Annual Report - Parkview Health

PARKVIEW CANCER 2015
ANNUAL REPORT
HOPE & HEALING IS
AROUND EVERY CORNER.
CANCER COMMITTEE
Physicians
David Trenkner, MD, Chair, Radiation
Oncology Associates
Doug Gray, MD, FACS, Parkview Physicians Group —
Cardiovascular Surgery
Sean Garrean, MD, Cancer Liaison
Physician, Parkview Physicians Group —
Colon & Rectal Surgery
Richard Kelty, MD, Parkview Physicians Group —
Family Medicine
Mahmoud Afifi, MD, Parkview Physicians
Group — Hematology & Oncology
Adeline Deladisma, MD, Parkview
Physicians Group — Breast Surgery
Community Representatives
Seung Soo Kim, MD, Allied Hospital Pathologists
Kevin Lowe, MD, Parkview Physicians Group —
Surgical Oncology
William Petty, MD, FWRadiology
Stephen Schreck, MD, ENT Specialists
Neil Sharma, MD, Parkview Physicians Group —
Gastroenterology
Donald Urban, MD, FACS, Parkview Physicians
Group — Urology
Clevis Parker, MD, HMA, FAAFP, ABHPM, Medical
Director, Parkview Physicians Group — Palliative Care
and Parkview Home Health & Hospice
TJ Krasun, Community Program
Representative, Great Lakes Division Inc.,
American Cancer Society
Marsha Haffner, Director of Clinical Services,
Cancer Services of Northeast Indiana
TABLE OF
CONTENTS
4 HOPE & HEALING:
A LETTER FROM MIKE PACKNETT
5
COLON CANCER QUALITY STUDY
GI/ONCOLOGY CLINIC
11
A NEW HOPE: CONTINUING THE FIGHT
12
EDUCATION, PREVENTION AND SCREENINGS
14
QUALITY OF CARE BENCHMARKS
Parkview Staff
Lauren Bodnar, RN, BSN, Nurse Navigator | Jill Branning, RHIT, CTR, Certified Tumor Registrar/Cancer Data Coordinator | Jean Dyben, RN, OCN,
Conference (Symposium) Coordinator | Nancy Ehmke, RN, MN, AOCN, Oncology Nurse Specialist | Mara Fisher, Cancer Conference (Tumor Board)
Coordinator | Rae Gonterman, RN, MSN, VP – Operations, Cancer Program Administrator | Heather Hicks, BS Biol, AS Chem, Quality/Accreditation
Coordinator | Breck Hunnicutt, RN, BSN, CCRC, Research Coordinator | Debi Kennedy, Community Outreach Coordinator | Jackie Kintz, RHIT, CTR,
Cancer Registrar | Melissa Mishler, RHIT, CTR, Cancer Registrar | Rebecca Nelson, MS, Genetic Counselor | Amy Poole, RN, BSN, Director, Parkview
Oncology Supportive Services | Jill Richey, MBA, BS, RT(T), Director, Parkview Radiation Oncology | Amy Spallinger, LMSW, Psychosocial Services
Coordinator | Kathryn Felts, RN, MSN, ACHPN, Palliative Care/Hospice
This annual report was published in December 2015. It describes activities from throughout the year and reports 2014 Cancer Registry data.
HOPE & HEALING:
A LETTER FROM MIKE PACKNETT
In collaboration with our physicians, board
members and Parkview leaders, we are
excited to announce that we will invest in a
new state-of-the-art, patient-centered and
physician-led cancer facility. This represents
our commitment to those we serve. What
happens inside the facility is the heart of
our program.
Mike Packnett
CEO and President
Parkview Health
David Trenkner, MD
Radiation Oncology Associates
Parkview Cancer Committee Chair
Cancer has the ability to take over your life
the information in this report is evidence of the work
and the lives of those who are close to you.
done by Dr. Trenkner, the Cancer Committee and
As healthcare providers, we are called to
everyone involved in the Parkview cancer program.
offer hope and healing, and to control
I am deeply appreciative of Dr. Trenkner’s dedication
the uncontrollable.
and leadership.
I am deeply grateful for the commitment of our
In collaboration with our physicians, board members
co-workers, physicians and Board of Directors who
and Parkview leaders, we are excited to announce that
believe in providing the absolute best care possible for
we will invest in a new state-of-the-art, patient-centered
patients and families living with cancer. I’m thankful
and physician-led cancer facility. This represents our
we’re able to help those who are living longer to lead
commitment to those we serve. What happens inside
more fulfilling lives. Because of our commitment, the
the facility is the heart of our program. We are creating
communities we serve have increasingly continued to
a healing environment that promotes comfort, hope
trust us in the care we provide.
and confidence while providing patients and families
One of our physicians, David Trenkner, MD, has made
the commitment to provide the care trusted by our
patients. His commitment to patients is demonstrated
through his daily interactions and focus on patient care.
Dr. Trenkner has served as Chairman of the Parkview
Cancer Committee since it was formed in 2001. Under
his leadership, other physicians and staff have diligently
worked to improve cancer care at Parkview.
Dr. Trenkner plans to retire at the end of this year. I
know he will be missed by patients and staff. Much of
4
I
Hope & Healing: A Letter from Mike Packnett
with access to specialized cancer care, physicians and
providers. This facility will be designed to deliver clinical
and supportive experiences for patients and families
that are unequalled throughout this region. The right
care navigators, physicians and other resources in one
environment, streamlined like never before, will help our
patients and their families focus on what is important — the
healing process, taking control and fearing less.
QUALITY STUDY: COLON CANCER SCREENING
RATES AMONG PRIMARY CARE PHYSICIANS
In the United States, colorectal cancer is
the third most likely cancer to be diagnosed.*
An estimated 132,700 newly diagnosed colorectal
cancers will occur this year. In Indiana, 2,890 new
diagnoses are predicted. In addition, 23 million
appropriately aged adults are not being screened
according to published guidelines (*excludes skin
cancer, American Cancer Society, 2015).
Heather Hicks, BS Biol, AS Chem
Quality/Accreditation Coordinator
Parkview Comprehensive Cancer Center
An evaluation of current internal colorectal cancer
had evidence of screening that was documented in a
screening rates, as compared to publicly reported
discrete manner that could be captured in a report. An
benchmarks, indicated an opportunity for improvement,
additional 25 percent of charts were identified as having
not only for screening, but also for documentation of
had appropriate screening. However, this documentation
that screening. For these reasons, the Parkview Cancer
was contained largely in narrative notes and could not
Committee identified colon cancer screening rates among
be easily identified without an exhaustive manual search.
primary care providers to be one of our 2015 studies of
Specifically, 197 patient charts contained evidence of
quality.
meeting this best practice measure in the documentation.
In collaboration with the Parkview Physicians Group
Quality Department, data was reviewed from a 2014
retrospective audit of 411 patient charts related to
best practice quality measurement of colon cancer
These results support the need for colon cancer
screening documentation to have discrete data fields
and standardized documentation for monitoring and
reporting for internal and external measurements.
screening. Of the 411 charts, approximately 23 percent
Continued on the following page.
Quality Study: Colon Cancer Screening Rates Among Primary Care Physicians
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5
QUALITY STUDY: COLON CANCER SCREENING
RATES AMONG PRIMARY CARE PHYSICIANS continued
The committee formed a workgroup to
modify the alerts in the EHR to make them
more meaningful and user-friendly, with
the ultimate goal being improved screening
rates and documentation.
Kelly Hammons
Quality Manager
Parkview Physicians Group
Clinical decision support alerts, referred to as health
that the average colon cancer screening compliance rate
maintenance (HM) and best practice advisories (BPA),
for 2015 was not a true representation of our colon cancer
exist within the electronic health record (EHR) to assist
screening rates due to the inability of the EHR to capture
clinical staff in identifying when patients are due for
screenings completed prior to implementation of the
screenings. If a patient between the ages of 50 and 75
current electronic record. To offset this problem, certified
years is seen in the office and has no record of colorectal
medical assistants were hired to update medical health
cancer screening in the EHR, an alert appears for the
records for colon cancer screening. While this process
clinical end-user to address the need for screening
improvement effort is ongoing, the provider performance
with the patient at the office visit. The alert gives the
rate for colorectal cancer screening has improved, on
opportunity to order a screening for the patient or
average, by 23.2% as a result of the efforts to date.
identify that the patient completed the screening. The
order set that is part of this alert aligns with the National
Comprehensive Cancer Network’s guidelines for colorectal
cancer screening and accommodates follow-up options for
References
patient-specific risk.
American Cancer Society (2015). Cancer Facts and Figures.
When opportunity for improved documentation
American Cancer Society (2015). 80% by 2018: Effective messaging to
reach the unscreened [communication guidebook].
was identified, the committee realized that the HM
and BPAs were not user-friendly. The committee formed a
workgroup to modify the alerts in the EHR to make them
National Comprehensive Cancer Network (2012). Colorectal cancer
screening [NCCN clinical practice guidelines in oncology: NCCN
guidelines]. (2012)
more meaningful and user-friendly, with the ultimate goal
being improved screening rates and documentation.
The Parkview Physicians Group Quality Department found
6
I
Quality Study: Colon Cancer Screening Rates Among Primary Care Physicians
ENDOSCOPIC ONCOLOGY CLINIC
AND GI ONCOLOGY PROGRAM
In 2013, the Parkview Cancer Committee set a programmatic
goal to develop and implement an endoscopic oncology
multidisciplinary clinic and build a formal GI Oncology Program.
Since then, the clinic has provided care to more than 300 patients.
Neil Sharma, MD
Parkview Physicians Group —
Gastroenterology
Recognizing the Complexity and Impact of Cancer
• Stomach cancer
The social and medical intricacy of cancer is profound. A
• Pancreatic cancer
cancer diagnosis impacts not only the individual, but also
their family and friends. Cancer is a complex collection
of different diseases that can affect all parts of the body
but share some similar features that require high-level,
multidisciplinary care. Keeping these facts in mind, the
• Rectal cancer
• Ampullary cancer
• Supportive/palliative treatments for colon cancer
clinic aims to provide a novel approach to the care of
The program aims to quickly see new patients who
GI cancers through an emphasis on the incorporation
may have a GI cancer; establish a diagnosis, stage and
of innovative tertiary treatments, multidisciplinary
treatment plan within two weeks; and begin the treatment
coordination and psychosocial/nutritional support, with
process. These integral steps of cancer care are at the
healthcare professionals at the patient’s side from the
core of the design for the GI Oncology Program. The
moment he or she receives a cancer diagnosis.
EOC guides and expedites patients through these steps
on their journeys. In the following pages, you can read
about Richard Haas’ battle with pancreatic cancer. To
Endoscopic Oncology Clinic
say he benefitted from the coordinated efforts, improved
The Endoscopic Oncology Clinic (EOC) is the backbone
communication and quality of the GI Oncology Program is
of the GI Oncology Program. It focuses on providing
an understatement. He survived and continues to thrive.
care to patients with specific types of cancers and
The clinic also allows for the incorporation of innovative
tumors, including:
treatments, clinical trials and research.
• Esophageal cancer
• Cholangiocarcinoma
Continued on page 9.
Endoscopic Oncology Clinic and GI Oncology Program
I
7
ENDOSCOPIC ONCOLOGY CLINIC
AND GI ONCOLOGY PROGRAM continued
EOC & GI Oncology Program Flow Chart
REFERRAL
PCP referral for
suspected cancer:
•
•
Patient’s imaging, labs and clinic notes
sent as direct referral to
Mass on endoscopy
Mass on imaging
Referrals from:
•
•
•
•
•
Endoscopic Oncology Clinic (EOC)
GI specialists
General surgeons
PCPs
VA Hospital
Other (oncology)
Case reviewed (labs, notes, reposts,
imaging) by Dr. Sharma
Surgical Oncology
DIAGNOSIS & STAGING
Advanced interventional endoscopy for
definitive diagnosis & initial treatment
Order as needed:
•
•
•
MULTIDISCIPLINARY
PLANNING & TREATMENT
FOLLOW-UP WITH
PATIENT & COORDINATION
OF CARE WITH PATIENT
SUPPORT SERVICES &
SURVEILLANCE
Additional CT / MRI / PET, etc.
Endoscopy / IR procedures
Labs
Tumor Board presentation
Tumor Board letter
I
•
•
•
•
Medical Oncology
Radiation Oncology
Surgical Oncology
Palliative Care
Review of final staging & treatment plan
with the patient
(follow-up at Endoscopic Oncology Clinic)
PRN - Initiation
of additional
endoscopic
treatment options
(stents, ablation,
etc.)
8
Referrals made from EOC to:
Endoscopic Oncology Clinic and GI Oncology Program
Follow-up 3-4
months posttreatment for
evaluation and
surveillance
Supportive meetings in
EOC with:
•
•
•
•
•
Nurse navigator
Nutrition
Genetics
Social work
Research and trials
ENDOSCOPIC ONCOLOGY CLINIC
AND GI ONCOLOGY PROGRAM continued
Clinic Process
Patients with a suspected cancer (either based on clinical
Once the stage and diagnosis are determined, the case
symptoms or imaging) may be directly referred for case
is reviewed by a team of cancer specialists at the Tumor
review. The case — including outside labs and imaging
Board, which is comprised of pathologists, radiologists,
— is reviewed within 24 to 48 hours by Neil Sharma, MD.
an advanced interventional endoscopist, radiation and
No further referrals are required by the primary care
medical oncologists, and surgical oncologists. Together,
physician or other referring specialist.
they determine the best multidisciplinary treatment
If deemed appropriate, the patient will be scheduled for
additional labs or imaging, and then for procedures to
complete the diagnostic evaluation within the next week.
The diagnosis and initial staging is obtained via minimally
invasive, innovative procedures such as cholangioscopy,
confocal laser endomicroscopy, and endoscopic
ultrasound-based procedures with on-site pathology
plan based upon national guidelines and the patient’s
individual needs. Tumor Board discussion also allows for
physicians interested in GI oncology care to learn about
new treatment offerings from various specialties. They
can avoid unnecessary treatments, which could increase
morbidity rates and costs but do little to improve the
overall quality of life for their patients.
conferencing. These procedures and skills are offered only
at high-level tertiary care cancer centers. If additional
testing is needed, Dr. Sharma and his staff order them.
Continued on the following page.
Endoscopic Oncology Clinic and GI Oncology Program
I
9
ENDOSCOPIC ONCOLOGY CLINIC
AND GI ONCOLOGY PROGRAM continued
It is the goal of the GI Oncology Program to perform
multidisciplinary Tumor Board review for at least 90
to 100 percent of all foregut GI cancer cases, which
are seen through referrals to the clinic. Every case has
the opportunity for multidisciplinary review, unless the
patient and family wish not to do so.
Tumor Board review allows for:
• Confirmation of diagnosis and stage
• Additional input from all specialties
• Incorporation of novel treatment technologies
• Incorporation of clinical trials and research
• Decreased time to treatment for patients
• Incorporation of palliative care, nutrition, navigation
and other supportive services
• Coordination of care and follow-up between specialties
• Fewer unnecessary visits and waiting for patients
• Avoidance of excess treatments, which have significant
cost but limited benefit to the patient
• Coordination of complex care
endoscopic palliative treatments, such as enteral stents,
cryoablation and endoscopic resection, are employed on
a case-by-case basis.
Patients may be incorporated into open research trials,
registries and databases because they come through the
clinic. This improves patient tracking and downstream
care for future patients. The clinic also performs follow-up
and surveillance post-treatment, as needed.
Dr. Sharma takes the input from the Tumor Board, all of
the staging workup, final diagnosis and clinical stage,
and places it into a Tumor Board letter. This letter is then
sent to referring physicians, primary care providers, and
all treatment physicians to make sure the appropriate
treatments are initiated and communication is maximized.
The Tumor Board letter prevents redundant testing and
can also be used as a summary letter, should the patient
need to coordinate care with another center.
is turned around in approximately two weeks for most
patients. The process of the EOC is revolutionary in
cancer care and sets our GI Oncology Program apart
from the rest. We constantly evaluate outcomes,
processes and patient experience. We are committed
to growth and evolution for continuous improvement.
Foregut GI cancer cases are extremely complex and often
have worse outcomes. The Endoscopic Oncology Clinic
is determined to be the vehicle that improves patient
The patient is then scheduled for a visit in the
experience, expedites and coordinates their care, and
Endoscopic Oncology Clinic (EOC), where the diagnosis
improves outcomes.
and treatment plan is reviewed. The patient has the
opportunity to meet with a patient nurse navigator,
nutrition specialist and a social worker. Innovative
10
One referral initiates this process of cancer care, which
I
Endoscopic Oncology Clinic and GI Oncology Program
A NEW HOPE:
CONTINUING THE FIGHT
Richard Haas nearly lost all hope when
doctors found a mass on the back of his
pancreas during an MRI to look at his kidneys
in 2013. You can imagine his fear. No one
wants to hear “you,” “mass” and “pancreas”
in the same sentence.
Richard Haas
Cancer Survivor
Richard wanted to pursue life, but his expectations, desires
Dr. Sharma presented Richard’s case to the Tumor Board,
and ambitions were fading after talking to doctors. “The
that agreed on a course of treatment. Surgical oncologist
discovery of a mass like this wipes out your future,” he said.
Alan Yahanda, MD, FACS, performed a resection of
One of his doctors referred him to the newly formed
Endoscopic Oncology Clinic at Parkview Comprehensive
Cancer Center to see Neil Sharma, MD, an advanced
interventional endoscopist. The multidisciplinary clinic is
designed to improve communication, patient experience,
quality and coordination of care. Here, patients receive
Richard’s pancreas and spleen. Then, even though all
evidence of the mass had been removed, Richard still went
through chemotherapy under the care of Shalini Chitneni,
MD, and intensity-modulated radiation therapy (IMRT),
one of the most precise and sophisticated radiotherapy
treatments in the world.
clinical and emotional support from physicians, patient
Richard appreciated the extra support and communication
navigators, dietitians and social workers.
he received from Parkview co-workers along the way. He
also liked having all his treatments in one location — only
Dr. Sharma recommended an endoscopic ultrasound
evaluation and transgastric biopsy. The non-surgical
procedure utilized advanced technologies to better
evaluate his condition. At the time, Richard was scared and
ready to throw in the towel, but didn’t. “Dr. Sharma gave
us enough hope that we felt it was worth continuing the
fight,” he said.
And so he continued with the recommended procedure.
Dr. Sharma found a 3-centimeter mass on the back of
Richard’s pancreas and sent a spot for biopsy. Afterward,
40 miles from home.
“You have to have hope when you go through that. You
can’t believe it’s a lost cause. You have to feel that there’s
a chance of winning the fight,” Richard said. “The staff at
Parkview was just super. They were there just when you
needed them all the time.”
Today, Richard is cancer-free, thanks to the dedicated
physicians, nurses and other healthcare workers at
Parkview. He says he’s healthier than he’s ever been.
Dr. Sharma ordered additional imaging and labs, and
diagnosed Richard with pancreatic cancer.
A New Hope: Continuing the Fight
I
11
EDUCATION, PREVENTION AND SCREENINGS
The purpose of Francine’s Friends is to
provide mobile mammography screening
and follow-up services to every woman
who might otherwise not have access. The
program aims to increase cancer screenings
in Northeast Indiana by providing a highly
accessible and visible community resource.
Francine’s Friends Mobile Mammography unit.
Parkview Comprehensive Cancer Center recognizes that
cancer screenings. The SmartLung CT lung cancer
screening, education and prevention play an important
screening program reached 194 people in 2015. This
role in the battle against cancer. Early detection of cancer
brings the total screened to 363 since its implementation
means treatment can start sooner, which can increase a
in September 2013.
patient’s chances of survival. Our education and prevention
programs assist individuals in the process of identifying
cancer risk factors. The programs also provide information
to help them decrease their risk of developing cancer.
We reached more than 4,400 individuals with cancer
education and prevention information in 2015, an increase
of more than 12 percent over 2014 figures.
In 2015, a total of 3,460 women have been screened
through Francine’s Friends Mobile Mammography
program as of October 31. And since its inception in
2005, almost 34,000 women have been screened.
The mobile mammography program is a partnership
between Parkview Health, Breast Diagnostic Center and
Francine’s Friends. It continues to make mammograms
From January to November 2015, Parkview reached more
accessible for women at a growing number of sites
than 500 individuals with free skin, oral and prostate
throughout the area.
12
I
Education, Prevention and Screenings
Cancer Screenings
Screenings from January 1 — October 31, 2015
SKIN CANCER
284
ORAL CANCER
101
PROSTATE CANCER
165
194
LUNG CANCER
0
20 40 60 80 100 120 140 160 180200220 240260280 300
Mammograms
Francine’s Friends Mobile Mammography Coach — As of October 31, 2015
5,000
4,278
4,000
4,557
4,171
3,776
3,000
3,262
3,326
2009
2010
3,460
2,947
2,263
2,000
1,917
1,000
0
Dec. 2005 –
2007
2008
2011
2012
2013
2014
2015
Dec. 2006
Education, Prevention and Screenings
I
13
COMMISSION ON CANCER BENCHMARKS AND
PARKVIEW CANCER CENTER’S RESULTS
(AS OF OCTOBER 30, 2015)
Parkview Comprehensive Cancer Center’s Cancer
coordination of patient care in the multidisciplinary
Registry collects and reports data to the Commission
setting. This process also fosters pre-emptive awareness
on Cancer (CoC) on an ongoing basis. The Cancer
for quality patient care. This chart shows the CoC
Committee utilizes the information from the CoC
benchmark standard and our cancer program’s result for
reports to assess and improve clinical management and
the seven metrics listed below.
Commission on Cancer (CoC) Metrics
Image or palpation-guided needle biopsy (core or FNA) of the
primary site is performed to establish diagnosis of breast cancer
CoC Benchmark
Parkview Cancer
Center Results
80%
86.7%
90%
91.6%
90%
91.4%
90%
91.4%
90%
92.9%
90%
94.1%
85%
90.8%
Tamoxifen or third generation aromatase inhibitor is
considered or administered within 1 year (365 days) of diagnosis
for women with AJCC T1c or stage IB-III hormone receptor
positive breast cancer
Radiation therapy is considered or administered following any
mastectomy within 1 year (365 days) of diagnosis of breast
cancer for women with >+ 4 positive regional lymph nodes
Radiation is administered within 1 year (365 days) of diagnosis
for women under the age of 70 receiving breast conservation
surgery for breast cancer
Combination chemotherapy is considered or administered
within 4 months (120 days) of diagnosis for women under 70
with AJCC T1cNO, or stage 1B-III hormone receptor negative
breast cancer
Adjuvant chemotherapy is considered or administered within 4
months (120 days) of diagnosis for patients under the age of 80
with AJCC stage III (lymph node positive) colon cancer
At least 12 regional lymph nodes are removed and pathologically
examined for resected colon cancer
14
I
Commission on Cancer Benchmarks and Parkview Cancer Center’s Results
PRIMARY SITE TABLE – 2014 CASES
This table represents the total number of cancer cases diagnosed and/or treated at Parkview Hospital
in 2014. The table is categorized by primary cancer site and stage (extent of disease at diagnosis).
Sites highlighted are Parkview’s top 4 primary sites for 2014.
STAGE
Anatomic Site
0
I
II
III
IV
NA
UNK
Total
% Total
HEAD AND NECK
Lip
0 2 0 0 0 00
2
0.12
Tongue
2
3
1
0
7
0
0
13
0.76
Salivary Gland
0111 1 1
0 5 0.29
Floor of Mouth
0
0
0
0
0
0
0
0
0.00
Gum and Other Mouth
0
0
0
0
2
0
0
2
0.12
Nasopharynx
0000 0 0
0 0
0.00
Tonsil
0000 5 0
2
7
0.41
Oropharynx
0000 0 01
1
0.06
Hypopharynx
1000 3 0
0 4
0.23
Other Oral Cavity and Pharynx
0
0
0
0
0
0
0
0
0.00
DIGESTIVE SYSTEM
Esophagus
0 4 3 8 6 09
30
1.75
Stomach
0252 1 0
4 14 0.82
Small Intestine
0
1
1
3
1
0
2
8
0.47
Colon
9
26
45
31
14
0
7
132
7.72
Rectosigmoid Junction
0
6
8
5
0
0
0
19
1.11
Rectum
2
4
10
17
6
0
8
47
2.75
Anus, Anal Canal and Anorectum
0
1
2
0
1
0
2
6
0.35
Liver
0
2
1
1
0
2
3
9
0.53
Intrahepatic Bile Duct
0
0
0
0
3
1
1
5
0.29
Gallbladder
0
0
0
1
1
0
0
2
0.12
Other Biliary
0000 2 0
4 6
0.35
Pancreas
0
10
8
1
19
0
11
49
2.87
Retroperitoneum
0000 0 0
0 0
0.00
Peritoneum, Omentum and Mesentery
0
0
0
2
0
0
2
4
0.23
Other Digestive Organs
0
0
0
0
0
0
0
0
0.00
RESPIRATORY SYSTEM
Nose, Nasal Cavity and Middle Ear
0
0
0
0
0
0
0
0
0.00
Larynx
0
6
3
3
3
0
0
15
0.88
Lung, Bronchus - Small Cell
0
1
1
7
29
0
9
47
2.75
Lung, Bronchus - Non-small Cell
1
60
23
31
97
0
59
271
15.85
Lung, Bronchus - Other Types
0
1
1
0
4
0
0
6
0.35
Pleura
0000 0 0
0 0
0.00
Trachea, Mediastinum, Other Respir.
0
0
0
0
0
0
0
0
0.00
BONES AND JOINTS
Bones and Joints
0
0
0
0
1
2
0
3
0.18
SOFT TISSUE INCLUDING HEART
Soft Tissue Including Heart
0
2
0
0
0
1
2
5
0.29
SKIN EXCL BASAL AND SQUAMOUS
Melanoma - Skin
11
14
9
6
3
0
2
45
2.63
Other Rare Skin Types
0
1
0
0
0
1
0
2
0.12
BREAST
Breast
41
108
100
25
6
0
1
281
16.43
FEMALE GENITAL SYSTEM
Cervix
2 7 0 5 1 03
18
1.05
Uterus
2
51
4
4
3
0
4
68
3.98
Ovary
0
8
3
7
3
1
1
23
1.35
Vagina
0000 1 0
0
1
0.06
Vulva
8
8
1
1
1
0
1
20
1.17
Other Female Genital Organs
0
0
0
0
0
0
0
0
0.00
MALE GENITAL SYSTEM
Prostate
0
17
48
7
12
0
9
93
5.44
Testis
0 3 1 1 0 00
5
0.29
Penis
0010 00
0 1
0.06
Other Male Genital Organs
0
0
0
0
0
0
0
0
0.00
URINARY SYSTEM
Bladder
3724 10 1
1 0 1
74
4.33
Kidney and Renal Pelvis
0
40
3
14
8
0
3
68
3.98
Ureter
1
2
2
0
1
0
0
6
0.35
Other Urinary Organs
1
0
0
0
0
0
0
1
0.06
EYE AND ORBIT
Eye and Orbit
0
0
0
0
1
0
0
1
0.06
BRAIN AND OTHER CNS
Brain
0000 078
0 78 4.56
Other CNS
0000 0 10
1
0.06
ENDOCRINE SYSTEM
Thyroid
027 8 4 6 01
46
2.69
Other Endocrine, Thymus
0
0
0
0
1
6
0
7
0.41
LYMPHOMA
Hodgkin - Nodal
0
1
1
0
0
0
4
6
0.35
Hodgkin - Extranodal
0
0
0
0
0
0
1
1
0.06
NHL - Nodal
0
3
5
5
5
0
23
41
2.40
NHL - Extranodal
0
3
6
1
1
1
10
22
1.29
MYELOMA
Myeloma
0000 022
0 22
1.29
LEUKEMIA
Acute Lymphocytic Leukemia
0
0
0
0
0
1
0
1
0.06
Chronic Lymphocytic Leukemia
0
0
0
0
0
5
0
5
0.29
Other Lymphocytic Leukemia
0
0
0
0
0
1
0
1
0.06
Acute Myeloid Leukemia
0
0
0
0
0
9
0
9
0.53
Acute Monocytic Leukemia
0
0
0
0
0
2
0
2
0.12
Chronic Myeloid Leukemia
0
0
0
0
0
3
0
3
0.18
Other Myeloid/Monocytic Leukemia
0
0
0
0
0
2
0
2
0.12
Other Acute Leukemia
0
0
0
0
0
5
0
5
0.29
Aleukemic, Subleukemic and NOS
0
0
0
0
0
0
0
0
0.00
MESOTHELIOMA/KAPOSI SARCOMA
Mesothelioma
0000 0 2
0 2
0.12
Kaposi Sarcoma
0000 0 0
0 0
0.00
MISCELLANEOUS
Miscellaneous
0000 037
0 37
2.16
TOTALS
TOTALS
118 449 315 194 260 184190
1710
100.00
•Highlights are the top 4 sites
Primary Site Table – 2014 Cases
I
15
Parkview Health
10501 Corporate Drive
Fort Wayne, IN 46845
NON-PROFIT ORG.
U.S. POSTAGE
PAID
FORT WAYNE, IN
PERMIT NO. 1424
Accredited as a Comprehensive Community
Cancer Program by the American College of
Surgeons since 2006.
www.parkview.com/cancer