2013 Annual Report

Transcription

2013 Annual Report

2013
A YEAR IN REVIEW
Experience Excellence.
MICHAEL HASSELLE, M.D
Radiation Oncology
_____________________________________________
Anderson Cancer Institute
Memorial University Medical Center
MEDICAL SCHOOL
Emory University
Atlanta, Georgia
RESIDENCY
Radiation & Cellular Oncology
University of Chicago
Chicago, Illinois
Stereotactic Radiation
University of Colorado
Aurora, Colorado
Brachytherapy
Memorial Sloan Kettering
Cancer Center
New York, New York
Thoracic and Skin Malignancy
Peter MacCallum Cancer Center
Melbourne, Australia
BOARD CERTIFICATION
2 | ACI 2013 YEAR IN REVIEW
Radiation Oncology
A MESSAGE FROM
THE PHYSICIAN-IN-CHIEF
It is my pleasure to present the 2013 annual report of the Curtis and Elizabeth
Anderson Cancer Institute (ACI) at Memorial University Medical Center.
In 2013, we continued our strong commitment to the mission of providing
safe, comprehensive, and excellent oncology care to patients and families in
southeast Georgia and South Carolina. This year’s annual report highlights
the significant expansion of our programs in breast oncology and endocrine
surgery. In our breast program, for more than 20 years, Drs. Ray Rudolph and
Paula DeNitto have provided outstanding surgical care to women with breast
diseases. This includes the development of the region’s first intraoperative
radiation therapy program (IORT). With the addition of Dr. Elena Rehl, the
program has experienced significant growth and has attracted national recognition.
Improvements in radiation therapy hardware are important but are only as effective as the “software”
used to precisely calculate the doses. Working with the region’s only
board-certified radiation medical physicists, we are able to provide
extra measures of safety to all our patients.
You will see how this highly skilled radiation oncology team
partners with oncologic and reconstructive surgeons to provide the
best possible outcomes.
Working with the region’s
only board-certified radiation
medical physicists, we are able
to provide extra measures of
safety to all our patients.
The increased clinical growth has supported the expansion of the breast cancer basic sciences program
under the direction of Dr. Himanshu Bose at the Mercer University School of Medicine, Savannah campus.
Patients with thyroid and parathyroid tumors also have the benefit of an experienced multidisciplinary
team, thanks to the addition of endocrinologist Dr. Ismary De Castro to the Metabolic Institute, combined
with my own expertise in thyroid and parathyroid surgery.
This is just a brief introduction to the progress we made in 2013. I am extremely proud to be one of the
dedicated professionals of the Curtis and Elizabeth Anderson Cancer Institute committed to excellence
in comprehensive cancer care. Please contact me with any thoughts regarding your experiences at the
ACI and how we can continue to improve our programs.
M . D. , P H . D. , M B A , FA C S
V I C E P R E S I D E N T O N C O L O G Y P R O G R A M S | P H Y S I C I A N - I N - C H I E F, A C I
G U Y P E T R U Z Z E L L I @ M E M O R I A L H E A LT H . C O M
] Since adding to our team of experts was a defining accomplishment of 2013, we take this
opportunity to introduce you to four of our newest stars in the opening pages of this report.
ACI 2013 YEAR IN REVIEW | 3
GUY PETRUZZELLI,
KELSEY JOHNSON,
M.S., CGC
Genetic Counseling
_____________________________________________
EDUCATION
B.S., Biology
Centre College
Danville, Kentucky
M.S., Genetic Counseling
South Carolina School of Medicine
Columbia, South Carolina.
BOARD CERTIFICATION
Genetic Counseling
CURTIS AND ELIZABETH ANDERSON
A MESSAGE FROM
THE ANDERSONS
In the 12 years since we opened the Curtis and Elizabeth Anderson
Cancer Institute (ACI) at Memorial University Medical Center, we’ve
seen many changes in the war against cancer. Treatments have
become more effective. Technology has improved. Lives have been
saved. But cancer continues to affect us all. It is a disease that creeps
into our lives when we least expect it, and changes us forever.
Whether you have battled cancer yourself, or cared for a loved one
with cancer, you know that the war is far from over. And so we continue
to fight. We fight in memory of the people we’ve lost. We fight with the
hope that one day we will find a cure for this disease. We fight alongside
our community, our supporters, and the entire team at the ACI.
In recent years, the ACI has acquired intraoperative radiation therapy, a TrueBeam linear accelerator,
and SPY Elite surgical equipment, all of which make treatment more
effective and convenient for patients. But we know that the best
equipment in the world is useless without top-notch professionals to
drive the program. It takes both talent and tools to make a successful
cancer center, and the ACI has captured that synergy.
It takes both talent and
tools to make a successful
cancer center, and the ACI
has captured that synergy.
In 2013, we saw an outstanding young radiation oncologist join our team. We saw our thriving
breast surgery practice expand with another talented surgeon. The radiology practice we work with
brought us an impressive specialist to review mammograms. And we added a highly regarded genetic
counselor to our team.
This annual report highlights some of the amazing professionals at the ACI. In the war against
cancer, they are on the front lines. They are guiding patients through treatment, supporting families,
and making strides in the fight to end this disease.
ELENA T. REHL, M.D., FACS
Breast Oncology
_____________________________________________
Center for Breast Care
Center for Advanced Medicine
MEDICAL SCHOOL
Uniformed Services University
of the Health Sciences
F. Edward Hébert School of Medicine
Bethesda, Maryland
INTERNSHIP
Brooke Army Medical Center,
San Antonio, Texas
RESIDENCY
Tripler Army Medical Center
Honolulu, Hawaii
FELLOWSHIP
Breast Surgery,
Vanderbilt University Medical Center
Nashville, Tennessee
D R . G U Y P E T R U Z Z E L L I , M . D. , P H . D. , M B A , FA C S
A NOTE FROM THE CHAIRMAN
OF THE CANCER COMMITTEE
This year I had the great privilege of being selected as the new chairman of the Cancer Committee at
Memorial University Medical Center (MUMC). As expected, under the administrative leadership of Ms. Karen
Terry, I found the Cancer Committee to be a highly structured, well-functioning, and efficient team. As one
of the important standing committees of the Memorial Medical Staff, the Cancer Committee is charged
with ensuring safe, effective, and quality cancer care throughout the region. The Cancer Committee also
ensures maintenance of certification by the Commission on Cancer of the American College of Surgeons,
fosters an environment of scientific inquiry, and provides a patient-centric care environment.
This year saw increases in clinical volumes in our gastrointestinal, head and neck, endocrine and breast
programs. Our breast oncology program continues to be the regional signature program in comprehensive
breast care. We were fortunate this year to add Dr. Elena Rehl from Vanderbilt University to the Center
for Breast Care team. Dr. Rehl is a fellowship-trained breast surgeon with experience in all aspects of
contemporary breast care. Her passion for excellence in patient care is already being felt in the region.
Another growing program is our head, neck and endocrine tumor service. In conjunction with our
colleagues in endocrinology, oral surgery, and plastic/reconstructive surgery, we evaluated almost 200
patients with tumors of the head and neck, thyroid, and parathyroid glands.
Patient and family centered care (PFCC) is at the core of the Curtis and Elizabeth Anderson Cancer
Institute (ACI) at Memorial University Medical Center. The year 2013 proved to be focused on increasing
the ACI’s commitment to providing patient and family centered care. The ACI added a patient and family
advisory board, increased the number of integrative therapy modalities
offered, and began growing a survivorship program. The patient and
family advisory board is comprised of patients and their family members
who have had a variety of experiences at the ACI. The board meets
monthly and is charged with providing feedback on a chosen topic.
Our breast oncology program
continues to be the regional
signature program in
comprehensive breast care.
The feedback received from the advisory board has led to the ACI implementing changes in patient
education, physical signage for easier navigation, and the addition of a peer support program.
By 2022 there will be an estimated 18 million cancer survivors in the U.S. Recognizing the growing
needs of cancer survivors, in 2013 the ACI began a survivorship lecture series. At the ACI we recognize that
the needs of our patients change as a patient progresses through diagnosis, treatment, and then into a
to survivors (i.e. nutrition, financial coaching, exercise, late effects, etc.).
The integrative therapies program is available to all ACI patients and survivors. The programs focus
not just on the physical aspects of oncology care but also the psychological and spiritual.
We will not rest on past successes. The Cancer Committee remains focused on continuous improvement
across the entire spectrum of our cancer programs.
period of surveillance. To help meet these needs, the ACI offered educational sessions on topics relevant
ERIC CLAYTON, M.S.
Outcomes Research Coordinator
_____________________________________________
EDUCATION
B.S., Psychology
Appalachian State University
Boone, North Carolina
M.S., Applied Experimental
Psychology
Old Dominion University
Norfolk, Virginia
CERTIFICATION
Certified Clinical Research
Coordinator (CCRC)
2013 DISEASE
MANAGEMENT TEAMS
GI TEAM
Raymond Rudolph, MD—Chair
Blair Baisden, MD
Himangshu Bose, PhD
Deborah Cunningham, MD
Jennifer Currin-McCulloch, LMSW,
OSW-C
Paula DeNitto, MD
John Duttenhaver, MD
Richard Greco, MD
Christopher Haberman, MD
Suzy Harmon, MED
Michael Hasselle, MD
Christopher Hulsey
Amy Jenkins, RN
Kelsey Johnson, MS, CGC
Andrea Jones
Jasmeet Kaur
Colleen Lane, BBA, CTR
Harvey Lebos, MD
Barry Luskey, MD
Vivian Palefsky, RN
Joyce Parrish, PT
Aaron Pederson, MD
Elena Rehl, MD
Julie Reid, RN
L.E. Robertson, MD
Karen Sather, BS, CCRC
Pat Sharpe, RN, MSN, MHA
Jennifer Sili, RN
Karen Terry, MPH, CHES
Donna Thornton, RT(R), BS
Corie Turley, MSPT, CLT-LANA
James Garber, MD—Chair
Patricia Aiken, RN
Blair Baisden, MD
Suzanne Bryan, RN
OSW-C
Sandra Kay Durden, RN
Allen Hardy, MD
Suzy Harmon, MED
DeeDee Johnson, RN
Kelsey Johnson, MS, CGC
Susanne Jonas, CTR
Andrea Jones
Alan Lord, MD
Barry Luskey, MD
Lisa Morgan, RN
Aaron Pederson, MD
Guy Petruzzelli, MD
Julie Reid, RN
L.E. Robertson, MD
Christopher Senkowski, MD
UROLOGY TEAM
Steve Michigan, MD—Chair
Blair Baisden, MD
Buffi Boyd, MD
David Cheng, MD
John Coursey, MD
Michael Cox, MD
OSW-C
Michael Funderburk, MD
Heather Geiger, CTR
Suzy Harmon, MED
Harvey Lebos, MD
Richard Mazo, MD
Ruth Miles, MD
Lisa Morgan, RN
Vivian Palefsky, RN
Aaron Pederson, MD
Julie Reid, RN
Thomas Shook, MD
THORACIC TEAM
Igor Aksenov, MD—Chair
OSW-C
Suzy Harmon, MED
Dariush Heidary, MD
DeeDee Johnson, RN
Suzanne Jonas, CTR
Robert Jones, MD
Mary “Liddy”Lake, RN
Jeremy London, MD
Barry Luskey, MD
Lisa Morgan, RN
Stephen Morris, MD
Vivian Palefsky, RN
Aaron Pederson, MD
James Ramage, MD
Julie Reid, RN
LE Robertson, MD
BREAST TEAM
BREAST CARE AT ACI
Oncology – that is, the medical specialty of treating cancer – is one of the most collaborative fields in all
of medicine. Cancer patients frequently find themselves being cared for by a team of surgeons, radiation
oncologists, and medical oncologists. This is especially true of breast cancer patients at Memorial University
Medical Center’s Center for Breast Care. Here, the surgeons from the only surgical practice in the region that
focuses solely on breast treatment deploy the latest technology as part of a treatment plan – and that
technology often brings other physicians into the picture.
Examples include the SPY Elite device, which helps surgeons envision blood flow to skin flaps. The
plastic surgeon uses this device during the initial surgery to help identify viable tissue and help prevent
complications that can lead to additional surgeries.
The innovative spirit has
remained part of the Center
for Breast Care’s philosophy
since its founding.
Another example is the use of intraoperative radiation therapy, or IORT.
When this device is used (for early stage cancers in women approaching
50 or older who are candidates for lumpectomy instead of mastectomy),
the radiation oncologist joins the surgeon in the operating room. The tip
of the IORT device is placed directly in the tumor bed after the surgeon
removes the lump, and a single large, highly targeted dose of radiation is administered. For many IORT
patients, that is all the radiation therapy their treatment plan will require.
All the new technology in the world, however, means nothing without skilled surgeons who remain
students forever, constantly seeking for better ways of doing things. That drive for innovation was behind
the formation of the Center for Breast Care in 2001, when surgeons Ray Rudolph, M.D., and Paula DeNitto, M.D.,
joined forces to form a practice that focused solely on breast health. The founding surgeons believed at
the time that the local surgical community was moving too slowly to embrace the idea of lumpectomies
instead of full mastectomies in appropriate cases.
The innovative spirit has remained part of the Center for Breast Care’s philosophy since its founding,
but it began to become obvious that some succession planning was called for as the founding physicians
from the practice moved toward retirement. In 2013, Elena T. Rehl, M.D., FACS, was recruited to join the
practice, becoming the third surgeon in the busy office.
Dr. Rehl’s medical career in its earlier phases coincided with her military career. She attended medical
school at the Uniformed Services University of the Health Sciences’ F. Edward Hebert School of Medicine in
Bethesda, Maryland. She interned at Brooke Army Medical Center in San Antonio, Texas, and completed
her residency at Tripler Army Medical Center in Honolulu. Her military career involved stateside postings
as well as tours of duty in Iraq, Germany, and Ghana.
She later completed a breast surgery fellowship at Vanderbilt University Medical Center in Nashville.
Upon moving to Savannah to join the Center for Breast Care, she found herself with big shoes to fill, since
she had been recruited in anticipation of Dr. Rudolph’s planned 2014 retirement.
Paula DeNitto, M.D., FACS; Raymond Rudolph, M.D., MPH, FACS; and Elena Rehl, M.D., FACS
of a practice focused solely on breast health. The infusion of new talent will guarantee that Drs. Rudolph
and DeNitto’s original vision persists as a vital resource in the health scene of Savannah and the
Coastal Empire.
This planned succession demonstrates the staying power of the Center for Breast Care and its concept
R I C H A R D G R E C O, M . D .
BREAST RECONSTRUCTION –
A WOMAN’S CHOICE
The treatment of breast cancer has made incredible progress over the last 100 years.
Surgical removal used to be called “radical mastectomy” because they removed the
entire breast, all the lymph nodes, and the chest wall muscles. Over time the treatment
has been reduced to lumpectomies with radiation therapy or simple mastectomies with
sentinel lymph node dissections. Breast reconstruction has also made equal leaps in
recovery times and outcomes.
The surgeons at the Georgia Institute For Plastic Surgery have assisted the oncologic
breast surgeons at the Curtis and Elizabeth Anderson Cancer Institute in providing cutting
edge reconstruction options to their patients. Memorial University Medical Center was one
of the first hospitals in the Southeast to offer the SPY Elite System to perform intraoperative
blood flow analysis of the mastectomy flaps and the patient’s autologous tissues to reduce complications.
This is just one example of the types of advanced technology offered to the patients of Savannah. Many of
our patients are in the National Institute of Health Post Mastectomy Outcome Study being conducted in
16 university settings. The Georgia Institute For Plastic Surgery is the only private practice setting in this
national study.
In 1993, I helped develop the first "Center of Excellence" for the treatment of breast cancer in Savannah.
The Anderson Cancer Institute has taken that concept to a new level — providing dedicated space to
provide physicians of many specialties the opportunity to see our patients in one location and discuss
their care. Through collaborative efforts, advances have been made that have led to the best treatment
of the underlying cancer, while leading to the best cosmetic reconstruction.
It is very difficult to express in words the feelings of loss that a woman suffers when she is told “We
have to remove your breast due to cancer.” The oncologic breast surgeons offer lumpectomies, often with
Through collaborative
efforts, advances have been
made that have led to the best
treatment of the underlying
cancer, while leading to the
best cosmetic reconstruction.
intraoperative radiation therapy (IORT), to preserve the women’s breasts.
Unfortunately, some cancers will require the removal of the entire breast
Every week, we get to meet wonderful, vibrant women with very
personal stories about how their recent diagnosis is going to affect their
lives. Some are in their twenties, having never been married, some are
getting ready for their daughter’s wedding, others are enjoying their senior
years with their significant others – but none of them are happy that their
“disease” will require them to lose one or both of their breasts. The loss of a part of our body is difficult enough,
but when we may lose part of what makes us feel special as a feminine or sexual being — that is really tough.
One of the passions of plastic surgeons is the ability to help make individuals feel more whole and
to help them heal both physically and emotionally. Today, through the use of skin-sparing mastectomies,
implants, tissue expanders, and the patient's own tissues, we can help recreate a patient’s breast either at
the same time as the mastectomy, or at a later date. Many of the results are very good. As I tell my patients,
“They are never as good as what God gave you — but they are definitely better than the alternative — no
breast.” One of the major advances was making “immediate reconstruction,” or the ability to help make
a woman look and feel as normal as possible at the completion of their surgery, available to every
woman who desired it.
Some of the latest advances in breast reconstruction include the use of SPY Elite technology to
evaluate the blood supply of the mastectomy skin flaps, as well as the blood supply to the flaps used to
recreate breasts. This technology has reduced our complication rate secondary to blood supply issues from
15 percent to less than 5 percent. This technology has allowed the team to consider and use nipple-sparing
breast mastectomies. In highly selected patients, the oncologic surgeons can leave the patient's nipple
areola complex intact, and the plastic surgeons can use implants or live tissue to fill the empty envelope
to recreate a very natural breast.
Shirley Martin developed breast cancer and elected to have bilateral mastectomies with nipplesparing techniques and immediate reconstruction with tissue expanders. At the completion of the implant
exchange, she said, “The result is much better than I ever expected.” And, indeed, her breast almost appears
normal. We will continue to use cutting edge techniques to adequately treat the underlying cancer,
while recreating the most natural breast possible.
MEET SHIRLEY MARTIN, A
BREAST CANCER SURVIVOR
A woman who starts getting annual mammograms at the age of 40 and keeps up the schedule diligently
can expect to receive as many as 30, 40, or more of the yearly screenings for breast cancer. If she is lucky,
that lifetime supply of mammograms will provide nothing more than reassurance.
But then there are women like Shirley Martin of Jesup. In 2006, when her two daughters were a
teen and a pre-teen, Shirley turned 40 and set a good example for her children by scheduling her first
mammogram, right at the age which the American Cancer Society recommends women add the annual
exams to their healthcare regimen. But instead of being a routine report in an anticipated long line of
such reports, Shirley’s first mammogram found breast cancer – an early diagnosis that saved her life.
“In December 2006, I went to have my very first mammogram ever. I had just turned 40 — and they
found something,” Shirley said, recalling that traumatic discovery eight years ago. “A biopsy showed
there was cancer in the milk ducts, very close to the chest wall.”
“In December 2006,
I went to have my very first
mammogram ever. I had
just turned 40 – and they
found something.”
What Shirley was facing was ductal carcinoma in situ. She reviewed her
various treatment options with Ray Rudolph, M.D., a breast cancer surgeon
with the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial
University Medical Center (MUMC). She chose to have a lumpectomy,
followed by a course of radiation therapy.
There’s nothing easy about breast cancer treatment, even when
everything goes well. She came to Memorial for the surgery, but opted to get her 35 daily radiation
treatments in Brunswick because it was closer to her home than Savannah. Every weekday afternoon,
she’d leave her job at a Jesup bank and drive 40 miles for radiation therapy, then drive 40 miles home.
That’s 400 miles a week for seven weeks. But her surgery and radiation paid off – eight years later,
there’s no indication that cancer has returned.
Cancer survivors are always diligently followed to make sure their disease does not recur. Along with
regular exams, Shirley kept up with her mammograms. And, in 2013, a mammogram found cancer in the
other breast. Once again, it was ductal carcinoma in situ, close to the chest wall. But her doctors assured
her that despite the same diagnosis a second time around, this cancer was not a recurrence of her earlier
breast cancer. She simply got breast cancer twice, seven years apart.
“After my first surgery, you couldn’t really tell the difference,” Shirley said about her breasts. The
lumpectomy did not seriously disfigure the appearance of her breast.
But now she faced a different scenario. The cancer in the second breast was more serious, with tests
indicating pre-cancerous cells around it. She could opt to repeat her previous treatment – a lumpectomy
followed by a full course of radiation. Her other option was a full mastectomy – the removal of the
entire breast – followed by reconstructive surgery, and that’s the option she went with.
Dr. Rudolph suggested she see Richard Greco, M.D., for the breast reconstruction. The two surgeons
paired up for the mastectomy, with Greco following Rudolph to begin the work on reconstruction that
As for the reconstructive surgery, Shirley said, “It really wasn’t a bad surgery. I went back to work in
two weeks.”
Today, Shirley feels well and is cancer-free. And the reconstruction went so well, she joined her family
in complete comfort on a beach vacation this summer.
would be completed in a later, separate surgery. Shirley was pleased to discover that the reconstruction
was covered by her insurance plan.
THE LATEST ADVANCES IN
RADIATION ONCOLOGY
For approximately 30 years, Memorial University Medical Center’s (MUMC) radiation oncology has been
a leader in advancing radiation oncology in Georgia. Under the direction of John Duttenhaver, M.D.,
the department was the first in Georgia to perform stereotactic radiosurgery and the first in Savannah
to perform prostate seed implants, intensity modulated radiation, and stereotactic body radiotherapy.
While 2013 saw Dr. Duttenhaver transition into retirement, the department continues to be a leader in
radiation oncology in Georgia. The department currently is run by Aaron Pederson, M.D., and Michael
Hasselle, M.D., both of whom are University of Chicago-trained, board-certified radiation oncologists
with more than 20 peer-reviewed journal articles between them. Drs. Pederson and Hasselle have
brought intraoperative radiation therapy (IORT) for breast cancer, SIR-Spheres for hepatic malignancies,
novoTTF for brain tumors, and MRI-guided brachytherapy for gynecologic malignancies to the Curtis
and Elizabeth Anderson Cancer Institute (ACI) at MUMC. In keeping with its tradition of innovation, ACI
was the first in the state/region to offer these technologies. ACI is fortunate for the foundation laid by
Dr. Duttenhaver and proud to continue the tradition of innovation and leadership in radiation oncology.
Here’s a description of some of the latest innovative technologies at ACI:
Intraoperative radiation therapy (IORT):
The goal of any cancer treatment is to maximize patient outcomes and minimize inconvenience and side
effects of treatment. IORT for breast cancer is a perfect example of a new technology meeting these goals.
The pivotal Targit-A trial demonstrated that appropriately selected women of at least 50 years of age with
low-risk stage I breast cancer can often be treated with a single dose of radiation on the day of surgery
with the same 5-year risk of recurrence as a traditional 4- to 6-week radiation regimen. Acute and late side
effects, including cardiovascular disease and second cancers, are also reduced with IORT. We continue to
be nationwide leaders in the application of intraoperative breast radiation using the Intrabeam 50kV
intraoperative linear accelerator and have now treated more than 200 women with IORT. Most of these
women required no further radiation for their breast cancer.
Radioembolization, Selective Internal Radiation:
SIR-Spheres are a targeted form of radiation where radioactive particles are injected into the liver
and preferentially target tumor rather than normal liver parenchyma. SIR-Spheres may be used for
primary or metastatic liver cancer and typically cause fewer side effects than chemoembolization,
with similar efficacy.
From left to right:
Aaron Pederson, M.D., radiation oncologist;
Michael Hasselle, M.D., radiation oncologist;
and Caleb Price, medical physicist.
THE LATEST ADVANCES IN
RADIATION ONCOLOGY
novoTTF:
2013 saw the introduction of novoTTF for patients with malignant brain tumors. This novel therapy
uses alternating electrical fields to interfere with the polarization needed during mitosis (cell division).
Randomized phase III data demonstrate novoTTF to be equivalent to salvage chemotherapy for
recurrent glioblastoma, with fewer side effects. ACI is the only center in southeast Georgia to offer this
therapy. We look forward to participating in a number of trials to investigate the use of novoTTF in other
malignancies, such as pancreatic and lung cancer.
MRI-guided brachytherapy: ACI has obtained MRI-compatible brachytherapy equipment for the
treatment of gynecologic malignancies. This equipment allows us to perform an MRI with the
brachytherapy applicator in place. Most gynecologic tumors can only be visualized accurately on MRI.
By obtaining a treatment-planning MRI, we can optimize the brachytherapy plans to treat the visible
tumor, while reducing dose to the small bowel, bladder, and rectum. Multiple investigators have shown
that MRI-guided brachytherapy reduces the rates of high grade, late radiation toxicities by 50 percent
compared to traditional 2D or CT planning.
We continue to offer the following advanced radiation technologies as well. Many of these therapies
have been improved upon with the use of the Varian TrueBeam and RapidArc technology. The TrueBeam
is the fastest and most accurate linear accelerator yet made. RapidArc allows us to treat effectively and
efficiently by delivering radiation through a series of arcs so that the radiation dose is highly conformal
to the target volume.
These additional advanced therapies are:
Stereotactic radiosurgery (SRS):
SRS uses conformal treatment plans to deliver high doses of radiation precisely to primary or
metastatic brain tumors in 1-5 treatments. We have been performing this treatment since 1989, with serial
improvements in precision and speed of delivery through the use of new technologies such as RapidArc.
Stereotactic body radiotherapy (SBRT):
This is similar in concept to SRS, but for extracranial sites including primary and metastatic lung and
liver tumors. Treatment typically is performed in conjunction with our respiratory gating technology
which allows us to turn the radiation beam on in coordination with respiratory motion, so that tumors
can be precisely and accurately targeted. With the use of TrueBeam and Rapid Arc, we have markedly
reduced treatment time. Shortening the treatment duration is important for patient convenience, but
also improves accuracy of treatment as the patient is less likely to move. Drs. Pederson and Hasselle
have numerous publications on the use of SBRT for patients with liver, lung, and oligometastatic cancers
(limited metastases, where local control of metastases may effect long-term progression-free survival).
Intensity modulated radiation therapy (IMRT):
This is an advanced form of external beam radiation in which the treatment plan is computer-optimized
using tumor and healthy tissue dose constraints to generate a more conformal plan compared to
conventional treatment. This is accomplished by varying the intensity of the radiation beam in multiple
small increments during treatment delivery. Drs. Pederson and Hasselle work closely with ACI dosimetrists
and physicists to optimize each plan. An IMRT plan is only as good as the user tells it to be. We have
extensive experience using this technology and have published articles on its use in a number of
different disease sites, including head and neck cancers and gynecologic cancers.
4D PET/CT treatment planning:
This allows us to acquire a PET scan in the treatment position so that tumors can be targeted more
precisely. It also allows us to account for respiratory-induced tumor motion during treatment
design/planning and subsequent treatment delivery. Together these technologies allow us to more
accurately pinpoint the tumor and thus reduce dose to healthy tissue.
High dose rate brachytherapy:
This uses radiation threaded through implantable catheters to deliver higher doses than could be
safely delivered through an external beam approach. It may be used to treat gynecologic, breast,
or prostate cancers.
Prostate seed implants:
This procedure involves implanting small radioactive seeds directly into the prostate. More than
Unsealed sources:
This method uses oral or injectable radiation to treat cancers such as thyroid cancer and bone cancer.
An exciting advancement has been the use of Radium 223 to treat men with prostate cancer that has
spread to the bone. Radium 223 is injected intravenously once per month for 6 months and improves
survival and pain control, while reducing fractures. Most men tolerate this therapy very well.
500 men have been treated with this technique at ACI.
THYROID CANCER ON THE RISE
The American Cancer Society predicts 63,000 new cases of thyroid cancer will be diagnosed in 2014,
representing a dramatic increase in this type of cancer over the past 40 years. Since 1975, the incidence
of thyroid cancer has increased from five cases per 100,000 individuals in the United States to almost 15
per 100,000. Debate continues as to whether this represents an absolute increase in the true incidence of
thyroid cancer or whether, though increased imaging and office-based needle biopsies, we are observing
an “epidemic of diagnosis.” We know much about the epidemiology, relative risk of malignancy and
overall prognosis of thyroid cancer based on a patient’s history, physical examination, and pathologic
features of their tumor. High-risk features include being male, age over 50, rapid increase in size of the
gland, history of prior radiation treatment to the neck, and symptoms such as a neck mass, difficulty
swallowing, or voice change. Low-risk features include being a woman, having a multinodular gland,
stable size of the nodule(s), no symptoms in the neck, and a previous benign needle biopsy
Thyroid cancer is a biologically diverse group of diseases classified into three broad categories.
Differentiated thyroid cancer includes the papillary, follicular, and Hurthle cell subtypes. Fortunately, it is
Since 1975, the incidence of
thyroid cancer has increased
from five cases per 100,000
individuals in the United States
to almost 15 per 100,000.
the most common form of thyroid cancer, accounting for greater than
90 percent of diagnosed patients. In many cases, these patients are
cured with thyroidectomy and only need to be monitored. Radioactive
iodine received as a pill is sometimes offered to patients with larger
tumors or tumors extending outside the thyroid capsule. Medullary
thyroid cancer accounts for just less than 10 percent of cases. This is a
more aggressive malignancy that can be associated with a familial cancer called multiple endocrine
neoplasia (MEN) syndrome. Patients with medullar cancer require a total thyroidectomy, removal of all
involved lymph nodes, post-operative radiation therapy and much closer clinical follow-up. The third type,
anaplastic thyroid cancer, is a very rare malignancy that is fatal even in the face of aggressive surgery,
radiation, and chemotherapy.
Thyroid cancer is most often diagnosed by a fine needle biopsy of a mass in the neck. The use of
an ultrasound to localize the most suspicious part of the mass increases the accuracy of the diagnosis.
Our head and neck surgeons at the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial
University Medical Center are certified by the American College of Surgeons in neck ultrasound and
fine needle biopsy and routinely perform this exam during a regular office visit. Recently, the ACI has
collaborated with the VeracyteTM Company to improve the accuracy of thyroid needle biopsies. Patients
requiring thyroid needle biopsies now have the option of having the material sent for molecular analysis
using the AffirmaTM gene expression classifier. This test has been shown to reduce significantly the need
for thyroidectomy in patients with intermediate needle biopsies.
Endocrinologists are central to the care of patients with thyroid cancer. The endocrinologist often
initially evaluates the patient and coordinates the ultrasound and needle biopsy. Endocrinologists are
closely involved in monitoring patients following surgery. They make recommendations regarding the
use of radioactive iodine, check blood levels of thyroid hormones and tumor markers, and adjust thyroid
hormone replacement. Memorial endocrinologists Kaveh Ehsanipoor, M.D., and Ismary Decastro, M.D.,
are dedicated to the care of patients with thyroid cancer. They are skilled in all aspects of thyroid cancer
diagnosis, treatment, and follow-up. They are not only experts in communicating with their patients but
also in working collaboratively with primary care providers.
Patients needing thyroid surgery are evaluated by ACI Physician-in-Chief Guy Petruzzelli, M.D., a
board-certified otolaryngologist and fellowship-trained head and neck surgical oncologist. Prior to
surgery, all patients have a careful head and neck examination, including an examination of the larynx
provide the best chance for excellent surgical outcomes.
At the ACI, patients with thyroid cancer are surrounded by state-of-the-art dedicated professionals
providing safe, efficient care in a patient and family centered environment. Board-certified, subspecialtytrained endocrinologists, radiation oncologists, radiologists, and surgeons using innovative technology
like molecular diagnostic techniques are committed to excellence in multidisciplinary oncology care.
and vocal cord function. In surgery, minimally invasive techniques, small incisions, and specialized
instrumentation including intraoperative monitoring of the nerves to the vocal cords are all used to
MEET STEVE GONTO, A
THYROID CANCER SURVIVOR
Steve Gonto has developed medical equipment that flew in space, and was himself an active candidate for
a space shuttle flight. He was also an avid martial artist and a U.S. National karate champion, who, if the
U.S. hadn’t skipped the Soviet-hosted 1980 Olympics for political reasons, might have been an Olympian.
He also has some hot dance moves — just ask the 136,597 YouTube viewers who’ve seen “Kung Fu Fighting
Daddy Daughter Dance.”
Gonto developed a lifesaving treatment protocol when his beloved family pet came down with a
kidney disease known as Fanconi Syndrome. His work is now used worldwide in treating canine, feline,
equine and even human patients. Google “Fanconi Protocol”and you will find him referenced more than
“It does wonders for your confidence
when you’re looking up information
on your surgery and you realize that
your surgeon literally wrote the
book on head and neck surgery.”
161,000 times as he continues to share his research freely with
veterinarians and physicians around the world, as well as
lecturing internationally. But those are just things he does for
fun. By day, he’s a veteran anesthesiologist assistant (AA)
who has logged 30 years at Memorial University Medical Center
(MUMC). Over the years, he’s helped care for laboring mothers,
people undergoing colonoscopies, brain and spinal surgery patients – you name it. Most of those patients
wouldn’t recognize him if they saw him, because they slept through some of his best work: such is the
lot of the anesthetist.
Gonto is also a cancer survivor. This natural-born storyteller tells a compelling story of that cancer
journey and the resources of the Curtis and Elizabeth Anderson Cancer Institute (ACI) that helped him
along the way.
“Sometimes, God smacks you upside the head and you have to listen,” is how he sums up his account.
It began with a visit to neurosurgeon James Lindley, M.D., to check out some chronic neck pain. The CT scan
studied showed his ongoing disc problem wasn’t really any worse, but a sharp-eyed Memorial radiologist
spotted something suspicious and completely unrelated on those studies. In short order, Gonto underwent
a biopsy of his thyroid and got back the scary news that he had thyroid cancer — discovered as an incidental
finding during other medical diagnostics.
“Everyone kept me really well informed. When you’re in the field, sometimes people assume you don’t
have questions – but you do. It was really great that everyone I dealt with realized that,” said Gonto.
And he did his own research, too, reporting to the medical library to check out thyroid cancer and head
and neck surgery. “It does wonders for your confidence when you’re looking up information on your surgery
and you realize that your surgeon literally wrote the book on head and neck surgery,” he said. “I had the
advantage of knowing I was in remarkable hands.”
The surgeon he’s referring to is Guy Petruzzelli, M.D., a head and neck surgeon who is the ACI’s
physician-in-chief. Petruzzelli removed Gonto’s cancerous thyroid and, after an overnight stay, Gonto
“took a Tylenol and went home.”
The ACI is a comprehensive cancer care center, meaning that it offers the full array of resources to treat
cancer – surgery, radiation therapy, chemotherapy, and integrative services. Gonto found himself drawing on
those resources again for follow-up therapy. After some much appreciated advice and pre-treatment
preparation by the compassionate medical and nursing staff of ACI, he underwent radiation therapy. His
treatment, administered in pill form by Aaron Pederson, M.D., drew on the ability of radioactive iodine to
concentrate exclusively in thyroid tissue, seeking out and destroying any remaining suspect cells. Patients
out for a week – even making a video of a Geiger counter registering his radioactivity.
Today, you’d never know Gonto had been sick. His surgical scar is carefully hidden in a natural fold in
his neck. His voice, swallowing, and appearance are unaffected. He takes daily medication to replace the
essential hormones his absent thyroid would otherwise produce, and he gets regular medical monitoring,
like any cancer survivor.
who have that type of therapy have to isolate themselves because they are literally radioactive for several
days. Gonto made the best of the enforced isolation, borrowing a friend’s Tybee Island condo and chilling
W A Y N E G L A S G O W, P H . D .
CHEMOTHERAPY TREATMENT IN
TODAY’S FIGHT AGAINST CANCER
The focus of the laboratory-based oncology research program within the Curtis and Elizabeth
Anderson Cancer Institute (ACI) at Memorial University Medical Center is on biomedical
research that is clinically relevant and has a high potential application to improve patient
care. Major themes of the laboratory-based cancer research program include discovery of
new therapeutic targets, identification and characterization of new biomarkers to aid in
early cancer diagnosis and prognostic decision making, and development of new targeted
drug delivery methods to improve therapeutic responses while decreasing side effects.
Biomedical scientists are actively engaged with their clinical colleagues in establishing
and developing working groups that are focused on cancer disease-based issues. Moreover,
ACI research programs are further enhanced by the close affiliation and collaboration with
Mercer University School of Medicine, Savannah campus. A Mercer Department of Biomedical Sciences has
been established on the Memorial University Medical Center campus, with faculty members representing
the biomedical science disciplines of anatomy, behavioral science, biochemistry, genetics, histology,
immunology, microbiology, neuroscience, pathology, pharmacology, and physiology. The presence of
these scientists with a broad spectrum of research skills and expertise provides a “critical mass” of
biomedical researchers for collaborative and programmatic research efforts.
In this past year, two specific new research projects highlight this effective collaboration between
Memorial and Mercer research faculty. Dominique Broccoli, Ph.D., and Robert Visalli, Ph.D., have developed
a research project to test the use of a modified virus to disrupt the growth of tumors. One common feature
of tumor cells is that they have acquired a dramatic ability to replicate and divide. Tumor cells have
developed specific biochemical pathways that provide the tumor cells with growth advantages over
normal cells. Many potential therapeutic targets of anti-tumor therapy involve blocking these pathways
that allow for tumor cells to have this growth advantage. This research project has generated a modified
virus that can interact with and inhibit the tumor cell replication cycle. This modified virus retains the
ability to disrupt tumor cell growth but the virus has been altered to not cause any infection. Preliminary
experiments demonstrate inhibition of tumor cell growth in cell culture and slowing the growth of tumors
in mice models.
In a related second project, Broccoli and Edward Perkins, Ph.D., are working on development of a new
model system that will allow for more definitive study and characterization of a key biochemical pathway
that leads to the unlimited growth potential of tumor cells. This project utilizes the artificial chromosome
expression system developed in Perkins’ lab to study the telomere stabilization pathways of tumor cells,
an area of focused research in Broccoli’s lab. This project has recently been awarded a grant from the
National Institutes of Health and will allow for continued collaboration with Broccoli and Perkins as
Mercer School of Medicine faculty. Both of these projects should provide new information regarding
mechanisms of tumor cell growth and identify potential novel approaches in anti-tumor therapy.
Biomedical scientists are actively engaged
with their clinical colleagues in establishing
and developing working groups that are
focused on cancer disease-based issues.
PAT R I C I A S H A R P E
CLINICAL TRIALS
When it comes to new treatments and drugs, someone has to be first — and that can be
scary. But when the diagnosis is cancer, what might first sound scary is actually a ray of
hope, a chance to improve your chances of recovery and help others at the same time.
Clinical trials at the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial
University Medical Center (MUMC) offer newer potential therapies before they are
available as a standard therapy. Whether it is new drugs, new combinations of drugs,
new methods of administering those drugs or other changes, clinical trials provide the
scientific evidence doctors depend upon in making their recommendations to patients.
Of the 1,299 analytical cases in 2013, 368 patients were enrolled in clinical trials (including
tissue procurement for cancer research and the National PET Registry).
The ACI serves as the hub for the region’s exclusive affiliation with the Southeast Cancer Control
Consortium (SCCC). This affiliation, led by medical oncologist Harvey C. Lebos, M.D., provides access to a
multitude of National Cancer Institute (NCI)-sponsored cooperative group clinical trials. These groups
include Southwest Oncology Group (SWOG), Radiation Therapy Oncology Group (RTOG), National Surgical
Adjuvant Breast and Bowel Project (NSABP), Cancer and Leukemia Group B (CALGB), and Cancer Trials
Support Unit (CTSU). These research studies offer cutting-edge alternatives to standard cancer treatment.
The SCCC continues to be one of the highest accruing Community Clinical Oncology Programs (CCOP) in
the country.
The ACI also maintains affiliations either singularly or through collaborative agreements to
participate in clinical trials conducted by the American College of Surgeons Oncology Group (ACOSOG)
The ACI serves as the hub for
the region’s exclusive affiliation
with the Southeast Cancer
Control Consortium (SCCC).
and the Children’s Oncology Group (COG).
The Gynecologic Oncology Group, a National Cancer Institute
(NCI) funded cooperative clinical trial group founded in 1970, has
had a presence at ACI since 1996. MUMC also is partnered with the
Georgia Center for Oncology Research and Education (CORE) and
Gynecologic Oncology Group (GOG) a statewide network for offering gynecologic clinical trials. James
Burke, M.D., is the local principal investigator and co-PI for the state consortium.
Numerous industry-sponsored pharmaceutical trials further enhance the clinical trials program at
Memorial. These studies are offered as an adjunct to the cooperative group studies to broaden patient
treatment options.
The ACI has open clinical trials for cancers of the brain, breast, colon/rectum, stomach, pancreas,
prostate, kidney ovaries, uterus, lung, skin, head and neck, non-Hodgkin’s lymphoma, and leukemia.
THE MEMORIAL HEALTH FOUNDATION:
A COMMITMENT TO GIVING
Cancer patients face so many challenges: difficult treatments, uncertain futures, pain and stress.
And another big item on that list: expenses. Fighting cancer is expensive.
Patients at the Curtis and Elizabeth Anderson Cancer Institute (ACI) at Memorial University Medical
Center don’t face those challenges alone. The generosity of donors provided nearly $130,000 in direct
patient assistance to cancer patients at the ACI in 2013.
Virginia Pearce knows this firsthand. One of ACI’s targeted funds, the Stephen D. Hollenberg Memorial
Fund, has stepped in to help her in her battle against stage 4 metastatic gallbladder cancer.
"There is no way I would be
here without the help of
this fund. I couldn't have
afforded any of this."
"There is no way I would be here without the help of this fund. I
couldn't have afforded any of this," said the Statesboro woman. The fund
has helped her pay for prescriptions that relieve pain and nausea.
Virginia worked for many years as a restaurant manager and in
catering. When her mother got seriously ill nine years ago, she stopped
work to care for her. Her mother died last November, and only two months before that, Virginia was
diagnosed with cancer. But things may be looking up for the embattled woman: her most recent CT scan
shows the cancer isn’t growing.
Virginia is one example of the many patients who are assisted by the ACI’s funds, but there are many
others who have been helped in many ways. Donors helped women who couldn't afford mammograms
get them, and helped them find resources for treatment if the screenings discovered problems. The gifts
from donors provided fuel cards to help patients get to and from their treatments, paid for prescriptions
that relieve pain and nausea, helped cancer patients with living expenses such as rent and utilities, and
bought medical equipment that helped patients walk, talk, and be independent.
The Memorial Health Foundation administers four philanthropic funds to assist patients — the
Stephen M. Hollenberg Memorial Fund, the Lynn Bishop Mammography Fund, the Richardson Prostate
Cancer Fund, and the Gynecologic Cancer Fund. Each of the funds is managed by the ACI's social workers.
To make a donation to one of these funds or to find out more about other ways to support the ACI,
please contact Anne Cordeiro at 912-350-8934 or [email protected]
2013 ANDERSON CANCER
INSTITUTE DONORS
The generosity of our donors makes it possible to fund new cutting-edge technology; to provide patients
assistance with medicines and transportation; to fill the lobby of the Anderson Cancer Institute with live music;
to knead away patient and caregivers’ tension with massage therapy and reflexology; to offer counseling
by a licensed clinical social worker, and much more. Every gift makes a difference in the lives of our patients.
Each of the following individuals, businesses, or foundations contributed
$250 or more between January 1, 2013 and December, 31, 2013.
Ms. Teresa R. Ackland
Mrs. Chris B. Aiken
Mrs. Phyllis Albertson
Mr. and Mrs. John B. Allen, Jr.
Dr. and Mrs. Stephen C. Allen
Alliance Medical Physics
Mr. and Mrs. Curtis G. Anderson
Mr. and Mrs. Thomas R. Angle
Anonymous
Mr. and Mrs. Robert Anspach
Armstrong Atlantic State University
Mr. and Mrs. Donald G. Arpin, Sr.
Susan D. Atkinson
Atlantic Radiology Associates, LLC
Ms. Gisela Baker
Dr. and Mrs. Arthur Baker
Ms. Cynthia Baker
Mr. and Mrs. Randall K. Bart
Mr. and Mrs. William J. Barton, Jr.
Dr. and Mrs. Bob Beard
Mr. and Mrs. Elvin R. Beck
Hussey, Gay, Bell and DeYoung, Inc.
Dr. Monique Belli
Berkshire Hathaway HomeServices
Southeast Coastal Properties
Tilly Blanken
Mr. and Mrs. William Boden
Mr. and Mrs. Scott K. Boice
Mrs. Ellen Bolch
Mr. John R. Willard and Ms. Tanis M. Bond
Mr. and Mrs. Patrick Booton
Mrs. Lisa H. Boswell
Mr. and Mrs. David R. Bothwell
Bouhan, Williams & Levy, LLP
Mr. and Mrs. Zeddie Bowen
Ms. Marilyn G. Brady
Brasserie 529
Mr. and Mrs. David E. Breithaupt
Mr. and Mrs. Terrance L. Breyman
Mr. and Mrs. Darryl Brown
Dr. and Mrs. Robert F. Brown, Jr.
Ms. Trina M. Brown
Marilyn and Joe Buck
Mr. Victor Burke
Mr. and Mrs. E. James Burnsed
Drs. David and Peggy Byck
Ms. Sheryl Campbell
Mr. and Mrs. Anthony R. Cappuccio
Mr. and Mrs. Paul H. Carini
Dr. and Mrs. Frank E. Carlton
Ms. Ann G. Carroll
Carroll & Carroll, Inc.
Mr. and Mrs. Raymond E. Cartledge
The Cartledge Foundation, Inc.
Dr. William L. Cathcart
Ms. Mimi Cay
Mr. and Mrs. John E. Cay III
Mr. Jack Cay
Cay Insurance Services
Cedar Animal Hospital LLC
Celia Dunn Sotheby's International Realty
CertaPro Painters
Chatham Capital Group, Inc.
Chatham Parkway Lexus/Toyota
Mrs. Fotini Cherry
Ms. Brenda S. Christian
Churchill's Pub
Coastal Allergy & Asthma, PC
Coastal Corvette Association
Mr. and Mrs. Bill W. Cole
Colliers International
Ms. Kelly Collins
Mr. and Mrs. Edward H. Conant
Mr. and Mrs. Robert A. Contino
Mr. and Mrs. John J. Cooney
Ms. JoEllen C. Cooper-Pyles
Ms. Anne M. Cordeiro
Ms. Carole G. Cornett
Mr. and Mrs. Richard L. Cote
Mr. and Mrs. Kenneth T. Cote
Ms. Dorothy Courington
Courtney Knight Gaines Foundation
Critz, Inc.
Mr. and Mrs. Rick L. Culbreth
Mr. and Mrs. James G. Cunningham
Mr. James McCulloch and Mrs. Jennifer
Currin-McCulloch
William T. Daniel, Jr. and Linda V. Daniel
Ms. Kelley Daniel
Mr. and Mrs. Gary Daniel
Ms. Glennis L. Daniel
Mr. James Dasher
Mrs. Thomas G. Davis, Jr.
Dr. and Mrs. William J. Degenhart
Deming, Parker, Hoffman, Campbell & Daly
Marie Dent, Ph.D.
Mrs. Catherine D. DiBenedetto
Dr. and Mrs. Kevin C. Dickinson
DJ Family Foundation
William J. Donahue
Mr. and Mrs. Chris Donegan
Mr. and Mrs. William A. Dowell
Mrs. Helen D. Downing
Drayer Family Fund of The Greater
Cincinnati Foundation
Mr. and Mrs. F. Reed Dulany III
Mr. F. Reed Dulany, Jr.
Dr. and Mrs. John R. Duttenhaver
Mrs. Jean Duttenhaver
Mrs. Linda Duttenhaver
Edgewood Travel
Dr. and Mrs. A. J. Edwards III
EEU, Inc.
Mr. and Mrs. James Eleczko
Mr. Charles Ellis III
Epic Charitable Contributions
Mr. and Mrs. David T. Erwin
Dr. and Mrs. Nizar Eskandar
Evans County C.A.R.E.S., Inc.
Mr. and Mrs. Sam Everitt
Mr. and Mrs. Robert F. Faircloth
Mr. and Mrs. Patrick E. Falconio
Edwin and Jane Feiler
Mrs. Elizabeth Flaherty
Ms. Belinda Flanigan
Mr. and Mrs. Robert M. Ford
Capt. Benjamin Frankland
Mr. and Mrs. Steven Peter Freund
Mr. and Mrs. Clifford A. Frohn
Mr. and Mrs. Arthur J. Gartland
Mr. and Mrs. Edgar L. T. Gay
GE Foundation
Ms. Jenny Gentry
Mr. and Mrs. Walter H. Gentry, Jr.
Mr. Richard M. Geriner, Jr.
Mr. and Mrs. Alan Getz
Sean and Maggie Gill
Mrs. AM Goldkrand
Theodora Gongaware, M.D.
Ms. Jennifer N. Gooch
Mr. Joel P. Goodman
Dr. and Mrs. Richard J. Greco
Drs. Martin and Doris Greenberg
Mr. Maurice Greene
Mr. and Mrs. Leonard D. Griffiths
Mr. and Mrs. Joseph J. Grispo
Dr. and Mrs. Chris Haberman
Ms. Sandy Hammond
Mr. and Mrs. Bill Hammontree
Hancock Askew & Company, LLP
Hansen Architects, P.C.
Brian and Kathleen Harlander
Ms. Lynn P. Harrington
Mr. and Mrs. J. Harry Haslam, Jr.
Mr. and Mrs. William H. Heald
Mr. and Mrs. Robert J. Heller
Help the Hoo-Hahs
Ms. Patricia Herrin
Ms. and Mr. Kari Herrin
Mr. and Mrs. Mark A. Moore
Mr. Anand K. Morar
Mr. and Mrs. John F. Morgan
Dr. and Mrs. Stephen L. Morris
Mr. J. Wilson Morris
and Mrs. Linda Fisk Morris
Morris Multimedia, Inc.
Ms. Nancy C. Muenzfeld
Mr. and Mrs. Frederick L. Muller
Carol M. Mulligan, M.D.
Dr. and Mrs. Mark E. Murphy
Dr. and Mrs. Samuel D. Murray, Jr.
Mr. and Mrs. Richard A. Myers
National Christian Foundation
Mr. and Mrs. Wayne D. Newberry
Mr. Joe E. Nix
Ms. Tammie Nix
Northern Trust Securities
OB-GYN Center, P.C.
Mr. and Mrs. Peter C. O'Connor
Mr. and Mrs. John D. Odell
Mr. George H. Oelschig, Jr.
Mr. and Mrs. Joseph O'Heaney
Ole Skool Cruziers
Ms. Kathyrn Z. O'Neil
Mr. and Mrs. Brian O'Neill
Optim Orthopedics
Mr. and Mrs. Michael Ost
Dr. and Mrs. Christopher L. Osteen
Ms. Regina Owensby
Mr. and Mrs. Benjamin A. Oxnard III
Dr. and Mrs. Elliot Palefsky
Ms. Wendy Partain
Mr. and Mrs. Kenneth Pattin
Mr. and Mrs. John O. Paull
Dr. Aaron W. Pederson
and Dr. Cindy Pederson
Mr. Carl Pedigo and Ms. Kathleen Horne
Mr. and Mrs. Frank K. Peeples
Drs. Yaron and Anna Perry
Dr. and Mrs. Guy J. Petruzzelli
Mr. William A. Pfeifer
Dr. Thomas Philbrick
Mrs. Joan M. Pierce
Mr. Glen S. Pilon and Ms. Louise McDonald
Mr. and Mrs. John F. Polmonari
Mrs. Jennifer Prince
Provident OB/GYN Associates
Mrs. Louise A. Quirk
Mr. and Mrs. Stephen Rabinowitz
Mr. and Mrs. Charles E. Raffe
Mr. Christopher T. Rampley
Ms. Sandy Randolph
Ms. Gaye S. Reese
Mr. and Mrs. Robert A. Reinhard
Mr. and Mrs. James R. Rich
Ms. Debbie G. Rich
Mr. and Mrs. John Richardson
Dr. and Mrs. Lester E. Robertson, Jr.
Mr. and Mrs. Paul E. Robinson
Dr. and Mrs. Robert C. Rollings
Mr. and Mrs. Jack Romanos
Rosalie S. Morris Foundation
Mr. and Mrs. Randall C. Roulier
Ms. Rosaleen Roxburgh
Dr. Anthony B. Royek
Mr. and Mrs. Michael E. Ruddy
Dr. and Mrs. Raymond Rudolph
Mr. and Mrs. Rick D. Sallee
Mr. and Mrs. Jeffrey R. Samuels
Ms. Carole H. Sangalli
Mrs. Christine S. Savage
Savannah Apparatus Repair CO. Inc.
Savannah Pathology Services, P.C.
Savannah Toyota
Savannah Vascular and Cardiac Institute
Savannah Wheelmen
Mr. Donald Scarpa
Mrs. Anne K. Schafer
Mr. and Mrs. Robert B. Schmarge
Mr. and Mrs. Richard R. Schulze, Jr.
Dr. and Mrs. Jeffrey P. Schyberg
Seacrest Partners, Inc.
Mr. and Mrs. David W. Seeley
Ms. Swann Seiler
Mr. Bill Sellers and
Mrs. Kathryn M. Clark-Sellers
Ms. Tara H. Setter
Mrs. Joyce Sharpe
Mr. and Mrs. Stephen P. Shea
Mr. and Mrs. Glenn A. Shealey
Mr. and Mrs. Carlton W. Sheets
Mr. James Sinclair
Jacqueline and Ken Sirlin
Stephanie L Skinner, D.M.D.
Mr. Dominic H. So
Mr. Shell Solomon
Mr. and Mrs. Philip Solomons, Jr.
Mr. and Mrs. John T. South, III
South State Bank
South University
Southeast ENT & Facial Plastic Surgery
Southern Motors of Savannah
Mr. and Mrs. George G. Staimer
Stephen Green Properties, Inc.
Mr. and Mrs. Jerry Stephens
Ms. Ursula Sterling
Stevens Hale & Associates
The Steward Center for Palliative Care
Mr. and Mrs. Jeff Stewart
Ms. Elizabeth T. Stout
Mr. and Mrs. Charles J. Stumpf
SunTrust Bank
SunTrust Robinson Humphrey
Mr. and Mrs. David M. Tallcott
Mr. and Mrs. Peter Tate
Mr. John C. Taylor
Mr. and Mrs. Sheldon Tenenbaum
THA Group
Judith A. Thomas, Ph.D.
Mr. and Mrs. John W. Thompson
Dr. and Mrs. William W. Thompson
Tidewater Landscape Management
Together for Hope
Mr. Trip Tollison
Mr. and Mrs. Glenn F. Toth
Mr. and Mrs. Michael W. Towson
Triad Isotopes, Inc.
Mr. and Mrs. Einar Trosdal, III
Mr. and Mrs. John L. Tucker
Mr. and Mrs. Bobby R. Tucker
J.T. Turner Construction
Tybee Art Works
Mr. Robert M. Tynan
United Community Bank
Mr. and Mrs. Kent D. Urness
Mr. and Mrs. John C. Van Puffelen
Mr. and Mrs. Martin Vernick
Dr. and Mrs. Jules Victor III
Volvo of Savannah
Mrs. Louise M. Wagner
Ms. Virginia G. Ward
Don and Cindy Waters
Wells Fargo Foundation
Dr. and Mrs. William N. Wessinger
Mr. and Mrs. Kent Westhelle
Alan Pritz and Susan Willetts
Ms. Lynne W. Williams
Mr. Russell Williams
Mr. and Mrs. Anthony Wilson
Mr. and Mrs. Kenneth Winnert
Mr. Gary Witbeck
Mr. Mark Woodruff and Ms. Sara Laidlaw
Mrs. Frank L. Wooten, Jr.
Yates-Astro Termite and Pest Control Co.
Mr. and Mrs. Joe E. Young
Ann and Jim Higbee
Mr. and Mrs. John M. Hoffman
Mrs. Toby W. Hollenberg
Mr. and Mrs. Albert G. Holzinger
Mr. and Mrs. James J. Holzinger
Home Again Consignment Interiors
Mr. and Mrs. Richard E. Hoover
Drs. William and Iffath Hoskins
Mr. and Mrs. Walter S. Hough
Dr. Michael R. Huntly
and Dr. Jacqueline Huntly
Hussey, Gay, Bell & DeYoung, Inc.
Mr. Derrol M. Hutcheson
Innomed, Inc.
J.C. Lewis Ford
J.C. Lewis Foundation, Inc.
J.E. Dunn Construction Company
Mr. and Mrs. Richard K. Jackson
James Hogan
Dr. and Mrs. Robert H. Jarman
Jenkins Plumbing
Mr. and Mrs. Robert S. Jepson
Mr. Lester B. Johnson, III
Mrs. Annette P. Johnston
Mr. and Mrs. Robert G. Jolie
Dr. and Mrs. Robert E. Jones
Mr. and Mrs. Michael J. Jordan
Mrs. Jane G. Kahn
S. Mark Kamaleson, M.D.
Karatx
Mr. and Mrs. Jack A. Kaster
Mr. and Mrs. William C. Keightley
Mr. and Mrs. Eldon Kennedy
Mr. and Mrs. Robert B. Kerdasha
Mr. Edwin W. King, Jr.
Mr. and Mrs. John L. Kinnaman
Ms. Angela S. Kirk
Kiwanis Club of Skidaway
Klein Law Group, LLC
Mr. and Mrs. Peter Koch
Mr. and Mrs. Donald Kole
Mr. and Mrs. Jeff Kole
Mrs. Sally Krissman
Ms. Christine Krukowsky
Mr. Raymond A. Lancaster
Landings Women's Golf Association
Mr. and Mrs. Robert H. Lang
W. Lynn Leaphart, M.D.
Mrs. Rene Lehrberger
Mr. and Mrs. Robert A. Lenehan
Mr. and Mrs. Henry Levy
Mr. and Mrs. Clifford F. Lindholm II
Dr. and Mrs. James G. Lindley, Jr.
Mr. David S. Linfoot and Dr. Dina E. Linfoot
Ms. Leslie B. Littlejohn
Ms. Beth Logan
Mr. and Mrs. William H. Lovett
Low Country Cancer Care Associates, P.C.
Mr. and Mrs. Joel Lynch
Mr. and Mrs. Alan Lynch
Ms. Debbie J. Macaluso
Ms. Maureen Maguire
Dr. and Mrs. Thomas P. Malan, M.D.
Mr. and Mrs. Doug Marchand
Ms. Susan Mason
Mr. and Mrs. Donald L. Mayer
Mr. and Mrs. E. H. McConnell, II
Mr. and Mrs. James McNaughton
Dr. and Mrs. Ramon V. Meguiar
Mr. and Mrs. Stuart B. Meisenzahl
Mercer University School of Medicine —
Savannah Campus
Mr. Gerard Meyer
Mr. Bud L. Mingledorff
Mingledorff's
Mrs. Nancy E. Minor
Mr. and Mrs. Michael C. Mobley
Mr. and Mrs. Jerome A. Montana
Mr. and Mrs. William T. Moore, Ph.D.
CANCER REGISTRY
The cancer registry is a data repository designed for the collection, management, and analysis of data
on all types of cancer diagnosed and/or treated within a health care institution. The registry captures a
complete summary of patient demographic information, medical history, diagnostic methods, treatments
used, and current status of every patient. Data collected are utilized by health and medical providers for
the evaluation of patient outcomes, follow-up information for surveillance, survival rates, and treatment
modalities and to report cancer incidence as required under state law. All patient-identifying information
and medical data is confidential and strictly maintained. Aggregate data are analyzed and published
without identifying information.
A CI TOTA L CASE S | 20 0 9– 20 1 3
2350
1300
1324
1299
1250
1250
1228
1200
1198
1150
1100
2009
2010
2011
2012
2013
The trends seen in new cancer cases at the Anderson Cancer Institute are in line with
incidence of these sites at the state and regional levels.
A CI TO P FI V E S I T E S | 20 1 3
350
300
316
250
200
150
146
100
128
121
71
50
Breast
Lung
GYN
Colorectal Prostate
0
OBSERVED SURVIVAL DATA
The quality outcomes data below compares the information from Memorial University Medical Center
with that of more than 1,500 accredited cancer programs across the country. All of the comparison
data is derived from cancer programs that are accredited by the American College of Surgeons
Cumulative Survival Rates
A C I B R EAS T S U R V I VAL | C ase s diagnos ed in 20 03 -2006
100%
95%
90%
85%
80%
75%
70%
65%
60%
55%
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
1.0
Years from Diagnosis
2.0
3.0
4.0
5.0
Stage 0 Stage I Stage II Stage III
Commission on Cancer using the National Cancer Data Base. If the confidence interval for our institution
overlaps with the confidence interval for all CoC-accredited facilities, then there is no statistical
difference between the two.
NATI O N A L BR E AS T S U R VI VAL | C ase s diagnos ed in 20 03 -2006
100%
95%
90%
85%
80%
75%
70%
65%
60%
55%
50%
45%
40%
35%
30%
25%
20%
15%
5%
0%
1.0
2.0
3.0
4.0
5.0
Stage 0 Stage I Stage II Stage III
10%
OBSERVED SURVIVAL DATA
The quality outcomes data below compares the information from Memorial University Medical Center
with that of more than 1,500 accredited cancer programs across the country. All of the comparison data
is derived from cancer programs that are accredited by the American College of Surgeons Commission
A C I C OLOR E CTAL S UR VI VAL | C ase s diagno se d in 2003-2 0 0 6
100%
95%
90%
85%
80%
75%
70%
65%
60%
55%
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
1.0
2.0
3.0
4.0
5.0
Stage 0 Stage I Stage II Stage III Stage IV
on Cancer using the National Cancer Data Base. The diagnosis year 2006 is the last year available to the
NCDB with reported 5-year follow-up information, which includes the date of last contact or date of death
and the vital status of the patient on the recorded date.
NATI O N A L CO LOR E CTAL S URVI VAL | C ase s diagnos ed in 20 03 -2 0 06
100%
95%
90%
85%
80%
75%
70%
65%
60%
55%
50%
45%
40%
35%
30%
25%
20%
15%
5%
0%
1.0
2.0
3.0
4.0
5.0
Stage 0 Stage I Stage II Stage III Stage IV
10%
COMMISSION ON CANCER
OUTCOMES DATA
The Curtis and Elizabeth Anderson Cancer Institute uses the data from the National Cancer Data Base to
evaluate the quality of cancer care provided and, where appropriate, implement quality improvement
activities. The goal of comparing the quality and outcomes of the ACI with that of other nationally
accredited programs is to assure we are carrying out the vision of the ACI to provide excellence in
comprehensive oncology care.
The Web-based Cancer Program Practice Profile Reports (CP3R) offer local providers comparative
information to assess adherence to and consideration of standard of care therapies for major cancers.
Adjuvant chemotherapy is considered or
Radiation is administered within 1 year
administered within 4 months (120 days)
(365 days) of diagnosis for women
of diagnosis for patients under the age
under the age of 70 receiving breast
of 80 with AJCC stage III (lymph node
conservation surgery for breast cancer.
positive) colon cancer.
C O M P L I A N C E R AT E | 2 0 1 2
100%
C O M P L I A N C E R AT E | 2 0 1 2
100%
98.8%
80%
98.8%
90%
60%
60%
40%
40%
20%
20%
0%
0%
ACI
CoC
90%
80%
ACI
CoC
This reporting tool provides a platform from which to promote continuous practice improvement to
improve quality of patient care at the local level and also permits hospitals to compare their care for
these patients relative to that of other providers. The aim is to empower clinicians, administrators, and
other staff to work cooperatively and collaboratively to identify problems in practice and delivery and
to implement best practices that will diminish disparities in care across Commission on Cancer (CoC)accredited cancer programs.
Tamoxifen or third generation
Radiation therapy is considered or
aromotase inhibitor is considered or
administered following any mastectomy
administered within 1 year (365 days)
within 1 year (365 days) of diagnosis of
of diagnosis for women with AJCC T1c
breast cancer for women with >= 4
or stage IB-III hormone receptor
positive regional lymph nodes.
positive breast cancer.
C O M P L I A N C E R AT E | 2 0 1 2
C O M P L I A N C E R AT E | 2 0 1 2
100%
93.1%
94.7%
90%
CoC
90%
80%
80%
60%
60%
40%
40%
20%
20%
0%
0%
ACI
CoC
ACI
100%
PUBLICATIONS LIST
ANN A BL UM ENTAL- PE RRY, P H. D.
Degar,A; Kenche,H; Pandit,K.; Kaminski,N; Richards,D; Nelson,C and Blumental-Perry,A.
miRNA-805 Up-regulation in Response to Cigarette Smoke Challenge Regulates Alveolar Type II Cells Regeneration
and Repair Capacity. American Thoracic Society meeting, May 2013, Philadelphia.
K Vedagiri, CE Reynolds, H Kenche, A Degar and A Blumental-Perry. Unfolded Protein Response as a driving force
of tissue loss during virally induced Exacerbations of Chronic Obstructive Pulmonary Disease. FASEB Summer
Research conferences: From Unfolded Proteins in the ER to Disease, short Data Blitz talk, June 2013, Vermont
Degar,A; Kenche,H; Pandit,K.; Kaminski,N; Nelson,C and Blumental-Perry,A. Regulation of Alveolar Type II Cells
Regeneration and Repair by miRNA-805. Gordon Research Conferences: Lung Development and Repair, August
2013, Andover, NH.
W A Y N E G L A S G O W, P H . D . , S H I - W E N “ A L B E R T ” J I A N G , P H . D . ,
AND JEN-PING LI, PH.D.
Hinton, J., Callan, R., Bodine, C., Glasgow, W., Brower, S., Jiang, S-W., and Li, J. Potential epigenetic
biomarkers for the diagnosis and prognosis of pancreatic ductal adenocarcinomas. Expert Review of
Molecular Diagnostics, 13(5): 431-435, 2013.
AARO N PE DE R S ON, M.D., CA L E B P RI CE , CH A NT E ’ F RA ZIE R ,
JOHN DUT TE NHAVE R, M .D.
Price C, Pederson A, Frazier C, Duttenhaver J. In vivo dosimetry with optically stimulated dosimeters and
RTQA2 radiochromatic film for intraoperative radiotherapy of the breast, Med Phys 2013 Sep;
40(9):091716.doi:10.1118/1.4819825
H I MANGSHU BO SE , P H .D., RAY R UD OL P H, M. D., A N D JASM EE T KAU R , P H . D.
Kaur J, Rudolph R, Bose HS: N-terminal placed signal sequences do not affect the topology of passenger
proteins. Proceeding of the 95th Annual Meeting of Endocrine Society, June 23-26, 2013, San Francisco, CA
C HR IS TO PH ER K S E NKOW SK I, M .D.
Miller N, Macnew H, Nester J, Wiggins J, Shealy C, Senkowski C: Jump starting a quality and performance
improvement initiative to meet the updated ACGME guidelines. J Surg Ed 70:758-768. 2013
Barney L, Jackson J, Mabry C, Savarise M, Senkowski C: Coding for damage control surgery. Bull AM Coll Surg
98(7) 48-51. 2013
Barney L, Jackson JJ, Ollapally VM, Savarise MT, Senkowski CK: Documentation of services in the postoperative
global period Bull AM Coll Surg 98(5) 48-51. 2013
Jackson JJ, Mabry CD, Savarise MT, Senkowski CK: Effectively using E/M coding for trauma care. Bull AM Coll
Surg 98(6) 56-65. 2013
Banks PA, Bollen TL, Dervenis C et al : Classification of acute pancreatitis-2012: revision of the Atlanta
classification and definitions by international consensus: Gut 62(1) 102-111. 2013.
Health Policy Advisory Council (HPAC) Webinar, “Improved insurance payment and RVUs for surgeons: How and
why the ACS is involved in the MA RUC process. Jun 2013
Surgeons and Bundled Payment Models. A Primer for understanding alternative physician payment approaches.
American College of Surgeons General Surgery coding and Reimbursement Committee, 2013
Surgeons as institutional employees: a strategic look at the dimensions of surgeons as employees of hospitals.
Jackson J, Jasak R, Mabry C, Senkowski CK: American College of Surgeons 2013
S COT T P UR I NTO N, M.D., AND JAM E S BUR KE , M .D.
Burke, J.J., S.C.Purinton and H. MacNew. Perioperative and Critical Care. Principles and Practices of Gynecologic
Burke, J.J. and S.C.Purinton. Five things every woman should know about gynecologic cancers.
Inside the ACI, 10-11, Fall 2013.
Oncology. Sixth Ed. Lippincott Williams & Wilkins. Chaper 8, 151-189, 2013.
W I L L I A M A N D I F F AT H H O S K I N S C E N T E R
FOR BIOMEDICAL RESEARCH
T H E C U RT IS A N D EL I Z A BE TH A N D E R SO N C A NC ER I N S TI T U TE
AT M EMO R I AL U N I V ER S IT Y M ED I CA L C EN TE R
47 00 WAT ER S AV E N U E , SAVA N N AH , GE O R G I A 31 4 0 4 - 6 2 2 0
91 2 - 35 0 - 8 49 0 8 0 0 - 3 43 - 30 2 5 AC I . ME MO R I AL HE ALTH . C O M
Experience Excellence.

2013 Annual Report

Transcription

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