2013 Annual Report

UnityPoint Health - St. Luke’s Hospital Cancer Care

Cancer is not an easy journey but at St. Luke’s Cancer Care we are committed to making sure you have the services available to help make the journey as easy and positive as possible. In collaboration with the Helen G. Nassif Community Cancer Center, we offer many specialty services to patients and their families, including:

• CareCoordinators• SocialWorkers• NutritionServices• Exercise–GroupandIndividualInstruction• GeneticCounseling/Testing• SexualityandBodyImage• Chaplains• CounselingServices• PalliativeCare–HomeCare&Hospice• ClinicalTrials• PatientEducationClassesand

Support Groups• CommunityEducationandOutreach• LookGood,FeelBetter-ACS• CancerNetwork• LungCancerClinic• MelanomaandAdvancedSkinCancerClinic• SurvivorshipProgram

FormoreinformationaboutSt.Luke’sCancerCareand the Helen G. Nassif Community Cancer Center, call (319) 558-4876.

Specialty Services

UnityPoint Health – St. Luke’s Hospital 2014 Cancer Committee Program Leadership

Thanks to the collaboration between St. Luke’s and the Helen G. Nassic Community Cancer Center, Betty McBurney was able to receive a new procedure which cut her treatment time in half.

Chair Dr.TomWarren MedicalOncologist

Physician LiaisonDr.RobertBrimmer GeneralSurgery

Physician MembersDr.StephenBurke RadiologistDr.RuthMacke PathologistDr.JasmineNabi MedicalOncologistDr.JamesBell PalliativeCareandHospiceDr.Cowden PulmonologistDr.Lee RadiationOncologist

Members Kimberly Ivester Director, St. Luke’s Cancer CareEmiChapman CareCoordinator,CommunityOutreachCoordinatorMonaCook CareCoordinator,CancerConferenceCoordinatorStephanieAsmussen OncologyNurse,ManagerInpatientUnitNancyHagensick SocialWorker,PsychosocialServicesCoordinatorRhonadaWeber CertifiedTumorRegistrar,QualityControlofRegistryDataCoordinatorSherrieJustice Director,PerformanceImprovement,QualityImprovementCoordinatorMaureenMcEvoy PalliativeCare,SpiritualCareJulieThompson Genetic,RiskAssessmentRepresentativeBethBeckett OncologyDieticianMattSchmitz CancerExerciseSpecialistAndreaWatkinson CareCoordinatorErinShanahan-Kauffman ClinicalResearchNurseCarmenKinrade VPNursingExcellencePatThies PharmacistShelleyWalker AmericanCancerSocietyMichelleNiermann VP/COO

Joy of Eating Headandneckcancerpatientsoftenexperiencepainfulswallowing,decreased ability to taste and loss of saliva as side effects of their chemotherapyandradiationtreatment.Aprogramdesignedforthespecialneedsofthesepatients,“JoyofEating,”waspresentedtoover 20 headandneckcancerpatientsonMay 22 as part of Helen G.NassifCommunityCancerCenter’sOutreachProgram.

Theprogram’sfocuswasonprovidingresourcesandpracticaltoolstomakemealtimemoreenjoyable.Aspeechpathologistandthreedieticians were available to answer questions and four local chefs prepared dishes for patients to taste, while providing information onnutrition,preparationtips(howtomodifyfoodtexture)andcooking.Thedishescombinedhighnutrientcount,increased moisture,spicesandseasonings,andsofttexturetomakethefoodanenjoyableexperience.Patientsreceivedapacketofrecipesandmealideasfromthepresentingchefs,includingcitrus-peachsmoothie, multigrain pancakes and salmon on polenta.

TheprogramwasacollaborativeeffortbetweentheHelenG.NassifCommunity Cancer Center, Holden Comprehensive Cancer Center atUniversityofIowa,IowaCancerConsortiumandHallPerrineCancer Center.

Caregivers Quality of Life RetreatCaring for a family member with cancer is rewarding but at the same time physically and emotionally demanding.Attimesitcanbeoverwhelming.The“FamilyCaregiverQualityofLifeRetreat”heldonMay2 was a reminder to caregivers to make self-careapriority.Thisspecialretreatemphasizedto caregivers the importance of caring for themselves through yoga, music, nature walks, meditationandmassage,amongotherstress- reducingoptions.Fourteencaregiversattended theeventatPrairiewoodsRetreatCenter,a collaborativeeffortbetweenSt.Luke’sPalliativeCare,PCIHematology-OncologyandGilda’s CluboftheQuadCities.Theeventwasfundedthrough a grant from the Iowa Cancer Consortium.

Bras for a CauseThemissionofBrasfortheCause,anonprofitfoundedin 2007, is to guarantee that all uninsured and underinsured womenlivinginasix-countyareaofEasternIowahaveaccess to programs and projects related to women’s health, including mammograms and cervical screenings.

The2013 BrasfortheCauseprogramwasgenerouslyfundedby a $10,000giftfromCarouselMotorstoSt.Luke’s Foundation.ThedonationallowedSt.Luke’sBreastandBoneHealthtosponsoraneventAugust 22 and 24 that offeredfreemammograms,paptestsandDXA(bonemineraldensity)tests.ThiseventprovidedservicetowomenwhoqualifyfortheCareforYourselfProgram,administeredbyLinn County to reduce cancer in women through screening, but could not participate because the fundraiser is limited to 331 womenannually.Thereisanestimated3,000 women whose age and income qualify them for the program but due to limited funding, their needs are not being met.

Theevent,whichprovided102procedures,wasa collaborativeeffortbetweenCareforYourself,UnitedWayWomen’sLeadershipInitiativeandSt.Luke’sBreastandBoneHealth.

Community Outreach

RallyAgainstCancer

“Everyone at St. Luke’s and the Community Cancer Center TREATED ME LIKE I WAS THEIR ONLY PATIENT. It was exactly the support I needed while battling cancer.”

– Betty McBurney

Educating students on dangers of tanning - Tanning is out, your skin is inAprogramdevelopedbytheHelenG.NassifCommunityCancerCenter uses student prom as common ground for educating high school students on the dangers of tanning.

“TaketheNo-TanningPledge”receivedfundinginfall2013 from the Iowa Cancer Consortium. Community Cancer Center staff launched theprograminApril2014, the month before prom, an event known to create a flurry of tanning among high school students.

Allareahighschoolswereinvitedtoparticipateintheno-tan program.TheHelenG.NassifCommunityCancerCenterprovidedflyersandposterswithskincancerstatistics.AnumberofschoolspostedinformationonFacebook,Twitterandtheschools’website,suchas“Melanomaisthesecondleadingcauseofcancerdeathforpeople age 15 to 30andtherateisincreasing.”

Thecoreelementofthe“TaketheNo-TanningPledge”wasto encourage students to sign a pledge, promising to refrain from indoor and outdoor tanning for prom and year round. Students couldhavetheirskinanalyzedbyEmiChapman,RN/CareCoordinator,who used DermaScan®, a skin analysis machine, to show skin damage.“Itwasawake-upcallformanystudents,”saidEmi.

Spirit FundAcancerdiagnosiscanbefrighteningandoverwhelming.TheSpiritFundwascreatedto help cancer patients obtain items and services not covered by insurance that are essential to an individual’s recovery and peace of mind.

ApartoftheHelenG.NassifCommunityCancerCenter, the fund provides assistance with addressing theemotionalandspiritualeffectsofcancer.Thefund addresses the supportive aspects of a patient’s ongoing care, which are equally important to his or her recovery.

PLEDGEBytheendofApril,1,500 students had signed the following pledge:

I pledge not to go tanning prior to the prom.

I will not intentionally tan by lying out in the sun or using tanning beds.

I realize that by getting a tan I am increasing my chances of developing melanoma, which can be fatal.

Plansareunderwaytoensurethe programreturnsnextyear.

DermaScan® is a registered product of NavoneEngineering,Inc.

The Spirit Fund assists with:

• Cancersupportivesupplies-camisoles,hats, wigs, swimwear

• Supportiveservices-notrecoveredbyinsurance

• Transportationassistance

• Otherservicesdeemedappropriatebythe SpiritFundCommittee

with over

Since 2011theSpiritFundhasprovided

155 patients $63,000 of assistance.

PATIENT VOLUMES BY CANCER SITE (2013)

Primary Site Total Male Female Breast 145 0 145

Lung/Bronchus 114 64 50

Prostate 108 108 0

Melanoma 82 45 37

Digestive System 65 39 26

Bladder 54 44 10

Colon 49 22 27

Blood&BoneMarrow 45 24 21

FemaleGenital 45 0 45

Non-Hodgkin’s 38 14 24

Endocrine 33 7 26

UrinarySystem 30 20 10

Brain&CNS 23 6 17

UunknownPrimary 20 12 8

OralCavity 16 9 7

Respiratory System 15 13 2

MaleGenital 7 7 0

Other 6 1 5

Connect/SoftTissue 4 2 2

Skin 2 1 1

Lymphatic System 1 0 1

Hodkin’s Disease 1 0 1

TOTAL 903 438 465

St. Luke’s Cancer Care understands each person’s cancer journey is unique, with their owncombinationofcancertype,cancertreatment,medicalhistoryandchallenges.Avastarrayofsupportservicesareavailabletoaddressthespecificneedsofcancerpatientsby assessingeachperson’sjourney,andprovidingacustomizedwellnessplantohelpthem lead a healthy life.

TheCancerWellnessProgramhasthreecomponents–exercise,nutritionandqualityoflifesupport.Atailoredplanisputtogethertoperfectlyfiteachpatient’sneedsandconcerns.

The Cancer Wellness Program is made up of a team of healthcare professionals:• CareCoordinator• CancerRiskAssessmentCounselor• CertifiedOncologySocialWorker• CertifiedOncologyDietitian• CancerExerciseSpecialist• Psychologist• CertifiedSexTherapist

TheCancerWellnessProgramlooksatthewholeperson,whilefocusingonthecancerexperienceanditsimpactontheentirefamily.Itisopentothosenewlydiagnosed,currentlyundergoing treatment or several years out from treatment.

Cancer Wellness Program

The program includes:• CookingDemonstrations• Family&IndividualSupport• SpiritualSupport• MassageTherapy• GroupExerciseClasses: Pilates,Zumba,TiaChiandyoga• Meditation• Reiki• Reflexology

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OneinfiveAmericanswilldevelopskincancerduringtheirlifetime.Melanoma,amalignanttumorofmelanocytes,isoneofthreemainformsofskincancer.OfthesevenmostcommoncancersintheU.S.,melanomaistheonlyonewhoseincidenceisincreasing.In2013 melanomawasthefourthmostcommoncancerdiagnosedatUnityPointHealth-St.Luke’sHospital, accounting for nine percent of our overall cases. Nationally, melanoma accounts forlessthanfivepercentofskincancercases,butthevastmajorityofskincancerdeaths.

Themostcommonriskfactorsformelanomaarefaircomplexion,severallargeormany small moles, a history of many blistering sunburns, especially as a child or teenager and beingexposedtosunlightorartificiallightintanningbedsoverlongperiodsoftime. Individuals who begin using tanning devices before age 30 are 75 percent more likely to develop melanoma.1Also,oneormoreblisteringsunburnsinchildhoodoradolescence more than doubles a person’s chance of developing melanoma later in life.

Melanomaislesscommonthanotherskincancers.However,itismuchmoredangerousifnot diagnosed in the early stages (Stages 0 and I).Ifmelanomaisfoundearly,whileitisstillsmallandthin,andifitiscompletelyremoved,thechanceofcureishigh.Thelikelihoodthatmelanoma will come back or spread depends on how deeply it has gone into the layers of the skin.Initialtreatmentformelanomaincludessurgicalremovalofthetumor.Formelanomasthatcome back or spread to other parts of the body, treatment includes chemotherapy, immunotherapy or radiation therapy.

Cancerstageatdiagnosis,whichreferstoextentofacancerinthebody,determinestreatmentoptions and has a strong influence on the patient’s survival. Comparison was made with NCDBdataforComprehensiveCommunityCancerProgramHospitalsintheMidwestandUnityPointHealth–St.Luke’sHospital.In2010 and 2011 respectively, 69 percent and 90 percentofmelanomacasesdiagnosedatUnityPointHealth–St.Luke’swerediagnosedasearlystage(Stage0andI)ascomparedto 71 percent and 73 percent for the same time periodsfromNCDB.

UnityPointHealth–St.Luke’sHospitalwillcontinuetoworkwiththeHelenG.Nassif CommunityCancerCenteraswellasorganizationsinthecommunitytoprovideeducationandawarenessonskincancerpreventionandearlydetection.Oureducationandawarenessefforts are focused on all populations including children, teens and adults.

MonitoringofstageatdiagnosisforallcancerstreatedatUnityPointHealth–St.Luke’s HospitalisafocusofSt.Luke’sCancerCommittee.Prevention,earlydetectionand programmaticinitiativesareestablishedbasedonourfindings.

1 SkinCancerFoundation,2014

Data Analysis Of MelanomaSt.Luke’sascomparedtoNationalCancerDatabase(NCDB)MelanomaCasesA.JohnVanderZee,MDReconstructiveSurgeon,MedicalDir.Melanoma&AdvancedSkinCancerCare

MaleFemale

Melanoma Cases by Age & Sex (2013)

Age

Comparison of UnityPoint Health - St. Luke’s vs. Community Cancer Program Hospitals*

10-29 30-39 40-49 50-59 60-69 70-79 80-99

706050403020100

0 I II III IV UNK NAStage

St. Luke’sNCAB

UNK = UnknownNA = Not Applicable

50

40

30

20

10

0 0 I II III IV UNK NA

Stage

2011 MELANOMABYSTAGE

*Data from 58 Hospitals in the ACS Division of the Midwest.

2010 MELANOMABYSTAGE

For more information about the programs and services St. Luke’sCancer Care provides, visit unitypoint.org/cancer

OurMission“Toprovideexceptionalcancercare that places you at the center ofallwedo.”

OurVision“Toberecognizedastheleaderinclinicalexcellenceandinnovationinourcommunity.”

UnityPoint Health St. Luke’s Hospital and Helen G. Nassif Community Cancer Center Collaborate for Patient-Centered, Comprehensive CareIn 2011,agroupoflocalcancerexpertsfrommultiplespecialties formedtheHelenG.NassifCommunityCancerCenter.The collaboration brought together more than 200 doctors from Physicians’ClinicofIowaP.C.,independentprovidersandgroupsand UnityPointHealth–St.Luke’sHospitaltoimprovecancercareinourcommunity by better coordinating resources and services that support cancerpatientsandtheirlovedones.Asaresultofthecollaboration, providershaveadoptedevidence-basedpathwaystostandardize cancer care, improved coordination between specialties and proactively provide support services to patients and their families.

TheHelenG.NassifCommunityCancerCenteristheconnectinglink for coordination of care and is open to all providers, cancer patients and the community.

2013 Helen G. Nassif Community Cancer Center Board of DirectorsMr.GaryJ.Streit,Board ChairMs.LornaM.BarnesMs.JenL.HoegerDr.RobertJ.BrimmerDr.RasaL.BuntinasDr. John D. RoofMr.BrianC.ScottMr.TedE.TownsendMs.TerriA.Christoffersen

OurValuesPatient and Family CenteredWeareherefirstandforemostfor our patients and their families. Meetingtheirneedsandexceedingtheirexpectationsisatthecenterof all we do.

Achieving ExcellenceWeadheretothehighestquality standards to deliver superior care andexceptionalprogramsto patients and their families.

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Respect for AllWevalueallpatients,theirfamiliesand colleagues in their beliefs, perspectives and wishes.

CollaborationThecommunityisbetterserved by collaborative partnerships. Coordination of care improves outcomes and quality of life for patients and their families.