Cancer Care 2020 Report to the Community A message from our chair David M. Lingle, MD, FACS Chair, Cancer Committee Vidant Roanoke-Chowan

Greetings to our community 2020 proved to be an extraordinary year for cancer care in Vidant Roanoke-Chowan, Vidant Bertie, and Vidant the Roanoke-Chowan area when we achieved accreditation Chowan . of our program through the Commission on Cancer, a Experts on cancer care discussed how to live a healthy quality program of the American College of Surgeons. life, and provided ideas and tips on how to decrease Cancer care services continued to operate despite the cancer diagnoses. The live event was saved on each of COVID-19 pandemic. Healthcare, not unlike many other the three hospital’s Facebook pages and continues to public services, was often delivered unconventionally, be viewed by the public. especially when compared to before the COVID-19 Many patients continue to benefit from surgery locally pandemic. A telehealth approach was used to ensure for diagnosis and treatment of their cancer. More than patient care continued and to support quality outcomes. 800 colonoscopies were performed for colon cancer Throughout the year our quality goal focused on decreasing screening in Edenton and Ahoskie during the 2020 the diagnosis of stage 3 and 4 lung cancer. Strategies calendar year. Screenings continued to help provide implemented included utilization of our Low Dose CT early diagnosis of colon cancers and monitor or (LDCT) services to detect first or second-stage lung cancer. remove lesions before cancer occurs. Cancer surgeries Dr. Madhu Parmar, OB-Gyn, Cancer Liaison Physician, continued after a short pause at the beginning of visited local provider’s offices to discuss the importance the Covid-19 pandemic. This pause was experienced and availability of the screening as well as sharing the throughout the nation and regionally as we worked information with their patients. The screening provides through the initial fog of the pandemic. support to decrease the number of patients who would 2020 welcomed the opening of a new Palliative Care eventually develop advanced-stage lung cancer. Each unit, known as the “Butterfly Suite.” This spacious area patient had to meet the established criteria, as determined consists of a patient room and an adjacent room that by their primary care provider, to receive a referral to has a few amenities to enhance comfort. The services be screened. are provided on a referral basis by an onsite hospitalist This initiative exceeded expectations. We saw an and a consult with the Palliative Care Team at Vidant 11.1% increase in Low Dose CT lung screenings which Medical Center. Services include: case management, increased low-stage diagnosis of lung cancer and hospice referrals, pain management, chaplain services, decreased advanced-stage lung cancer. What an amazing and implementation of advance directives. accomplishment! Due to these outcomes, this initiative Our Cancer Committee was formed in 2017 and we are will continue into 2021 so we can further reduce advanced excited about the tremendous progress that has been stage lung cancer. This is a great example of the impact our made over the past 3 years. This progress represents the cancer committee has on our community’s health. work of many dedicated members of our committee To address the ongoing need for community education, the and providers of cancer care in our region. It is a first-ever Virtual Cancer Care Event was produced and made privilege to be involved with this team as we celebrate available in October by the marketing teams at past and look forward to future accomplishments.

2 2020 Cancer Committee members

Current Member – Area/Role Name Alternate ACS Rachel Urban Robbie Tilley Cancer Committee Chair David Lingle, MD Madhu Parmar, MD Cancer Conference Coordinator William Ballance, MD Cancer Liaison Physician Madhu Parmar, MD Cancer Program Administrator Kasey Pearce, BSN, RN, OCN Jennifer Riley, BSN, RN Cancer Registry/CTR Jaimie Morales, CTR Merrill Bright, CTR, RHIA Clinical Research Coordinator Jennifer Stallings, RN Diagnostic William Hope, MD Brian Kuszyk, MD Lisa Newsome (Jan-May) Marketing/Events Robin Bland, VROA Marketing Spec. Brian White (eff. June) Medical Oncology Chang Son, MD Darla Liles, MD Oncology Nurse Ann Munford, RN Tiffany Johnson, RN Palliative Care Ellie Ward, BSN, RN Melanie Davis, RN Pathology William Ballance, MD Quality Coordinator Susan Brinkley, MSN, RN Stacy Simmons, MSN, RN Radiation Oncology Melva Pinn-Bingham, MD Andrej Hnatov, MD Rehabilitation Jonathan Unger, BS Chris Burby, MPT Social Worker/Psychosocial Services Patricia Owens, MS, LCMHC, LCAS Shirley Clark, LCSW Coordinator Surgeon David Lingle, MD David Friedman, MD Survivorship Program Coordinator Rhonda Overton, RN Nita Doughtie, RN

Cancer Committee participating in the virtual American College of Surgeons- Commission on Cancer survey on December 21, 2020.

3 Special Highlight of 2020

Vidant Roanoke-Chowan Hospital Cancer Committee Goals & Quality Initiatives The Vidant Roanoke-Chowan Hospital Cancer Committee’s Program Goal was to decrease the number of chemo- therapies taking longer than 60 minutes to receive to the floor. Understanding that longer mix times mean that our patients are waiting longer, we felt that this was an incred- ibly important initiative. Through strategies implemented by both pharmacy and oncology staff and with the help of our The Vidant Roanoke-Chowan Hospital Radiology Low-Dose Process Improvement team, we were able to decrease these CT Team: Robbie Etters, MHA, Manager, Radiology Division; Marietta Chavis, Radiology Tech Assistant; Stephanie infusions taking longer than 60 minutes to mix by a total of Jernigan, RT(R) (CT), CT Supervisor and Katilyn Marie 54.2% for the 2020 calendar year. We are thankful for any ini- Hoggard, RT (R), CT Technologist. tiatives that give our patients more time with their families. We understand the importance of LOW Dose CT and the impact that screening has on early detection. At VROA, we have noticed that despite the availability of LDCT, our numbers performed have not been stellar. During 2020, our cancer committee, chose to focus on decreasing the diagnosis of later stage lung cancer by community and provider education, screening clinics, and use of screening test readily available at VROA.

This initiative, led by our quality coordinator and Dr. Parmar, Physician Liaison, Cancer Committee, resulted in a significant decrease in the diagnosis of stage 3-4 cancer and an increase in the diagnosis of more treatable stage 1 and 2 lung cancer.

David Broome, PharmD and Melissa Barnes, Pharmacy David Broome, PharmD and Melissa Barnes, Pharmacy Tech II, work together to verify, mix, and check the chemo Tech II, (above) work together to verify, mix (right), and drugs when the patients come for their treatments. check the chemo drugs when the patients come for their treatments. In the photo on the right, Melissa prepares to mix the chemo. 4

VROA receives Commission on Cancer Accreditation

Dr. Parmar Cancer Liaison Physician, Cancer Committee Vidant Roanoke-Chowan Hospital

Institutional commitment is essential for the development • Participate in the national data base and success of an accredited Commission on Cancer (CoC) It will allow us to compare how we are doing with the program. Beginning in 2016, with Dr. Lingle’s vision and the rest of the country and improve our own quality and support of Vidant Roanoke-Chowan Hospital (VROA) and standards of cancer care. leadership, we began pursuing accreditation Over the last four years, quality initiatives were developed and by the CoC, a Quality Program of the American College of implemented and educational outreach community events Surgeons. On January 31, 2017, VROA held our first Cancer were held to help improve awareness. Committee meeting and over the past 4 years have been One of the improvement initiatives was to decrease stage 3-4 We understand the importance of LOW Dose CT and the impact that screening has on early detection. At VROA, we have noticed that meeting quarterly to fulfill our commitment to achieve better lung cancer diagnosis using low-dose lung CT scans. Despite despite the availability of LDCT, our numbers performed have not been stellar. During 2020, our cancer committee, chose to focus on outcomes and improve the quality of life for the patients we the availability of the low-dose CT at VROA, we were not decreasing the diagnosis of later stage lung cancer by community and provider education, screening clinics, and use of screening test serve. On December 21, 2020, VROA had a virtual CoC survey performing as many screening exams as we hoped. The team and the surveyor was very complimentary on the work readily available at VROA. chose to focus on decreasing advanced-stage lung cancer by around our focused clinical goals, our commitment to patient educating the community, providers and holding free screen- This initiative, led by our quality coordinator and Dr. Parmar, Physician Liaison, Cancer Committee, resulted in a significant decrease in safety, and the focus on continuous quality improvement. ing clinics. This initiative resulted in diagnosing more treatable the diagnosis of stage 3-4 cancer and an increase in the diagnosis of more treatable stage 1 and 2 lung cancer. It is with great honor that we announce that Vidant Roanoke stage 1-2 lung cancers and a decrease in advanced difficult to Chowan hospital has received Commission on Cancer treat stage 3-4 cancers. Accreditation. With the accreditation, the CoC validates that Diagnosing cancer at an earlier stage means a patient has a VROA met or exceeded a set of high quality and care stan- better chance of recovery. Outreach and prevention events dards that would not only help current patients, but also to like Dinner with a Doc, Pink Power and breast, colon, and reduce the number of patients who may develop cancer. prostate cancer screenings, Senior Health and Fitness Day, Some of the significant benefits of being accredited include: and others, are important to our mission of serving our patients and improving the quality of life in our communi- • The delivery of comprehensive care ties. Any initiative that gives our patients more time with their We provide care needs in all aspects of the cancer jour- families is truly a worthy cause. ney from diagnosis, treatment, recovery, survivorship, palliative, and hospice care. • The use of a multidisciplinary team approach. Lung Cancer by Stage % of Population All different specialists from Vidant Roanoke Chowan 2018 to 2020 Compare Hospital, , and throughout the 50% 48% 47% 45% Region collaborate on each case to develop the best 41% treatment plan. 40% 35% • Patient centered care 30% 24% We are committed to working with patients and families 25% to come up with the best-individualized care plans. 20% 16% • Quality care close to home 15% 12% We understand the comfort of home is very important 10% 7% 4% to those affected by cancer. Our newly accredited 5% 0% program will allow patients to receive cancer care locally, Stage 1 Stage 2 Stage 3 while also having access and support of latest technolo- 2018 2020 gies and clinical expertise of Vidant Medical Center.

5 The Vidant Radiation Oncology Integration On October 5, 2020, Ahoskie Radiation Oncology officially joins Vidant Radiation Oncology, LLC (VRO), a joint venture between Vidant Medical Center and GenesisCare. Founded in 2016, VRO brings forward leading technology, research and expertise from both GenesisCare, Vidant and ECU Brody School of Medicine. The collaborative partnership remains one of the largest providers of radiation therapy in the US for GenesisCare. VRO has a team that includes radiation oncologists, nurse practitioners, physicists, dosimetrists, radiation (l-r) Debbie Tucker, patient access representative at the Vidant therapists, certified nursing assistances, nurses, financial Radiation Oncology Clinic, discusses a patient’s treatment counselors, social workers, nurse navigators, nutritionists, schedule options with Dr. Melva Pinn-Bingham, Radiation and patient access staff. Our physicians have over 120 years of combined experience in the radiation oncology. VRO utilizes a multidisciplinary approach through tumor boards and peer review to provide individualized, specialized care to oncology patients. Tumor boards are held with expert physicians in Vidant including (medical oncologist, surgical oncologist, surgical subspecialists, radiologist, and pathologist) to discuss the best treatment options for patients diagnosed with cancer. VRO treats all types of cancers and some non-cancerous disease processes with the most current technology. Vidant Radiation Oncology Clinic team members, work as a VRO clinics use state-of-the-art equipment and multiple team to ensure the highest quality of care and treatment for radiotherapy modalities to provide effective radiation the patients. (l-r, below) Brandi Roberson, Radiation Therapist and Rae White, Radiologic Technician. therapy. These modalities include Varian TrueBeam linear accelerators, Cyberknife and Gamma Knife radiosurgery, high dose brachytherapy, Y-90 Cancer Conference Team Members radioembloization, Gammatile and CivaSheet introperative brachytherapy, and radiopharmaceutical including radium 223. Vidant Radiation Oncology holds accreditations with both the American College of Radiology as well as the American College of Radiation Oncology. VRO clinics in combination treat an average 140 patients daily. During 2020 VRO provided over 20,000 radiation treatments to patients within Eastern . During the ongoing COVID-19 pandemic VRO continued to William Ballance, MD; Keith Begelman, MD; Crystal Brabble, FNP; provide safe, effective care to our patients, with adequate David Broome, PharmD; Nita Doughtie, RN; Timothy Frei, MD; David PPE, and COVID-testing protocols. VRO has increased the Friedman, MD; William Hope, MD; James Johnson, MD; George utilization of telehealth visits to expand access to healthcare Jordan, DO; Jessica Kim, DO; Brian Kuszyk, MD; David Lingle, MD; and decrease the risk of exposure to patients, family Shamusideen Ogbulu, MD; Rhonda Overton, RN; Madhu Parmar, MD; members, and team members. Kasey Pearce, RN, ONC; Melva Pinn-Bingham, MD; Joel Reynolds, MD; Pierre Selwane, MD; Charles Shelton, MD; Rebecca Snyder, MD; Chang 6 Son, MD; Linda Vaders, NP-C; Dwan Varner, MD; and Jan Wong, MD Our Donors Survivorship programs he opportunity to donate to Cancer Care Services is available year-round and the names of individuals and Vidant Roanoke-Chowan Cancer Care provides patient organizations are being added to the donor wall with navigation and resources for each patient and family eligible donations. Some of our most recent donors based on their needs. Many opportunities for support and include: education are usually offered throughout the year, however • Edith Freeman Sunday School Class with First Baptist with COVID, the Cancer Support Group and IN-Power Church of Ahoskie Exercise Class were paused for the safety of the survivors. • Woodmen Life Although this year looked very different for patients, • Alpha-Kappa-Alpha Sorority (pictured) support and navigation services were still provided at Donations provided include gas cards, and gift cards appointments and over the phone. from Walmart, Walgreens, and Food Lion. The monetary One resource that continued to assist patient in 2020 is the donations help us to grow the services we provide, enhance the patient’s experience when they are in our rural patient transportation program called Transporting care, and to assist with financial burdens that survivors Resident using Innovative Practices (TRIP), a grant-funded face. rural patient transportation program provided by Roanoke Chowan Community Health Center. Ten patients from We would like to honor our donors to show how much Vidant Cancer Care received transportation services to we appreciate the ongoing support from the community. oncology, radiation, and other medical appointments at no cost to the patient. Over 330 trips were scheduled for these patients last year. A big thank you to HETS Transportation for going above and beyond in getting these patients transported to important appointments safely. It is the goal of Vidant Cancer Care to continue to grow survivorship programs to offer to the community. Hopefully, these services will open back up in-person next year with keeping safety as the main objective.

(l-r) Members of the Xi Rho Omega Chapter of Alpha Kappa Sorority, Inc. are one of the local groups that supports Vidant Roanoke- Chowan Hospital Cancer Care Services through their donations.

Community outreach, education and early intervention 2020 Virtual Cancer Event Vidant Bertie, Vidant Chowan and Vidant Roanoke-Chowan hospitals teamed up to provide speakers from each hospital to develop the hospital’s first ever virtual community education event in October 2020. Facebook Analytics reports that the 45-minute Cancer Care event reached 232 visitors with over 430 views at the time this report was printed and will remain available for viewing and as source of reference on each of the three regional hospital Facebook pages. Jerry Futrell, Cancer Care patient, talks with Rhonda Overton, RN, Cancer Care Navigator, about his plan of care.

7 When I had Covid, Dr Liles Rebecca Farmer called me about getting an infusion to help me feel better. . . . A patient’s story When I got there that day, I was very happy to see MY My journey began back in 2019 when I was referred to the nurses. Tiffany Johnson was gastroenterologist. To my surprise, they found protein in my the nurse that took care of blood work, which was not normal. From there I was sent to me. She started my IV, got me Dr. Abdallah who did a bone marrow biopsy. Dr. Abdallah straight, and explained every- diagnosed me with myeloma in July of 2019. He said I could thing about the medicine. get all my treatments in Ahoskie so I would not have to Before I left I was feeling a little travel back and forth to Greenville. I will admit that I was very better and was even able to nervous, I had not even thought about being diagnosed with get up by myself, even though cancer much less receiving treatments in Ahoskie. I have had Tiffany told me to call her. several visits and procedures at Vidant Roanoke Chowan, I In a couple of days I felt a lot better thanks to the infusion had my last baby there, a cyst removed from my breast, my [Bamlanivimab]. When I went in for the next round of chemo, gallbladder removed, and I was even born there. I asked Dr. I told Linda (Vaders) “that girl needs a gold star”. Abdallah if I wanted to could I return to him. He said that if I felt as though I needed or wanted to come back to Greenville I’ve never had a bad experience while I was at that hospital. I after meeting the Ahoskie team, he would make me an know they have other patients but they treat me like a queen. appointment. When I found out that my appointment was They are mighty special and I think the world of all of them. with Dr. Son, the Lord verified that he was sending me to the They are angels, every single one of them. Everyone has taken best. I felt a peace come over me and I knew I was going to such good care of me; they are a true blessing. be just fine. I am a red bird person… I just love cardinals. The last time I On my first visit with Dr. Son I could tell that he was knowl- went to my chair to get my infusion, there was a cardinal right edgeable, intelligent, and very up to date. He was all business there waiting for me in the garden. I sat back in my chair and ensuring that everything that needed to be done was taken listened to him sing through the window. He touched me; I care of. My next visit I met Linda Vaders, Nurse Practitioner. felt like the Lord put the red bird there for me to see. She was so down to earth, it made me feel as though I can It has been a tough experience but a wonderful one at the ask her anything. I’m comfortable opening up to her and same time. I love everything about Vidant Roanoke Chowan telling her anything that I am going through. I think of her like Hospital. They are super nice, understanding, and helpful. On a member of my family. I can call her at any time and tell her a scale of 1-10, they are beyond the number 10 in my book. I how I feel and she will listen. If she isn’t available right then, am thankful that Dr. Abdallah sent me to have my treatment she quickly calls me back and helps me. She is a very easy in Ahoskie, otherwise I would have never known the care that person to talk with. is provided right here. During my work up by Dr. Son and Linda, I developed pain Beyond what I have already said, the center is local and I can in my leg, and was found to have a blood clot. After this was be there within 15-20 minutes. I don’t have to travel. I know I treated, I was told I would need radiation for my cancer. I was will be well taken care of and loved while I am there. They are sent to the radiation center across the street. Those girls were always glad to see you, glad to help you. They are warm, lov- wonderful. They are the best group of young ladies that work ing people. They all want you to get well, and live life the best there. I go back and visit them even now just to see how they you can while you are here. are doing. The Lord really put me in the right places to get the best care. I am proud to say that I have not had any protein in my blood in over a year, therefore no sign of cancer. This gives me more I have been in the hospital at Vidant Roanoke-Chowan time to enjoy my family because family is so important. I am Hospital on several occasions since I was diagnosed. I was looking forward now to a trip to Florida to see my sister. in the hospital on my birthday last year in 2020. I have been a patient on the ED, second floor and third floor and have Every day we have choices; I choose to remember all the never had a bad experience. There were times while I was good things in life. If you just listen to that small voice, He will in the hospital that I was so sick, I honestly didn’t think I was guide you. going to make it. If you don’t think the Lord doesn’t provide for you - He provides everything!

8 year. Over 100 data requests were provided for research and Monitoring and reporting outcomes outcome studies. Data for these studies include: county-based data, follow up, and annual case load statistics. Hospital specific Cancer Registry case totals and other information were reported for Vidant A cancer registry is a data system for the collection, manage- Medical Center, Vidant Edgecombe, , ment, and analysis of data on persons with a cancer diagno- and Vidant Beaufort hospitals. sis. Vidant Roanoke-Chowan Hospital’s (VROA) cancer registry accesses over 130 cases annually. The Vidant Health nine Cancer registry data is utilized to report standard compliance to hospitals combined accession over 4,000 cases annually. The the American College of Surgeons Commission on Cancer for top five sites diagnosed and treated at VROA are breast, lung, accreditation purposes. The cancer registry reports annually the prostate, colorectal, and uterine/cervical cancer. National Cancer Data Base (NCDB) and monthly to the North Carolina Central Cancer Registry. Data reported to the NCDB The Cancer Registry Team is used in the Cancer Programs Cancer Profile Practice Profile The registry team consists of a Supervisor, Assistant Reporting tool in order to monitor the facilities compliance Supervisor, four oncology data abstractors, three of which with national standard treatment guidelines of care. are Certified Tumor Registrars (CTR’s), and one follow up analyst. A Certified Tumor Registrar is a nationally certified Rapid Quality Reporting System (RQRS) data collection and management expert with the training Vidant Roanoke-Chowan Hospital was accredited by the and specialized skills to provide the high quality data required Commission on Cancer as an Accredited Cancer Program in in all avenues of cancer statistics and research. They review, December, 2020. VROA participates in the American College interpret and capture a complete summary of patient history, of Surgeons Commission on Cancer Rapid Quality Reporting demographic, diagnosis, staging, treatment modality and System (RQRS) which has recently transformed to the Rapid follow-up information. They also provide a valuable service to Cancer Reporting System (RCRS). The objective of the RQRS the hospital and public health professionals in determining and RCRS is to promote and facilitate evidence-based cancer needs in the community for resources for cancer prevention, care at Commission on Cancer accredited cancer programs. diagnosis and treatment services in order address the cancer The RCRS serves to assess compliance with six National burden in . Cancer registrars provide Quality Forum-endorsed quality performance measures for a valuable service leading to better monitoring of trends, breast and colon cancers. Participation in RCRS provides the designing and evaluating programs and providing data for VROA cancer program with real-time clinical alerts for indi- cutting-edge research. vidual cases in which pending adjuvant treatment has not yet been reported to the system. These alerts were developed Data usage to provide a warning system for cancer programs to prevent Cancer registry data is used continuously throughout the patients from “slipping through the cracks.”

2019 selected cancer sites (most current available data)

Vidant Roanoke Chowan Hospital North Carolina National Primary site Cases Percent Cases Percent Cases Percent Breast 31 22.5% 8,870 15.1% 268,600 15.2% Lung 27 19.6% 8,010 13.6% 228,150 12.9% Prostate 13 9.4% 7,490 12.8% 174,650 9.9% Colorectal 10 7.2% 4,310 7.3% 145,600 8.3% Bladder 2 1.4% 2,490 4.2% 80,470 4.6% NH Lymphoma 4 2.9% 2,220 3.8% 74,200 4.2% Corpus uteri 4 2.9% 1,960 3.3% 61,880 3.5% Melanoma 0 0.0% 3,550 6.0% 96,480 5.5% Leukemia 3 2.2% 1,960 3.3% 61,780 3.5% Cervix 5 3.6% 410 0.7% 13,170 0.7% All others 39 28.3% 17,420 29.7% 557,470 31.6% Total cases 137 100.0 55,130 100.0 1,762,450 100.0 9 Scope of services Vidant Roanoke-Chowan Hospital Cancer Care • Hematology and Oncology • Vidant Radiation Oncology - Ahoskie Programs and services • Animal Therapy • Behavioral Health • Cancer Conference • InPower cancer survivorship and exercise programs • Infusion suite/chemotherapy bay • Nutrition counseling • Pharmacy Radiology services • 3D Mammography • Bone density • CT • Diagnostic radiography with Vicki Dale, Cancer Care patient, listens as Jennifer Stallings • MRI RN, Cancer Care Services, explains in detail what she can • Nuclear Medicine expect during her treatment process. • PET/CT • Ultrasound Rehabilitation therapy • Physical therapy • Speech therapy Referral services • Clinical trials • Genetic Counseling

10 Vidant Roanoke-Chowan Hospital is fully-accredited by The American College of Surgeons Commission on Cancer! Dear Cancer Program:

“The Commission on Cancer (CoC) would like to extend its congratulations to the cancer program at Vidant Roanoke Chowan Hospital for submitting deficiency resolution(s) and achieving full accreditation status after its most recent CoC site visit.” As you may recall, VROA had our site visit December 21, 2020, and as with most things in life, no one is perfect. This was our first CoC survey at VROA. A small deficiency was identified and we worked through said deficiency. Here are a few words, from Kasey Pearce, RN Nurse Manager: “I am so excited to share that VROA has received full accreditation through the Commission on Cancer. I am thankful for our team and their hard work and dedication throughout this process. To me, achieving this accreditation has never been about the accreditation itself, its’ beyond any one thing, it truly speaks to the amazing team that we have here at VROA and the work they do every day for our patients and our community with every interaction. Thriving in our Vidant Mission, Vision and Values every day. I am beyond proud that I am part of such an amazing group of individuals. I am thankful for Dr. David Lingle’s vision for our cancer center. I never thought that our “rural little hospital” could not only pursue, but could achieve accreditation.”

Thank you, for those words Kasey. I could not agree more! I applaud you, Dr. Lingle, the entire VROA Cancer Committee, as well as the host of team members and physicians, who have contributed to this achievement! As you’ve reflected, becoming accredited is a wonderful achievement. It also means, our patients are receiving improved care coordination, which can have a positive impact on their cancer journey. Again, I am SO VERY PROUD of all of you! You guys are AWESOME!!! With heartfelt gratitude,

Judy Bruno, MBA, BSN, RN, NE-BC, FACHE President, Vidant Roanoke-Chowan Hospital

11 Your Vidant Roanoke-Chowan Hospital Cancer Care team members

Front Cover: (top) Dr. Chang (Chase) Son, Medical Oncologist (bottom) Linda Vaders, Nurse Practitioner and Ann Marie Munford, RN.

500 S Academy Street Ahoskie, NC 27910 21-RCH-500 06/21 VidantHealth.com