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When Someone Has Cancer

When Someone Has CancerWhen someone has cancer, his healthcare team has to look at him very closely. They have to determine his specific type of cancer. They must stage the cancer for how large the tumor is, and everywhere it may exist in the body.

In planning treatment, an oncologist must determine the precise medications or combinations of drugs that show the most promise for the best outcome. The radiation oncologist must calculate the optimum dosage with pinpoint accuracy for delivery of radiation.

A dietitian has to watch the patient’s weight, pound by pound, week by week, to make sure his body has the nourishment it needs to stay the course of treatment. Infusion nurses must monitor patients during chemotherapy, watching for any signs of complication.

Everyone on the healthcare team has a defined, critically important role to play in giving the patient his greatest platform for recovery and the best possible quality of life. They must scrutinize an immense volume of clinical data and coordinate care down to the smallest detail.

And when they’ve done all this, they still haven’t looked closely enough.

To truly care for a cancer patient, you have to look beyond the chart to see a person. A grandmother who has a vacation planned with her grandchildren. A father who wants to walk his daughter down the aisle. A mother who needs to make sure her own mother is safe and happy. A sister who is the heart of her entire family. Every single patient is someone with a life. A story. A unique way of impacting the world.

In the pages of this report, you’ll meet clinicians at Baptist Cancer Services who bring a wealth of professional expertise to their patients. But they bring a lot more than that, too. They bring the ability to truly SEE our patients as individuals with intrinsic dignity, made in the image of God, connected to their families and friends by their shared love and experiences.

When patients come to Baptist for cancer care, we do indeed look at them very closely. They deserve no less.

01

Tonya Ball, RN, BSN, OCNCancer Services Navigator

“I basically just steer patients through the whole cancer process in the Cancer Center.” So says Cancer Services Navigator Tonya Ball, now in her fifteenth year at Baptist.

That steering can take patients down any number of paths as they access the abundant variety of resources available to them. “We have a dietitian, we have a clinical psychologist, there’s a multitude of services within Baptist Cancer Services,” Tonya explains. “The team is rather large; it consists of many physicians—oncologists, radiation oncologists, radiation therapists, and many oncology nurses. I also work with physical therapists in our lymphedema program. We also offer cancer rehab. It’s just astounding the services and the people that are all connected here.”

In her role, Tonya has an opportunity to connect with many patients. Someone who recently made a lasting impact is Adam. “He has an extraordinary faith,” Tonya says. “I met Adam and his dad when Adam was starting radiation at the Cancer Center. I got to find out more about him and his story, and it’s just been amazing getting to follow him through. But the more I found out about him, the more I felt connected with him. It was all related to his faith.”

“In 2007 I was diagnosed with a Grade II oligodendroglioma, which is in essence a brain tumor,” says Adam. “I have had four surgeries since then. I have done, overall, about nine chemo sessions. I can’t remember how many radiation sessions I did -- 32 or 36—it was lot.” Adam’s seizures and headaches persisted, and finally led to surgery in which Adam’s entire frontal lobe was removed.

“He makes me think of what it’s really all about,” Tonya shares. “It’s not about all the worldly stuff – and status and position. It’s about what Adam has and that’s faith – like real faith.”

“He does inspire me everyday to not only do a better job, but to make sure that I hear the voice of the Lord, and I do the things that I’m supposed to do,” Tonya concluded. “I don’t feel like this is just my job that I get a check for. I actually feel like it is my calling.”

Adrienne Russell, RN, MSN, CN-BNBreast Health Navigator at the Center for Breast Health

Breast Health Navigator Adrienne Russell, who describes herself as a “resource person,” is based in the Center for Breast Health. There, she is readily available to help from the moment a patient first discovers she has an abnormal mammogram.

“I am there for our patients from the beginning all the way through treatment,” she says. “I connect them to other resources. I do a lot of education, and a lot of follow up. I also work with our surgeons in the Center for Breast Health surgery clinic as well.”

03

05

In addition to Adrienne’s services as Navigator, the Center for Breast Health offers patients an on-site, dedicated radiologist. This means that, with her previous studies on file, a patient can know her screening mammogram results before she leaves the Center. And should she need additional views, a diagnostic mammogram, or even breast ultrasound, in many cases those tests can be done right away. Also, a surgical biopsy typically can be performed the next business day. Navigating women along these courses is Adrienne’s forte. Breast cancer survivor Angie Brewer, recently treated at Baptist, is someone who especially inspires Adrienne. “I felt there were a lot of similarities between us,” Adrienne explains. “She is a mother and a spouse. She said to me, ‘I don’t care what you have to do to me, I just need to be there and to be OK for my family.’ And that really resonated with me.”

“When I came in Adrienne’s office, I just felt like I couldn’t see light at the end of the tunnel,” Angie shares. “But she truly has been such a blessing for me throughout my entire journey of breast cancer. She has taken a difficult situation and made it not so scary. If it’s possible, by her follow up phone calls, her encouraging words, and literally being by my side if I had any questions, she’s opened my eyes to what’s really important in life, which is being there for other people.”

“Patients like Angie inspire me every day,” Adrienne says. “I’m privileged to get to know these women diagnosed with cancer and to see them, initially upset, of course, but then showing this strength and faith in God through the whole process, even after surgery, and chemo when they’re sick. These women, and men, have such faith and strength that I think, ‘If they can do that, then what more can we all do?’”

Baptist’s Girl Friend’s Guide for Breast CancerWhen someone has cancer, he or she isn’t the only one affected. The patient’s family, friends, church, workplace, and entire circle of relationships are also affected.

For women who are undergoing breast cancer treatment, Baptist Cancer Services has developed “Baptist’s Girl Friend’s Guide to Breast Cancer,” a free resource designed to equip a woman’s friends with tools they need to provide meaningful support.

Filled with information about everything from treatments to side effects to practical ideas for what really helps, the publication is a guide to help breast cancer patients as they travel the challenging path that leads from breast cancer diagnosis to recovery and beyond.

Some topics include:What to Cook, Gift Ideas, Ways to Help, What’s Going On Inside, Lend a Listening Ear

Download a free electronic copy Baptist’s Girl Friend’s Guide to Breast Cancer at:mbhs.org/powerofpink

Cases by County (1,971)

n More Than 400 Patients

n 200-399 Patients

n 50-199 Patients

n 20-49 Patients

n 19 and under

n No Patients

2014 Cancer Cases

MADISON

RANKINHINDS

TISH

OMIN

GO

QUITMAN

STONE

PONTOTOC

CLAY

MARSHALLTIPPAH

TUNICA TATE PRENTISS

ITAWAM

BA

HANC

OCK

BENTON

GEORGE

CALHOUN

DESOTO

JACKSON

PANOLA

ALCORN

CHICKASAW

WEBSTER

WAYNE

LAFAYETTE

KEMPER

LEE

TALLAHATCHIE

CHOCTAW

NOXUBEE

WILKINSON

WALTHALL

GREENEPERRY

ISSA

QUEN

A

UNION

COAHOMA

YALOBUSHA

AMITE

JEFFDAVIS

HARRISON

MONROE

LOWNDES

MARION

PEARL RIVER

CLARKE

SUNF

LOW

ER

CARROLL

MONTGOMERY

GRENADA

OKTIBBEHAHU

MPHRE

YS

WINSTON

SHAR

KEY

NESHOBA

NEWTON

CLAIBORNE

JEFFERSON

FRANKLIN

LAMAR

COVINGTON

JASPERSMITH

JONES

LAUDERDALE

ADAMS

LEFLORE

LAW

RENC

E

FORR

EST

WARR

EN

LINCOLN

HOLMES

BOLIVAR

WASHINGTON

ATTALA

PIKE

COPIAH

YAZOO

SCOTT

SIMPSON

LEAKE

OUT-OF-STATE CASES

Alabama - 3California - 1Georgia - 2Iowa - 1Louisiana - 19Nevada - 1N. Carolina - 1Tennessee - 1Texas - 1

More than 200

MISSISSIPPI CASES BY COUNTY

60 - 199

26 - 59

25 and under

None

Out-of-State Cases (27)

Alabama - 1Arkansas - 3Florida - 1Louisiana - 17

Tennessee - 1Texas - 3Virginia - 1

07

Primary Site Study – Breast Carcinoma in Situ The American Cancer Society estimates during 2015 there will be 60,290 new cases of female breast carcinoma in situ which is about 20% of all reported U.S. breast cancers. (1) The term “carcinoma in situ” also known as “pre-cancer” or “pre-malignant” is used to describe abnormal epithelial cells that have not invaded nearby tissues but look similar to cells with invasion under the microscope. More recent research indicates that the transition of cells from normal to carcinoma in situ to invasive carcinoma involves a series of molecular changes that are complex and more subtle than the older view based on microscope appearances. In situ breast cancers may involve ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS).

If left untreated, some DCIS lesions become invasive cancers, while others remain non-invasive. Despite decades of effort, there is no way for doctors to know which lesions will progress and which ones will not. As a result, breast specialists recommend that all DCIS be treated with surgery, often followed by radiation and hormone therapy. Many women treated for DCIS are likely to have not needed treatment at all, but there is no way to predetermine which patient’s disease will progress to invasive cancer. (2)

PURPOSE The purpose of this review is to look at patterns of care and outcomes of breast cancers treated at Baptist Medical Center (BMC) as well as to review United States statistics from the National Cancer Data Base (NCDB). NCDB is a nation-wide oncology database of over 1500 hospitals from 50 states, a joint project between the Commission on Cancer of the American College of Surgeons and the American Cancer Society. Criteria used for this review will be from NCDB data from comprehensive community cancer centers in the Mid- South division (61 hospitals) for patients diagnosed during the years 2003-2013. The Mississippi data used in this review is from 11 hospitals in Mississippi. (3)

INCIDENCEFor this review (2003 – 2013), the NCDB regional data reported 9,946 or 21% patients with breast carcinoma in situ and 36,635 or 79% with invasive breast cancer. Mississippi has 2,347 (17%) patients with breast carcinoma in situ and 11,753 (83%) patients with invasive cancer and BMC has 543 (19%) patients with breast carcinoma in situ and 2,343 patients with invasive breast cancer. (Graph 1) The percent of carcinoma in situ cases per year for each data set are similar except BMC had a higher percentage of in situ cases in 2012 and 2013. This may be due to early detection on screening mammograms. (Graph 2) The histology for in situ cases will be about 83% ductal carcinoma in situ (DCIS) and 12% will be lobular carcinoma in situ (LCIS) or lobular neoplasia. (1)

BREAST CANCER: THE 2015 SITE STUDY

07

0

20

40

60

80

100InvasiveIn situ

NCDBMSBMC

Breast Cancer Histology 2003 - 2013Graph 1 pe

rcen

t

BREAST CANCER: THE 2015 SITE STUDY

RISK FACTORS FOR DCISIn general, the risk factors for carcinoma in situ and invasive disease are similar. Mammography screening can be considered a “risk factor” for DCIS because the incidence is much lower in woman not screened but screening mammography detects DCIS lesions and does not cause the disease. In a recent study, which included 1.2 million postmenopausal women in the United Kingdom, the risk of DCIS was higher for women with “fewer” or no children, “old” at first childbirth, or reaching menopause after age 50, women with high breast density and menopausal women on hormonal therapy. A study found high breast density for women under age 55 with associated increased risk. (1) For this review, women between the ages of 50 to 69 years old accounted for 54% to 56% of each data set. (Graph 3)

0 2 4 6 8 10 12 14

NCDBMSBMC2013

YEAR

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

Incidence Carcinoma In Situ by yearGraph 2

0

5

10

15

20

25

30NCDBMSBMC

80+70-7960-6950-5940-49under 39

Age at DiganosisGraph 3

perc

ent

09

EARLY DETECTIONMammography is valuable as an early detection tool, often identifying breast cancer before physical symptoms develop. DCIS would be a rare diagnosis without mammogram. Most DCIS is detected by microcalcifications (clusters of calcium) on a mammogram. Rarely does DCIS turn into a lump. In the 1970s and early 1980s with mammography introduced as a screening tool, DCIS diagnoses began to rapidly increase. Numerous studies have shown early detection saves lives and increases treatment options. In October 2015, the American Cancer Society (ACS) released updated breast cancer screening guidelines that recommend women at average risk have the opportunity to begin annual screening with mammography between the ages of 40 - 44 years; start regular annual screening with mammography at age 45 (if not previously) and transition to screening biennially at age 55 or have the opportunity to continue screening annually. Women should have the opportunity to continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer. The guidelines were published in the Oct. 20, 2015 issue of the Journal of the American Medical Association (“Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society”. )(4) Recommendations for women at high risk for breast cancer are pending. Annual screening using magnetic resonance imaging (MRI), in addition to mammogram, is recommended only for women at high risk starting at age 30. All suspicious findings on physical exam or mammogram should be further investigated.

STAGE OF DISEASEBreast carcinoma in situ is noninvasive (premalignant) or Stage 0 according to the American Joint Committee on Cancer (AJCC), the very earliest stage of disease for breast cancer and most often picked up by screening mammograms. (5)

TREATMENT Treatment options for DCIS include surgery, radiation, hormonal treatment either alone or in combination, as well as no therapy. Age at diagnosis is strongly associated with the type of treatment given. Surgery is the most common treatment which includes breast conserving surgery (lumpectomy or partial mastectomy) with or without sentinel lymph node biopsy or mastectomy. Radiation therapy is often recommended as part of breast conserving therapy, after lumpectomy. The three data bases reveal similar treatment modalities: percent of surgery alone at BMC (44%), MS (41%), and NCDB (43%) followed by combination of surgery, radiation and hormonal therapy for BMC (23%), MS (23%) and NCDB (19%). The next combination therapy is surgery and radiation BMC (10%), MS (14%) and NCDB (21%). Combination of surgery and hormone therapy is BMC (12%), MS (15%) and NCDB (9%). No therapy given is BMC (4%), MS (4%) and NCDB (3%). (Graph 4) About 40% of patients receive radiation as part of their first course of therapy. Radiation therapy following breast conserving surgery may include external beam radiation or brachytherapy. Brachytherapy has become more available since 2008. For this review, external beam radiation was given - BMC (32%), MS (35%) and NCDB (36%) and brachytherapy - BMC (3%), MS (4%) and NCDB (5%) - revealing similar patterns of care.

BREAST CANCER: THE 2015 SITE STUDY

0 5 10 15 20 25 30 35 40 45

NCDBMSBMC

None

Other

S/R/H

S/H

S/R

Surgery

First Course TreatmentGraph 4

percentS = Surgery R = Radiation H = Hormonal Therapy

DISTANCE TRAVELED FOR BREAST CANCER TREATMENTReview of the data for the miles traveled to treatment reveals 28% of BMC patients travel more than 50 miles each way for treatment which is further than MS or NCDB. (Graph 5) Baptist can assist patients and their care providers in finding temporary lodging during cancer treatment. The American Cancer Society Hope Lodge is coming soon to the Jackson area, and the Hope House is already providing lodging for qualified patients.

SUMMARYThe incidence of invasive cancer and carcinoma in situ breast cancer for all the data sets is comparable. BMC had a higher percentage of in situ cases in 2012 and 2013 which reveals early detection on screening mammograms. BMC data compares favorably with MS and NCDB data with incidence, age and first course treatment. The treatment for carcinoma in situ is primary surgery, radiation and hormonal therapy. BMC has a slightly higher “surgery only” rate. The types of radiation therapy given are all similar between the data sets.

BAPTIST CANCER SERVICESBaptist Center for Breast Health is a comprehensive, multidisciplinary accredited center that offers a full complement of services in a private, personal and comfortable setting. The Center for Breast Health provides easy access to a wide range of services as well as education, information and support. Services include screening mammography with same-day results (if prior films available at time of appointment); digital diagnostic mammography performed by certified radiological technologists and interpreted by on-site board-certified dedicated radiologists and a Certified Breast Care Navigator. Our team is supported by a full range of physician specialists including Surgeons, Medical and Radiation Oncologists, Pathologists, and Plastic and Reconstructive Surgeons. Baptist Cancer Services includes oncology nurses, registered dietitians, chaplains, a board certified Clinical Psychologist, and a certified physical therapist in lymphedema management. All are dedicated to caring for women with breast health problems. Screening and diagnostic digital mammography, stereotactic biopsies, sentinel lymph node mapping, up-to-date radiation therapy equipment, genetic testing, a multitude of chemotherapy drugs, and clinical trial availability help make Baptist a leader in treating breast cancer. To further enhance patient care, weekly multidisciplinary patient care conferences are held. Specialists in all disciplines discuss the patient’s case, review pathology and radiology findings and discuss the plan of care. “The Positive Ones” is an ongoing breast cancer support group to help connect patients with others whom are sharing the breast cancer journey. “Caregivers Support Group” for care givers meets monthly at the Hederman Cancer Center. “Standing Strong”, is a free, supervised exercise program offered to cancer patients. Appearances, a boutique which carries wigs, hats, scarves and skin care products for patients undergoing chemotherapy and radiation therapy helps patients with their physical appearance needs. It is located on the ground floor of the Hederman Cancer Center.

0

10

20

30

40

50

60NCDBMSBMC

>100 miles50-99 miles25-49 miles5-24 miles<5 miles

Distance Traveled forBreast Cancer Treatment (one way)

Graph 5

BREAST CANCER: THE 2015 SITE STUDY

Baptist has established a fund called, “fund for the girls” which helps women who need financial assistance for breast care services at Baptist. The fund works by providing payment for breast health services, including screening and diagnostic mammograms, ultrasounds, biopsies and other services as medically indicated. Funding begins when requested by physicians on staff at Baptist Health Systems. This built-in accountability ensures two important goals of “fund for the girls”: 1) Patients can obtain necessary medical care without financial stress and concern. Working with a patient’s physician means that the services provided are driven by what the physician and patient determine, as necessary as opposed to a predefined set of services. 2) Funds are directed to the people

with the greatest financial need. Physicians’ offices can determine a person’s ability to pay, while preserving privacy and dignity. All services available through the fund are offered at the Center for Breast Health at Baptist Health Systems.

NATIONALLY RECOGNIZED FOR QUALITY OF CARE THROUGH ACCREDITATIONSSince June 2011, Baptist Center for Breast Health has maintained accreditation from the National Accreditation Program for Breast Cancer (NAPBC), a national accreditation program for breast centers. Baptist Center for Breast Health was the first facility in Mississippi to achieve this! Baptist is the only hospital in Mississippi to earn The Joint Commission’s Gold Seal of Approval for Breast Cancer which demonstrates compliance with The Joint Commission’s National standards for health care quality and safety in breast care. Our physicians and staff members provide the highest quality evaluation and management for people with breast disease. Healthgrades has awarded Baptist Medical Center the Outstanding Patient Experience Award for 2015 and Patient Safety Excellence Award for 2015. Healthgrades evaluated 3,558 hospitals across the United States in BOTH areas of patient safety and patient satisfaction /experience. Baptist is one of only 93 hospitals, out of the 3,558 hospitals evaluated in the United States, to win both awards putting Baptist in the Top 2% of hospitals in the country.

For more information about Baptist Cancer Services, call 1-800-948-6262 or visit our website www.mbhs.org and Baptist Center for Breast Health 1-601-973-3180 or visit our website www.mbhs.org/breasthealth for services, programs, education podcasts etc. For more information or support for “fund for the girls”, www.mbhs.org/baptist-health-foundation/areas-of need/support-fund-for-the-girls. For information on cancer in general visit our website or www.cancer.org, or www.nci.nih.gov. Prepared by Richard B. Friedman, M.D. and Pam Barlow, CTR

REFERENCES1. American Cancer Society: Cancer Facts and Figures 2015.Atlanta, Ga. Online www.cancer.org/research/cancerFactsFigures. pages 26 -35. 2. Cancer Today, Summer 2015. “The DCIS Dilemma” by Sue Rochman, page 24-29.

3. Commission on Cancer, American College of Surgeons. NCDB Hospital Comparison Benchmark Reports, Cases 2003 – 2013. Chicago, IL, 2015 4. Journal of the American Medical Association. “Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society”. Oct. 20, 2015 issue

5. American Joint Committee on Cancer 2010, 7th Edition, Springer-Verlag New York, page 323

CANCER REGISTRY The Cancer Registry is an important part of the cancer program at Baptist with the primary goal to maintain an accurate comprehensive database for patients diagnosed and/or treated with cancer or a reportable tumor since January 1982. The registry collects cancer related data from diagnosis through treatment as well as lifetime follow-up. The Baptist database includes more than 62,000 cases. Registry data is used for reporting the incidence of cancer seen at Baptist, educational purposes, and evaluating the patient care provided as well as treatment outcomes and survival results. The registry data is submitted to the National Cancer Data Base (NCDB), Mississippi Cancer Registry and Rapid Quality Reporting System. Annual patient follow up is essential to accurately assessing treatment outcomes. The Baptist Cancer Registry exceeds the standard for follow up with 91% for the patients in last 5 years and 84% for patients since the reference year of 1982.

BREAST CANCER: THE 2015 SITE STUDY

11

Summary of 2014 CasesTotal new cancer registry cases 1971Analytic (diagnosed and treated at Baptist) 1764Non-Analytic (1st seen at Baptist on recurrence) 207

TOP FIVE SITES LAST 5 YEARSSite 2010 2011 2012 2013 2014Breast 263 264 357 340 284Lung 267 256 295 289 254Colorectal 171 175 148 173 173Prostate 165 162 149 193 204Kidney 55 42 85 81 102

200 400 600 800 1000 1200 1400 1600 1800 2000

1764

1876

1794

1663

1701

1530

1539

1688

1563

1551

1604

New Cancer Registry Cases (analytic) 2004-2014

0

46%54%

Females

Males

Sex

14%

58%

31%

under 59

over 80

60-79

Age at Diagnosis

Reviewing the 2014 analytic primary sites for Baptist Medical Center (BMC) reveals the top five to be breast, lung, prostate, colorectal and kidney. Data from the NCDB reveals the major sites in the U.S. to be lung, breast, colorectal and prostate which correlates with the major sites for Mississippi and BMC.

STAGE OF DISEASEThe AJCC Stage of Disease for primary sites for BMC 2014 and NCDB 2003-2013 cases have been reviewed with very similar stage of disease between the two data sets. See graphs for details.

13

0

5

10

15

20

25

30

35

40NCDBBMC

UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE ISTAGE 0

Breast

0

10

20

30

40

50

60

70

80NCDBBMC

UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE I

Prostate

perc

ent

perc

ent

0

5

10

15

20

25NCDBBMC

UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE ISTAGE 0

Colon

0

10

20

30

40

50

60

70

80NCDBBMC

UNKNOWNSTAGE IVSTAGE IIISTAGE IISTAGE ISTAGE 0

Kidney & Renal Pelvis

perc

ent

perc

ent

15

Primary Site Measure Type Measure Specifications 2010 2011 2012 2013BreastBCSRT Accountability (NQF #219) Radiation therapy is administered within 1

year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer.

100% 98% 97% 97%

MAC Accountability (NQF #0559) Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or stage II or III hormone receptor negative breast cancer.

100% 100% 97% 98%

HT Accountability (NQF #0220) Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1cN0M0, or stage II or III hormone receptor positive breast cancer.

100% 99% 99% 98%

MASTRT Surveillance Radiation therapy is considered or administered following any mastectomy within 1 year (365 days) of diagnosis of breast cancer for women with ≥ 4 positive regional lymph nodes.

100% 100% 100% 100%

nBx Quality Improvement Image or palpation-guided needle biopsy (core or FNA) is performed to establish diagnosis of breast cancer.

86% 89% 85% 85%

ColonACT Accountability (NQF #0223) Adjuvant chemotherapy is considered or

administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer.

100% 100% 100% 95%

12RL Quality Improvement (NQF #0225) At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer.

85% 76% 84% 86%

Quality DataThe Rapid Quality Reporting System (RQRS) was developed to assist CoC-accredited cancer programs in promoting evidence-based cancer care at the local level. It is a Web-based, systematic data collection and reporting system that advances evidence-based treatment through a prospective alert system for anticipated care that supports care coordination required for breast and colorectal cancer patients.

Baptist has been participating with the Cancer Program Practice Progam (CP3R) program since 2004 and the RQRS in 2013. See below for details.

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4941

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4545

08

179

3412

Retro

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Perit

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150

123

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19

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179

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Trach

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62 (3

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2159

358

411

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524

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77

52

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BREA

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3 (15

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311

283

3029

122

6010

668

2715

7

FEM

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172 (

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172

126

4616

012

268

1324

154

# Cer

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eri43

(2.2%

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4318

2540

31

84

41

0

Corp

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272

40

566

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1

Corp

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61

Uteru

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3

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52

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10

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10

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140

14

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20

Othe

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33

03

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30

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MAL

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ITAL S

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7 (12

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70

215

3224

43

119

129

4618

2

Pros

tate

236 (

12.0%

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60

204

3223

33

013

127

4518

1

Testi

s7 (

0.4%

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07

07

00

41

10

1

Penis

4 (0.2

%)

40

40

40

12

10

00

URIN

ARY S

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9 (9.

6%)

106

8317

514

166

2332

8416

2815

0

Urina

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adde

r72

(3.7%

)45

2769

358

1428

209

57

0

Kidne

y & Re

nal P

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113 (

5.7%

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5410

211

105

82

646

228

0

Urete

r3 (

0.2%

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23

02

11

01

10

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Othe

r Urin

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0.1%

)1

01

01

01

00

00

0

BRAI

N &

OTHE

R NE

RVOU

S SYS

TEM

44 (2

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1842

228

160

00

00

42

Brain

22 (1

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148

211

913

00

00

021

Crania

l Ner

ves O

ther

Nervo

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stem

22 (1

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1210

211

193

00

00

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CRIN

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TEM

60 (3

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4958

260

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393

51

10

Thyro

id50

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4149

150

00

393

51

1

Othe

r End

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Thym

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89

110

00

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LYM

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4722

5910

4821

08

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321

Hodg

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81

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69

281

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346

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146

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119

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241

214

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11

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1012

211

1111

00

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mia

115

611

02

90

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yeloi

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55

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1826

386

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00

038

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112

349

833

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130

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quam

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he sk

in. #

Exclu

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Sex

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17 (0

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317

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10

43

35

2

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26

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1

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30

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10

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10

10

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DIGE

STIV

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TEM

399 (

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197

202

371

2828

811

116

5370

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310

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5

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1515

291

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34

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24 (1

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1410

231

213

02

212

61

Colon

Exclu

ding R

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m13

7 (7.0

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6473

125

1211

522

916

3136

312

Cecu

m28

1315

280

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31

86

100

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83

58

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10

31

22

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313

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36

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m &

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86

127

88

7

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67

130

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11

35

30

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1916

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57

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& Int

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47

140

11

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5

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1511

411

45

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11

42

3

Intrah

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45

05

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22

0

Othe

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59

05

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04

11

3

Panc

reas

90 (4

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4941

8010

4545

08

179

3412

Retro

perit

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Perit

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tum

& M

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15 (0

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015

150

123

00

19

41

RESP

IRAT

ORY S

YSTE

M28

0 (14

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413

626

020

175

105

179

1943

104

14

Lary

nx6 (

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24

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10

40

00

0

Lung

& Br

onch

us27

2 (13

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139

133

254

1816

810

41

7519

4310

412

Trach

ea, M

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her R

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2

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2 (0.

1%)

11

20

20

01

10

00

SOFT

TISS

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46

04

20

22

02

0

**SK

IN EX

CLUD

ES B

ASAL

& SQ

UAM

OUS

62 (3

.1%

)41

2159

358

411

357

30

3

Melan

oma -

- Skin

56 (2

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3818

533

524

1133

52

02

Othe

r Non

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helia

l Skin

6 (0.3

%)

33

60

60

02

21

01

BASA

L & SQ

UAM

OUS S

KIN

7 (0.

4%)

61

77

52

00

00

00

BREA

ST31

3 (15

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)2

311

283

3029

122

6010

668

2715

7

FEM

ALE G

ENITA

L SYS

TEM

172 (

8.7%

)0

172

126

4616

012

268

1324

154

# Cer

vix Ut

eri43

(2.2%

)0

4318

2540

31

84

41

0

Corp

us &

Uteru

s, NO

S76

(3.9%

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7674

272

40

566

47

1

Corp

us Ut

eri74

074

722

704

055

64

61

Uteru

s, NO

S2

02

20

20

01

00

10

Ovar

y31

(1.6%

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3122

927

40

02

125

3

Vagin

a5 (

0.3%

)0

52

34

10

01

10

0

Vulva

14 (0

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014

77

140

14

00

20

Othe

r Fem

ale Ge

nital

Orga

ns3 (

0.2%

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33

03

00

00

30

0

MAL

E GEN

ITAL S

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M24

7 (12

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70

215

3224

43

119

129

4618

2

Pros

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236 (

12.0%

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60

204

3223

33

013

127

4518

1

Testi

s7 (

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07

07

00

41

10

1

Penis

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%)

40

40

40

12

10

00

URIN

ARY S

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M18

9 (9.

6%)

106

8317

514

166

2332

8416

2815

0

Urina

ry Bl

adde

r72

(3.7%

)45

2769

358

1428

209

57

0

Kidne

y & Re

nal P

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113 (

5.7%

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5410

211

105

82

646

228

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02

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BRAI

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S SYS

TEM

44 (2

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160

00

00

42

Brain

22 (1

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148

211

913

00

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Crania

l Ner

ves O

ther

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stem

22 (1

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1210

211

193

00

00

021

ENDO

CRIN

E SYS

TEM

60 (3

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4958

260

00

393

51

10

Thyro

id50

(2.5%

)9

4149

150

00

393

51

1

Othe

r End

ocrin

e inc

luding

Thym

us10

(0.5%

)2

89

110

00

00

00

9

LYM

PHOM

A69

(3.5

%)

4722

5910

4821

08

711

321

Hodg

kin Ly

mph

oma

9 (0.5

%)

45

81

72

01

12

40

Hodg

kin - N

odal

83

57

17

10

11

23

0

Hodg

kin - E

xtran

odal

11

01

00

10

00

01

0

Non-

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kin Ly

mph

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60 (3

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4317

519

4119

07

69

281

NHL -

Nod

al 40

2911

346

3010

02

58

181

NHL -

Extra

noda

l20

146

173

119

05

11

100

MYE

LOM

A25

(1.3

%)

1510

241

214

00

00

024

LEUK

EMIA

34 (1

.7%

)14

2029

522

120

00

00

29

Lym

phoc

ytic L

euke

mia

10 (0

.5%)

46

64

91

00

00

06

Chro

nic Ly

mph

ocyti

c Leu

kem

ia9

36

54

81

00

00

05

Othe

r Lym

phoc

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euke

mia

11

01

01

00

00

00

1

Myelo

id &

Mono

cytic

Leuk

emia

22 (1

.1%)

1012

211

1111

00

00

021

Acut

e Mye

loid L

euke

mia

115

611

02

90

00

00

11

Chro

nic M

yeloi

d Leu

kem

ia10

55

91

82

00

00

09

Othe

r Mye

loid/

Mono

cytic

Leuk

emia

10

11

01

00

00

00

1

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r Leu

kem

ia2 (

0.1%

)0

22

02

00

00

00

2

Othe

r Acu

te Le

ukem

ia1

01

10

10

00

00

01

Aleu

kem

ic, Su

bleuk

emic

& NO

S1

01

10

10

00

00

01

MES

OTHE

LIOM

A1 (

0.1%

)0

10

10

10

00

00

0

MIS

CELL

ANEO

US44

(2.2

%)

1826

386

2222

00

00

038

Tota

l1,

971

891

1,08

01,

764

207

1,61

036

112

349

833

828

130

721

7

** Th

is ex

clude

s all l

ocali

zed b

asal

and s

quam

ous c

ell ca

rinom

a of t

he sk

in. #

Exclu

des 2

4 carc

inom

a in s

itu of

the c

ervix

.

The Tumor Board and Comprehensive Breast Patient Care conferences are held in the Hederman Cancer Center Conference Room every Monday at 5:00 p.m. and Neurology/Neurosurgery/Spine/Radiology meetings are held every Tuesday at 7:30 a.m. These patient care conferences offer multidisciplinary consultative services for patients and an educational opportunity for the cancer support professionals. The discussions include the use of AJCC stage of disease, prognostic indicators and evidence-based national treatment guidelines in planning for optimal treatment strategies and expected outcomes. In 2014, 294 cases or 23% of analytic cases, were discussed at the meetings with 96% of the discussion for prospective treatment options

and management. The major primary sites discussed were breast, CNS tumors, lung, colon and rectum, lymphoma and melanoma cases.

Baptist is accredited by the Mississippi State Medical Association to provide continuing medical educational (CME) for physicians. Participation in the conference earns one hour of Category I Continuing Education credit. Conferences are open to all the medical staff and appropriate ancillary personnel. Anyone interested in presenting a case or receiving a weekly agenda, may contact the Cancer Registry at 601-968-1339.

Eric Amundson, MDVinod K. Anand, MDJustin T. Baker, MDEric L. Balfour, MDGeorge Copeland, MDRichard B. Friedman, MDAlexander J. Haick, MDKeith O. Jones, MDA. Michael Koury, MDPhillip B. Ley, MDNathan Maples, MDJames L. Moore, MDJason Murphy, MDGerald P. Randle, MD

Grace G. Shumaker, MDDavid Steckler, MDW. Lynn Stringer, MDDavid A. Wahl, MDRichard E. Weddle, MDBob S. Wilkerson, MDTammy H. Young, MD

Pathologists:Steven Bigler, MDKathryn Brown, MD James Cavett, MDNanette Pinkard, MDWilliam Payne, MD

Radiologists:E. J. Blanchard, MDJames L. Burkhalter, MDLarkin Carter, MDGary A. Cirilli, MDJ. Mack Haltom, III, MDR. Houston Hardin, MDJason R. Hosey, MDEdward K. Phillips, MDCharles K. Pringle, MDC. Dallas Sorrell, MDWilliam E. Studdard, MDJ. Dean Tanner, MDTimothy G. Usey, MD

Physicians Presenting at Cancer Conferences in 2014

Cancer Conferences

2015 Cancer Committee

Richard B. Friedman, MDRadiation Oncology Chairman

A. Michael Koury, MDThoracic SurgeryAmerican College of SurgeonsCancer Liaison Physician

Justin Baker, MDMedical Oncology

Eric Balfour, MDRadiation Oncology Scott Berry, MDSurgery

Steven Bigler, MDPathology

Alexander Haick, MDSurgery

Jason Hosey, MDDiagnostic Radiology

Michael Maples, MDChief Medical Officer

James Moore, MDGynecologic Oncology

William Payne, MDPathology

Charles Pringle, MDDiagnostic Radiology

Grace G. Shumaker, MDMedical Oncology

Margaret Wadsworth, MDRadiation Oncology

David Wahl, MDRadiation Oncology

Bob Wilkerson, MDMedical Oncology

Tammy Young, MDMedical Oncology

Tonya Ball, BSN, RN, OCNCancer Center Patient Navigator

Pam Barlow, CTRCancer Registry CoordinatorQuality of Cancer Registry Data Coordinator

Cara Chandler, BSN, RN Nurse Manager, Oncology

Teresa Davis, BSN, RN, OCNClinical Trials Coordinator

Kelly Gettings, BSN, RN, OCN Outpatient Infusion Clinic Nurse Manager

Harold Gore, PharmDBryan Miller, PharmDOncology Pharmacists

Dana Price, RD Clinical Dietitian

Brenda Howie, Ph.D., RN, NE-BCVice President of Nursing

Wanda Lett, CTR Cancer RegistrarCancer Conference Coordinator

Donna Lustig, RT, (R) (M)Director, Radiation OncologyQuality Improvement Coordinator

Bufkin Moore, PsyDOncology Counselor

Deniece Ponder, MHSA, BSN, RN, OCNDirector of Oncology ServicesCommunity Outreach Coordinator

Mark Roth, LMSW Social Worker/Discharge Planning

Solon Smith, MDivChaplain

Ginger Stover, PT, DPT, CLTLymphedema Coordinator

Bobbie Ware, MHSA, BSN, RN, FACHE, NEA-BC Vice President/Chief Nursing Officer

19

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1215

1225 north state street / jackson mississippi 39202 / 1.800.948.6262 / www.mbhs.org

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