center for cancer care - osf healthcare 2013 center for cancer care annual report, highlighting our...

OSF Saint Anthony Medical Center

2013 Annual Report

Summarizing data of the year 2012

C e n t e r F o r

C a n c e r C a r e

Approved with Commendationby the Commission on Cancer

of the American College of Surgeons5666 East State Street

Rockford IL, 61108-2472www.osfsaintanthony.org

• AJCC Cancer Staging Handbook, Seventh Edition, American Joint Commission on Cancer; 2009.

• American College of Surgeons National Cancer Database (NCDB) Benchmark Reports,www.facs.org/cancer/ncdb/index.html

• Cancer Facts and Figures 2012, American Cancer Society, 2012, www.cancer.org

• Cancer Prevention & Early Detection Facts & Figures 2012, American Cancer Society, 2012, www.cancer.org

For general information or to refer a patient to theCenter for Cancer Care at OSF Saint Anthony Medical Center call (815) 227-2273.

The annual report is prepared by Lynn Kiehl, CTR, Supervisor Cancer Registry and Tanya Magnuson,CTR, and dedicated to our cancer patients andtheir families for inspiring us with their courage.

A special thank you to the Cancer Committee members fortheir dedicated leadership and tireless effort.

Physician MembersRichard Nora, MD, Chairman, Oncology/HematologyIftekhar Ahmad, MD, Radiation OncologyJeffrey Barteau, MD, General SurgeryGeorge Bryan, MD, Radiation OncologyKent Hoskins, MD, Oncology/HematologyShivi Jain, MD, Oncology/HematologyAjaz Khan, MD, Oncology/HematologyMete Korkmaz, MD, Oncology/HematologyDavid Laib, MD, PathologyStephen Lehnert, MD, RadiologyIsmael Shaukat, MD, Oncology/HematologyShylendra Sreenivasappa, MD, Oncology/Hematology

CANCER COMMITTEE

Allied MembersLisa Bruno, BSN, RN, OCN, CBCN, Nurse NavigatorKim Calabro, BSN, RN, OCN, Oncology NursingJulie Carlson, MSN, RN, APN, AOCNS, Oncology NursingAllison Gleason, R.T. (R) (M), Women’s CenterKelli Groomer, PA-C, Oncology/HematologyBeth Hayden, BSN, RN, MBA, OCN, Oncology ServicesLynn Kiehl, CTR, Cancer RegistryNicole Killion, American Cancer SocietyGayle Kruse, RN, ACHPN, GCNS-BC, Palliative CareKatie Loehr, Pharm. D., PharmacyTanya Magnuson, CTR, Cancer RegistryJane Malone, RHIA, Health Information ServicesMelody Meier, RN, Quality CareDean Parker, Pastoral CarePeggy Rogers, BSN, RN, OCN, Genetic CounselingKelene Rousey, BSN, RN, OCN, Oncology ResearchLisa Timpe-Johnson, PT, Rehabilitation ServicesDarlynn Venne, BSN, OCN, Oncology NursingJoanne Walker/Karen Gessner/Suzanne Nguy, MSW,LCSW, Social ServicesJodi Witte, RD, LDN, CSO, Oncology Dietitian

REFERENCES

Cancer 2014 PS_Cancer 5/8/14 10:51 AM

11

Iftekhar Ahmad, MD Radiation Oncology

Ajaz Khan, MD Medical Oncology

Kelli Groomer, PA-CMedical Oncology

Shivi Jain, MDMedical Oncology

Shylendra Sreenivasappa, MDMedical Oncology

George Bryan, MD Radiation Oncology

Mete Korkmaz, MD Medical Oncology

Our Dedicated Oncology Team

Richard Nora, MD Medical Oncology

Ismael Shaukat, MD Medical Oncology

Kent Hoskins, MD Medical Oncology

On behalf of the OSF Saint Anthony Medical Center cancer program, it is an honor to sharethe 2013 Center for Cancer Care Annual Report, highlighting our comprehensive community can-cer program.

Caring for the health and needs of patients in our community is the paramount goal of the physi-cians and staff at the Center for Cancer Care. We constantly strive to improve all facets of carein order to provide the absolute best for the Rockford region. The cancer program is pleased andproud to share our accomplishments of this past year.

We are pleased to announce that Dr. Shivi Jain joined the medical oncology team this year. Dr.Jain is knowledgeable, well trained and board certified. And just as importantly, she is a warm,compassionate and caring physician.

Our stereotactic radiation program, including stereotactic radiosurgery and stereotactic bodyradiation therapy, continues to increase in both the number of sites and the number of patientstreated. Drs. George Bryan and Iftekhar Ahmad have now treated both concurrent multiple brainmetastases and soft tissue metastases.

Navigation services were inaugurated this year for patients with lung, breast, colon and prostatecancers. The navigation staff are utilizing validated tools and “maps” developed by a multidisci-plinary oncology team. These maps expedite diagnostic testing, staging and treatment for pa-tients, but also assure integration of education, and supportive, palliative and survivorship careinto each patient’s care plan.

OSF Saint Anthony Medical Center participated as a host site for the American Cancer Society’sCancer Prevention Study 3 study, as well as recruited volunteers for the study. OSF Saint Anthonyhad the highest enrollment of all sites in the region with 209 individuals enrolled.

We are proud to note that the Pedigree Assessment Tool developed at OSF Saint Anthony MedicalCenter by Dr. Kent Hoskins and staff was recently referenced and recommended by the US Pre-ventive Services Task Force as one of a small number of validated tools for determining appropri-ate families for BRCA screening in a primary care setting.

This past year, OSF HealthCare became a member of the Mayo Clinic Care Network, which givesour physicians the ability to quickly consult and collaborate with Mayo specialists through elec-tronic consults and teleconference tumor boards.

In keeping with our Mission, we strive to provide a warm, supportive and dignified environmentfor patients at all stages of their disease, whether receiving treatment, rehabilitation or palliativecare.

We personally extend our thanks to a team of extremely motivated and dedicated physicians,nurses, therapists, cancer registry team, multi-disciplinary staff and volunteers for their tireless effortson behalf of our patients, their families and the entire community we serve. Their collaborativeefforts ensured quality patient care and are reflected in the national recognition of our cancerprogram.

We also remain grateful for the support received from the Administration at OSF Saint AnthonyMedical Center that continues to allow the program to move forward and grow.

Sincerely,

Richard E. Nora, MD, MBA, FACP Beth Hayden, BSN, RN, MBA, OCNMedical Director for Oncology Services Clinical Director for Oncology Services

2

Cancer 2014 PS_Cancer 5/8/14 10:52 AM Page 3

3

AwardsPatricia Ruschmeyer, RN, BSN, was presentedwith the 2013 Interdisciplinary Clinical Excel-lence “Rookie of the Year” Award.

Kim Calabro RN, BSN, OCN, was presented withthe 2013 Interdisciplinary Clinical Excellence“Professional Practice” Award.

Peggy Rogers RN, BSN, OCN, was presentedwith the 2013 Interdisciplinary Clinical Excel-lence “Community Involvement” Award.

Professional InvolvementJulie Carlson, RN, MSN, APN, AOCN, is themembership and program chair for the North-west Illinois Chapter of the Oncology Nursing So-ciety.

Amy Clendening, RN, BSN, OCN, is the web-sitechair for the Northwest Illinois Chapter of theOncology Nursing Society.

Beth Hayden, RN, BSN, MBA, OCN, serves as thesecretary of the Northwest Illinois Chapter of theOncology Nursing Society, the co-chair of theEducation Committee for the American Collegeof Oncology Administrators and is on the boardof directors for Healing Pathways Resource Cen-ter.

Research StudiesBeth Hayden, RN, BSN, MBA, OCN; PeggyRogers, RN, BSN, OCN; Colleen Klein, PhD, RN,FNP-BC; Laurie Badzek LLM, JD, RN, FAAN; Kath-leen Calzone, PhD, RN, APNG, FAAN; JeanJenkins, PhD, RN, FAAN,

Expanding RN Scope of Practice: A Method forIntroducing a New Competency into NursingPractice – National Multi-site Study – NationalState Boards of Nursing – Magnet Study.

10

National/Regional Podium PresentationsBeth Hayden, RN, MBA, OCN, presented “TheNuts and Bolts of Developing a Cancer Pro-gram” at the 2013 American College of Oncol-ogy Administrators Oncology NationalConference in Las Vegas, Nev., on April 10,2013.

Cindy Chiodini, RN, BSN; Marilyn Holsinger, RN,BSN, Abstract accepted as a podium presenta-tion at the 21st National Evidence-Based Prac-tice Conference: Promoting Patient DecisionMaking with Evidence-Based Practice. Presenta-tion entitled, “Nutritional Care for the OutpatientOncology Patient”.

OSF Center for Cancer Care is pleased toannounce the addition of two oncologynurse navigators to its program. Naviga-tors Lisa Bruno and Peggy Malone are fa-cilitating care with patients newlydiagnosed with breast, lung, colon andprostate cancers. The nurses have exten-sive clinical knowledge about oncologyand the community they serve. They pro-vide education and resources to facilitateinformed decision making and timely ac-cess to quality care, throughout allphases of the cancer continuum. Addi-tionally, patient and family anxiety andstress are reduced by the navigatorsbeing able to anticipate patients’ needs,initiating appropriate referrals and provid-ing one on one support.

Commitment to Professional Development

CANCER REGISTRY The Cancer Registry plays a vital role in main-taining accreditation approval standards set bythe American College of Surgeons (ACOS) forthe Center for Cancer Care at OSF Saint An-thony Medical Center. The registry utilizes adata system designed for the collection, man-agement, analysis and reporting of clinical can-cer information on all inpatients and outpatientsdiagnosed and/or treated for cancer at this fa-cility.

As required by state law, registry data is re-ported to the Illinois State Cancer Registry (ISCR)at the Illinois Department of Public Health. Datais also submitted to the National Cancer Data-base (NCDB) and the Facility Information ProfileSystem (FIPS) data-sharing project with theAmerican Cancer Society where it is used as abenchmarking tool.

The collected data on more than 12,000 casesmaintained in the cancer registry is available foruse by the medical staff and other healthcareprofessionals for special studies, reports and re-search. Each patient entered in the registrydatabase is followed for life, withtreatment and survival data thenbeing summarized and utilized atlocal, state and national levels.

The registry is overseen by two certi-fied tumor registrars (CTR) who areresponsible for coordinating cancerconferences, cancer committeemeetings and the survey processwith ACOS, ensuring that each ofthe standards are being met. Theregistry also assists with quality stud-ies and oversees production andpublication of the annual report.

CANCER CONFERENCECancer conferences provide an open forum formultidisciplinary presentations and discussionson various treatment options and ultimately thedetermination of the most appropriate patientmanagement plan.

Weekly cancer conferences continued with en-thusiasm in 2012 and were extremely well at-tended by the medical staff. There were 48Wednesday morning conferences, includingone didactic lecture, which are approved andcertified for AMA PRA Category 1 Credit™.

These convenient on-site educational opportu-nities for the medical staff included diagnostic,pathologic and treatment overviews on 199cases. The most commonly presented primarycancers were breast, head & neck, lung, colon,lymphoma, melanoma and brain. Physiciansand health care professionals are welcome toattend these meetings that enhance patientcare.


Men’s Wellness Night: On June 11, 2013,staff from the Center for Cancer Care volun-teered their time to assist in the Aldeen Men’sGolf Association’s Wellness Night. Each partici-pant was given a scorecard and was encour-aged to visit six health and wellness stations.After attending the stations and completing therequired activity, the scorecard was checkedoff. Participants who had successfully com-pleted all the stations had their names put intoa drawing for assorted gift baskets. Skin cancerprevention and safe sun protection practiceswere the health topics for the Center for Can-cer Care’s station. Participants were given sunscreen samples and information on preventingand detecting skin cancer. Thirty-three individu-als attended the booth and successfully com-pleted their scorecards.

Bow Tie March:On June 8, 2013, OSFSaint Anthony Med-ical Center wasproud to participatein the Annual Bow TieMarch for Men’sCancer Awareness.The event was a 1.5mile walk with pro-ceeds benefitingcancer-relatedcounseling, educa-tion and supportservices at Healing Pathways Cancer ResourceCenter. RNs from the Center for Cancer Carehosted an educational booth with preventionand early detection information focused onmen. In 2013, 75 packets of educational infor-mation were distributed.

Pink Glove Contest: In October of 2013, OSFAnthony Medical Center participated in thePink Glove Dance contest to raise awareness re-garding breast cancer, as well as to attempt towin $10,000 for our breast cancer charity ofchoice, the American Cancer Society’s MakingStrides Against Breast Cancer in Rockford. Morethan 200 staff members throughout the medicalcenter produced a video, which was posted onFacebook and YouTube. This year, the hospitalpartnered with the Girl Scouts of Northern Illinoisin producing the video. OSF Saint Anthonycame in 33rd overall and first in Illinois.

Styling for Pink: Making Strides Against BreastCancer Fashion Show Fundraiser was held onOctober 6, 2013 at Cliffbreakers Riverside Resort.

9

The Center for Cancer Care and the OSFWomen’s Center hosted an educational boothand display related to early detection and pre-vention of breast cancer. More than 600 peopleattended this event.

Making Strides Against Breast CancerWalk: The American Cancer Society walk washeld on Saturday, October 19, 2013 at MartinPark in Loves Park, Ill. The Women’s Centerhosted an educational booth with breast can-cer prevention educational materials whilemany OSF employees and their family membersparticipated in this annual walk.

Kick-In for Cancer: Staff from the OSF SaintAnthony Oncology Unit (4 West) hosted an edu-cational booth at the Swedish Music and SickFraternity’s (SM&SF) Kick-In for Cancer event.

SM&SF is a non-profit so-cial club that maintains atradition of caring for thecommunity by hosting thisannual event. Kick-In forCancer raises more than$30,000 a year to benefitthe local hospitals’ oncol-ogy departments andhospice care providers.

Senior EXPO: On Sep-tember 13-14, 2013, stafffrom the Women’s Center

held an educational booth with cancer preven-tion and early detection materials at the EXPO.The Senior EXPO is a two day resource fair fea-turing the latest in programs, products, eventsand information for those 60 and older. It servesas a one-stop shop for caregivers or familymembers seeking information for the senior intheir lives.

Additional Breast Cancer AwarenessActivities: Radio station B-103 interviewed KentHoskins, MD, Iftekhar Ahmad, MD, Lisa Bruno,Beth Hayden, Peggy Rogers and DouglasBlume, MD, on breast cancer related topics in-cluding prevention and early detection strate-gies, 3-D Mammography, genetics andsurvivorship. The informative interviews wereaired on the radio station throughout themonth, as well as posted on its website. Portionsof the OSF Saint Anthony Pink Glove Dancevideo were aired on WGN, WBBM Chicago andWIFR TV stations during the month of October.

2012 STATISTICAL SUMMARY

Information obtained in demographics is important.By understanding our patient population, OSF SaintAnthony Medical Center is able to offer community

education, improve screening programs, implementstate of the art technology, offer clinical trials and pro-vide enhanced support services.

Total Cases 857

Analytic Cases 810 (95%)These include patients who were diagnosed and re-ceived all or part of their first course of treatment atOSF Saint Anthony Medical Center. The data in this re-port will reflect only analytic cases.

Non-Analytic Cases 47 (5%)These include patients who were diagnosed and re-ceived their entire first course of treatment at an out-side institution and now come for treatment after initialtreatment failure or with recurrent disease.

63%

15%

10%

3%

2%

7%

Winnebago

Ogle

Dekalb

Lee

Other

Boone

2012 County of Residence at Diagnosis

Lee

D

2012 County of Residence at Diagnosis2012 County of Residence at Diagnosis2012 County of Residence at Diagnosis

0

37.5

75

112.5

150

0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+

2012 Age & Gender Distribution at Diagnosis

Num

ber

of A

naly

tic C

ases

Age Ranges at DiagnosisMale Female

12

66

108106

88

35

147 5

57

112107

61

20

57

OSF Illinois

Breast Lung Colorectal Melanoma Prostate

National

16%

14% 14%15%

10%

7%

4%5% 5%

14%15%

9% 9%

14%14%

4


Analysis of Major SiteUnlike many other cancers, the rates of melanomahave continued to increase over the last 30 years mak-ing it the fastest-growing malignancy in the UnitedStates. According to the American Cancer Society,cancer of the skin is by far the most common of allcancers. Melanoma accounts for less than two per-cent of skin cancer cases but causes a large majorityof skin cancer deaths. Approximately 76,690 newmelanomas will be diagnosed in the UnitedStates in 2013. About 9,480 people are ex-pected to die of melanoma (about 6,280men and 3,200 women).

According to the American Cancer Society the risk ofmelanoma increases with age, but people under theage of 30 are developing melanomas at an alarmingrate. The incidence in the United States has been risingin part due to changes in behavior that have resultedin increased exposure to solar UVR and the use of in-door tanning booths. In its comprehensive review, theInternational Agency for Research on Cancer re-ported that indoor tanning has no positive effect onhealth, and found a 75 percent increase in melanomarisk among those who used indoor tanning booths intheir teens and 20s.

Illinois recently banned indoor tanning for personsunder the age of 18. This will hopefully impact futureincidence. Additional novel strategies must be em-ployed to discourage the intentional provision and useof this cancer causing agent. Lessons from the cam-paigns against tobacco and asbestos exposure mightbe learned and used in order to decrease the finan-cial incentives and rewards of tanning equipment andservices. Higher direct taxation, establishment of strictliability for both manufacturers and service providers,and mandated contributions to public health funds inorder to mitigate future damages and public costs,are all strategies to be considered. On the consumerside, higher cost resulting from the above strategiesmay decrease usage, and organized campaigns fromthe “beauty industry” and victims of melanoma shouldbe considered.

Risk Factors for Melanoma (American Cancer Society)

RPersonal or family history of melanoma

RLight skin or sun-sensitive skin types

RPresence of moles and freckles

RHistory of excessive sun exposure, including severe sunburn

RExposure to indoor tanning booths occurring early in life

M e l a n o m a

5

Prevention (American Cancer Society)

R Limit ultraviolet (UV) exposure

R Use sunscreen

R Protective clothing including hats and sun glasses

R Seek shade, particularly between 10 a.m. and 4 p.m. when the UV rays are the strongest

R Avoid tanning beds and sunlamps

R Perform routine skin exams and report any abnormal moles or changes to a doctor

3-D Mammography Now AvailableOSF Saint Anthony Medical Center is the first hospital

in the Rockford region to be able to provide 3-D

mammography to all patients. This revolutionary

technology is also known as digital breast tomosyn-

thesis (DBT), which gives radiologists the ability to

identify and characterize individual breast structures

without the confusion of overlapping tissue. DBT pro-

duces a 3-dimensional view of breast tissue that im-

proves breast cancer screening and detection, while

reducing women's anxiety associated with being

called back for additional views. During the 3-D part

of the exam, the X-ray arm sweeps in a slight arc

over the breast, taking multiple images instead of

one straight-down picture. The computer can then

produce a 3-D image of the breast tissue in one mil-

limeter slices, providing greater visibility for the radi-

ologist to see breast detail in a way never before

possible. These new machines were purchased with

our patients in mind. We want to make sure our pa-

tients have access to the best screening technology

available.

Community PartnershipsOSF Saint Anthony Medical Center, Center forCancer Care has partnered with several com-munity organizations in the Rock River Valley in-cluding the American Cancer Society, HealingPathways Resource Center, the Black HealthCoalition, and the Young Men’s Christian Asso-ciation (YMCA). Partnership activities with theAmerican Cancer Society include Relay for Life,Making Strides Against Breast Cancer, CancerPrevention Study-3, Look Good Feel Better Pro-gram, the Styling for Pink event and the PinkGlove Dance contest. They also partner withthe American Dermatological Association toprovide skin cancer screenings for the commu-nity. These partnerships are instrumental inmeeting the needs of the community by pre-venting, diagnosing, and treating cancer andproviding support for patients and their families.

The following community events and programswere held in 2013 in support of the OSF Saint An-thony Medical Center cancer program and ourpatients:

Cancer Prevention Study-3 (CPS-3): OnOctober 12 and 18, 2013, OSF Center for Can-cer Care fought back against cancer by host-ing enrollment at our facility for the AmericanCancer Society’s new research study called theCancer Prevention Study-3. The aim of the studyis to understand the genetic, environmental andlifestyle factors that can cause or prevent can-cer. The Center for Cancer Care partnered withthe American Cancer Society by serving as ahost site, recruiting study participants, promotingand marketing the study. Staff from the Centerfor Cancer Care and the Women’s Center as-sisted on the day of the event by serving asgreeters and room monitors. OSF Saint Anthonyenrolled 209 participants to the study, whichwas the highest enrollment site in Rockford, Ill.

8


2012 Total Analytic Incidence by Site, Gender, AJCC StagePrimary Site Male None

ORAL CAVITY & PHARYNX 18 17 1 0 3 3 3 8 1Tongue 3 2 1 0 1 0 0 2 0Salivary Glands 2 2 0 0 0 0 1 0 1Floor of Mouth 1 1 0 0 0 1 0 0 0Gum & Other Mouth 2 2 0 0 1 1 0 0 0Tonsil 5 5 0 0 1 0 1 3 0Oropharynx 1 1 0 0 0 0 1 0 0Hypopharynx 4 4 0 0 0 1 0 3 0DIGESTIVE SYSTEM 143 77 66 5 31 26 30 38 13Esophagus 5 4 1 0 0 1 1 3 0Stomach 10 6 4 0 0 0 3 7 0Small Intestine 7 6 1 0 1 2 1 2 1Colon Excluding Rectum 58 29 29 2 21 13 14 7 1Rectum & Rectosigmoid 15 8 7 3 4 1 6 0 1Anus, Anal Canal & Anorectum 5 1 4 0 0 3 1 0 1Liver & Intrahepatic Bile Duct 14 9 5 0 3 0 2 4 5Gallbladder 1 1 0 0 0 1 0 0 0Other Biliary 3 2 1 0 0 1 1 1 0Pancreas 24 11 13 0 2 4 1 13 4Other Digestive Organs 1 0 1 0 0 0 0 1 0RESPIRATORY SYSTEM 135 79 56 0 17 11 28 73 6Larynx 11 9 2 0 4 2 3 2 0Lung & Bronchus 123 69 54 0 13 9 25 71 5Trachea, Mediastinum & Other 1 1 0 0 0 0 0 0 1BONES & JOINTS 1 1 0 0 0 1 0 0 0SOFT TISSUE 3 2 1 0 1 0 2 0 0SKIN (EXCLUDING BASAL & SQUAMOUS CELL) 61 30 31 7 30 9 3 4 8Melanoma 59 28 31 7 30 8 3 4 7Other Non-Epithelial Skin 2 2 0 0 0 1 0 0 1BREAST 132 0 132 28 53 29 10 12 0FEMALE GENITAL SYSTEM 32 0 32 0 10 2 10 8 2Cervix Uteri 6 0 6 0 0 2 2 1 1Corpus & Uterus 16 0 16 0 9 0 3 3 1Ovary 10 0 10 0 1 0 5 4 0MALE GENITAL SYSTEM 47 47 0 0 8 27 4 6 2Prostate 44 44 0 0 7 27 3 5 2Testis 2 2 0 0 1 0 1 0 0Penis 1 1 0 0 0 0 0 1 0URINARY SYSTEM 51 35 16 5 24 3 5 10 4Urinary Bladder 30 24 6 5 15 3 1 3 3Kidney & Renal Pelvis 20 11 9 0 9 0 3 7 1Ureter 1 0 1 0 0 0 1 0 0EYE & ORBIT 2 1 1 0 0 0 0 0 2BRAIN & OTHER NERVOUS SYSTEM 36 12 24 0 0 0 0 0 36Brain 16 8 8 0 0 0 0 0 16Cranial Nerves Other Nervous System 20 4 16 0 0 0 0 0 20ENDOCRINE SYSTEM 34 13 21 0 11 4 5 1 13Thyroid 21 8 13 0 11 4 5 1 0Other Endocrine Including Thymus 13 5 8 0 0 0 0 0 13LYMPHOMA 35 18 17 0 5 8 6 12 4Hodgkin Lymphoma 3 3 0 0 0 1 2 0 0Non-Hodgkin Lymphoma 32 15 17 0 5 7 4 12 4MYELOMA 15 9 6 0 0 0 0 0 15LEUKEMIA 22 11 11 0 0 0 0 0 22Lymphocytic Leukemia 13 8 5 0 0 0 0 0 13Myeloid & Monocytic Leukemia 9 3 6 0 0 0 0 0 9MISCELLANEOUS 43 22 21 0 0 0 0 0 43

Stage IIStage OFemale Stage III Stage IVStage ITotal

Total 810 374 436 45 193 123 106 172 171

Melanoma of the skin can occur anywhere on the skinand generally presents as a new or changing mole. Itoccurs most commonly on the extremities in femalesand on the trunk in males.

The prognosis and treatment for melanoma is depend-ent upon its stage, the sum of how far a cancer hasspread. Melanoma thickness, tumor ulceration and mi-totic rate are all important measures to determine thestage of disease.

Surgical resection remains the first line of treatment,with surgery alone being the standard therapy forearly stage melanoma. More advanced cancersoften require other treatments, which can include im-munotherapy, targeted therapy, chemotherapy or ra-diation therapy.

OSF National

0%

13%

25%

38%

50%

Stage 0 Stage I Stage II Stage III Stage IV

Stage of Melanoma Diagnosed in 2011*

29%

23%

37%

42%

19%

14%

7% 8%

4% 5%

Unknown

4%

8%

OSF NCDB

0%

25%

50%

75%

100%

Year 0 Year 1 Year 2 Year 3 Year 4 Year 5

Melanoma - Overall Survival Diagnosis 2003 - 2005

0%

23%

45%

68%

90%


Five-Year Overall Survival for Five Frequent Sites for All Stages at

Diagnosis /Cases Diagnosed in 2003-2005

OSF NCDB

11%16%

89%85%

61%56%

67%

80% 87%88%

6 7*Most current statistics available from the NCDB Benchmark Reportscomparing similar Comprehensive Community Cancer Programs.


Analysis of Major SiteUnlike many other cancers, the rates of melanomahave continued to increase over the last 30 years mak-ing it the fastest-growing malignancy in the UnitedStates. According to the American Cancer Society,cancer of the skin is by far the most common of allcancers. Melanoma accounts for less than two per-cent of skin cancer cases but causes a large majorityof skin cancer deaths. Approximately 76,690 newmelanomas will be diagnosed in the UnitedStates in 2013. About 9,480 people are ex-pected to die of melanoma (about 6,280men and 3,200 women).

According to the American Cancer Society the risk ofmelanoma increases with age, but people under theage of 30 are developing melanomas at an alarmingrate. The incidence in the United States has been risingin part due to changes in behavior that have resultedin increased exposure to solar UVR and the use of in-door tanning booths. In its comprehensive review, theInternational Agency for Research on Cancer re-ported that indoor tanning has no positive effect onhealth, and found a 75 percent increase in melanomarisk among those who used indoor tanning booths intheir teens and 20s.

Illinois recently banned indoor tanning for personsunder the age of 18. This will hopefully impact futureincidence. Additional novel strategies must be em-ployed to discourage the intentional provision and useof this cancer causing agent. Lessons from the cam-paigns against tobacco and asbestos exposure mightbe learned and used in order to decrease the finan-cial incentives and rewards of tanning equipment andservices. Higher direct taxation, establishment of strictliability for both manufacturers and service providers,and mandated contributions to public health funds inorder to mitigate future damages and public costs,are all strategies to be considered. On the consumerside, higher cost resulting from the above strategiesmay decrease usage, and organized campaigns fromthe “beauty industry” and victims of melanoma shouldbe considered.

Risk Factors for Melanoma (American Cancer Society)

RPersonal or family history of melanoma

RLight skin or sun-sensitive skin types

RPresence of moles and freckles

RHistory of excessive sun exposure, including severe sunburn

RExposure to indoor tanning booths occurring early in life

M e l a n o m a

5

Prevention (American Cancer Society)

R Limit ultraviolet (UV) exposure

R Use sunscreen

R Protective clothing including hats and sun glasses

R Seek shade, particularly between 10 a.m. and 4 p.m. when the UV rays are the strongest

R Avoid tanning beds and sunlamps

R Perform routine skin exams and report any abnormal moles or changes to a doctor

3-D Mammography Now AvailableOSF Saint Anthony Medical Center is the first hospital

in the Rockford region to be able to provide 3-D

mammography to all patients. This revolutionary

technology is also known as digital breast tomosyn-

thesis (DBT), which gives radiologists the ability to

identify and characterize individual breast structures

without the confusion of overlapping tissue. DBT pro-

duces a 3-dimensional view of breast tissue that im-

proves breast cancer screening and detection, while

reducing women's anxiety associated with being

called back for additional views. During the 3-D part

of the exam, the X-ray arm sweeps in a slight arc

over the breast, taking multiple images instead of

one straight-down picture. The computer can then

produce a 3-D image of the breast tissue in one mil-

limeter slices, providing greater visibility for the radi-

ologist to see breast detail in a way never before

possible. These new machines were purchased with

our patients in mind. We want to make sure our pa-

tients have access to the best screening technology

available.

Community PartnershipsOSF Saint Anthony Medical Center, Center forCancer Care has partnered with several com-munity organizations in the Rock River Valley in-cluding the American Cancer Society, HealingPathways Resource Center, the Black HealthCoalition, and the Young Men’s Christian Asso-ciation (YMCA). Partnership activities with theAmerican Cancer Society include Relay for Life,Making Strides Against Breast Cancer, CancerPrevention Study-3, Look Good Feel Better Pro-gram, the Styling for Pink event and the PinkGlove Dance contest. They also partner withthe American Dermatological Association toprovide skin cancer screenings for the commu-nity. These partnerships are instrumental inmeeting the needs of the community by pre-venting, diagnosing, and treating cancer andproviding support for patients and their families.

The following community events and programswere held in 2013 in support of the OSF Saint An-thony Medical Center cancer program and ourpatients:

Cancer Prevention Study-3 (CPS-3): OnOctober 12 and 18, 2013, OSF Center for Can-cer Care fought back against cancer by host-ing enrollment at our facility for the AmericanCancer Society’s new research study called theCancer Prevention Study-3. The aim of the studyis to understand the genetic, environmental andlifestyle factors that can cause or prevent can-cer. The Center for Cancer Care partnered withthe American Cancer Society by serving as ahost site, recruiting study participants, promotingand marketing the study. Staff from the Centerfor Cancer Care and the Women’s Center as-sisted on the day of the event by serving asgreeters and room monitors. OSF Saint Anthonyenrolled 209 participants to the study, whichwas the highest enrollment site in Rockford, Ill.

8


Men’s Wellness Night: On June 11, 2013,staff from the Center for Cancer Care volun-teered their time to assist in the Aldeen Men’sGolf Association’s Wellness Night. Each partici-pant was given a scorecard and was encour-aged to visit six health and wellness stations.After attending the stations and completing therequired activity, the scorecard was checkedoff. Participants who had successfully com-pleted all the stations had their names put intoa drawing for assorted gift baskets. Skin cancerprevention and safe sun protection practiceswere the health topics for the Center for Can-cer Care’s station. Participants were given sunscreen samples and information on preventingand detecting skin cancer. Thirty-three individu-als attended the booth and successfully com-pleted their scorecards.

Bow Tie March:On June 8, 2013, OSFSaint Anthony Med-ical Center wasproud to participatein the Annual Bow TieMarch for Men’sCancer Awareness.The event was a 1.5mile walk with pro-ceeds benefitingcancer-relatedcounseling, educa-tion and supportservices at Healing Pathways Cancer ResourceCenter. RNs from the Center for Cancer Carehosted an educational booth with preventionand early detection information focused onmen. In 2013, 75 packets of educational infor-mation were distributed.

Pink Glove Contest: In October of 2013, OSFAnthony Medical Center participated in thePink Glove Dance contest to raise awareness re-garding breast cancer, as well as to attempt towin $10,000 for our breast cancer charity ofchoice, the American Cancer Society’s MakingStrides Against Breast Cancer in Rockford. Morethan 200 staff members throughout the medicalcenter produced a video, which was posted onFacebook and YouTube. This year, the hospitalpartnered with the Girl Scouts of Northern Illinoisin producing the video. OSF Saint Anthonycame in 33rd overall and first in Illinois.

Styling for Pink: Making Strides Against BreastCancer Fashion Show Fundraiser was held onOctober 6, 2013 at Cliffbreakers Riverside Resort.

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The Center for Cancer Care and the OSFWomen’s Center hosted an educational boothand display related to early detection and pre-vention of breast cancer. More than 600 peopleattended this event.

Making Strides Against Breast CancerWalk: The American Cancer Society walk washeld on Saturday, October 19, 2013 at MartinPark in Loves Park, Ill. The Women’s Centerhosted an educational booth with breast can-cer prevention educational materials whilemany OSF employees and their family membersparticipated in this annual walk.

Kick-In for Cancer: Staff from the OSF SaintAnthony Oncology Unit (4 West) hosted an edu-cational booth at the Swedish Music and SickFraternity’s (SM&SF) Kick-In for Cancer event.

SM&SF is a non-profit so-cial club that maintains atradition of caring for thecommunity by hosting thisannual event. Kick-In forCancer raises more than$30,000 a year to benefitthe local hospitals’ oncol-ogy departments andhospice care providers.

Senior EXPO: On Sep-tember 13-14, 2013, stafffrom the Women’s Center

held an educational booth with cancer preven-tion and early detection materials at the EXPO.The Senior EXPO is a two day resource fair fea-turing the latest in programs, products, eventsand information for those 60 and older. It servesas a one-stop shop for caregivers or familymembers seeking information for the senior intheir lives.

Additional Breast Cancer AwarenessActivities: Radio station B-103 interviewed KentHoskins, MD, Iftekhar Ahmad, MD, Lisa Bruno,Beth Hayden, Peggy Rogers and DouglasBlume, MD, on breast cancer related topics in-cluding prevention and early detection strate-gies, 3-D Mammography, genetics andsurvivorship. The informative interviews wereaired on the radio station throughout themonth, as well as posted on its website. Portionsof the OSF Saint Anthony Pink Glove Dancevideo were aired on WGN, WBBM Chicago andWIFR TV stations during the month of October.

2012 STATISTICAL SUMMARY

Information obtained in demographics is important.By understanding our patient population, OSF SaintAnthony Medical Center is able to offer community

education, improve screening programs, implementstate of the art technology, offer clinical trials and pro-vide enhanced support services.

Total Cases 857

Analytic Cases 810 (95%)These include patients who were diagnosed and re-ceived all or part of their first course of treatment atOSF Saint Anthony Medical Center. The data in this re-port will reflect only analytic cases.

Non-Analytic Cases 47 (5%)These include patients who were diagnosed and re-ceived their entire first course of treatment at an out-side institution and now come for treatment after initialtreatment failure or with recurrent disease.

63%

15%

10%

3%

2%

7%

Winnebago

Ogle

Dekalb

Lee

Other

Boone

2012 County of Residence at Diagnosis

Lee

D

2012 County of Residence at Diagnosis2012 County of Residence at Diagnosis2012 County of Residence at Diagnosis

0

37.5

75

112.5

150

0-29 30-39 40-49 50-59 60-69 70-79 80-89 90+

2012 Age & Gender Distribution at Diagnosis

Num

ber

of A

naly

tic C

ases

Age Ranges at DiagnosisMale Female

12

66

108106

88

35

147 5

57

112107

61

20

57

OSF Illinois


National

16%

14% 14%15%

10%

7%

4%5% 5%

14%15%

9% 9%

14%14%

4


3

AwardsPatricia Ruschmeyer, RN, BSN, was presentedwith the 2013 Interdisciplinary Clinical Excel-lence “Rookie of the Year” Award.

Kim Calabro RN, BSN, OCN, was presented withthe 2013 Interdisciplinary Clinical Excellence“Professional Practice” Award.

Peggy Rogers RN, BSN, OCN, was presentedwith the 2013 Interdisciplinary Clinical Excel-lence “Community Involvement” Award.

Professional InvolvementJulie Carlson, RN, MSN, APN, AOCN, is themembership and program chair for the North-west Illinois Chapter of the Oncology Nursing So-ciety.

Amy Clendening, RN, BSN, OCN, is the web-sitechair for the Northwest Illinois Chapter of theOncology Nursing Society.

Beth Hayden, RN, BSN, MBA, OCN, serves as thesecretary of the Northwest Illinois Chapter of theOncology Nursing Society, the co-chair of theEducation Committee for the American Collegeof Oncology Administrators and is on the boardof directors for Healing Pathways Resource Cen-ter.

Research StudiesBeth Hayden, RN, BSN, MBA, OCN; PeggyRogers, RN, BSN, OCN; Colleen Klein, PhD, RN,FNP-BC; Laurie Badzek LLM, JD, RN, FAAN; Kath-leen Calzone, PhD, RN, APNG, FAAN; JeanJenkins, PhD, RN, FAAN,

Expanding RN Scope of Practice: A Method forIntroducing a New Competency into NursingPractice – National Multi-site Study – NationalState Boards of Nursing – Magnet Study.

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National/Regional Podium PresentationsBeth Hayden, RN, MBA, OCN, presented “TheNuts and Bolts of Developing a Cancer Pro-gram” at the 2013 American College of Oncol-ogy Administrators Oncology NationalConference in Las Vegas, Nev., on April 10,2013.

Cindy Chiodini, RN, BSN; Marilyn Holsinger, RN,BSN, Abstract accepted as a podium presenta-tion at the 21st National Evidence-Based Prac-tice Conference: Promoting Patient DecisionMaking with Evidence-Based Practice. Presenta-tion entitled, “Nutritional Care for the OutpatientOncology Patient”.

OSF Center for Cancer Care is pleased toannounce the addition of two oncologynurse navigators to its program. Naviga-tors Lisa Bruno and Peggy Malone are fa-cilitating care with patients newlydiagnosed with breast, lung, colon andprostate cancers. The nurses have exten-sive clinical knowledge about oncologyand the community they serve. They pro-vide education and resources to facilitateinformed decision making and timely ac-cess to quality care, throughout allphases of the cancer continuum. Addi-tionally, patient and family anxiety andstress are reduced by the navigatorsbeing able to anticipate patients’ needs,initiating appropriate referrals and provid-ing one on one support.

Commitment to Professional Development

CANCER REGISTRY The Cancer Registry plays a vital role in main-taining accreditation approval standards set bythe American College of Surgeons (ACOS) forthe Center for Cancer Care at OSF Saint An-thony Medical Center. The registry utilizes adata system designed for the collection, man-agement, analysis and reporting of clinical can-cer information on all inpatients and outpatientsdiagnosed and/or treated for cancer at this fa-cility.

As required by state law, registry data is re-ported to the Illinois State Cancer Registry (ISCR)at the Illinois Department of Public Health. Datais also submitted to the National Cancer Data-base (NCDB) and the Facility Information ProfileSystem (FIPS) data-sharing project with theAmerican Cancer Society where it is used as abenchmarking tool.

The collected data on more than 12,000 casesmaintained in the cancer registry is available foruse by the medical staff and other healthcareprofessionals for special studies, reports and re-search. Each patient entered in the registrydatabase is followed for life, withtreatment and survival data thenbeing summarized and utilized atlocal, state and national levels.

The registry is overseen by two certi-fied tumor registrars (CTR) who areresponsible for coordinating cancerconferences, cancer committeemeetings and the survey processwith ACOS, ensuring that each ofthe standards are being met. Theregistry also assists with quality stud-ies and oversees production andpublication of the annual report.

CANCER CONFERENCECancer conferences provide an open forum formultidisciplinary presentations and discussionson various treatment options and ultimately thedetermination of the most appropriate patientmanagement plan.

Weekly cancer conferences continued with en-thusiasm in 2012 and were extremely well at-tended by the medical staff. There were 48Wednesday morning conferences, includingone didactic lecture, which are approved andcertified for AMA PRA Category 1 Credit™.

These convenient on-site educational opportu-nities for the medical staff included diagnostic,pathologic and treatment overviews on 199cases. The most commonly presented primarycancers were breast, head & neck, lung, colon,lymphoma, melanoma and brain. Physiciansand health care professionals are welcome toattend these meetings that enhance patientcare.


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Iftekhar Ahmad, MD Radiation Oncology

Ajaz Khan, MD Medical Oncology

Kelli Groomer, PA-CMedical Oncology

Shivi Jain, MDMedical Oncology

Shylendra Sreenivasappa, MDMedical Oncology

George Bryan, MD Radiation Oncology

Mete Korkmaz, MD Medical Oncology

Our Dedicated Oncology Team

Richard Nora, MD Medical Oncology

Ismael Shaukat, MD Medical Oncology

Kent Hoskins, MD Medical Oncology

On behalf of the OSF Saint Anthony Medical Center cancer program, it is an honor to sharethe 2013 Center for Cancer Care Annual Report, highlighting our comprehensive community can-cer program.

Caring for the health and needs of patients in our community is the paramount goal of the physi-cians and staff at the Center for Cancer Care. We constantly strive to improve all facets of carein order to provide the absolute best for the Rockford region. The cancer program is pleased andproud to share our accomplishments of this past year.

We are pleased to announce that Dr. Shivi Jain joined the medical oncology team this year. Dr.Jain is knowledgeable, well trained and board certified. And just as importantly, she is a warm,compassionate and caring physician.

Our stereotactic radiation program, including stereotactic radiosurgery and stereotactic bodyradiation therapy, continues to increase in both the number of sites and the number of patientstreated. Drs. George Bryan and Iftekhar Ahmad have now treated both concurrent multiple brainmetastases and soft tissue metastases.

Navigation services were inaugurated this year for patients with lung, breast, colon and prostatecancers. The navigation staff are utilizing validated tools and “maps” developed by a multidisci-plinary oncology team. These maps expedite diagnostic testing, staging and treatment for pa-tients, but also assure integration of education, and supportive, palliative and survivorship careinto each patient’s care plan.

OSF Saint Anthony Medical Center participated as a host site for the American Cancer Society’sCancer Prevention Study 3 study, as well as recruited volunteers for the study. OSF Saint Anthonyhad the highest enrollment of all sites in the region with 209 individuals enrolled.

We are proud to note that the Pedigree Assessment Tool developed at OSF Saint Anthony MedicalCenter by Dr. Kent Hoskins and staff was recently referenced and recommended by the US Pre-ventive Services Task Force as one of a small number of validated tools for determining appropri-ate families for BRCA screening in a primary care setting.

This past year, OSF HealthCare became a member of the Mayo Clinic Care Network, which givesour physicians the ability to quickly consult and collaborate with Mayo specialists through elec-tronic consults and teleconference tumor boards.

In keeping with our Mission, we strive to provide a warm, supportive and dignified environmentfor patients at all stages of their disease, whether receiving treatment, rehabilitation or palliativecare.

We personally extend our thanks to a team of extremely motivated and dedicated physicians,nurses, therapists, cancer registry team, multi-disciplinary staff and volunteers for their tireless effortson behalf of our patients, their families and the entire community we serve. Their collaborativeefforts ensured quality patient care and are reflected in the national recognition of our cancerprogram.

We also remain grateful for the support received from the Administration at OSF Saint AnthonyMedical Center that continues to allow the program to move forward and grow.

Sincerely,

Richard E. Nora, MD, MBA, FACP Beth Hayden, BSN, RN, MBA, OCNMedical Director for Oncology Services Clinical Director for Oncology Services

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OSF Saint Anthony Medical Center

2013 Annual Report

Summarizing data of the year 2012

C e n t e r F o r

C a n c e r C a r e

Approved with Commendationby the Commission on Cancer

of the American College of Surgeons5666 East State Street

Rockford IL, 61108-2472www.osfsaintanthony.org

• AJCC Cancer Staging Handbook, Seventh Edition, American Joint Commission on Cancer; 2009.

• American College of Surgeons National Cancer Database (NCDB) Benchmark Reports,www.facs.org/cancer/ncdb/index.html

• Cancer Facts and Figures 2012, American Cancer Society, 2012, www.cancer.org

• Cancer Prevention & Early Detection Facts & Figures 2012, American Cancer Society, 2012, www.cancer.org

For general information or to refer a patient to theCenter for Cancer Care at OSF Saint Anthony Medical Center call (815) 227-2273.

The annual report is prepared by Lynn Kiehl, CTR, Supervisor Cancer Registry and Tanya Magnuson,CTR, and dedicated to our cancer patients andtheir families for inspiring us with their courage.

A special thank you to the Cancer Committee members fortheir dedicated leadership and tireless effort.

Physician MembersRichard Nora, MD, Chairman, Oncology/HematologyIftekhar Ahmad, MD, Radiation OncologyJeffrey Barteau, MD, General SurgeryGeorge Bryan, MD, Radiation OncologyKent Hoskins, MD, Oncology/HematologyShivi Jain, MD, Oncology/HematologyAjaz Khan, MD, Oncology/HematologyMete Korkmaz, MD, Oncology/HematologyDavid Laib, MD, PathologyStephen Lehnert, MD, RadiologyIsmael Shaukat, MD, Oncology/HematologyShylendra Sreenivasappa, MD, Oncology/Hematology

CANCER COMMITTEE

Allied MembersLisa Bruno, BSN, RN, OCN, CBCN, Nurse NavigatorKim Calabro, BSN, RN, OCN, Oncology NursingJulie Carlson, MSN, RN, APN, AOCNS, Oncology NursingAllison Gleason, R.T. (R) (M), Women’s CenterKelli Groomer, PA-C, Oncology/HematologyBeth Hayden, BSN, RN, MBA, OCN, Oncology ServicesLynn Kiehl, CTR, Cancer RegistryNicole Killion, American Cancer SocietyGayle Kruse, RN, ACHPN, GCNS-BC, Palliative CareKatie Loehr, Pharm. D., PharmacyTanya Magnuson, CTR, Cancer RegistryJane Malone, RHIA, Health Information ServicesMelody Meier, RN, Quality CareDean Parker, Pastoral CarePeggy Rogers, BSN, RN, OCN, Genetic CounselingKelene Rousey, BSN, RN, OCN, Oncology ResearchLisa Timpe-Johnson, PT, Rehabilitation ServicesDarlynn Venne, BSN, OCN, Oncology NursingJoanne Walker/Karen Gessner/Suzanne Nguy, MSW,LCSW, Social ServicesJodi Witte, RD, LDN, CSO, Oncology Dietitian

REFERENCES


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