the 2015Annual Report

2

As Chair of the Cancer Committee, I am proud to present our 2015 Annual Report. The Cancer Committee

is a group of dedicated health care professionals committed to the treatment and support of cancer patients.

Our program continues to offer high-quality cancer care for patients in Cumberland County and surrounding

counties including Harnett, Hoke, Bladen, Sampson and others.

During this past year, significant expansions have taken place to further improve our ability to offer cancer care

in our area. A formerly private practice, the Blood and Cancer Clinic, has joined the hospital, including medical

oncologists Shirish Devasthali M.D. and Tariq Nazir M.D. Nay Min Tun M.D. has also joined our cancer center

team in medical oncology, seeing patients at our Health Pavilion North location. We also have added a new

location where medical oncology services are offered in Dunn, Cape Fear Valley Cancer Center at Harnett. We

are also excited about future expansion to other counties in the area.

The cancer program remains accredited by the American College of Surgeons Commission on Cancer

(ACSCoC) as a Community Hospital Comprehensive Cancer Program. Accreditation can only be obtained

and kept if a rigorous set of quality criteria are met and maintained. This accreditation demonstrates that our

patients continue to receive quality cancer care closer to home through the Cape Fear Valley Health System.

We are proud of the many dedicated and committed people involved at Cape Fear Valley Medical Center in

providing the highest quality cancer care possible. This work continues on a daily basis, with one goal in mind:

to provide exceptional and comprehensive cancer care to the population that we serve here in Cumberland

County and the surrounding area.

Sincerely,

Istvan Pataki, MD, FRCP (C)

Chair, Cancer Committee

Chairman’s Reportistvan pataki, md, frcp (c)

4

of sceneryMore patients are turning to Cape Fear Valley’s cancer centers for treatment.

A change

A change

The cancer treatment landscape in southeastern North Carolina is in a state of flux, thanks to two

area cancer centers recently closing. The situation has

forced patients to seek treatment elsewhere, including at

Cape Fear Valley Cancer Centers.

The patient shuffling started in the summer of 2014

after The Blood and Cancer Clinic closed to join Cape

Fear Valley’s cancer treatment program. The Fayetteville

practice’s two physicians, five staff members and large

patient base came with the acquisition.

Most of the patients chose to continue their care at

Health Pavilion North Cancer Center, where their former

physicians ended up. Brenda Hall, Cape Fear Valley’s

Cancer Director, said the rapid influx of new patients

strained Health Pavilion North resources.

“We literally tripled our patient volumes overnight,” Hall

said, “and we haven’t slowed down since.”

Staff had to be re-arranged to better meet patient needs,

while renovations were started to ease patient flow. More

rooms were added, a separate blood work area created,

and the facility’s clinical space and chemotherapy infusion

area expanded. Work will soon begin on the facility’s

second floor to accommodate future growth.

Cancer Centers of North Carolina (CCNC) added to the

upheaval, when the company closed its Dunn outpatient

treatment center soon after The Blood and Cancer Clinic

closed. Seeing neighbors in need, Cape Fear Valley Health

quickly stepped in and agreed to reopen the Harnett

County facility.

Located across from Betsy Johnson Hospital, the shuttered

cancer clinic was quickly renovated and re-opened as

Cape Fear Valley Cancer Center at Harnett. But former

patients weren’t as quick to return. The facility averaged

just 20 patient visits a month at first.

“We knew there was a need for our services,” Hall said.

“But we weren’t sure how long it would take to get

patients back from CCNC’s multiple Wake County offices,

where they were sent after the Dunn office closed.”

Shirish Devasthali, M.D., volunteered to help reopen

the Dunn clinic. The Cape Fear Valley oncologist had

experience opening a clinic from the ground up. Cape

Fear Valley administrators then put a plan in motion to

help him bring patients back.

The plan included providing experienced physicians,

expert staff and convenient access to several services. They

include chemotherapy, an onsite pharmacy, lab, support

programs, oncology social workers and dietitians.

It worked. Within six months, Dr. Devasthali and his new

team were seeing more than 700 patient visits a month.

The rapid growth led to another oncologist and mid-level

provider being hired.

Growth TrendsCancer treatment services have grown nationwide, as

more advanced treatment options became available. Even

patients with cancers once thought untreatable now have

options.

“Twenty yeas ago, people with advanced cancer would

have died within a year,” Dr. Devasthali said. “Now

we’re seeing patients live for years with more effective

treatments.”

The growth in cancer treatment led to Cape Fear Valley’s

decision to build a full-service cancer center at Central

Harnett Hospital in Lillington. Slated to open in 2018,

the facility will be located behind the main hospital and

offer an array of services. They will include diagnostic

imaging, radiation therapy, chemotherapy and infusion

therapy with onsite pharmacy, social workers and cancer

survivor support. It will serve as a one-stop shop for

cancer patients.

Cape Fear Valley’s own Cancer Center in Fayetteville

is also seeing a steady increase in patients. Starting last

summer, the center’s Radiation Oncology department

went from treating 80 to 90 patients a day to 130. The

surge came after a fire temporarily closed Gibson Cancer

Center in Lumberton.

6

“Integrating so many patients at once wasn’t a simple

task,” said Margaret Coates, Radiation Oncology Clinical

Manager. “But our team knew these patients had to be

helped.”

Cape Fear Valley took on most of the Gibson Cancer

Center patients within a week of the fire. That allowed

patients to resume radiation therapy treatments without

disruption. Taking on new patients normally takes weeks,

but Cape Fear Valley physicians and staff worked around

the clock to make it happen.

The health system’s Medical Oncology program has also

grown in recent years. Since 2012, patients receiving

chemotherapy and infusion therapy at Cape Fear Valley’s

main Fayetteville campus rose from 22 patients per day to

54, more than doubling patient volumes.

All the growth has forced Cape Fear Valley to take a

hard look at expanding and upgrading equipment at its

Cancer Treatment and CyberKnife Center. The in-house

pharmacy was already expanded last year.

Next on the upgrade list is the Medical Oncology

unit’s infusion space. Built in 1981, the space will

eventually offer eight new infusion chairs. An old linear

accelerator used for treatment by the Radiation Oncology

department will also be replaced.

Twenty yeas ago, people with

advanced cancer would have

died within a year, now we’re

seeing patients live for years

with more effective treatments.

In time, Highsmith-Rainey Specialty Hospital’s Lung

Nodule Clinic will be relocated closer to the Cancer

Treatment and CyberKnife Center. The change is being

made for greater patient convenience and coordinated care.

The move will be a challenge, because space at the main

Cancer Center’s Fayetteville campus is already at a

premium. But Hall feels it will be well worth it.

“All the groundwork being laid now,” she said, “will

eventually provide more convenience and greater capacity

for growth at the Cancer Center.”

With cancer incidence rates increasing every year, the

Cancer Center will be ready.

U.S. cancer incidence rates continue to climb, but so has the survival rate, thanks to a greater emphasis on catching and treating the disease early.Mammograms help detect breast cancer, while colonoscopies can do

the same for colon cancer. But detecting early stage lung cancer has

traditionally been more difficult. That’s because there was no widely

accepted screening tool for the disease until recently.

The American Society of Clinical Oncologists now recommends smokers

and former smokers receive annual low-dose CT scans to check for

developing lung problems. These scans are far more accurate at showing

small abnormalities, which normal X-rays can miss.

“With these new guidelines,” said Angie Syphrit, “we have a screening tool

in place that can potentially help us cure a patient’s cancer, rather than just

offering palliative care once the disease is too far advanced.”

Syphrit is Cape Fear Valley Health’s Lung Nodule Coordinator. It’s her job to

be the single point of contact between patients and their families and the

health system’s Lung Nodule Clinic team.

The role includes explaining unfamiliar terms and treatments to patients,

guiding them through the treatment process and helping them access the

various treatment resources available. The goal is to catch possible tumors

at their smallest and most curable state. Doing so can save lives.

In 2015, roughly 221,000 new lung cancers were diagnosed in the U.S.,

according to the American Cancer Society. More than 158,000 Americans

died from the disease that same year.

Active smokers and former longtime smokers, age 55 to 74, are urged

to get lung cancer screening. Low-dose CT scans are usually covered by

insurance for this age group.

Benign nodules require no treatment, other than monitoring for changes

over time. Malignant nodules can be treated through radiation therapy,

traditional surgery or CyberKnife robotic surgery. Syphrit and her team at

Cape Fear Valley’s Lung Nodule Clinic provide follow-up care, no matter the

screening outcome.

“Closely monitoring any changes we see in the tumors, helps us stay ahead

of the cancer fight, “ Syphrit said. “It’s exciting to finally have a tool that

gives so many smokers access to treatment options in the cancer’s early

stages.”

8

patient outcome analysis

national statistics

In the United States, non-small cell lung cancer (NSCLC)

accounts for over 221,000 cases each year, making it the

second most commonly diagnosed cancer after breast

cancer. However, it is by far the most common cause of

death from cancer in both men and women, resulting in

151,000 deaths, more than prostate, breast and colorectal

cancer combined. Lung cancer accounts for about 27%

of all cancer deaths. Rates for new lung and bronchus

cancer cases have been falling on average 1.7% each

year over the last 10 years. Death rates have not changed

significantly over 2002-2012. Lung cancer mainly occurs

in older people. About 2 out of 3 people diagnosed with

lung cancer are 65 or older; fewer than 2% of all cases are

found in people younger than 45. The average age at the

time of diagnosis is about 70.

Non-Small Cell Lung Cancerat Cape Fear Valley Health

north carolina statistics

About 6,800 new cases of non-small cell lung cancer are

diagnosed each year in North Carolina. About 3900 of these

are in males, with the remaining 2,900 cases are in women.

The age-adjusted mortality rate in North Carolina in 2006

was 59.6, which is higher than the national average of 51.5

non-small cell lung cancer at cape fear valley health system for 2007

During the study period of 2007, a total of 165 new cases

of non-small cell lung cancer were diagnosed at Cape Fear

Valley Health System. The cases were split evenly between

males and females, with 83 and 82 patients, respectively. Only

1% of patients were younger than 40. Seven percent were

between 40 and 49, 17% were between the ages of 50 and

59. The largest single age group was those between 60 and

69, comprising 35% of patients. Those between 70 and 70

made up 30% of the patient population, while those over 80

represented 8% of the group.

Eighty-one percent of the above patients were residents of

Cumberland County. Robeson County residents accounted

for 6 percent while Sampson, Harnett and Lee County

residents accounted for four percent, three percent and three

percent, respectively.

Caucasians accounted for 71 percent of cases, African-

Americans made up 25 percent, and American-Indians about

one percent. Two percent of patients were listed as unknown

ethnicity.

Patients diagnosed with Stage I disease accounted for 18% of

the patient population, eight percent had Stage II, 31 percent

had Stage III, while 39% percent of patients had Stage IV

The Cape Fear Valley Health System Cancer Registry is designed for the collection, management, analysis and distribution of information on all reportable malignancies diagnosed or treated at our health system. The registry also helps assess the effectiveness of treatment for cancer by gathering treatment information and lifetime follow-up of our patients.

As required by law, newly diagnosed cancer cases are reported to the North Carolina Central Cancer Registry. The data submitted to NCCCR is shared with the American Cancer Society, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries. Cancer case information is also submitted to the National Cancer Database (NCDB) of the American College of Surgeons Commission on Cancer. The data gathered here is combined with data from our state and across the nation to study patterns of treatment and care.

In 2014, 1,426 cases were added to the Cape Fear Valley Health System Cancer Registry database, excluding localized squamous cell and basal cell carcinoma of the skin and carcinoma in situ of the cervix. Of that total 1,311 were newly diagnosed cases. Statistics on recurrence, subsequent treatment and disease status are maintained in the database.

The Cancer Registry annually performs lifetime follow-up on all cancer patients diagnosed and or treated at Cape Fear Valley Health System. This directly benefits the patients by reminding the physician and patient of needed regular checkups. Continued surveillance ensures early detection of a possible recurrence or a new malignancy. The Cancer Registry is required to maintain a 5 year follow-up rate of 90 percent. The Cancer Registry appreciates the prompt response to requested follow-up information from area physicians to help us met this required standard from the American College of Surgeons Commission on Cancer.

Cancer Registry Overview

NSCLC. In two percent of patients the stage was unknown.

This compares with national data reported by the National

Cancer Institute (NCI), which reports 16 percent being

localized (confined to primary site, which would include stage

I and II), 22 percent regional (spread to regional lymph nodes),

and 57 percent being metastatic at the time of diagnosis, and

5% with unknown stage.

The two most common histologic subtypes found in this

patient population were adenocarcinoma which comprised

36% of the group, and non-specified non-small cell histology

with also 36 %. Squamous cell carcinomas were 18%, and large

cell carcinomas were 2%.

treatment trends by stage at cape fear valley health system

All stage I patients received definitive (as opposed to palliative)

treatment. Surgery was the most common single modality

used, with 15 patients in this group. Chemo-radiation was the

second most common with 6 patients out of a total of 30 stage

I patients. For stage II, surgery and chemotherapy (with or

without radiation) was used in 7 of the 14 patients. In the 52

patients diagnosed with stage III NSCLC, chemo-radiation was

used in 25 patients, with an additional 8 receiving radiation

alone. Thirty of the 64 stage IV patients received chemotherapy

as part of their treatment regimen

overall survival

The overall survival for patients with Stage I disease was 48

percent, for Stage II it was 29 percent, for Stage III it was 12

percent, and for Stage IV it was 3 percent.

This compares favorably with national statistics, reported by

the American College of Surgeons National Cancer Database,

which reports a range of 47 to 48 percent overall survival for

Stage I, 28 to 29 percent survival for Stage II, 12 percent for

Stage III and 2.6 percent overall survival for Stage IV.

10

harnett

2014 Diagnosis by County

cumberlandhoke

bladen

harnett

robeson

75%

1%

5%

4%

3%

other

12%

0-29 22 1.68%

30-39 35 2.67%

40-49 109 8.31%

50-59 279 21.28%

60-69 417 31.81%

70-79 309 23.57%

80-89 119 9.08%

90+ 21 1.60%

Unknown 0 0%

Total 1,311 100%

2014 Age at Diagnosis

age count percent

55.61%

africanamerican

39.13%

american indianaleutian or

eskimo

2.29%

other

2.97%729 cases 513 cases 30 cases 39 cases

caucasian

2014 Cases by Race

Cancer Statistics

2014 Cancer Cases by Sex

59.65%Female

40.35%Male

2014

Breast 329Lung 218Colon 98Prostate 98Bladder 44

Top 5 Sites from 2010-2014

2013

Breast 278Lung 212Prostate 96Colorectal 85NHL 38

2012

Breast 296Lung 248Prostate 135Colorectal 109NHL 35

2011

Breast 285Lung 215Prostate 167Colorectal 131NHL 40

2010

Breast 275Lung 210Colorectal 102Prostate 86NHL 57

s ta t i s t i c s

type # % # %

Prostate 233,000 27% 98 18%

Lung&Bronchus 116,000 14% 112 22%

Colon&Rectum 71,830 8% 52 10%

UrinaryBladder 56,390 7% 33 6%

MelanomaofSkin 43,890 5% 14 3%

Kidney&RenalPelvis 39,140 5% 7 1%

Non-HodgkinLymphoma 38,270 4% 22 4%

OralCavity 30,220 4% 12 2%

Leukemia 30,100 4% 19 4%

Liver&IntrahepaticBileDuct 24,600 3% 10 2%

AllOtherSites 171,780 19% 150 28%

TotalforMen 855,220 100% 529 100%

Breast 232,670 29% 327 42%

Lung&Broncus 108,210 13% 106 13%

Colon&Rectum 65,000 8% 60 8%

UterineCorpus 52,630 6% 11 1%

Thyroid 47,790 6% 31 4%

Non-HodgkinLymphoma 32,530 4% 21 3%

MelanomaofSkin 32,210 4% 4 1%

Kidney&RenalPelvis 24,780 3% 6 1%

Pancreas 22,890 3% 19 2%

Leukemia 22,280 3% 13 2%

AllOtherSites 169,330 21% 184 23%

TotalforWomen 810,320 100% 782 100%

Men

Women

united states* cape fear valley health

2014 Cancer Cases

Excludesbasalandsquamouscellskincancersandinsitecarcinomaexcepturinarybladder.

*AmericanCancerSociety2014Facts&Figures.

12

Summary by Body System, Sex, Class, Status and Best AJCC Stage Report

ORALCAVITY&PHARYNX 23(1.6%) 13 10 20 3 15 8 0 3 2 3 12 0 0 0

Tongue 9 (0.6%) 7 2 8 1 7 2 0 0 0 2 6 0 0 0

Salivary Glands 4 (0.3%) 1 3 4 0 4 0 0 2 1 1 0 0 0 0

Gum & Other Mouth 1 (0.1%) 0 1 0 1 0 1 0 0 0 0 0 0 0 0

Tonsil 3 (0.2%) 3 0 3 0 3 0 0 0 1 0 2 0 0 0

Oropharynx 4 (0.3%) 0 4 3 1 1 3 0 1 0 0 2 0 0 0

Hypopharynx 2 (0.1%) 2 0 2 0 0 2 0 0 0 0 2 0 0 0

DIGESTIVESYSTEM 261(18.3%) 133 128 250 11 137 124 10 40 60 45 78 0 17 0

Esophagus 16 (1.1%) 10 6 16 0 2 14 0 1 0 7 3 0 5 0

Stomach 29 (2.0%) 18 11 28 1 8 21 0 4 2 4 14 0 4 0

Small Intestine 11 (0.8%) 5 6 10 1 9 2 0 1 4 2 1 0 2 0

Colon Excluding Rectum 75 (5.3%) 37 38 73 2 60 15 5 15 18 16 18 0 1 0

Cecum 13 7 6 13 0 10 3 3 1 3 5 1 0 0 0

Appendix 1 0 1 1 0 1 0 0 0 0 0 1 0 0 0

Ascending Colon 20 11 9 20 0 17 3 2 4 3 5 6 0 0 0

Hepatic Flexure 2 0 2 2 0 2 0 0 1 1 0 0 0 0 0

Transverse Colon 7 3 4 7 0 5 2 0 0 4 3 0 0 0 0

Splenic Flexure 4 2 2 3 1 3 1 0 0 2 0 1 0 0 0

Descending Colon 3 3 0 3 0 2 1 0 0 1 0 2 0 0 0

Sigmoid Colon 22 9 13 22 0 18 4 0 8 4 2 7 0 1 0

Large Intestine, NOS 3 2 1 2 1 2 1 0 1 0 1 0 0 0 0

Rectum & Rectosigmoid 43 (3.0%) 19 24 39 4 35 8 1 13 11 5 8 0 1 0

Rectosigmoid Junction 7 4 3 5 2 6 1 1 2 1 0 1 0 0 0

Rectum 36 15 21 34 2 29 7 0 11 10 5 7 0 1 0

Anus, Anal Canal & Anorectum 17 (1.2%) 5 12 17 0 13 4 3 1 6 3 3 0 1 0

Liver & Intrahepatic Bile Duct 15 (1.1%) 11 4 13 2 1 14 0 1 3 1 5 0 3 0

Liver 14 11 4 13 2 1 14 0 1 3 1 5 0 3 0

Intrahepatic Bile Duct 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0

Gallbladder 3 (0.2%) 1 2 3 0 0 3 0 0 0 2 1 0 0 0

Other Biliary 5 (0.4%) 1 4 5 0 1 4 0 0 2 0 3 0 0 0

Pancreas 45 (3.2%) 25 20 44 1 6 39 1 4 14 3 22 0 0 0

Retroperitoneum 1 (0.1%) 0 1 1 0 1 0 0 0 0 1 0 0 0 0

Peritoneum, Omentum & Mesentery 1 (0.1%) 1 0 1 0 1 0 0 0 0 1 0 0 0 0

RESPIRATORYSYSTEM 250(17.5%) 132 118 234 16 87 163 1 51 10 55 113 0 4 0

Nose, Nasal Cavity & Middle Ear 1 (0.1%) 0 1 1 0 1 0 0 1 0 0 0 0 0 0

Larynx 16 (1.1%) 14 2 15 1 14 2 1 5 3 2 4 0 0 0

Lung & Bronchus 233 (16.3%) 118 115 218 15 72 161 0 45 7 53 109 0 4 0

SOFTTISSUE 5(0.4%) 2 3 5 0 5 0 0 3 1 1 0 0 0 0

Soft Tissue (including Heart) 5 (0.4%) 2 3 5 0 5 0 0 3 1 1 0 0 0 0

SKINEXCLUDINGBASAL&SQUAMOUS 19(1.3%) 14 5 18 1 14 5 4 5 3 4 2 0 0 0

Melanoma - Skin 19 (1.3%) 14 5 18 1 14 5 4 5 3 4 2 0 0 0

sex class

primary site total (%) male female analy na alive exp stg 0 stg i stg ii stg iii stg iv 88 unknown blank/inv

ORALCAVITY&PHARYNX 23(1.6%) 13 10 20 3 15 8 0 3 2 3 12 0 0 0

Tongue 9 (0.6%) 7 2 8 1 7 2 0 0 0 2 6 0 0 0

Salivary Glands 4 (0.3%) 1 3 4 0 4 0 0 2 1 1 0 0 0 0

Gum & Other Mouth 1 (0.1%) 0 1 0 1 0 1 0 0 0 0 0 0 0 0

Tonsil 3 (0.2%) 3 0 3 0 3 0 0 0 1 0 2 0 0 0

Oropharynx 4 (0.3%) 0 4 3 1 1 3 0 1 0 0 2 0 0 0

Hypopharynx 2 (0.1%) 2 0 2 0 0 2 0 0 0 0 2 0 0 0

DIGESTIVESYSTEM 261(18.3%) 133 128 250 11 137 124 10 40 60 45 78 0 17 0

Esophagus 16 (1.1%) 10 6 16 0 2 14 0 1 0 7 3 0 5 0

Stomach 29 (2.0%) 18 11 28 1 8 21 0 4 2 4 14 0 4 0

Small Intestine 11 (0.8%) 5 6 10 1 9 2 0 1 4 2 1 0 2 0

Colon Excluding Rectum 75 (5.3%) 37 38 73 2 60 15 5 15 18 16 18 0 1 0

Cecum 13 7 6 13 0 10 3 3 1 3 5 1 0 0 0

Appendix 1 0 1 1 0 1 0 0 0 0 0 1 0 0 0

Ascending Colon 20 11 9 20 0 17 3 2 4 3 5 6 0 0 0

Hepatic Flexure 2 0 2 2 0 2 0 0 1 1 0 0 0 0 0

Transverse Colon 7 3 4 7 0 5 2 0 0 4 3 0 0 0 0

Splenic Flexure 4 2 2 3 1 3 1 0 0 2 0 1 0 0 0

Descending Colon 3 3 0 3 0 2 1 0 0 1 0 2 0 0 0

Sigmoid Colon 22 9 13 22 0 18 4 0 8 4 2 7 0 1 0

Large Intestine, NOS 3 2 1 2 1 2 1 0 1 0 1 0 0 0 0

Rectum & Rectosigmoid 43 (3.0%) 19 24 39 4 35 8 1 13 11 5 8 0 1 0

Rectosigmoid Junction 7 4 3 5 2 6 1 1 2 1 0 1 0 0 0

Rectum 36 15 21 34 2 29 7 0 11 10 5 7 0 1 0

Anus, Anal Canal & Anorectum 17 (1.2%) 5 12 17 0 13 4 3 1 6 3 3 0 1 0

Liver & Intrahepatic Bile Duct 15 (1.1%) 11 4 13 2 1 14 0 1 3 1 5 0 3 0

Liver 14 11 4 13 2 1 14 0 1 3 1 5 0 3 0

Intrahepatic Bile Duct 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0

Gallbladder 3 (0.2%) 1 2 3 0 0 3 0 0 0 2 1 0 0 0

Other Biliary 5 (0.4%) 1 4 5 0 1 4 0 0 2 0 3 0 0 0

Pancreas 45 (3.2%) 25 20 44 1 6 39 1 4 14 3 22 0 0 0

Retroperitoneum 1 (0.1%) 0 1 1 0 1 0 0 0 0 1 0 0 0 0

Peritoneum, Omentum & Mesentery 1 (0.1%) 1 0 1 0 1 0 0 0 0 1 0 0 0 0

RESPIRATORYSYSTEM 250(17.5%) 132 118 234 16 87 163 1 51 10 55 113 0 4 0

Nose, Nasal Cavity & Middle Ear 1 (0.1%) 0 1 1 0 1 0 0 1 0 0 0 0 0 0

Larynx 16 (1.1%) 14 2 15 1 14 2 1 5 3 2 4 0 0 0

Lung & Bronchus 233 (16.3%) 118 115 218 15 72 161 0 45 7 53 109 0 4 0

SOFTTISSUE 5(0.4%) 2 3 5 0 5 0 0 3 1 1 0 0 0 0

Soft Tissue (including Heart) 5 (0.4%) 2 3 5 0 5 0 0 3 1 1 0 0 0 0

SKINEXCLUDINGBASAL&SQUAMOUS 19(1.3%) 14 5 18 1 14 5 4 5 3 4 2 0 0 0

Melanoma - Skin 19 (1.3%) 14 5 18 1 14 5 4 5 3 4 2 0 0 0

status stage distribution – analytic cases only

primary site total (%) male female analy na alive exp stg 0 stg i stg ii stg iii stg iv 88 unknown blank/inv

s u m m a r y

14

sex class

primary site total (%) male female analy na alive exp stg 0 stg i stg ii stg iii stg iv 88 unknown blank/inv

BREAST 346(24.3%) 3 343 329 17 312 34 60 112 95 40 21 1 0 0

Breast 346 (24.3%) 3 343 329 17 312 34 60 112 95 40 21 1 0 0

FEMALEGENITALSYSTEM 69(4.8%) 0 69 65 4 53 16 0 32 5 13 11 2 2 0

Cervix Uteri 13 (0.9%) 0 13 11 2 7 6 0 5 2 3 1 0 0 0

Corpus & Uterus, NOS 38 (2.7%) 0 38 38 0 34 4 0 24 2 5 5 0 2 0

Ovary 12 (0.8%) 0 12 11 1 8 4 0 2 0 5 4 0 0 0

Vagina 1 (0.1%) 0 1 1 0 0 1 0 0 1 0 0 0 0 0

Vulva 2 (0.1%) 0 2 1 1 2 0 0 1 0 0 0 0 0 0

Other Female Genital Organs 3 (0.2%) 0 3 3 0 2 1 0 0 0 0 1 2 0 0

MALEGENITALSYSTEM 130(9.1%) 130 0 103 27 119 11 0 21 66 7 9 0 0 0

Prostate 125 (8.8%) 125 0 98 27 114 11 0 20 62 7 9 0 0 0

Testis 4 (0.3%) 4 0 4 0 4 0 0 1 3 0 0 0 0 0

Penis 1 (0.1%) 1 0 1 0 1 0 0 0 1 0 0 0 0 0

URINARYSYSTEM 59(4.1%) 41 18 57 2 47 12 27 13 7 3 6 0 1 0

Urinary Bladder 44 (3.1%) 33 11 44 0 39 5 27 7 5 2 2 0 1 0

Kidney & Renal Pelvis 15 (1.1%) 8 7 13 2 8 7 0 6 2 1 4 0 0 0

BRAIN&OTHERNERVOUSSYSTEM 20(1.4%) 9 11 15 5 13 7 0 0 0 0 0 15 0 0

Brain 16 (1.1%) 7 9 13 3 9 7 0 0 0 0 0 13 0 0

Cranial Nerves, Other Nervous System 4 (0.3%) 2 2 2 2 4 0 0 0 0 0 0 2 0 0

ENDOCRINESYSTEM 38(2.7%) 7 31 37 1 37 1 0 25 3 3 4 2 0 0

Thyroid 36 (2.5%) 5 31 35 1 35 1 0 25 3 3 4 0 0 0

Other Endocrine including Thymus 2 (0.1%) 2 0 2 0 2 0 0 0 0 0 0 2 0 0

LYMPHOMA 48(3.4%) 27 21 46 2 36 12 0 12 5 9 19 1 0 0

Hodgkin Lymphoma 3 (0.2%) 3 0 3 0 3 0 0 0 2 1 0 0 0 0

Non-Hodgkin Lymphoma 45 (3.2%) 24 21 43 2 33 12 0 12 3 8 19 1 0 0

Non-Hodgkin Lymphoma - Nodal 34 17 17 33 1 23 11 0 5 2 8 18 0 0 0

Non-Hodgkin Lymphoma - Extranodal 11 7 4 10 1 10 1 0 7 1 0 1 1 0 0

MYELOMA 46(3.2%) 26 20 35 11 34 12 0 0 0 0 0 35 0 0

Myeloma 46 (3.2%) 26 20 35 11 34 12 0 0 0 0 0 35 0 0

LEUKEMIA 37(2.6%) 20 17 32 5 26 11 0 0 0 0 0 32 0 0

Lymphocytic Leukemia 12 (0.8%) 8 4 9 3 11 1 0 0 0 0 0 9 0 0

Acute Lymphocytic Leukemia 2 2 0 2 0 1 1 0 0 0 0 0 2 0 0

Chronic Lymphocytic Leukemia 10 6 4 7 3 10 0 0 0 0 0 0 7 0 0

Myeloid & Monocytic Leukemia 23 (1.6%) 11 12 21 2 14 9 0 0 0 0 0 21 0 0

Acute Myeloid Leukemia 10 4 6 10 0 2 8 0 0 0 0 0 10 0 0

Chronic Myeloid Leukemia 13 7 6 11 2 12 1 0 0 0 0 0 11 0 0

Other Leukemia 2 (0.1%) 1 1 2 0 1 1 0 0 0 0 0 2 0 0

MESOTHELIOMA 2(0.1%) 1 1 2 0 1 1 0 0 0 1 0 1 0 0

Mesothelioma 2 (0.1%) 1 1 2 0 1 1 0 0 0 1 0 1 0 0

MISCELLANEOUS 73(5.1%) 32 41 63 10 28 45 0 0 0 0 0 63 0 0

TOTAL 1,426 590 836 1,311 115 964 462 102 317 257 184 275 152 24 0

status stage distribution – analytic cases only

primary site total (%) male female analy na alive exp stg 0 stg i stg ii stg iii stg iv 88 unknown blank/inv

BREAST 346(24.3%) 3 343 329 17 312 34 60 112 95 40 21 1 0 0

Breast 346 (24.3%) 3 343 329 17 312 34 60 112 95 40 21 1 0 0

FEMALEGENITALSYSTEM 69(4.8%) 0 69 65 4 53 16 0 32 5 13 11 2 2 0

Cervix Uteri 13 (0.9%) 0 13 11 2 7 6 0 5 2 3 1 0 0 0

Corpus & Uterus, NOS 38 (2.7%) 0 38 38 0 34 4 0 24 2 5 5 0 2 0

Ovary 12 (0.8%) 0 12 11 1 8 4 0 2 0 5 4 0 0 0

Vagina 1 (0.1%) 0 1 1 0 0 1 0 0 1 0 0 0 0 0

Vulva 2 (0.1%) 0 2 1 1 2 0 0 1 0 0 0 0 0 0

Other Female Genital Organs 3 (0.2%) 0 3 3 0 2 1 0 0 0 0 1 2 0 0

MALEGENITALSYSTEM 130(9.1%) 130 0 103 27 119 11 0 21 66 7 9 0 0 0

Prostate 125 (8.8%) 125 0 98 27 114 11 0 20 62 7 9 0 0 0

Testis 4 (0.3%) 4 0 4 0 4 0 0 1 3 0 0 0 0 0

Penis 1 (0.1%) 1 0 1 0 1 0 0 0 1 0 0 0 0 0

URINARYSYSTEM 59(4.1%) 41 18 57 2 47 12 27 13 7 3 6 0 1 0

Urinary Bladder 44 (3.1%) 33 11 44 0 39 5 27 7 5 2 2 0 1 0

Kidney & Renal Pelvis 15 (1.1%) 8 7 13 2 8 7 0 6 2 1 4 0 0 0

BRAIN&OTHERNERVOUSSYSTEM 20(1.4%) 9 11 15 5 13 7 0 0 0 0 0 15 0 0

Brain 16 (1.1%) 7 9 13 3 9 7 0 0 0 0 0 13 0 0

Cranial Nerves, Other Nervous System 4 (0.3%) 2 2 2 2 4 0 0 0 0 0 0 2 0 0

ENDOCRINESYSTEM 38(2.7%) 7 31 37 1 37 1 0 25 3 3 4 2 0 0

Thyroid 36 (2.5%) 5 31 35 1 35 1 0 25 3 3 4 0 0 0

Other Endocrine including Thymus 2 (0.1%) 2 0 2 0 2 0 0 0 0 0 0 2 0 0

LYMPHOMA 48(3.4%) 27 21 46 2 36 12 0 12 5 9 19 1 0 0

Hodgkin Lymphoma 3 (0.2%) 3 0 3 0 3 0 0 0 2 1 0 0 0 0

Non-Hodgkin Lymphoma 45 (3.2%) 24 21 43 2 33 12 0 12 3 8 19 1 0 0

Non-Hodgkin Lymphoma - Nodal 34 17 17 33 1 23 11 0 5 2 8 18 0 0 0

Non-Hodgkin Lymphoma - Extranodal 11 7 4 10 1 10 1 0 7 1 0 1 1 0 0

MYELOMA 46(3.2%) 26 20 35 11 34 12 0 0 0 0 0 35 0 0

Myeloma 46 (3.2%) 26 20 35 11 34 12 0 0 0 0 0 35 0 0

LEUKEMIA 37(2.6%) 20 17 32 5 26 11 0 0 0 0 0 32 0 0

Lymphocytic Leukemia 12 (0.8%) 8 4 9 3 11 1 0 0 0 0 0 9 0 0

Acute Lymphocytic Leukemia 2 2 0 2 0 1 1 0 0 0 0 0 2 0 0

Chronic Lymphocytic Leukemia 10 6 4 7 3 10 0 0 0 0 0 0 7 0 0

Myeloid & Monocytic Leukemia 23 (1.6%) 11 12 21 2 14 9 0 0 0 0 0 21 0 0

Acute Myeloid Leukemia 10 4 6 10 0 2 8 0 0 0 0 0 10 0 0

Chronic Myeloid Leukemia 13 7 6 11 2 12 1 0 0 0 0 0 11 0 0

Other Leukemia 2 (0.1%) 1 1 2 0 1 1 0 0 0 0 0 2 0 0

MESOTHELIOMA 2(0.1%) 1 1 2 0 1 1 0 0 0 1 0 1 0 0

Mesothelioma 2 (0.1%) 1 1 2 0 1 1 0 0 0 1 0 1 0 0

MISCELLANEOUS 73(5.1%) 32 41 63 10 28 45 0 0 0 0 0 63 0 0

TOTAL 1,426 590 836 1,311 115 964 462 102 317 257 184 275 152 24 0

s u m m a r y

16

1638 Owen Drive, Fayetteville, NC

Medical Oncology: (910) 615-6910

Radiation Oncology: (910) 615-5894

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and cyberknife center

6387 Ramsey Street, Fayetteville, NC

Phone: (910) 615-3840

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805-C Tilghman Drive, Dunn, NC

Phone: (910) 230-7800

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