2014 CANCER PROGRAM ANNUAL REPORT WITH 2013 STATISTICS TABLE OF CONTENTS 1 MESSAGE FROM THE DIRECTOR 2 CANCER REGISTRY 4 CANCER COMMITTEE MEMBERS/ CANCER REGISTRY STAFF 5 CANCER ACTIVITIES 23 CANCER DATA 29 PUBLISHED ABSTRACTS Giant Cell Carcinoma Courtesy of Dr. A. Julian Garvin, Department of Pathology 2014 1 CANCER PROGRAM ANNUAL REPORT ANNUAL PROGRAM CANCER Comprehensive Cancer Center AT WAKE FOREST BAPTIST MEDICAL CENTER “ We are extremely proud of the achievements of our Comprehensive Cancer Center as we strive to deliver the best care possible to our patients, their families and caregivers.” – Boris Pasche, MD, PhD, FACP Director, Comprehensive Cancer Center The Comprehensive Cancer Center The Cancer Center recognizes the existing floors, which house all at Wake Forest Baptist Medical the importance of building cross- outpatient oncology services as well Center was founded in the early departmental and transdisciplinary clinical trial staff. This new building 1960s and became a National Cancer team approaches to advance the provides an exceptional environment Institute-designated cancer center science and treatment of cancer. for patients, family and caregiver in 1974, shortly after the National Teams have been developed in cancer experience. Cutting-edge research Cancer Act was placed into law. genomics, tumor microenvironment, and precision medicine is available The Cancer Center received an NCI nanotechnology, imaging, novel to all patients, who have access to “comprehensive” designation in 1990. anticancer drugs, novel anticancer approximately 200 clinical trials. It is one of the longest-standing NCI devices, cancer survivorship, tobacco The Cancer Center was founded with centers, and we are proud to be a part control and cancer health disparities. a strong community orientation and a very distinguished group of only Collaborations with other centers and continues this tradition by addressing 41 NCI-designated comprehensive schools within the institution are an cancer issues that are important to cancer centers in the country. In essential element to the success of the region’s large contingents of addition, the Cancer Center is this research. The Cancer Center has African-Americans, Latinos, Native currently ranked as the #1 cancer strong connections with the Wake Americans, rural poor and pockets hospital in the state of North Carolina Forest Institute for Regenerative of urban poor. The Cancer Center by U.S. News & World Report. Medicine, the Center for Human works closely with the Medical Genomics and Personalized Medicine, The mission of the Cancer Center is to Center’s Maya Angelou Center for Wake Forest Innovations, the Wake improve the lives of cancer patients by Health Equity, which was founded Forest University undergraduate focusing basic, clinical and population by the renowned poet to address Departments of Physics and sciences on the problems of cancer health disparities across the region Chemistry, and the Virginia Tech-Wake prevention, early diagnosis and novel and the nation. We also established a Forest University School of Biomedical treatment. The membership of the Cancer Health Equity initiative in 2012 Engineering and Sciences. Cancer Center is comprised of more with the sole mission of addressing than 125 faculty members from 34 The Cancer Center is the main the needs of our patients in both departments. The Cancer Center’s tertiary referral center for patients in a culturally and linguistically relevant research is divided into four programs: large geographic region. It provides ways. As an example, we hired a Cell Growth and Survival, Cellular a multidisciplinary approach to Hispanic Clinical Trial Navigator Damage and Defense, Clinical treatment in a state-of-the-art facility. in mid-2014 to provide navigation Research, and Cancer Prevention and A six-story expansion of the Cancer services, clinical trial education and Control. To facilitate the scientific and Center opened in December 2013. community outreach specifically translational goals of the programs, The new portion of the building to our Hispanic population in their the Cancer Center has established contains acute care oncology native language. three Centers of Excellence, in brain, inpatient beds and an oncology breast and prostate cancer. intensive-care unit, in addition to 2 The primary functions of the Cancer Registry are to collect relevant data, conduct lifetime CANCER PROGRAM ANNUAL REPORT ANNUAL PROGRAM CANCER follow-up and disseminate cancer information. 2014 Cancer Registry The Cancer Registry works with neoplasms. The registry also collects The Cancer Registry maintains physicians, administrators, researchers selected benign neoplasms and data management and regulatory and health care planners to provide metastatic squamous cell and basal reporting on cancer statistics for support for cancer program cell carcinoma of the skin approved various health care agencies. As development, ensure compliance by the Cancer Committee. The required by law, newly diagnosed with reporting standards, and serve cancer data set includes patient cases are reported to the North as a valuable resource for cancer demographics, cancer identification, Carolina Central Cancer Registry information with the ultimate goal of extent of disease (stage), prognostic (NC-CCR). The data submitted is preventing and controlling cancer. indicators, treatment, recurrence shared with the North American and outcome information. Effective Association of Central Cancer The Cancer Registry functions in Jan. 1, 2012, the registry began the Registries (NAACCR) and the U.S. accordance with guidelines set by collection of the provider-based Centers for Disease Control and the American College of Surgeons clinics cancer cases. The registry Prevention’s National Program of (ACoS). It plays an important began the collection of cancer cases Cancer Registries (CDC-NPCR). role in ensuring that the cancer diagnosed on or after Jan. 1, 2013, for In addition, cancer cases are program is accredited by the Wake Forest Baptist Health Lexington submitted to the Commission on Commission on Cancer and that the Medical Center. Cancer’s National Cancer Data Base Breast Care Center is accredited (NCDB). The NCDB is a comparative by the National Accreditation Follow-up is performed annually on database for ongoing assessment Program for Breast Centers. patients in the registry. Follow-up of cancer patient care and is a joint directly benefits patients and The Cancer Registry is involved project of the American College of physicians by reminding them of in managing and analyzing Surgeons (ACoS) and the American the need for medical checkups. clinical cancer information for the Cancer Society. Continued surveillance ensures early purpose of education, research detection of possible recurrence or a The Association of North Carolina and outcome measurement. The new primary. Outcome data provides Cancer Registrars helps cancer primary functions of the Cancer survival information reflecting the registrars in the state maintain their Registry are to collect relevant data, effectiveness of treatment modalities. continuing education hours by conduct lifetime follow-up and The Cancer Registry fulfills requests providing up-to-date educational disseminate cancer information. for cancer data from staff physicians, workshops. The National Cancer The registry also participates in allied health professionals, outside Registrars Association serves as the hospital-based, state and national institutions and requests for follow-up premier education, credentialing and studies, and research projects. information from other cancer advocacy resource for cancer data The Cancer Registry collects all registries. All data requests are professionals. malignant neoplasms and benign handled with the utmost care for the brain and central nervous system patient’s confidentiality. 2014 3 CANCER PROGRAM ANNUAL REPORT ANNUAL PROGRAM CANCER Cancer Committee The Cancer Committee is one of the major components of being an approved cancer program of the American College of Surgeons (ACoS). The committee is responsible for planning, initiating, stimulating and assessing all cancer-related activities. The committee must be a multidisciplinary, standing committee that meets at least quarterly. ACTIVITIES ▶ The Cancer Program Annual Report is compiled and published as an educational activity of the committee. Published journal articles and abstracts are included. ▶ Quality management activities/ improvements are planned, multidisciplinary attendance, total monitored for casefinding, reviewed and implemented case presentation and prospective accuracy of data collection, each year. case presentation. abstracting timeliness, follow-up The College of American and data reporting. ▶ Studies that measure quality ▶ and outcomes are completed so Pathology’s scientifically validated ▶ A subcommittee monitors the that patients receive care that is data elements outlined on the activities of the Breast comparable to national standards. surgical case summary checklist of Care Center. the CAP publication, Reporting on ▶ The AJCC TNM staging by the Cancer Specimens, are reviewed managing physician is monitored. and monitored. ▶ Cancer conferences are reviewed ▶ The Cancer Registry data and and monitored for frequency, activities are evaluated and 4 CANCER PROGRAM ANNUAL REPORT ANNUAL PROGRAM CANCER Cancer Committee Members 2014 Edward Levine, MD, Chair \ Surgical Oncology Amanda Backus, MHA, CAPM, AT-Ret \ Business Planner Joseph Bonkowski,