Help along the way - Cayuga Medical Center

Help along the way
Cancer Care Center | Annual Report 2014
C H AIRMAN’S REPORT
2014 Cayuga Medical Center Cancer Committee
Charles Garbo, MD, Chairman
Board certified in internal medicine and medical oncology.
Graduated University of Vermont Medical School, Burlington,
VT. Internship and residency in internal medicine at St.
Vincent Hospital, Worcester, MA. Fellowship in hematology
and oncology at University of Massachusetts Medical Center,
Worcester, MA. Assistant clinical professor of oncology at
Roswell Park Cancer Institute, Buffalo, NY.
William Carroll, MD, PhD
Board certified in diagnostic radiology. Doctor of Philosophy
and physiology from Pennsylvania State University,
College Park, PA. Graduated Jefferson Medical College in
Philadelphia, PA. Internship in family practice at St. Margaret
Memorial Hospital in Pittsburgh, PA. Residency in diagnostic radiology at Geisinger Medical Center in Danville, PA.
Fellowship in vascular and interventional radiology at Western
Pennsylvania Hospital, Pittsburgh, PA.
John Powell, MD
Board certified in radiation oncology. Graduated SUNY
Upstate Medical University, Syracuse NY. Transitional program
internship at Riverside Regional Medical Center, Newport
News, VA. Residency in radiation oncology at Upstate Medical
University, Syracuse, NY. Dr. Powell is an assistant professor of
oncology at Roswell Park Cancer Institute, located full time at
Cayuga Medical Center.
David Schwed, MD
Board certified in surgery. Graduated SUNY Upstate Medical
University, Syracuse, NY. Internship and general surgical
residency at New Jersey’s Morristown Memorial Hospital, an
affiliate of Columbia Presbyterian Medical Center in New
York, NY.
Daniel Sudilovsky, MD
Board certified in cytopathology, anatomic pathology, and
clinical pathology. Graduated Case Western Reserve University
of Medicine, Cleveland, Ohio. Residencies in anatomic pathology and laboratory medicine at the University of California at
San Francisco. Fellowship in pathology, cytopathology, and
surgical pathology at University of California at San Francisco.
Dr. Sudilovsky is director of Pathology and Laboratory
Medicine at Cayuga Medical Center.
Robin Anderson-Eastburn, RN
Registered Nurse in Medical Oncology
Clinical Research Coordinator
Carolyn Bartell, MSW, ACSW
Community Representative
Anna Bartels, PMP
Quality Improvement Specialist,
Performance Improvement
Deborah Danko, RN, OCN
Oncology Nurse Navigator, Oncology Services
Ellen Dugan, MBA
Vice President, Service Lines
Quality Improvement Coordinator
Jennifer Fuller, RN, OCN
Manager, Oncology Nursing
Kristina Gambitta, RN, BSN, MHA
Acting Director, Oncology Services
Leah Gugino, BSN, CHPN
Certified in Hospice and Palliative Care Nursing
Director of Patient Services for Hospicare and
Palliative Care Services of Tompkins County
Betty McEver, RN, BSN, OCN, CRN
Oncology Nurse Navigator, Oncology Services
Bob Riter, MHSA
Executive Director, Cancer Resource Center
of the Finger Lakes
Marguerite Sterling, BSN, RN
Registered Nurse in Radiation Medicine
Cancer Conference Coordinator
Deb Traunstein, LMSW, MBA, ACHP-SW
Oncology Social Worker, Oncology Services
Psychosocial Services Coordinator
Sally VanIdistine, CTR
Certified Tumor Registrar, Cancer Registry
Cancer Registry Quality Coordinator
Jason Warchal
Account Representative, Hospitals
American Cancer Society
Jessica Waters, AOS
Administrative Assistant, Cancer Registry
Outreach Coordinator
I
t has been a year of growth at the Cayuga Cancer Center as
we offer an even more comprehensive program of patient-care
services. With new physician specialists on staff and other
additional staffing resources, we will be better able to implement
the standards from the Commission on Cancer (CoC). Elsewhere
in this annual report, advances in radiation therapy are also
highlighted.
This fall Cayuga Medical Center welcomed interventional
radiologist Dr. Roman Politi, who enhances our ability to
perform certain types of biopsies and therapies. He also enables
us to offer localized cancer therapies leading to ablation of
small tumors. Two new pulmonologists, Dr. Lavanya Kodali
and Dr. John Suen, joined our medical staff, as well, expanding
our capabilities to diagnose and treat lung cancers and in
the future to perform types of lung biopsies that we could not
provide in the past.
We are pleased to have Jennifer Fuller, RN, take on the role
of oncology nurse manager. She has worked with us for several
years, doing a superb job, and she has proven herself to be
an energetic, talented leader of our nursing team. Oncology
nurse Deborah Danko, RN, has joined Betty McEver, RN,
to take on new responsibilities in nurse navigation and
survivorship. At the fall meeting of the Commission on Cancer
Liaison Physicians for Upstate New York, Deborah presented
the survivorship care plan we implemented at the Cayuga
Cancer Center. Her work was so impressive that we have
been asked by other hospitals if they could look into using
our care plan. In addition, I am happy to report that Kristina
Gambitta, RN, is doing excellent work as our interim director
of oncology services.
We have also committed resources to have a medical
social worker be part of the oncology service line on a
“go-to” basis. Debra Traunstein, LMSW, follows our hospital
inpatients and sees patients in our outpatient chemotherapy
clinic and in radiation oncology. She brings in-depth
experience to our team in palliative care and is also involved
with our psychosocial distress screening. Utilization of
palliative care services continues to grow. Our relationship
with Hospicare and Palliative Care Services is enriched
as Jane Schantz, FNP, from Hospicare works closely with
1
Deb Traunstein, Rev. Tim Dean, and Rev. Christopher Szarke at
Cayuga Medical Center.
According to the NYS Cancer Registry over 100 cases of cancer
are diagnosed every year in Schuyler County, yet for more than
five years residents living there have been without a medical
oncologist seeing patients in the county. In July 2014 oncologists
from the Oncology Services Program of Cayuga Medical Associates
began seeing patients in Montour Falls. We are getting to know
Schuyler County physicians and are working with them to fill
this important need. In addition to medical oncology, cancer-care
services in Schuyler County now include outpatient surgery,
anesthesia, pathology, and gastroenterology.
In 2014 we initiated new lung cancer screening for early detection of patients at higher risk for developing lung cancer. The United
States Preventative Services Task Force recommends annual screening for lung cancer with low-dose CT (LDCT) in adults aged 55 to 80
years old who have a 30-pack-year smoking history. We have worked
closely with our Department of Imaging Services to develop the
screening process and to provide patients with physician followup to discuss their screening results and to talk about smoking
cessation when appropriate. The cost of this screening may not be
covered by all health insurance plans, so we are working to make it
affordable for patients.
A second multidisciplinary tumor board dedicated solely to
breast cancer patients is in development and we will begin meeting
in January 2015. We are seeing more complex breast cancer cases
and this second tumor board meeting will allow us to discuss these
patients in greater detail.
Thanks to the hard work of our entire cancer-care team, we have
successfully implemented all of the latest standards from the CoC.
At the same time, we have expanded our reach into surrounding
communities and are providing oncology services to previously
underserved areas. With these many accomplishments in mind,
we are looking forward to another highly successful survey by the
CoC in 2015.
Charles Garbo, MD
Chairman, Cayuga Medical Center Cancer Program
Cancer Liaison Physician to the Commission on Cancer
Help along the Way
One Woman’s Journey with Cancer
Antoinette Di Ciaccio, 49,
has many interests. She
became curious about wine
after moving to Schuyler
County in 1997 and living
among lush hillsides covered
with grapevines.
For five-and-a-half years she was
the wine club manager at Sheldrake
Point Winery on Cayuga Lake, where
she discovered that serving wine
made from grapes grown by folks she
knows is a very satisfying experience.
She’s also interested in old houses.
Her circa 1918 red brick house in
Montour Falls speaks volumes about
the artistry of its owners. Lovingly refurbished over the years by Di Ciaccio
and her husband, Wayne Perregaux,
it is the perfect expression of their
shared passion for beautiful surroundings and gracious hospitality.
The lovely gardens around the house
express one more of her pursuits that
evolved into genuine talent.
However, for the past couple of
summers Di Ciaccio did not have
quite enough energy to tend those
lovely gardens, as she turned her
attention to other matters. Right
before Thanksgiving 2012, she felt a
pea-sized lump during a breast selfexam. In early January 2013, she saw
her doctor, who referred Di Ciaccio
for a diagnostic mammogram and an
ultrasound. She has dense breast tissue, so while the lump did not show
up clearly on a mammogram, it did
appear on the ultrasound.
Di Ciaccio was referred for a
biopsy, which was performed by
Cayuga Medical Center radiologist Dr.
Anthony Massi in the Women’s Imaging Center at the Convenient Care
Center in Ithaca. “I had such a great
experience with Dr. Massi, and the
nurses who assisted him were wonderful, too,” Di Ciaccio recalls. “One
of the nurses lives here in Schuyler
County and I think about her often.
She was so comforting and she used touch gently to give
me something to focus on.”
The biopsy was positive for cancer. The morning after
she learned this news, Di Ciaccio received a phone call
from an oncology nurse navigator at the Cayuga Cancer
Center. “She set things up for me and sat through several
different appointments with me and my husband,” says Di
Ciaccio. “Nurse navigation was really key; I felt there was
always someone there for me.”
Like all patients facing cancer, Di Ciaccio felt overwhelmed by the many decisions she had to make. The first
of those revolved around surgery. She says her surgeon,
Dr. Cora Foster at Surgical Associates of Ithaca, clearly
presented all of the treatment options. “Dr. Foster didn’t
try to push me in any one direction but she gave me all of
the information and she gave me her perspective. I loved
having her as my doctor; she’s really on top of things
and she was very helpful to me,” says Di Ciaccio. Foster
referred Di Ciaccio to medical oncologist Dr. Timothy Bael
of Cayuga Hematology Oncology Associates (CHOA) for a
consultation the next day. After talking with her doctors,
Di Ciaccio chose to have a lumpectomy with sentinel node
biopsy.
In meeting with Dr. Foster following surgery, Di Ciaccio
learned that the sentinel node (which is the lymph node
into which a tumor drains) contained cancer cells. As a result, Foster explained that she had removed about a third
of the lymph nodes closest to the tumor and had taken
enough breast tissue around the tumor to get a clean,
cancer-free margin. Foster also told her that her case
would be discussed at the Cayuga Cancer Center’s Tumor
Board, held each week at Cayuga Medical Center.
Di Ciaccio met again with Dr. Bael following her
lumpectomy. “Dr. Bael was amazing and will be forever in
my heart,” says Di Ciaccio. Among the recommendations
for treatment of her cancer was the removal of the remaining lymph nodes under her arm. However, due to a family
history of edema, which is swelling caused by the accumulation of fluid in certain parts of the body, Di Ciaccio
was afraid of chronic lymphedema if she had the surgery.
She talked with Bael about wanting to get a second opinion, which he encouraged her to do. “Before I went out of
town for that appointment, Dr. Bael called me and told me
that whatever I decided to do he would support me 100
percent. It was so wonderful that he called; it felt so good
to have his support.”
Di Ciaccio chose not to have additional lymph nodes
removed but she did go on to have the recommended
chemotherapy and radiation therapy at the Cayuga
Cancer Center. “Chemotherapy was difficult but I expected
it to be worse than it was,” says Di Ciaccio. Dr. Bael and
Di Ciaccio agreed upon a course of eight treatments over a
period of sixteen weeks. “There are no words to describe
my chemotherapy nurses [at CHOA],” she says tearing up.
“I feel like I was part of a family there, they were so fun and loving. I looked forward to seeing Kate, Hannah, Jodessia,
Jilian, Amy, and Jen; they do hospitality well and they are
very caring. This is clearly not just a job for them.”
Once she finished chemotherapy, Di Ciaccio began radiation therapy with radiation oncologist Dr. John Powell. “Dr.
Powell has a very special presence, one that I have never
experienced with any other doctor in my entire life,” she says.
“When I met with him I was feeling like, here I go again, and
dreading it. He looked me in the eye and put me right at ease.”
Di Ciaccio had reservations about her radiation therapy and
once again considered getting a second opinion. “Dr. Powell
took the initiative, contacted the doctor I had seen at Sloan
Kettering and then shared their e-mails with me, which I
thought was very unusual. But he wanted me to have all of the
data he was looking at, which I really appreciated.”
Volunteers from the Cancer Resource Center of the Finger
Lakes help to cover the Cancer Center’s patient resource room
right across the hall from the CHOA chemotherapy suite.
Volunteers are also available in the reception area of the
Radiation Oncology Department. “Having staff and volunteers
right there was extremely helpful to me when I was making
my decisions,” says Di Ciaccio. “When I left my chemotherapy
and radiation treatments it was refreshing to have that personal
connection; to see those smiling faces was really special.”
In appreciation for their care and support, Di Ciaccio raised
$4,000 for the Cancer Resource Center’s Walkathon and 5K
in 2013.
A year after completing her treatment for breast cancer
Di Ciaccio is cancer-free and her prognosis is good. But she says
the experience of having cancer has changed her. “I’ve learned
that just because I am done with treatment, I’m not necessarily done with the experience of cancer. I’m figuring out what
comes next and where I go from here.” To help her on that part
of her journey, she will be participating in the new Survivorship
Program offered through the Cayuga Cancer Center.
“I’m grateful for my life and for my wonderful husband,”
says Di Ciaccio, “but in those quiet hours alone, knowing you
have cancer can be very frightening. Once I got into my cancer
care, I was able to build a whole different kind of family to
lean on during my treatment. They were a really good team.”
3
CA N C ER P R O G R A M H I G HL I GHT S
2013 STATISTIC S
Roswell Park Cancer Institute Affiliation Brings Advances in Radiation Therapy
5 Year Trend of Major Sites at Cayuga Medical Center
Radiation oncologist Dr. John Powell, medical
staff member of Roswell Park Cancer Institute
and Cayuga Medical Center, introduced two
significant developments in radiation therapy
that expanded our patient-care capabilities
at the Cayuga Cancer Center. Stereotactic
body radiation therapy (SBRT)
makes it possible to administer
pinpoint radiation throughout
a patient’s body with exquisite precision and has given
our Department of Radiation
Therapy a whole new set of
treatment options. In certain
cases we can administer very
strong individual doses, which
enables us to reduce what was
traditionally a long course of
radiation therapy down to
between one and five treatments.
Radiation oncologists are currently
in the process of exploring how SBRT
can be applied to different types
of cancer. SBRT is noninvasive and
well tolerated by patients and we
have treated a number of patients with early-stage lung
cancer, with very positive results.
The second important development involves a new
technology called “rapid arc” or volumetric modulated
arc therapy (VMAT). This technology is used to administer
intensity modulated radiation therapy (IMRT), which is
an advanced approach to radiation therapy that delivers
precise, conformal doses of radiation. The advantage of
VMAT is that the treatment machine rotates in an arc as it
delivers IMRT, increasing our ability to focus the radiation
on the target and avoid healthy tissue, while reducing
the radiation treatment time by more than half. VMAT is
being used very successfully in treating prostate cancer.
Analytic Cases 2009-2013
Patient-focused Care
Community Education and Outreach
The Commission on Cancer (CoC) surveys accredited cancer
programs every three years to confirm that caregivers are
meeting the latest standards of cancer care. These standards
are revised every year leading to more effective approaches
to patient care. Cayuga Medical Center will be surveyed in
2015, and all of the new standards are successfully in place.
As area residents become more knowledgeable about
prevention and screening, they are more likely to seek
earlier treatment for cancer, which in turn leads to better
survival rates and a higher quality of life. Therefore, the
Cayuga Cancer Center sponsored ten different community education events focusing on melanoma for people of
all ages at different venues in Tompkins, Schuyler, and
Cortland counties. In November we participated in a
national event called Shine a Light on Lung Cancer,
in collaboration with the American Cancer Society and
the Cancer Resource Center of the Finger Lakes. The
program featured talks by radiologist Dr. Walter Silbert
and oncologist Dr. Timothy Bael. Forty people attended,
traveling through the first snow of the season to get to
the event.
We are also reaching out to the offices of primarycare physicians to educate providers in the community
about our patient navigators, social work services,
palliative care program, and survivorship. Our message
to physicians is that we are here to help them help their
patients, with comprehensive services from diagnosis
through survivorship.
A large number of prostate cases were diagnosed through our medical staff that did not require treatment
in the hospital; therefore they were not included in these numbers.
• Expanded Navigation Services: In order to provide quality
nurse navigation services a second navigator has been added to the oncology service line to help newly diagnosed
cancer patients. Our oncology navigators are liaisons between cancer patients and their care providers, serving as patient advocates, interpreters, and educators for cancer patients and their families.
• Screening for Psychosocial Distress: A patient screening
tool to evaluate psychosocial distress, and to provide
distressed patients with helpful resources. Screening for distress and psychosocial health needs is a critical first
step to providing high-quality cancer care. At Cayuga
Cancer Center, this program includes the services of an
oncology social worker.
• Survivorship Plan of Care: A plan to help patients who have completed therapy, with guidelines for monitoring and maintaining their health and improving their quality of life following cancer treatment. Because survivorship services are quite labor intensive, the CoC is requiring
that 10 percent of patients in approved cancer programs have access to survivorship care plans in 2015; however,
our goal for 2015 is to get as close to 100 percent partici-
pation as we possibly can.
Prevention and Screening
In September pathologist Dr. Elizabeth Plocharczyk
provided a lecture on melanoma prevention, diagnosis,
and staging. In October CMC and the Cancer Services
Program of Cortland and Tompkins County worked
collaboratively to offer a free breast cancer screening
to uninsured and underinsured women 40 and older.
The goal was to promote screening and early detection
for women in underserved areas.
4
100
90
Number of New Cases
80
70
86
83
73
69
75
59 59
58
60
50 49
50
38
40
30
30
40 40
32
37
28 25
35 33
39
27
35 32
29
20
10
0
Breast
2009
Lung
2010
2011
Colorectal
2012
Melanoma
Bladder
2013
2013 Analytic Case Site Distribution
Site2013 Total
MalesFemales CMC
NCDB 2012
Breast
75 0 7518%19%
Lung
59 26 3314%11%
Colorectal 40 15259% 8%
Melanoma33 18 15 7% 4%
Bladder
2921 8 7% 4%
All other sites
194
104
90
45%
54%
Total all sites
430
184
246
100%
100%
Analytic: Patients diagnosed and/or received any of their first course of treatment at CMC.
NCDB: National Cancer Data Base (2012 is the most recent NCDB data available).
Distribution by County
Analytic/Non Analytic by Year
Analytic Cases 2013
Cases 2009 - 2013
1+79+643
Tioga 3% Other 1%
Seneca 3%
Schuyler 4%
Cortland 4%
Cayuga 6%
2013
2012
2011
2010
2009
Tompkins
79%
Analytic
Non Analytic
430
79
463
91
415
106
380
140
408
138
0 50 100 150200
250
300
350 400
450
500
Analytic: Patients diagnosed and/or received any of their first course
of treatment at CMC.
While most of our cases come from Tompkins County,
we continue to have about 25% of our cases from
neighboring counties.
Non Analytic: Patients diagnosed and first course treatment administered elsewhere. Patients with pathology or lab specimens only.
5
A STUDY OF Breast CANCER AT CMC
2014 Quality Improvement: Increase Provider Referrals to Nurse Navigation
An estimated 232,670 new cases of invasive breast
cancer are expected to be diagnosed among women
in the US during 2014. Excluding cancers of the skin,
breast cancer is the most frequently diagnosed cancer
in women. The dramatic decrease in the breast cancer
incidence rate of almost 7% from 2002 to 2003 has
been attributed to reductions in the use of menopausal hormone therapy (MHT), previously know as hormone replacement therapy, following the publication
of results form the Women’s Health Initiative in 2002.
This study found that the use of combined estrogen
plus progestin MHT was associated with an increased
risk of breast cancer, as well as coronary heart disease.
From 2006 to 2010, the most recent five years for
which data are available, breast cancer incidence
rates were stable. In addition to invasive breast cancer,
62,570 new cases of in situ breast cancer are expected
to occur among women in 2014. Of these, approximately 83% will be ductal carcinoma in situ (DCIS).
In situ breast cancer incidence rates were also stable
from 2006 to 2010.
In 2014 an estimated 40,000 women will die from
breast cancer. Breast cancer ranks second as a cause
of cancer death in women (after lung cancer). Death
rates for breast cancer have steadily decreased in
women since 1989, with larger decreases in younger
women; from 2006 to 2010, rates decreased 3.0% per
year in women under 50 years and 1.8% per year in
women 50 and older. The decrease in breast cancer
death rates represents improvements in early detection and treatment, and possibly decreased incidence.
A study of analytic breast cancer cases at Cayuga
Medical Center was carried out covering 386 patients
diagnosed from 2009 to 2013. The age distribution
at initial diagnosis at CMC is similar to the NCDB
data base.
The 2014 quality improvement project is based on
analysis of the 2013 Study of Quality, which examined
the length of time from diagnosis to nurse navigation referral during the period from January through
September 2013. Our analysis of the 2013 data identified a significant problem: only 38 percent of all
patients utilizing navigation services during the study
period were referred by providers, meaning, 62 percent
of all patients were proactively contacted by a nurse
navigator. In order to address this issue, we undertook
a quality improvement project to increase provider
referrals to our oncology nurse navigator, thereby
improving patient access to navigation services.
CMC Breast Cancer Incidence Trend
Analytic Cases 2009-2013
90 86
80
83
73
75
69
70
60
50
40
30
20
10
0
2009
2010
2011
2012
2013
Analytic Cases 2009-2013
6%
3%
CMC
NCDB
17%
Surgery, Radiation,
Chemo and Hormone
10%
13%
10%
Surgery Only
18%
22%
Surgery, Radiation
and Hormone
Actions
35%
0 10%20%30%
40%
First course of therapy at CMC shows that our patients have been treated
similarly to those elsewhere in NCDB. An analysis done by Roswell Park Cancer
Institute showed all cases reviewed were treated per national guidelines.
60%
50%
40%
30%
Analytic Cases
20%
1+17+482482 2+21+412484
NCDB 2012
Unknown
1%
Stage III
8%
3) The goal of the 2014 quality improvement project
was to increase nurse navigation referrals, which had
been identified as a problem in our 2013 Study of
Quality. We have achieved the goal of our QI project,
as reflected by a 57 percent increase over the previous
year in provider referrals to nurse navigation.
Oncology Nurse Navigation Referrals
30%
Breast Cancer Stage at Diagnosis
Stage IV
2%
Stage III
8%
2) During the 2014 quality improvement project,
the total number of referrals to the nurse navigation
program increased by 22 percent. The number of new
patients increased by 10 percent during that same
time.
21%
Other Specified
Therapy
CMC 2009-2013
1) The number of patients referred for nurse
navigation between July and December 2013 was only
49 percent of 140 patients. Referrals for nurse navigation increased between January and June 2014 to 60
percent of 155 patients.
2) Improve communication with primary care physicians and other specialists, in order to expedite the
referral process. For example, Surgical Associates of
Ithaca now uses a new electronic medical record that
facilitates timely referrals, which are faxed to our
oncology nurse navigators.
15%
Surgery and Hormone
Achievements
1) Develop a Power Point presentation to educate
and increase awareness about the services offered by
the Cayuga Cancer Center, including oncology nurse
navigation, psychosocial services, and survivorship care
planning. We used this presentation during educational programs for the Finger Lakes Office Managers
Association, Cayuga Medical Associates, and the
Trumansburg Family Health Center.
First Course of Therapy Breast Cancer
No Treatment
3) Expand community education at various outreach
events to heighten public awareness of the oncology
navigation process and increase the number of selfreferrals. For example, our oncology nurse navigator
shared information with a wide audience by participating in an interview broadcast live on the Cayuga
Radio series “To Your Health.”
Stage IV
4%
Stage 0
17%
Unknown
2%
51%
July - December 2013
January - June 2014
40%
23%
26%
7% 8%
10%
0%
Patients
Proactively
Contacted by
Nurse Navigator
CHOA
Radiation
Oncology
9%
7% 8%
4%
Self Referral
Surgical
Associates
4%
5%
Breast
Navigator
3% 3%
1% 1%
GI
Associates
Other
Stage 0
21%
Stage II
24%
Stage II
24%
Stage I
48%
Betty McEver, RN, BSN, OCN, CRN
Oncology Nurse Navigator
Stage I
42%
Cayuga Medical Center’s stage at diagnosis mirrors national statistics.
6
7
T he C ommunity N etwork
Ties to other community agencies, such as the American Cancer Society,
Hospicare and Palliative Care Services, Cancer Resource Center of the Finger
Lakes, and the Cancer Services Program of Cortland and Tompkins Counties,
strengthen cancer services provided by Cayuga Medical Center.
The American Cancer Society (ACS), in partnership
with Cayuga Medical Center’s cancer program, provides
diagnosis-specific information, referrals to community
and ACS resources, and critical peer and professional
support to all those facing a cancer diagnosis. ACS offers
a number of educational and supportive programs for
people living with a cancer diagnosis and their families.
Among those programs is Look Good, Feel Better, a
hands-on workshop to help patients learn how to camouflage areas of concern and improve their appearance
during cancer treatment. (www.cancer.org)
Hospice and Palliative Care Services provides inpatient and outpatient palliation and hospice services in
patients’ homes, at the hospital, in nursing homes, in
other residential settings, and at the Nina K. Miller Center
for Hospicare and Palliative Care. (www.hospicare.org)
Cancer Resource Center of the Finger Lakes offers
personalized support and information to area residents
affected by cancer. Services include one-to-one assistance and many support groups, including the Women’s
Noon Group, Men’s Breakfast Club, Young Adult Group,
New to Cancer Group, Pat’s Group: Living with Cancer
as a Chronic Disease, Colorectal Group, Cancer Research
Group, and Tompkins Prostate Support Group.
CRCFL also offers a well-stocked lending library;
a boutique with free wigs, hats, and other items;
wellness programs such as yoga and water aerobics;
resource guides; numerous volunteers who provide
assistance to cancer patients and their families at
the Cancer Resource Center and at Cayuga Medical
Center; and an experienced, caring local staff.
(www.crcfl.net)
Cancer Resource Room is located at Cayuga
Medical Center on the first floor of the adjacent
medical office building. The resource room is
operated by Cayuga Medical Center through an
affiliation with the Cancer Resource Center of the
Finger Lakes, which serves as the lead agency for
this service. The room is open daily to provide
support, information, and respite to people with
cancer and their loved ones.
Cancer Services Program of Cortland and
Tompkins Counties helps those with little or no
health insurance gain access to services to reduce the
risk of breast, cervical, prostate, and colorectal cancers. For more information please call (607) 758-5523.
Glossary
AJCC Staging:
American Joint Committee on Cancer (AJCC).
Classification of malignant disease to denote how far the cancer has advanced.
Malignancy is categorized by (T) Tumor, (N) Nodes, and (M) Metastasis.
Analytic:
Patients diagnosed and/or any of their first course of treatment administered at CMC.
Non-Analytic:
Patients diagnosed and first course treatment administered elsewhere.
Patients with pathology or lab specimens only.
First Course of Treatment: Initial cancer-directed treatment or series of treatments planned and usually
initiated within four months of diagnosis or as determined by the physician.
Observed Survival: Estimate of the probability of surviving all causes of death for a specified time
interval calculated from the cohort of cancer cases.
NCCN:
National Comprehensive Cancer Network clinical practice guidelines.
References:
1. Cancer Facts & Figures 2014. American Cancer Society.
2. National Cancer Data Base (NCDB).
3. American Joint Committee on Cancer Staging Manual
8
Cayuga Cancer Center
101 Dates Drive
Ithaca, NY 14850
(607) 274-4397
www.cayugamed.org