Adventist Medical Center

2016 Cancer Program Annual ReportW I T H D A T A F R O M 2 0 1 5

CANCER COMMITTEE CHAIRAaron Hicks, MD Radiation Oncology

CANCER PHYSICIAN LIAISONFrances Ting, MDGeneral Surgery / Breast Surgery

QUALITY IMPROVEMENT COORDINATORWesley Rippey, MD General Surgery / Vascular Surgery

CANCER CONFERENCE COORDINATORRebecca Orwoll, MDInternal Medicine / Hematology / Oncology

MEDICAL STAFF REPRESENTATIVESDong Xiang, MDHematology / Internal Medicine / Oncology

Aaron Hicks, MDRadiation Oncology

Jingjing Hu, MDInternal Medicine / Hematology / Oncology

M.C. Theodore Mackett, MDGeneral Surgery / Vascular Surgery

Meredith Peake, MDChief of Pathology

Arnold Petersen, MDObstetrics / Gynecology

Jed Peterson, MDRadiology / Interventional Radiology

CANCER DATA MANAGEMENT SERVICES / REGISTRYLaura Wallace, RHIT, CTRCancer Program Coordinator

OTHER MEMBERSDonald Anderson, RTAdministrative Director Medical Imaging

Irene Franklin, MS, RD, LDNutritional Services

Thom Crawford, ACHP-SWSocial Work

Kim Earp, RT (R) (T), MBAChief Therapist, Radiation Oncology

Kristi Grindle, RNClinical Trials Nurse / Radiation Oncology

Linda Henry, RN, MS, CNS, WOCNClinical Nurse Specialist

Cindy Hiday, RNCPI Coordinator

Janice Hogue, RPHPharmacy Director

Ed Hoover, MACommunity Outreach Coordinator LivingWell / Community Wellness Manager

Karen Johnson, RN, BSN, CHPN Palliative Care Coordinator

Shannon Lang, RNHyperbaric Medicine Manager

Daryll GeorgePhysician Liaison

Maureen McNabb, RNAdministrative Director, Nursing Services

Pam Strachan, Mdiv, BSChaplain

Julie RobertsonAmerican Cancer Society

David RussellSenior Vice President, Chief Executive Officer

Dee Santella, RN, OCN, MSNCancer Care Nurse Coordinator

Heather Saviage, OTR/LSpecialty Rehabilitation / Occupational Therapy

Susan Steffey, MTLaboratory Services Director

Cancer Committee Roster – 2016

Cancer Committee Roster ............. 2

Chair’s Report ............................... 3

Prevention & Screening ................. 4

Cancer Data Services ................... 6

Contents

AcknowledgementsThis report is produced by Adventist Medical Center’s Cancer Registry and the Marketing and Communication Department. The production of a cancer program annual report is in compliance with the requirement of the American College of Surgeons Commission on Cancer.

To contact us, write to: Adventist Medical Center – Cancer Registry, 10123 SE Market Street, Portland, Oregon 97216.

To learn more about the Adventist Health Cancer Program visit:AdventistHealth.org/NW/Cancer

AdventistHealth.org/NW

2 Adventist Medical Center | Cancer Program

Cancer is a diagnosis that can ignite fear, anxiety and dread. For much of human history, this disease has been the source of tremendous suffering with little hope for remission or cure. Fortunately, over the past few decades, and especially in recent years, the landscape has been changing. Never before has there been more hope. We are now living in a time of great progress towards prevention, screening and treatment of cancer. However, cancer is still a disease that occurs in human beings and therefore optimal care requires individualized, personal and compassionate human healing.

At Adventist Health, our team is committed to ensuring that each person coming to our cancer program in their greatest time of need has an exceptional experience, in addition to receiving excellent, compassionate and personalized cancer care. Highlighting this commitment, our cancer program continues to be accredited by the Commission on Cancer, signifying our ongoing dedication to providing comprehensive, high-quality and multidisciplinary patient-centered care.

It has been well established that early detection of cancer is critical to saving lives. With this in mind, our cancer program has recently designed and implemented a lung cancer screening program. This screening tool has been shown to significantly reduce the chance of dying of lung cancer in patients at high risk for developing this disease.

High risk patients who qualify for low dose CT lung screening include those aged 55-79 with a history of smoking the equivalent of 1 pack of cigarettes per day for 30 years and who are currently smoking or have quit in the past 15 years and have no symptoms concerning for lung cancer. This screening procedure is a non-invasive and fast CT scan of the chest that is performed using special techniques to minimize radiation exposure to the patient and does not require any contrast to be injected into the patient. If no abnormalities are discovered, this scan is obtained annually until the patient falls outside the high-risk definition.

Over the past year, our lung cancer screening program has screened over 400 people and contributed to earlier detection of lung cancer, when treatment is much more likely to be successful. Additionally, as our lung cancer screening program has grown over the past year, we have appointed a Lung Cancer Screening Coordinator whose role is monitoring and assisting with arranging follow-up for patients in the program.

Aligned with our commitment to early detection of cancer, AMC has acquired state-of-the-art, advanced breast cancer screening technology called digital breast tomosynthesis or more commonly 3D mammography. Our first 3D mammography machine was recently installed and we expect to begin using it to screen women in early 2017. This screening tool increases the accuracy of breast cancer detection, resulting in fewer “false alarms” and a reduction in unnecessary stress, anxiety, expense and inconvenience for women.

Over the past year, our cancer program has continued to promote cancer awareness and education in the community we serve. At the Relay for Life, an annual American Cancer Society sponsored fundraiser held in August, team members led participants along a pathway through a model of the human GI system and provided information about GI malignancies, strategies for cancer prevention and the importance of screening colonoscopy. We also continued our work of educating the public regarding the hazards of radon exposure, which can lead to lung cancer, and offered radon test kits. Next year, we are planning to host a citywide radon awareness event and offer discounted radon test kits to our community.

Exceptional care requires a dedicated team. At AMC, our values of Integrity, Quality, Compassion, Wholeness, Respect, Family and Stewardship are embodied by each member of our cancer team, including physicians, nurses, patient navigators, social workers, genetic counselors, palliative care experts, chaplains and many others working in unison with a singular goal: Exceptional and loving care for our patients who inspire us daily.

Our Mission... to demonstrate the human expression of the healing ministry of Jesus Christ.

Chair’s Report

2016 Cancer Program Annual Report 3

Aaron Hicks, MD

4 Adventist Medical Center | Cancer Program

Prevention and Screening

Lung cancer continues to be one of the leading primary cancer sites in Oregon. At AMC we diagnosed and/or treated 60 new lung cases during 2014. Lung cancer is the second most common cancer diagnosed at AMC. Worldwide, lung cancer is largely diagnosed at an advanced, and less treatable, stage.While the leading cause of lung cancer is related to tobacco use, the second leading cause is exposure to radon, a colorless, odorless, radioactive gas, the result of the breakdown and decay of uranium, which is naturally found in some soils. In fact, U.S. reports suggest that around 21,000 lung cancer deaths each year are radon-related. According to the Environmental Protection Agency, nearly one out of every fifteen American homes has an unsafe level of radon gas inside. For many zip codes within Adventist Health’s primary service area, the Oregon Health Authority has listed them as “high risk” for dangerous home radon levels. As part of our community prevention and screening efforts, Adventist Health in Portland has engaged in a two-year initiative to educate about radon, and to make it easier for families to access low-cost home test kits. Between January 2014 and October 2015 we:

1) Conducted three community education presentations on radon in cooperation with the American Lung Association, American Cancer Society and the Oregon Health Authority

2) Sold 100 low-cost home test kits to local residents (50/year)

3) Provided additional radon education through hospital publications and targeted emails

Of the 35 home radon kits that were submitted and considered to have been done properly, 25% were above 4 pCi/L (“high risk”, where it recommended that residents have work done on their homes to reduce radon exposure), 23% were classified as “moderate risk” where repairs should be considered, and 51% were classified as low risk. Three of the homes tested were over 11 pCi/L. “If 1,000 people who never smoked were exposed to this level of radon over a lifetime, it is estimated that 18+ could get lung cancer.” In 2016, we are continuing to offer this lung cancer prevention and screening service.

Additional Prevention and Awareness Activities Included:

• Colorectal cancer awareness campaign— posters, materials & public displays in March

• FREE weekly smoking cessation support group

• Community programs on lifestyle approaches and cancer risk reduction (nutrition, exercise, stress reduction, water, sunlight, rest, etc.) including Complete Health Improvement Program, Sleeping Well Again, No Added Sugar Challenge, New Pre-diabetes class, Holiday Hold’Em Weight Challenge, From Sickness to Health Series, etc.

• Cosponsor of the Northwest Health and Nutrition Conference—a professional conference on the health benefits of a whole food, plant-based diet

• Family Fun and Fitness Fair at Cherry Park Elementary School

• Portland Better Living Show and Portland Vegfest booths on prevention

• East Portland Relay for Life (ACS) and Portland Race for the Cure

Cancer Screening Activities

• New lung cancer screening program for eligible clients. Started in January, approved by Medicare and insurers in April 2015, over 360 patients have been screened using low-radiation CT scans, and eight cancers identified and treated.

• Colorectal cancer screening improvement project — AHMG clinics

• Mammography Outreach Program for no or low-cost screening mammography

• Home radon screening project• Lung cancer awareness month—“should

you be screened” low-radiation dose lung CT exam education and discussion in the Adventist Medical Center community areas

2016 Cancer Program Annual Report 5

Prevention and Screening

2015 Community Outreach Prevention, Education & Screening Programs

• Breast cancer/breast health education• Colorectal cancer education• Great American Smokeout/Walk-in Smoking

Clinic• Health fairs and seminars• LivingWell staff wellness education program• Lymphedema education and prevention

program• Nutritional education and screening• Oral health screening• Prostate cancer education• Relay For Life events• Skin cancer education and screening• Tobacco cessation program support groups/

services• Breast cancer support group• Bereavement luncheons• Cancer navigation services• Cancer survivors day• Cancer support group• Genetic counseling referral by partnering

medical oncology specialists, such as OHSU/Knight and Compass Oncology

• Grief counseling• Look Good, Feel Better classes, free wigs

and wig fittings in collaboration with American Cancer Society

• Lymphedema support and treatment• Ostomy support group• Pastoral care• Road to Recovery• Cancer support group for patients• Grief support group

6 Adventist Medical Center | Cancer Program

AMC’s Cancer Data Services is a key component of the cancer program and is under the direction of the oncology service line, the Cancer Committee and stringent compliance to the American College of Surgeons Commission on Cancer program standards.

Cancer Data Services is responsible for managing and analyzing clinical cancer data to collaborate with physicians, administrators, and health care planners to provide support for cancer program development, treatment, providing cancer incidence, and to ensure compliance of reporting standards.

Cancer Data Services: Cancer Registryby Laura Wallace, RHIT, CTR

TotalPrimary Cancer Sites Male Female 0 I II III IV UNK N/A Cases

BREAST 0 112 16 48 29 14 4 1 0 112LUNG 37 35 0 20 10 10 29 0 3 72URINARY BLADDER 28 6 19 8 6 1 0 0 0 34PROSTATE 30 0 0 2 22 5 1 0 0 30COLON 13 14 0 9 8 7 2 0 1 27STOMACH 13 4 0 3 3 3 5 0 3 17RECTUM 12 2 1 1 4 5 2 0 1 14PANCREAS 6 8 0 1 6 1 5 0 1 14CORPUS UTERI 0 14 0 7 1 4 1 0 1 14NON-HODGKINS LYMPHOMA 5 8 0 2 1 2 6 0 2 13ESOPHAGUS 9 4 0 1 1 2 8 0 1 13UNKNOWN PRIMARY 5 7 0 0 0 0 0 12 0 12KIDNEY 6 5 0 6 2 1 0 0 2 11THYROID 3 6 0 5 1 0 2 0 1 9OVARY 0 7 0 2 0 4 1 0 0 7LIVER 3 2 0 0 0 0 3 1 1 5SOFT TISSUE 2 2 0 3 0 0 0 0 1 4MELANOMA SKIN 1 3 0 2 2 0 0 0 0 4OTHER URINARY 2 2 2 0 0 1 0 0 1 4LYMPHOID LEUKEMIA 1 3 0 0 2 2 0 0 0 4MULTIPLE MYELOMA 2 1 0 0 0 0 0 3 0 3LIP ORAL CAVITY PHARYNX 3 0 0 0 0 0 3 0 0 3SMALL INTESTINE 2 1 0 0 1 1 1 0 0 3ANUS 1 2 0 1 1 0 0 0 1 3OTHER DIGESTIVE ORGAN 1 1 0 0 1 0 0 1 0 2HODGKINS LYMPHOMA 1 1 0 0 0 0 2 0 0 2OTHER MALE GENITAL 2 0 0 2 0 0 0 0 0 2BRAIN & NERVOUS SYSTEM 1 1 0 0 0 0 0 2 0 2MYELOID & MONOCYTIC LEUKEMIA 2 0 0 0 0 0 0 2 0 2OTHER HEMATOPOIETIC 1 0 0 0 0 0 0 1 0 1OTHER SKIN 0 1 0 0 0 0 0 1 0 1OTHER FEMALE GENITAL 0 1 0 0 0 0 1 0 0 1LARYNX 0 1 0 1 0 0 0 0 0 1BONES & JOINTS 1 0 0 0 0 0 1 0 0 1

TOTAL 186 246 29 114 114 75 72 13 15 432

STAGE

2015 Cancer Data Year Analytic Cases – Site & Stage Distribution

2016 Cancer Program Annual Report 7

2016 Registry Data

Adventist Medical Center Cancer Program offers:

• Educational, prevention, community outreach, and early cancer detection programs

• Financial Advisors specialized in uninsured or complex financial situations

• Financial Assistance program for partial to full hospital care

• Cancer-related support groups—grief, bereavement, cancer survivor, smoking cessation

• Medical oncology inpatient and outpatient units staffed by oncology-certified, bachelor-degreed, registered nurses (RN, OCN)

• Oncology nutrition and dietitian services• Social work services• Grief and bereavement support• Pastoral care services• Inpatient palliative care service by a certified

hospice and palliative care RN• Cancer care coordination service by oncology-

certified RN patient navigator• Radiation oncology• Interventional radioisotipe therapy• Surgical oncology• Clinical trials• Diagnostic and interventional radiology• Personal home care by home health aides,

personal caregivers, and nurses• Hospice—MD, RN, social worker, chaplain, nurses

aide, and trained hospice volunteer home visits• Outpatient palliative care for certain qualified

patients• Specialty rehabilitation services including physical

therapy, speech/swallow therapy, occupational therapy, and cancer-related lymphedema therapy

• Interpreter and translator services in dozens of languages and dialects—face to face, telephonic, or via live internet

• Inpatient and outpatient psychiatric consultation and care

• Hyperbaric medicine therapy for some cancer-related conditions.

• Durable medical equipment services

American Cancer Society

• Adventist Medical Center (AMC) Cancer Program partners with the American Cancer Society (ACS), and provides up-to-date, educational materials published by the ACS. AMC helps provide ACS-donated new wigs, offers private wig fitting appointments, as well as “Look Good, Feel Better” classes, guided by a licensed cosmetologist, and offered to women experiencing temporary side effects of certain cancer treatments. All ACS material and services are free.

• The AMC cancer navigation program offers assistance with cancer education and information, as well as guiding patients and families to AMC and community resources, with a goal to reduce any barriers to cancer care. The cancer nurse navigator is a cancer nurse who may assess emotional health and distress, find a care provider, or help a patient address transportation, financial, and insurance concerns he or she may encounter on their cancer journey. AMC cancer navigation services are free.

Community Outreach• Adventist Medical Center Cancer Program actively

reaches out to the communities it serves to share information about enjoying a healthier lifestyle, the importance of regular cancer screenings, and maintaining good physical, mental, and spiritual health by being mindful of the benefits of good sleep, stress reduction, smoking cessation, a plant-based diet, and physical exercise. Outreach wellness services are open to the public, and most programs are available as free or low-cost.

• The Adventist Medical Center Cancer Program Committee is a multidisciplinary team that meets four times a year to monitor and strengthen the services offered and ensure cancer prevention, screening, and care is current, comprehensive, and meets the needs of our community. In addition, a Cancer Program subcommittee meets once a month to evaluate the cancer program objectives and progress.

• Breast and Cervical Cancer Program (BCCP) screening and services, and BCCP treatment application assistance for medically urgent Oregon Health Plan enrollment.

• Mammography outreach program offering free or low-cost breast cancer screening to eligible women.

A special thank you . . . to our community, the American Cancer Society and our private donors.

Adventist Medical Center10123 SE Market Street, Portland, Oregon 97216(503) 257-2500 | AdventistHealth.org/NW

Cancer Services

Screening ServicesColon cancer screeningProstate cancer screeningSkin cancer screeningDigital mammographyLow-dose CT lung cancer screening

TreatmentSurgeryInpatient chemotherapyRadiation oncologyInterventional radiologyHematology servicesCancer specialty rehabilitationClinical trials

DiagnosticRadiology ServicesCT imagingMRIPET/CTPathology/LaboratoryNuclear medicine imagingDigital mammographyUltrasoundColonoscopiesBiopsies

Support ServicesCancer nurse navigatorPain management

Wellness servicesPhysical therapySpecialty rehabilitationLymphedema clinicOccupational therapyAudiology servicesSpeech and swallow therapyNutritional servicesHome healthInpatient and oputpatient social work servicesInterpretation servicesFinancal aide assistance and referralHome hospice careInpatient palliative careOutpatient palliative care – Care Oregon clientsNurse specialist ostomy care management and instructionCancer treatment transportationFree wigs and wig fitting appointments

Staff EducationPhysician cancer lecturesNurse training in cancer careLymphology Association of North America

Program Activities

Support GroupsCancer support groupBreast cancer survivor support groupMammography programSmoke free supportBereavement support groupHospice: Grief support groups and classes

Educational ActivitiesLook Good, Feel Better American Cancer SocietyThe Latest Nutrition DiscoveriesCreating Health SeriesSelf-Help Materials for Tobacco CessationComputerized Health Risk AssessmentsGreat Race Fitness ChallengeLivingWell with Stress SeriesWeb-based classes: weight, tobacco, nutrition, stress, etc.

Community ActivitiesAmerican Cancer Society’s Relay for LifeRace for the Cure Expo & WalkCommunity and worksite screeningsPlant-based nutrition conferencePortland VegFestBetter Living Show

When it comes to providing the best care to our community, Adventist Medical Center depends on your donations. Contact the Adventist Health Foundation at (503) 251-6197.

AdventistHealth.org/NW/Cancer