 5 3 8 0

Connective Soft Tissue 8 6 2 6 2

Hodgkin's Disease 8 4 4 8 0

Other Throat Sites 7 6 1 7 0

Other Urogenital Sites 7 5 2 7 0

Other Blood/Bone Marrow 5 4 1 5 0

Bone 5 1 4 4 1

Lip 4 3 1 4 0

Other Male Genital Sites 4 4 0 4 0

Other Brain 4 2 2 4 0

Other Female Genital Sites 3 0 3 3 0

Other Ill Defined Sites 2 1 1 2 0

Oropharynx 1 0 1 1 0

Hypopharynx 1 1 0 1 0

Nasausinus 1 1 0 1 0

Other Endocrine Sites 1 1 0 1 0

Total 1,336 505 831 1,298 38

SummaAkronCityandSt.ThomasHospitals

SUMMa akron city and St. thoMaS hoSpitalS

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Colorectal CorpusUteri

Prostate

Female Male

Female Male

Female Male

Portage: 93%

Other: 2%

Trumbull: 3%

Summit: 2%

Summit: 70%

Other: 4%

Portage: 10%

Medina: 8%

Stark: 5%

Wayne: 3%

Summit: 67%

Other: 2%

Medina: 13%

Wayne: 10%

Stark: 8%

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Prostate

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Colorectal

Corpus Uteri

Lung andBronchus

Breast

Bladder

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Colorectal

Lung andBronchus

Lung andBronchus

277

196

129

90

62

104

97

45

22

19

70

57

32

39

27

NUMBER OF CASES

NUMBER OF CASES

NUMBER OF CASES

2012



Top Five Cancer Sites SummaAkronCityand St. Thomas Hospitals’ cancer registry accessioned 1,336 new cancer cases for 2012. This graph illustrates the most frequent primary sites seen at this facility. They account for more than 55% of all new cancer cases in 2012.

Female/Male Top Sites Thetopfivesitesforallpatients arebreast,lung,colorectal,uterine and prostate. The gender distributionforthesetopsitesisrepresented in the graph.

County of Residence Themajority(70%)ofthepatientspresentingtoSummaAkronCityand St. Thomas Hospitals reside in Summit County. This is represented bytheaccompanyingchart.



SummaBarbertonHospital

Primary Site Total Sex Class of Case

M F Analytic Non-AnalyticLung 104 54 50 102 2

Breast 97 0 97 94 3

Colon 32 13 19 31 1

Pancreas 22 8 14 22 0


Rectum 13 9 4 13 0

Prostate 13 13 0 10 3

Leukemia 12 9 3 10 2

Esophagus 9 6 3 9 0


Liver 8 6 2 8 0

Bladder 8 7 1 8 0

Stomach 8 3 5 8 0

Melanoma 7 3 4 6 1


Tongue 6 4 2 6 0

Larynx 6 3 3 6 0


Ovary 6 0 6 6 0

Other Digestive 4 0 4 4 0

Other Blood & Bone Marrow 4 2 2 4 0


Other Brain & CNS 4 2 2 4 0

Thyroid 4 0 4 3 1


Other Oral Cavity 2 2 0 2 0


Other Respiratory 2 2 0 2 0

Connective/Soft Tissue 2 2 0 2 0

Vulva 2 0 2 2 0

Kidney 2 1 1 1 1


Other Female Genital 1 0 1 1 0

Testis 1 1 0 1 0

Other Urinary 1 1 0 1 0

Other Endocrine 1 1 0 1 0


Other Ill-Defined 1 1 0 1 0

Total 434 171 263 419 15

2012 Primary Cancer Sites SUMMa BarBerton hoSpital

0 50 100 150 200 250 300

0 20 40 60 80 100 120

0 10 20 30 40 50 60 70 80

0 50 100 150 200 250 300

0 20 40 60 80 100 120

0 10 20 30 40 50 60 70 80

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Breast

Pancreas


Prostate

Colorectal

Colorectal

Corpus Uteri

Lung andBronchus

Breast

Bladder

Prostate

Colorectal

Lung andBronchus

Lung andBronchus

277

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Prostate

Female Male

Female Male

Female Male

Portage: 93%

Other: 2%

Trumbull: 3%

Summit: 2%

Summit: 70%

Other: 4%

Portage: 10%

Medina: 8%

Stark: 5%

Wayne: 3%

Summit: 67%

Other: 2%

Medina: 13%

Wayne: 10%

Stark: 8%

2012



Top Five Cancer Sites SummaBarbertonHospital’s cancer registry accessioned 434newcancercasesfor2012.This graph illustrates the most frequent primary sites seen at this facility. They account for more than 65% of new cancer cases in 2012.

Female/Male Top Sites The top 5 sites for all patients are lung,breast,colon,pancreasandnon-Hodgkin’slymphoma.Thegenderdistributionforthesetopsites is represented in this graph.

County of Residence Themajority(67%)ofthepatientspresentingtoSummaBarbertonHospital reside in Summit County. Thisisrepresentedbythe accompanying chart.



RobinsonMemorialHospitalan aff il iate of SUMMa health SySteM

Primary Site Total Sex Class of Case

M F Analytic Non-AnalyticBreast 70 2 68 70 0

Lung/Bronchus 57 34 23 56 1

Prostate 32 32 0 32 0

Colon 29 14 15 29 0

Bladder 27 20 7 27 0

Rectum 10 6 4 10 0




Ovary 7 0 7 7 0

Pancreas 6 4 2 6 0

Leukemia 6 4 2 6 0

Esophagus 5 5 0 5 0

Liver 5 4 1 5 0

Testis 4 4 0 4 0

Digestive System - Other 4 3 1 4 0

Skin - Other 4 3 1 0 4

Melanoma 4 1 3 4 0


Larynx 3 3 0 3 0


Thyroid 3 0 3 3 0

Vulva 3 0 3 3 0

Oral Cavity - Other 2 1 1 2 0

Tongue 2 1 1 2 0


Kidney/Renal 1 1 0 1 0

Connect/Soft Tissue 1 1 0 1 0

Nasal/Sinus 1 1 0 1 0

Blood & Bone Marrow - Other 1 1 0 1 0


Female Genital - Other 1 0 1 1 0

Bone 0 0 0 0 0

Brain (Benign) 0 0 0 0 0



Lip 0 0 0 0 0

Oropharynx 0 0 0 0 0

Stomach 0 0 0 0 0

Other/Ill-Defined 0 0 0 0 0

Total 326 157 169 320 6

2012 Primary Cancer Sites roBinSon MeMorial hoSpital

0 50 100 150 200 250 300

0 20 40 60 80 100 120

0 10 20 30 40 50 60 70 80

0 50 100 150 200 250 300

0 20 40 60 80 100 120

0 10 20 30 40 50 60 70 80

Breast

Breast

Pancreas


Prostate

Colorectal

Colorectal

Corpus Uteri

Lung andBronchus

Breast

Bladder

Prostate

Colorectal

Lung andBronchus

Lung andBronchus

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196

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Prostate

Female Male

Female Male

Female Male

Portage: 93%

Other: 2%

Trumbull: 3%

Summit: 2%

Summit: 70%

Other: 4%

Portage: 10%

Medina: 8%

Stark: 5%

Wayne: 3%

Summit: 67%

Other: 2%

Medina: 13%

Wayne: 10%

Stark: 8%

2012


Top Five Cancer Sites RobinsonMemorialHospital’scancer registry accessioned 326 new cancer cases for 2012. This graph illustrates the most frequent primary sites seen at this facility. They account for almost70%ofnewcancercases in 2012.

Female/Male Top Sites Thetopfivesitesforallpatients arebreast,lung,prostate,colorectalandbladder.Thegenderdistributionfor these top sites is represented in this graph.

County of Residence Themajority(93%)ofthepatientspresentingtoRobinsonMemorialHospital reside in Portage County. Thisisrepresentedbythe accompanying chart.

RobinsonMemorialHospitalan aff il iate of SUMMa health SySteM


Reducing health disparities for uninsured and underinsured women through mammography, breast health educationSumma Screens provides free screening and diagnostic mammograms, breast ultrasounds, and breast health navigation services throughout the continuum of care to ensure appropriate follow-up to low-income women who are uninsured or underinsured. Awareness and education empowers people to make informed choices about their health.

According to the Susan G. Komen Northeast Ohio County Characteristics (2009), 50,700 age-appropriate women in Summit County are in need of mammography services. More than 15 percent of those women are uninsured, resulting in more than 7,600 women without access to recommended breast health services.1

For many uninsured women, the thought of scheduling a mammogram can bring about a lot of heavy emotions. Many women wonder how they’ll pay for the testing and may even decide to not make an appointment because of their inability to pay. Summa Screens helps by

taking those worries away. This is the heart of what the Summa Health System program is all about.

The program provided 732 breast imaging services in 2012. Of those services, 604 were to unique patients. In 2012, we provided 317 screening mammograms, 225 diagnostic mammograms and 190 diagnostic breast ultrasounds. In 2012, Summa Screens diagnosed 11 cases of breast cancer.

Often, women say, “I wouldn’t have received my mammogram without Summa Screens.” Our mission is to take away barriers for women who are in need of a mammogram.

Through a generous grant from Susan G. Komen for the Cure, the American Cancer Society, the Women’s Board of Summa Health System, Summa Foundation and private donors, Summa Screens is equipped to offer free mammography services to low-income, uninsured and underinsured women in our community.

Patient Comments“Everyone was very helpful. When the mammogram came back with results that were scary for me, they were reassuring and helped me schedule a follow-up bilateral ultrasound. I can’t thank Summa Screens enough for the emotional and financial support.”

“I would like to express my gratitude for being able to participate in Summa Screens. My routine mammogram indicated that I needed to have a diagnostic mammogram and ultrasound of my left breast. I have no insurance coverage, and I’m a 15-year cancer survivor. The diagnostic mammogram provided by Summa Screens ruled out breast cancer. I can’t tell you what peace of mind this gave me.”

“I lost my job and insurance but knew that I needed my 6-month follow-up. I had an irregular mammogram prior. I called the office crying and upset, and the lady on the phone told me about Summa Screens and there would be no cost to me. I can’t tell you how that made me feel. Even though I felt sad and worried, she provided immediate comfort. And I am thankful to say that everything turned out OK. Thank you.”

1SchmidtM,BrownB,Eve-CahoonH,ThompsonC,McCarrollM,ScottED.Reducing Health Disparities for Uninsured and Underinsured Women through Mammography and Breast Health Education.SummaAkronCityHospital,Akron,OH.

Outcomes

Breast Cancer ScreeningC O M M U N I T Y O U T R E A C H P R O G A M S


Stage Cases

0 1

1 0

1A 2

1B 0

2 1

2A 4

2B 2

3 0

3A 0

3B 0

3C 0

4 1

Total 11

Number of Cancers Diagnosed

Screening Mammograms: 317 43% diagnostic Mammograms: 225 31% diagnostic Ultrasounds: 190 26% total imaging Services: 732 100%

total Unique patients Served: 604

Who Benefits from Summa Screens?

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*Graphsbasedon732patientvisits


Improving lymphedema outcomesProblem Summa Barberton Hospital patients who underwent axillary dissection (AD), axillary radiation (AX) or both procedures were not consistently and proactively referred for a lymphedema prevention consultation.

HypothesisThe first line of defense against lymphedema is prevention. The risk factors of lymphedema can be minimized by preventing infection and avoiding behaviors/procedures that restrict lymph flow. Prior to or immediately following axillary

surgery and/or axillary radiation, it is essential to decrease the risk of infection, prevent injury and avoid increased pressure to the involved arm/breast tissue.

By proactively referring patients who have had AX, AD or both prior to surgery/radiation, or immediately following surgery/radiation (within two weeks) for lymphedema consult, lymphedema may be prevented and/or the lymphedema incidence will be recognized at onset with treatment modalities initiated promptly, decreasing the severity of lymphedema2.

Intervention Educate treating physicians (surgeons, medical oncologists, radiation oncologists) to identify appropriate patients for lymphedema consultation referral. Patients with AD, AX or both were referred for lymphedema consult prior to surgery/radiation or within two weeks following surgery.

The breast care navigator was available to assist with the referral process as needed.

2Stout-GergichN,etal.PreoperativeAssessmentEnablestheEarlyDiagnosisandSuccessfulTreatmentofLymphedema.Cancer.2008Jun15;112(12):2809-19.

findingsIn2012,patientswhohadAD,AXorboth 9

Patients referred or offered referral for lymphedema consult 9

Percentage of appropriate referrals 100%

NumberofpatientsreferredtoSummaHealthCenteratAnnaDean 7

Numberofpatientsreferredtooutsidetherapycenter 1

Numberofpatientswhorefusedlymphedemaconsult 1

Referrals made preop 1

Referralsmadewithintwoweeksofsurgery 3

Patientsseenwithintwoweeksofsurgery 2

Averagenumberofvisitsperpatientsseenfortherapy 3

Incidence of lymphedema 2/7,or30%

Outcomes

LymphedemaE V I D E N C E - B A S E D I N T E R V E N T I O N S


In 2010, 4 of 13 eligible patients were not referred for physical therapy/occupational therapy (2 had comorbidities/ECF). In 2011, 1 of 12 eligible patients were not referred for physical therapy/occupational therapy

In 2012, of the seven patients seen in physical therapy at Summa Health Center at Anna Dean, these referrals generated a total of 34 physical therapy treatment sessions. One of these patients had a second round of therapy in 2012 for treatment of edema. There were a total of three patients that had signs of edema and were treated in 2012. Of these referrals, two patients carried over for the treatments in 2013.

ConclusionBy proactively referring patients for lymphedema consultation prior to surgery/radiation or immediately following surgery, lymphedema was either prevented, or it was detected early and treated promptly. The lymphedema consultation provided patients with knowledge of lymphedema signs/symptoms, techniques to stimulate the lymphatic system, ROM exercises,

massage techniques, skin care, and strengthening exercises as appropriate for the patient’s lifestyle.

Early diagnosis and timely treatment provided more successful outcomes for the patients and less long-term complications than patients who do not receive this lymphedema prevention and early identification education.

Data compiled and Study Completed by Tami O’Connor, PTA, Kari Kovach, BSN, RN, Barb Saylor, BSN, RN, Cherie Hart-Spicer, M.D., Quality Improvement Coordinator


Summa leads way on CPS-3 enrollmentCPS-3 (Cancer Prevention Study-3) is a research study conducted by the American Cancer Society that aims to help better understand how to prevent cancer. It is a long-term study – not a clinical trial. Participants between ages 30 and 65 and with no personal history of cancer (not including basal or squamous cell skin cancer) will be asked to complete surveys every few years for the next 20 to 30 years.

The American Cancer Society’s Epidemiology Research program recruits men and women in the United States and Puerto Rico for CPS-3.

Led by Kari Kovach, BSN, RN,

Summa Barberton Hospital

enrolled 134 individuals in the

CPS-3 study in 2012, surpassing

its goal by six. This made Summa

the only site in Ohio to meet its

intended goal.

Research

Preventing CancerC A N C E R R E S E A R H A C C R U A L S

Summa’s Kari Kovach enrolls individuals in the CPS-3 cancer study during the 2012 Relay For Life of Barberton. Study enrollees were asked to complete a brief survey, provide physical measurements and allow a certified, trained phlebotomist to collect a small blood sample. At home, participants will receive periodic follow-up surveys and newsletters for the next 20 to 30 years.


Summa is one of only two major health systems in Northeast Ohio to earn the prestigious American College of Radiology (ACR) accreditation in

radiation oncology.Summa’s Stereotactic Radiosurgery technology includes stereo

fluoroscopy and dual-diagnostic X-ray capabilities, allowing real-time

imaging and precision even for the most challenging treatment techniques,

especially those that involve moving targets like lung, liver and prostate cancers. Photo courtesy Brainlab

Summa Cancer Institute’s radiation oncology program is equipped with StereotacticRadiosurgery(SRS)andStereotacticBodyRadiotherapy(SBRT)technology, including image guidance.

Powerful,advancedStereotacticRadiosurgery allows our specialists to reachtumorsdeepinsidethebodywithouttheriskofsurgery.ThroughSRSandSBRT,wetreattumorsvirtuallyanywhereinthebodyincludingthebrainand lung, as well as tumors requiring highly focused precision or are medically inoperable.Withcustomtracking,wealsotreat small tumors close to critical organs.

Thisprovidespatientswithmorepreciseandnon-invasivetreatment.Throughthistechnology our radiation oncologists pinpoint the exact location of a tumor anddelivertheradiationtreatmentsmoredirectly while decreasing exposure to surrounding tissue – in days, not weeks.

Radiation OncologyP R E C I S E , N O N - I N V A S I V E T R E A T M E N T

Technology

Summa Health System | (800) 237-8662 | summahealth.org/cancer

CAN-13-19069/CS/JM/11-13

Documents

Summa Cancer Institute 2012 Annual Report/media/Files/pdfs... · Corpus Uteri Lung and Bronchus Breast Bladder Prostate Colorectal Lung and Bronchus Lung and Bronchus 277 196 129