Genesis Cancer Care Institute 2009 Annual Report
Vision: Genesis will be a national leader in health care quality and safety, recognized by all as the best place in the region to receive care … practice medicine … and work.
Accredited by: www.genesishealth.com Table of Contents a message from the director
By Sally Werner, Director, Genesis Cancer Care Institute about Genesis Cancer Care Institute
Summary of Services clinical research
By: Kim Turner community outreach
By: Kim Turner, Linda Rymars Screenings, Health Fairs, Support Services National Breast and Cervical Cancer Early Detection Program Iowa Breast and Cervical Cancer Early Detection Program Scott County Breast and Cervical Cancer Early Detection Program National Breast and Cervical Cancer Prevention & Treatment Act The Voucher Program cancer registry narrative report
By: Dee Westfall Supporting our Institute with Data .Genesis Davenport - Top ten Sites – Stage at Diagnosis: Year 2008 .Genesis Davenport - Distribution by State/County: Year 2008 .Genesis Davenport – Sex by Age at Diagnosis & Sex by Stage: Year 2008 .Genesis Davenport – Primary Site Table: Year 2008 .Genesis Illini– Primary Site Table: Year 2008 site review
Lung Carcinoma cancer committee members 2009 A message from the director
Welcome to our 2008-2009 annual report. Below is a message from the Genesis Cancer Care Institute Program Director, Sally Werner:
Dear Readers,
As we review another incredible year of accomplishments in 2009 I reflect on how far we have come and look forward to the future of our ongoing growth of services and treatment offerings! Some of our advances are described Sally Werner, RN, BSN, MHSA below: Director , Genesis Cancer Program
. The introduction of the Varian Trilogy with BrainLAB Exactrac Robotics. In March of 2009 Genesis became one of only a few hospitals in the nation to offer this technology. This provides the Genesis Cancer Care Institute with the best methods for treating the widest variety of cancers with radiation delivered with sub-millimeter accuracy. This combined technology means that clinicians can see what they treat in real time. Trilogy offers the highest dose rate in a shorter session, the ability to target small lesions, imaging to position patients quickly and accurately, and CT to fine tune patient set ups with ultra-precision. The versatile Trilogy system delivers 3D conformal radiotherapy, IMRT, stereotactic radiosurgery, fractionated stereotactic radiation therapy, and intensity-modulated radiosurgery for cancer and neurosurgical treatment. We continually strive to ensure patients receive the best technology and the most comfortable care.
. The expansion and relocation of our Infusion Center. While more and more patients are discovering the world-class treatment options we offer right here in the Quad Cities, we are expanding to meet their growing needs! We doubled the size of our outpatient infusion center and re-located it to the second floor of Pavilion 1 on our West Campus. The new area has larger patient and family member seating areas and activities and each spacious treatment bay has comfortable recliners, individual TV's, and offers privacy, if desired, or the opportunity for conversation with neighboring patients, if preferred. Our outpatient infusion area continues to work closely with the inpatient infusion suite to offer the option of infusion services 24 hours a day 7 days a week.
. Launch of an Oncology Rehabilitation Center. With renovations, a new oncology rehabilitation center is now located within the Cancer Care Institute and offers comprehensive rehabilitation services including: lymphedema care, physical therapy, occupational therapy, speech therapy, and massage therapy. Our rehab services will strive to empower our patients, during their cancer treatment and beyond, with high quality physical support. The oncology rehabilitation center helps patients regain function lost to cancer and its treatments and is conveniently located down the hall from radiation therapy and directly below the infusion center. http://www.genesishealth.com/news/2009/rehabilitation-for-cancer-patients.aspx . Initiation of a world class Nurse Navigation program. Nurse navigation of cancer patients has emerged in the United States over the last decade as a response to the compllexiity of cancer management through a “contiinuum of care.“. Patients and families can easily be overwhelmed with information provided and have difficulty getting to the right place at the right time. Navigators are guides, supporters, and communicators, who work to smooth the pathways for patients and families as they face the challenges of cancer diagnoses. The Genesis Cancer Care Institute understands that care coordination is key to the support of our patients and the quality of their care.
. Offering of minimally invasive DaVinci Robotic Surgery for Prostate and Colorectal Cancers. da Vinci is a breakthrough surgical technology that offers a minimally invasive option for removal of cancer. da Vinci offers the benefits of surgical removal with significantly less pain, a shorter hospital stay, faster return to normal daily activities and the potential for a better clinical outcome.
. Installation of Automated Breast Ultrasound at the Center for Breast Health. Genesis is the first in the region and one of only a few sites in the country to install this breast cancer detection enhancing equipment. Combine the known benefit of ultrasound for breast cancer diagnosis with an automated image acquisition tool that can simplify the ultrasound process and you have what some radiologists describe as "icing on the cake."
. Expanded Oncology Support Services including: social services, nutrition, pastoral care, added outreach and screening programs, and a cancer survivorship program. All of these services are located within the "one stop shop" Genesis Cancer Care Institute! I would like to highlight the importance of our outpatient oncology dietitian program for our cancer patients as we "build them up" for treatment and support their nutrition goals during and after treatment.
. Partnership with the Satva Center and addition of "CAM" classes to our monthly calendar. As we continue to add top notch technology and state of the art support services it is a natural progression to add classes for our patients and their families. The Genesis Cancer Care Institute has recently formed a partnership with the Satva Center to offer Complementary and Alternative Medicine classes including Yoga, Tai Chi and Meditation. These courses are beneficial to the overall wellbeing of our patients and their families and help ease the stress and anxiety of treatment. The calendar can be found in each of our treatment areas and on-line at www.genesishealth.com/services/cancer
. Cancer Survivor Celebration with "Oncology on Canvas", Camp Genesis, Haircuts for Hope are just a few of the outstanding events held by the Genesis cancer team this year to give back to our patients and the community. http://www.genesishealth.com/news/2009/oncology-on-canvas.aspx
The entire Cancer Care Team at Genesis looks forward to exceeding our patient expectations in 2010 and beyond. Please feel free to contact me at any time with feedback and suggestions on how we can continue to enhance cancer services at Genesis and be your cancer team of choice: [email protected]
Kind Regards, Sally Werner Genesis Cancer Care Institute Summary of Services
Accessible locations and hours:
Center for Breast Health 1228 East Rusholme, Suite 210, Davenport - 563-421-3200, press 1 - Hours – Monday through Friday, 7:30am – 4:30pm 4017 Devils Glen Road, Bettendorf - 563-421-3200, press 1 - Hours – Monday through Friday, 8:00am – 4:00pm 801 Illini Drive, Silvis, IL - 563-421-3200, press 1 - Hours – Monday through Friday, 7:00am – 4:00pm Saturday, 7:00am - Noon 1118 11th Avenue, DeWitt – 563-659-4270 - Hours – Monday, Wednesday, Friday, 7:30am – 3:30pm No weekend hours unless stated above, no emergency services available
Infusion Center – 1351 West Central Park – Pavilion I 563-421-1903 Hours – 7 days a week; 24 hours a day
Oncology Inpatient Unit – 1401 West Central Park, Floor 3E 563-421-2360 Hours – Open 7 days a week, 24 hours a day
Radiation Oncology - 1351 West Central Park – Pavilion I 563-421-1900 Hours – Monday through Friday, 8:00am – 4:30pm 24 hour emergency/MD paging service
Oncology Rehabilitation – 1351 West Central Park – Pavilion I 563-421-1470 Hours – Monday through Friday, 8:00am – 4:30pm
Administrative Office – 1351 West Central Park – Pavilion II – 421-1909 Hours – Monday through Friday, 7:30a – 4:00pm
Gilda’s Club – 1401 West Central Park - Pavilion II 563-421-1917 Hours – Monday, Tuesday, Thursday, 8:30am-Noon; Wednesday, 1:00pm-4:30pm
Susan G. Komen Q.C. Affiliate - 1401 West Central Park - Pavilion II 563-421-1915 Hours – Tuesday and Wednesday, 8:30am – 2:00pm
The American Cancer Society - 1401 West Central Park - Pavilion II 563-421-XXXX Hours – Mondays, 8am - Noon
www.genesishealth.com/services/cancer
Staff Oncology Certified Nurses (OCN) – This achievement reflects dedicated time and effort spent building the qualifications and knowledge to meet the Oncology Certified Nurse competency standards and demonstrates their personal commitment to quality cancer care. Genesis has OCN nurses in both our inpatient and outpatient areasl.
Oncology Dietitian – Registered Dietitians offer nutritional counseling Amanda and support to both inpatients and outpatients as part of maintaining Wilson health and well being during active cancer treatment and afterward. MA, RD, LD Amanda can be reached at 563-421-1953.
Research Nurse – A registered nurse who is nationally credentialed as an Oncology Nurse assists in all aspects of the clinical trials process. Genesis participates in clinical trials with: National Cancer Institute Cooperative Clinical Trials Groups . Southwest Oncology Group (SWOG) Kim Turner, . National Surgical Adjuvant Breast and Bowel Project RN, MSN, (NSABP) OCN . American College of Surgeons Oncology Group (ACOSOG) . Cancer Trials Support Unit (CTSU) . Pharmaceutical Industry Studies Kim can be reached at 563-421-1908. Susan Williams, Oncology Social Worker –Social Workers are involved in the care of LISW our oncology patients. Oncology Social Workers have a Masters degree in social work and are trained in individual and family counseling. They provide a broad range of services including emotional support, coping skills, cancer education and advocacy. Ruth Laabs- They also assist with financial concerns, home care services, Wilcox, transportation, long-term care, and other community resources. LMSW Susan can be reached at 563-421-1082. Ruth can be reached at 563-421-1086.
Oncology Rehab – Lymphedema Management Program. Lymphedema, a complication of Chris cancer treatment, is an accumulation of lymphatic fluid and may cause Beuthin, PT, swelling mainly in the arm or leg. The goal of the program is to help GCS, CLT decrease swelling and allow for the patient to manage their condition through use of light manual lymphatic massage, bandaging, remedial exercise and skin care. Oncology rehab services also include physical therpay, occupational therapy, speech and massage therapy for patients. Chris can be reached at 563-421-1470. Bobbi Rudiger, Spiritual Care Support – Staff chaplains are available to personally Chaplain minister to patients and their families and friends. Bobbi can be reached at 563-421-1954 or 421-1909.
Oncology Program Coordinators – These nurses provide patient Wendy navigation and coordination of care and serve as a primary point of Ballou. contact for patients throughout the cancer care continuum, Wendy RN, BS, OCN,CCM Ballou can be reached at 563-421-1030. Chris Kuehl can be reached at 563-421-1029. Chris Kuehl, RN Medical Oncologists on Staff
Iowa Cancer Specialists (563-421-1960) George Kovach, M.D. David Mercer, M.D. Susannah Friemel, M.D.
Hematology and Oncology Associates (563-355-7733) Shobha Chitneni, M.D. Mario Sy, M.D. Jose Ness, M.D.
Hematology & Oncology Care (563-359-9876) Costas Constantinou, M.D.
Brahma Konda, M.D. (309-792-6770)
Outpatient Infusion Services – NEW LOCATION: 2nd floor – Pavilion I
Adult patients requiring parenteral therapies on an outpatient basis including, but not limited to: transfusions of blood products, hydration IV’s, parenteral pain management therapies, Antineoplastic chemotherapies, administration of parenteral antibiotics, management of central lines (ports, passports, Hickman catheters, Groshong catheters), phlebotomy for labs as well as therapeutic phlebotomy, insertion and care of PICC catheters and patients requiring plasmaphoresis exchange procedures.
Radiation Oncologists on Staff
Quint Cities Radiation & Oncology (563-421-1900) Thomas J. Stoffel, M.D. Antonio Vigliotti, M.D. Christina Sharis, M.D.
Radiation Therapy of the Quad-Cities (563-441-1998) Farida Rajput, M.D.
Radiation Oncology Specialists
Radiation oncologist: Consults with patients, establishes and executives treatment, evaluates treatment and follow-up. Physicist: Calibrates radiation oncology equipment and specifications of therapy equipment; performs acceptance testing and QA; measures, analyzes and tabulates beam data; reviews patient charts; provides radiation safety education. Dosimetrist: Plans treatment and calculates dose, measures radiation, assists physicist with quality control testing and other staff with treatment plans. Radiation therapist: Responsible for proper simulation and delivery of radiation, use of equipment, implementation of treatment plan, quality assurance and education. Oncology Certified Nurse: Provides care during the initial consultation, throughout the treatment course, and on a post-treatment basis. They assist patients with managing possible treatment related side effects, and they also coordinate any additional appointments, resources and ancillary support needed.
Radiation Oncology Technology
Tomotherapy Varian Triology with BrainLAB Exactrac CT-based simulation room IMRT/IGRT/SRS 3D Capabilities
Community Outreach
Genesis Cancer Care Institute staff reaches out to the local community to provide education and health screenings for a variety of types of cancer. In 2009 Genesis provided the following free screenings:
Colorectal Screening Skin Screening Pulmonary Screening
The Genesis Cancer Care staff participates in numerous community and company heath fairs throughout each year. Educational materials and one-to-one contact with staff are provided at both screenings and health fairs. Monthly education calendars are now available on our website. www.genesishealth.com/services/cancer
Genesis Cancer Care Institute partners with many other cancer-oriented community groups. These include, but are not limited to:
American Cancer Society . Relay for Life . Look Good/Feel Better Gilda’s Club of the Quad Cities . Week of Laugher Susan G. Komen Quad Cities Affiliate . Q. C. Race for the Cure Tobacco Free Quad Cities Iowa Department of Public Health Quad Cities Symphony Satva Center – Healing Arts, Spiritual Teachings & Retreats, Meditation Practices Haircuts for Hope Haircuts for Hope Local Support Groups Breast, Prostate and Brain
Center for Breast Health Using the latest diagnostic technology and treatments, the Center for Breast Health is dedicated to the care and treatment of women with breast cancer. We remain committed to provide our patients with highly trained technologist and registered nurses. The Center for Breast Health physicians are dedicated to the care and treatment of women’s health in a coordinated effort with both highly specially trained Radiologist and Surgeons.
Digital mammography became available at all locations in October 2007. Digital mammography uses an x-ray beam that is captured on specially designed digital detectors. The digital detector converts the x-ray beams into electronic signals, which are then sent to a computer. The radiologist can review the digital mammogram on a high – resolution computer monitor. Services provided at various locations: Digital Mammography Breast Ultrasound and Automated Ultrasound Breast MRI Breast Biopsy Bone Density Scanning Genetic Screening
The Center for Digestive Medicine
The center was established in 2004 as a joint venture between Gastroenterology Associates, P.C. and Genesis Medical Center. The center provides high quality digestive health care procedures and services including: Open Access Endoscopy Colonoscopy Endoscopy Capsule Endoscopy
Physicians at the Center are: Erling Larson III, MD; David Pratt, MD; William Davidson III, MD; Richard Weyman IV, MD; Young Huh, MD; and Anjana Kumar, MD.
Surgery Specialists
Surgeons that deal with the majority of the cancer diagnosis at Genesis include, but are not limited to:
Davenport Surgical Group, P.C. (563-823-9300) Joseph L. Lohmuller, MD, FACS Michael A. Phelps, MD, FACS Douglas A. Khoury, MD, FACS Matthew C. Christophersen, MD, FACS David J. Aanestad, MD K. John Hartman, MD Robert E. Harson, MD
Chest & Vascular Surgery, PC (563-324-3818) Richard Sadler, MD Genesis Cardiac Surgeons (563-421-3990) Nicholas V. Augelli, MD Robert Fietsam Jr., MD
Genesis Health Group Surgical Associates (309-792-6355) George J. Kontos Jr., MD
Genesis Health Group (309-792-4930) Douglas R. Elliott, MD
Muscatine Medical-Surgical Associates (563-263-4848) Calvin E. Atwell, MD
Urological Specialists
Urologists who treat prostate cancer patients at the Genesis campuses include:
Urology Associates, P.C. of the Iowa and Illinois Quad Cities Region (563-359-1641) Spring Park Surgery Center, LLC is affiliated with Genesis Medical Center Gus H. Harb, MD Thomas C. McKay, MD Mark A. Milleman, MD William C. Mobley, MD David P. Rohlf, MD William Rosen, MD
Urological Group Ltd (309-277-3050) Morris J. Gist, MD Brian P. Engebrecht, MD Roger L. Lubbers, MD
Support Services
Camp Genesis - A specialty camp that is a collaborative effort of Genesis Health System, Gilda’s Club Quad Cities, and the Scott County Family where children and teens directly impacted by a cancer diagnosis in their family may attend a week-long residential camp for free. Campers participate in a lot of fun activities: swimming, horse- back riding, shooting bows and arrows, campfires, and much more. Another unique component to this camp is the opportunity for each child to explore and express through different games and activities how cancer impacts their life in a daily group time with a Gilda’s Club staff or representative. The 2009 Camp Genesis hosted 35 campers.
Cancer Resource Center – An important part of the cancer journey includes seeking information about cancer diagnosis, treatments, and symptom management. The Genesis Cancer Resource Center, located withing the Cancer Care Institute, is a library of information on a multitude of topics. The Genesis website, www.genesishealth.com/services/cancer also includes a wide variety of links in a convenient format, designed for easy navigation.
End of Life – Hospice is specialized care for people at the end of life that treats the physical, emotional and spiritual needs of the central family. These services take place in the patient’s home, nursing home or home-like setting. For more information, please call 563-421-4663.
Look Good, Feel Better - The latest cancer treatments are not always prescribed by doctors. This free program helps cancer patients improve their appearance and self-image by teaching hands-on techniques to overcome the appearance-related side effects of chemotherapy and radiation. For more information, please call 563-421-1907.
Medical Yoga, Tai Chi and Meditation Therapy – These classes are specifically designed to provide a calming therapeutic class that introduces postures and breathing techniques, gradually building flexibility and strength. It is suitableo those with special needs, or who simply want to move at a slower pace.
Satva Center – The Center offers Healing Arts, Spiritual Teachings & Retreats, and Meditation Practices for our patients and their families.
Support Groups – Our support groups and networks provide opportunities for cancer survivors and their loved ones whether newly diagnosed or after years of survival. . Monthly education calendars are now available on our website. www.genesishealth.com/services/cancer
Volunteers – Our volunteers are a very important aspect of our patients social and emotional care and are available in our inpatient and outpatient areas.
Additional Certifications
Genesis Medical Center is accredited by:
American College of Surgeon - Commission on Cancer (ACoS-COC) The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) Magnet Recognition Program Mammography Quality Standards Act (MQSA) Clinical research
Genesis Cancer Care Institute participates in cancer research also known as clinical trials. Clinical trials may test new drugs, new approaches to surgery or radiation therapy, new combinations of treatment, or new methods such as gene therapy or targeted therapy. Local oncologists bring cancer patients advanced medicine by offering clinical trials covering a wide range of areas such as breast, colon, lung, kidney and prostate cancer as well as others. These trials are conducted by recognized research organizations affiliated with the National Cancer Institute and through the pharmaceutical industry. The Genesis research affiliations George Kovach, M.D. with the National Cancer Institute include: Principal Investigator
Southwest Oncology Group (SWOG) through an affiliation with Loyola University Medical Center National Surgical Adjuvant Breast and Bowel Project (NSABP) through an affiliation with the University of Iowa American College of Surgeons Oncology Group (ACOSOG) Cancer Trials Support Unit (CTSU)
Patients receiving cancer care at Genesis Cancer Care Institute have the benefit of participating in state-of-the-art research protocols without leaving the local community.
The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients. Each clinical trial is designed to find new or better ways to treat cancer patients. In oncology, clinical trials are especially important because, in the absence of high cure rates, nearly all therapeutic approaches are the result of clinical trials. A clinical trial is one of the final stages of a long and carefully constructed cancer research process.
Patients are monitored closely by physicians at the forefront of cancer research and may be the first to benefit from new treatments. In addition, both the study’s sponsor and the Genesis Health System Institutional Review Board, a group of people who review research to protect patient rights and welfare, monitor research patients’ safety.
A research or clinical trials nurse is an integral member of the Genesis multidisciplinary team that implements the clinical trials. The research nurse is responsible for teaching the patient about the trial, implementing the physician's orders as described in the protocol and evaluating patient responses and toxicities. Patients who are eligible for a clinical trial and choose to participate are followed closely by the research team and data on their case carefully recorded.
If you would like more information about clinical trials offered at Genesis Cancer Care Institute please call Kim Turner, Cancer Research Nurse at 563-421-1908. You may also find a listing of current clinical trials being offered at www.genesishealth.com/services/cancer . Community Outreach – Screenings, Health Fairs, and Support Services
Genesis Cancer Care Institute staff reaches out to the local community to provide education and health screenings for a variety of types of cancer. In 2008 Genesis provided the following free screenings:
. In March, the colorectal screening using hemoccult testing supported by Walgreen’s and Metropolitan Medical Laboratory. The hemoccult testing is available year round on request. . In May, six local dermatologists provided free skin cancer screenings. . The Genesis Pulmonary Rehab Department provided pulmonary screenings using spirometry at several health fairs and at the Great American SmokeOut in November.
The Genesis Cancer Care staff participates in numerous community and company heath fairs throughout each year. Educational materials and one-to-one contact with staff is provided at both screenings and heath fairs.
Genesis Cancer Care Institute partners with many other cancer-oriented community groups. These include, but not limited to:
. American Cancer Society . Gilda’s Club of the Quad Cities . Susan G. Komen Quad Cities Affiliate . Tobacco Free Quad Cities . Iowa Department of Public Health . Local Support Groups for Breast, Prostate, Brain
For more information regarding cancer screenings and health fairs, please contact Kim Turner, Community Outreach Coordinator, at 563-421-1908.
The National Breast and Cervical Cancer Early Detection Program (BCCEDP) The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) was federally legislated in 1990 and is administered by the Centers for Disease Control and Prevention (CDC). Its goal is to reduce deaths from breast and cervical cancer by providing screening, diagnostic and case management services to eligible women. Program eligibility varies by state within guidelines set by CDC. Client services are provided through contractual relationships with healthcare providers, labs, mammography facilities and hospitals. Genesis Medical Linda Rymars, RN Centers at Davenport, DeWitt and Illini and Genesis Health Group are Coordinator, BCCEDP & Voucher providers for both the Iowa and the Illinois BCCEDP. Programs Currently all states, tribes and territories are funded and in 2007, the federal government assured an additional 5-year commitment to the program. Iowa Breast and Cervical Cancer Early Detection Program (Ia BCCEDP-Care For Yourself)
The Iowa program has been funded since 1993 by a grant to the Iowa Department of Public Health (IDPH). Unlike other states, Iowa receives little state funding to augment the federal funds. Assistance to pay for mammograms and computer aided detection has been provided by the 4 Komen Affiliates in Iowa, either through IDPH directed grants or locally-targeted grants. IDPH currently contracts with 26 Boards of Health for statewide implementation and local program management. Most Iowa coordinators accept women who . are age 40 and over . are under age 40 who have breast symptoms, either self reported or discovered on a clinical exam. . have a self reported income at or below 250% of federal poverty level. . are under-insured or uninsured. Those with Medicaid or Medicare part B are not eligible. . Eligibility is not contingent on US citizenship.
Local programs have the autonomy to modify these guidelines to align their eligibility pool with the IDPH grant funds allotted to their program area. Due to the continued large demand for services and continued funding constraints, the Scott County program continues to limit new client eligibility to women who reside within Scott County and who are between the ages of 45 and 64.
Scott County Breast and Cervical Cancer Early Detection Program (BCCEDP - Care for Yourself - MAPS)
Since program inception in July of 1996, IDPH has contracted with the Scott County Board of Health, who in turn subcontracts to Genesis Medical Center to provide day-to-day program management and coordinate services. Locally, the program is referred to as “MAPS” (Mammograms, Annual office visits and Pap Smears). For several years, Scott County has been the 2nd largest program in Iowa; surpassed only by Polk County.
The local coordinator reports to the Scott County Health Department and the Genesis Cancer Care Institute director. BCCEDP programs throughout eastern Iowa and western Illinois work very closely to coordinate services and transfer clients as state/county residency changes. Much of the success of our program in Scott County is due to the strong relationships built within the community and across the state. We are extremely indebted to our large provider base that has generously agreed to accept program reimbursement for covered services as payment in full.
National Breast and Cervical Cancer Prevention & Treatment Act (BCCPTA)
NBCCEDP legislation does not include provisions for financial assistance for cancer treatment. In December of 2000, congress passed the National Breast and Cervical Cancer Prevention & Treatment Act which provides limited funding to a state’s Medicaid program when the state agrees to accept BCCEDP women for breast or cervical cancer treatment.
National eligibility guidelines mandate that the woman be uninsured, a US citizen, under age 65 and received screening services paid with funds from the BCCEDP. Iowa’s BCCPTA also includes women who had breast related screening or diagnostic services paid by a Komen funded program. At the current time, Women in Iowa and Illinois receive full Medicaid benefits under the BCCPTA, not just coverage for their cancer care.
BCCPTA is one of two Medicaid options that the Iowa legislature has permitted to have access to Presumptive Eligibility (PE). PE allows women immediate, temporary access to Medicaid benefits. The Scott County BCCEDP coordinator, as an agent for Genesis Medical Center, an authorized PE Medicaid provider, processes BCCPTA applications for women from throughout eastern Iowa. Referrals are then made to the Department of Human Services when Medicaid coverage is needed beyond the PE time limit.
The Voucher Programs Funded by a grant from Susan G. Komen for the Cure-Quad Cities Affiliate Programs administered by Genesis Medical Center, Davenport, Iowa
Genesis Medical Center holds a grant from Susan G. Komen for the Cure-Quad Cities Affiliate for administration of a program whose primary purposes are to promote early detection and to eliminate cost as a barrier to receiving mammography screenings. The VP has been in place under this arrangement since January 1, 2001.
The program covers mammograms, screening or diagnostic; computer aided detection associated with mammography; breast ultrasound, manual or automated and 3D image reconstruction associated with automated ultrasound.. Services continue to be provided by imaging facilities and radiologists throughout the service area who agree to accept program reimbursement as payment in full. Reimbursement continues to be based on Iowa Medicare part B rates and may vary annually according to available funding and demand for assistance.
Depending on the annual grant allocation and the cost of and anticipated demand for services, persons diagnosed with breast cancer are given assistance for selected products. Currently included are wigs and wig care kits, mastectomy bras and camisoles, breast prostheses and lymphedema precaution medical alert bracelets. Product providers work with the VP to provide these items at little or no cost to patients.
Currently, the only eligibility guideline is that the voucher recipient resides within the 8 counties of the Affiliate’s service area and have a self-reported need for assistance.
For more information regarding accessing the Breast and Cervical Early Detection Program or the Voucher Program, please contact Linda Rymars, Program Coordinator, at 563-421-7620. Cancer registry narrative report
The Cancer Registry at Genesis Medical Center is under the management and direction of the Cancer Committee. The reference date of the Genesis – Davenport campus registry is January 1, 1979. Future development of the Genesis Illini campus program is underway, which will involve accrediting the facility through the Commission on Cancer. Dee Westfall, CTR In 2008, 1167 new cases were abstracted; 856 of those cases where Cancer Registrar analytic cases with initial diagnosis and/or first course of treatment done at Genesis – Davenport campus. An additional 311 cases were non-analytic cases of recurrent and progressive disease diagnosed and initially treatment at another facility.
Another 176 new cases were abstracted at Genesis – Illini campus in 2008. Of those, 160 were analytic cases.
The Registry gathers information that identifies characteristics of cancer patients seen at GMC. Data collected on patients diagnosed with cancer include, but is not limited to: demographics, primary site, histology, diagnosis, stage of disease, treatment modalities and lifelong follow-up. All information recorded in the registry is maintained on a confidential basis and is reported to the State Health Registry of Iowa (SHRI) and the National Cancer Database (NCDB). SHRI is a member of the Surveillance, Epidemiology and End Results (SEER) programs, sponsored by the National Cancer Institute (Contract No. N01-CN-05229). The Health Registry also provides help with the follow-up of cancer patients, data collection training, quality control and continuing education programs.
The top five sites seen at GMC were breast, lung, colorectal, prostate, and Non- Hodgkin’s Lymphoma. The table below shows the top ten sites, which have the greatest impact on care at Genesis – Davenport campus.
Site Total Analytic Non- Male Female Cases Analytic Breast 277 227 50 2 275 Lung 171 142 29 98 73 Colorectal 116 92 24 54 62 Prostate 116 80 36 116 -- Non-Hodgkin’s Lymphoma 67 37 30 38 29 Melanoma 44 34 10 31 13 Kidney 40 32 8 29 11 Leukemia 38 17 21 20 18 Pancreas 32 24 8 15 17 Thyroid 30 28 2 6 24
The following graphs show distribution of cases by state/county, sex by age and sex by stage. Distribution by State/County – 2008 Cases
GenesisMedical Center - Davenport Campus Distribution by State/County - 2008 Cases
Ot her 11%
Cl i nt on - I A 6%
Muscatine - IA 7%
Rock Island - IL Scot t - I A 13% 63%
Male vs Female by Age at Diagnosis – 2008 cases
Genesis - Davenport Campus Male vs Female by Age at Diagnosis - 2008 Cases
30% Male Female 25%
20% s e s a C
f o
e 15% g a t n e c r e
P 10%
5%
0% <40 40-49 50-59 60-69 70-79 80-89 >90 Age Distribution Male vs Female by Best Stage – 2008 Cases
Genesis - Davenport Campus Male vs Female by Best Stage - 2008 Cases
4 5 % Male Female 4 0 %
3 5 %
3 0 %
2 5 %
2 0 %
15 %
10 %
5 %
0 % Stage0 StageI StageII StageIII StageIV
S t a ge Genesis – Davenport - 2009 annual report primary site table based on 2008 statistics
Primary Site Total A N/A Primary Site Total A N/A Cases Cases ALL SITES 1,167 856 311 Female Genital 45 29 16 Oral Cavity/Pharynx 14 9 5 Corpus Uteri 29 20 9 Digestive Organs 190 143 47 Ovary 10 5 5 Anal/Anus 7 5 2 Other Female Genital 3 3 0 Colon 90 73 17 Male Genital 124 81 43 Esophagus 11 5 6 Prostate 116 80 36 Liver/Intraheptic Bile 8 6 2 Other Male Genital Organs 8 1 7 Pancreas 32 24 8 Urinary Tract 62 51 11 Rectum/Rectosigmoid 26 19 7 Bladder 20 17 3 Stomach 8 6 2 Kidney/Renal Pelvis 40 32 8 Other Digestive Organs 8 5 3 Other Urinary Tract 2 2 0 Respiratory/Intrathoracic 182 145 34 Eye/Brain/Other 26 23 3 Larynx 8 4 4 Brain 15 12 3 Lung/Bronchus 171 142 29 Other Nervous System* 11 11 0 Other Respiratory Organs 3 2 1 Thyroid/Other Endocrine 32 29 3 Blood/Bone 53 24 29 Thyroid 30 28 2 Leukemias 38 17 21 Other Endocrine 2 1 1 Myeloma 15 7 8 Lymph Nodes 70 39 31 Skin (exclude Basal & 48 36 12 Hodgkin’s Disease Nodal 3 2 1 Squamous) Melanoma 44 34 10 NHL Nodal/Extranodal 67 37 30 Other Nonepithelial Skin 4 2 2 Miscellaneous 41 15 26 Soft Tissue (Including Heart) 5 3 2 * Includes benign and borderline Primary Intracranial, CNS, & Eye Breast 277 227 50 Genesis – Illini - 2009 annual report primary site table based on 2008 statistics Primary Site Total A N/A Primary Site Total A N/A Cases Cases ALL SITES 176 160 16 Female Genital 8 7 1 Oral Cavity/Pharynx 5 5 0 Corpus & Uterus 5 4 1 Digestive Organs 25 25 0 Other Female Genital 3 2 1 Colon 16 16 0 Thyroid & Other Endocrine 6 6 0 Rectum & Rectosigmoid 5 5 0 Male Genital 28 17 11 Other Digestive Organs 4 4 0 Prostate 22 12 10 Respiratory/Intrathoracic 28 27 1 Other Male Genital Organs 6 5 1 Lung/Bronchus 25 24 1 Urinary Tract 24 23 1 Other Respiratory Organs 3 3 0 Bladder 15 14 1 Skin (exclude Basal & Squamous) 8 8 0 Kidney/Renal Pelvis 9 9 0 Melanoma 8 8 0 Lymph Nodes 8 8 0 Breast 29 28 1 NHL Nodal/Extranodal 8 8 0 Miscellaneous 7 6 1 A = Analytic (Cases diagnosed and/or treated at Genesis) N/A = Non-analytic (Cases diagnosed and treated at physician’s office only, or cases where 1st course of treatment has been performed elsewhere, and now present at Genesis for additional treatment) Lung Cancer Site-Specific Study
According to the American Cancer Society’s (ACS) Cancer Facts and Figures 2009, it is estimated that 219,440 new cases of lung cancer will be diagnosed in the U.S.; 116,090 men/103,350 women. Approximately 159,390 people will die; 88,900 men/70,490 women.
Lung cancer is the leading cause of cancer death for both women and men. The average age of people found to have lung cancer is sixty.
Risk Factors - One of the specific aims of this study was to assess the documented risk factors, if any for each patient. As shown on the chart below, smokers or past smokers make up the highest number of patients diagnosed with lung cancer.
ACS studies show these risk factors can increase the chances of lung cancer:
Smoking 2nd hand smoke Radon Asbestos Certain metals (Chromium, cadmium, arsenic) Organic Chemicals Radiation Air Pollution History of tuberculosis
Symptoms - Common signs and symptoms for lung cancer may include:
Cough Sputum streaked with blood Chest pain Voice changes Recurrent pneumonia or bronchitis
Screening/Early Detection - Screening for early lung cancer detection has not yet been proven to reduce mortality. Newer test, such as the low dose spiral computed tomography (CT) scan and molecular markers in sputum, have produced promising results in detecting lung cancer at an earlier stage. At this time, there is no standard of care for the screening of lung cancer. The National Lung Screening Trial (NLST) funded by the National Cancer Institute, with testing being completed in Iowa City. The trial is to assess whether screening individuals at high risk for lung cancer with spiral CT or standard chest x-ray can prevent lung cancer deaths. The results of this study are expected by 2010-2011.
Clinical Trials - As noted on the National Cancer Institute (NCI) website, a clinical trial is one of the final stages of a long and careful cancer research process. Studies are done with cancer patients to find out whether promising approaches to cancer prevention, diagnosis, and treatment are safe and effective. At the time of this study, the clinical trials open at Genesis Medical Center for lung cancer patients who meet criteria as of June 2009 are: ACO1L08 (Industry): A Multi-Center Randomized Phase 2b Study of Cetuximab (Erbitux) in Combination with Platinum-Base Chemotherapy as First Line Treatment of Patients with Recurrent or Advanced Non-Small Cell Lung Cancer (NSCLC) SWOG S9925: Lung Cancer Specimen Repository Protocol, Ancillary SWOG E5597: Phase III Chemoprevention Trial of Selenium Supplementation in Persons with Resected Stage I Non-Small Cell Lung Cancer (NSCLC) SWOG S0424: Molecular Epidemiology Case-Series of Non-Small Cell Lung Cancer in Smoking and Non-Smoking Women and Men (Male and female smoker strata closed 7/15/07) SWOG S0720: Phase II ERCC1 and RRM1-Based Adjuvant Therapy Trial in Pts with Stage I Non-Small Cell Lung CA (NSCLC) CTSU E1505: Phase III Randomized Trial of Adjuvant Chemo with or without Bevacizumab for Pts with Completely Resected Stage 1B (>4 cm) –IIIA Non-Small Cell Lung Cancer N0723 MARVEL: Marker Validation of Erlobtinib in Lung Cancer – Phase III Biomarker Validation Study of Second-Line Therapy in Pts with Advanced Non-Small Cell Lung Cancer (NSCLC) Randomized to Pemetrexed vs Erlotinib
Lung cancer was the second most common cancer treated at Genesis Medical Center in 2008. Genesis continues to see about the same number of lung cancers as we have in previous years. The average number of lung cancers treated in our institute in the last ten years was 150. The ratio of male to female patients in 2004 showed that GMC ratio was higher for males that the NCDB2004, 59% to 52%. The 2006 NCDB data, which is the most recent available, shows about the same percentage by gender when compared to GMC2008.
GMC data showed that in 2004 the highest percentage of patients diagnosed with lung cancer were age 60-69, which was substantially higher that NCDB statistics. But when comparing GMC2008 to NCDB2006 the most diagnosed age group was 70-79, with a 1% difference.
GMC data showed that in 2004 the highest percentage of patients diagnosed with lung cancer were age 60-69, which was substantially higher that NCDB statistics. But when comparing GMC2008 to NCDB2006 the most diagnosed age group was 70-79, with a 1% difference.
Age Distribution Genesis Medical Center Analytic Cases Comparison GMC 2004 - NCDB 2004 &GMC 2008 - NCDB 2006
4 5 % GMC2004 4 0 % NCDB2004 GMC2008 3 5 % NCDB2006 3 0 %
2 5 %
2 0 %
15 %
10 %
5 %
0 % <39 40-49 50-59 60-69 70-79 80+ Comparison of stage at diagnosis statistics shows that both GMC and NCDB continue to be diagnosing lung cancers at late stage (Stage III and Stage IV). Researchers continue to work on ways to make early lung cancer detection possible.
Stage of Disease at Diagnosis Genesis Medical Center Analytic Cases Comparison GMC2004 - NCDB2004 & GMC 2008-NCDB2006
6 0 % GMC2004 NCDB2004 GMC2008 5 0 % NCDB2006
4 0 %
3 0 %
2 0 %
10 %
0 % Stage0 StageI StageII StageIII StageIV Unk
A review of smoking history was done for GMC 2004 to GMC 2008. Comparison data is not available through the NCDB. The percentage of current smokers who have been diagnosed with a lung cancer seems to be on the decrease.
Smoking History Comparison 2004 to 2008 GMC - Analytic Cases
60% 2004 2008 50%
40%
30%
20%
10%
0% Smoker Prior Smoker Never Smoked A comparison of 1st course of treatment was completed. In review of the GMC2008 data to the NCDB2006 data, the national average for patients who do not receive any type of therapy is almost 20%, but 28% of GMC patients did not receive 1st course therapy after being diagnosed. GMC also shows a decrease in patients receiving both radiation and chemotherapy over both GMC2004 data and the NCDB data.
1st Course of Treatment Genesis Medical Center Analytic Cases Comparison GMC2004 - NCDB2004 & GMC2008-NCDB2006
NCDB2006 S urg e ry GMC2008 NCDB2004 R ad GMC2004
C he mo
S urg / C he mo
R T/ C he mo
Other specified Ther
N o Tx t
0% 5% 10% 15% 20% 25% 30% 35% Awaiting survival data from State Health Registry – requested 8/5/09
Survival data is provided by the State Health Registry of Iowa.
Lung Cancer Patient Care Evaluation GMC - Analytic Cases 5 year Observed Survival Rates - Year 1999-2005
45% State of Iowa
40% Genesis
35%
30%
25%
20%
15%
10%
5%
0% All stages Stage I Stage II Stage III Stage IV Unk As published in the 2009 Cancer Facts and Figures: “The 1-year relative survival for lung cancer increased from 35% in 1975-1979 to 41% in 2001-2004, largely due to improvement in surgical techniques and combined therapies. However, the 5-year survival rate for all stages combined is only 15%. The 5-year survival rate is 50% for cases detected when disease is still localized, but only 16% of lung cancers are diagnosed at this early stage.”
Conclusions
The highest amount of patients seen at GMC for a lung cancer diagnosis in the past ten years was in 2001; lowest number in 2004. Average is 150 patients. Gender distribution when comparing GMC2008 and NCDB2006 is about the same. In 2004 age 60-69 had the largest number of diagnosed patients, while in 2008 the age group 70-79 led. This is consistent with NCDB data. Comparing stage at diagnosis with both GMC and the NCDB data, Stage III and Stage IV are still where the majority of patients are being diagnosed. The percentage of current smokers seems to be on a decrease. The percentage of patients who were diagnosed in 2008 at GMC and who did not receive treatment is higher by 8% than the NCDB2006 data.
Recommendations/Goal Setting
Continue to support and promote early detection and appropriate treatment of lung cancer . Professional Support - Thoracic Surgery - Clinical Trials - Professional Education . Community Support - Smoking cessation - Health Fairs - Pulmonary Screening - Tobacco Free Q.C. - Iowa Cancer Consortium
NOTE: All data for this report is from the Genesis Medical Center (GMC) registry program, with comparison to the National Cancer Database (NCDB) Hospital Type: Comprehensive Community Cancer, American Cancer Society (ACS) Mid-West Region, data from 26 hospital, and from the State Health Registry of Iowa. Cancer Committee Members – 2009
Chairs: David Mercer, M.D., Chair Hematology/Medical Oncology Medical Director, Cancer Care Institute Kimball Thompson, M.D. Chair Pathology Medical Staff: David Aanestad, MD Surgery/General Medical Director, Center for Breast Health Shobha Chitneni, MD Hematology/Medical Oncology William Davidson III, MD David Mercer, M.D. Gastroenterology Medical Director Robert Hartung, MD Cancer Care Institute Radiology Matthew Ketelaar, MD Radiology George Kontos, MD Surgery/General/Cardiovascular & Thoracic Anthony Maiorello, MD Neurosurgery Mark Milleman, MD Urology Robert Nelson, MD Vice President, Clinical Services Genesis - Davenport Campuses Michael Phelps, MD Surgery/General David Aanestad, M.D. ACoS Physician Liaison Medical Director Center for Breast Health Richard Sadler, MD Cardiothoracic Surgeon Thomas Stoffel, MD Radiation Oncology Antonio Vigliotti, MD Radiation Oncology Medical Director, Radiation Oncology
Genesis Medical Center Staff: Chris Beuthin, PT, GCS, CLT Physical Therapy Mareen Carty, RN, MSN, OCN Nursing Outcomes Specialist Kevin Cassatt, R.PH. Assistant Manager, Pharmaceutical Services Antonio Vigliotti, M.D. Medical Director Radiation Oncology Kristin DeNike, RN, BSN, OCN Nurse Manager, Oncology Unit Teresa Fraker, RN, BSN, MS, CBN Director, Outpatient Services Joan Reynolds, RN, BSN Quality Specialist Cindy McGee, RN, BSN Manager, Center for Breast Health Christina Nall, BS, RT(R)(T) Manager, Radiation Therapy Linda Rymars, RN Clinical Research Coordinator Kim Turner, RN, MSN, OCN Cancer Services Specialist Dee Westfall, CTR Cancer Registrar Sally Werner, RN, BSN, MHSA Director, Cancer Program Susan Williams, LISW Continuum Services Amanda Wilson, MA, RD, LD Clinical Dietitian
Advisory Specialty Members: Gregory Garvin, MD Pediatrics Thomas Gellhaus, MD Obstetrics/Gynecology Robert Godwin, MD Dermatology Todd Ridenour, MD Neurosurgeon
Additional Committee Members: Christy Thurman American Cancer Society Representative Deb Ide Genesis Cancer Care Institute, Recording Secretary Institute Location: 1351 West Central Park, Pavilion I Davenport, IA 52804 563-421-1900
Mailing Address: 1227 E. Rusholme Davenport, IA 52803
www.genesishealth.com/services/cancer