Annual Report2015

C O V E N A N TH E A L T H

EXPERT MINDS. CARING HANDS.

Table of Contents

Report from the Chair 4

Supportive Services 5

2014 Tumor Registry Review 8

2014 Primary Data 9

Colorectal Screening Initiative Progress Update 10

Massage Therapy: A Healing Touch 11

Patient Success Story: Meet Terry 12

Good Food, Good Health 13

Cancer Program Standards: Ensuring Patient-Centered Care 14

Tumor Board Conferences 16

2014–15 Cancer Committee Roster 17

3D Tomosynthesis: Cutting-Edge Mammography 18

Awards and Accrediations 19

Our mission is to continue the healing ministry of the Catholic Church in the spirit of St. Marguerite d’Youville

by providing preventive, curative, restorative, and supportive services with compassion and respect for everyone.

We commit to these values as guides to our decisions and behavior:

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Respect, Excellence, Compassion, & Stewardship2 3

The year 2015 was one of growth and expansion at St. Mary’s Center for Cancer and Blood Disorders. It was also a year for evaluation and assessment. This annual report highlights some of the year’s accomplishments as well as the accredited services offered.

ACCREDITATIoNSt. Mary’s Center for Cancer and Blood Disorders is an American College of Surgeons (ACS) Commission on Cancer accredited cancer program that provides a level of medi-cal expertise that adheres to standard national guidelines as it provides its patients with a personal level of commitment and compassionate care. We are proud to report that the St. Mary’s cancer program was again awarded a three-year accreditation, starting in 2015.

St. Mary’s Center for Cancer and Blood Disorders also participated in a breast health survey by the National Accreditation Program for Breast Centers (NAPBC) and was once again granted full accreditation for 2015 through 2018. NAPBC, guided by the ACS, sets high standards to ensure quality care is being provided to patients being evaluated and treated for breast cancer. We are very proud of this recognition of the high-quality care offered by St. Mary’s breast cancer program.

CoMMuNITy ouTREACH AND PARTNERS IN HEAlTH

St. Mary’s cancer program places a great emphasis on community outreach. We provide annual screening programs for lung, breast, colon, and prostate cancers. We offer physician lectures and screening events throughout the community. Through these efforts, we seek to ensure that local and regional residents are aware of cancer risk factors and symptoms, understand how to reduce their risk for cancer, and know how they can access high-quality cancer-related services. Our goals are to prevent cancer, diagnose cancers in our community early, and achieve cure. We also emphasize cancer survivorship, which is a life-long commit-ment. At St. Mary’s, we provide a cancer survivorship clinic and an integrative medicine program.

We also continue to build upon our valuable relationship with Maine Health and other leading cancer institutions, such as the Dana Farber Cancer Institute. We have worked together to create and streamline care processes and evidence-based algorithms for cancer patients throughout the state and nation. Each year brings new challenges and new opportunities and enables our program to grow further and serve our community better. Each year we utilize the best technology and innovations for cancer treatment right near home.

We are proud of our accomplishments in 2015 and look forward to continued development and progress in 2016. None of these accomplishments would have been possible without the hard work and dedication of the professional and staff who work each day caring for our patients.

Na Liu, MDOncologist/HematologistCancer Committee ChairSt. Mary’s Center for Cancer & Blood Disorders

Report from the ChairAMERICAN CANCER SoCIETy RESouRCE RooMThis patient resource center provides free information on a wide range of cancer topics. Visitors can browse a variety of brochures as well as access cancer and com- munity resource databases.

CANCER REGISTRyStaffed by a certified cancer registrar, the office collects information about the incidence of cancer, type and extent of disease (stage), and types of treatment patients receive. The data are reported to a statewide registry. Reliable registry data are critical for public health pro-fessionals to better understand and address the nation’s cancer burden.

CHAPElThe Marcotte Chapel is a soothing and peaceful place for silence, prayer, or reflection. Catholic Mass is offered most days as well.

ClINICAl TRIAlSAll patients with a cancer diagnosis are screened for clinical trials and have the opportunity to participate in one if eligible. Clinical trials help to improve outcomes for cancer patients worldwide.

GENETICSAn initial assessment of family history, risk factors, and evalu-ation of cancer diagnosis can help providers and patients be proactive in treatment planning. A complete genetics consult is offered by referral.

INfuSIoN CENTERThe 14-chair ambulatory infusion center offers a safe, therapeu-tic environment for receiving outpatient treatment. The center is staffed by highly trained oncology and chemotherapy certified nurses.

INTEGRATIvE MEDICINEPatients are offered a 90-minute consultation to determine any appropriate integrative treatment options, including: nutrition, supplements, and mind/body techniques.

Supportive Services

INTERvENTIoNAl RADIoloGyThe Interventional Radiology Lab performs approximately 25 different procedures including permanent ports and PICC lines for long-term infusion therapy.

lAboRAToRy SERvICESAccredited by the College of American Pathologists, the main St. Mary’s lab offers comprehensive services to support the needs of all of our patients.

looK GooD, fEEl bETTERTrained cosmetologists teach both men and women how to cope with skin and hair changes. Topics include the use of wigs and make-up to enhance appearance. Women take home a bag of skin-care products donated by cosmetic companies.

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Supportive ServiceslyMPHEDEMA SERvICESTreatment of lymphedema secondary to cancer surgery or treatment is provided to patients at our Auburn Medical Campus.

MASSAGE THERAPyThis healing, soothing therapy is offered once weekly to cancer patients and their caregivers.

MEDITATIoN RooMPositioned conveniently near the emergency room and operating rooms, the Meditation Room is a space where people of all faiths can find solitude and quiet.

NuRSE NAvIGATIoNOur nurse navigators guide patients through their cancer journey, from their first call through their

treatment process and into survivorship. They offer education, help to minimize financial barriers to care, and offer support every step of the way. They work closely with the healthcare team to provide comprehensive care.

NuTRITIoN SERvICESOur dieticians provide an individualized consultation for all patients beginning chemotherapy. They teach patients how to optimize nutrition with the goal of keeping patients strong while promoting healing and minimizing complications and side effects of cancer treatment.

PAllIATIvE CAREPalliative care focuses on a patient’s quality of life throughout the continuum of curable and terminal illnesses. Practitioners work with patients on symptom management, goals of care, and how to live better every day.

PHARMACyPharmacists based in the hospital setting provide services to the outpatient Oncology and Infusion Center. They review all medi-cation and chemotherapy orders, ensuring they are evidence-based.

REHAbIlITATIoN SERvICESThe Center for Physical Rehabilitation provides physical, occupational, and speech therapy services. Working in conjunction with a patient’s health care provider, our therapists work with patients to max-imize their physical function and educate them on how to promote continued health.

RoAD To RECovERyA free transportation service, provided through the American Cancer Society, can get patients to and from medical appoint-ments while they are completing treatment.

SoCIAl SERvICESOur Social Worker assists patients and their loved ones in both outpatient and inpatient settings. In addition to helping them manage distress related to their cancer diagnosis, the social worker provides resources for transportation, home care needs, and financial concerns and offers counseling services.

SPIRITuAl CAREPastoral care provides spiritual support while honoring patients’ faith, values, and beliefs. Available on request, this service can ease the stress of coping with an illness or grief.

SuPPoRT GRouPSThese opportunities to share and learn from others are offered on-site and in the community. In addition to groups open to all, specialized groups are offered for women, young adults, and breast cancer survivors.

SuRvIvoRSHIP SERvICES & CARE PlANNINGSurviving cancer begins on the day of diagnosis and continues every day after. Our team works collaboratively to provide ongoing care, schedule appropriate follow-up appointments, and provide patients with treatment summaries and referrals to supportive services as needed. The Nurse Practitioner meets one-on-one with patients and their families after chemotherapy is complete to provide education and a survivorship care plan. The care plan, which is individualized for each patient, outlines follow-up care and how to monitor for late side effects.

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Cancer registries play a critical role in the fight against cancer. They capture the data used by researchers and medical professionals to advance cancer research and improve cancer prevention and treatment programs.

The Tumor Registry at St. Mary’s Regional Medical Center has a beginning reference date of August 1, 1968, which is also the date of our initial accreditation with the Commission on Cancer (CoC).

Currently, the Tumor Registry Database contains 10,436 cases. In 2014, as the certified tumor registrar, I accessioned 261 new incidences of cancer under the management of the Center for Cancer and Blood Disorders administration and Cancer Committee and in strict adherence to the Commission on Cancer. Confidentiality of patient information and related medical data is strictly maintained and protected.

Our primary role is the collection of data, both demographic and clinical, beginning at diagnosis and continuing throughout the cancer patient’s lifetime. The Cancer Registry is responsible for maintaining lifetime follow-up on all analytic patients.

The current follow-up success rate of 95.12% is based on patients diagnosed within the past five years. Additional required follow-up is based on all patients within the database, with a current success rate of 94.12%. These rates significantly exceed the established benchmarks mandated by the CoC.

Participation and collaboration with the Maine Cancer Consortium, Maine Health Oncology Quality Committee, and Maine Health Registry Network help inform valuable quality initiatives and enable comparison of data so that the hospital can better serve the community on the local and state level.

2014 Tumor Registry ReviewBethaney Hartford, Certified Tumor Registrar

REGISTRy ACCoMPlISHMENTS foR 2014• Maintained weekly general tumor board case presentations.• Submitted required data to the National Cancer Database in a timely manner without errors or rejections.• Reported required incidence of cancer cases to the Maine State Cancer Registry quarterly. • Collaborated with abstracting software provider (METRIQ) and the Maine Health Registry Network for system upgrades. • Was instrumental in supplying data for continuing quality improvements and physician requests for research. • Maintained on a monthly basis a Rapid Quality Reporting System per CoC guidelines.

CANCER REGISTRy EDuCATIoN foR 2014• Participated at general tumor board case presentations. • Attended the Cancer Registrars Association of Maine spring and fall trainings. • Attended the Breast Cancer Symposium.

2014 Data

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PERCENTAGE of PATIENTS AT EACH STAGE of CANCER DIAGNoSIS

Note: 2014 data. "Other" = stage was not able to be determined, for various reasons.

2014 PRIMARy SITE TAblE

NOTE: Top five sites are in bold.

PRoGRESS uPDATEAccording to the National Colorectal Cancer Roundtable (NCCR, 2016), colorectal cancer is the second highest cause of cancer death in the United States, with more than 50,000 people dying each year. Although this number reflects a 5% reduction within the past three years, still too many could have potentially been saved with early detection screenings. In 2015, St. Mary’s continued its efforts to promote colorectal health.

Colorectal screenings significantly reduce death from colorectal cancer (Medline, 2014; Steffen et al., 2014). However, approximately one in three people go unscreened with-in the recommended screening age bracket — between ages 50 and 75 (NCCR, 2016). St. Mary’s follows NCCR guidelines, as well as those of the American Cancer Society (ACS) and the American Association of Gastroenterology (AAG), and has screened more than 70% of active patients due for screenings since May 2015. As of December 2015, St. Mary’s screening initiative reached 75% participation, nearing the 2018 goal of 80%.

ACS and AAG recommend colonoscopy as the best screening type, but when patients refuse the test, they are then offered annual fecal occult blood tests, which also aid in detecting early colorectal cancers. When patients refuse testing because of the expense, we refer them to the Colon Cancer Alliance (www.ccalliance.org), which helps low-income patients receive the screenings they need.

REFERENCESMedline. (2014). Committee opinion no. 609: Colorectal cancer screening strategies. Obstetrics & Gynecology, 124(4), 849–855.National Colorectal Cancer Roundtable. (2016). Tools and resources – 80% by 2018. Retrieved from http://nccrt.org/tools/80-percent-by-2018Steffen, A., Weber, M. F., Roder, D. M., & Banks, E. (2014). Colorectal cancer screening and subsequent incidence of colorectal cancer: Results from the 45 and up study. Medical Journal of Australia, 201(9), 523-527.

Cancer screening programs help detect cancers at an early stage, which improves the likelihood of increased survival and decreased morbidity. At St. Mary’s we offer the following:

BREAST: Mammography, ultrasound, and MRIsCOLON: Colonoscopy and fecal occult blood testingCERVICAL: Pap testingSkIN: Physical examsLUNG: Low-dose computed tomography

Colorectal Screening InitiativeHeather Butler, LCSW, Oncology Social Worker

Massage TherapyHeather Butler, LCSW, Oncology Social Worker

A HEAlING TouCHAs part of a holistic approach to cancer care, massage therapy has become an integral part of healing the whole person at St. Mary’s Regional Medical Center’s cancer program as of the fall of 2015. With surgeries and various treatments, patients may experience some physical pain, and massage may be an apparent choice to alleviate physical effects (Amer-ican Cancer Society, 2015). However, massage is also beneficial for those with cancer, as well as caregivers, for other less obvious reasons.

Massage combats fatigue, a common side effect of cancer treatment, by helping to improve sleep (Jacobs et al.,2016). Patients report more ease falling asleep as well as staying asleep following massage therapy. Back massage has also proven effective at decreasing anxiety and blood pressure in both patients and caregivers (Pinar & Afsar, 2015). Reduction in levels of patient stress has shown to improve outcomes from treatment, so inclusion of therapeutic massage can enhance patient progress. Massage therapy has also become a way to combat nausea, another common side effect of cancer treat-ment, by reducing complications caused by chemotherapy medications and steroid use (Firoozabadi & Rahmani, 2015). Scar tissue and adhesions from surgeries or radiation therapy can also be greatly minimized.

In addition to improved physical wellness, cancer patients have reported that massage renews a sense of wholeness, helps them

REFERENCESAmerican Cancer Society. (2015). Non-medical treatments for pain. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/pain/non-medical-treatments-for-cancer-painFiroozabadi, M. D., & Rahmani, H. (2015). Prevention of nausea and vomiting: Methods and utility after surgery in cancer patients. Asian Pacific Journal of Cancer Prevention, 16(7), 2629–2635.Jacobs, S., Mowbray, C., Cates, L. M., Baylor, A., Gable, C., Skora, E., . . . & Hinds, P. (2016). Pilot study of massage to improve sleep and fatigue in hospitalized adolescents with cancer. Pediatric Blood & Cancer, 63(5), 880–886.Pinar, R., & Afsar, F. (2015). Back massage to decrease anxiety, cortisol level, blood pressure, heart rate and increase sleep quality in family caregivers of patients with cancer: A randomized controlled trial. Asian Pacific Journal of Cancer Prevention, 16(18), 8127–8133.Society for Oncology Massage. (2016). What are the benefits of massage for someone with cancer? Retrieved from http://www.s4om.org/faq/item/what-are-the- benefits-of-massage-for-someone-with-cancer.

to relax and release their feelings, builds positive feelings about their body, and builds hope (Society for Oncology Massage, 2016).

The licensed massage therapists who offer their services as part of the cancer program at St. Mary’s are skilled in a variety of methods and work with patients to tailor their approach. They are sensitive to the particular needs of cancer patients, so patients can relax, knowing they are in skilled, caring hands.

Because of the many benefits of therapeutic oncology massage, St. Mary’s is grateful for these massage therapists who volun-teer their time and services to our patients. Perhaps eventually it may be possible to hire permanent massage therapists for more ready access to these benefits for our patients and their caregivers.

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Patient Success Story

During the fall of 2015, Terry made an appointment with Dr. Isaac, his primary care physician, because he was having diffi-culty swallowing. Dr. Isaac found a growth in Terry’s throat that appeared suspicious so he sent Terry for a battery of tests. Terry noted that St. Mary’s was swift in getting him analyzed. Wasting no time, he had a CT scan, PET scan, biopsy, and multiple blood tests. When his test results came in, Terry said he felt like he was “hit over the head with a sledgehammer”: He had cancer of the tongue.

The experience of being given a cancer diagnosis is different for everyone and every variation of the disease. In Terry’s case, despite his fear, St. Mary’s doctors and nurses made him feel confident he would get through it. He called them “kind and considerate of his condition” even when he lost his voice and ability to swallow, which occurred right before the holidays. Terry battled loss of appetite and changes in taste, even before beginning treatment, so for him, it was a very difficult process. Then it was time for a feeding tube. Terry explained how the tube helped him to get nutrition but he missed biting into a steak! He was with us as an inpatient the weeks leading up to Christmas Eve, but steady treatment made it possible for him to be discharged in time to be with family for the holiday, and for that he expressed much gratitude.

Terry has progressed by leaps and bounds since Christmas: He is finished with radiation and chemotherapy and has been given a clear plan for survivorship with his oncology care team. Terry said he was impressed with the “openness of the two hospitals [St. Mary’s and Central Maine] to coordinate care, calling one another if [he] would be late for an appointment” due to scheduling at the other facility. He also commended the coor-dination of St. Mary’s oncologist with his dentist to provide him with protective fluoride trays to use during treatment to protect his teeth.

Overall, Terry had a positive experience here at St. Mary’s and said he would definitely recommend this hospital to family and friends. He still has his feeding tube but hopes to be without it in the next few months, back to work and to “business as usual.” He will be checking in with us every three months for ongoing scans the first two years, then annually for five years. I look for-ward to seeing him again at his future visits, and I know the team here is all cheering for him. Thank you, Terry, for the opportunity to serve you.

Heather Butler, LCSW, Oncology Social Worker

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MEET TERRyOne of the privileges of my work here at St. Mary’s Regional Medical Center is accompanying oncology patients on their journeys. I get to know them as individuals as I seek to offer the support and coordination each of them needs. Recently, I took the opportunity to sit down and chat with one of my patients, Terry McCarthy, about his overall experience.

When I asked him why he chose our hospital for cancer care, Terry said it was “family tradition” to come here. He said he has “always received good care” here since his parents began bringing him to St. Mary’s as a child. However, he would never have imagined one day needing the services of the Center for Cancer and Blood Disorders.

Good Food, Good HealthNuTRITIoN EDuCATIoN

St. Mary's Nutrition CenterFounded by St. Mary’s Regional Medical Center in 2006, the St. Mary’s Nutrition Center (NC) promotes community health through organizing, advocacy, and educa-tion. It serves families, youth, adults, and elders who have limited incomes and are at increased risk for food insecurity and poor health. Located in the midst of diverse neigh-borhoods in Lewiston, Maine, the Nutrition Center has become a true community center, sitting within walking distance to some of the area’s most economically challenged residents. The long-term goal of the center is to build a viable food system while supporting local leaders, strengthening community ties, and engaging youth as agents of change.

At the St. Mary’s Nutrition Center in Lewiston, Maine, we offer a full range of cooking-centered healthy eating classes and programs for kids, youth, adults, and seniors. The cooking education programs empower families and individu-als with the skills, knowledge, and confidence to make healthy eating choices and provide opportunities to learn to love good food. Many patients of the Center for Cancer and Blood Disorders attend these programs to optimize their health.

Specialty classes such as cheese making, bread making, and making “mother sauces” are offered seasonally at St. Mary’s Nutrition Center. These classes offer community members the chance to sharpen their culinary skills and expand their knowledge of fine foods.

St. Mary's Food PantryAnother resource for patients of the Center for Cancer and Blood Disorders is the St. Mary’s Food Pantry. As one of the largest

emergency food pantries in Maine, the St. Mary's Food Pantry has been providing emergency food assistance to residents of the greater Lewiston/Auburn area for over 20 years. Located on the corner of Bates and Walnut Streets, the Food Pantry is conveniently located in the heart of downtown Lewiston across the street from kennedy Park and serves approximately 430 people per week.

In addition to distributing food, the Food Pantry connects guests with opportunities to participate in other Nutrition Center programming such as the cooking and nutrition classes detailed above. Referrals to other community resources are also provid-ed. In addition, the Food Pantry provides medical nutrition for-mula to patients who need it through the New England Enteral Exchange Distribution Solution Program.

Cancer Program StandardsYasmine King, FNP-C

STANDARD 4.7: STuDIES of QuAlITyEach calendar year, the cancer committee, under the guidance of the Quality Improvement Coordinator, develops, analyzes, and documents the required number of studies (based on the program category) that measure the quality of care and out-comes for cancer patients.

STANDARD 4.8: QuAlITy IMPRovEMENTSEach calendar year the cancer committee, under the guidance of the Quality Improvement Coordinator, implements two cancer care improvements. One improvement is based on the results of a quality study completed by the cancer pro-gram that measures the quality of cancer care and outcomes. The other improvement can be based on a completed study from another source. Quality improvements are docu-mented in the cancer committee minutes and shared with medical staff and administration.

With the use of the OnControl Powered Drill, patients reported less pain and discomfort, less time has been required for each individual procedure, and less strain was reported on the provider’s body to obtain adequate samples, in comparison to the manual Jamshidi needle technique. In addition, improving patients’ understanding of bone marrow procedures by providing an updated informational pamphlet on bone marrow aspiration and biopsy procedures prior to the date of the procedure was implemented through another quality improvement project.

Providing patients with additional information that they could then take home and read or share with their family was found to improve patient’s satisfaction in regard to improving their under-standing of the procedure.

Multiple quality improvements in 2015 had a central focus on patient safety. These improvements focused on pharmacy pro-cedures, chemotherapy delivery, and prescribing medications and monitoring bloodwork. For example, the recently increas-ing number of patients being prescribed oral cancer medication led to concern as to whether patients are taking these medica-tion as prescribed. There is a misconception among patients that oral cancer treatments are safer than the intravenous medica-

tions, but oral chemotherapy drugs can be deadly or not work as well as expected if they are taken incorrectly. The infusion center nurses recognized the importance of being able to assess if patients were taking their oral cancer medications correctly. In the past a pill count was utilized to verify pills were taken as prescribed, but this method was not working because many times patients forgot to bring their pills to count. The infusion center nurses reviewed the nursing literature for an evidence-based way to assess adherence to oral chemotherapy and devel-oped an assessment tool based on what they found. Beginning in early 2016, the infusion nurses will be able to use the oral chemotherapy adherence assessment tool so that barriers to adherence can be identified and nurses can address any adherence issues.

Other improvements addressed workflow. For example, the infusion nurses felt the daily nursing assignments were some-times not equally divided.

Although each nurse may have had the same number of patients, the amount of care each patient required could vary greatly. To ensure fairness in daily assignments, it was decided to classify patients by acuity, as is done on many inpatient units.

ENSuRING PATIENT-CENTERED CAREAt St. Mary’s Center for Cancer and Blood Disorders, we are committed to providing high-quality and distinguished care. The evaluation of care with patients provides the opportunity to implement quality and correct and/or improve care. Healthcare is ever evolving and cannot reach full potential unless change-making becomes an intrinsic part of every day. Improvements are challenging but necessary to provide up-to-date and current care. A central goal of healthcare quality improvement is to maintain what is good about the existing health care system while focusing on the areas that need improvement. Quality improvements have a goal of providing healthcare that is efficient, effective, and of a consistently high quality.

Quality or performance improvements are the actions taken, processes implemented, or services created to improve patient care, which is the center of our quality improve-ments. At the Center for Cancer and Blood Disorders, many quality enhancements were completed in 2015 to help improve patient outcomes and patient safety.

A substantial quality improvement was the implementation of the OnControl Powered Drill for all bone marrow aspiration and biopsy procedures. This quality improvement advanced the patient experience by improving the tolerability and applying a safer practice for all patients and staff.

A search of the nursing literature verified that other outpatient oncology units are using patient classification systems in their planning of assignments. As a result, the shared governance group developed an acuity system that is now in place. The workload among nurse is now more evenly distributed among the nurses.

One new study of quality was the research behind prophylactic anticoagulation with patients receiving treatment with Revlimid, thalidomide, and Pomalyst. The study was implemented to establish safer practices for patients with anticoagulation therapy and a more consistent use of anticoagulation medica-tion. During the research period it was found that guidelines for anticoagulation therapy were few but guidelines to identify high-risk patients with correlating appropriate anticoagulation therapy were sufficient. This study of quality will be continued through 2016 to implement a set of guidelines to be used in the Center for Cancer and Blood Disorders.

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The Commission on Cancer (CoC), a program of the American College of Surgeons, recognizes cancer care programs for their commitment to providing compre-hensive, high-quality, and multidisciplinary patient centered care. The CoC is dedicated to improving survival and quality of life for cancer patients through standard- setting, prevention, research, education, and the monitoring of comprehensive quality care. The CoC's Cancer Program Standards: Ensuring Patient-Centered Care (2016 Edition) encompasses the requirements cancer programs must meet to earn and maintain CoC accreditation.

The "Cancer Program Standards" article highlights how St. Mary's Center for Cancer and Blood Disorders met the following two quality standards:

Tumor Board ConferencesTumor board conferences are a key component of the cancer program and integral to patient management at St. Mary’s Center for Cancer and Blood Disorders. The conferences, held every Thursday, provide a forum for education and collaboration with a multidisciplinary team. Cases are presented for diagnostic assessment and treatment planning while referencing nationally recognized treatment guidelines to obtain the best clinical outcomes for our patients.

Attendees include radiologists, pathologists, medical oncologists, radiation oncologists, surgeons, and other specialists along with ancillary and support staff. Analytic cases are presented throughout the year; in 2015, a total of 213 cases were presented.

“The tumor board conferences are extremely important to the care of cancer patients. It allows the patient’s entire care team to come together and discuss the best treatment regimen, based on evidence, that is right for the patient.” —Lori Dyer, RN, OCN Oncology Nurse Navigator

“In breast cancer care, multidisciplinary approaches have shown improvements in quality of care, leading to improved care of the breast cancer patient and improved education for

the treating physicians and team members.” —Dotty Guild, RN, OCN CN-BN

Breast Health Nurse Navigator

“Cancer care is extremely complex. With all of the new treatments, clinical trials, genetic testing, and procedures available, cancer is being treated as a chronic disease because people are surviving and living much longer fruitful lives. Tumor board provides a multidisciplinary approach to treatment planning that involves health care providers from many different specialties reviewing and discussing the treatment of newly diagnosed patients. This allows the best treatment plan to be decided so patients have the best opportunity for a longer survival and a good quality of life.”

—Yasmine King, FNP-C

2014-15 Cancer Committee RosterThe Cancer Committee is the designated multidisciplinary body for the administrative oversight, development, and review of cancer care services at St. Mary’s Regional Medical Center. Mem-bers include physician representatives from the medical, surgical, diagnostic, and clinical areas along with representatives from supporting services involved with the care of patients with cancer. The multidisciplinary committee meets regularly to review and evaluate the quality and direction of the overall cancer program and make recommendations for improvement with the goal of offering the utmost excellence in care.

REQuIRED MEMbER PoSITIoN PRIMARyCommittee Chair Dr. Mahesh Pandey Coordinator PositionsCancer Conference Coordinator Bethaney HartfordQuality Improvement Coordinator Yasmine kingCancer Registry Quality Coordinator Evie TaylorCommunity Outreach Coordinator Jennifer RadelClinical Research Coordinator Lori DyerPsychosocial Services Coordinator Heather Butler

Required Physician MembersRadiology Dr. James PlacePathology Dr. Ola MelhusSurgeon Dr. Marsha O’RourkeMedical Oncologist Dr. Na LiuCancer Liaison Physician Dr. Mahesh Pandey

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Other Required MembersAdministration Representative Susan keilerOncology Nurse Dotty Guild Social Worker/Case Manager Heather ButlerCertified Tumor Registrar Bethaney HartfordPerformance Improvement/Quality Management Representative Lisa MorinPalliative Care Representative Nastasha HorvathRecommended Members Mission Integration Elizabeth keenePrimary Care Dr. Jeffrey BrownPharmacy Representative Carolyn BauerNutrition Representative Angela VerrillPhysical Therapy Representative Rebecca HarringtonInpatient Nursing Representative Heather TurcotteAmerican Cancer Society Nicole Heanssler

3D ToMoSyNTHESISIn 2015, St. Mary’s secured funding to implement a new method for breast cancer screening called 3D digital breast tomosynthesis. This next-generation imaging offers an increased ability to find cancer of the breast (30% to 40%). It also lessens the need for additional views referred to as callback mammograms. Fewer extra mammogram views can decrease the time to diagnosis and simplify the overall screening process.

To the patient, the 3D mammography experience is much the same as that of traditional mammography, though some patients have reported the exam is more comfortable. The improved cancer pick-up rate is due to the x-ray tube moving in an arc over the breast. This creates image slices similar to what is obtained by a CAT scan. The radiologist can thereby examine thin slices of breast anatomy. Subtle but high-grade cancers can be seen that would not be seen via traditional digital mammography.

The technique is approved by the FDA and is being established at a few hospitals in Maine. St. Mary’s plans to begin offering this service in 2017.

Cutting-Edge MammographyJames Place, MD Chief Radiologist

Awards & AccreditationsCENTER foR CANCER AND blooD DISoRDERSSt. Mary’s Regional Medical Center has been accredited by the American College of Surgeons Commission on Cancer (COC) since 1968. CoC accred-itation challenges cancer programs to enhance the care they provide by addressing patient-centered needs and measuring the quality of the care they deliver against national standards. CoC-accredited cancer programs are dedicated to providing the best in patient-centered care.

The Center for Cancer and Blood Disorders goes through a rigorous evaluation process and survey every three years. This includes an on-site evaluation by a physician surveyor. During the most recent evaluation in 2015, St. Mary’s not only achieved accreditation but also demonstrated an “accreditation with commendation” level of compliance for many of the program features including clinical trials, cancer registrar education, public reporting of outcomes, nursing care, and cancer data management. The Oncology Infusion nurses are certified by the Oncology Nursing Society.

The Breast Health program has accreditation by the National Accredi-tation Program for Breast Centers (NAPBC). This designation is granted to breast centers that are committed to providing the best in breast cancer diagnosis and treatment and that comply with established NAPBC standards. The program undergoes a rigorous evaluation and review of its performance and compliance with the standards every three years.

RADIoloGy DEPARTMENTThe Imaging Services Department completed several rigorous applications and was granted accreditation by the American College of Radiology (ACR) in Breast Ultrasound, Stereotactic Breast Biopsy, Mammography, CT, and General Ultrasound. ACR accreditation is recognized as the gold standard in medical imaging. It symbolizes achievement of high practice standards, quality performance, and a commitment to providing the safest, best quality of care possible.

Working along with the board-certified medical staff are registered radiologic technologists and sonographers who meet the standards of the American Registry of Radiologic Technologists and the American Registry of Diagnostic Medical Sonography, respectively.

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C O V E N A N TH E A L T H

ST. MARY'S REGIONAL MEDICAL CENTER93 Campus Avenue, Lewiston, ME

207-777-8100

ST. MARY'S CENTER FOR CANCER & BLOOD DISORDERS

207-777-4420

Patient Transport Available

Free Valet Parking at Drive-up Emergency Entrance

www.stmarysmaine.com/cancercenter

EXPERT MINDS. CARING HANDS.