We set the standard for cancer care.

We set the
standard for
cancer care.
2014 Oncology Annual Report
With a special feature on our Paqui and
Brian Kelly Comprehensive Breast Center
Reflecting on what we’ve achieved and never losing sight
of what needs to be done. Building on the strength of
our partnerships, and caring for the smallest and most
vulnerable. It’s hard work, but it’s good work, and it’s why
we’re here. Living our mission. Acting on our faith.
Providing healthcare inspired by faith.
Table of Contents
A Message From Bilal Ansari, MD, Oncology Medical Director 5
Services & Locations 6
Special Feature: Paqui and Brian Kelly Comprehensive Breast Center
8
8
State-of-the-Art Breast Care, Close to Home
Giving Back
8
Setting the Standard
8
The 3D Advantage
9
Better Detection, Better Outcomes
9
Meeting the Needs of Our Community Through Cancer Screening
10
Breast Cancer Statistics
10
We Tackle Cancer Cases in a Multidisciplinary Approach 12
Special Feature: Pancreatic Cancer
14
15
Pancreatic Cases Diagnosed 2003-2007
Special Feature: Uterine Corpus Cancer
16
17
Making a Connection: My Personal Story
The Oncology Program at SJRMC Meets the Needs of the Patient
20
Genetics and Risk Assessment Center
20
Research & Clinical Trials
21
Nurse Navigation
22
Palliative Care
23
Cancer Registry
24
Abstracting Cancer Data
24
Lifetime Follow-Up on Cancer Patients
25
Primary Site Table
26
2013 Cancer Incidence Report
27
Cases by County
27
Community Support Services
28
Women's Task Force
28
Secret Sisters Society®
29
RiverBend Cancer Services
30
American Cancer Society
31
Oncology Committee
32
Affiliates, Approvals & Accreditations
33
Oncology Future Vision
34
A Message from Our Medical Director
Last year Saint Joseph Regional Medical Center (SJRMC) took significant
steps to improve the cornerstone of cancer care in the community. First and
foremost we pursued an accreditation that has been awarded to fewer than
75 oncology programs in the United States. This took years of preparation,
self-improvement and process alignment to ensure we were delivering the
best care possible to our patients. We reviewed case findings, treatment
decisions, registry databases and clinical outcomes, and compared them with
national norms to continuously improve. Everyone was highly engaged in the
accreditation process and very proud of the improvements along the way. We
have an incredibly gifted team and their efforts paid off.
In 2013, SJRMC received the Outstanding Achievement Award from the
American College of Surgeons Commission on Cancer (CoC). In addition,
SJRMC received seven areas of commendations from the CoC. Receiving seven
commendations entitled our oncology program to receive a Gold Award rating.
SJRMC is honored to receive this accreditation as we are committed to caring
for our community by providing leading-edge, comprehensive services for both
prevention and treatment of cancer.
In the spirit of excellence, SJRMC recruited Katina Wood as the Executive
Director of Oncology Services. It was clear with all of the governmental
changes, healthcare reform and pay-for-performance proposals that we
needed a dedicated individual to strategically move our cancer program into
the future. We were thrilled when Katina came on board with more than 15
years of oncology experience in both academic and private-practice settings.
Katina's clinical background began in the U.S. Army, where she used her degree
in Radiologic Science to detect radiation exposure. Her career evolved into the
medical field of radiation therapy and grew with a master's degree in Health
Science and a master's degree in Business Administration. Katina has worked
at Trinity Health for the past eight years as an Oncology Administrator and
brings a wealth of knowledge and expertise. We are lucky to have Katina and
look forward to working with her in 2015.
Lastly, SJRMC was honored in 2014 to receive the philanthropic funds of
Brian and Paqui Kelly to create The Paqui and Brian Kelly Comprehensive
Breast Center. This center will change the way we think about breast
cancer. As medical professionals, we are no longer just responsible for
patients' medical care, but also for their mind, body and spirit. The Paqui and
Brian Kelly Comprehensive Breast Center is an exciting honor and a blessing
for the community.
2014 was an exceptional year for our oncology program. I look forward to what
is in store for 2015.
Bilal Ansari, MD
Oncology Medical Director
5
Services & Locations
Saint Joseph Regional Medical Center provides access to cutting-edge cancer services
and care for patients across Michiana.
Mishawaka
Lymphedema Treatment Clinic
Mishawaka Campus
5215 Holy Cross Pkwy.
Mishawaka, IN 46545
574.335.5000
611 E. Douglas Rd., Ste. 140
Mishawaka, IN 46545
574.335.8500
Garcia Family Foundation Oncology Unit
The Garcia Family Foundation Oncology Unit, located
on the sixth floor of the Mishawaka Campus, is specially
designed to create a soothing environment for patients
with cancer. We provide care that helps our patients
maintain the highest possible quality of life through their
journey with cancer.
All of our providers are specially trained to care for cancer
patients. Our nurses attend Oncology Nursing Society
chemotherapy/biotherapy provider courses in order to
administer these medications to our patients. The unit also
includes a large Hospice Room to accommodate patients
with special needs or a longer length of stay.
Paqui and Brian Kelly Comprehensive Breast Center
611 E. Douglas Rd., Ste. 123
Mishawaka, IN 46545
574.335.6216
The Paqui and Brian Kelly Comprehensive Breast Center,
located in the Medical Office Building connected to the
hospital, offers a unique and convenient experience
for Michiana women. The center is committed to the
importance of early detection and promotion of breast
health with leading-edge technology and a highly-trained
staff. All the resources and technology our staff needs
to effectively and efficiently care for patients are in one
convenient location. The center is accredited by The
National Accreditation Program for Breast Centers.
The Lymphedema Treatment Clinic, located in the
Medical Office Building connected to the hospital, offers
a comprehensive approach to help patients manage
lymphedema. The program is a collaboration between
Roger Klauer, MD, of Saint Joseph Family Medicine at Elm
Road, and Joanna Hartman, Physical Therapist, of SJRMC’s
Outpatient Rehabilitation. Patients are seen by both
professionals simultaneously in an initial evaluation.
A treatment course is outlined and the patient is scheduled
with a certified lymphedema therapist in a location that fits
their clinical needs, insurance coverage and driving distance.
Saint Joseph Medical Imaging Center
53940 Carmichael Dr.
South Bend, IN 46635
574.335.8100
Saint Joseph Medical Imaging services are available
at the Mishawaka Campus and a freestanding location
on Carmichael Drive in South Bend. Our state-of-theart equipment ensures the best possible detection and
diagnosis of a variety of conditions. Technology has
substantially improved the quality of exams, and our
facilities offer many of the newest and best devices on the
market. Our expert staff of radiologists and technicians
is dedicated to quality care and treating every patient
with dignity, respect and compassion. All of our images
are digitally acquired and graphically stored for future
reference and quick access. The center is accredited by
The National Accreditation Program for Breast Centers.
Michiana Hematology Oncology Advanced Centers
for Cancer Care
5340 Holy Cross Pkwy.
Mishawaka, IN 46545
574.237.1328
All the cutting-edge cancer services and care that a
patient may need can be found under one roof at Michiana
Hematology Oncology Advanced Centers for Cancer Care,
a joint venture located directly across the street from the
Mishawaka Campus. This state-of-the-art, freestanding
facility was designed by highly skilled experts in cancer
care who asked for input from real patients to ensure
that it was designed as a welcoming place. Technically
advanced and completely integrated, this Cancer Center
treats the whole person, mind, body and spirit.
Plymouth
Plymouth Cancer Institute
1915 Lake Ave.
Plymouth, IN 46563
574.948.4000
The Plymouth Cancer Institute offers patients who live
in Marshall County and surrounding communities access
to the latest treatments conveniently close to home. Our
medical oncologists, radiation oncologists and specially
trained nurses provide expert cancer care in a soothing and
healing environment.
7
Paqui and Brian Kelly
Comprehensive Breast Center
Now, women have access to state-of-the-art
breast care, close to home.
In Spring 2015, Saint Joseph Regional Medical Center
(SJRMC) will begin construction of the new Paqui and
Brian Kelly Comprehensive Breast Center (CBC). The
Paqui and Brian Kelly CBC offers a team of dedicated
professionals and state-of-the-art services to help
patients along their journey.
Setting the Standard
“This center will provide women with the medical
resources they deserve,” says Albert Gutierrez,
President & CEO of SJRMC. “Better care is our calling.
The Paqui and Brian Kelly Comprehensive Breast
Center allows us to provide our patients the best-inclass healthcare. This means better coordination and
timeliness, along with the most advanced technology, to
deliver better outcomes.”
for a variety of benign breast diseases, as well as
breast cancer.
• The highest quality screening, detection and diagnostic
technology, including 3D mammography and molecular
breast imaging.
• A peaceful, comfortable patient-centered environment.
• Access to forward-thinking clinical trials and research.
• Comprehensive genetic screening, genetic testing and
genetic counseling services.
• Individualized patient consultation, education,
treatment and community support resources.
• A multidisciplinary team approach to breast cancer
that ensures all patient cases are reviewed by a team of
experts who work closely with the patient to create an
individualized treatment plan.
• Reconstructive surgery, survivorship and rehabilitation.
Giving Back
The Paqui and Brian Kelly CBC will be advanced by a
generous gift from the Kelly Cares Foundation. A twotime breast cancer survivor, Paqui Kelly created the
Kelly Cares Foundation with her husband, University
of Notre Dame football coach Brian Kelly, to support
initiatives in health, community and education.
“Brian and I are committed through our foundation work
in assisting those in need during their cancer journey,”
Paqui Kelly says. The Kellys chose SJRMC because of
its alignment with the Catholic mission, its commitment
to serve the underserved and because it provides
unwavering compassionate care to those in need.
The Paqui and Brian Kelly CBC delivers specialized care
for all aspects of breast health, setting the standard of
care in Michiana. The Paqui and Brian Kelly CBC allows
women access to:
• Patient navigation through evaluation and treatment
“These services will greatly improve breast care in
Michiana,” says Michael Rotkis, MD, breast surgeon at
SJRMC. “Not only do we have access to state-of-the-art
technology, but we have a team of physicians working
closely together to guide patients through their journey.”
SJRMC will join the ranks
of six other regional Trinity
hospitals to create a
Comprehensive
Breast Center.
“Being a comprehensive
breast center is so much
more than a name,” said
Katina Wood, Executive
Director of Oncology
Services. “A CBC means
that our program has met
the national standards
Comprehensive Breast Center
of comprehensive breast
care. Meeting these standards ensures our patients’
needs are met from the first appointment all the way
through survivorship. Watch for our marketing campaign
in the spring of 2015 to learn about our signature
trademark services.”
Better Detection, Better Outcomes
“This new technology is a great benefit to the women of
this community,” says Brett Stephens, MD, Radiologist.
“With the additional 3D images, radiologists may be able
to detect more cancers sooner and significantly decrease
the need for recall exams for additional views.”
“We know 3D mammography will lead to better outcomes
for many women, and it truly is a significant advancement
in the constant drive to improve breast health,” adds David
Hofstra, Administrative Director of Imaging and Therapy.
“Our work at SJRMC is a ministry, and we want to stay
true to our commitment to provide leading healthcare and
peace of mind for our patients,” says Hofstra. The Paqui
and Brian Kelly Comprehensive Breast Center is one more
way that SJRMC is accomplishing this.
The 3D Advantage
The new 3D mammography screening, also called
tomosynthesis, adds an additional view to a traditional
2D mammogram. During the brief 3D portion of the
exam, multiple low-dose images of the breast are taken
at different angles. These images are used to produce a
series of 1-millimeter-thick slices that can be viewed by
the radiologist in 3D, similar to a CT scan.
9
Meeting the Needs of Our Community Through Cancer Screening
In the state of Indiana less than 60% of women receive an annual
mammogram. One contributing factor is the lack of access or transportation
to a medical facility. To make sure the needs of Michiana women are met,
SJRMC uses our Mobile Medical Unit (MMU) to go to them! The MMU allows
mammograms to be performed at regional locations and corporate wellness
and screening events. Executive Director of Oncology Services Katina Wood
states, “Our goal is to detect breast cancer in its earliest stages, which
leads to better treatment options and outcomes. Services like the mobile
mammography unit make this possible.”
The primary service provided on the MMU is mammograms. To receive a
mammogram, a woman must be 40+ years of age (or have a family history of
breast cancer) and have a primary care physician or OB/GYN. During 2013, the
MMU provided 1,450 mammograms. Other services include health screenings,
prenatal services, flu shots and corporate wellness programs.
The MMU is out in the community approximately five days a week in St. Joseph,
Elkhart and Marshall Counties, and follows a routine rotation of sites.
Occasionally, on Saturdays, the MMU travels to health fairs, community
education and prevention-oriented events. Find the schedule posted on our
website www.sjmed.com/mobile-medical-unit.
Breast Cancer Statistics
There were 211 new breast cancer cases at SJRMC in 2013; 174 were diagnosed at SJRMC–Mishawaka
and the remaining 37 were diagnosed at SJRMC–Plymouth. The charts below break out the 2013 new
breast cancer cases by stage.
2013 TOTAL BREAST CANCER
NEW BREAST CANCER CASES BY STAGE
2013 NEW BREAST CANCER
CASES BY CAMPUS
70
60
50
40
Stage 0 (22%)
Stage 1 (38%)
Stage 2 (24%)
Stage 3 (12%)
30
20
10
Stage 4 (4%)
0
Stage 0
Stage 1
Stage 2
Mishawaka
Stage 3
Stage 4
Plymouth
Unknown
11
We Tackle Cancer Cases in a Multidisciplinary Approach
At 6:30 in the morning, three to four days per week,
our team of experts comes together to discuss cancer
cases that have been diagnosed at SJRMC. The goal of
this cancer forum is to discuss treatment options, risks,
benefits and outcomes.
The rationale for conducting cancer forums is to:
According to the American College of Surgeons (ACoS)
Commission on Cancer (CoC), the standard number of
oncology cases to be reviewed annually should be at
least 15% of the hospital’s total annual accrual. SJRMC
achieved 23.7% of our annually accrued cases in 2013
and is on target for meeting or exceeding this same
percentage in 2014.
• Improve the patient experience through enhancing
The ACoS CoC has also set another cancer forum
standard that requires at least 80% of all cases reviewed
to be prospective cases. Prospective cases are defined as:
Considering the rationale for conducting cancer forums
and combining this with ACoS CoC’s high-percentage
standard for prospective cases, ACoS, SJRMC and local
physician partners are clearly focused on achieving the
highest impact on patient outcomes possible. In fact,
SJRMC has exceeded the ACoS CoC prospective case
review standard of 80% by having 100% of all cancer
patient cases reviewed being prospective cases.
• Newly diagnosed and not yet treated.
• Newly diagnosed and treatment initiated, but additional
treatment is needed.
• Previously diagnosed, initial treatment completed, but
adjuvant treatment or recurrence treatment is needed.
• Previously diagnosed, but supportive or palliative care
is needed.
• Ensure patients are receiving treatment according to
national guidelines.
• Alter treatment plans if necessary based on
multidisciplinary case discussions.
efficiency of care.
• Improve treatment planning, which will improve
patient outcomes.
• Increase access to research and clinical trials for
patients.
• Provide for multidisciplinary continuing education.
In addition to the number and type of cases presented by
a multidisciplinary team, SJRMC has collaborated with
other medical partners in the number of cancer sitespecific forums held annually, in the technology available
to present each case and in how forums are conducted.
In 2013, SJRMC physicians, genetics counselors,
cancer registrars and research nurses, along with
Michiana Hematology Oncology medical and radiation
oncologists, South Bend Medical Foundation pathologists,
surgeons from many area organizations and physicians
from Chicago medical centers, have collaboratively
participated in over 140 cancer site-specific forums.
Site-specific cancer forums are held weekly (breast
and lung), monthly (gastrointestinal and lymphoma),
bimonthly (head and neck, urology, and neurosurgical) or
quarterly (hematology). SJRMC’s Cancer Registry staff
prepares the case presentations and then coordinates the
technology needed to conduct the forums. Some of the
technology coordination includes the use of an elaborate
videoconferencing system, visual display of actual
pathology slides and radiographs for each case presented,
and technological coordination with urban medical
centers’ physician specialists (Loyola University Medical
Center, University of Chicago and Rush University).
Finally, some of the patients whose cases are being
presented choose to attend the cancer forum. During
the forum, the patient is the center of the care team’s
presentation and discussion. During the multidisciplinary
team’s discussion, the patient and family are encouraged
to ask questions so they are an active participant in
treatment decisions. Following the patient-attended case
presentation, the treating physicians will accompany the
patient and family members out of the room to provide
yet another opportunity to answer any of their questions
in a more intimate and less formal setting. Because of
the collaboration, coordination, multidisciplinary team
engagement, technology utilization, forum presentation
preparation, professionalism and patient involvement
planning, SJRMC has received recognition from the
most recent ACoS CoC Accreditation surveyor and
accolades from our urban medical center guest physicians
recognizing our cancer forums as exceeding what they
have experienced in other forums across the country.
2013 TOTAL CASE PRESENTATION BY
SITE-SPECIFIC CONFERENCE
2013 PROSPECTIVE CASE PRESENTATION
BY ANNUAL CASELOAD
90
25
“It is impressive to sit amongst a team of world-renowned
experts that are discussing patients as if they were
a family member,” said SJRMC Executive Director of
Oncology Services Katina Wood.
80
20
70
60
15
50
40
10
30
20
5
10
0
0
BCF
GYN
LUNG
HN
GI
URO
NEURO
LYMPH
ACoS CoC
SJRMC
13
Special Feature: Pancreatic Cancer
Pancreatic cancer is one of the deadliest forms of cancer primarily because
early stage pancreatic cancer usually has no symptoms. When symptoms do
occur, the tumor has typically already spread to surrounding tissues or distant
organs. Common symptoms of pancreatic cancer according to the American
Cancer Society (ACS) include mild abdominal discomfort, mid-back pain,
jaundice (yellowing of the skin or whites of the eyes) and weight loss. Nausea
and vomiting may occur among patients with more advanced disease. Since
there is no single most reliable test for detecting pancreatic cancer, health
agencies such as the Unites States Preventive Services Task Force (USPSTF)
found no evidence that screening for pancreatic cancer is effective in the
reduction of mortality.
According to statistics reported in 2013 to the ACS, pancreatic cancer is the
tenth most common cancer diagnosis among men and the ninth most common
among women in the U.S. During 2005-2009, the age-adjusted incidence rate
(per 100,000) was 13.6 for men and 10.5 for women. In 2013, there were an
estimated 45,220 new cases of pancreatic cancers diagnosed nationwide.
Most pancreatic cancer incidence and death rates increase with advanced
ages and a steep increase after about the age of 50. According the ACS,
during 2005-2009, the median age at diagnosis of pancreatic cancer was 71.
Therefore, approximately half of all patients who developed this disease were
older than age 71 years old.
The highest incidence and mortality rates of pancreatic cancers vary in
race and ethnicity. However, the highest occur in African Americans and the
lowest rates occur in Asian Americans/Pacific Islanders. Studies have shown
that this difference is largely explained by established risk factors, such as
cigarette smoking, obesity and diabetes, as well as heavy alcohol drinking.
Most patients who are diagnosed with pancreatic cancer will die within the
first year of diagnosis. Approximately 6% will survive five years.
Pancreatic cancer is typically diagnosed by CT scan with
a contrast dye that can also be used to stage the tumor.
If pancreatic cancer is highly suspected and the CT scan
returns normal, additional diagnostic testing such as
an endoscopic ultrasound or ERCP may be performed.
A diagnosis is typically confirmed with fine-needle
aspiration biopsy.
The stage of disease at diagnosis will determine the
prognosis of a patient’s pancreatic cancer diagnosis.
For early stage I or II, the five-year survival is only
about 20-25%. The best treatment for these patients
will be determined utilizing a multidisciplinary team of
surgeons and medical and radiation oncologists along
with radiologists, gastroenterologists, pain management
experts, nutritionists, social workers and others who are
involved in the management of care in patients who have
been diagnosed.
Currently, for patients who are surgical candidates,
surgery provides the only chance of prolonged survival
for a pancreatic cancer diagnosis. The operative
approaches typically include the Whipple procedure,
distal pancreatectomy, or total pancreatectomy
depending on the location of the tumor. Postoperative
adjuvant chemotherapy and/or radiation therapy has
been proven to improve the overall progression-free and
overall survival.
For patients who have advanced pancreatic cancer, the
focus is on managing symptoms and relieving pain and
suffering (palliative care). According to the National
Comprehensive Care Network, treatment for advanced
stage pancreatic cancer will depend on the patient’s
performance status and can include a single agent or
combined agents to include FOLFIRINOX, gemcitabine
plus paclitaxel or erlotinib or 5-FU and leucovorin.
Palliative and supportive care services are offered to
patients to help relieve symptoms and side effects
including pain, depression, malnutrition and bile duct or
gastric outlet obstruction. In addition, psychological and
pastoral care services are offered to relieve patient’s
stresses associated with their advanced pancreatic
cancer diagnosis and treatment.
There is hope for the future in pancreatic research. The
ACS, through 32 research grants, is funding $8 million in
pancreatic cancer research. One known research project
will identify new avenues of early detection and treatment
and a better understanding of the biological mechanisms
of pancreatic cancer development, progression and
metastasis, among other research.
Another breakthrough in pancreatic cancer was based
on a study funded by the National Cancer Institute (NCI)
utilizing low-dose aspirin. “The use of low-dose aspirin
was associated with cutting the risk of pancreatic cancer
in half, with some evidence that the longer low-dose
aspirin was used, the lower the risk,” researcher Harvey
A. Risch, MD, PhD, professor of epidemiology in the
Department of Chronic Disease Epidemiology at the Yale
School of Public Health.” 1
PANCREATIC CASES DIAGNOSED 2003-2007
National Cancer Data from 1,463 facilities
Cummulative Survival Rates
120
100
80
Stage 0 n=617
60
Stage 1 n=6,850
40
Stage 2 n=19,245
Stage 3 n=11,300
20
Stage 4 n=42,852
0
0x
1
1 Year
2 Years
3 Years
4 Years
5 Years
HemOnctoday, volume 15 number 17, September 10, 2014. Streicher SA. Cancer Epidemiol Biomarkers Prev.
2014;dol:10.1158/1055-9965. The study was funded by NCI.
American Cancer Society. Cancer Facts & Figures 2013. Atlanta: American Cancer Society;2013.
15
Special Feature: Uterine
Corpus (Endometrium) Cancer
Abnormal uterine bleeding or spotting especially in postmenopausal women is a common early warning sign
of uterine cancer. Other symptoms include pain during
urination or intercourse, or in the pelvic area, that should
not be ignored. According to the 2013 American Cancer
Society’s Cancer Facts & Figures, from 2005-2009 there
was an increase in incidence rates amongst African
American women by 2.2% per year; however, among
Caucasian women the rates have remained stable. From
2006-2010 there was an increased incidence rate by 1.5%
among women younger than 50 and 2.6% per year among
women 50 and older.1
Statistics show an estimated 52,630 new cases of uterine
cancer were expected to be diagnosed in 2014.2 In 2013,
the American Cancer Society (ACS) Cancer Facts &
Figures reported an estimated 49,560 new cases, which
is an estimated 6% increase in new uterine cancers
diagnosed within one year.
This increase in endometrium cancer incidence is
attributed to risk factors such as obesity and abdominal
fatness, which occurs as a result of increased estrogen
in the body in post-menopausal women. Other factors
that have shown an increase in estrogen exposure is
menopausal estrogen therapy, late menopausal women
who have never had children and/or a history of polycystic
ovary syndrome.
According to the 2013 ACS Facts & Figures, the one- and
five-year relative survival rates for uterine corpus cancer
were 92% and 82%, respectively. The five-year survival
rate is 95%, 6%, or 16% if the cancer is diagnosed at a
local, regional or distant stage, respectively. According to
reports in 2014, the overall five-year relative survival for
Caucasian females (84%) is 23 percentage points higher
than that for African Americans (61%). Attributes such as
higher body weight adversely affect endometrial cancer
survival, whereas physical activity is associated with
improved survival.
Although there are no standard or routine screening tests
for endometrial cancers, 68% are diagnosed at an early
stage because of post-menopausal bleeding or spotting.
Treatment for uterine corpus cancers includes surgery,
radiation, hormones and/or chemotherapy, depending on
the stage of disease.
American Cancer Society. Cancer Facts & Figures 2013. Atlanta: American Cancer Society; 2013.
1
2
American Cancer Society, Cancer Facts & Figures 2014, Atlanta: American Cancer Society; 2014.
Making a Connection: My Personal Story
Over my 20+ years
working as a cancer
registrar at SJRMC,
I had overheard the
medical oncology
community make a
statement that “cancer
affects everyone.” Even
though I had heard this
message multiple times
throughout my career,
I never associated this
statement to my personal life since there were no
members of my immediate or extended family who had
been diagnosed with cancer.
However, 2014 was full of many surprises. In early 2014
my oldest brother, 59, shared with me that he had been
diagnosed and treated for prostate cancer. A maternal
uncle was diagnosed with multiple myeloma at age
78. And recently my sister, 60, was diagnosed with
endometrial cancer. This was a bit overwhelming for me
because, for so long, I didn’t think cancer ran in my family.
What I also failed to realize was that cancer affects
family members and close friends as well as the patient.
According to the ACS, 66% of caregivers are spouses,
18% are siblings of the cancer patients and 65% are
women caregivers. Through all of the family cancer
diagnoses, the one that impacted me the most was my
sister Gloria’s diagnosis because she is the eldest of my
siblings. She held the role as our second mother, being
strong and resilient.
Thus my journey began on helping my sister navigate
through her cancer experience as her caregiver, falling
into that 18% group. I began looking at Saint Joseph
Regional Medical Center’s cancer program and what it
had to offer as far as patient navigation and psychosocial
distress screening. As a Women’s Task Force member, I
reached out to other members who are cancer survivors
and who had similar experiences.
This is my “teachable moment” shared by Kathy Ann
Reinhart during a Women’s Task Force retreat:
“I am a breast cancer survivor of four years now!
I have routinely scheduled a mammogram in
January of each year since my 40th birthday. In
2010 I was getting ready to go on a family vacation
with all my siblings and their children and we were
leaving July 1. I had received a second letter (my
hubby threw the first one away) in June of 2010
from where I had been having my mammograms
done saying I had not had it done yet. That seemed
a bit shocking to me since I always had done it in
January. So as busy as I was getting ready to go
on vacation, I called and found out that, indeed,
I had been too busy to even schedule my routine
mammogram. So I got it done on June 30, knowing
it was important and something I needed to get
done before I left on vacation. I was 53 years old and
it was my 13th mammogram.
The rest is really history. It was breast cancer and,
at first, to my oncologist, it was just pea-sized, so a
lumpectomy should do it and if it wasn’t in the lymph
nodes, I may not even have to have chemotherapy.
Well, a week after my lumpectomy, I had an
appointment with my oncologist and I was given the
bad news that on Monday I was going to have my
breast removed – a mastectomy – the dreaded word
no one wants to hear. The cancer was fast-growing
– now Stage 3 – so I it was important to act quickly.
Then, I had chemotherapy and radiation.
As much as cancer is something no one wants to
get, it provided me a time in my life where I could
reprioritize what is really important and stop and be
thankful for simply, life. It gave me the privilege of
being cared for by my younger and only sister, Mari.
My hubby, Guenter, was there for my surgeries,
but he couldn’t get away for all the treatments. So
Sister was my caregiver, and she really cared for
me. Mari always kept me busy during chemotherapy
or at least tried – sometimes I fell asleep on her
so I’m sure it was rather boring for her. I can’t
underestimate the importance of the emotional
and physical support that Mari provided my family
and me. I know it gave Guenter and my two teenage
sons (ages 17 and 15 at the time) peace of mind
that Mari was there for all of us.
17
I also can’t underestimate the caregivers – the nurses were incredible
about knowing my needs and making me feel like a princess when I felt
anything but a princess. Four years later, they still make me feel like a
princess and not a flawed woman. My oncologist was amazing and kept
me motivated to keep going. I believe that in addition to Mari, my doctor
was the most special healing tool I had at my fingertips.
At the end of the day, we are only here for a short time. I’m thankful God
used my physician, nurses, family and friends to help me survive this
awful disease. Because of this, I feel motivated and moved to help other
women. So, since 2010, I have become involved in Secret Sisters Society®
and Women’s Task Force of SJRMC Foundation as a task member. Since
2012 I have been the chairperson of the Women’s Task Force of SJRMC
Foundation, leading a group of passionate ladies (some survivors and
others are experts in the field of cancer) to continue to educate women in
our area about how important that yearly mammogram is. If I hadn’t had
mine done before I went on vacation and not gotten it done until later that
year, I might not be here today. That is how important mammograms are
to get done each and every year. Think about it and don’t delay.”
Kathy Ann and her sister, Mari, shared with me the importance of having
someone who could be the patient’s eyes and ears when going through
treatment and recovery. I had done my homework and the next step was to go
into this new role completely prepared with the information I had received.
July 2014 we had a surgical consultation with Gloria’s gynecological
oncologist. Upon review of her biopsy report, he indicated that she would
need a total hysterectomy with bilateral salpingo-ooporectomy and surgical
staging. He discussed all treatment scenarios during our visit with him,
including adjuvant chemotherapy and/or radiation therapy as a worst-case
scenario. Because I had done some upfront research, I had a collection of
questions to ask on my sister’s behalf because she was overwhelmed with the
information the surgeon was sharing with her. First and foremost, I needed to
ensure that he and his team would pray before proceeding with this surgery.
He assured me that he would. In the hour-long surgical consult, all of my
questions and concerns were addressed. I assured him that I would be back
after she had her surgery to follow up on her after care.
In August 2014 my sister Gloria had her surgery and her pathology report
came back as a Stage 1A, in which no further treatment was recommended —
just continued observation.
During her recovery journey she had experienced bouts of depression and
anxiety; however, this was quickly relieved due to me being prepared as her
caregiver and sister!
Today she is fully recovered and back to herself. I thank God for bringing us
through this situation. I am thankful for Kathy Ann and her sister, Mari, and all
the prayers I received.
Sincerely,
Marian A. Brown, CTR
Manager, Cancer Registry
19
The Oncology Program at SJRMC
Meets the Needs of the Patient
Genetics and Risk Assessment Center
Dynamic and rapid changes are occurring in the field of oncology genetics
that are reshaping the approach to patient care. The Genetics and Risk
Assessment Center at Saint Joseph Regional Medical Center continues to
serve as a leader in oncology genetic services. With two genetic counselors
and a medical director, the SJRMC genetics program is able to identify
genetic and hereditary risks for multiple patient populations.
Comprehensive oncology genetic counseling services available:
• Risk assessment for any heritable cancer condition through
evaluation and interpretation of medical and family history.
• Identification of the most appropriate and informative
approach to genetic testing for patients and their families.
• Facilitation of decision-making through discussion of benefits,
risks and limitations of genetic testing.
• Interpretation of genetic test results and recommendations on
how to apply the result for medical management decisions.
• Recommendations for personalized surveillance and/or
preventive measures.
• Connection of patients to supportive, informative and
research-related resources.
In 2015 we will join the ranks of national programs to offer MammoPlus® and
RiskPlus™, which will offer genetic screening options with every mammogram
performed at SJRMC. This will help women identify their own genetic risks as
well as those of their family members. These signature services are unique
within Trinity Health and a tremendous benefit to our patients.
We are also excited to enter the revolutionary area of tumor genomics. The
ability to identify the unique genetic changes in an individual’s tumor offers
the promise of individualized prognostic information and guidance in making
treatment decisions. Tumor genomics can also offer clues to whether an
individual’s cancer is due to an inherited mutation. Therefore we look forward
to using our expertise in genetics to help interpret tumor genomic testing
to identify individuals who could benefit from an evaluation for a hereditary
cancer condition.
Jose Bufill, MD
Melissa Gillette
Gretchen Skurla
Research & Clinical Trials
The Northern Indiana Cancer Research Consortium, Inc. (NICRC) is composed
of the following members: Elkhart General Hospital, Indiana University La
Porte Hospital, Michiana Hematology Oncology, PC and Saint Joseph Regional
Medical Center with campuses in Mishawaka and Plymouth, Indiana.
SJRMC collaborates with and supports the NICRC by providing Oncology
Research Nurses who assist our physicians in presenting over 70
available clinical trials to our community. We strive to bring the most
beneficial treatments to our community by offering trials in cancer
control, prevention and treatment medications as well as quality of life
and symptom management. The NICRC is now offering cutting-edge
investigational cancer therapies that target specific genetic mutations and
is one of the few sites offering these trials, putting our community at the
forefront of cancer research.
The NICRC continues to enroll patients to clinical trials exceeding national
standards provided by the American College of Surgeons, helping SJRMC’s
Oncology Program achieve the Outstanding Achievement Award.
Conquer Cancer Foundation and the American Society of Clinical Oncology
(ASCO) selected the NICRC to receive the 2014 Conquer Cancer Foundation of
ASCO Clinical Trials Participation Award. This recognizes the NICRC important
contributions to clinical cancer research.
The success of the NICRC can be attributed to the cooperative efforts by
the competing hospital systems along with the committed investigators and
dedicated, knowledgeable research staff. Teamwork between all components
has developed into a strong clinical research presence in Indiana.
21
Nurse Navigation
Where do I go? What should I expect? Who can explain
this procedure to me? What if I have a problem with my
insurance? How am I going to get to my treatments?
Who can help me?
So many questions arise when patients are told they
have cancer. SJRMC offers the help, understanding and
care patients and their families need at this difficult
and overwhelming time. Our nurse navigators serve as
the one person who can guide them to getting those
questions answered.
They are available to patients in person and over the
phone at the Mishawaka and Plymouth campuses.
Our nurse navigators assist patients by:
• Providing emotional support.
• Coordinating services among medical providers.
• Finding financial assistance resources.
• Arranging transportation.
• Educating patients and families about their disease
and treatment plan.
• Linking patients to healthcare resources quickly.
• Translating medical terminology.
• Communicating with physicians and other members
of the healthcare team.
• Obtaining referrals to community services for
support groups.
• Arranging palliative care, hospice and home
healthcare services.
• Facilitating timely access to quality medical and
psychosocial care.
Carol Walker, Oncology Administrative Director, says,
“Our goal is that every cancer patient at SJRMC has one
point of contact throughout their cancer journey. Nurse
navigators are there to help answer questions, connect
the dots between physicians and facilitate the needs
of the patient, whether they are spiritual, financial or
physical. Nurse navigators really are the glue that holds
everything together.”
Palliative Care
Chronic, debilitating or life-threatening illnesses such as
cancer, congestive heart failure, heart disease, COPD/
emphysema, cystic fibrosis, stroke or multiple sclerosis
can become difficult and complex for patients, their
families and healthcare providers to manage. As these
illnesses progress, pain and other symptoms (shortness
of breath, fatigue, etc.) often impact other aspects of a
patient’s quality of life. Some other aspects of a patient’s
life that can be affected include:
• Relationships with family, friends and/or caregivers.
• Need for others to assist with care (loss
of independence).
• Psychosocial, emotional and spiritual needs/concerns.
To meet specific patient/family needs, the SJRMC
Palliative Care Services Team consists of the
following members:
• Physician
• Advanced practice nurse
• Chaplain
• Social worker
• Pharmacist
• Rehabilitation professionals
• Nurse navigator and/or case manager
Multidisciplinary Palliative Care Services at SJRMC
assist patients, families and healthcare providers with
pain and symptom management, and integrate the
patient’s/family’s hopes, goals, beliefs and desires into
the plan of care.
Palliative Care Services are not only for patients
facing end-of-life challenges. Palliative Care is here to
support the patient, family members, physicians and
other healthcare providers at any stage of the patient’s
disease. The Palliative Care Services team works with
the physician to provide an extra layer of support for the
patient and his or her family. Palliative Care Services
provide expert symptom management, and extra time for
communication, as well as help the patient and family
navigate through the healthcare system.
The goal of the program is to focus on relieving
discomfort and distress while collaborating with the
patient, family and other healthcare providers to achieve
the best quality of life. SJRMC Palliative Care Services
achieves this goal by providing consultation, intervention
and discharge planning for hospitalized patients. In other
words, to help the patient feel better, sooner.
SJRMC Palliative Care Services are currently coordinated
by Louis J. Pace, MSN, RN, CCNS; with integral
collaboration from Gregory C. Gifford, MD, JD, Center
for Hospice’s Chief Medical Officer and Board Certified
Hospice and Palliative Medicine physician; and Roger
Klauer, M.DIV., MD, SJRMC Palliative Care Medical
Director and Physiatrist. Because of the palliative care
needs of patients and families, this program will be
expanding in 2015 to include another advanced practice
registered nurse and a dedicated social worker.
23
Cancer Registry
The Cancer Registry is composed of a team of
professionals who analyze cancer data. This data is used
by physicians, health officials and researchers to prevent
and control cancer within our local community. The
data collected from registries is also used in response
to local questions about referral patterns and trends
or patterns of management by disease site and/or
treatment modalities.
In 2013, there were a total of 856 new cancer cases
collected with the largest population of cases diagnosed
in Saint Joseph County at 61%. We had more women
(59%) diagnosed with a new cancer in 2013 than men
(41%). Compared to the national statistics, the top three
estimated new cancer cases for men are prostate, lung
and colorectal, which is consistent with the trends at
Saint Joseph Regional Medical Center. For females, the
top three estimated new cancer cases nationally are
breast, lung and colorectal. At SJRMC our top three
estimated new cases are breast, lung and uterine corpus.
The quality of cancer registry operations and the data
collection is greatly influenced by the education and
training of cancer registrars. Within the Cancer Registry
at SJRMC, there are three credentialed certified tumor
registrars (CTRs).
Key components of any hospital cancer registry consist of
the following:
Abstracting cancer data
Patient Pathology reports are reviewed for evidence of
malignancy, history of cancer, ambiguous terminology
that suggests cancer or physician information that
includes an oncologist. As of Nov. 30, 2014, we reviewed
5,332 reports for our Mishawaka campus and 1,983
reports for our Plymouth campus.
The data is entered into a database that holds information
on every cancer case that was either diagnosed or treated
at SJRMC since 1982. The new case is entered and
abstracted within 5-6 months. An “abstract” is a complete
summary of a patient’s cancer from date of diagnosis
through completion of treatment, and lifetime follow-up.
Both federal and state legislation made cancer
a reportable disease in Indiana since 1993. Case
discernment requires knowledge of diagnoses and
data sets required by Indiana state law to be reported.
Since SJRMC is also accredited by the American
College of Surgeons (ACoS) Commission on Cancer as a
Comprehensive Community Cancer Program, abstractors
must be aware of cases required by ACoS for inclusion
in the cancer registry, and subsequently reported to the
National Cancer Database (NCDB). Accordingly, SJRMC
has a “Reportable List,” which serves as a basic guide
to the cancer registry for those malignancies that are
mandated for reporting. This list is updated periodically
when there are changes in reporting rules. For instance, in
January 2004 benign brain tumors became reportable.
Once a case is entered, it is ready to be abstracted,
which requires review of all reports available through the
electronic medical record (EMR) and other sources of
documentation. In 2013, two dedicated CTRs completed
1,332 cases, and to-date in 2014 completed 1,310 cases.
There are more than 200 data fields per case required
for completion. The Facility Oncology Registry Data
Standards (FORDS) manual provides definitions and
detailed instructions for coding diagnosis, treatment
and outcomes. These fields include: demographics,
cancer identification (anatomic site and tissue type),
stage or extent of disease, first course of treatment and
outcomes. In addition to consulting various EMR systems,
abstractors may have to contact treating physician offices
either by phone or letter to complete the treatment
information not otherwise available.
Cases are routinely completed within five months of
diagnosis. This is very timely as the maximum length
of time to complete a case is six months according to
ACoS. Each case requires a complex validation system
and staging algorithm that generates edits, all of which
must be cleared prior to reporting the cancer case to
the state or NCDB. Abstractors are responsible for this
process. The Rapid Quality Reporting System (RQRS) is
a voluntary, prospective quality reporting tool providing
real clinical time assessment of case and hospital level
adherence to quality of cancer care measures. Breast
and colorectal cases are reported within three months of
diagnosis in order to meet this requirement.
There are approximately 1,600 visits per quarter reviewed
for our Mishawaka campus and 1,400 visits per quarter
for our Plymouth campus.
The quality of data in the Cancer Registry is critical since
our data is used at the community, state and national
levels to make important public health decisions, and
for resource allocation. We are an NAPBC-Accredited
Breast Center and in 2013 received the Outstanding
Achievement Award from the Commission on Cancer of
the American College of Surgeons. We are proud to be a
part of this achievement and appreciate the wonderful
working relationship we have developed with physicians in
the community who help support our cancer program.
Lifetime follow-up on cancer patients
Follow-up is essential to evaluate cancer care outcomes.
The data outcome results are compared with regional,
state or national statistics.
The follow-up coordinator’s responsibilities are to obtain
and record outcomes of more than 5,928 new cancer
patients annually. Each month a report is generated on
all patients whose last date of contact is 13 months prior.
Cases are delinquent (lost to follow-up) if the follow-up
interval exceeds 15 months.
Using our EMR and other sources, data is obtained
from pathology, radiology and oncology reports, as well
as physician notes and cancer conferences to crossreference each patient to obtain the last contact date,
status of their cancer and well-being.
As an accredited cancer program, the registry is
required by the ACoS to have a follow-up rate of 80%
for all analytic patients and 90% for patients diagnosed
in the last five years. In November, our follow-up rates
for all patients in the cancer registry database was
98.89%, and for patients diagnosed within the last five
years was 99.07%.
Cancer data is followed for life; gathering this data leads
to cancer outcomes and survival data. Outcomes and
survival data help physicians determine best practice in
diagnosing and treating cancers in the future.
25
Primary Site Table
SEX
STAGE DISTRIBUTION - ANALYTIC CASES ONLY
PRIMARY SITE
TOTAL (%) M
F
CLASS OF ANALY STG 0
STG I
STG II
STG III
STG IV
88
UNK
ORAL CAVITY & PHARYNX
Lip
Tongue
Salivary Glands
Floor of Mouth
Hypopharynx
DIGESTIVE SYSTEM
Esophagus
Stomach
Small Intestine
Colon Excluding Rectum
Cecum
Appendix
Ascending Colon
Transverse Colon
Splenic Flexure
Sigmoid Colon
Large Intestine, NOS
Rectum & Rectosigmoid
Rectosigmoid Junction
Rectum
Anus, Anal Canal & Anorectum
Liver & Intrahepatic Bile Duct
Liver
Intrahepatic Bile Duct
Gallbladder
Other Biliary
Pancreas
Peritoneum, Omentum &
Mesentery
Other Digestive Organs
RESPIRATORY SYSTEM
Larynx
Lung & Bronchus
SOFT TISSUE
Soft Tissue (including Heart)
SKIN EXCLUDING BASAL &
SQUAMOUS
Melanoma - Skin
BREAST
FEMALE GENITAL SYSTEM
Cervix Uteri
Corpus & Uterus, NOS
Corpus Uteri
Uterus, NOS
Ovary
Vulva
Other Female Genital Organs
MALE GENITAL SYSTEM
Prostate
Testis
Penis
URINARY SYSTEM
Urinary Bladder
Kidney & Renal Pelvis
Ureter
BRAIN & OTHER NERVOUS
SYSTEM
Brain
Cranial Nerves Other Nervous
System
ENDOCRINE SYSTEM
Thyroid
Other Endocrine including Thymus
LYMPHOMA
Hodgkin Lymphoma
Non-Hodgkin Lymphoma
NHL - Nodal
NHL - Extranodal
MYELOMA
LEUKEMIA
Lymphocytic Leukemia
Chronic Lymphocytic
Leukemia
Other Lymphocytic Leukemia
Myeloid & Monocytic Leukemia
Acute Myeloid Leukemia
Acute Monocytic Leukemia
Chronic Myeloid Leukemia
MESOTHELIOMA
MISCELLANEOUS
10 (1.2%)
1 (0.1%)
4 (0.5%)
2 (0.2%)
1 (0.1%)
2 (0.2%)
148 (17.3%)
10 (1.2%)
13 (1.5%)
2 (0.2%)
45 (5.3%)
15
3
10
4
1
9
3
17 (2.0%)
6
11
2 (0.2%)
13 (1.5%)
11
2
5 (0.6%)
2 (0.2%)
29 (3.4%)
9
0
4
2
1
2
82
7
9
2
20
7
1
3
3
1
5
0
11
4
7
1
11
9
2
4
1
14
1
1
0
0
0
0
66
3
4
0
25
8
2
7
1
0
4
3
6
2
4
1
2
2
0
1
1
15
10
1
4
2
1
2
148
10
13
2
45
15
3
10
4
1
9
3
17
6
11
2
13
11
2
5
2
29
0
0
0
0
0
0
4
1
0
0
1
0
0
1
0
0
0
0
1
0
1
0
0
0
0
1
0
0
4
1
1
1
1
0
21
1
3
0
10
4
0
5
0
0
1
0
2
1
1
1
4
4
0
0
0
0
2
0
0
1
0
1
34
0
3
1
9
2
1
3
2
0
1
0
6
2
4
1
2
0
2
1
0
11
0
0
0
0
0
0
32
4
2
0
12
6
0
0
2
1
2
1
5
1
4
0
1
1
0
1
0
3
4
0
3
0
0
1
40
3
3
0
12
2
2
1
0
0
5
2
1
1
0
0
2
2
0
2
0
12
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
0
0
2
0
0
0
0
0
0
0
12
1
2
1
1
1
0
0
0
0
0
0
2
1
1
0
2
2
0
0
0
3
8 (0.9%)
0
8
8
0
0
0
4
4
0
0
2 (0.2%)
141 (16.5%)
8 (0.9%)
133 (15.5%)
3 (0.4%)
3 (0.4%)
2
79
7
72
3
3
0
62
1
61
0
0
2
141
8
133
3
3
0
0
0
0
0
0
0
26
1
25
0
0
0
20
3
17
1
1
0
22
0
22
1
1
1
69
4
65
1
1
1
0
0
0
0
0
0
4
0
4
0
0
11 (1.3%)
8
3
11
0
5
5
0
1
0
0
11 (1.3%)
173 (20.2%)
121 (14.1%)
9 (1.1%)
69 (8.1%)
68
1
30 (3.5%)
10 (1.2%)
3 (0.4%)
47 (5.5%)
42 (4.9%)
4 (0.5%)
1 (0.1%)
74 (8.6%)
42 (4.9%)
28 (3.3%)
4 (0.5%)
8
5
0
0
0
0
0
0
0
0
47
42
4
1
53
31
20
2
3
168
121
9
69
68
1
30
10
3
0
0
0
0
21
11
8
2
11
173
121
9
69
68
1
30
10
3
47
42
4
1
74
42
28
4
0
37
6
0
0
0
0
0
6
0
0
0
0
0
19
17
0
2
5
65
69
6
53
53
0
7
3
0
12
9
3
0
30
14
16
0
5
45
8
1
3
2
1
4
0
0
16
16
0
0
8
5
3
0
0
19
22
2
6
6
0
12
1
1
5
4
1
0
6
1
5
0
1
6
14
0
7
7
0
7
0
0
13
13
0
0
8
4
2
2
0
1
2
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
3
1
2
0
14 (1.6%)
4
10
14
0
0
0
0
0
14
0
7 (0.8%)
2
5
7
0
0
0
0
0
7
0
7 (0.8%)
2
5
7
0
0
0
0
0
7
0
28 (3.3%)
26 (3.0%)
2 (0.2%)
45 (5.3%)
5 (0.6%)
40 (4.7%)
33
7
13 (1.5%)
16 (1.9%)
4 (0.5%)
10
9
1
23
2
21
16
5
9
8
3
18
17
1
22
3
19
17
2
4
8
1
28
26
2
45
5
40
33
7
13
16
4
0
0
0
0
0
0
0
0
0
0
0
16
16
0
7
0
7
2
5
0
0
0
4
4
0
7
2
5
5
0
0
0
0
1
1
0
13
2
11
11
0
0
0
0
5
5
0
17
1
16
15
1
0
0
0
2
0
2
0
0
0
0
0
13
16
4
0
0
0
1
0
1
0
1
0
0
0
3
3
0
3
0
0
0
0
0
3
0
1
12 (1.4%)
8
2
2
2 (0.2%)
10 (1.2%)
0
5
2
2
1
2
9
1
7
6
0
1
0
1
1
12
8
2
2
2
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
12
8
2
2
0
10
0
0
0
0
0
1
0
TOTAL
856
351
505
856
66
255
150
121
179
63
22
*Exclusions: Not Male and Not Female
2013 Cancer Incidence Comparison Report
by Site and Sex
There were 856 new cancer (analytic) patients diagnosed and/or treated at
SJRMC in 2013, of which 505 (59%) were females and 351 (41%) were males.
The estimated national figures from 2013 for females was (48%) and males
(52%) respectively.
These graphs show the leading 2013 and 1st and 2nd quarters of 2014 new
cancer cases at SJRMC compared to the estimated 2013 and 2014 leading
new cancer cases in the United States for both men and women.
2013 LEADING NEW
MALE CANCER CASES
2013 LEADING NEW
FEMALE CANCER CASES
35
35
30
30
25
25
20
20
15
15
10
10
5
5
0
0
Prostate
Lung &
Bronchus
USA
Colon &
Rectum
Breast
SJRMC
Lung &
Bronchus
USA
Uterine
corpus
SJRMC
Cases by County
There were 856 new cancer (analytic) cases
diagnosed and/or treated at SJRMC in 2013, of
which 61.10% were diagnosed from Saint Joseph
County. 9.58% of our patients are from Berrien
County, Michigan, 5.84% traveled from Elkhart
County, 10.51% traveled from Marshall County and
12.97% of the patients diagnosed and/or treated in
2013 were from other counties within Indiana.
Berrien
9.58%
St. Joseph
61.10%
Elkhart
5.84%
Marshall
10.51%
Other IN
Counties
12.97%
27
Community Support Services
Women’s Task Force
Founded in 2001 as an all-volunteer group of cancer survivors, the Women’s
Task Force today is made up of women cancer survivors, healthcare
professionals and community members who have come together to raise
awareness and develop initiatives regarding women’s health issues. Initiatives
include recommending and implementing programs that relate to women
and cancer, promoting early detection, explaining treatment options, providing
supportive care and celebrating survivorship.
The Women’s Task Force partners with community groups, area schools
and universities on many initiatives, including the University of Notre Dame
Women’s Basketball Pink Zone and Women’s Volleyball Block Out Cancer
events. Funds raised through these efforts support cancer awareness
programs and provide free cancer screenings and follow-up testing for
patients in need.
Secret Sisters Society®
The Secret Sisters Society is a community program of the
Women’s Task Force, which was created and introduced
in 2001 at the first Secret Sisters Society Luncheon
and Style Show. The event raises funds to provide
mammograms for uninsured women in our community.
The Women’s Task Force believes that early detection is
the key to surviving cancer and every woman should have
the opportunity for screening tests.
Continuing its mission, the 2014 Secret Sisters Society
Luncheon celebrated its 13th year with an event held
at Century Center on Sept. 10. Over 800 people were in
attendance as the event continued its tradition of serving
lunch followed by a style show. The featured models, who
are cancer survivors and some who are still in treatment,
modeled clothing from local retailers with their honored
escorts. The Women’s Task Force was pleased to have the
physicians and staff of Michiana Hematology Oncology,
PC (MHO) as the honorary chairs of the event. The MHO
physicians and nurse practitioners, who provided the care
and treatment for the models, walked down the runway
with them and also modeled their own special attire.
Proceeds from the Secret Sisters Society Luncheon
are used to provide mammograms and in 2011, made
cervical cancer screenings available to uninsured and
underinsured women. The program is unique in that
the women can have their screenings done at a site
convenient to them from any one of the local hospitals,
including Saint Joseph Regional Medical Center, Memorial
Hospital or Elkhart General Hospital.
2014 Secret Sisters Society model Kim Geist,
escorted down the runway by her doctor,
Bilal Ansari, MD.
The Secret Sisters Society Mammogram and Cervical
Screening Program provides initial testing to women ages
40-49 who qualify financially. Since its inception in 2003,
the program has provided over $510,000 in life-saving
cancer screenings for women who live all around us.
The screenings have been provided or scheduled at the
following sites:
40.7% - Saint Joseph Regional Medical Center
40.8% - Elkhart General Hospital
18.5% - Memorial Hospital
This year’s luncheon premiered the Secret Sisters
Society T-shirt that was available to purchase along
with South Bend Chocolate Company’s Crunch for
Cancer. The product sales, along with the luncheon
sponsorships and annual memberships, provide vital
funding for the program. Memberships and products
can be purchased throughout the year. All proceeds
benefit the Secret Sisters Society Mammogram and
Cervical Screening Program.
The Women’s Task Force is a strong community partner
with RiverBend Cancer Services and United Health
Services (UHS). UHS is the local administrator of the
Indiana Breast and Cervical Cancer Program (BCCP) and
administers the Secret Sisters Society Mammogram and
Cervical Screening Program.
Please visit www.womenstaskforce.org for more
information on how to become Secret Sisters Society
member. You might save a life.
2014 Secret Sisters Society models posing
after the style show.
29
RiverBend Cancer Services
What’s the next step after cancer treatment?
Understanding the “new normal” of being cancer-free
can be intimidating to survivors. After treatments end,
survivors are quite often left with that feeling of
“what now?”
With approximately 14 million cancer survivors in the
United States, healthcare providers need to consider
how best to help survivors and their families continue
to thrive once they’ve been released from treatment.
RiverBend Cancer Services new cancer survivorship
program, which incorporates the standards established
by the American Society of Clinical Oncology
(ASCO), will provide cancer survivors with long-term
monitoring and prevention services. This care can
enhance patients’ long-term health by managing and
responding to their concerns.
RiverBend works hand-in-hand with the local medical
community to advance survivorship aftercare. In
the new year, RiverBend will begin a program with
SJRMC and Michiana Hematology Oncology’s
Advanced Centers for Cancer Care to offer a “Survivor
101” program. The program provides every survivor
with a transition plan when they leave treatment.
This includes services such as support groups, a
combination of exercise and nutrition counseling or
more in-depth therapy.
The programming at RiverBend Cancer Services is
available for each survivor and their support team and
customized to their needs. Services will be even more
customized after RiverBend’s move into a new, larger
facility in the spring of 2015.
The services provided at RiverBend Cancer Services
are referred to as supportive services. RiverBend
does not prescribe medicine or calculate radiation
dosages. It does not perform surgeries or administer
chemotherapy. RiverBend helps people with cancer
live their lives well through programs and services that
augment cancer treatments and improve their quality
of life – during and after treatment.
The tools to survive
The list of services that RiverBend is able to provide
continues to grow:
•
•
•
•
•
•
•
•
Licensed counseling
Nutrition classes
Exercise classes
Support groups
Yoga
Reiki therapy
Massage therapy
Wellness Wednesday
programs
Knitting and crocheting
Social activities
Wig salon
Bra and prosthesis salon
Nutritional products
Community education
classes
• Prescription assistance*
*qualified clients
•
•
•
•
•
•
RiverBend Cancer Services' new facility is
scheduled for completion in the spring of 2015.
American Cancer Society
Saint Joseph Regional Medical Center and the American Cancer Society have
formed a strong relationship that helps meet the needs of patients going
through cancer treatment.
The American Cancer Society’s Cancer Resource Network is available 24/7,
365 days a year via 800.227.2345 and cancer.org. Through the Resource
Network, patients and their families can find free comprehensive cancer
information, day-to-day help and emotional support throughout every step of
the cancer journey. Available topics include:
• Tools to understand a cancer diagnosis by learning what to
expect and how to plan
• Understanding their treatment options
• Help with insurance concerns, including Medicare and Medicaid
• Financial assistance programs
• Local support groups
• Transportation and lodging assistance
• Clinical trial matching service
• Cancer education tools
• Prescription assistance
31
2013-2014 Oncology Committee
Bilal Ansari, MD
Cancer Committee Chair
Oncology Medical Director
Medical Oncologist
David Hofstra
Quality Improvement Coordinator
Director, Rehab Services & Diagnostic
Imaging
Rachelle Anthony
American Cancer Society
Roger G. Klauer, M.DIV., MD
Cancer Registry Quality Coordinator
Lymphedema Clinic
Lisa Barnaby, CCRP
Clinical Research Coordinator
Director, NICRC
Erica Bory, RD, CD
Clinical Dietician
Marian Brown, CTR
Cancer Conference Coordinator
Manager, Cancer Registry
Jose Bufill, MD
Genetic Program Director
Medical Oncologist
Truc Ly, MD, FACC
Cardiothoracic Surgeon
Louis Pace, RN, MSN
Pain Control Specialist
Pain Management
Vanessa Perkins
Recorder
Lisa Ribble, PharmD
Clinical Pharmacist
Robert Carbonell
Chaplin, Spiritual Care
Michael Rotkis, MD
Cancer Liaison Physician
General Vascular Surgeon
Gwen Ehler, RD, CD
Clinical Dietician
Terri Teegarden, RN
Case Management
Stacy Garton, MSW, LCSW
Psychosocial Services Coordinator
Camilla Shaw, RN
Oncology Nurse Navigator
Melissa Gillette, PhD
CGC Senior Genetic Counselor
Gretchen Skurla, MS, CGC
Genetic Counselor
Amelia Taggart, RN, OCN
Manager, Oncology Unit
Robert Tomec, MD
Pathologist
Medical Director
South Bend Medical Foundation
Binh Tran, MD
Radiation Oncologist
Linda Tuthill, MD
Diagnostic Radiologist
Kate Voelker
Community Outreach
RiverBend Cancer Services
Carol Walker, MSN, RNC-NIC
Cancer Program Administrator
Administrative Service Line Director
Carol (Cari) Wilson
Community Outreach Coordinator
Katina Wood, MS, MBA
Executive Director of Oncology Services
Kim Woofter, COO
Michiana Hematology Oncology, PC
Affiliates, Approvals &
Accreditations
Affiliations
American Academy of Family Physicians
American Board of Family Practice
American Hospital Association
American Medical Rehabilitation Providers Association
Association of Community Cancer Centers
Catholic Health Association
(Consolidated Catholic Health Care)
Indiana Hospital Association
Indiana University
Loyola University Health System
Peyton Manning Children’s Hospital at St. Vincent
South Bend Medical Foundation
Approvals
Indiana Board Department of Health
Indiana State Nurses Association
Indiana State Emergency Medical Services Commission
Centers for Medicare & Medicaid Programs
Accreditations
American College of Radiology
American College of Surgeons’ Commission on Cancer
American Council on Graduate Medical Education
American Registry of Radiologic Technology
Association for Clinical Pastoral Education
College of American Pathologists
The Joint Commission
National Accreditation Program
for Breast Centers
33
Oncology Future Vision
In closing, we thank you for your continued
support. We are very excited about the future of
cancer care and what it means for Saint Joseph
Regional Medical Center.
Katina Wood
Executive Director of Oncology Services
35
At Saint Joseph Regional Medical Center, our values
give us strength.
That character guides every decision we make — even
when those decisions are complicated, costly, or hard.
We honor our mission to heal body, mind, and spirit by
investing in technology, people, and capabilities that
allow us to set the standard for quality care. Because
we answer to a higher calling.
This is healthcare, inspired by faith.
Our Mission
We, Trinity Health, serve together in the spirit of the
Gospel as a compassionate and transforming healing
presence within our communities.
South Bend
Mishawaka
Plymouth
sjmed.com