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View our Cancer Centers' Annual Report

  1. 1. 1 Annual Report Cancer Care Centers at Blue Ridge HealthCare Grace Hospital and Valdese Hospital With Statistical Data from 2008
  2. 2. 2 Table of Contents Message from the Cancer Committee Chair…..............................................3 Cancer Committee Membership 2008………………………….………….. 3 Summary of Cancer Services Case Management………………………………………………………………….. 4 Home Health……………………………………………………………………….. 4 Financial Counselor………………………………………………………………… 4 Medical Oncology………………………………………………………………….. 4 Patient Navigator........................................................................................................4 Pathology ………………………………………………………………………….. 5 Pharmacy…………………………………………………………………………… 5 Radiology and Imaging Services…………………………………………………... 5 Radiation Oncology ……………………………………………………………….. 5 Rehabilitation Services…………………………………………………………….. 5 Summary of Support Services Food & Nutrition ………………………………………………………………….. 6 Hospice…………………………………………………………………………….. 6 Pastoral Care……………………………………………………………………….. 6 Phifer Wellness Center…………………………………………………………….. 6 Tobacco Prevention………………………………………………………………… 6 Program Activities 2008 Goals Accomplished……………………………………………………………….. 7 Program Improvements…………………………………………………………….. 7 Quality & Outcome Studies………………………………………………………… 7 Community Outreach……………………………………………………………….. 8 Cancer Education…………………………………………………………………… 9 Professional Education Programs 2008……………………………………10 Cancer Registry Report…………………………………………………....11 Grace Hospital Statistics………………………………………………………….. 12 Valdese Hospital Statistics………………………………………………………... 16 Breast Cancer – 2008 Site Review Grace Hospital……………………………………………………………………..20 Valdese Hospital……………………………………………………………….…..23 Words from the Heart……………………………………………………..26 Program & Support Services Contact Information……………………… .27 Cancer Center Location & Map………………………………………….. 28 Acknowledgements We want to acknowledge and thank Cancer Committee members, cancer program staff and others who supported our cancer center program this past year. This report was prepared by BRHC staff from the Cancer Registry and Marketing and Communications, with guidance from the Cancer Committee. Requests for more information can be directed to the Cancer Registry at 828-580-6875 or 828-879-7685. ………….
  3. 3. 3 Christopher R. McDonald, MD Medical Oncologist/Hematologist Cancer Committee Chair The Cancer Center at Blue Ridge HealthCare continues its dedication to being the region’s pre-eminent provider of cancer care services in Burke County and surrounding areas. The cancer care team is committed to enhancing life by providing excellent care. We have a devoted cancer care team that coordinates and delivers comprehensive, compassionate, multi-disciplinary patient care using the latest advanced technologies and innovative techniques. In 2009, both Grace and Valdese Hospitals have been re-accredited by the American College of Surgeons (ACoS), Commission on Cancer (CoC). Maintaining CoC accreditation ensures our patients will have access to a full range of services necessary to diagnose, treat, rehabilitate and support patients with cancer and their families. With increasing technologies and early detection the Blue Ridge cancer program and services continue to grow. Our cancer conference consists of physicians, nurses, and support services that meet bi- weekly to discuss newly diagnosed cases in order to establish the best treatment available for that particular patient’s cancer. The facility at Valdese Hospital is outstanding in our area – equipped to provide the highest level of care available in a community setting. In 2008, the cancer center completed the addition of a new vault and linear accelerator. Radiation Oncology in 2009 upgraded a linear accelerator to include On Board Imaging (OBI) and Rapid Arc. A satellite medical oncology office is located at Grace Hospital in the Medical Office Building. Two medical oncologists, Muhammed Janjua, M. D. and Doug Thompson, M.D., have been recruited to join our team in 2010. We at BRHC Cancer Center will continue to strive for that perfect mix of quality staff and intelligent, loving care that provides hope and support in the fight against cancer in our community. Cancer Committee Membership Listing 2008 Dr. Christopher McDonald Chair Cancer Committee Medical Oncologist Dr. William Cloud Physician Liaison General Surgery Dr. Dorwyn Croom Pathology Dr. Benjamin Garrou Family Practice Dr. Edwin Holler General Surgery Dr. Alan Jacks Physician Liaison General Surgery Dr. Gregory Jones Radiation Oncology Dr. John Lafferty Obstetrics/Gynecology Dr. Timothy Robinson Family Practice Dr. Michael Skolochenko Family Practice Dr. John Spiggle Urology Dr. W. Frank Steele General Surgery Dr. Scott Whiddon Radiology Dr. Jamie Young Internal Medicine Kathy Bailey V.P., Administration Tina Brooks Pharmacy Camille Welch, Tobacco Prevention Coordinator Debbie Dale Oncology Service Line Director Amy Davis Burke County Hospice Lindsay Wall Financial Counselor Carol Ervin Nursing Administration Kim Ellingson Radiation Oncology Kathleen Foote Cancer Registry Sue Hall, RN Medical Oncology Karen Hicks, RN Medical Oncology Rachel Hobbins Food & Nutrition Jan Hollar Cancer Services Coordinator William Minor Quality Improvement Barbara Rush American Cancer Society Diana Spangler-Crawford Chaplain Delores Wall, CTR Cancer Registrar Anne Coffey Social Work
  4. 4. 4 CANCER SERVICES Case Management: The Case Management Department consists of social workers and nurse case managers whose goal is to improve the quality of life for patients and their families through coordination of care with community resources, helping the patients adjust to and cope with the changes and circumstances brought on by prolonged or terminal illness. The social worker serves as the liaison between the interdisciplinary team, physician and community resources such as the American Cancer Society, Hospice, Home Health, skilled nursing facilities and other community support groups to ensure that the patients and their families are linked with the appropriate resources. Home Health Care: BRHC’s Home Care agency can accept patients with a cancer diagnosis who are homebound and under the care of a physician. They provide a single service or a combination of services in the patient's home all under the care and direction of a physician. The care is individualized to meet each patient’s special needs and to ensure that services are designed to accomplish the goals and outcomes of each patient. Home Health provides continuity of care and a smooth transition from the hospital to home while providing care and treatment in the home that can prevent re-hospitalization and urgent care visits. Financial Liaison: The Patient Financial Liaison helps determine patient resources and assists with insurance and other financial matters. These may include: medication reimbursement, food assistance (Meals on Wheels), applying for Medicaid, and more. Medical Oncology: BRHC’s Medical Oncology services are available to inpatients and outpatients, 18 years or older, with a diagnosis of cancer/blood dyscrasias. Care is delivered by skilled staff including a medical oncologist, registered nurses, and registered nurses with oncology certifications. Other patient care needs are coordinated with home health, hospice, food and nutrition services, radiation oncology, physical therapy, laboratory, pharmacy, radiology and patient/family services. Patient Navigator: The Patient Navigator for Breast Health is a professional counselor/coordinator who specifically provides patient support upon diagnosis of breast cancer. She may assist with issues as broad as understanding physician prescribed treatment options, obtaining medications, dealing with hair loss, arranging transportation and much more. BRHC Oncology certified nurses Certifications Certifications in oncology nursing makes a difference, not only to the nurse who works to elevate his or her knowledge, but to the patients whose care is provided by a more skilled staff. Karen Hicks, RN, OCN Mary Wise, RN, OCN Wanda Mace, RN, OCN Sherry Rockett, RN, OCN Peggy Hewitt, RN, OCN
  5. 5. 5 Pathology: The Clinical and Anatomic Pathology Laboratory at BRHC supports the hospital’s Cancer Program through a number of clinical and anatomic pathology services. The laboratories are accredited by the College of American Pathologists Laboratory Accreditation Program (CAP) and by the Centers for Medicare and Medicaid Services (CLIA). Four pathologists, all board certified in Anatomic and Clinical Pathology, direct the laboratory, ensuring prompt and accurate results. One of the pathologists serves on the Cancer Committee and attends the Cancer Conferences to present the pathologic findings on each case. Pharmacy: The Department of Pharmacy Services at BRHC provides chemotherapeutic agents at both Valdese Hospital and Grace Hospital. The Pharmacy prepares the medication doses for Oncology and assists with drug dosing, standing orders for medications and literature searches. Pharmacists work closely with the nursing staff and physicians to provide the most appropriate therapy possible for the patients being treated in our Medical Oncology facilities. Radiation Oncology: The Radiation Oncology Department for BRHC is located at the Valdese campus. We offer our services to in-patients and outpatients from 18 years of age and older that have been diagnosed with benign or malignant tumors for a prescribed series of treatments. We perform teletherapy treatment (conformal and IMRT external beam irradiation), brachytherapy treatment (seed implant for gynecological and prostate irradiation), and superficial x-ray treatment (skin lesions and pterygium cases). Our highly skilled team consists of a Radiation Oncologist, Registered Nurse, Certified Medical Dosimetrist, a Physicist and a team of Radiation Therapists that are all supported by our dedicated front office personnel. Radiology (Imaging) Services: The Department of Diagnostic Imaging provides state of the art technologies to diagnose diseases at BRHC. Some of the technologies offered are Multi-detector CT, High- resolution 512K ultrasound, State-of-the-art Gamma cameras, PET/CT Tomography, High strength 1.5 Tesla MRIs, Computerized radiography, Mammography/Computer Aided Detection, Vacuum Assisted Breast Biopsy, and Image Guided Interventions. Rehabilitation Services: At BRHC’s Rehabilitation Services, our professional and highly skilled staff provides patients, families, and caregivers with the resources, training and support needed to best guide them through the recovery process. By giving our patients the level of care they need and closely monitoring their progress, we help them get their lives back on track as quickly as possible. Rehabilitation Services include: Physical Therapy, Occupational Therapy, Speech Therapy, Hand Therapy, Lymphedema Therapy, and Aquatic Therapy.
  6. 6. 6 SUPPORT SERVICES Food and Nutrition: For the cancer patient, the registered dietician may provide nutritional counseling or recommend food supplements. They also provide education and resources to help the patient understand their unique nutritional needs as it relates to their treatment regimen. The clinical nutrition staff participates in the HOPE support group as requested and a clinical dietitian is an active member of the Cancer Committee and Tumor Board. Hospice: Burke Hospice and Palliative Care, Inc. (BHPC) as an integral part of BRHC, leads in the planning and provision of services at the end of life. BHPC sponsors a Palliative Care program which provides support to people living with any type illness, such as cancer, who are undergoing aggressive treatment. Personnel actively participate in the Tumor Board and Cancer Committee meetings. Pastoral Care: When a patient has been given a diagnosis of cancer, the chaplain often plays an important role in counseling and listening – both to the patient and family members facing the uncertainty of life with cancer. In some cases they can help obtain financial support for the patient through the Chaplain’s Discretionary Funds. Our chaplains are also experts in advance directives and can assist with the completion of a living will or healthcare power of attorney. Phifer Wellness Center: Phifer encompasses two areas related to the prevention, education and well being of persons with cancer through our Restorative yoga and therapeutic massage programs. Cardiac Rehab nurse, Beth Blanton, offers cancer survivors and patients a class twice a week in Restorative Yoga. The licensed massage therapists at Phifer are experienced in therapeutic massage that can aid the cancer patient in relieving pain, improving sleep, decreasing fatigue and removing toxins in the body. Tobacco Prevention: The Tobacco Prevention project provides prevention, education and resources to reduce the number of teens who use tobacco, increase the number of teens who wish to quit using tobacco, and expand TRU (Tobacco Reality Unfiltered) Club youth advocacy membership. The project also works with the community to decrease youth exposure to secondhand smoke by increasing the number of smoke free youth venues, compliance with Tobacco-Free Schools policies, and partnering with the local American Cancer society to advocate for more Burke County restaurants to go smoke free.
  7. 7. 7 Program Activities 2008 Goals Accomplished 2008 • A colorectal study investigated the number of patients being diagnosed at an earlier stage and compared 2008 data to 2004, 2005, 2006 and 2007 data. At Valdese Hospital the majority of patients continue to be diagnosed at a later stage, Stage IV. At Grace Hospital, the majority of patients were diagnosed at Stage 1 and II. We will continue this study in 2009. • A study to ascertain if radiation therapy was administered within one year of diagnosis for women under age 70 who had also received breast conserving surgery for breast cancer. At both Grace and Valdese Hospitals, all patients received radiation therapy or it was recommended. • Determine the number of breast cancer patients contacted at diagnosis who remain at BRHC for care, goal 60%. Develop a patient survey regarding patient navigation services. Determine the percentage of patients with positive diagnosis being consulted by the patient navigator, goal 75%. The percentage of patients remaining at BRHC for care is 85%. The survey was developed and implemented with 100% rating. A very high percentage, 98%, of patients with positive diagnosis are being consulted by the patient navigator. This service will continue in 2009. Program Improvements 2008 • Started a Lymphedema Support Group • Added an additional linear accelerator at Valdese Radiation Oncology • Added a patient education computer for Radiation Oncologist to discuss radiology studies with patients. Quality & Outcomes Studies • A 2008 colorectal study was done to evaluate the stage at diagnosis. At Grace most colorectal cases are being diagnosed at Stage II. At Valdese, most cases are being diagnosed at Stage III. More screenings are being done now helping to decrease the higher stages. • A study to evaluate if a needle biopsy was performed prior to breast cancer surgery was conducted. At Valdese, 44% of breast cancer cases underwent needle biopsy prior to excision. At Grace, 25% had needle biopsy prior to surgery. This study will be continued. The Cancer Committee recommended that physicians discuss with patients the benefit of needle biopsy.
  8. 8. 8 Program Activities 2008 Community Outreach During 2008, we increased participation in patient support programs by 10%. In 2008 we began offering art therapy to cancer patients and established free wig styling with local cosmetologists for our patients. We continue to provide drug assistance for patients, nutritional consults and cardiopulmonary therapy. The BRHC Cancer Program participates in the American Cancer Society’s Relay for Life fundraiser each year. In 2008, BRHC sponsored a team with approximately 30 people in attendance. In addition we implemented Road To Recovery Program of the American Cancer Society for patient assistance with transportation. In 2008, we hosted “Putting For The Pink” Golf Tournament raising over $7000.00 for Komen Breast Cancer Foundation and assisted with “Cut For The Cure” which raised $10,000.00 for Komen Foundation. In June 2008, we held National Cancer Survivor’s Day with over 500 in attendance. The Cancer Center staff sponsors and participates in this event for our cancer patients and survivors. Our Tobacco Prevention Program was successful in increasing the number of smoke-free policies in local businesses frequented by youth and educating local merchants about the “Red Flag” campaign aimed at reducing underage tobacco sales. We provided training for dental and medical professionals in Burke County regarding spit tobacco education and cessation. In our community, we were able to participate in 24 health fairs/screenings and reached approximately 8000 individuals at these events. We provided 453 free PSA screening tests, 2 free skin screenings to 150 individuals, 550 free colorectal screening kits and one community program on colorectal cancer.
  9. 9. 9 Program Activities 2008 Cancer Education Our Cancer Support Program goal is to help people with cancer be as comfortable as possible in a physical, emotional, and/or spiritual sense, as they go through their illness. BRHC continues to offer several FREE programs throughout the year. Restorative Yoga Classes – every Tuesday at Phifer Wellness Center, 11:30am-12:30pm The Look Good Feel Better Program – third Monday each month at Valdese Cancer Center (pre-registration required) Financial Counseling – Cancer Center Financial Counselor Information and Education – free brochures, videos, books, and audiotapes available in our resource center at Valdese Cancer Center Our HOPE Cancer Support Group continues to meet the second Monday of each month at The Learning Center behind Grace Hospital at 6:00pm. January 12 – Facing Life’s Challenges (Facilitator – Greg Brown, MDTV, MED, LDC) February 9 – Healing Power of Storytelling (Facilitator – Jan Hollar) March 9 – Discovering Your Body’s Wisdom (Facilitator – Kristine White) April 13 – Yoga for Cancer Care (Facilitator – Beth Blanton, RN) May 11 – Facing Life’s Challenges (Facilitator – Greg Brown) June 8 – The Price Is Right (Facilitator – Wanda Mace, ICN, Mary Wise, OCN and Peggy Hewitt, OCN) July 13 – Music Is Therapy (Facilitator – Helen Moore, PA-C) August 10 – Update on Cancer (Facilitator – Karen Hicks, RN) September 14 – Healing Power of Storytelling (Facilitator – Jan Hollar) October 12 – An Attitude of Gratitude (Facilitator – Kristine White) November 9 – Music Therapy December 14 – Christmas Party
  10. 10. 10 Professional Education Programs 2008 As required by the Commission on Cancer, the physicians, nurses and other allied health professionals participate in cancer related educational activities each year. In our continuing effort to provide relevant and new topics for our professional staff, the Cancer Program at BRHC offered two educational programs in 2008. Karen Russell and Judy Ray presented a program on “Benefits of Healing Touch Therapy.” Walter Shephard, Director of North Carolina State Cancer Comprehensive Program presented a program on state initiatives.
  11. 11. 11 CANCER REGISTRY REPORT The Cancer Registry reports cancer information to the National Cancer Data Base and North Carolina Central Cancer Registry on an annual basis. Most importantly this data is used to analyze current trends to improve patient care by comparing diagnostic studies, treatment, stage and survival data for national research. The Cancer Registry is also required to conduct a lifetime follow up of the patients. The Grace Hospital Cancer Registry database consists of 4050 patients since our reference year of 1995. The Valdese Hospital Cancer Registry database consists of 4765 patients since our reference year of 1985. The Grace Registry collected data on 195 cases in 2008; 74 males and 121 females. The majority of Grace patients came from Burke, Caldwell and McDowell counties. Analytic cases totaled 183; 64 males and 119 females. The following graphs are based on the analytic data. The Valdese Registry collected data on 357 patients; 165 males and 192 females. The majority of Valdese patients came from Burke, Caldwell and Catawba counties. Analytic cases totaled 309; 139 males and 170 females. The graphs that follow are based on analytic data. The Cancer Committee oversees the registry activity by ensuring quality of data collection through monitoring of abstracting. The registry is responsible for coordinating Tumor Boards at each hospital where a majority of newly diagnosed cases are discussed. This facilitates in providing the most comprehensivecare for the cancer patient. Delores Wall, RHIT, CTR, BRHC System Cancer Registrar, joined the Cancer Registry in 1998 at Grace Hospital. In 2003, Delores assumed responsibility for the Valdese Hospital Cancer Registry. Delores earned her CTR in 2002. Kathleen Foote, CTR, Cancer Registrar, BRHC Cancer Registry, was certified by the National Cancer Registrars Association in September 2008. Kathleen has worked in several areas of the cancer program since 2004.
  12. 12. 12 GRACE HOSPITAL STATISTICS In 2008 breast cancer was again the top cancer site. Grace Hospital saw an increase in colorectal cancer cases diagnosed and treated. The Cancer Care Outreach program continues to promote early detection through mammography and colorectal screenings. As a result, the majority of the top 5 sites were diagnosed at an early stage, providing earlier treatment options and increased survival. Top 5 Sites by Stage - Analytic Cases Stage 0 15 4 Stage I 17 7 7 7 Stage II 19 15 1 Stage III 4 14 8 4 Stage IV 3 13 1 Unstageable 1 2 Breast Colorectal Bronchus, Lung Bladder Ovary Top 5 Cancer Sites - Analytic Cases 15 17 8 55 25 13 4 5 Breast Colorectal Bronchus, Lung Bladder Ovary Males 40 Females 102
  13. 13. 13 Grace Hospital continues to treat patients from surrounding counties offering the latest high-tech tools, drugs and other treatment options supporting the most excellent cancer care in the region. The majority of our patients are diagnosed in the seventh decade of their life. County at Diagnosis - Analytic Cases 152 10 10 7 2 1 1 Burke McDowell Caldwell Catawba Avery Lincoln South Carolina Age at Diagnosis by Sex - Analytic Cases 1 1 6 13 17 16 8 2 4 15 18 21 39 19 3 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+ Males - 64 Females - 119
  14. 14. 14 2008 CANCER INCIDENCE: 2008 TOTAL Male Female Analytic Non-Analytic PRIMARY SITE (All Sites) 195 74 121 183 12 ORAL CAVITY & PHARYNX Nasopharynx 1 1 1 Oropharynx 1 1 1 DIGESTIVE SYSTEM Esophagus 1 1 1 Stomach 3 3 3 Small Intestine 1 1 1 Colon, excluding rectum 36 15 21 34 2 Rectum, Rectosigmoid 6 2 4 6 Anus, Anal Canal 2 2 2 Liver, Intrahepatic Bile Duct 3 1 2 3 Pancreas 2 2 1 1 RESPIRATORY SYSTEM Lung, Bronchus 30 17 13 30 Pleura 1 1 1 Soft Tissue 1 1 1 MELANOMA - SKIN 3 3 2 1 The Cancer Registry at Grace Hospital recorded a total of 195 cases this year. Analytic cases consisted of 183, with 12 cases being non-analytic. Analytical cases were diagnosed and/or had part of their first course of treatment at Grace Hospital whereas non-analytical cases were seen for recurrence of cancer.
  15. 15. 15 2008 CANCER INCIDENCE: 2008 TOTAL Male Female Analytic Non-Analytic PRIMARY SITE (All Sites Continued) 47 25 22 41 6 BREAST 57   57 55 2 FEMALE GENITAL SYSTEM           Cervix Uteri 1   1 1   Corpus & Uterus, NOS 4   4 4   Ovary 5   5 5   MALE GENITAL SYSTEM           Prostate 7 7   1 6 Testis 2 2   2   URINARY SYSTEM           Urinary Bladder 12 8 4 12   Kidney & Renal Pelvis 2 2   2   NERVOUS SYSTEM 1   1 1   ENDOCRINE SYSTEM           Thyroid 4 2 2 4   Other Endocrine  1   1 1   NON-HODGKIN LYMPHOMA 3 2 1 3   MULTIPLE MYELOMA 2 1 1 2   LEUKEMIA 1   1 1   MISCELLANEOUS 2 1 1 2  
  16. 16. 16 VALDESE HOSPITAL STATISTICS Top 5 Cancer Sites - Analytic Cases 38 1 16 27 8 34 70 20 10 Lung Breast Colorectal Prostate Hematopoietic Males 90 Females 134 In 2008 the number of cancer cases diagnosed and /or treated at Valdese Hospital increased. Lung and breast cancer were the top cancer sites. The Cancer Care Outreach program continues to promote early detection through mammography and colorectal screenings. As a result, breast cancer cases are being diagnosed at an early stage, providing earlier treatment options and increased survival. Top 5 Sites by Stage - Analytic Cases Stage 0 10 Stage I 11 25 1 Stage II 1 22 8 25 Stage III 27 12 20 Stage IV 33 2 7 2 Unstageable 18 Bronchus,  Lung Breast Colorectal Prostate Gland H & R
  17. 17. 17 Valdese Hospital continues to treat patients from Burke and surrounding counties offering the latest high-tech tools, drugs and other treatment options supporting the most excellent cancer care in the region. At Valdese, the majority of patients were diagnosed in their 7th decade. The age range was from 22 to 93 with average age being 65. County at Diagnosis - Analytic Cases 227 49 16 12 2 1 1 1 Burke Caldwell M cDow ell Catawba Rutherford Avery  Lincoln W ilkes Age at Diagnosis by Sex 2 1 8 31 36 43 16 21 9 18 30 38 48 24 2 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+ Males -139 Females - 170
  18. 18. 18 2008 CANCER INCIDENCE Total Male Female Analytic Non-Analytic PRIMARY SITE (All Sites) 357 165 192 309 48 ORAL CAVITY & PHARYNX           Gum, other mouth 3 3   3   Nasopharynx 3 2 1 3   Tonsil 2 2   2   Oropharynx 2 1 1 2   Hypopharynx 1   1 1   DIGESTIVE SYSTEM           Esophagus 6 6   6   Stomach 1   1 1   Small Intestine 1 1     1 Colon Excluding Rectum 36 20 16 30 6 Rectum, Rectosigmoid 7 2 5 6 1 Anus, Anal Canal 3 3   3   Liver, Intrahepatic Bile Duct 2 2   2   Gallbladder 2   2 2   Pancreas 9 4 5 8 1 Retroperitoneum 1 1   1   RESPIRATORY SYSTEM           Nasal Cavity 1   1   1 Larynx 5 4 1 5   Lung, Bronchus 80 41 39 72 8 Pleura 1   1 1   SOFT TISSUE 1   1 1   MELANOMA - SKIN 3 1 2 3   The Cancer Registry at Valdese Hospital recorded a total of 357 cases this year. Analytic cases consisted of 309, with 48 cases being non-analytic. Analytical cases were diagnosed and/or had part of their first course of treatment at Valdese Hospital whereas non-analytical cases were primarily diagnosed and treated elsewhere.
  19. 19. 19 2008 CANCER INCIDENCE Total Male Female Analytic Non-Analytic PRIMARY SITE (All Sites Continued) 357 165 192 310 47 BREAST 78 1 77 71 7 FEMALE GENITAL SYSTEM           Cervix Uteri 2   2 2   Corpus & Uterus, NOS 4   4 4   Ovary 4   4 4   Vagina 1   1 1   MALE GENITAL SYSTEM           Prostate 34 34   27 7 Testis 4 4   4   URINARY SYSTEM           Urinary Bladder 2 2     2 Kidney & Renal Pelvis 2 2   1 1 BRAIN & OTHER NERVOUS SYSTEM 4 2 2 4   ENDOCRINE SYSTEM           Thyroid 3 2 1 3   Other Endocrine 1   1   1 LYMPHOMAS           Hodgkin Lymphoma 1   1 1   Non-Hodgkin Lymphoma 15 6 9 11 4 MULTIPLE MYELOMA 9 6 3 7 2 LEUKEMIAS           Lymphocytic Leukemia 9 4 5 4 5 Myeloid & Monocytic Leukemia 2 1 1 2   MESOTHELIOMA 2 2   2   MISCELLANEOUS 10 6 4 9 1
  20. 20. 20 Breast Cancer – 2008 Site Review at Grace Hospital Breast Cancer Overview Breast cancer is the most frequently diagnosed malignancy in women (excluding skin cancer). According to the American Cancer Society Cancer Facts and Figures, in the U.S. an estimated 184,450 new cases of breast cancer would be diagnosed in 2008, representing 26% of all cancers diagnosed in women. An estimated 5,000 of these cases were expected to be in North Carolina. Of that number, it was projected that 71 new cases would be Burke County residents. Though the death rates have decreased since 1990, breast cancer ranks second after lung cancer as the leading cause of cancer death in women. Early detection and improved treatment options are key in the fight against cancer. Grace Hospital Experience – 2008 Cases Since 1995 Grace Hospital has been collecting data on cancer and breast cancer has consistently been the most common cancer diagnosed and treated. In 2008, Grace Hospital saw 55 newly diagnosed cases of breast cancer. Of these, the majority of patients were diagnosed in their 7th decade of life and greater than 90% were diagnosed at an earlier stage. (refer to Figure 1,and Figure 2). Early detection can help detect breast cancer at an early stage. This saves lives and increases treatment options available for the patient. Grace Hospital patients are diagnosed by mammogram followed by biopsy for abnormal findings. Screening guidelines from the American Cancer Society recommend yearly mammograms starting at age 40, clinical breast exams about every 3 years and every year for women 40 and older, and screening MRI for women with approximately 20-25% or greater lifetime risk of breast cancer. This early detection and diagnosis is indicative of increased survival rates at five years. At Grace Hospital 80% of the cases diagnosed at early stage survive 5 years or more. Cases diagnosed at later stage have a 70% survival rate at 5 years. Treatment Options Patients at Grace Hospital received up-to-date advances in cancer therapy including the latest in surgical options, highly precise technology in radiation treatment, modern advances in chemotherapy and hormone modulation therapy as needed. The best news for cancer patients in Burke County is that they can feel confident about treatment options in their own community (refer to Figure 3). Grace Hospital is committed to continuing to upgrade our facilities and stay on the cutting edge of technology with standards of care here that match or exceed what patients would find at any other cancer facility in the U.S.
  21. 21. 21 Breast Cancer - 2008 - Age at Diagnosis Grace Hospital 3 10 8 9 18 6 1 30-39 40-49 50-59 60-69 70-79 80-89 90+ 55 Cases Average age - 64 Age Range - 36 to 94  Breast Cancer - 2008 - Stage at Diagnosis 15 17 19 4 Stage 0 Stage I Stage II Stage III 55 Cases  Figure 1. Age at Diagnosis In 2008, Grace Hospital saw 55 newly diagnosed cases of breast cancer. Of these, the majority of patients were diagnosed in their 7th decade of life with the average age at diagnosis to be 64. Figure 2. Stage at Diagnosis In 2008, Grace Hospital saw 55 newly diagnosed cases of breast cancer. Of these, greater than 90% were diagnosed at an earlier stage.
  22. 22. 22 Figure 3. Treatment of Breast Cancer Diagnosed 2000-2006 Compared to other community cancer centers in North Carolina, the majority of patients diagnosed with breast cancer at Grace Hospital were offered surgery, radiation and hormone therapy. Figure 4. Stage of Breast Cancer Diagnosed 2000 to 2006. Compared to other community cancer centers in North Carolina, the majority of patients diagnosed at Grace Hospital with breast cancer were early stage reported cases. 88% of the cases were diagnosed at Stage II or better, as compared to 84% at all other facilities.
  23. 23. 23 Breast Cancer – 2008 Site Review at Valdese Hospital Breast Cancer Overview Breast cancer is the most frequently diagnosed malignancy in women (excluding skin cancer). According to the American Cancer Society Cancer Facts and Figures, in the U.S. an estimated 184,450 new cases of breast cancer would be diagnosed in 2008, representing 26% of all cancers diagnosed in women. An estimated 5,000 of these cases were expected to be in North Carolina. It is expected that 71 of these will be Burke County residents. Though the death rates have decreased since 1990, breast cancer ranks second after lung cancer as the leading cause of cancer death in women. Early detection and improved treatment options are key in the fight against cancer. Valdese Hospital Experience – 2008 Cases Valdese Hospital has been collecting and analyzing data on cancer cases since 1985. In 2008, Valdese Hospital diagnosed and/or treated a total of 71 new cases of breast cancer. The average age at diagnosis was 63 and a majority of patients were diagnosed at Stage I (refer to Figure 1,and Figure 2). Early detection saves lives and increases treatment options for the patient. Screening guidelines from the American Cancer Society recommend yearly mammograms starting at age 40, clinical breast exams about every 3 years and every year for women 40 and older, and screening MRI for women with approximately 20-25% or greater lifetime risk of breast cancer. This early detection and diagnosis can help detect breast cancer at an early stage which is indicative of increased survival rates at five years. At Valdese Hospital 85% of the cases diagnosed at early stage survive 5 years or more. Cases diagnosed at later stage have a much less survival rate. Treatment Options Patients at Valdese Hospital received up-to-date treatment options in cancer therapy including surgery, highly precise technology in radiation treatment, modern advances in chemotherapy and hormone modulation therapy as needed. The best news for cancer patients in Burke County is that they can feel confident about treatment options in their own community (refer to Figure 3). Valdese Hospital is committed to continuing to upgrade our facilities and stay on the cutting edge of technology with standards of care here that match or exceed what patients would find at any other cancer facility in the U.S.
  24. 24. 24 Breast Cancer - 2008 - Age at Diagnosis Valdese Hospital 3 9 14 17 22 6 30-39 40-49 50-59 60-69 70-79 80-89 71 Cases Average age - 63 Breast Cancer - 2008 - Stage at Diagnosis Valdese Hospital 10 25 22 12 2 Stage 0 Stage I Stage II Stage III Stage IV Figure 1. Age at Diagnosis In 2008, Valdese Hospital saw 71 newly diagnosed cases of breast cancer. Of these, the majority of patients were diagnosed in their 7th decade of life with the average age at diagnosis to be 63. Figure 2. Stage at Diagnosis In 2008, Valdese Hospital saw 71 newly diagnosed cases of breast cancer. Of these, the majority were diagnosed at Stage II or better which represents greater than 80% diagnosed at an earlier stage.
  25. 25. 25 Figure 3. Treatment of Breast Cancer Diagnosed 2000-2006 Compared to other community cancer centers in North Carolina, the majority of patients diagnosed with breast cancer at Valdese Hospital were offered surgery, radiation and hormone therapy. Figure 4. Stage of Breast Cancer Diagnosed 2000 to 2006. Compared to other community cancer centers in North Carolina, the majority of patients diagnosed at Valdese Hospital with breast cancer were early stage reported cases. 81% of the cases were diagnosed at Stage II or better, as compared to 80% at all other facilities.
  26. 26. 26 Words from the heart “I honestly love the people who work in The Cancer Center. When you walk through the doors, you know you’re in a place where people understand what you are going through, and truly care about how you feel.” -Leigh Mazaleski, Morganton, NC “When you have cancer you get depressed easily – you just get so tired having to go back and forth to treatments. But when you walk into The Cancer Center you definitely begin to have hope –” -Vicki Dula, Lenoir, NC -“When I first learned I had cancer I was scared to death. But as I went to The Cancer Center every week, seeing the same wonderful people, the fear passed…They know how to encourage you and keep you going.” - Nancy Thomas, Glen Alpine, NC
  27. 27. 27 Program & Support Services Contact Information Breast Prosthesis and Bras Burke Pharmacy 828-437-5800 East Burke Pharmacy 828-397-3420 Second To Nature 1-800-789-7306 Cancer Center 828-879-7536 Cancer Registry Grace Hospital 828-580-6875 Valdese Hospital 828-879-7685 Cancer Resource Center 828-879-7536 Cancer Services Coordinator Jan Hollar 828-580-6703 Chemotherapy Grace Hospital 828-580-6700 Valdese Hospital 828-879-7536 Financial Counselor Lindsay Wall 828-879-7536 Hospice & Palliative Care 828-1601 Outpatient Infusion Center 828-879-7536 Pastoral & Spiritual Services Dennis Stamper 828-580-5143 Diana Spangler-Crawford 828-874-2251 x114 Patient Navigator Dolly Wilson 828-228-4898 Radiation Oncology 828-879-7536 Social Services Tracy Copas 828-580-5405 Anne Coffey 828-874-2251 x259 Tobacco Prevention Camille Welch 828-580-6728 Complementary Care Look Good Feel Good Rhonda Crowe 828-438-4643 Wigs Rhonda Crowe 828-438-4643 Resource Directory Diagnostic Imaging Grace Hospital 828-580-6901 Valdese Hospital 828-879-7611 Cancer Foundation 828-580-5357 Health Information Management Grace Hospital 828-580-6887 Valdese Hospital 828-874-2251 x381 Home Health Services 828-580-6455 Nutritional Services Rachel Hobbins 828-874-2251 x142 Phifer Wellness Center 828-580-6615 Rehabilitation Services 828-879-7592 Wound Care 828-879-7563
  28. 28. 28 The Cancer Center at Blue Ridge HealthCare Main Campus - Valdese Hospital I-40, Exit 113 • 1 mile North of Interstate 720 Malcolm Blvd. Rutherford College, NC Phone: 828-879-7536 For more information or to make an appointment, call 828-879-7536, or visit www.wherehopegrows.org

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