2018 cancer care center report to the - rushcopley.com · the clinic offers supportive care from...

2018 Cancer Care Center Annual Report to the Community

Rush Copley Cancer Care Center Annual Report 1

Dear Colleagues and Community Members,

I am pleased to present the 2018 Rush Copley Cancer Care Center Annual Report. In this year’s Annual Report, you’ll find an overview of our programs and services, a moving story from one of our patients, some of the major accomplishments during the year, statistics from our cancer registry and a cancer report by Medical Oncologist, Kaushik Patel, MD.

This past year was an exciting one for the center. We were surveyed by both the American College of Surgeons (ACOS) Commission on Cancer and the National Accreditation Program for Breast Centers (NAPBC). We received the Commission on Cancer Outstanding Achievement Award (OAA) by striving for excellence in compliance with the standards and ensuring the highest level of cancer care. Additionally, we met all of the requirements to receive re‐accreditation with the NAPBC!

Another significant accomplishment for us was the re‐opening of our joint venture, the Radiation Therapy Center at Riverwest. Riverwest is a freestanding radiation therapy center in Aurora that underwent a significant renovation. Our team is now equipped to provide patients with the latest treatment options using a Philips Brilliance CT Big Bore scanner and Varian TrueBeam linear accelerator.

Aside from accreditations and technological enhancements, our center was able to expand its service line and establish a gynecologic oncology clinic. This clinic is held within the cancer care center twice a month and ensures we are providing continuity of care to our patients. The center is also in the process of establishing a cardio oncology clinic, which will further enhance our cancer care program to support the needs of those living in the Fox Valley and surrounding area.

The items discussed above are examples of the work taking place behind the scenes to ensure that Rush Copley’s Cancer Care Center is providing patients comprehensive care in a high quality and safe environment.

Sincerely,

Judi Bonomi, RN, MS, MSN, OCN, NE‐BCDirector, Rush Copley Cancer Care Center

Me s s a g e f r om L e a d e r s h i p

Table of Contents

1 Message from Leadership

3 Cancer Care Services Overview

4 Support Services – Patient Spotlight

6 2018 Highlights

7 Cancer Registry Report and Analytic Data

9 Acute Myeloid Leukemia Cancer Report

13 HPV Vaccination Initiative (4.1 Prevention and 4.2 Screening)

17 Oncology and NAPBC Committee

19 References

R u s h C o p l e y C a n c e r C a r e C e n t e r

CLINICAL SERVICES

Advanced Illness Support ClinicThe clinic offers supportive care from specialists trained to provide medical intervention through all phases of illness that focus on comfort, maintaining or improving daily function by reducing and controlling symptoms, as well as counseling and support services to assist with difficult medical decisions. For questions or to schedule an appointment, please call 800‐570‐8809.

Clinical Trials and ResearchPatients at Rush Copley have access to National Cancer Institute sponsored and local investigator‐initiated studies with the goal of improving the treatment of cancer. These studies test promising new approaches to cancer diagnosis and treatment, as well as new interventions to help manage the side effects of treatment. Rush Copley invites eligible patients to participate in clinical trials and contribute to the development of new medical knowledge, while being treated close to home.

Connection to Academic MedicineRush University Medical Center and Rush Copley will more fully integrate Rush’s clinical programs, research, education and community priorities. Specific new initiatives include: neurosciences clinical program development, neonatal and specialty pediatric program development, expanded access to surgical sub‐specialties, advanced women’s health specialization and programming, pursuit of magnet nursing designation, emergency medicine residency program and a thoracic oncology program. This partnership is about ensuring our patients have access to the best care we can provide. It’s a meaningful investment in our communities and

a commitment to the Rush vision of building the leading academic health system in the region and transforming health care.

Genetic CounselingSome families have a hereditary, or genetic, factor that can greatly increase their chances of developing cancer. Identifying these families and educating them about available cancer screenings, risk reduction and prevention options can significantly reduce their risk for some types of cancer. Our genetics program provides risk assessment, genetic counseling and testing, and referral to a genetics specialist, if appropriate. Speak to your physician to learn if genetic testing is right for your care.

Gynecologic Oncology ClinicRush Copley Cancer Care Center has partnered with Rush University Medical Center to offer an on‐site clinic to patients. Clinic is held twice a month in the cancer care center to ensure continuity of care for all patients.

Recognized for Outstanding Cancer Care

Rush Copley’s Cancer Care Institute is the area’s first Comprehensive Community Cancer Program and is accredited by the Commission on Cancer of the American College of Surgeons and the National Accreditation Program for Breast Centers. The center’s breast imaging program has been recognized as a Breast Imaging Center of Excellence by the American College of Radiation for outstanding mammography, ultrasound and MRI breast services.


SUPPORT SERVICESFinancial CounselingFinancial counseling is available to patients and families to help understand the costs of treatment, insurance coverage and financial responsibility.

Freedom From Smoking®

This seven‐week workshop is sponsored by the American Lung Association to provide support and the skills needed to quit smoking. Sessions are held in a friendly, comfortable environment and led by an experienced facilitator who understands the unique challenges of quitting.

Nurse Navigation SpecialistsExperts in navigating complex health care situations, nurse navigators serve as patient care advocates and coordinators for patients, families and their health care providers. They are available as a point of contact, providing advice, support and direction as needed. Rush Copley’s Cancer Care Center employs two nurse navigators and a breast health navigator.

NutriTherapy Nutrition CounselingRush Copley offers a comprehensive and proactive nutrition support program. Nutritional services are provided by a certified dietitian who has extensive experience counseling patients. The dietitian works in concert with the patient’s care team to help reduce the risk of diet complications during and after cancer treatment.

Psycho‐Social SupportCancer may be one of the most difficult challenges a person can face. Our center has a licensed clinical social worker to help patients and their families cope with their cancer and to assist them in dealing with psychological or social barriers to their treatment.

Spiritual CareSpiritual beliefs can be a great source of strength and comfort during cancer treatment. Rush Copley’s clinically trained chaplains are available to meet with our patients and their families any time during the course of treatment or after treatment is complete.

Survivorship ProgramAt Rush Copley, we are dedicated to helping cancer survivors live their lives to the fullest after treatment. Our team works with survivors to monitor for signs of cancer recurrence and focus on identifying, preventing and controlling any long‐term and late effects associated with cancer and its treatment. Survivors receive a detailed care plan outlining their treatment as well as a plan for follow‐up care that can be shared with the primary care physician. All survivors should continue scheduling regular checkups with a primary care physician to prevent, detect and treat any complications that may have resulted from treatment as well as receive routine screenings.

Waterford Place Cancer Resource CenterWaterford Place is where services and support, free of charge, are available to anyone impacted by a cancer diagnosis. Waterford Place staff and volunteers aim to provide comforting, understanding and fortifying resources for those in any stage of treatment or survivorship – along with their loved ones. Waterford Place offers an array of comprehensive programs and services to provide holistic support that include information and education classes and workshops, yoga and exercise classes, cooking demonstrations, support groups, family fun nights, mindfulness, meditation, Reiki, oncology massage and facials, reflexology, an American Cancer Society Wig Boutique and much more.

Rush Copley Cancer Care Center Annual Report4

Pa t i e n t S p o t l i g h t – Wa t e r f o r d P l a c e


Valarie Traynham was diagnosed with multiple myeloma in 2015, a few months before Waterford Place first opened its doors to the public. After going through eight rounds of chemo and a stem cell transplant, she came to our first “Look Good Feel Better” session in January 2016 in an emotionally and medically fragile state. The program helps patients manage the appearance‐related side effects of cancer treatment.

At the time, Valarie says she didn’t even know the kinds of support she needed or how seeking it could benefit her. So she tried every kind of therapy and educational program that Waterford Place offers. She found that everything she tried helped her in ways she didn’t even know she needed help. She says that even just being there, among people who looked like she did and understood what she was going through, offered a sense of profound comfort and relief.

The wig boutique at Waterford Place is a prime example. Faced with hair loss, Valarie did not know how to get a wig, nor how to care for one. Now she wears wigs confidently and owns several. To learn about nutrition, she went to a cooking demonstration and got information about foods that can make her feel better and help her to heal. She went to seminars on topics like neuropathy and chemo brain. She tried reiki, not even knowing what it was, and discovered that the Mind, Body & Spirit programs at Waterford Place are the most beneficial to her of all.

She now leads the International Myeloma Foundation’s (IMF) support group for patients with Multiple Myeloma at Waterford Place, a role to which she is passionately committed. The IMF had been sending out a support group leader, so she stepped up to that challenge, as a way of paying forward the value she has

received from Waterford Place. Determined that no one should be unsure of where to turn for help and resources, Valarie is educating patients about their disease and the resources available at Waterford Place, both through the support group and as a Waterford Place ambassador at Rush Copley’s Cancer Care Center.

She tells newly diagnosed cancer patients that Waterford Place helps you get off the emotional rollercoaster and brings you a sense of calm. Being part of a community of people on the same journey helps you let go of the fear, live your life calmly in the moment, without your diagnosis always in the forefront. Waterford Place has a soothing ambiance, not a sterile environment of white lab coats, but a wonderful place with a holistic approach to healing and a hopeful focus on the future.

Since it opened three years ago, Waterford Place has served more than 1,100 cancer patients and their family members. All of the programs are offered free of charge, because 100 percent of the operating costs associated with Waterford Place are underwritten by donations.

This past year was an exciting one for the Cancer Care center:

We received a three‐year re‐accreditation from the Commission on Cancer (CoC) and National Accreditation Program for Breast Centers (NAPBC).

Our services were expanded to include a gynecologic oncology clinic. Amina Ahmed, MD and Andras Ladanyi, MD hold clinic in our center two days a month.

A revolutionary process, Magnetic Seed Localization or MSL, was introduced for breast patients. This new technique is used by radiologists and breast surgeons to localize breast lesions prior to surgery. It provides more accurate identification of lesions and significantly increases patient comfort.

The Rush System launched a major branding campaign across the Chicagoland area. This includes new ads for TV, radio, outdoor digital and transit.

2 0 1 8 H i g h l i g h t s


Rush Copley’s Cancer Registry Department supports the activities of the Oncology Committee and the Cancer Care Center.

The registry staff oversees the collection, quality assurance, lifetime follow‐up and analysis of data from patients diagnosed with cancer who receive all or part of their care at Rush Copley and others deemed reportable.

The registry provides vital statistics and information to clinicians and researchers as well as local, state and national cancer databases and cancer‐related organizations. This contribution of information advances the body of knowledge in the field of cancer and ultimately has a positive impact on cancer patient care.

The world of a cancer registrar is ever changing, and so are the guidelines that registrars use to conduct accurate data abstracting. Cancer centers report specifics of diagnosis, stage of disease, medical history, patient demographics, laboratory data, tissue diagnosis, medical radiation and surgical methods of treatment for

each cancer diagnosed at the facility. The data is used to observe cancer trends and provide a research base for studies into the possible causes of cancer with the goal of reducing cancer death and illness.

Registry data also serves as an ongoing resource to the Oncology Committee in determining the most effective allocation of resources for developing community education and outreach initiatives, as well as monitoring program quality.

For Rush Copley’s data to be comparable to those collected at other programs around the country, the registrars adhere to data rules established by the collecting and credentialing organizations. Keeping up with these changes can be challenging, but Rush Copley registrars understand the significance of their work and are experts in their field.

C a n c e r R e g i s t r y R e p o r t


Primary Site DistributionRush Copley 2017 Analytical Cases

SITE Analytical Cases

% Anal. Cases

Stage 0

Stage 1

Stage 2

Stage 3

Stage 4

NotStaged

Unknown/Other

Breast 205 31% 43 89 53 12 7 0 1

Lung & Bronchus 74 11% 0 17 4 13 37 1 2

Other Digestive 54 8% 0 3 10 9 17 10 5

Colorectal 51 8% 5 7 11 11 14 3 0

Endocrine System 48 7% 0 17 2 4 3 19 3

Brain & CNS 48 7% 0 0 0 0 0 48 0

Lymphoma 34 5% 0 10 7 5 9 0 3

Female Genital System 32 5% 0 17 2 9 0 4 0

Leukemia 21 3% 0 0 0 0 0 21 0

Prostate 19 3% 0 3 6 4 6 0 0

Skin (excluding basal & squamous)

19 3% 7 8 1 1 2 0 0

Oral Cavity & Pharynx 13 2% 0 0 1 2 10 0 0

Larynx 9 1% 0 4 0 1 4 0 0

Urinary System 7 1% 0 1 0 0 6 0 0

Myeloma 5 1% 0 0 0 0 0 5 0

Soft Tissue 4 1% 0 2 1 0 1 0 0

Nose, Nasal Cavity & Middle Ear

1 0% 0 0 0 1 0 0 0

Trachea, Mediastinum & Other

1 0% 0 0 0 1 0 0 0

Miscellaneous 19 3% 0 0 0 0 0 19 0

Total 664 100% 55 178 98 73 116 130 14


Analytic: Cases diagnosed and/or received all or part of first course of care at Rush Copley Medical Center.

Acute Myeloid Leukemia Cancer ReportKaushik Patel, MD

INTRODUCTIONAcute Myeloid Leukemia (AML) is a cancer of the blood. It occurs when blood and bone marrow develop too rapidly. Although it accounts for only 1% of all cancers, AML is the most common type of leukemia. AML is rarely found in people under the age of 45, average age being 68. It is more common in men than women but the average lifetime risk of developing AML for both sexes is ½‐1%.

RISK FACTORSRisk factors are things that affect your chance of getting a disease such as cancer. Different cancers have different risk factors. There are some risk factors, like smoking, that can be changed and there are other risk factors that are hereditary and nothing can be done about them.

AML has some known risk factors. AML can occur at any age, but it is more common when people get older. AML is more common in males than females. As with most cancers, smoking is also a risk factor. If you have been exposed to certain chemicals you can have an increased risk of developing AML. Some chemicals linked to AML are benzene and formaldehyde. Benzene is a solvent used in the rubber industry, oil refineries, chemical plants, cigarette smoke, gasoline, cleaning products, detergents, art supplies and paints. Some studies have linked heavy exposure to formaldehyde to increased risk of developing leukemia, but this has not been seen in all studies.

Some people, previously treated for cancer with certain chemotherapy drugs, are at higher risk for developing AML. A certain class of chemotherapy drugs called alkylating agents can lead to an increased risk of developing AML. In addition, chemotherapy drugs called topoisomerase II inhibitors are also linked to AML.

Those who have been exposed to high‐dose radiation such as an atomic bomb blast or nuclear reactor accident have an increased risk of developing AML. Some treatments for cancer also include radiation treatment and these treatments have also been linked to an increased risk of AML. This risk depends on the amount of radiation given and the area treated. Some concern exists over whether or not low levels of radiation from x‐rays or CT scans increase the risk of developing AML. These concerns remain ill defined. Therefore, most doctors try to limit too much exposure to children and pregnant women.

Some blood disorders, such as myelodysplasticsyndrome (MDS), can evolve into AML over time. If AML develops after MDS, it can be difficult to treat. Some syndromes caused by genetic mutations present at birth can increase the risk of AML. In addition, Down syndrome and Trisomy 8 are also linked to AML.

AML does not have a strong genetic link but having a close family history (such as parent or sibling) with AML increases the risk. There is a very high risk in identical twins.

SIGNS AND SYMPTOMSAt time of diagnosis, AML has several non‐specific symptoms. These include weight loss, fatigue, fever, night sweats and loss of appetite. These are considered non‐specific because they can mean so many different things.

Clinically, AML presents with low blood counts found in routine blood work. This happens when the leukemia cells (blasts) crowd out the normal cells in the bone marrow. This leads to lower red blood cell, white blood cells and platelets.

When the red blood cells are low, one may feel tired, weak, cold, dizzy, short of breath, suffer


SIGNS AND SYMPTOMSfrom headaches and appear pale. When white blood cells are low, infections are more likely to occur. These infections do not seem to go away and multiple infections can keep occurring. Fever accompanies these infections. When the platelets are low, excessive bruising, petechiae and bleeding occur. Bleeding can be in the form of frequent heavy nosebleeds, bleeding gums or heavy menstrual periods in women. The presence of blasts in blood work causes problems as well. Blasts are bigger than normal cells and have a more difficult time going through the blood vessels. When the vessels get clogged, this can lead to headache, confusion, sleepiness, slurred speech and weakness on one side of the body. If blood vessels in the lungs are affected, one can experience shortness of breath.

AML can cause problems with bleeding or clotting. This is shown with abnormal bleeding or blood clots. Blood clots in the legs present with calf swelling and chest pain and shortness of breath may indicate a blood clot in the lung.

The presence of blasts in the blood stream can also cause bone or joint pain due to backup in these areas. Blasts are also known for building up in the liver or spleen, making them larger. This can be diagnosed upon palpation by a doctor.

Other symptoms of AML are when the leukemia spreads. AML can spread to the skin causing lumps or spots. AML can spread to the gums causing gum swelling, pain and bleeding. If AML spreads to other organs, such as the brain and spinal cord, headaches, weakness, seizures, vomiting, trouble with balance, facial numbness and blurred vision can occur.

SCREENING AND DIAGNOSISAML is diagnosed with a physical exam, medical history, blood, bone marrow and lymph node tests. These tests include:

Complete blood count (CBC) ‐ Test counts the levels of the white blood cells, red blood cells and platelets.

Complete metabolic panel (CMP) ‐Measures the levels of certain chemicals in the body.

Bone marrow biopsy and aspiration ‐ Test removes bone marrow for evaluation.

Genetic testing ‐ Test looks for genetic changes that have occurred.

Lumbar puncture ‐ Test examines cerebrospinal fluid for AML cells, blood and other markers for the disease.

Leukemia does not generally form tumors so imaging tests are not used in making a diagnosis. Imaging is used when an infection or other problem is suspected.

STAGINGAML is not staged like solid tumor cancers are. AML is widespread throughout the bloodstream. The prognosis is made depending on the subtype of AML (determined by lab tests), the patient’s age and other lab test results. The distribution of age at diagnosis for patients at Rush Copley is represented below (See Figure 1).


Figure 1. RCMC AML Age at Diagnosis

STAGINGKnowing the subtype of AML is very important as it affects the outlook and treatment plan. There are two commonly used systems to classify AML. The French‐American British (FAB) system classifies leukemia based on how it looks under the microscope. The World Health Organization (WHO) system takes into account several prognostic factors to classify AML based on a patient’s outlook. Prognostic factors help doctors determine the risk of AML coming back after treatment and, therefore, what type of treatment they should get. As part of the workup for AML, doctors order tests to examine chromosome abnormalities, genetic mutations and markers on the leukemia cells. These results, along with the patient’s age, white blood cell count at time of diagnosis and medical history all aid the doctor in determining a patient’s prognosis.

TREATMENT

CHEMOTHERAPYThe most common type of treatment of AML is chemotherapy. This is often followed by stem cell transplantation. Surgery and radiation are only used in special circumstances. Chemotherapy treatment is divided into phases. The first phase is called induction. This lasts about a week and takes place while admitted in the hospital. The goal is to clear the blood of blast cells. Once the patient has recovered from induction chemotherapy, the second phase, or consolidation phase, is initiated. Consolidation chemotherapy is given in cycles. Its purpose is to kill the small amount of leukemia cells that cannot be seen. The third phase of chemotherapy is called the maintenance phase. This involves giving low dose chemotherapy for months or years after consolidation is finished. If there are signs that the leukemia has reached the brain or spinal cord, intrathecal chemotherapy is given through a small hole in the skull or during a lumbar puncture. The most common combination of chemotherapy given to AML

patients is cytarabine and daunorubicin. There are other drugs that can be used but these are the most common. The most common side effects of chemotherapy are hair loss, mouth sores, loss of appetite, nausea and vomiting and diarrhea or constipation.

TARGETED THERAPIESMost recently, drugs that target specific parts of the cancer cell have been discovered. Targeted therapy drugs work differently than standard chemotherapy and have different side effects. Targeted therapy side effects include low blood counts, fever, nausea, vomiting, sores in the mouth, headache, muscle and bone pain, bleeding, high blood glucose levels, upper respiratory infections, liver or kidney infections, build‐up of fluid, infusion reactions, infections and heart arrhythmias.

SURGERYSurgery plays a very small role in the treatment of AML. Often, before chemotherapy starts, the placement of a central venous catheter is performed. This is left in place during treatment in order to administer chemotherapy and other intravenous drugs. This lowers the number of needles sticks needed during treatment and reduces the risk of infection.

RADIATION THERAPYRadiation therapy is generally not part of the main treatment for people with AML, but there are a few instances when it may be used. When leukemia has spread outside the bone marrow and blood, such as to the brain, spinal fluid or testicles, radiation may be considered. Sometimes, prior to transplant, whole body radiation can be performed. Radiation can also be used to reduce pain in bones invaded by the leukemia.


STEM CELL TRANSPLANT (SCT):SCT is used to give higher doses of chemotherapy than can normally be given due to serious side effects. The most common type of SCT used to treat AML is an allogeneic SCT. This is when stem cells come from someone other than the patient, usually a donor, who closely matches the patient. The closer the match between the donor and the recipient, the better the chance for success. The best donors are close relatives; sometimes even umbilical cord stem cells are used. The most serious side effect of an allogeneic SCT is graft‐versus‐host disease (GVHD). This happens when the patient’s immune system is taken over by the donor system and the donor system attacks the patient’s system as if it is foreign. Symptoms of GVHD are rash, itching, mouth sores, nausea and severe diarrhea. Liver damage can occur causing yellowing of the skin and eyes.

An autologous transplant occurs when a patient’s own stem cells are removed from his or her blood marrow or blood. They are frozen and stored while the person gets treatment. The cells are purged in the lab to try to remove any leukemia cells in the sample. After treatment, the stem cells are put back into the patient’s blood. Autologous transplants are easier for patients to tolerate. The biggest problem related to autologous transplants is that it is difficult to remove all the leukemia cells from the sample. This leads to a risk of returning some leukemia cells with the transplant.

TREATMENT RESPONSE RATESThe goal for treatment of AML is complete remission. This means that the blood and bone marrow return to normal. Statistics show that approximately two out of three people with AML who receive induction chemotherapy go into remission. This means the bone marrow contains less than 5% blast cells and the blood count has returned to normal. As stated earlier, thechances of remission depends largely on the patient’s specific prognostic factors such as age

and the presence of certain genes or chromosomes. Once remission is reached, patients go into the consolidation part of treatment in an effort to get rid of any remaining leukemia cells. Nearly 50% of patients who get consolidation chemotherapy go into long‐term remission and may even be cured.

CONCLUSIONIn 2018, Rush Copley conducted an in‐depth analysis of AML cases that were diagnosed and treated in our facility in 2017 (See Figure 2). There were nine cases in total and all cases were reviewed to ensure that the recommended first course of treatment from the National Comprehensive Cancer Network Guidelines was followed. The results indicated that seven cases followed the recommended guidelines. Two patients expired during treatment due to poor prognostic factors such as age, and one expired five days after bone marrow biopsy. This information was presented to the Oncology Committee and reaffirms that Rush Copley continues to follow evidence‐based medicine and provides exceptional care to its patients.


Figure 2. RCMC AML Treatment Summary

2018 PREVENTION AND SCREENING INITIATIVES COMMUNITY NEEDS ASSESSMENTRush Copley Medical Center’s primary service areas include Kane County and Kendall County, Illinois. The 2018 Kane County Community Health Needs Assessment (CHNA) was released in June 2018; we had based our prevention and screening initiatives on the 2014 CHNA and then updated our statistics with the 2018 CHNA mid‐year. Findings from the 2018 CHNA identified cancer as the leading cause of deaths in Kane County accounting for 23.4% compared to 25.7% in 2014. Risk factors associated with cancer include tobacco, diet, physical activity and environmental/occupational exposures. Because 13.7% of the residents are current smokers, Kane County doesn’t meet the Healthy People 2020 goal of less than 12%. The highest rate of smoking is in Southern Kane County at 17.6% which is within Rush Copley’s service area. The 2018 CHNA also showed that vaping has tripled to 8.4% compared to 2.7% in 2015. The Kendall County CHNA for 2016 demonstrated that 13.7% of residents are current smokers. Another method of cancer prevention is use of the HPV vaccination among preteens, adolescents and young adults. In Illinois, the HPV vaccination rate for females ages 13‐17 is 40.2% and males 26.8% This includes both genders that have received the entire series of three vaccinations. The Kane and Kendall County Needs Assessment lacked data specific to HPV vaccination rates, therefore, data from the 2015 National Immunization Survey was utilized.

Along with HPV vaccination, our center focused on colorectal cancer screening. According to the American Cancer Society, colorectal cancer is the second leading cause of cancer‐related deaths when both sexes are combined. Rush Copley’s Cancer Care Center treated 52 patients in 2017 for colorectal cancer; the majority were stage three or four. There are different methods for colorectal cancer (CRC) screening and of these

the gold standard is a colonoscopy. The Rush Copley Cancer Care Center is committed to preventative screening to find colorectal cancer at an early stage and signed the National Colorectal Cancer Roundtable pledge to reach 80% screened by 2018. In Illinois, it is estimated by the 2016 Behavioral Risk Factor Surveillance System (BRFSS) data that 71.8% White Non‐Hispanic (increase of 8.9% compared to previous year) men and women have received colorectal screening, as have 63.6% of Blacks (increase of 3.5% compared to previous year), and 50.3% of Hispanics (increase of 2.6% compared to previous year). The 2018 CHNA estimated that in Kane County 75.1% have had a colonoscopy which is an increase of 2.1% compared to the 2014 CHNA; however, it doesn’t reflect the numbers broken down by race and ethnicity to demonstrate the disparity in routine colorectal cancer screening.

GOALS FOR INITIATIVES• Provide screening and education to identify

colorectal cancer at earlier stages.

• Strengthen the collaboration with local health care agencies, Rush Copley Medical Group (RCMG) and the VNA Healthcare, a Federally Qualified Health Center (FQHC) in the area.

• Establish a relationship with the local school of district nurses on increasing awareness of the benefits of the HPV vaccine as a method of cancer prevention among preteens and adolescents.

• Assess current avenues in which the community and patients receive information on tobacco cessation.

CANCER PREVENTION INITIATIVE COMMITTEEThe committee includes the following: Cancer Care Center Manger, Community Health Outreach Coordinator, Director of Clinical Services and Advance Practice Providers, American Cancer


CANCER PREVENTION INITIATIVE COMMITTEESociety Hospital Health Systems Manager, Care Coordination Nurse (VNA Health Care – FQHC), Senior Customer Representative (Merk) and Administrative Health Coordinator, East Aurora School District 131.

PREVENTIONThe HPV vaccination committee met every other month in 2018. The group was able to establish goals to be met by the end of the year. There were two goals identified: The first goal was to have a school nurse join the HPV vaccination committee and the second goal was to host a Continuing Education (CE) program for dentists and dental hygienists on HPV prevention and the dental community’s role.

The Administrative Health Coordinator for East Aurora School District 131 attended the HPV vaccination committee meeting in January 2018 along with a colleague and formally joined the committee. The Administrative Health Coordinator has been attending the meetings throughout the year and provided valuable feedback and input. In 2019 the committee is hoping to partner with District 131 and host information booths around parent‐centered activities at the middle schools and high school. We have now established baseline data on HPV vaccine rates for the district which will be utilized for comparing data in 2019.

In order to host the CE program for dentists and dental hygienists, the committee connected with the American Dental Association to partner and provide the CE credits, and the ADA connected the committee to the local dental chapter, the Fox River Valley Dental Society (FRVDS). Due to the society’s schedule for CE programs, the CE will be hosted April 16, 2019 at the Rush Copley Heart Institute. The speakers for the CE include: Rachel Caskey, MD, MaPP, University of Illinois at Chicago, Kristen M. Stenson, MD, Rush University

Medical Center and Mark Lingen, DDS, PhD, FRCPath, University of Chicago.

Another effort to increase cancer prevention within the community is in the form of smoking cessation programs. Rush Copley Cancer Care Center hosts the American Lung Association’s Freedom From Smoking® Program for tobacco cessation. The program is facilitated by two Rush Copley employees who received certification from the American Lung Association’s Freedom From Smoking program. Freedom From Smoking® is offered on a quarterly basis in English at RCMC. Nine participants attended the program in 2018: four completed the program and quit smoking. This equates to a program completion rate of 44.4% in 2018. This data doesn’t include the November 2018 program.

In October, Rush Copley kicked off a subcommittee to Rush University Medical Center’s Tobacco Oversight Committee (TOC). The subcommittee will meet once a month to address tobacco cessation for Rush Copley Medical Center and Rush Copley Medical Group. They will be looking at the current tobacco cessation assessment, education resources and assessment of clinicians on patient’s willingness to quit. The Rush Copley Medical Center Sub‐TOC will play a crucial role in the 2019 prevention initiative for the Cancer Care Center.

BARRIERS WITH HPV VACCINATION EDUCATIONOne barrier facing the HPV committee was not being able to meet the second goal identified which was to host a CE program for dentists and dental hygienists in 2018; however, the committee will not meet this goal until 2019 when the Dental CE is hosted on April 16.


Year Participants Finished FFS

Didn't Finish FFS

Quit Avg. Age Started

Cigs Per Day

#of Quit Attempts

2018* 9 4 5 4 15 16 2*November session is not included in the numbers above

CANCER SCREENING INITIATIVE COMMITTEEThe committee for the colorectal cancer screening meets quarterly and includes the following: Cancer Care Center Manger, Community Health Outreach Coordinator, Digestive Health Services and Pain Clinic Manager, Digestive Health Services and Pain Clinic Lead Nurse, Health Screening Coordinator, American Cancer Society Hospital Health Systems Manager and Gastroenterology Practice Manager.

NCCN GUIDELINESRush Copley’s Cancer Care Center follows the NCCN Guidelines for colorectal cancer screening for average risk patients. Patients that were identified as Increased or High Risk were recommended to discuss colorectal cancer screening options with their physician.

Average Risk Patients• Adults between the ages of 50‐75 • No history of adenomatous polyp or sessile serrated polyp or colorectal cancer• Negative family history for colorectal cancer

MARKETINGThe information for colorectal cancer screenings was disseminated in a variety of formats to the community, healthcare providers and centers in the area.

The avenues of communication include: • Healthy Connections ‐ Hospital Community Newsletter• Get the Scoop on the Scope and Don’t Dread the Prep Flyers ‐ Providers, Community Events, Hospital• Hospital Website ‐ Screening and Cancer Care Services• Cancer Care and Rush Copley Medical Group E‐newsletters• Local parish bulletins

EDUCATION AND SCREENINGRush Copley’s Cancer Care Center educated 16 community participants about the importance of following prep instructions, getting a colonoscopy and risk factors for colorectal cancer. The “Get the Scoop on the Scope” program focuses on the importance of colonoscopy screening with a short presentation. “Don’t Dread the Prep” aids in reducing anxiety and fear regarding the prep for a colonoscopy. “Get the Scoop on the Scope” was presented by a gastroenterologist and surgeon and “Don’t Dread the Prep” by nursing staff from Digestive Health Services and the Pain Clinic. This year the program incorporated a tour of the GI Lab for participants who wanted to see where they would go for their screening. The tour was optional but the majority attended and found it very beneficial.

The “Get the Scoop on the Scope” event was held twice in 2018. The first program was held in March by Dr. Dhiraj Gulati. Twelve participants attended the event and three participants scheduled a colonoscopy. The second program was held in September with Dr. Neha Sahnipresenting in English with simultaneous interpretation in Spanish. There were four participants in attendance. One of the participants from the Spanish program was connected with the VNA Health Care, a local Federally Qualified Healthcare Center (FQHC), for a colonoscopy due to symptoms the patient was having and being uninsured. VNA Health Care was in attendance during our program and followed up with the patient. The participant evaluations stated that they gained knowledge, the program met their expectations and they feel better equipped to discuss colorectal cancer screening with a physician.

The CRC Committee began in 2016 and since then there has been an increase in colonoscopy screenings among the two (Hispanic/Latino and African American) community target populations. At Rush Copley there was an increase


EDUCATION AND SCREENINGof 3.8% among Hispanic/Latino patients from 2017‐2018 and an increase of 106.9% between 2015‐2018. In the African American patients there was an increase of 3.1% from 2017‐2018 and 80.0% between 2015‐2018. Among all races/ethnicities there was an increase in colonoscopies of 62.3% from 2015‐2018. The data from 2018 showed the smallest increase in colonoscopy screening since starting the initiative in 2016.

SCREENING AMONG UNINSURED POPULATIONSRush Copley’s Cancer Care Center received a hospital Mission and Vision Grant to offer free iFOBT kits for average risk individuals that were either uninsured or underinsured. Participants that received free iFOBT kits completed an intake form and the Community Health Outreach Coordinator explained the iFOBT kit to them. Each iFOBT kit was accompanied by a letter from the Cancer Care Center explaining the test, testing instructions and a prepaid envelope to mail the test back. The letter and instructions were available in English and Spanish. Kits were returned to the lab for results and a follow‐up call would take place for positive findings. Additionally, a letter was sent to all participants with results and instructions. The letter would inform the participant if they needed to schedule a colonoscopy and that the information was also provided to their primary care physician.

Rush Copley’s Cancer Care Center was able to provide 19 free iFOBT Kits in 2018. From the 19 iFOBT kits handed, eight were returned and they were negative. The Community Health Outreach Coordinator contacted the participants that didn’t return the iFOBT kit. Each received two calls and voicemails.


Colonoscopies at RCMC

2015 2016 2017 2018 Annualized

2017 ‐ 2018 % Increase

2016 ‐ 2017 % Increase

2015 ‐ 2018 % Increase

Hispanic 145 210 289 300 3.8% 20.9% 106.9%African American

110 147 192 198 3.1% 14.3% 80.0%

Total 1,283 1,565 1,986 2,082 4.8% 10.6% 62.3%

Positive Negative1/28/2018 Sacred Heart Church 2 0 1 11

4/14/2018 Compañeros en Salud Health Festival 17 0 7* 68

19 0 8 79*Invalid sample

Total

Date EventiFOBT

AttendeesHanded Out

Returned

O n c o l o g y C omm i t t e e

Physician and Oncology Committee MembersKaushik Patel, MD Hematology/Medical Oncology, Chairman

Ying Zhang, MD Radiation Oncology, Vice‐Chair, Cancer Liaison Physician

Kurian Abraham, MD Pathology

Saud Ahmed, MD Diagnostic Radiology

Suzanne Bergen, MD Gynecologic Oncology Surgeon

Justin M. Karush, DO Cardiovascular & Thoracic Surgery

Joseph Meschi, MD Hematology/Medical Oncology

Paola Molina, MD Palliative Medicine

Ho Myong, MD Hematology/Medical Oncology

Non‐Physician Members of Oncology Committee

Judi Bonomi, RN, MS, MSN, OCN, NE‐BC Director, Inpatient Nursing and Cancer Care Center

Mary Shilkaitis, MSN, MBA, RN, NEA‐BC,FACHE

Vice President, Patient Care Services & Chief Nursing Officer

Ryan Alvarez, MS Manager, Cancer Care Center

Laura Rollins, LSW Oncology Social Worker, Psychosocial Services Coordinator

Mariana Martinez, CHES Community Health Outreach Coordinator

Amanda Baker, CCRP Clinical Research

Stephanie Beam, PharmD Pharmacy

Vickie Burdick, RHIT, CTR Tumor Registry

Jennifer Lerner, RN, MSN, OCN Oncology Nursing, Quality Coordinator

Ashley Lach American Cancer Society Representative

Prema Ramakrishnan, RHIT, CTR Tumor Registry

Kelly Huggins, LCSW Waterford Place Cancer Resource Center

Mira Vujovic, APN, MSN, CBCN Breast Care Navigator and Genetics Counselor

Jeni Aguina, RN, OCN Patient Navigator

Michelle Cordes, RD Nutritionist

Leanne Brand, RN, BA, MA, CGRN Digestive Health Center

Mona Seaver, APN Gynecologic Oncology

Ellen Berg, RN, OCN Oncology Nursing

The Oncology Committee is a designated multidisciplinary body for the administrative oversight, development and review of cancer care services at Rush Copley. Members include physician representatives from diagnostic and treatment specialties along with representatives from supporting services involved with the care of patients with cancer.


B r e a s t P r o g r am L e a d e r s h i p C omm i t t e e

Physicians and Breast Program Leadership Team Committee Members

Kurian Abraham, MD Pathology

Mohsen Anwar, MD Imaging Services

Ho Myong, MD Hematology/Medical Oncology

Mehee Choi, MD Radiation Oncology

Nancy Whereatt, MD Surgeon

Judi Bonomi, RN, MS, MSN, OCN, NE‐BC Director, Inpatient Nursing and Cancer Care Center (CCC)

Allen Bloom, MD Surgeon

Joseph Meschi, MD Hematology/Medical Oncology

Kaushik Patel, MD Hematology/Medical Oncology

Non‐Physician Breast Program Committee Members

Mary Shilkaitis, RN, MS, MBA Vice President, Patient Care Services & Chief Nursing Officer

Ryan Alvarez, MS Manager, Cancer Care Center

Mariana Martinez Community Health Outreach Coordinator

Amanda Baker, CCRP Clinical Research

Vickie Burdick, RHIT, CTR Tumor Registry

Michelle DeHass Nurse Navigator, Midwest Center for Advanced Imaging

Tisha Hailey Manager, Therapy Services

Gloria Hall Director, Midwest Center for Advanced Imaging

Julie Kwait Therapy Services

Tom Markuszewski Director, Imaging Services

Prema Ramakrishnan, RHIT, CTR Tumor Registry

Laura Rollins, LSW Oncology Social Worker, Psychosocial Services Coordinator

Mira Vujovic, APN, MSN, CBCN Breast Care Navigator and Genetics Counselor

Ashley Lach American Cancer Society Representative

Kelly Huggins, LCSW Waterford Place Cancer Resource Center

The Breast Program Leadership Committee is a designated multidisciplinary body committed to improving the quality of breast health care by coordinating the best care and treatment options available at Rush Copley. Members include physician representatives from diagnostic and treatment specialties along with representatives from supporting services involved with the care of patients with breast cancer.


R e f e r e n c e s


Coffey, Carles, Ghanem, Tamer and Maghami, Ellie. “Cancer of the Oropharynx: Rick Factors, Diagnosis, Treatment and Outcomes”. https://www.ahns.info/oropharyngeal‐carcinoma‐overview/. Accessed 5 December 2017.

Lydiatt, W. M., Patel, S. G., O'Sullivan, B., Brandwein, M. S., Ridge, J. A., Migliacci, J. C., Loomis, A. M. and Shah, J. P. (2017), Head and Neck Cancers—Major Changes in the American Joint Committee on Cancer Eighth Edition Cancer Staging Manual. CA: A Cancer Journal for Clinicians, 67: 122–137. doi:10.3322/caac.2138.

National Cancer Institute. Head and Neck Cancer (PDQ) – Patient Version, 2017. https://www.cancer.gov/types/head‐and‐neck/head‐neck‐fact‐sheet. Accessed 5 December 2017.

Palefsky, Joel M., Hirsch, Martin S. and Bloom, Allyson. “Human Papillomavirus Infections: Epidemiology and Disease Associations”. https://www.uptodate.com/contents/human‐papillomavirus‐infections‐epidemiology‐and‐disease‐associations?source=see_link. Accessed 6 December 2017.

2018 cancer care center report to the - rushcopley.com · the clinic offers supportive care from...

Documents