Cancer Program Annual Report

Transcription

CANCER PROGRAM
ANNUAL REPORT 2015
U T I L I Z I N G 2 0 1 4 C A N C E R D ATA
Eisenhower Medical Center’s
Cancer Program
Physicians and Specialists
0
(Blank inside front cover)
EISENHOWER MEDICAL CENTER
Eisenhower Cancer Program
Annual Report 2015
Utilizing 2014 Data
Table of Contents
Cancer Committee Members .................................................................. 2
Cancer Center Welcomes New Chief Administrative Officer .................. 3
Focus Cancer Site: Acute Myeloid Leukemia
Overview and Management ............................................................ 4
Adult Acute Myeloid Leukemia ........................................................ 8
Patient Advisory Committee ............................................................ 9
Integrative Oncology Services ........................................................ 10
2014 Primary Cancer Cases Index ........................................................ 13
2014 Top Cancer Cases .......................................................................... 14
Cancer Conference Report .................................................................... 15
Eisenhower Lucy Curci Cancer Center Programs
Overview of the Center .................................................................. 16
Eisenhower Schnitzer/Novack Breast Center.................................. 18
Arnold Palmer Prostate Care .......................................................... 21
Cancer Registry .............................................................................. 23
Cancer Support Services ................................................................ 24
Cancer Research ............................................................................ 26
Eisenhower BIGHORN Radiation Oncology Center ...................... 27
Eisenhower Infusion Centers .......................................................... 30
BIGHORN Behind a Miracle: Transforming Breast Care ................ 32
Cancer Committee Members
Eisenhower Medical Center Cancer Committee has had a
significant impact on the Eisenhower Lucy Curci Cancer Center
Program. A special thank you to the Cancer Committee members
for their dedicated leadership and tireless efforts.
Amy Law, MD
Barbara Bigelow, RN, MSN, AOCNS, C-HPN
Chair, Cancer Committee
Advanced Practice Nurse, Oncology/Palliative Care
Donna Boatman
Murthy Andavolu, MD, Medical Oncology
Coordinator, Community Outreach and Cancer
Support Services
James Cohn, MD, Radiology
Bo Dunn, RN, MSN, OCN
Luke Dreisbach, MD, Medical Oncology
Radiation Oncology
Frederick Eko, MD, Plastic Surgery
Stephanie Farrell, MBA, BSN, RN, CCRC, CPHQ
Varun Gupta, MD, Medical Oncology
Director, Research Administration
Vicki Koceja, RN-BC, OCN, MBA, FAAMA, PhD
David Hyams, MD, General Surgery
Chief Administrative Officer, Eisenhower Lucy Curci
Cancer Center/Wound Care Center/Infectious
Disease Center
Robert Johnson, MD, Radiation Oncology
Rupinder Mann, MD, Palliative Care
Danielle Meglio, COTA/C, MLD/CDT
Iliana Popescu, MD, Medical Oncology
Occupational Therapy
Ann Mostofi, RN, MSN
Justin Reckard, MD, General Surgery
Chief Nursing Officer and
Vice President, Patient Care Services
Patti Richardson, MD, Pathology
Peter Schulz, MD, General Surgery
Tijuana Parker, RN, MSN
Director, Medical/Surgical 3 East/Oncology
Youssef Tanagho, MD, Urology
Tammy Plante, MHA, CTR, CHES
Justin Thomas, MD, Pulmonary Disease
Manager, Cancer Information Management
Alison Mayer Sachs, MSW, CSW, OSW-C
Henry Tsai, MD, Medical Oncology
Director, Community Outreach and Cancer
Support Services
Davood Vafai, MD, Medical Oncology
Cera Salamone Stanford, BSN, RN, PHN, NE-BC, HACP
Clinical Director, Infusion Centers, Radiation Oncology,
Hematology/Oncology and Arnold Palmer
Prostate Center
Belinda Zaparinuk, RT(M), BS, CBEC
Manager, Eisenhower Schnitzer/Novack Breast Centers
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Eisenhower Lucy Curci Cancer Center
Welcomes Chief Adminstrative Officer
Dr. Koceja has a number of published articles including
Developing Staff Nurse Shared Leadership
Behavior in a Professional Nursing Practice, and
Decreasing the days from detection to a diagnosis
for women with the use of a Breast Care Coordinator
during the diagnostic phase of care.
Vicki Koceja, RN-BC,
OCN, MBA, FAAMA,
PhD, began her career
in Oncology/HIV/AIDS
nursing in the mid-1980s
and has more than 29
years of direct oncology
experience. She brings
solid expertise as a
clinical manager and administrative director in the
design, development and implementation of
oncology programs in Arizona, Wisconsin and
Nevada. She recently completed a Fellowship
with the Oncology Nursing Society, and also has
a Fellowship from the American Academy of
Medical Administrators.
She has completed her Oncology Nursing
Certification through the Oncology Nursing
Society and is Board Certified in Pain Management.
She is a Certified Trainer for the Oncology Nursing
Society Chemotherapy Course, is certified
through the National Consortium of Breast Centers
as an Instructor of Breast Self-Exam, and is a
national trainer for the Generalist Hospice/
Palliative Care Clinical Review, and a National
End-of-Life Nursing Education Consortium trainer.
In addition to her administrative duties in the area
of oncology, she has developed nurse driven
palliative care models. Her training in palliative
care was established through the City of Hope,
which provided a strong focus on program
development. She has completed additional
training through the Wisconsin Pain Initiative on
pain management as well as end-of-life care
through the Milwaukee County Hospital/Medical
College of Wisconsin.
She has served as the President of the Greater
Las Vegas Chapter of the Oncology Nursing Society
and as the State Director for the American
Academy of Medical Administrators. She volunteers
with the Nevada Cancer Coalition, the American
Cancer Society, the Nevada Breast Coalition, and
the Nevada Ovarian Coalition. In 2003, she
received the March of Dimes Community Nurse
of the Year award for community service. She
currently serves as the Center’s Community Liaison
II on the Board of the Desert Cancer Foundation.
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FOCUS CANCER SITE
antecedent hematologic disorders that predispose
patients to AML include aplastic anemia and
certain myeloproliferative neoplasms (polycythemia
vera, primary myelofibrosis or other, less
common entities).
Acute Myeloid Leukemia
Overview and Management
at Eisenhower Medical Center
Constantin A. Dasanu, MD, PhD
Medical Oncology and Hematology
Among exogenous factors, radiation exposure
and chemotherapy use play an important role.
Antracyclines and alkylating agents used for the
therapy of other cancers are well-studied risk
factors, linked with particular subtypes of AML.
The typical latency period between drug exposure
and acute leukemia is about 3 to 5 years for alkylating
agents and radiation exposure, but only 9 to 24
months for antracyclines. In these patients, AML
is qualified as secondary, and they have a poorer
prognosis than individuals with de novo acute
leukemia. Notably, most patients with de novo
The most common type
of acute leukemia in
adults, acute myeloblastic
leukemia (AML) is a group
of hematologic cancers
characterized by the
presence of more than
20% myeloblasts in the
bone marrow. The
American Cancer Society® estimates the average
lifetime risk for AML at 1 in 227 for men and 1 in
278 for women. This results in approximately
18,860 new yearly AML cases and an estimated
death toll at 10,460 per year. AML is more
common in Caucasians than in any other ethnic
group. Its prevalence increases with aging, the
median age of onset being 70 years.
AML have no identifiable risk factors.
Maturational arrest of the bone marrow cells in
the earliest stages of development is the hallmark
of the AML pathophysiology. This process involves
activation of abnormal genes through chromosomal
translocations or other genetic abnormalities.
Production of normal blood cells markedly
decreases, which results in varying degrees of
anemia, thrombocytopenia, and neutropenia.
Rapid proliferation of blasts, along with reduced
ability to undergo programmed cell death
(apoptosis), results in their accumulation in the
bone marrow, blood, and, sometimes, the spleen
and liver. These patients are at risk for spontaneous
tumor lysis syndrome, an oncologic emergency
that, if left unattended, can lead to acute kidney
failure and death.
Several factors have been linked with AML,
including antecedent hematologic disorders,
certain familial syndromes and environmental
exposures. An important risk factor for AML is the
presence of an antecedent hematologic disorder
such as a myelodysplastic syndrome (MDS). MDS
represents a family of bone marrow diseases that
manifest as progressive cytopenias and affect
predominantly persons older than 65. Patients
with high-risk MDS are more likely to develop
AML than those with low-risk MDS. Other
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The workup for AML includes complete blood
count and peripheral smear, bone marrow
aspiration and biopsy, and analysis of genetic
abnormalities. Immunopenotyping by flow
cytometry is used to help distinguish AML from
acute lymphocytic leukemia (ALL), and further
classify the subtype of AML (M1 through M8).
Cytogenetic findings in the bone marrow represent
the most reliable prognostic indicators and can
guide the treatment. Patients with translocations
t(8;21), t(15;17), t(16;16), or inversion 16 have the
best prognosis, with long-term survival rates of
approximately 65%. These patients may not
require allogeneic hematopoietic stem cell
transplantation (HSCT). Patients with normal
cytogenetic findings have an intermediate
prognosis, with a long-term survival rate of
approximately 25%. Patients with poor-risk
cytogenetic findings (especially deletions of
chromosomes 7 or 5) have a poor prognosis, with
a long-term survival rate of less than 10%. The
presence of an FLT3 mutation is associated with
a poorer prognosis. Mutations in CEBPA are
associated with a longer remission duration and
longer overall survival. Mutations in NPM are
associated with a better response to chemotherapy.
Typical signs and symptoms of AML include
excessive fatigue, easy bruising, mucosal bleeding,
fever, bone pain and infection. Patients often
retrospectively note a decreased energy level
over past several months. They often have
decreased neutrophil counts despite increased
total white blood cell (WBC) counts. Many of
them present with fever that may occur with or
without documentation of an infection. The
patients with the lowest absolute neutrophil count
(ANC) (< 500 cells/µL, but especially < 100 cells/µL)
have the highest risk of a serious infection.
Patients may also present with bleeding gums
and multiple ecchymoses. Bleeding may be
caused by thrombocytopenia, coagulopathy that
results from disseminated intravascular coagulation
(DIC), or both. Potentially life-threatening sites of
bleeding include the lungs, gastrointestinal tract
and the central nervous system. In addition, some
symptoms may result from the spleen, liver, gums
and skin infiltration with leukemic cells. Infiltration
occurs most commonly in patients with the
monocytic (M5) or myelomonocytic (M4) subtypes
of AML. Patients with splenomegaly may note
fullness in the left upper quadrant or early satiety.
Patients with gum infiltration often present to
their dentist first. The patients with markedly
elevated WBC counts (>100,000 cells/µL) can
present with symptoms of leukostasis such as
respiratory distress, dizziness or altered mental
status. Deadly if left untreated, leukostasis is a
medical emergency that calls for immediate
leukapheresis.
AML treatment depends on the biology of the
disease and the patient's age and performance
status. For the most part, we use combination
chemotherapy plus postremission therapy that
may include additional chemotherapy and
allogeneic HSCT. If the patient is eligible for
allogeneic HSCT, this is our approach for any
intermediate- or high-risk patients with AML.
However, HSCT neither cures every single patient
nor is available to every patient.
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Patients are first stabilized with intravenous fluids,
allopurinol and, if needed, antibiotics. Current
standard induction chemotherapy for AML consists
of an antracycline administered intravenously
daily for 3 days and cytarabine continuous infusion
for 7 days (e.g., 3+7 regimen). Patients who do
not go into remission require a second course of
Increasing age is an adverse factor as older
patients more frequently have a previous
antecedent hematologic disorder, along with
comorbid medical conditions that compromise
the ability to receive high-dose chemotherapy.
Unfortunately, we are only able to cure fewer than
10% of adults older than 65 years with AML. This
induction therapy. Consolidation therapy protocols
vary, but high-dose cytarabine has been
successfully used in younger patients.
Hypomethylating agents (5-azacitidine, decitabine)
are used in unsuitable candidates for standard
induction therapy due to advanced age,
co-morbidities or preference, especially when
secondary AML is diagnosed or suspected. When
receiving chemotherapy, patients should avoid
exposure to crowded places and people with
contagious illnesses, especially children with viral
infections. Any patient with neutropenic fever
or infection should immediately receive broadspectrum antibiotics. Appropriate transfusion
support must be provided to all patients with
AML. Blood products must be irradiated to
prevent transfusion-associated graft versus host
disease (GVHD) which can be fatal. Nonetheless,
death in individuals with AML may result from an
uncontrolled infection or hemorrhage that may
happen even after use of appropriate blood
products and antibiotic support. Evaluation of
myocardial function is needed once the diagnosis
of AML is confirmed as many of the chemotherapy
agents used are cardiotoxic. Human leukocyte
antigen (HLA) or DNA typing is required in
patients who are potential candidates for
allogeneic transplantation.
is because standard induction chemotherapy
followed by remission therapy is not effective in
most of these patients, and many of them are not
candidates for allogeneic HSCT. Almost universally,
individuals older than 60 are offered reducedintensity alloSCT, that is less toxic while maintaining
similar efficacy to the fully myeloablative approach.
Nearly 10% of adults with AML have acute
promyelocytic leukemia (APL or M3 subtype),
usually with translocation t(15;17) involving the
retinoic acid receptor gene. These patients have
an excellent response to all-trans-retinoic acid
(ATRA) plus either an antracycline or arsenic
trioxide. These combinations have induced
sustained remissions and cures in more than 90%
of APL patients.
In 2014, a total of 82 patients were diagnosed
with AML and treated at Eisenhower Medical
Center. Out of those, 47 were men and 35 were
women. Eisenhower has vast experience in
managing acute leukemia. Patients are offered
high-dose chemotherapy as induction and
consolidation therapy, when applicable. Most
patients are then referred to a transplantation
center for consideration of HSCT. Eisenhower
offers AML patients highly specialized nursing
care in the Oncology unit (3 East). The AML
patients receive necessary blood product support,
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growth factor support, leukapheresis and
hemodialysis as needed. Qualified candidates go
on to receive allogeneic HSCT. Subsequently, our
team of Medical Oncologists/Hematologists
follow them at Eisenhower Lucy Curci Cancer
Center jointly with the transplant physicians at the
tertiary centers.
Well-designed clinical trials using an array of new
agents are available at larger university centers,
aiming at obtaining robust remissions and
increasing long-term survival of AML patients. In
addition, some of these trials address the long-term
effects of leukemia therapy.
In the near future, we hope to be able to evaluate
our patients for clinical trials involving targeted
pharmacotherapy agents based on the molecular
biology of this disease. These new agents are
becoming more promising as we learn about the
genes involved in the pathogenesis of AML. They
include kinase inhibitors, epigenetic modifiers,
and exportin inhibitors. In addition, new
immunotherapy agents that are effective in other
malignancies merit to be studied in AML. Our
short-term goals include enrollment of patients in
some of these clinical trials, and offering them
qualified care and follow-up in our Leukemia and
HSCT Survivorship clinics.
Some long-term effects of AML treatment, such
as moderately severe fatigue, can linger for years
after therapy. Other long-term sequelae seen in
the AML survivors include heart conditions, thyroid
problems, lung damage, infertility, osteoporosis,
hearing loss, cataracts, peripheral neuropathy,
second cancers and long-term impairment of
immune system function. Late complications also
include depression, post-traumatic stress disorder,
and cognitive effects such as problems with
concentration, memory, and the ability to multitask
(also called “chemo brain”). At Eisenhower Lucy
Curci Cancer Center, patients are not only
constantly screened for disease relapse, but also
for these long-term consequences of AML therapy
and are addressed promptly. The Social Services
Department is extremely helpful at helping build
a supportive network for the AML patients and
their loved ones.
1. NCCN Clinical Practice Guidelines in Oncology. Acute Myeloid
Leukemia: Version 2.2014. National Comprehensive Cancer
Network. Available at http://NCCN Clinical Practice Guidelines
in Oncology. Acute Myeloid Leukemia: Version 2.2014.
Accessed: August 14, 2014.
2. American Cancer Society. (2014). Cancer facts and figures 2012.
Retrieved from http://www.cancer.org/Research/CancerFacts
Figures/index
3. American Cancer Society. (2014). Leukemia—Acute myeloid
(myelogenous). Retrieved from http://www.cancer.org/acs/
groups/cid/documents/webcontent/003110-pdf.pdf
While AML is currently viewed as a potentially
curable disease, overall AML survival has improved
only modestly for patients younger than 60 years
over the last two decades. In 1966, the median
survival of adult patients with AML was only 40
days; today, patients younger than 60 years have
complete response rates of 70% to 80% after
induction chemotherapy. Overall survival, however,
remains at only about 50% for those who go into
a complete remission or 30% overall.
4. Leukemia and Lymphoma Society. (2014). Managing your cancer:
Long-term and late effects. Retrieved from http://www.lls.org/#/
diseaseinformation/managingyourcancer/survivorship/
longtermlateeffects
5. National Cancer Institute. (2014). Adult acute myeloid leukemia
treatment (PDQ®). Retrieved from http://www.cancer.gov/
cancertopics/pdq/treatment/adultAML/healthprofessional
6. Lowenberg B, Pabst T, Vellenga E, et al. Cytarabine dose for
acute myeloid leukemia. New England Journal of Medicine
2011;364(11):1027-36.
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chemotherapy: eleven (11) received (7+3)
daunorubicin and standard-dose cytarabine
treatment; one (1) received decitabine, and four
(4) received 5-azacitidine treatments. Five of
sixteen (16) or 31% of patients that received
induction and subsequent consolidation treatments
are alive at the time of this report.
Adult Acute Myeloid Leukemia
Amy Law, MD
Chair, Cancer Committee
Eisenhower Medical Center
An estimated 19,000
people will be diagnosed
with Acute Myeloid
Leukemia (AML) in the
United States in 2015.
More than 55% of people
diagnosed with AML will
die of the disease with
most deaths occurring in
patients older than 65 years in the first year. Age
at the time of an AML diagnosis impacts overall
survival. Median age of diagnosis in the United
States is 67 years with approximately a third
diagnosed at older than 75 years of age. Patients
with AML are often neutropenic which is associated
with high morbidity. Treatment is divided into
induction and consolidation therapy. Supportive
care included use of transfusion support and
infection management.
A third of patients presented with febrile neutropenia
at the time of diagnosis. Three (3) cases had
identifiable source of infection: enterococcus and
staphylococcus bacteremia and clostridium difficile
colitis. Nine (9) patients had venous access device
placements, seven (7) PICC lines and two (2)
mediports. Only one (1) case of central line
associated bloodstream infection with
staphylococcus.
Central vascular access device placements are
ubiquitous in patients undergoing intensive or
cyclic chemotherapy among cancer patients.
Central line associated bloodstream infections are
associated with morbidity. Neutropenia is a major
risk factor for development of infections in
patients with acute leukemia and cancer patients
undergoing chemotherapy. Identifying patients at
risk for neutropenia, preventing and managing
infections in neutropenic patients is often a
dynamic process, requiring a multidisciplinary
treatment and management approach.
Twenty-four (24) new cases of AML were diagnosed
at Eisenhower Medical Center in 2013-2014.
Thirteen (13) were male and eleven (11) were
female. Median age at the time of diagnosis is 71
years, ranges 45-87. Seventeen (17) patients were
older than 65 years, and a third diagnosed at
older than 75 years. Six (6) patients aged 72 years
and older chose supportive care at the time of
diagnosis and died on hospice within five days of
diagnosis. One (1) patient was transferred to her
home in Canada, not allowing for follow-up.
Eighteen (18) or 75% patients died of the disease.
Sixteen (16) patients received induction
Tijuana Parker, MSN, RN, OCN, Clinical Director,
Inpatient Oncology Unit, and Barbara Bigelow,
MSN, RN, AOCNS, along with expansive committees
at Eisenhower Medical Center, led the charge in
developing and implementing protocols and
procedures for the care of patients with
neutropenia. Multilingual neutropenic precaution
signs for patients and visitors were enforced on
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Patient Advisory Committee
the inpatient oncology unit. Policies on indications
for central line necessity, maintenance and
de-clotting of central lines were enforced.
Vicki A. Koceja, RN-BC, OCN, MBA,
FAAMA, PhD
Chief Administrative Officer
Eisenhower Lucy Curci Cancer Center
Eisenhower Lucy Curci Cancer Center held its first
Patient Advisory Committee meeting in June this
year. The committee was developed with volunteer
patients from all areas of service. The purpose?
To focus on patient centered care to determine if
the Cancer Center is offering patients the services
they desire. Patients give direct feedback regarding
the planning, development and implementation of
new services with suggestions for improvements in
the Center’s current services.
The first meeting presented a new concept —
the nurse navigator — a position that would be
developed to address the complex needs of
patients with specific diseases. For example, the
Center’s Breast Care Navigator helps patients
in the Breast Center through the process of
additional tests necessary to rule out a cancer
diagnosis. The nurse navigator follows the
patient’s care through surgery and any subsequent
treatment if a cancer diagnosis is confirmed.
Nurse navigators will follow up with patients to
see how they did with their tests, procedures, and
treatments and are additionally focused on guiding
the patient through all of the information that
comes with a cancer diagnosis and treatment.
This role would work with the multidisciplinary
team to develop a plan of care identifying the
patient’s goals for their care.
In 2015, Eisenhower Medical Center received
Magnet Recognition® by the American Nurses
Credentialing Center after a rigorous multifaceted
evaluation. Magnet recognition was granted
partly based on developing and implementing
quality initiatives that aim for safe, effective and
patient centered care. A key quality initiative
evaluated as part of Magnet recognition was
reduction in Central Line Associated Bloodstream
Infections. Multidisciplinary teams consisting of
nursing, infection prevention and intravenous
access staff participated in the initiative.
Eisenhower effectively reduced the Central Line
Associated Bloodstream Infections rates below
the national Health Safety Network benchmark.
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The second new service would be the Patient
Financial Counselor. The counselor role is being
developed to work in conjunction with the physician’s
plan of care and insurance companies to determine
the overall out-of-pocket expenses that may arise.
Additionally, the counselor would assist in finding
programs that are available for patients to help
with premiums, co-payments or prescription
assistance programs.
Integrative Oncology Services
Alison Mayer Sachs, MSW, CSW, OSW-C
Director, Community Outreach and Cancer
Support Services, Eisenhower Lucy Curci
Cancer Center
Being a cancer patient is
never easy. Whether you
or someone you care
about is a cancer patient,
the journey from diagnosis
through treatment and
recovery is filled with
many questions.
Eisenhower Lucy Curci
Cancer Center offers guidance, support, education
and understanding to help every step of the way.
The committee also discussed service preferences,
asking if patients preferred services all on the same
day or the option of having labs drawn one day in
advance, allowing tests to be run in order to be
prepared the next day for their treatments.
Committee members stated they actually
preferred the latter so they wouldn’t have to wait
for lab test results that determine if treatment is
needed.
Cancer affects mind, body and soul, so the Cancer
Center’s Integrative Oncology services are designed
to meet the specific needs and concerns of cancer
patients and their loved ones as well as the needs
of our community as a whole. Incorporating the
latest information on cancer prevention, detection,
treatment and research into an array of programs
helps calm the mind, strengthen the body and
support the soul.
The Patient Advisory Committee brings patients
together with members of the health care team to
help improve communication and coordination
among all services. By providing the patient and
family perspective, this collaborative process
gives the health care team vital information
needed to continue to provide the comprehensive
and compassionate care that distinguishes
Eisenhower Lucy Curci Cancer Center as a
healing place like no other.
Committed to treating the whole person, the
Cancer Center’s goal is to nurture hope and healing
for patients and their loved ones and to provide a
healing place like no other.
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Integrative Oncology Services
Center offers various support groups where
participants can share personal experiences or
just listen with other cancer patients and
survivors. There is no fee to participate and
new members are always welcome.
■ Social Work Services: Offering both short-term
individual and family counseling, trained
oncology social workers are available to help
develop the emotional and social resources to
deal with cancer and access needed community
resources and services.
■ Exercise: Patients undergoing active treatment
are looking for ways to combat fatigue,
maintain muscle strength, and feel as though
they have control over some part of their lives.
Studies have shown patients and survivors may
benefit from certain exercises, with many
reporting improved appetite, lessening of
fatigue, improvement in sleep patterns and
overall improvement in quality of life.
Partnering with Eisenhower’s Department of
Rehabilitation Medicine, the Cancer Center
offers classes focusing on strength training,
movement, walking and yoga.
■ Genetic Counseling: Science and Research
have shown that genes contribute to the
development of certain cancers. The Cancer
Center’s program offers genetic counseling
with the only Certified Genetic Counselor
(CGC) in the Coachella Valley, providing
genetic counseling as well as education to our
physicians and the community at large.
■ Nutrition: Cancer and cancer treatments can
change patients’ eating habits and affect their
appetite and nutritional needs, resulting in loss
of appetite. Patients must pay special attention
to nutrition in order to maintain their health
and strength. The Cancer Center provides a
registered dietician, available to meet with
patients to evaluate their nutritional needs and
provide follow-up care through all phases of
their cancer treatment and recovery. Lectures
on diet, nutrition and cancer are offered
throughout the year.
■ Cancer Lecture Series and Lunch and Learn
with the Expert: Maintaining a healthy lifestyle
is important for all of us. That is why we offer
ongoing lectures and educational presentations
about treatment options and the latest in
cancer prevention and detection. Eisenhower
Lucy Curci Cancer Center also hosts
teleconferences, community meetings, cancer
screenings and other workshops. In addition,
the Center is actively involved in the community
and works in cooperation with local, regional
and national cancer organizations such as the
American Cancer Society, the Lung Cancer
Alliance, the National Cancer Institute, the
Oncology Nursing Society and the Association
of Oncology Social Work.
■ Support Groups: According to the National
Cancer Institute, “Often, support groups can
help people affected by cancer feel less alone
and can improve their ability to deal with the
uncertainties and challenges that cancer brings.
Support groups give people who are affected
by similar diseases an opportunity to meet and
discuss ways to cope with illness.” The Cancer
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■ Stress Management and Relaxation:
with insurance premiums, co-pays and costs of
cancer treatments. Through a long-standing
relationship with the American Cancer Society®,
the Cancer Center provides on-site programs
such as the bi-monthly Look Good, Feel Better
and our weekly Wig Bank providing free wigs,
hats and scarves to those undergoing treatment.
Weekly Healing Touch Massage and classes
on mindfulness meditation and guided
imagery teach new approaches to working with
stress, pain, chronic illness and the challenges
of living with (or caring for a person with) a
cancer diagnosis.
■ Cancer Resource Center: When it comes to
■ Smoking Cessation Program: The U.S. Surgeon
cancer, knowledge is power. In the Harry and
Joy Goldstein Cancer Resource Center —
conveniently located on the first floor of the
Cancer Center — the most comprehensive and
up-to-date information about cancer prevention,
diagnosis, treatment and research is available.
Using the touch-screen computer, CancerHelp®
General has said, “Smoking cessation represents
the single most important step that smokers
can take to enhance the length and quality of
their lives.” Eisenhower Lucy Curci Cancer
Center offers the community a Stop Smoking
program based on the American Cancer
Society’s Freshstart® program. Open to anyone
instantly connects to the National Cancer
Institute’s data base, providing information
that is updated monthly and available in both
English and Spanish.
ready to commit to becoming a non-smoker,
regardless of their age, how much or long they
have been smoking, the program offers the
participants the tools necessary to break their
nicotine addiction and use behavior modification
techniques to help stay smoke free. Unique to
the Cancer Center’s program is the addition of
a monthly support group allowing those who
have graduated from the program to check-in
with each other and discuss their challenges
and their achievements.
■ Community Partnerships: Working with our
non-profit community partners, Eisenhower
Lucy Curci Cancer Center is able to provide a
safety net for cancer patients and their families
through direct referrals for basic needs such as
food vouchers, assistance in covering monthly
bills for utilities, rent or mortgage, and help
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2014 EMC Primary Cancer Cases Index
Site Group
ALL SITES
Breast
Prostate
Lung/Bronchus-Non Sm Cell
Bladder
Colon
Leukemia
Other Hematopoietic
Non-Hodgkin’s Lymphoma
Pancreas
Melanoma of Skin
Unknown or Ill-Defined
Other Nervous System
Kidney and Renal Pelvis
Brain
Rectum and Rectosigmoid
Ovary
Thyroid
Myeloma
Lung/Bronchus-Small Cell
Liver
Anus, Anal Canal, Anorectum
Corpus Uteri
Stomach
Esophagus
Soft Tissue
Testis
Tonsil
Tongue
Bile Ducts
Other Female Genital
Other Digestive
Pleura
Cervix Uteri
Other Endocrine
Small Intestine
Gallbladder
Larynx
Other Skin Cancer
Vulva
Salivary Glands, Major
Mouth, Other and Nos
Ureter
Lip
Oropharynx
Nasal Cavity, Sinus, Ear
Uterus Nos
Hodgkin’s Disease
Nasopharynx
Hypopharnyx
Pharynx and Ill-Defined
Bone
Kaposi’s Sarcoma
Penis
Other Urinary
Class
Sex
Total
F Other 0
Cases Analytic NonAn Other M
2069 1685 371
13 1066 1000 3
147
321
264
55
2
3
318
0
55
226
147
77
2
226
0
0
0
217
195
20
2
108 109
0
2
135
110 25
0
120
15
0
68
117
107
10
0
68
49
0
1
82
47
35
0
57
25
0
0
80
55
23
2
46
33
1
0
76
55
21
0
38
38
0
0
75
63
12
0
45
30
0
0
72
61
11
0
46
26
0
10
71
66
3
2
39
32
0
0
70
64
6
0
21
49
0
0
53
47
6
0
32
21
0
1
49
39
7
3
30
18
1
0
45
41
4
0
29
16
0
2
38
23
15
0
0
38
0
0
37
34
3
0
11
26
0
0
31
21
10
0
18
13
0
0
29
27
2
0
13
16
0
0
26
21
5
0
21
5
0
0
25
21
4
0
15
10
0
5
19
15
4
0
0
19
0
1
17
16
1
0
13
4
0
0
14
9
5
0
12
1
1
0
14
8
6
0
7
7
0
0
12
11
1
0
12
0
0
0
10
8
2
0
8
2
0
1
8
7
1
0
6
2
0
0
8
7
1
0
3
5
0
0
8
8
0
0
0
8
0
0
7
7
0
0
6
1
0
0
7
7
0
0
5
2
0
0
7
3
4
0
0
7
0
0
7
5
2
0
1
6
0
0
6
5
1
0
3
3
0
0
6
5
1
0
1
5
0
0
6
6
0
0
4
2
0
1
6
5
1
0
4
2
0
0
6
3
3
0
0
6
0
0
3
3
0
0
2
1
0
0
3
3
0
0
1
2
0
0
3
3
0
0
2
1
0
0
2
2
0
0
2
0
0
0
2
2
0
0
1
1
0
0
2
1
1
0
2
0
0
0
2
0
2
0
0
2
0
0
2
2
0
0
2
0
0
0
1
1
0
0
0
1
0
0
1
0
1
0
0
1
0
0
1
1
0
0
0
1
0
0
1
1
0
0
0
1
0
0
1
1
0
0
1
0
0
0
1
1
0
0
1
0
0
0
1
1
0
0
1
0
0
0
Stage
I
II
III
IV
Unknown
N/A
Missing
399
113
18
61
22
24
1
0
8
9
27
0
0
27
0
15
3
18
0
2
7
3
7
2
0
4
7
1
2
1
0
0
1
1
0
0
0
4
2
1
1
1
1
2
1
0
0
0
1
0
0
1
0
0
0
278
50
91
13
19
31
0
0
12
6
11
0
0
3
0
7
3
7
0
1
2
4
2
1
2
2
0
0
2
1
0
0
0
1
0
0
1
1
1
2
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
206
33
16
37
0
26
1
0
8
6
9
0
0
4
0
10
9
5
0
3
5
6
1
5
3
2
3
2
0
0
2
0
1
0
0
4
1
0
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
278
10
14
77
5
23
0
0
26
41
3
0
0
9
0
4
7
2
0
21
2
2
3
6
3
0
0
3
3
1
0
0
3
1
0
1
3
0
0
0
1
2
0
0
1
0
0
1
0
0
0
0
0
0
0
46
3
8
4
6
1
0
0
1
1
1
0
0
3
0
3
1
2
0
0
2
1
1
2
1
0
0
1
0
2
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
331
0
0
1
0
1
55
55
0
0
0
66
64
0
39
0
0
0
21
0
3
0
0
0
0
0
1
0
0
2
6
7
1
0
5
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
1
0
1
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
At 15 percent of total cases, breast
2014 Top Cancer Cases
cancer continues to be the most
There were 2,069 total cancer cases accessioned for Eisenhower
frequent cancer site receiving care at
Medical Center in 2014. The 2014 Primary Site table outlines
Eisenhower Medical Center. Next,
each cancer site by class, sex and stage at diagnosis (previous
lung, prostate, colorectal and bladder
page). The pie chart below compares the incidence of each of
cancer complete the top five sites at
the top five cancer sites in 2014 at Eisenhower Medical Center.
12, 11, 9 and 7 percent, respectively.
2014 Eisenhower Medical Center
Top Five Sites of Total Cases
Breast, 15%
321 Cases
Lung, 12%
246 Cases
Remaining Cases
46%, 954 Cases
Prostate, 11%
226 Cases
Bladder, 7%
135 Cases
Colorectal, 9%
187 Cases
14
Cancer Conference Report
Multidisciplinary cancer conferences are vital to the patient
care process. Also known as Tumor Boards, the conferences
bring together physicians and other health care professionals
to plan treatment on individual cases. Tumor Boards are an
opportunity for the review of diagnostics and to recommend
treatments for optimal patient care. These conferences
provide excellent educational benefits for attendees and
valuable multidisciplinary consultative and treatment guidance
benefits for our patients. Cancer Conference case presentations
are open to staff physicians. Eisenhower Medical Center
currently has a Main Tumor Board with case presentations
from all sites, as well as specialty tumor boards in breast, lung,
gastrointestinal, brain and urological cancer sites.
Please call the Cancer Registry to schedule a Tumor Board
case at 760-773-1511.
Through the commitment of many physicians at Eisenhower
Medical Center, 475 cancer cases were discussed at Tumor
Boards in 2014, including 97 percent prospective case
presentations. The Tumor Boards were well attended by
representatives from Medical Oncology, Radiation Oncology,
Surgery, Pathology, Radiology, Nursing, Social Services,
Clinical Research, Cancer Registry and other medical
professionals, exceeding the goals set by the Cancer Committee.
The Main Tumor Board is held on the first and third Mondays
at the Annenberg Center for Health Sciences dining room.
Breast Tumor Board meetings are held bi-monthly at Eisenhower
Lucy Curci Cancer Center. A Gastrointestinal Tumor Board,
Urology Tumor Board and a Thoracic Tumor Board are held
monthly at Eisenhower Lucy Curci Cancer Center. A Brain
15
2014 Tumor Board Case Presentations
Topic
Number
Breast............. 220
Prostate............ 18
Lung................. 80
Colorectal ........ 58
Bladder-Kidney . 11
Hematopoietic ...11
Topic
Number
Head & Neck/
CNS ............... 37
Gastrointestinal ..14
Unknown or
Ill-Defined ....... 2
Skin..................... 3
Other Cases ......20
GYN ................... 1
Total number of cases......................... 475
Tumor Board is held monthly with
discussion of primary brain/CNS lesions
and cancers with brain metastasis.
In 2014, 736 physicians and 680
additional health care professionals
attended Eisenhower Medical Center
Tumor Boards.
The Annenberg Center for Health
Sciences at Eisenhower hosts Grand
Rounds, Main Tumor Boards, and
many other educational programs.
In 2014, there were 49 Grand Rounds
educational presentations on treatment
issues pertaining to cancer patients.
For more information on upcoming
Grand Round topics, call
760-773-4500.
EISENHOWER LUCY CURCI CANCER CENTER
Overview of Eisenhower
Lucy Curci Cancer Center
Unrivaled Medical Care
Eisenhower Lucy Curci Cancer Center is truly a remarkable cancer
treatment facility, bringing together in one place a tremendous
technological strength and a profoundly human environment.
We offer the cancer patient state-of-the-art medical care and
comprehensive cancer services. Treatment is provided by caring and
for the person as well as the cancer, Eisenhower Lucy Curci Cancer
Center is indeed a healing place like no other®.
Simply the Best
There is a reason that more people choose Eisenhower Lucy Curci
Cancer Center for all of their cancer care when facing the diagnosis
of cancer.
Eisenhower Lucy Curci Cancer Center is accredited by the American
College of Surgeons (ACOS), one of only a few hospitals to attain
this accreditation in Riverside County. More than 1,500 cancer programs
attain ACOS accreditation in the United States, yet these accredited
centers treat nearly 70 percent of cancer patients in the nation.
Coachella Valley to receive the award for
two consecutive periods.
The Cancer Center maintains the highest
standards of care and is accredited by the
American College of Radiology, which
accredits all facilities providing
mammography on behalf of the United
States government.
Eisenhower Medical Center is accredited
by The Joint Commission, the leader in
accreditation and certification of health care
organizations, and is a member of the
prestigious Eastern Cooperative Oncology
Group, one of the largest clinical cancer
research organizations in the United States.
One of only nine participating organizations
in the state of California, Eisenhower has
access to more than 90 active clinical trials.
Additionally, the Cancer Center is designated
a Lung Cancer Screening Center by the
American College of Radiology and a
Screening Center of Excellence by the Lung
Cancer Alliance.
The Infusion Centers are recipients of the
Press Ganey Guardian of Excellence
Award℠ in Patient Excellence – an award
given to organizations that have consistently
achieved the 95th percentile for patient
satisfaction.
The Center received the Commission on Cancer (CoC) Outstanding
Achievement Award (OAA) from the American College of Surgeons
in March 2010. The award is among the most prestigious for cancer
centers and Eisenhower Medical Center is the first hospital in the
The Clear Choice
for Your
Cancer Care
Eisenhower Lucy Curci Cancer Center is an extraordinary facility, nationally
accredited and clinically distinguished. The healing environment, the
uncompromising care, the personalized services, the team of professionals
coming together to care for you and your loved ones are critical components
to top notch cancer treatment.
If you have questions or would like to learn more about services and
treatment options at Eisenhower Lucy Curci Cancer Center, please call
760-674-3602, or visit our website at emc.org/cancer.
Comprehensive Cancer Services
Eisenhower BIGHORN Radiation Oncology Center
provides convenient access to some of the most
advanced equipment and newest technology in treating
malignant conditions, designed to meet your individual
needs, including the combined Novalis Tx™ radiosurgery
platform with RapidArc™ radiation technology to treat
a wide range of cancer and neurological disorders.
Arnold Palmer Prostate Care offers a unique blend
of high-tech treatment, personal service, and
compassionate, confidential care.
Eisenhower Schnitzer/Novack Breast Center offers
access to complete breast care, from screening
mammography through diagnosis and follow-up. The
compassionate healing environment at our multiple
convenient Breast Center locations is the very hallmark
of clinical excellence, melding the best technologies
with passionate patient care – creating the most
nurturing, welcoming and affirming surroundings.
Eisenhower Imaging Center is on the leading edge of
the most advanced technology and a model for imaging
facilities worldwide.
Cancer Support Services is designed to meet the
specific needs and concerns of cancer patients and
their family and friends every step of the way. We
incorporate the latest information on cancer treatment
and research into an array of programs to help
strengthen the body, physically, spiritually and
emotionally. Our goal is to nurture hope and healing
for our patients and their families.
Leo and Gloria Rosen Infusion Center staff
understands the challenges, both physical and
emotional, that affect every patient and their loved
ones. That is why our team of registered nurses is
experienced in infusion services, certified in chemotherapy
administration and available to provide information and
answer questions.
17
Eisenhower Schnitzer/Novack
Breast Center
■ Streamlined scheduling and
registration reduces wait time.
Woman-centered care in a warm, supportive environment.
■ Having your mammography breast
exam performed at any of our
beautifully appointed facilities.
The compassionate healing environment of our breast centers is
the very hallmark of clinical excellence, melding the very best
technologies with passionate patient care — creating the most
nurturing, welcoming and affirming surroundings at our multiple
convenient locations.
■ Board certified, fellowship-trained
radiologists — physicians dedicated
to breast health — are the foundation
of the Center and truly understand
the concerns and needs of women.
■ State-of-the-art digital threedimensional tomosynthesis
mammography equipment.
■ Computer-aided detection (CAD)
software improves the accuracy of
every mammogram.
■ Certified mammography and breast
ultrasound technologists.
The Eisenhower Schnitzer/Novack Breast Center offers an approach
to women’s health care that is comprehensive, convenient and
caring. Here you have access to complete breast care, from
screening mammography through diagnosis and follow-up.
Diagnostic findings and best treatment options for women diagnosed
with breast cancer are discussed at collaborative biweekly
multidisciplinary patient care conferences. A breast nurse specialist
is available to act as guide throughout the entire diagnosis, treatment
and follow-up process for the benefit of our patients.
While our focus is breast health care, our goal is your peace of mind.
Getting your mammogram here offers distinct advantages.
Whether it is your annual check-up or an advanced procedure,
having it at the Eisenhower Schnitzer/Novack Breast Center means
you benefit from:
Providing excellence
in all aspects of
breast imaging.
■ Additional diagnostic tools for follow-up
exams are offered in cases of suspicious
lumps or lesions, or difficult-to-read
mammograms.
The Eisenhower Schnitzer/Novack Breast
Center offers convenient locations for
your annual breast exam in Rancho
Mirage or La Quinta.
To schedule an appointment for your
mammogram, please call 760-773-4338.
Please request your appointment at
the location that is most convenient
for you.
Eisenhower Schnitzer/Novack Breast Center is designated an American
College of Radiology Breast Imaging Center of Excellence and is the first
facility in the Coachella Valley to earn this prestigious designation.
If you have questions or would like to learn more about services at any
of our Eisenhower Schnitzer/Novack Breast Center locations in Rancho
Mirage and La Quinta, please call 760-773-2038, or visit emc.org/breast.
Comprehensive Program Services
acquire the unique anatomical coronal plane not
available using conventional ultrasound.
The Eisenhower Schnitzer/Novack Breast Center is the
only place you need for your breast care.
Breast Specific Gamma
Imaging (BSGI):
Eisenhower was the first
facility in Southern
California to offer BreastSpecific Gamma Imaging,
a technology that more
accurately identifies
breast cancer previously
undetected by
mammography. Clinically
proven as an effective device in the early detection
of breast cancer, BSGI functions as a complementary
diagnostic tool following difficult-to-read mammograms.
Patients with dense breast tissue, multiple suspicious
lesions, breast implants, a previously diagnosed mass, or
those using Hormone Replacement Therapy will benefit
most from BSGI.
Screening mammography:
With the advances in the
treatment of breast
cancer, the best chance
for survival remains early
detection. And the key
to early detection is
regular mammograms.
The Center offers stateof-the-art digital threedimensional tomosynthesis
mammography equipment enhanced with computeraided detection software, as well as education to
encourage women to stay on top of their health. As a
service to our patients, we send reminders when it is
time to make an appointment for a mammogram.
Accurate diagnosis and evaluation: Our fellowshiptrained physicians and personal nurse navigators
provide our patients with personalized, experienced,
expert care, complemented by state-of-the-art
technology. A variety of imaging methods are available to
accommodate every woman and her unique needs.
Contrast Enhanced
Spectral Mammography
(CESM): Eisenhower was
the first facility in the
desert to offer CESM,
performed as an adjunct
to inconclusive
mammography and
ultrasound, SenoBright®
contrast-enhanced spectral
mammography highlights
areas of unusual blood
flow patterns. The system automatically acquires the
spectral data necessary to automatically create two
images per view; a standard mammographic image
showing tissue density and a contrast-enhanced image
in exactly the same position with the background signal
subtracted out.
Breast MRI: Eisenhower offers a dedicated breast MRI,
which may aid in showing spots the breast that may or
may not be cancer. A breast MRI is generally used to
complement a mammogram for women with certain
conditions, family history or other factors.
Our fellowship-trained physicians will recommend the
best imaging capability for your body and needs if such
follow-up is required.
Whole Breast Ultrasound: We are the first facility in
Southern California to add the ACUSON S2000™
Automated Breast Volume Scanner (ABVS), a highly
advanced, multi-purpose ultrasound system ideally
suited to patients with dense breast tissue or a history of
breast disease. This 3-D ultrasound technology enables
never-before-seen detail resolution and the ability to
19
Stereotactic breast biopsy is a safe, minimally
invasive biopsy that obtains tiny samples from an
identified abnormal breast mass for examination. A
sample of suspicious breast tissue is precisely located
with computer-guided imaging and removed with a
needle. Eisenhower is the first breast center in Southern
California to offer the Giotto next generation stereotactic
table, ensuring comfortable positioning for patients
while allowing 360-degree access of the breast. This
outpatient procedure requires no hospitalization or
surgical incision and is performed using only local
anesthesia.
Ultrasound Guided Core Biopsy is a safe, minimally
invasive biopsy that obtains tiny samples from an
identified abnormal breast mass for examination. A
sample of suspicious breast tissue is precisely located
with ultrasound guidance and removed with a vacuum
assisted needle. This outpatient procedure requires no
hospitalization or surgical incision and is performed
using only local anesthesia.
Bone density screening
(Dexa Scan): This
comprehensive X-ray
measures the strength
of your bones and
provides important
information for the
treatment and prevention
of osteoporosis. The test
is safe, painless, quick
and accurate.
20
Arnold Palmer Prostate Care
at Eisenhower Lucy Curci Cancer Center
Arnold Palmer
for the person as well as the cancer, the
Eisenhower Lucy Curci Cancer Center is
indeed a healing place like no other.
Interdisciplinary Team Approach
Since undergoing prostate surgery in 1997, Arnold Palmer has
Through collaboration and commitment,
brought the same level of commitment to prevention, treatment
an interdisciplinary team approach is used
and cure of prostate cancer that he brought to the game of golf.
in the treatment management of prostate
Throughout his career, Arnie enjoyed a long and close relationship
cancer at the Arnold Palmer Prostate
with President Dwight D. Eisenhower, which is why Arnie lent his
Center. The coordinated efforts of urology,
name to the Prostate Center.
radiation oncology and medical oncology
staff are utilized to create a cohesive
multi-faceted program, assuring that your
care is of the highest professional quality.
Your primary care physician is also part of
this team and will receive information
regarding your personal treatment options
and outcomes.
Your nurse will work closely with you and
Arnold Palmer Prostate Care offers a unique blend of high-tech
the interdisciplinary team guiding you
treatment, personal service, education and compassionate,
throughout your treatment experience,
confidential care.
coordinating and optimizing your time,
The Eisenhower Lucy Curci Cancer Center is truly a remarkable cancer
ensuring any questions or concerns that
treatment facility, bringing together a tremendous technological
may arise are answered to your satisfaction
strength and a profoundly human environment available nowhere
and arranging any follow-up visits.
else in the desert.
We offer the cancer patient unrivaled medical care and comprehensive
cancer services. Treatment is provided by caring and gentle health
care professionals who are always considerate of your dignity and
comfort. Our environment nurtures and calms the spirit with the
soothing surroundings that incorporate the colors of nature. Caring
Your Prostate
Cancer
Treatment.
Whether you are a resident of Coachella Valley, or plan to be treated while
staying at one of the many area resorts, Arnold Palmer Prostate Care at
Eisenhower Lucy Curci Cancer Center offers a blend of high-tech treatment
and individualized compassionate, confidential care for every patient.
If you have questions or would like to learn more about services and
treatment options at Arnold Palmer Prostate Care, please call
877-674-3800 or 760-674-3838, or visit emc.org/prostate.
The Latest Prostate Treatment Options
Nerve-Sparing Prostatectomy is a modified form
Treatment options which you may discuss with your
of radical prostatectomy. When prostate nerves are
physician include:
cancer-free, only the prostate gland is removed and the
nerves are preserved.
External Beam Radiation Therapy (EBT) uses stateof-the-art linear accelerators to deliver radiation to a
Robotic Prostate Surgery: da Vinci® Prostatectomy –
precise location within the body. A series of three-
Eisenhower Medical Center was the first facility in the
dimensional radiation beams are tailored to the size,
Coachella Valley to offer this less invasive procedure,
shape and location of the tumor or cancer cells to stop
which offers such benefits as a shorter hospital stay,
their growth and reproduction while sparing the
less pain, less risk of infection, less blood loss, less
surrounding healthy tissue.
scarring, faster recovery and a quicker return to normal
activities. The da Vinci Surgical System has been used
Image Guided Intensity Modulated Radiation
worldwide in thousands of prostate cancer procedures,
Therapy (IMRT) treats tumors that were previously
resulting in excellent patient outcomes with respect to
considered untreatable due to their size or location
cancer control, urinary continence and maintenance of
with an extremely precise variable beam intensity.
sexual function.
Image Guided Radiation Therapy (IGRT) uses
UroNav Fusion Biopsy System from Invivo brings the
radiation treatment guided by daily imaging and a
power of MRI to the urology suite with the introduction
tracking system to pinpoint tumor sites and adjust
of the UroNav Fusion Biopsy System — the next
patient positioning, allowing for precise delivery of
generation of prostate care. UroNav’s state-of-the-art
radiation to the tumor site and minimizing the amount
technology fuses pre-biopsy MR images of the prostate
of surrounding healthy tissue exposed to radiation
with ultrasound-guided biopsy images in real time, for
during the treatment.
excellent delineation of the prostate and suspicious
lesions, as well as clear visualization of the biopsy
needle.
22
Cancer Registry
A state mandate in 1985 required all cancers diagnosed in
California to be reported to the California Department of Health
Services in an effort to better understand cancer and to develop
strategies for its prevention, treatment and management. Federal
law now requires state reporting, and an information collection
system has been designed to obtain specific data on all cancer
patients nationwide.
■ The patient’s re-admission to the
hospital or outpatient visit is
automatically updated in the registry.
■ The patient’s physician will be contacted
if the patient has not received any
service from Eisenhower Medical Center
during the previous year.
■ If these update attempts are
unsuccessful, a patient letter will be
sent to the last known address as these
statistics are vital to ensure accurate
survival statistics.
How You Can Help
Operated by specially trained staff, Eisenhower Medical Center
Cancer Registry utilizes a highly sophisticated computer system
designed to document details of diagnosis, treatment and follow up
of each cancer patient.
How It Helps
While strictly maintaining patient confidentiality, the Cancer Registry
provides statistical cancer information vital to saving lives and
ultimately, defeating cancer.
How It Works
Cancer patients are automatically enrolled in the registry database
after receiving medical care at Eisenhower Medical Center. The
Cancer Registry tracks a patient’s health status annually in the
following ways:
Evaluating,
If you receive a letter, please complete
and return it to the Cancer Registry in the
envelope provided. It is also important to
include any address or physician changes.
If you prefer, you can also call us directly
at 760-773-1511.
The state uses this information to identify
preventable causes of cancer, observe
treatment outcomes to help identify the
best therapies, and track survival rates.
All diagnostic information, treatment data
and follow-up history submitted is strictly
confidential and provided in statistical form
only. Periodic reports are also utilized by
the hospital in an effort to maintain the
highest treatment quality and provide
insight on improving patient care.
Ever wonder how the American Cancer Society® compiles their statistics? Or,
how physicians predict the outcomes of certain cancers or know which treatments
Monitoring and
were the most effective? This information is gathered from Cancer Registries.
Improving
If you have questions or would like to learn more about our Cancer Registry,
Patient Care
please call 760-773-1511.
Cancer screening and early cancer detection changes patient outcomes!
Cancer Support Services
■ Social Work/Case Management
It’s hard to be a cancer patient.
Whether you or someone you care about is a cancer patient, the
journey from diagnosis through treatment and recovery is filled with
many questions. At Eisenhower Lucy Curci Cancer Center, we offer
guidance, support and understanding to help you every step of
the way.
The Harry and Joy Goldstein Resource Center offers patients and
family or friends a place to gather information about the latest
detection, prevention and treatment options for cancer.
Our support services are designed to meet the specific needs
and concerns of cancer patients and their family and friends.
We incorporate the latest information on cancer treatment and
research into an array of programs to help strengthen the body,
physically and emotionally.
Our goal is to nurture hope and healing for our patients and
their families.
Cancer Support Services
Every individual is unique and so is every cancer patient. That is why
we have a variety of programs and services available to help each of
our patients and their families.
Learning about
cancer is an
important part
of treatment.
Sometimes, just talking with someone
can be healing. Short-term individual
and family counseling with trained
oncology social workers is available to
help you develop the emotional and
social resources to deal with cancer.
■ Genetic Counseling
Science and research have shown that
genes contribute to the development
of certain forms of cancer. Our program
provides genetic counseling with the
only Certified Genetic Counselor (CGC)
in the Coachella Valley. The Genetic
Counselor provides education to
physicians and the community as well
as genetic testing and counseling.
■ Nutrition
Cancer and cancer treatments can
change eating habits, affecting
appetites and nutritional needs.
Treatment side effects can result in loss
of appetite, and patients need to pay
special attention to nutrition in order to
maintain their health and strength. Our
Cancer Center provides a registered
dietitian, available to meet with
patients to evaluate their needs and
provide follow-up care through the
phases of their cancer treatment and
recovery. Lectures on diet and nutrition
are offered throughout the year.
We’re here for you.
Eisenhower Lucy Curci Cancer Center is a resource for the entire
community. You don’t have to be a patient to take advantage of all that
we offer. If you or someone close to you has cancer, we’re here for you.
If you have questions or would like to learn more about any aspect of
Cancer Support Services, please call 760-834-3798, or visit
emc.org/cancersupport.
0
Center – conveniently located on the first floor of the
Cancer Center − the most comprehensive and up-to-date
information about cancer diagnosis, treatment,
prevention and research is literally at your fingertips.
With a touch-screen computer, an electronic catalog
of information called CancerHelp® accesses more than
100 National Cancer Institute-certified websites. It is
easy to use whether you have had a lot or a little
experience with computers.
■ Support Groups
According to the National Cancer Institute: Often,
support groups can help people affected by cancer
feel less alone and can improve their ability to deal
with the uncertainties and challenges that cancer
brings. Support groups give people who are
affected by similar diseases an opportunity to meet
and discuss ways to cope with illness. We offer
various support groups where participants can share
personal experiences or just listen with other cancer
patients and survivors. There is no fee to participate
and new members are always welcome.
The CancerHelp® system is updated monthly, so
you can always find the latest information available.
Information is explained in easy-to-understand
terms and is available in English and Spanish.
■ Cancer Lecture Series
Learning about cancer is an important part of
treatment. That is why we offer ongoing lectures and
educational presentations about treatment options
and the latest in cancer prevention and detection.
■ Community Partnerships
Working with our non-profit community partners,
Eisenhower Lucy Curci Cancer Center is able to
provide a safety net for cancer patients and families
through direct referrals for basic needs such as food
vouchers, assistance in covering monthly bills for
utilities, rent or mortgage, and help with insurance
premiums, co-pays and costs of cancer treatments.
Eisenhower Lucy Curci Cancer Center also hosts
teleconferences, community meetings, cancer
screenings and other workshops. In addition, the
Center is actively involved in the community and
works in cooperation with local, regional and national
cancer organizations such as the American Cancer
Society, the National Cancer Institute and the
Department of Health and Human Services.
Through our long-standing relationship with the
American Cancer Society®, we provide on-site
programs such as the bi-monthly Look Good, Feel
Better and our weekly Wig Bank providing free wigs,
hats and scarves to those undergoing treatment.
■ Exercise for Cancer Patients
Patients undergoing treatment are looking for ways
to combat fatigue, maintain muscle strength, and feel
as though they maintain control over some part of
their lives. Studies have shown patients may benefit
from certain exercises, with many reporting improved
appetite, lessening of fatigue, improvement in sleep
patterns and overall improvement in quality of life.
Partnering with Eisenhower Medical Center’s
Rehabilitation Services, we offer a variety of on-site
exercise classes.
May is Skin Cancer Awareness Month, during which
we partner with staff physicians (dermatologists and
primary care physicians) to offer free skin cancer
screenings to our community.
Classes on Mindfulness Meditation and weekly
Healing Touch Massage are offered through our
Stress Management and Relaxation Program. The
program teaches new approaches to working with
stress, pain, chronic illness and the challenges of
living with a cancer diagnosis. The goal of the program
is to help restore a sense of balance, hope and wellbeing for cancer patients and their caregivers.
■ Harry and Joy Goldstein Cancer Resource Center
When it comes to cancer, knowledge is power.
At our Harry and Joy Goldstein Cancer Resource
25
Cancer Research
For the past several decades, clinical trials have been integral in the
advancement of cancer treatment. Before medical advances in cancer
or other disease states can be offered to the general public, they must
be evaluated and approved through rigorously structured research
studies, called clinical trials, involving human volunteers.
■ If the approach being studied is
found to be helpful, patient may be
among the first to benefit
■ Opportunity to make a valuable
contribution to cancer research
Types of Clinical Trials
Prevention trials test new approaches,
such as medicines, vitamins, minerals, or
other supplements that doctors believe
may lower the risk of a certain type of
cancer or may prevent cancer from
coming back or a new cancer in people
who have already had cancer.
Screening trials test the best way to find
cancer, especially in its early stages.
Participation in cancer research is an important commitment of
Eisenhower Lucy Curci Cancer Center in its mission to provide the
best cancer treatment. In support of its mission, Eisenhower Medical
Center has affiliated with Stanford Cancer Center to offer National
Cancer Institute-endorsed phase II and III, multi-center, randomized,
clinical trials and is just one of the aspects of the advanced care that
the Center offers. Clinical trials available through Eisenhower Lucy
Curci Cancer Center are helping to find new and better treatments
for those diagnosed with cancer. Today’s cancer treatments are
yesterday’s clinical trials. Every cancer treatment that is used today
began with research in a clinical trial.
As a patient, there are potential benefits from participation in clinical
trials, including:
■ Health care provided by leading physicians in the field of
cancer research
■ Access to new drugs and interventions before they are widely
available
■ Close monitoring of our patient’s health care and any side effects
■ More active patient participation role in own health care
Treatment trials test new treatments like
a new cancer drug, new approaches to
surgery or radiation therapy, new
combinations of treatments, or new
methods such as gene therapy.
Diagnostic trials study new tests or
procedures that may help identify, or
diagnose, cancer more accurately.
Diagnostic trials usually involve people
who have some signs or symptoms
of cancer.
Quality of life, or supportive care, trials
explore ways to improve comfort and
quality of life for cancer patients.
Patient participation is key to the success
of cancer research. Patients who participate
in clinical trials play a critical role in the
development of advancements in the
Today’s cancer treatments are yesterday’s clinical trials.
Patient participation
is key to the success
of cancer research.
“Our ability to offer national clinical trials, endorsed by the National Cancer
Institute, ensures our patients receive health care as it should be by providing
world-class treatment right here on the Eisenhower Medical Center campus,” says
Stephanie Farrell, MBA, BSN, RN, CCRC, CPHQ, Director, Research Administration.
For a listing of current trials at Eisenhower, visit emc.org/clinicaltrials, or for
more information or to inquire about enrolling a patient, call 760-837-8034.
■ S1207: Phase III Randomized, Placebo-Controlled
Clinical Trial Evaluating the Use of Adjuvant Endocrine
Therapy +/- One Year of Everolimus in Patients with
High-Risk, Hormone Receptor-Positive and HER2/neu
Negative Breast Cancer
treatment of cancer. “We are honored that our patients
participate in research. Curing all cancer is the ultimate
goal of clinical trials. Hopefully, each trial they participate
in will get us one step closer to finding a cure for
cancer,” states Luke Dreisbach, MD, Chairman,
Clinical Cooperative Research Work Group, Eisenhower
Medical Center.
■ S1400: Phase II/III Biomarker-Driven Master Protocol
for Second Line Therapy of Squamous Cell
Non-Small Cell Lung Cancer (NSCLC)
Since 2006, the clinical research program at
Eisenhower Lucy Curci Cancer Center has received
commendations, the highest honor, during the
tri-annual American College of Surgeons Cancer
Center Survey. The clinical research program has been
recognized for providing patients with information
about cancer-related clinical trials and enrolling our
patients in screening, prevention or treatment trials.
Eisenhower Lucy Curci Cancer Center’s pursuits in
clinical research ensure that our patients receive the
five-star treatment they have come to expect from
Eisenhower Medical Center.
■ S1320: A Randomized Phase II Trial of Intermittent
Versus Continuous Dosing of Dabrafenib and
Trametinib in BRAFV600E/K Mutant Melanoma
■ I-ELCAP: Lung cancer detection program using Low
Dose CT screening for smokers or previous smokers
■ FAMRI/I-ELCAP: Study to determine the likelihood
of specific pulmonary diseases, including chronic
obstructive pulmonary disease (COPD), emphysema,
lung cancer, cardiac disease, and other diseases in
never smokers exposed to secondhand smoke
■ S0820: A Phase III Double Blind Placebo-Controlled
Trial of Eflornithine and Sulindac to Prevent Recurrence
of High Risk Adenomas and Second Primary Colorectal
Cancers in Patients With Stage 0-III Colon Cancer
Clinical Trial Participation —
A Best Practice in the Care of Cancer Patients
The National Comprehensive Cancer Network (NCCN)
believes that the “best management of any cancer
patient is in a clinical trial. Participation in clinical trials
is especially encouraged.” (www.nccn.org)
■ S1403: A Randomized Phase II/III Trial of Afatinib Plus
Cetuximab Versus Afatinib Alone in Treatment-Naive
Patients with Advanced, EGFR Mutation Positive
Non-Small Cell Lung Cancer (NSCLC).
The American Society of Clinical Oncology honors
practices that are dedicated to developing new ways
to slow, halt, cure and prevent cancer through clinical
research. Today, there are nearly 12 million cancer
survivors in the United States, mainly because of the
work done in clinical trials. New clinical trials are
opened throughout the year. Contact the research
office for the most up-to-date availability. The Cancer
Center currently has the following clinical trials that are
accepting new patients:
■ INCB-MA-PV-401: Prospective Non-Interventional Study
of Disease Progression and Treatment of Patients with
Polycythemia Vera in United States Academic or
Community Clinical Practices (REVEAL).
■ LCCC-001: Randomized, Double Blind, Control Trial
Evaluating the Effects of Inhaled Aromatherapy on
Nausea and Vomiting in Adult Cancer Patients Receiving
Treatment in an Outpatient Cancer Center
■ S0931: The EVEREST study – EVErolimus for Renal
Cancer Ensuing Surgical Therapy: Histologically or
cytologically confirmed renal cell carcinoma (clear
cell or non-clear cell), either Intermediate High Risk
or Very High Risk Full surgical resection with negative
margins, including removal of all + nodes. No evidence
or history of distant metastases
Every cancer treatment used today is a direct
result of clinical trials and the people who took
part in them. That is why it is so important to
continue cancer research.
27
Eisenhower BIGHORN
Radiation Oncology Center
Undergoing any type of radiation treatment can be frightening and
confusing. That’s why our caring staff takes time to explain what’s
happening, answer questions and provide information every step of
the way. We’re here to make a difficult situation not just bearable,
but better.
Monica Khanna, MD, Medical Director, Eisenhower BIGHORN
Radiation Oncology Center, consults with a patient.
Radiation Oncology Centers are located at the Eisenhower Lucy
Curci Cancer Center in Rancho Mirage and at Eisenhower George
and Julia Argyros Health Center in La Quinta.
Understanding Radiation Oncology
Radiation Oncology is a subspecialty of radiology, devoted to the
treatment of both benign and malignant conditions. Radiation has
been used to treat cancer since the early 1900s. Therapeutic
techniques have advanced continuously over the years. Treatments
are now available that minimize exposure to surrounding healthy
tissue while maximizing radiation dose to the cancer.
Treatment Planning Starts with You
If your physician decides that radiation
therapy is appropriate for you, the first
step is to develop a plan for your
individual treatment. To ensure the highest
level of patient safety and compassionate
care, your care team, including Board
Certified Radiation Oncologists, oncology
trained/certified nurses, oncology certified
social worker, radiation therapists,
dosimetrist, physicist, registered dietitian
and experienced front desk personnel,
work collaboratively with your primary
physician, surgeon and/or medical
oncologist to ensure ease of referral
and seamless care, and an individualized
treatment plan.
External Beam Radiation Therapy (EBT)
uses our state-of-the-art linear accelerators
to deliver radiation to a precise location
within the body. A series of 3-D radiation
beams are tailored to the size, shape and
location of the tumor or cancer cells.
EBT is effective for treating a variety of
different types of cancers and is often
used in cooperation with other forms
of treatment, such as surgery and
chemotherapy.
Two great locations to serve you.
Aggressive
treatment,
compassionate
care.
When you or someone you love is facing cancer, it helps to know you have a
team of experienced, compassionate medical professionals with access to the
most advanced treatment options available.
If you have any questions about either the Eisenhower BIGHORN Radiation
Oncology Center on campus at the Eisenhower Lucy Curci Cancer Center in
Rancho Mirage or at the Eisenhower George and Julia Argyros Health Center
in La Quinta, please call 760-674-3600, or visit emc.org/radiationoncology.
Intensity Modulated Radiation Therapy (IMRT) has
been one of most significant innovations in radiation
therapy. IMRT uses sophisticated computer technology
to create extremely precise and accurate treatment
plans with precision and accuracy. The variable beam
intensity, which is the hallmark of the IMRT technique,
allows the radiation beams to be shaped in ways
previously thought impossible. Due to its advanced
accuracy, radiation is often delivered at higher doses
without increased side effects. This allows us to treat
tumors that, even a few years ago, would have been
considered untreatable due to their size or proximity
to vital, healthy organs.
■ Stereotactic body radiation therapy (SBRT) refers to
stereotactic radiation treatments delivered within
the body (e.g., lung). A customized plan allows
physicians to administer high doses of radiation to
the cancer with less treatments, typically one to five
weeks rather than several weeks.
Aggressive Treatment, Compassionate Care
When you or someone you love is facing cancer,
it helps to know you have a team of experienced,
compassionate medical professionals with access to
the most advanced treatment options available. This
is what you’ll find at the Eisenhower BIGHORN
Radiation Oncology Center.
Stereotactic Radiation
The surroundings are designed for comfort and
tranquility, including our private patient lounges with
panoramic windows overlooking the surrounding
desert spectacle. Intimate seating and a selection of
complimentary refreshments are provided to help
patients and their loved ones relax during appointments.
Even the treatment rooms feature ceilings that resemble
a desert night with a canopy of twinkling stars designed
to engage patients during treatment sessions.
A specialized type of external beam radiation therapy
called stereotactic radiation uses focused radiation
beams targeting a well-defined tumor, relying on
detailed imaging studies, computerized threedimensional treatment planning and precise treatment
set up to deliver a radiation dose with extreme
accuracy.
There are two types of stereotactic radiation:
Beyond the state-of-the-art medical technology and
warm, healing environment is a team of experienced
and compassionate health care professionals, greeting
individuals by name, getting to know them as more
than just a patient, making special efforts to break
through the “high tech” and provide our patients with
“high touch” care, making this a healing place like no
other.
■ Stereotactic radiosurgery (SRS) does not actually
involve surgery. It is a non-invasive method of
delivering a precise dose of intense radiation to a
tumor located in the brain. SRS offers an important
alternative for many brain tumors, benign and
malignant, which have traditionally been treated
with invasive surgical methods. Depending on the
type of tumor, one or several radiation treatments
may be involved. This treatment technique can
reach virtually any area in the brain, including those
not accessible by conventional surgery.
29
Eisenhower Infusion Centers
Comprehensive Infusion Services
to Help You Regain Your Health
Combining Clinical Excellence with Compassionate Care
Chemotherapy is the treatment of
cancer with powerful medications to
destroy cancer cells by stopping their
growth and reproduction. Often referred
to as “anti-cancer” drugs, they are most
often administered intravenously (IV) or by
injection or orally. Chemotherapy can be
used alone, or in conjunction with radiation
therapy or surgery.
We understand the challenges, both physical and emotional, that
affect every patient and their loved ones. That is why our team of
registered nurses are experienced in infusion services, certified in
chemotherapy administration and available to provide information
and answer questions.
Patient and family education is an essential part of your care.
We encourage all of our patients to be informed and active partners
Biotherapy – treatment to stimulate or
restore immune system abilities. Used in
various illnesses.
Blood transfusions – administration of
blood components such as red blood
cells and platelets when individuals have
low blood counts due to various illnesses.
Our nurses’ stations are located in the middle of the Infusion Center,
allowing our staff to provide the care and attention necessary while
reducing surrounding noise and distractions that may make it
difficult for patients to rest and relax.
in their treatment and healing process. Whether it is special instructions
for taking care during and after treatments, or tips to help reduce
unpleasant side effects associated with some infusions, we help treat
Intravenous antibiotic treatment –
to treat infections.
Subcutaneous injections – administration
of injectable drugs such as those used to
boost production of red or white blood
cells, or in anticoagulant therapy.
Hydration therapy – infusion therapy to
treat dehydration in patients undergoing
chemotherapy or persons dehydrated due
to insufficient fluid intake.
the disease and care for the whole person – our patient.
A Place Where
Your Needs
Come First
When you have cancer or another diagnosis that calls for infusion
treatment, you can rely on the Infusion Centers at the Eisenhower Lucy
Curci Cancer Center to support your care. With seven locations to meet
your needs, our team of experienced, caring medical professionals and facilities focused on patient comfort and convenience — we’re here for you.
If you have questions about infusion therapy or services available, please
call 760-773-1500, or visit emc.org/infusion.
Uncompromising Clinical Care
in a Comfortable Setting
When you don’t feel well, the comfort of your home is
especially important. From the picture windows to the
welcoming smiles of our staff, our Center was designed
with you in mind – to make your treatment experience
as pleasant and comfortable as possible.
The unique environment within our Infusion Centers
are complemented by the additional features of the
Eisenhower Lucy Curci Cancer Center, such as a
tranquil Auxiliary Healing Garden available for strolls in
the fresh air, sunlight or personal meditation. All of
these details combined create a healing place like no
other for our patients.
We’ve taken every detail into account to help you feel
at home.
National Oncology Nursing Certification
Makes a Difference
■ Oversized reclining treatment chairs.
In both the inpatient and outpatient departments of
the Eisenhower Medical Center Cancer Program,
oncology nursing care is delivered by nurses with
specialized knowledge and skills. Nurses complete
additional education and training focused on cancer
care. All nursing staff have completed the National
Oncology Nursing Society standard chemotherapy and
biotherapy training for specialized competency in the
handling, administration, and management of
chemotherapy drugs and side effects.
■ Pillows and heated blankets.
■ A variety of refreshments are available.
■ Semi-private and private rooms available in most
locations upon request and according to individual
circumstances.
■ Complimentary Wifi
NEW Locations for Infusion Centers
There are now seven locations in Rancho Mirage, Yucca
Valley, Palm Springs, and our newest Infusion Center at
the Eisenhower George and Julia Argyros Health
Center in La Quinta, thanks to a generous donation by
BIGHORN Golf Club.
Many of Eisenhower’s chemotherapy-trained nursing staff
have attained a specialized national certification as an
Oncology Certified Nurse (OCN), a distinctive certification
for qualified and experienced registered nurses, who
have demonstrated specialized knowledge in cancer
care by meeting specific eligibility requirements and
passing a rigorous certification exam.
31
BIGHORN Behind a Miracle:
Transforming Breast Care
Since its inception eight years ago, BIGHORN Behind a
Miracle (BAM) has raised more than $5 million for local
cancer patients. This year an amazing $600,000 was
raised benefiting the Eisenhower Schnitzer/Novack
Breast Center, Eisenhower Lucy Curci Cancer Center,
and the BIGHORN Radiation Oncology Center.
committee members, none of this would have been
possible.”
BIGHORN BAM executive committee members include
Selby Dunham; Debi Aarthun; Cheryl Hall, Golf
Tournament Chair; Marie Pinizzotto, MD, and Carol
Ammon.
In addition to the purchase of new, state-of-the-art
breast imaging and ultrasound equipment, funds will
continue to support a year of round-trip transportation
services for patients undergoing radiation and
chemotherapy treatments who would normally rely on
public transportation.
Through the leadership and dedication of Dunham
and the entire BAM committee, and the support of
BIGHORN Golf Club members, breast care and
diagnostic capabilities at Eisenhower have been
transformed.
“We are so grateful for the incredible on-going support
from BAM, and we thank them for their generosity,”
says Laura Fritz, Vice President, Foundation. “BAM
members have changed the course of history for
Eisenhower. Theirs is a remarkable story of impact,
progress and compassion.”
“BIGHORN Behind A Miracle has proven to be exactly
that...a true miracle,” shares Selby Dunham, BAM
founder. “The generosity of the BIGHORN members,
our friends and supporters from the Vintage, Toscana,
Reserve and Indian Ridge is truly extraordinary....without
the enthusiasm and energy of so many volunteers and
32
(Blank inside back cover)
39000 Bob Hope Drive / Rancho Mirage, CA 92270
760-340-3911 / emc.org
© 2015 Eisenhower Medical Center 12/15 175

Cancer Program Annual Report

Transcription

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