“Do not go where the path may lead, go instead where there is no

Transcription

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“Do not go where the path may lead,
go instead where there is no path and leave a trail.”
— Ralph Waldo Emerson
[ 2 0 0 3
A N N U A L
R E P O R T ]
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C O N T E N T S
From the Presidents . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
From the Committee Chair . . . . . . . . . . . . . . . . . . . . . 3
From the Lab to the Bedside
Reaching Out to Our Community
Head and Neck Tumor Board Formed . . . . . . . . . . . . . 5
Camp Rainbow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Green Tea Research Uncovers Cell Pathways . . . . . . . . 6
Gynecologic Cancer Awareness Month . . . . . . . . . . . 13
Enhancements Underway at
Prostate Cancer Support Group . . . . . . . . . . . . . . . . . 13
Georgia Radiation Therapy Center . . . . . . . . . . . . . . . 7
Prostate Cancer Awareness Week . . . . . . . . . . . . . . . . 13
Mobile MRI Acquired . . . . . . . . . . . . . . . . . . . . . . . . . 7
Breast Cancer Awareness Month . . . . . . . . . . . . . . . . 13
Gynecologic Cancer Prevention Center Expands . . . . 7
Lung Cancer Awareness Week . . . . . . . . . . . . . . . . . . 13
Two Programs Aim to Snuff Out Smoking . . . . . . . . . . 8
Tips for Tobacco Prevention . . . . . . . . . . . . . . . . . . . 13
Cancer Research Building Funding Obtained . . . . . . . 9
Great American Smokeout . . . . . . . . . . . . . . . . . . . . . 14
Interdisciplinary Research Building Addition
Health Hotline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Nears Completion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Relay for Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Study Pursues Self-Destruction of
Susan G. Komen Foundation Ultimate Drive™ . . . . . 14
Prostate Cancer Cells . . . . . . . . . . . . . . . . . . . . . . . . . . 9
National Oral Cancer Screening Week . . . . . . . . . . . . 14
Study Focuses on How Cancer Cells Spread . . . . . . . 10
Tour de Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
New Treatment for Ovarian Cancer Studied . . . . . . . 11
MCG Breast Cancer Support Group . . . . . . . . . . . . . . 15
Study Targets Natural Mechanism for Cell Death . . . 11
Share and Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Star Wars Helps Locate Cancer Cells . . . . . . . . . . . . . 11
Sibling Day . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Cancer Registry
Cancer Committee . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Cancer Registry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Multidisciplinary Cancer Conferences . . . . . . . . . . . . 18
Distribution by Site and Stage: 2002 Analytic Cases . . 20
Where the Patients Live: 2002 Analytic Cases . . . . . . 21
2002 Analysis: Ovarian Cancers . . . . . . . . . . . . . . . . 22
Statistical Summary . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Glossary . . . . . . . . . . . . . . . . . . . . . . Inside Back Cover
Contact Us . . . . . . . . . . . . . . . . . . . . Inside Back Cover
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F R O M
T H E
P R E S I D E N T S
Dr. Daniel W. Rahn
Don Snell
President
President & CEO
Medical College of Georgia
MCG Health, Inc.
The Medical College of Georgia (MCG) campus
We have significantly enhanced our technological
community is an academic medical center. We are
capabilities. For example, we have upgraded and
different from a community hospital. We conduct
expanded our Intensity Modulated Radiation Therapy
pioneering research that defines tomorrow’s medicine
potential. We acquired an open, combination Positron
and we apply those discoveries to today’s patient care.
Emission Tomography/Computerized Tomography
Our cutting-edge treatments go from the lab bench to
scanner with simulation ability and we obtained the
the patient bedside with warp speed instead of at a
services of a mobile Magnetic Resonance Imaging unit.
snail’s pace. From preventive care to early diagnosis to
At a 1996 benefit for Georgetown University’s Center
innovative treatment, we offer our patients one-stop
for Breast Cancer Research, the late Princess Diana of
shopping. Our highly trained, board certified physicians
Great Britain said, “The story of breast cancer is no
provide a multidisciplinary approach to comprehensive
longer the story of death, but one of new, improved
patient care.
life.” That is our hope for all cancers. We are fighting
cancer – all cancers – by contributing to the body of
We recently recruited a number of world-class physicianknowledge and by demonstrating the effectiveness of a
scientists. We attracted Dr. Thomas Wang and Dr. Daniel
variety of treatments.
Albo, nationally known surgical oncologists, from
M.D. Anderson. Hematology/oncology physicians
This report highlights our many efforts to prevent,
Dr. Oscar Ballester and Dr. John Hiemenz joined our
diagnose and treat cancer. And, perhaps more impor-
faculty after spending a number of years at Albany
tantly, this report tells of our initiatives to understand
Medical Center/Moffitt. We have seven Georgia Cancer
cancer and, therefore, control the course of the disease.
Coalition scholars and a large cadre of MDs and Ph.D.s
Sincerely,
conducting cancer research.
Dan Rahn
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Don Snell
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C A N C E R
C O M M I T T E E
C H A I R
The American Cancer Society and the Georgia Hospital
The quality of our oncology program was recognized in
Association predict that there will be an estimated
September 2002 when we received a three-year accredita-
1.3 million new cancer cases in the U.S. this year,
tion from the American College of Surgeons. The surveyors
of which more than 33,000 will be Georgians.
awarded us a perfect score, which placed our program
Approximately 565,000, or 1,500 a day, are expected to
in the top quartile among nearly 1,200 programs.
die. Cancer is the second leading cause of death, one of
For the past several years, we have worked hard to forge
every four, in the U.S. and Georgia.
a collaborative educational, research and clinical partDo we stand a chance against such a powerful,
nership between the Medical College of Georgia and
mysterious and prevalent disease? Emphatically, yes.
the University of Georgia. Our goal is to build on the
The number of recent advances and the successful
strengths of our respective institutions to secure National
treatment protocols give me great confidence and
Cancer Institute designation as a Comprehensive
optimism. MCG has played a key role in cancer
Cancer Center within eight years. We took a step in the
research and in patient treatment, of which you will
right direction this year when the state approved two
learn more in the following pages.
cancer designations for the region and us. First, the
Georgia Cancer Research Center, a collaborative proposal
from MCG and the University of Georgia, received
provisional designation as a Cancer Center of Excellence.
Second, the East Georgia Cancer Network, composed
of Augusta and Athens hospitals and physicians,
received designation as one of three Regional Programs
of Excellence.
Sincerely,
Dr. W. Chris Sheils
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T H E
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Head and Neck Tumor Board Formed
PET/CT scan
Each week a multidisciplinary Head and Neck Tumor
Board, composed of specialists from head and neck
surgery, medical oncology, radiation oncology, oral
same morning, the group reconvenes with each patient
surgery and speech pathology, meets and prospectively
and schedules any appointments and interventions
evaluates newly referred patients. Following those
necessary to begin treatment.
one-stop patient evaluations, the team reviews X-rays
In addition to providing patients with access to multiple
with radiologists and histology slides with pathologists.
specialists in a single setting, the Tumor Board serves as
All reasonable treatment options, including state-of-the-
an excellent source for recruiting patients for clinical
art protocols, are considered in a spirited discussion.That
trials and testing new treatment modalities. Because of
our pioneering nature, we offer innovative surgical
techniques, including minimally invasive neck surgery.
MCG Health System is the only institution in the South
that offers thyroidectomy under local anesthesia and
parotidectomy through a facelift incision that helps
hide the scar.
The Head and Neck Tumor Board is spearheaded by
Dr. David J. Terris, a physician-scientist who joined MCG
to head the newly created Department of Otolaryngology
(head and neck surgery) after serving for many years
as a physician leader at Stanford University. Dr. Terris
In November 2002, 56-year-old Bill Matlock began to have trouble swallowing,
especially solid food. His general practitioner referred him to Dr. David J. Terris,
who diagnosed Matlock as having laryngeal liposarcoma, a tumor located in
an unusual site in his larynx. In December 2002, Dr. Terris performed a partial
laryngectomy to remove about half of Matlock’s voice box and reform his vocal
was selected from among 39 candidates for the Gyrus
Leadership Development Program of the American
Academy of Otolaryngology, a new program designed
to foster leadership qualities.
cords using tissue and muscle from Matlock’s throat. Matlock’s 21-year-old
daughter, Brenna, said that the news of her father’s cancer was unexpected.
"We’re grateful that Dr. Terris was able to leave half of his voice box in place so
that he still has a voice."
Matlock (left) is pictured with Brenna (right), who is holding her daughter,
Keeley. Dr. Terris is in the center.
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Green Tea Research Uncovers
Cell Pathways
Cell Biologist Dr. Stephen Hsu, who helped identify
He further found that P-57, a protein that helps regulate
cancer-fighting properties in green tea, has traced the
cell growth and differentiation, changes the behavior
juncture at which healthy cells are shuttled to safety
of healthy cells as polyphenols target cancer cells for
and cancer cells are sentenced to death.
destruction. This change of behavior protects the
healthy cells.
Dr. Hsu has been intrigued by the properties of green tea
since observing that Asians – who typically drink green
His latest, and perhaps most dramatic finding is that
tea on a regular basis – have much lower cancer rates
the polyphenols actually activate two separate path-
than other populations. His research helped determine
ways, one for normal cells and one for cancer cells. The
that compounds in the green tea, called polyphenols,
polyphenols seem to serve as a sentinel, separating cells
help eliminate free radicals that can alter DNA, cause
with P-57 from cancer cells, which lack P-57. Using
mutations and lead to cancer formation.
human cancer cells, he found that while the normal
cells are shuttled to safety, the polyphenols destroy the
mitochondria of cancer cells.
Dr. Stephen Hsu
Cell Biologist
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Enhancements Underway at Georgia
Radiation Therapy Center
Gynecologic Cancer Prevention
Center Expands
The Georgia Radiation Therapy Center has undergone
The Gynecologic Cancer Prevention Center has been in
significant improvements and additions, enabling it to
operation for three years. Due to its growing reputation,
increase the types of services it offers to greater numbers
the center saw an increase in the number of referrals
of cancer patients throughout the region.
from across Georgia and from much of South Carolina
during the past year. The program provides women an
Improvements include an upgrade to one of our four
expert level of care that is unmatched in the Southeast.
linear accelerators to provide Intensity Modulated
Radiation Therapy (IMRT). IMRT gives cancer patients
In addition to patient care, the center focuses on teaching
the benefit of much more precise and focused radiation
and research in the areas of cervical, vulvar and vaginal
treatment. In addition, we have purchased an additional
neoplasias. Dr. Daron Ferris, Director of the center, is also
IMRT-ready accelerator.
a co-investigator of several studies involving HPV vaccines,
one of which made national headlines. The center has
The Georgia Radiation Therapy Center has been
also been extensively involved in the development
expanded to house an open, combination PET and CT
and evaluation of fluorescent and reflective spectroscopy
scanner with simulation capability. The Positron Emission
equipment used to diagnose and triage women with
Tomography/Computerized Tomography scanner procervical neoplasia. The center’s tissue bank continues to
vides the best diagnostic imaging technology available
expand with the addition of an international
for detecting cancers early, evaluating recurrence and
collaboration with Chiang Mai
showing the patient’s response to therapy.
University, Thailand.
Mobile MRI Acquired
We recently acquired the services of a mobile Magnetic
Resonance Imaging (MRI) unit, our third MRI. This unit
helps us meet our growing patient demand by allowing
us to perform an additional 30 procedures a week.
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Two Programs Aim to Snuff Out Smoking
Researcher Jeannette Andrews is conducting a pilot
Dr. Martha Tingen, Associate Professor of Nursing
study to test a community-based smoking cessation
Science, who has focused on tobacco prevention in
program targeting impoverished black women in
children, designed Project GIFT to help reduce the
Augusta-Richmond County. The program, funded by
number of Georgians who smoke and are exposed to
the American Cancer Society, began with a call for help
secondhand smoke. Tobacco causes 87 percent of all
from a guidance counselor at Jenkins-White Elementary
lung cancers in the state.
School, where the counselor noted high rates of asthma
and respiratory diseases – the effect of second-hand
smoke – in the school’s pupils.
The curriculum, taught by public school nurses, includes
15 classes of Life Skills training to help students learn
to resist substance abuse and to live a healthy lifestyle.
The culturally appropriate anti-smoking campaign
Nearly 550 students and parents/guardians were recruited
includes an advisory board to disseminate smoking-
to participate in Project GIFT.
prevention information to young people; a community
message board in Barton Village to provide positive
health messages; coordination with a federally funded
WEED and SEED program to battle crime and cultivate
Karlton Clay is a 17-year-old Davidson Fine Arts student who was first diagnosed
community growth; and mentoring, tutoring and
with leukemia in March 2002. His cancer is in remission. He is a very positive
and optimistic young man and hopes to some day write movie, TV and stage
parenting classes. Another element in the intervention
scripts as well as books that incorporate the lessons he’s learned as a result of
program is to employ adult women who have already
having cancer. "We’ve had awesome treatment at MCG," said his mother, Sonya.
stopped smoking to serve as community health advisors.
His father, Kenneth, added: "The manner in which our caregivers explained
the disease and the treatment plan helped us get a good understanding of
These community health advisors assist with smoking-
leukemia and helped to make it easier for all of us to accept."
cessation programs for women living in the Barton
Karlton is pictured with Dr. Michelle Brenner (left), a Pediatrician in
Chapel school district.
Hematology/Oncology, and his mother, Sonya (right).
In a second program, MCG joined forces with the
Georgia Division of Public Health to give Georgia
youth the GIFT of a tobacco-free life. Project GIFT
(Georgia’s Initiative to Fight Tobacco) is a statewide
initiative targeting sixth grade classrooms in each
of the state’s 19 public health districts.
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Cancer Research Building
Funding Obtained
The Robert W. Woodruff Foundation, Inc. awarded a
$2 million grant to support construction of a $46.9 million
Dr. M. Vijay Kumar
Molecular Biologist and
Director of Research,
cancer research building. We received $10 million in
Section of Urology
funding from the state of Georgia to plan, design and
assist with the construction of the building. MCG also
has submitted requests for federal support as a partial
or complete match for state support. The balance of
funding will be raised through philanthropic support
of individuals and charitable foundations as well as
support from the MCG Physicians Practice Group.
The cancer research building is a key component of
Study Pursues Self-Destruction of
Prostate Cancer Cells
MCG, the University of Georgia and the cities of Augusta
Prostate cancer cells skilled at avoiding self-destruction are
and Athens being a regional cancer center as well as
the target of research by Dr. M. Vijay Kumar, Molecular
MCG’s and the University of Georgia’s provisional
Biologist and Director of Research for the Section of
designation as a Center of Excellence through the
Urology. He found that when hormone-dependent
Georgia Cancer Coalition.
cancer cells are treated with anti-hormone therapy, some
manipulate their internal workings to avoid destruction.
Interdisciplinary Research Building
Addition Nears Completion
Construction nears completion on the 94,000-square-
He is exploiting the death pathways that all cells have in
order to find a safe, effective way to get prostate cancer
cells to self-destruct.
foot addition to the Interdisciplinary Research Building.
The addition will double the building’s available
research space. Cancer research will be one of the
major areas for study.
Stem Cell Gene Transfer
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Dr. Thomas N. Wang
Surgical Oncologist, Cancer Researcher,
T O
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B E D S I D E
Since coming to MCG from the University of Texas
M.D. Anderson Cancer Center, Dr. Wang has also
and Georgia Cancer Coalition
Distinguished Cancer Clinician and Scientist
become interested in the potential for manipulating the
immune system to target destruction of cancer. MCG
researchers have identified a mechanism that enables
the immune system to ignore a developing fetus, which
is genetically foreign to the mother and should be
rejected by her immune system. Mounting evidence
indicates that some cancer tumors may also utilize this
mechanism to escape attack. Dr. Wang is looking for
ingenious ways to target tumors and cancer cells and
Study Focuses on How
Cancer Cells Spread
eliminate the need for current therapies that don’t
Why liver and pancreas cancer cells are so good at
He is applying some of the new knowledge in a study
invading healthy tissue is a question currently being
looking at the lymph nodes of patients with pancreatic
studied by Dr. Thomas N.T. Wang, Surgical Oncologist
cancer, to see if he can identify a sentinel lymph node
and Cancer Researcher, and Georgia Cancer Coalition
where this cancer most typically spreads and whether
Distinguished Cancer Clinician and Scientist. Pancreatic
that node has unique characteristics that make it
cancer, colorectal cancer that spreads to the liver and
an easy place to spread. He is hopeful that identifying
primary liver cancer are all extremely invasive. Dr. Wang
the sentinel lymph node for pancreatic cancer could
is studying the characteristics of these cancer cells
also lead to better ways to stage pancreatic cancer,
that allow them to invade structures so well.
as it has for melanoma and breast cancer. This may
differentiate between cells to kill all dividing cells.
also help identify a tumor marker that will aid in
diagnosing the disease.
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Dr. Sharad Ghamande
Assistant Professor,
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Dr. Michael S. MacFee
Chief of Gynecologic Oncology
Gynecologic Oncology
New Treatment for
Ovarian Cancer Studied
Dr. Sharad Ghamande, Assistant Professor of
Gynecologic Oncology, is a principal investigator and
Dr. Michael S. MacFee, Chief of Gynecologic Oncology,
is a sub-investigator in an international study that
adds Interferon gamma 1-b to the standard treatment
protocol for women with late-stage ovarian cancer. The
agent stimulates the immune system to identify and
eliminate abnormal cells.
Star Wars Helps Locate Cancer Cells
A new cellular-imaging system based on technology
developed by NASA as part of the U.S. Strategic Defense
To ensure that the latest treatments under evaluation
are available to all of its patients, Gynecologic
Oncology became an affiliate member of the National
Cancer Institute’s Gynecologic Oncology Group, which
gives the doctors and their patients access to all NCI-
Initiative, better known as Star Wars, helps MCG Health
System pathologists locate cancer cells. We are the first
in the region to use the ChromaVision Automated
Cellular Imaging System to detect, count and classify
abnormal cells based on color, size and shape.
sponsored clinical trials.
This new technology can locate a single tumor cell
among 10 million normal cells and track numbers of
Study Targets Natural Mechanism
for Cell Death
As cells take their first steps toward becoming cancer, a
gene called p53 often realizes something is amiss and
causes wayward cells to self-destruct. Dr. Andrew C. Phillips,
Molecular Biologist and Georgia Cancer Coalition
cancer cells to determine if the disease is proliferating.
It can also measure the quantities of certain proteins
expressed by cells, important in determining the efficacy
of cancer drugs and a patient’s prognosis. Pathologists
can then provide oncologists with a comprehensive
report that will assist in their clinical decision-making.
Distinguished Cancer Scientist, is working to understand
The system is being primarily used to detect breast cancers,
how that self-destruction, called apoptosis, happens. His
but also has applications for gastrointestinal tumors,
goal is to find the genes involved in apoptosis that may be
which have a well-recognized set of tumor markers.
lost or mutated in cancer, so that more effective and less
toxic cancer treatments that target these genes can be found.
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Camp Rainbow
Prostate Cancer Awareness Week
Each year, we host Camp Rainbow, a free summer camp
Prostate Cancer Awareness Week was commemorated
for children with cancer or a rare blood disease. The
in September by Urologic Oncologist Dr. James A. Brown,
weeklong camp is held at Camp Twin Lakes in Rutledge,
Georgia Cancer Coalition Distinguished Cancer Clinician
Ga., and allows children to enjoy a break from
and Scientist. Dr. Brown provided community education
hospital stays and physician visits.
through the news media about detection methods and
encouraging men over 40 to get examined and tested.
To help raise funds, the MCG Children’s Medical Center
hosted the ninth annual Camp Rainbow Benefit Open
Horse Show at the Hippodrome Horse Complex in North
Breast Cancer Awareness Month
We teamed with the American Cancer Society to offer
Augusta. The show was open to equestrians of all ages.
educational literature, videos and demonstrations.
Classes included English, Western, Championship and
Cancer Center Nurse Manager Kim Cheely also used
Exhibition, with awards for first through sixth place.
the news media to tell women about the risk factors
As a prelude to the camp, T-Bonz Restaurant hosted
and the importance of early detection through
the Annual Teen Night for Camp Rainbow participants.
mammograms and self-examinations.
After having a free steak dinner, the campers visited
Funsville for an evening of fun and games.
Lung Cancer Awareness Week
Oncologist Dr. Andre Kallab provided public education
Gynecologic Cancer Awareness Month
about early detection and screening examinations
Dr. Michael MacFee, Chief of Gynecologic Oncology,
through the news media. He also encouraged smokers
commemorated Gynecologic Cancer Awareness Month
to quit and asked nonsmokers not to start.
in September by issuing diagnostic and prevention tips
through the news media. He encouraged women to
Tips for Tobacco Prevention
help prevent, detect and treat gynecologic cancers by
Dr. Robert Pendergrast, Director of Adolescent Medicine,
getting an annual exam and having a pap smear.
prepared an article in which he encouraged parents to
use the American Cancer Society’s annual Great American
Smokeout as an opportunity to begin a dialogue with
their adolescent children about the dangers of smoking.
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Left: We recognize that children, regardless of their health, need to be children, so
we provide our pediatric oncology patients with ample opportunities to forget
about their health and focus on having fun. Right: MCG Health System
Mammography Technicians Kellie Bedenbaugh and Andrea Phommachanh were
just two of the participants of The BMW of North America, Inc. Ultimate Drive for
the Susan B. Komen Breast Cancer Foundation.
Great American Smokeout
The Ultimate Drive™
Free tobacco cessation and prevention information was
Nurse Gita Giddens and Marketing Specialist Kate Wicker
available as we took part in the American Cancer Society’s
served as Co-chairs of The BMW of North America, Inc.
national initiative to help people quit smoking. The
Ultimate Drive for the Susan B. Komen Breast Cancer
public was invited to stop by information tables staffed
Foundation held at Taylor BMW, for which we helped
by health care professionals who answered questions
raise nearly $7,000. The Ultimate Drive is a nationwide
about how smoking affects the body and offered guide-
breast health awareness campaign where participants are
lines on how to quit successfully.
invited to test drive a new BMW. For each mile driven,
BMW contributes $1 to the Foundation on behalf of
Health Hotline
the driver.
Urologic Oncologist Dr. Martha Terris participated in the
Tamika Weaver, Senior Administrative Secretary in
Health Hotline co-sponsored with The Augusta Chronicle,
Cardiology, was honored as a “Local Hero” at the event.
in which members of the public called in to have their
Weaver was diagnosed with breast cancer at 27. Now
health questions answered. Prostate cancer (risk factors,
29, she has been an active volunteer with the Breast
diagnosis, surgical treatment, seed implants, hormone
Cancer Support Group for the past two years. Weaver
treatment and nutritional therapies) was among the
also served as a team captain during the 2002 and 2003
topics covered by Dr. Terris.
American Cancer Society Relay for Life fund-raisers, and
Relay for Life
is a volunteer with the American Cancer Society Reach
to Recovery program.
Each year, we actively support the American Cancer
Society’s Relay for Life of Richmond-Columbia County.
In 2003, our faculty, staff, students, cancer patients and
family members raised $20,708.11. Andy Anderson,
Director of Materials Management, and Shawn Vincent,
the Administrative Director of our Comprehensive Cancer
Center, served as event Chair and Co-chair, respectively.
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National Oral Cancer Screening Week
The Ear, Nose and Throat Department offered free
screenings for head, neck and oral cancers, which are
more prevalent in the South.
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Tour de Georgia
Sibling Day
The Cancer Center was a sponsor of the inaugural Tour
Siblings want their sick brother or sister to get better,
de Georgia. The event is a six-day professional cycling
but often they feel left out because of the amount of
race sanctioned by the International Cycling Union.
attention focused on the sick child. Many times, they
Proceeds of Tour de Georgia benefited the Georgia Cancer
simply don’t understand what their sick sibling has to
Coalition, a public/private partnership that coordinates
endure. Annually, we host Sibling Day to provide siblings
the development of world-class, comprehensive cancer
of children with cancer the opportunity to visit the
control programs.
clinic and learn about hospital and treatment routines.
Breast Cancer Support Group
The Breast Cancer Support Group meets the first
Thursday of each month. For further information,
contact Nurse Gita Giddens at 721-1467.
Share and Care
Each year, MCG Health System invites children recently
diagnosed with cancer and their families to participate in
a weekend retreat to share their experiences in a relaxed,
nonclinical environment. Special programs are offered
to help parents understand the challenges that await
them and the treatments their children will face. While
parents engage in support groups, the children and
their siblings enjoy fun activities.
Twenty-nine-year-old Tamika Weaver was diagnosed with breast cancer at 27.
She underwent a mastectomy on her right breast with reconstruction in
September 2001. She did not require chemotherapy treatment. “At any age,
it is devastating to learn that you have breast cancer, but particularly so
when your life is just beginning. I was lucky to find compassionate, state-ofthe-art care at MCG.”
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C A N C E R
W. Chris Sheils, MD
Cancer Committee Chair
Radiation Oncology
Christine Gourin, MD
Otolaryngology-Head and
Neck Surgery
Oscar Ballester, MD
Medical Oncology
Richard Hessler, MD
Pathology
James A. Brown, MD
Surgery/Urology
Shannon Horne, RN
Children's Medical Center
Patient Care Services
Lee Bultman
Social Work Services
Kim Cheely, RN, BSN, OCN
Patient Care Services
Katrina Fortier
Quality Management
16
Deborah L. Humphrey
Public Relations
Melissa H. Jarriel, RHIA,
CTR, CHP
Health Information
Management Services
C O M M I T T E E
Angela Lambert, RN
Hospital Administration
Michael MacFee, MD
GYN Oncology
James Rawson, MD
Radiology
Carolyn Sanders, CTR
Registry Services
David Terris, MD
Otolaryngology-Head and
Neck Surgery
Roger A. Vega, MD
Pediatric Hematology and
Oncology
Shawn Vincent
Comprehensive Cancer
Services
Miriam Whaley, RHIA, CTR
Registry Services
Marilyn Yarmon, RHIA, CTR
Georgia Radiation Therapy
Center
Karen Yeh, MD
Surgery Oncology
11/17/03
1:30 PM
Page 20
C A N C E R
R E G I S T R Y
The Cancer Registry collects data about each cancer
The resulting data illustrates statewide and nationwide
patient diagnosed or treated at our inpatient and
trends in cancer incidence, and helps clinicians and
outpatient facilities. Established in 1985, the Cancer
researchers evaluate the effectiveness of different types
Registry now has more than 14,200 cases in the database.
of treatment.
A Registry Services Administrator and a Registry Services
In 2002, the registry staff accessioned 870 new cases,
Specialist II, both of which are Certified Tumor Registrars,
786 of which were diagnosed or received first course
staff the MCG Cancer Registry. Their work begins when
treatment here. More than 4,500 cases are under
a new patient is diagnosed or referred. The registrars
active follow-up. The registrars also coordinated our
collect the demographic, tumor, staging, treatment
Multidisciplinary Cancer Conferences and bimonthly
and follow-up data that forms the complete picture of
Cancer Committee meetings, assisted in preparations for
each patient’s cancer experience. Completed cases are
the American College of Surgeons Commission on Cancer
submitted to the Georgia Comprehensive Cancer
accreditation survey, contributed to this Annual Report,
Registry and to the National Cancer Data Base, a joint
and reported data to clinicians and administrators.
project of the American Cancer Society and the
For more information about our activities or the cancer
Commission on Cancer of the American College of
information we collect, please call (706) 721-1768.
Surgeons. In both of these larger databases, our data is
combined with data from other submitting facilities.
17
11/17/03
1:30 PM
Page 21
M U L T I D I S C I P L I N A R Y
C A N C E R
C O N F E R E N C E S
MCG Health System and Augusta Veterans Administration
professionals meet weekly to discuss challenging cancer
cases during multidisciplinary cancer conferences.
These conferences are held on Wednesdays at 3:30 p.m.
in our fourth floor Amphitheater. The conferences
review the medical, surgical and radiation oncology
perspectives of each case, which are correlated with the
radiologic and pathologic findings. This provides an
ideal forum for rendering a multidisciplinary opinion,
promotes American Joint Committee on Cancer staging,
and serves to educate the medical staff.
In 2002, comprehensive cancer conferences were held
under the direction of Karen Yeh, MD. A total of 109
cancer cases were presented at the conferences with
an average attendance of 17 medical professionals.
The multidisciplinary group included hematology/
oncology, surgical oncology, surgery, radiation therapy,
pathology, radiology, nursing oncology, and allied
health representatives and students. In addition, more
than 90 departmental cancer conferences were held
during 2002. Multidisciplinary cancer teams reviewed
each of the cases to determine treatment options and
to discuss patient outcomes.
Current Management of
Ovarian Cancer
William Hoskins, MD
Mercer University
Savannah, Ga.
Dendritic Cell-Based
Cancer Vaccines
Jim Mulé, Ph.D.
Director, Tumor Immunology
Program of the Comprehensive
Cancer Center
University of Michigan
Medical Center
Ann Arbor, Mich.
Acute Chest Syndrome
In addition, the following cancer-related lectures and
seminars were presented.
18
Iris Buchanan, MD
Pediatric Hematology/Oncology
Morehouse School of Medicine
Atlanta, Ga.
STAT Activation in Acute
Myeloid Leukemia: A Model for
Targeted Molecular Therapy
Kenneth Stuart Zuckerman, MD
Professor of Internal Medicine,
Biochemistry & Molecular
Biology & Interdisciplinary
Oncology; Director, Division of
Medical Oncology & Hematology
University of South Florida and
H. Lee Moffitt Cancer Center &
Research Institute
Tampa, Fla.
Oncogene Expression
Cervical Cancer
Feng Wang Johanning, MD
Research Assistant Professor,
Department of Medicine,
Division of Hematology/
Oncology
University of Alabama at
Birmingham
11/17/03
1:30 PM
Page 22
M U L T I D I S C I P L I N A R Y
G-rich Olignucleotides:
Activity, Mechanism, and
How They Led to a
New Molecular Target
Paula Bates, Ph.D.
Assistant Professor, Department
of Medicine
James Graham Brown
Cancer Center
University of Louisville
Radiation-induced
Genomic Instability
William F. Morgan, Ph.D.
Professor and Director,
Radiation Oncology Research
Laboratory
University of Maryland
Baltimore, Md.
New Treatment Modalities in
Pancreatic Cancer: From the
Laboratories to the Clinics
Thomas N. T. Wang, MD, Ph.D.
Surgical Oncologist and
Molecular Pathobiologist
Augusta, Ga.
Thrombospondin-1 in
the Regulation of the
Plasminogen/Plasmin System
and Tumor Cell Invasion
Daniel Albo, MD, Ph.D.
Fellow, Surgical Oncology
MD Anderson Cancer Center
Houston, Texas
Current Issues in the
Management of Breast Cancer
Karen A. Yeh, MD
Associate Professor and
Service Chief, Surgical Oncology
Augusta, Ga.
Restoring the TGF-beta
Tumor Suppressor Pathway
in Cancers
Brian Law, Ph.D.
Research Assistant Professor,
Vanderbilt-Ingram
Cancer Center
Vanderbilt University
Nashville, Tenn.
A Novel Hormonal Approach
for Breast Cancer
Patricia V. Schoenlein, Ph.D.
Associate Professor, Cellular
Biology & Anatomy
Augusta, Ga.
and
Andre M. Kallab, MD
Assistant Professor,
Hematology/Oncology
Augusta, Ga.
Programmed Cell Death and
Cancer: An Overview
Baldev B. Singh, Ph.D., BDS
Professor, Oral Biology and
Maxillofacial Pathology
Augusta, Ga.
Descriptive Epidemiology
of Cancer Information in the
Mass Media
Laurie Hoffman-Goetz, Ph.D.
Professor, Department of Health
Studies and Gerontology
University of Waterloo
Ontario, Canada
C A N C E R
C O N F E R E N C E S
Biology and Targeting of
Prostate Cancer Metastasis
Leland Chung, MD
Professor of Urology,
Hematology/Oncology &
Biochemistry & Director
of Molecular Urology
and Therapeutics
Winship Cancer Institute,
Emory University
Atlanta, Ga.
Caloric Restriction Reduces
Angiogenesis and Growth in
Experimental Brain Cancer
Thomas N. Seyfried, Ph.D.
Professor of Biology
Boston College
Chestnut Hill, Mass.
Hormonal Therapy of Breast
Cancer Cells Induces Two
Distinct Cell Death Pathways:
Autophagocytic Versus
Apoptotic Cell Death
and
Strategies to Improve the
Hormonal Therapy of Breast
Cancer
Patricia Schoenlein, Ph.D.
Associate Professor, Department
of Cellular Biology & Anatomy
Augusta, Ga.
A New Way to Observe
Induction of Oral Cancer
Cell Death
Stephen Hsu, Ph.D.
Assistant Professor, OBMP,
School of Dentistry
Augusta, Ga.
New Horizons in Cancer
Gene Therapy: Development
of Anti-angiogenic,
Immunomodulatory,
and Oncolytic Gene
Transfer Vectors
Nori Kasahara, MD, Ph.D.
Assistant Professor, Institute for
Genetic Medicine & Departments
of Pathology & Biochemistry
University of Southern California,
Keck School of Medicine
Los Angeles, Calif.
Minimally Invasive Surgical
Approach to Urologic Oncology
James A. Brown, MD
Assistant Professor, Urology,
School of Medicine
Augusta, Ga.
Bone Marrow-derived
Endothelium Regulate
Tumor Responses to
Ionizing Radiation
Richard Kolesnick, MD
Head, Laboratory of Signal
Transduction and Member,
Sloan Kettering Institute,
Molecular Pharmacology &
Chemistry
New York, N.Y.
Probing the Phosphoproteome
in Cancer Cells
Satya Saxena, Ph.D.
Scientist, Proteomics and
Molecular Biology Program
Lovelace Respiratory Research
Institute
Albuquerque, N.M.
Induction of Apoptosis in
Prostate Cancer Cells by
Activating TRAIL Pathway
Vijay Kumar, Ph.D.
Associate Professor, Urology,
School of Medicine
Augusta, Ga.
19
11/17/03
1:30 PM
D I S T R I B U T I O N
Site of Cancer
Total
0
B Y
I
Page 23
S I T E
II
III
A N D
IV Unknown†
Lip
Tongue
Salivary Glands
Floor of Mouth
Gum and Other Mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
Other Buccal Cavity & Pharynx
2
10
4
5
8
4
6
3
8
1
0
0
0
0
2
0
0
0
0
0
0
3
0
0
3
0
0
0
0
0
0
2
1
1
0
0
1
1
0
1
1
2
0
0
0
0
0
0
0
0
1
2
3
4
3
4
5
2
8
0
0
1
0
0
0
0
0
0
0
0
Buccal Cavity & Pharynx
51
2
6
7
3
32
1
Esophagus
13
Stomach
7
Small Intestine
4
Colon Excluding Rectum
38
Rectum & Rectosigmoid
18
Anus, Anal Canal & Anorectum
1
Liver & Intrahepatic Bile Duct
9
Other Biliary
2
Pancreas
8
Other Digestive Organs
1
Digestive System
101
0
0
0
3
0
0
0
0
0
0
3
3
1
0
3
2
1
0
0
1
0
11
4
0
1
9
3
0
3
0
1
0
21
2
0
0
7
2
0
2
0
0
0
13
1
3
0
12
5
0
3
1
6
0
31
3
3
3
4
6
0
1
1
0
1
22
0
2
0
0
0
2
14
1
0
3
7
0
0
4
21
0
0
5
46
0
2
1
5
0
Nasal Cavity, Middle Ear &
Accessory Sinuses
Larynx
Lung & Bronchus
Pleura
Trachea, Mediastinum &
Other Respiratory Organs
2
17
93
1
S T A G E :
2 0 0 2
A N A LY T I C
Site of Cancer
Total
Prostate
Testis
Penis
Male Genital System
77
7
2
86
0
0
1
1
0
5
1
6
60
1
0
61
8
1
0
9
9
0
0
9
0
0
0
0
Urinary Bladder
Kidney & Renal Pelvis
Ureter
Other Urinary Organs
17
24
1
1
10
0
1
0
2
12
0
0
1
1
0
0
1
5
0
0
3
4
0
0
0
2
0
1
43
11
14
2
6
7
3
Urinary System
0
I
II
C A S E S
III
IV Unknown†
Brain
Other Nervous System
Brain & Other
Nervous System
28
1
0
0
0
0
0
0
0
0
0
0
28
1
29
0
0
0
0
0
29
Hodgkin’s Lymphoma
Non-Hodgkin’s Lymphoma
Lymphomas
10
27
37
0
0
0
1
4
5
2
6
8
2
1
3
4
11
15
1
5
6
Acute Lymphocytic Leukemia
Chronic Lymphocytic Leukemia
Other Lymphocytic Leukemia
Acute Myeloid Leukemia
Other Myeloid Leukemia
Other Acute Leukemia
Multiple Myeloma
Blood & Bone Marrow
7
3
2
12
2
1
9
36
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
3
2
12
2
1
9
36
Thyroid
Other Endocrine
(Including Thymus)
18
0
10
2
3
1
2
1
0
0
0
0
0
1
2
0
0
0
0
0
2
114
2
17
10
25
51
9
Endocrine
20
0
10
2
3
1
4
Bones and Joints
Soft Tissue (Including Heart)
Bones, Joints & Soft Tissue
1
8
9
0
0
0
0
2
2
1
3
4
0
2
2
0
0
0
0
1
1
Eye & Orbit
2
0
0
0
0
0
2
Other & Unknown Site
30
1
1
3
0
2
23
Melanomas-Skin
Other Nonepithelial Skin
Skin (Excluding Basal &
Squamous)
31
2
12
0
10
0
6
0
2
0
1
0
0
2
Total 2002
Analytic Cases
786
55
134
170
112
167
33
12
10
6
2
1
2
68
9
12
25
16
5
1
30
40
3
23
7
21
3
127
1
0
0
0
1
12
0
14
13
19
0
2
1
4
1
40
7
5
0
3
2
4
0
21
7
7
2
11
0
1
2
30
1
5
0
6
1
0
0
13
1
4
1
1
2
0
0
9
Respiratory System
Breast
Cervix Uteri
Corpus Uteri
Uterus, NOS
Ovary
Vagina
Vulva
Other Female Genital Organs
Female Genital System*
20
† Includes primary sites that do not have an AJCC staging scheme
* Excludes In-Situ Cervical Carcinoma
148
11/17/03
W H E R E
1:30 PM
T H E
Page 24
P A T I E N T S
L I V E :
2 0 0 2
A N A L Y T I C
C A S E S
The Medical College of Georgia Cancer Registry accessioned 786 analytic patients in 2002.
Total GA . . . . . . . . . . . . . . . 666
Total SC . . . . . . . . . . . . . . . . 118
Other states . . . . . . . . . . . . . . 2
Georgia
Appling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Atkinson . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Bacon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Baldwin . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Barrow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Bartow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Berrien . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Bulloch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Burke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Butts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Camden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Candler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Carroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Chatham . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Cherokee . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Clarke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Cobb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Coffee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Colquitt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Columbia . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Crawford . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Crisp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Decatur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DeKalb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Dodge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Dougherty . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Douglas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Elbert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Emanuel . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Evans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Forsyth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Franklin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Fulton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Gilmer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Glascock . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Glynn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Gordon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Greene . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Gwinnett . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Hall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Hancock . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Hart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Houston . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Jackson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Jeff Davis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Jefferson . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Jenkins . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Johnson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Lamar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Laurens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Lincoln . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Lowndes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
McDuffie . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Madison . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Mitchell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Monroe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Morgan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Murray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Muscogee . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Oconee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Oglethorpe . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Peach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Pierce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Putnam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Quitman . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Randolph . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Richmond . . . . . . . . . . . . . . . . . . . . . . . . . 188
Screven . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Spaulding . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Stephens . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Sumter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Talbot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Taliaferro . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Tattnall . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Telfair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Terrell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Thomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Tift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Toombs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Treutlen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Troup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Twiggs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Union . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Upson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Walton . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Ware . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Warren . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Washington . . . . . . . . . . . . . . . . . . . . . . . . 19
Wayne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Wilkes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Worth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
South Carolina
Abbeville . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Aiken . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Allendale . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Barnwell . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Beaufort . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Berkeley . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Edgefield . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Florence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Greenwood . . . . . . . . . . . . . . . . . . . . . . . . . . 3
McCormick . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Newberry . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Pickens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Saluda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Spartanburg . . . . . . . . . . . . . . . . . . . . . . . . . 1
Spartanburg
Pickens
Union
Murray
Florence
White
Gilmer
Newberry
Stephens
Greenwood
Abbeville
Saluda
Franklin Hart
Gordon
Cherokee Forsyth
Hall
Madison Elbert
McCormick
Edgefield
Barrow Clarke Oglethorpe
Lincoln
Aiken
Wilkes
Gwinnett
Oconee
Cobb
Columbia
alton
Walton
DeKalb
Dekalb
Greene
Fulton
McDuffie
aliaferro McDuffie
Taliaferro
Barnwell
Morgan
Richmond
Douglas
arren
Warren
Allendale
Putnam Hancock Glascock
Carroll
Burke
Butts
Jef
ferson
Jefferson
Spaulding
Baldwin
ashington
Washington
Jenkins Screven
Lamar
Monroe
Johnson
Emanuel
Troup
Upson
Twiggs
Bulloch
Crawford
Candler
Laurens
Talbot
reutlen
Treutlen
Peach
Houston
Evans
Chatham
oombs
Toombs
Muscogee
Tattnall
Dodge
Bartow
Jackson
Sumter
elfair
Telfair
Crisp
Berkeley
Beaufort
Jeff Davis Appling
ayne
Wayne
Terrell
Quitman
Randolph
Worth
Dougherty
Coffee
ift
Tift
Berrien
Mitchell
Decatur
Atkinson
Pierce
Glynn
Ware
Camden
Colquitt
Thomas
Bacon
Lowndes
21
11/17/03
1:30 PM
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Page 25
A N A L Y S I S :
O V A R I A N
C A N C E R S
During 2002, 24 new cases of epithelial ovarian cancer
Fifty percent of the patients had a family history of some
were diagnosed or received their primary treatment
kind of cancer. Three patients had a family history of
here. In the United States there are approximately
ovarian cancer and two had a family history of breast
23,000 new cases of ovarian cancer per year.
cancer. Those patients with family pedigree analysis
suggestive of BRCA mutations were referred for genetic
While the overall survival rate has minimally increased
counseling. One patient with a history suggestive of
over the past 10 years, the progression free interval has
Lynch II syndrome was also referred.
significantly lengthened. Survival rates were related to
the stage of disease. The survival rates for our patients
The majority of patients were in the sixth and seventh
over the past five years are: Stage I – 95 percent, Stage II –
decades of life. There was no apparent difference in
72 percent, Stage III – 42 percent and Stage IV – 19 percent.
survival by race.
As would be expected, 75 percent of the cancers
presented at an advanced stage.
Michael S. MacFee, MD
The majority of cases with advanced disease were treated
Professor and Vice Chairman,
with surgery and chemotherapy. The three cases treated
Department of Obstetrics and Gynecology
by surgery alone were tumors of low malignant potential.
Two patients with Stage IV disease elected palliative
care only.
22
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1:30 PM
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Page 26
A N A L Y S I S :
O V A R I A N
C A N C E R S
Ovarian Cancers 2002
Survival by Stage at Diagnosis 1997-2002
12
10
100%
8
80%
Percent Surviving
Number of Cases
Stage Distribution
6
4
2
0
I
II
III
IV
Stage I
Stage II
NA/Unknown
60%
Stage III
40%
20%
Stage IV
Stage at Diagnosis
0%
1
2
3
4
5
Years Survival
Age at Diagnosis
Treatment Modality by Best Stage
10
9
Stage II
Stage III
Stage IV
TOTAL
0
2
0
0
1
2
0
2
10
2
0
4
2
5
16
0
2
1
4
0
12
0
6
1
24
No Treatment
Surgery Only
Surgery & Chemotherapy
Surgery, Chemotherapy,
Hormone Therapy
TOTAL
8
Number of Cases
Stage I
7
6
5
4
3
2
1
0
30-39
40-49
50-59
60-69
70-79
80-89
Age Range
5
Family History of Cancer
No
50%
4
3
2
Yes
50%
Race
AfricanAmerican
21%
Other
4%
Caucasian
75%
vic
al
Co
lon
En
do
m
et
ria
l
Le
uk
em
ia
Ov
ar
ian
Pr
os
ta
te
St
om
Un
ac
kn
h
ow
nT
yp
e
Ce
r
Br
ea
st
1
0
Br
ain
Number of Patients
Patients with Family History of Cancer
Type of Cancer
23
11/17/03
1:30 PM
Page 27
S T A T I S T I C A L
S U M M A R Y
According to the American Cancer Society (ACS), an
diagnosed in 2002, remaining one of the top 10 sites of
estimated 1,284,900 new cancer cases were diagnosed
cancer for both males and females. In agreement with
in the United States in 2002. Cases diagnosed in
ACS statistics, the incidence of colorectal cancers
Georgia accounted for an estimated 31,600 of these
among MCG patients under age 50 was evenly divided
cases, with MCG Health System reporting 2.5 percent
between genders. Among MCG patients age 50 and over,
of Georgia’s cases.
colorectal cancer was more frequently diagnosed in men,
with males accounting for 57.1 percent of the cases.
Lung and bronchus, prostate and breast cancers were
the cancers most frequently diagnosed and treated at
The cancer patient volume at MCG continued to
MCG Health System in 2002, in agreement with the
increase, with more new patients from both Georgia and
state and national estimates. The percentages of MCG
South Carolina. Patients came from 92 Georgia counties
patients with leukemia, cervical cancers and uterine
to be diagnosed or treated at MCG, representing over
cancers were higher than for the corresponding United
57 percent of the total counties in Georgia. South
States and Georgia estimates.
Carolina patients represented about 15 percent of the
2002 caseload, coming from 14 different counties in
The ACS predicted 148,300 new colorectal cancers
that state.
would be diagnosed in the United States in 2002,
accounting for 11.5 percent of all cancers. At MCG,
colorectal cancers accounted for 7.1 percent of cancers
2002 Incidence Percent
Most Frequent Cancer Sites for 2002
MCG
GA
Female
Bronchus & Lung
16.0%
Prostate Gland
Breast
14.0%
SITE
Male
US
18.0%
Bone Marrow
12.0%
Skin (Melanoma)
10.0%
Corpus Uteri
8.0%
Cervix Uteri
Colon
Brain
6.0%
Lymph Nodes
4.0%
Kidney
2.0%
Ovary
Vulva
Ut
ia
er
in
eC
e
Ut
rv
er
ix
in
eC
o
Co
r
No
p
lon
us
nHo
&
Re
dg
c tu
kin
m
’s L
ym
ph
Ur
om
in
ar
a
yB
lad
de
r
a
om
ke
m
Le
u
st
ta
te
lan
Me
Pr
os
Br
ea
ale
Fe
m
Lu
n
g&
Br
on
ch
us
0%
24
Reference: American Cancer Society Cancer Facts and Figures 2002
(www.cancer.org)
Thyroid Gland
Bladder
0
20
40
60
80
100
11/17/03
1:30 PM
Page 28
G L O S S A R Y
Analytic Case
Cancer cases initially diagnosed and/or treated at MCG.
Summary Stage
In-Situ – A neoplasm that fulfills all the microscopic criteria for
malignancy except invasion.
Non-Analytic Case
A patient initially diagnosed and treated elsewhere receiving subsequent care at MCG.
Reference Date
The date after which all eligible cancer cases must be included in the
MCG Cancer Registry database. This date is January 1, 1985.
Tumor Grade
A method used to describe a tumor’s resemblance to the normal tissue from which it arose.
Grade 1 – Well differentiated
Grade 2 – Moderately differentiated, intermediate differentiation
Grade 3 – Poorly differentiated
Grade 4 – Undifferentiated, anaplastic
Neoplasm
Abnormal growth, such as a tumor.
Localized – Neoplasm is confined to the site of origin.
Regional – A neoplasm that has spread by direct extension to immediately adjacent organs or tissue and may have metastasized to
regional lymph nodes or organs, appearing to have spread no further.
Distant – A neoplasm that has spread beyond immediate adjacent
organs or tissues by direct extension and may have developed either
a secondary or metastatic tumor.
Unknown – A neoplasm whose stage cannot be determined from the
medical record or from a medical authority.
TNM Stage
A staging system developed by the American Joint Committee on
Cancer (AJCC) that takes into account the tumor (T) size and/or depth
of invasion, lymph node (N) involvement and distant metastases (M).
For each applicable site, a combination of T, N and M elements gives
a classification of Stage I, II, III, IV or unknown. A higher stage usually
suggests a less favorable prognosis.
References: American Cancer Society, National Cancer Institute, National Cancer Data Base, American Joint Committee on Cancer
C O N T A C T
U S
For Patients:
For more information on our Comprehensive Cancer Program or to schedule an appointment, call 706-721-CARE (2273) or 1-800-736-CARE (2273).
For Physicians:
Specially trained Health Referral Specialists answer calls 24 hours a day, seven days a week, and connect you directly with the MCG physician you
request or the on-call physician.
MCG Physicians Direct
1-800-733-1828
You can:
• Reach MCG physicians’ offices to arrange appointments
• Consult with faculty physicians
• Follow up on patient status
• Access clinical studies and receive research updates
• Access other MCG professional programs and services, including
continuing medical education and the
medical library
On the Web:
MCGHealth.org
MCG Transfer Direct
Emergency Communications Center
1-877-561-5600
Our experienced paramedics will:
• Arrange emergency patient transfers
• Arrange helicopter transport
• Stay on the line while you speak with an attending physician or
specialist
• Handle your request for the Pediatric Transport Team
11/17/03
1:29 PM
Page 1
1120 15th Street | Augusta, GA
706-721-CARE (2273) | 800-736-CARE | MCGHealth.org
Medical College of Georgia Health System

“Do not go where the path may lead, go instead where there is no

Transcription

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