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Treatment m.feinberg Treatment m.feinberg Presentation Transcript

  • 2010 Cancer Plan Stakeholder’s Meeting Pancreas Cancer Patient Management October 21, 2010
  • Goal 12: Elevate the Quality of Cancer Care in Maine to meet or Exceed national standards Objective 12.1: • Conduct one to three State of Maine Cancer Outcomes studies per year to monitor concordance with National Comprehensive Cancer Network clinical practice guidelines Objective 12.2: • Support at least three professional development opportunities per year
  • Goal 13: Increase access to quality cancer care Objective 13.1: • Improving online resources and assuring at least one public presentation per year of the Maine Cancer Outcomes studies Objective 13.2: • Support the maintenance of ACoS CoC-accredited cancer programs
  • Goal 13: Increase access to quality cancer care Objective 13.3: • Discuss financial, geographic and resource barriers to guideline-directed cancer care in Maine at one regional professional meeting per year Objective 13.4: • Increase clinical trial enrollment in Maine to 2%
  • Incidence of Invasive Pancreatic Cancer, Maine 2004-2008 Year Number 2004 204 2005 219 2006 189 2007 181 2008 199 992 *Includes only Behavior Code (3). Excludes histologies greater than 9590.
  • Distribution of Invasive Pancreatic Cancer by Regional Node, Maine 2004-2008 combined Nodes analysis Number Percent All nodes examined negative 63 6.3 1 or more nodes positive 85 9.2 Positive aspir. Lymph node 4 0.4 No nodes examined 761 76.1 Unknown 79 8 992 100
  • Distribution of Pancreatic Adenocarcinoma by treatment, Maine 2004-2008 Treatment Number Percent R only 19 2.6 C only 201 27.2 C &R only 127 17.2 S only 37 5.0 S & C only 14 1.9 S&C&R 60 8.1 Unk R (no S & C) 1 0.1 Unk R (no S & yes C) 1 0.1 Recommended & Unk admin C (no S & R) 8 1.1 C (no R & Unk S) 1 0.1 Unk S (No S & R) 7 0.9 Unk S & R (no C) 1 0.1 None 262 35.5 Total 739 100.0 S=Surgery, C= Chemotherapy, R=Radiation Therapy, Unk=
  • What about Maine? • No standard protocol for neoadjuvant therapy • Retrospective review of neoadjuvant cases may allow for “proof of practice” • Statewide cooperative protocol will allow for seamless patient management
  • Proposal • Accept a protocol for neoadjuvant therapy • Multi-institutional retrospective review of neoadjuvant cases • Share patient care components
  • Regional Care Pathway • 37 hospitals with different patient care components • 4 hospitals with panc ca volume • Shared navigator system to centralize care • Shared diagnostic and therapeutic protocols (including neoadjuvant protocol)
  • Patient Care Components • Medical oncology • Surgical oncology • Radiation oncology • Radiology – Pancreas protocol CT – MRI • Interventional GI – EUS – ERCP
  • Patient Care Components • Pain & Palliative care • Genetics • Oncology nursing • Upper GI navigator