Kennedy Cancer Center 2014 Annual Report

Kennedy Cancer Center
2014 Annual Report
Contents
Welcome Letter 2
Cancer Network
3
2014
Research
Reports
Kidney Cancer4
Breast Cancer
Cancer Registry
8
10
Radiation Oncology
18
Comprehensive Cancer & Hematology Specialists
19
Oncology Patient Navigation Program
20
Psychosocial Services
21
Oncology Clinical Research
22
Center for Hope and Healing
23
Pathology at Kennedy
24
Medical Imaging at Kennedy
24
Lung Cancer Screening
25
Skin Cancer Screening 26
Urinary Bladder Cancer Screening 27
Cancer Committe 2014 28
Directory
29
1
Dear Friends,
We are pleased to present our 2014 Cancer Program Annual Report, which highlights our state-of-theart cancer care and services provided to our patients and their families. The hard work of our physicians
and staff along with support from hospital leadership has again resulted in significant accomplishments
benefiting our patients and the communities we serve.
On the heels of completing the American College of Radiology (ACR), National Accreditation Program for
Breast Centers (NAPBC) and American College of Surgeons (ACS) Commission on Cancer (CoC) 3-year
re-accreditation surveys, 2014 was another successful and productive year for Kennedy’s Cancer program.
The Cancer Committee remains committed to improving the lives of our current patients and improving
opportunities for those we will serve in the future.
One such area of opportunity is early diagnosis of lung cancer. In our community, like in most
communities across the country, a significant percent of patients are diagnosed with advanced stage
disease. As a result, the survival rate of lung cancer patients has remained low.
We have the opportunity to reduce the number of late-stage lung cancers over time with responsible lung
screening. The Cancer Committee felt an obligation to offer this at no cost to the community. In 2013, the
Kennedy Cancer Program began offering Free Low Dose CT Lung Cancer Screening to patients at high risk
for lung cancer. We are now proud to offer the Electromagnetic Navigation Bronchoscopy™ (ENB) system,
which provides our patients with a minimally invasive approach to accessing difficult-to-reach areas of the
lung, providing earlier diagnosis and personalized treatment, and potentially saving lives.
The 2014 annual report is a cooperative effort featuring our program activities, cancer statistics from
our registry, and a special report on renal cell cancer. All the disciplines of a successful cancer program
are highlighted in the pages to follow. Every member of the Cancer Committee works together toward a
common goal — to provide the very best cancer care with compassion and understanding. For patients
afflicted by cancer and their families, we know the difficulty in beginning and continuing their care and
we are with them every step of the way.
We hope you enjoy our Annual Report.
2
Trina Poretta, DO
Joseph W. Devine
Medical Director
President & CEO
Penn Cancer Network
As a member of the Penn Cancer Network since
2008, Kennedy’s comprehensive community Cancer
Program has developed a collaborative and
complementary alignment with Penn Medicine’s
Abramson Cancer Center in Philadelphia, an NCIdesignated Comprehensive Cancer Center. Through this
relationship, Kennedy physicians, staff, and patients have
access to the latest research and treatments available
at an academic tertiary care center to complement the
community-based diagnostic and treatment services
available at the Kennedy Cancer Center.
Penn cancer specialists believe the overwhelming
majority of cancer care can, and should, be provided in
the community setting. Processes are in place to assist
patients requiring second opinions or specialized services
to seamlessly receive those services at Penn and then
return to their community physician. By partnering
with regional community experts, such as the Kennedy
Cancer Center, Penn is able to offer highly specialized
services and research activities, including bone marrow
transplants and proton therapy services, that could not
be offered cost-effectively in the community setting.
Additionally, Kennedy University Hospital (KUH) physicians,
nurses, and ancillary staff are provided access to extensive
professional educational programs offered by Penn
Medicine and the Perelman School of Medicine at the
University of Pennsylvania. Building upon the strengths
and expertise of both institutions allows the Kennedy
Cancer Center to provide comprehensive community
cancer services without duplication, and to conduct
research of importance to southern New Jersey.
1.
2.
3.
4.
5.
6.
7.
Monmouth Medical Center
Community Medical Center (Toms River)
Kennedy University Hospital (Cherry Hill)
Kennedy University Hospital (Stratford)
Kennedy University Hospital (Washington Twp)
Shore Memorial Hospital
Cape Regional Medical Center
3
The Kennedy Cancer Center
2014 Report on Kidney Cancer
In 2014, a study on kidney cancer was initiated by Kennedy University Hospital’s Cancer Committee’s using
data collected by the Tumor Registry Office. This study includes data on patients treated between
January 1, 2012 through December 31, 2013, resulting in 65 analytic kidney cancer cases. Variables
examined across our study include: gender, age, stage at diagnosis, first course of therapy and survival
rates. The Tumor Registry Office compared the data to NCCN Clinical Practice Guidelines in Oncology
and concluded that these patients diagnosed with kidney cancer and treated at our medical center
were managed according to national standard levels and within clinical management guidelines. In
addition, favorable survival rates were demonstrated when compared to national standards for accepted
approaches in treating kidney cancer.
OVERVIEW
It was estimated that 63,920 Americans were diagnosed with kidney cancer and 13,860 would die of the
disease in the United States in 2014. Renal cell carcinoma comprises approximately 3.8 percent of new
cancers and 2.7% of all cancer deaths.
Renal cell cancers (RCC), which originate in the
renal cortex, constitute 80-85 percent of primary
kidney carcinomas. Transitional cell carcinoma of
the renal pelvis and ureter (drainage system of the
kidney) make up eight percent of kidney carcinomas.
The remainder of cancer types in the kidney
include benign entities, such as: Oncocytomas,
Angiomyolipomas, Adenomas, Cystic Nephroma, and
Renal Medullary Fibroma, or very aggressive forms of
RCC (that occur rarely), Collecting Duct Carcinoma,
Sarcomas, and Renal Medullary Carcinoma.
“The five year survival
rates of patients with
kidney cancer have
increased significantly
over the past 50 years.”
Patients with localization, early stage RCC can present without any symptoms and, as such, the cancer
is diagnosed incidentally on imaging studies – CT scan, ultrasound, and MRI that has been requested
for other purposes. The majority of patients are diagnosed with disease confined to the kidney.
Approximately 25 percent of patients have either metastatic or advanced locoregional disease (i.e.,
spread to regional lymph nodes) at the time of diagnosis. These patients can present with any of the
following signs or symptoms: hematuria, flank pain, palpable mass, anemia, or symptoms related to an
organ dysfunction where the tumor has metastasized, such as shortness of breath with lung metastases.
Smoking and obesity are established risk factors for this disease. Other risk factors include: hypertension,
acquired cystic disease of the kidney, chronic hepatitis C infection, and occupational exposure to
cadmium, asbestos, and petroleum by-products. Several hereditary types of RCC also exist with the most
common form being von Hippel-Lindau disease.
4
GENDER DISTRIBUTION
In 2012, there were 14 women and 21 men diagnosed with kidney cancer at Kennedy Health. In 2013,
there were 12 women and 18 men newly diagnosed. Figure 1 illustrates the gender distribution at
Kennedy University Hospital for the past two years, which shows a slight decrease for females and males.
25
Figure 1
20
2012
2013
15
10
5
0
Male
Female
Number of Newly Diagnosed
AGE DISTRIBUTION
Figure 2 illustrates the age distribution at Kennedy University Hospital for patients with kidney cancer. Our
patient population is slightly older than that of national levels. The national median age is 64.
10
Figure 2
8
2012
2013
6
4
2
0
0-39
40-49
50-59
60-69
70-79
80-89
Age of Patient
5
STAGE AT DIAGNOSIS
Kidney cancer patients were grouped by stage at diagnosis as determined by the American Joint
Committee on Cancer (AJCC) Cancer Staging System, which is sponsored by the American Cancer Society
(ACS) and the American College of Surgeons (ACoS). Figure 3 demonstrates the stage that was reported at
the time of diagnosis.
Figure 3
2012
2013
25
20
15
10
5
0
In Situ
Stage 1
Stage 2
Stage 3
Stage 4
Stage Reported at Time of Diagnosis
TREATMENT
The first course of therapy for analytic kidney cancer patients is illustrated in Figure 4. First course of
therapy is limited to all treatment given within the first four months after diagnosis, or can include
treatment given beyond four months if it was part of a treatment plan stated in the medical record.
In 2012, 77 percent of our patients received surgery only. Seven percent of our patients received surgery,
followed by systemic therapy. In 2013, 81 percent of patients received surgery only. Eight percent of
patients received surgery, followed by systematic therapy.
Figure 4
6
SURVIVAL AFTER TREATMENT
The five-year survival rate of patients with kidney cancer has increased significantly over the past 50 years,
and now is 72.5 percent. The improved survival rate is mostly due to earlier detection of smaller tumors and
curative surgical treatments.
DISCUSSION
This study offers an assessment of the nature and
management of kidney cancer at our medical center.
Our data reaffirmed the age distribution seen at
national levels for kidney cancers. The peak incidence
is in the sixth decade of life. Data on stage distribution
support the ACoS National Cancer Data Base (NCDB)
which shows that the majority of patients have limited
disease at the time of diagnosis. It is clear that survival
from kidney cancer is greatly improved when the
disease is detected in its earliest stages. At this point, 59
patients are alive, with the vast majority doing very well.
Approximately 73% of patients are living with no
evidence of disease and with minimal to no co-morbidities
secondary to their disease. Six patients seen at our Cancer
Center have since died of their disease.
“Treatment outcomes
for our medical center
met or exceeded
benchmark results.”
Surgical treatment provided prolonged disease-free survival for many of our patients with localized
disease, but is rarely curative in patients with metastatic disease. Patients with metastatic disease
are often co-managed by their Urologist and Medical Oncologist. In patients with metastatic disease,
survival is optimized when the patient has first had a nephrectomy, followed by either Immunotherapy
or targeted agents for metastatic RCC. Newer targeted therapies approved by the FDA attack the
tumors’ ability to form blood vessels (a process known as angiogenesis) and inhibit other pathways
of cancer growth. These medicines, generally, are more tolerable and have been shown to statistically
prolong one’s survival. In general, treatment outcomes for our medical center met or exceed published
benchmark results seen by the ACoS NCDB.
7
The Kennedy Cancer Center
2013 Report on Breast Cancer
Breast cancer is the most frequently diagnosed malignancy in women in the United States, excluding skin
cancers. Breast cancer-related deaths remain the second-leading cause of deaths in women in the U.S.,
exceeded only by lung cancer. Estimates by The American Cancer Society project 235,030 newly diagnosed
cases of invasive breast cancer in 2014. Approximately 2,360 of these cases will occur in men. Additionally,
it is estimated there will be 62,570 new cases of breast carcinoma in-situ. There are 40,430 breast cancerrelated deaths estimated in 2014.*
In 2013, there were 118 breast cancer patients diagnosed and/or treated at Kennedy. Nineteen patients,
or 16% of cases, were diagnosed with Stage 0 (in-situ breast cancer). Invasive carcinoma was diagnosed
in 99 patients (83.8%). A total of 100 patients were diagnosed with early breast cancer (Stages 0, I, and II),
comprising 85% of cases. Diagnoses established by palpation-guided or image-guided percutaneous biopsies
comprised 99% of all cases. Breast conservation therapy was performed in 55% of breast cancer cases.
In 2011, the Kennedy Cancer Center successfully achieved accreditation with commendation by the
National Accreditation Program for Breast Centers (NAPBC), administered by the American College of
Surgeons. To obtain accreditation, breast centers must meet or exceed strict quality standards established
by the consortium of multidisciplinary organizations which comprise the NAPBC.
In 2013, the Kennedy Cancer Center, in conjunction with the Penn Cancer Network, hosted its first “Updates
on Breast Cancer” Symposium. This well-attended educational event featured various experts within each
field of breast cancer, presenting the latest updates in breast cancer care. This was in addition to ongoing
programmatic series, such as lectures held on-site, as well as at local community organizations.
Community outreach continues to be an integral component of the Kennedy Breast Cancer program.
Online moderated Web chats and free mammogram screenings during Breast Cancer Awareness Month are
examples of how the Kennedy Cancer Center strives to inform and educate the South Jersey community.
Successful programs, such as the patient nurse navigation program and psychosocial services – including
monthly breast cancer support groups and an online email-based breast cancer network – were continued
and further expanded.
The Kennedy Breast Cancer Program within the Kennedy Cancer Center has proudly become a leader,
continually striving to provide excellence in diagnosing and treating breast cancer. Increasing breast
cancer awareness through education and outreach remains an integral part of our commitment to the
South Jersey community.
*“American Cancer Society Facts & Figures 2014”. Atlanta, American Cancer Society 2013.
8
Comprehensive
Breast Program
Leadership Team
Eduardo Carega, MD
Medical Director, Breast Cancer Program
Louise Baca, MSN, RN Administrator, Cancer Program
Jennifer Conaway, RDMS
Ultrasonographer
Janice Decina, RT (R)(MR)
MRI Coordinator
Joseph DeLaurentis, MD
Radiologist
Brian Duffy PT, DPT, MSPT
Director, Rehabilitation Services
Janusz Godyn, MD Chief of Pathology and Laboratory Medicine
Eric Gonzales, BSN, RN, OCN Oncology Nurse Navigator
surgeons, medical oncologists
Abigale Hassel, MSW, LCSW, OSW-C
Oncology Social Worker
and radiation oncologists who
Susan Hollywood Office Manager, Breast Cancer Program
specialize in the treatment of cancer
Carolyn Horowitz, MD, PhD
Radiation Oncology
by providing treatments that can
Marsha Kalb, RT (R) (M)
Lead Mammography Technologist
complement surgery or be used
William Klinepeter, CTR
Cancer Registry Director
alone. In addition, radiologists
Jun Liu, MD, PhD
and pathologists provide pivotal
Jean McDermott, APN Nurse Pracitioner, Breast Cancer Program
information to accurately diagnose
Trina Poretta, DO
Medical Oncology
the cancer and select the most
Karen Sewnson, RN, OCN
Oncology Clinical Research Coordinator
effective treatment approach.
Elizabeth Wilkie, MSN, RN
Penn Cancer Network Administrator
Our team of physicians include
Breast Specific Pathologist
9
Cancer Registry Report
Kennedy Health Cancer Registry reviewed and entered a total of 1,028 cases into the registry database for
2013. Seven hundred and thirty-eight (738) were analytical cases and two hundred and ninety (290) were
non-analytical cases. Analytical cases are cases that were diagnosed and/or treated at KUH. Non-analytical
cases are cases with a previous history of cancer diagnosed and/or treated elsewhere, or cases that are
considered non-reportable, such as Basal and Squamous Cell Carcinoma of the skin. The top five sites for
2013 are: Lung, Breast, Colon, Prostate and Bladder. Individual breakdown as follows:
Lung
Breast
Colon/Rectal
Prostate
Bladder
129
117
97
55 59 17.4% of the total analytic cases
15.8% of the total analytic cases
13.1% of the total analytic cases
7.4% of the total analytic cases
7.9% of the total analytic cases
The majority of KUH patients come from two counties:
Gloucester
477
Camden402
Burlington 58
Atlantic 24
Other 67
Patients entered via four different Kennedy facilities:
Washington Township Hospital 63%
Stratford Hospital 13%
Radiation Oncology
12%
Cherry Hill Hospital
7%
Other 5%
The Cancer Registry is responsible for the quality of the data entered into the database, which is performed
using several different methods:
✚✚ Review of pathology reports, radiation oncology consults & treatment notes, medical oncology
treatment notes, disease index report
✚✚ Edit checks built within the software application ensures the data being reported is accurate
✚✚ Annually, a quality review is performed on 10% of all abstracts by the Cancer Registry Department
and the quality of this data is subsequently reviewed by the Cancer Registry Quality Coordinator.
10
Kennedy Health received accreditation from the American College of Surgeons Commission on Cancer
in 2011and maintained the accreditation through our 2013 survey. As an accredited program, cancer
conferences are held that evaluate the diagnosis and treatment of 15% of all analytic cases.
In 2013, conferences were coordinated five times a month, with 175 cases being presented and more than
90% of these cases were prospective. Two Breast Conferences per month are held, along with a Lung and
Genitourinary conference. A fifth conference each month focuses mainly on Gastrointestinal and Colon
cases. Cancer Conferences provide a forum for the review of cases, treatment planning and didactic
lectures, as well as providing continuing education credits for physicians.
In 2013, as part of the Kennedy Health and Penn Cancer Network, several physicians from the University of
Pennsylvania Abramson Cancer Center presented at our conferences:
APRIL 30TH 2013
Carolyn Horowitz, MD, PhD, Moderator; and Michael Kasper, MD, FACRO, presented “High Dose Rate
Brachytherapy for Skin Cancer: Not Your Grandfather’s Skin Radiology”
MAY 15TH 2013
Eduardo Careaga, MD, Moderator; Joseph J. DeLaurentis, MD; Carla Fisher, MD; Amy S. Clark, MD, MSCE; Trina A.
Poretta, DO; Carolyn Horowitz, MD, PhD; Gary M. Freedman, MD; and Rebecca Mueller, MS, CGC; presented “Current
Trends in Breast Cancer”
On a monthly basis, the Cancer Registry submits all completed cases from that month to the New Jersey
State Cancer Registry. The file is run through edit check software prior to submission to ensure that all
submitted information is accurate and complete.
The Registrar also performs follow-up on patients in the Cancer Registry. The Registry is currently following
3,710 patients. All patients entered into the registry database are followed or monitored for their latest
cancer health status. Health status is captured in a variety of methods that may consist of: accessing our
hospital database, various other hospital databases, and notifying physicians involved with the patient
care. Additionally, the Cancer Registry uses internet-based websites, such as various newspaper obituaries.
The Cancer Registry Department employs two Certified Tumor Registrars. The Cancer Registry Director
supervises the accuracy of all information gathered and input into the Registry database. The CTRs are
required to attend continuing educational and training meetings relating to oncology, as well as semi-annual
accredited State oncology conferences to maintain the CTR credential. The Cancer Registry staff is a member
of the National Cancer Registry Association (NCRA) and the Oncology Registrars Association of NJ (ORANJ).
11
Cancer Site Distribution Table
Analytic Cases 2013
SEX
STATUS
PRIMARY SITE
TOTAL (%)
M
F
ANALY N/A
ALIVE
EXP
Oral Cavity & Pharynx
15 (2.0%)
9
6
15
0
10
5
Tongue
4 (0.5%)
3
1
4
0
3
1
Salivary Glands
3 (0.4%)
3
0
3
0
3
0
Floor of Mouth
1 (0.1%)
0
1
2
0
0
1
Gum & Other Mouth
3 (0.4%)
0
3
3
0
2
1
Tonsil
2 (0.3%)
1
1
2
0
1
1
Hypopharynx
2 (0.3%)
2
0
2
0
1
1
Digestive System
156 (21.1%)
101
55
156
0
81
75
Esophagus
10 (1.4%)
10
0
10
0
3
7
Stomach
15 (2.0%)
10
5
15
0
4
11
Small Intestine
4 (0.5%)
1
3
4
0
3
1
Colon (Excluding Rectum)
76 (10.3%)
42
34
76
0
53
23
Cecum
15
5
10
15
0
10
5
Appendix
2
1
1
2
0
2
0
Ascending Colon
8
6
2
8
0
7
1
Hepatic Flexure
1
1
0
1
0
1
0
Transverse Colon
5
4
1
5
0
1
4
Splenic Flexure
1
1
0
1
0
1
0
Descending Colon
8
6
2
8
0
7
1
Sigmoid Colon
29
17
12
29
0
20
9
Large Intestine, NOS
7
1
6
7
0
4
3
Rectum & Rectosigmoid
12
CLASS OF CASE
21 (2.8%)
13
8
21
0
12
9
Rectosigmoid Junction
5
5
0
5
0
3
2
Rectum
16
8
8
16
0
9
7
Anus, Anal Canal & Anorecturm
1 (0.1%)
1
0
1
0
1
0
Liver & Intrahepatic Bile Duct
9 (1.2%)
9
0
9
0
3
6
Liver
8
8
0
8
0
3
5
Intrahepatic Bile Duct
1
1
0
1
0
0
1
Gallbladder
2 (0.3%)
2
0
2
0
0
2
Other Biliary
2 (0.3%)
2
0
2
0
0
2
Pancreas
15 (2.0%)
10
5
15
0
1
14
Rectroperitoneum
1 (0.1%)
1
0
1
0
1
0
STAGE DISTRIBUTION
STAGE 0
STAGE I
STAGE II
STAGE III
STAGE IV
88
UNKNOWN
0
2
2
2
7
0
2
0
0
1
0
3
0
0
0
1
0
1
1
0
0
0
0
0
0
0
0
1
0
1
0
0
1
0
1
0
0
0
0
2
0
0
0
0
1
1
0
0
0
18
29
30
25
46
0
8
0
2
1
2
4
0
1
0
1
3
1
8
0
2
0
1
0
1
1
0
1
14
18
19
11
11
0
3
3
5
0
5
2
0
0
0
1
1
0
0
0
0
3
2
1
1
0
0
1
0
0
1
0
0
0
0
1
2
0
0
1
0
1
0
0
1
0
0
0
0
2
0
5
1
0
0
0
4
7
9
3
5
0
1
1
1
1
1
3
0
0
3
3
2
8
4
0
1
1
0
0
2
1
0
1
2
3
2
6
3
0
0
0
0
0
0
1
0
0
0
1
0
0
8
0
0
0
1
0
0
7
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
0
1
1
0
0
0
0
0
0
1
4
1
9
0
0
0
1
0
0
0
0
0
13
Cancer Site Distribution Table
Analytic Cases 2013
SEX
14
CLASS OF CASE
STATUS
PRIMARY SITE
TOTAL (%)
M
F
ANALY N/A
ALIVE
EXP
Respiratory System
135 (18.3%)
65
70
135
0
45
90
Larnyx
6 (0.8%)
5
1
6
0
4
2
Lungs & Brochus
129 (17.5%)
60
69
129
0
41
88
Bones & Joints
1 (0.1%)
0
1
1
0
1
0
Soft Tissue (Including Heart)
2 (0.3%)
2
0
2
0
2
0
Skin
(Excluding Basal & Squamos)
2 (0.3 %)
2
0
2
0
0
2
Melanoma - Skin
1 (0.1%)
1
0
1
0
0
1
Other Non-Epithelial Skin
1 (0.1%)
1
0
1
0
0
1
Basal & Squamos Skin
27 (3.7%)
14
13
27
0
24
3
Breast
117 (15.9%)
0
117
117
0
104
13
Female Genital System
31 (4.2%)
0
31
31
0
23
8
Cervix Uteri
12 (1.6%)
0
12
12
0
12
0
Corpus & Uterus, NOS
15 (2.0%)
0
15
15
0
11
4
Ovary
3 (0.4%)
0
3
3
0
0
3
Vulva
1 (0.1%)
0
1
1
0
0
1
Male Genital System
63 (8.5%)
63
0
63
0
55
8
Prostate
55 (7.5%)
55
0
55
0
49
6
Testis
6 (0.8%)
6
0
6
0
5
1
Penis
2 (0.3%)
2
0
2
0
1
1
Urinary System
90 (12.2%)
59
31
90
0
67
23
Urinary Bladder
59 (8.0%)
40
19
59
0
44
15
Kidney & Renal Pelvis
30 (8.0%)
18
12
30
0
22
8
Other Urinary Organs
1 (0.1%)
1
0
1
0
1
0
Brain & Other Nervous System
18 (2.4%)
6
12
18
0
8
10
Brain
13 (1.8%)
6
7
13
0
4
9
Cranial Nerves / Other
Nervous Systems
5 (0.7%)
0
5
5
0
4
1
Endocrine System
16 (2.2%)
6
10
16
0
15
1
Thyroid
16 (2.2%)
6
10
16
0
15
1
STAGE DISTRIBUTION
STAGE 0
STAGE I
STAGE II
STAGE III
STAGE IV
88
UNKNOWN
3
33
10
24
64
0
1
1
4
0
1
0
0
0
2
29
10
23
64
0
1
0
0
1
0
0
0
0
0
0
0
1
0
0
1
0
0
0
1
0
1
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
19
56
24
11
6
0
1
0
8
3
5
3
0
0
0
0
0
0
0
0
0
0
8
2
4
1
0
0
0
0
0
1
2
0
0
0
0
1
0
0
0
0
0
15
38
6
3
0
1
0
8
37
6
3
0
1
0
6
0
0
0
0
0
0
1
1
0
0
0
0
28
33
13
8
7
0
1
26
17
8
5
2
0
1
1
16
5
3
5
0
0
1
0
0
0
0
0
0
0
0
0
0
0
18
0
0
0
0
0
0
13
0
0
0
0
0
0
5
0
0
9
1
5
1
0
0
0
9
1
5
1
0
0
15
Cancer Site Distribution Table
Analytic Cases 2013
SEX
STATUS
PRIMARY SITE
TOTAL (%)
M
F
ANALY N/A
ALIVE
EXP
Lymphoma
21 (2.8%)
14
7
21
0
13
8
Hodgkin Lymphoma
6 (0.8%)
3
3
6
0
4
2
Non-Hodgkin Lymphoma
15 (2.0%)
11
4
15
0
9
6
NHL - Nodal
11
8
3
11
0
7
4
NHL - Extranodal
4
3
1
4
0
2
2
Myeloma
9 (1.2%)
6
3
9
0
6
3
Leukemia
11 (1.5%)
7
4
11
0
4
7
Lymphocytic Leukemia
4 (0.5%)
4
0
4
0
3
1
1
1
0
1
0
1
0
Chronic Lymphocytic Leukemia 3
Acute Lymphocytic Leukemia
3
0
3
0
2
1
6 (0.8%)
3
3
6
0
1
5
Acute Myeloid Leukemia
1
1
0
1
0
0
1
Acute Monocytic Leukemia
2
0
2
2
0
0
2
Other Myeloid /
Monocytic Leukemia
3
2
1
3
0
1
2
Other Leukemia
1 (0.1%)
0
1
1
0
0
1
Mesothelioma
2 (0.3%)
2
0
2
0
0
2
Miscellaneous
22 (3.0%)
11
11
22
0
6
16
Total
738
367
371
738
0
464
274
Myeloid & Monocytic Leukemia
16
CLASS OF CASE
STAGE DISTRIBUTION
STAGE 0
STAGE I
STAGE II
STAGE III
STAGE IV
88
UNKNOWN
0
2
4
3
11
0
1
0
1
3
1
1
0
0
0
1
1
2
10
0
1
0
0
1
2
7
0
1
0
1
0
0
3
0
0
0
0
0
0
0
9
0
0
0
0
0
0
11
0
0
0
0
0
0
4
0
0
0
0
1
0
1
0
0
0
0
0
0
3
0
0
0
0
0
0
6
0
0
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
3
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
0
0
0
0
0
22
0
68
187
126
92
149
61
16
17
Radiation Oncology
at the Kennedy Cancer Center
Radiation Oncology at Kennedy offers excellence and expertise in radiation therapy close to home for
South Jersey patients. Last year, close to 7,000 radiation treatments were provided to patients at Kennedy’s
Radiation Oncology Center. Services, such as consultation and second-opinion, supportive care and
symptom management, are offered to ensure patients receive the most complete and collaborative
patient-centered care. At Kennedy, patients will receive personalized cancer care tailored to their specific
diagnosis, using advanced technology with a full range of radiation oncology treatment options including:
✚ Image-Guided Radiation Therapy (IGRT)
✚ Skin High Dose Rate (HDR) Brachytherapy ✚ Intensity-Modulated Radiation Therapy (IMRT)
✚ Mammosite (Breast) HDR Brachytherapy
✚ GYN HDR Brachytherapy
The Kennedy Cancer Center offers Varian’s
TrueBeam™ technology. This state-of-the-art
linear accelerator uses a very precise method
of delivering IGRT and IMRT. This means that
patients receive the dose of radiation that is
required to effectively treat the cancer while
minimizing exposure to normal tissue and
other organs in the area.
In addition, Kennedy offers a comprehensive
brachytherapy program for skin, GYN and
breast (Mammosite) cancers. Brachytherapy
allows doctors to deliver higher doses of
radiation to more specific areas of the body,
compared with the conventional form of
radiation therapy (external beam radiation) that
projects radiation from a machine outside of
the body. This type of radiation treatment may
cause fewer side effects than does external
beam radiation, and the overall treatment time
is usually shorter with brachytherapy.
“Patients receive the
dose of radiation that is
required while minimizing
exposure to healthy cells.”
As the only radiation center in southern New Jersey that offers High-Dose Rate (HDR) for Skin and with
HDR for breast and GYN, Kennedy provides personalized treatment options to achieve the best possible
outcomes. Our collaborative and integrated team of experts includes physicians, nurses, physicists,
dosimetrists, radiation therapists, nutritionists and social workers dedicated to offering excellence and a
seamless patient experience.
18
Comprehensive Cancer
and Hematology Specialists, PC
Comprehensive Cancer and Hematology Specialists (CCHS) is a private practice of board-certified
hematologists and medical oncologists. Their spacious and friendly office is located on the second floor of
the Kennedy Cancer Center. They have a full service office with accommodations for physician and nurse
practitioner visits, chemotherapy, intravenous iron therapy, phlebotomy, lab draws and genetic testing.
Family and /or friends are welcome to be a part of the initial consult visit, which can be overwhelming, if
not shared with others. In addition to their office work, they provide consultative and primary services at
each of Kennedy’s three hospitals.
Oncology and chemo-certified nurses facilitate the education, treatment, symptom management and social
support necessary for oncology care. Advancement in medical research has led to the use of several oral
chemotherapy drugs. The nursing staff is experienced in acquiring the often challenging authorization of
these medications.
Patients have access to clinical trials that offer the best care. The treatment of any patient with cancer often
requires coordination of several medical and surgical specialists. The doctors of CCHS maintain open lines
of communications with those physicians to provide seamless care. The staff is courteous and attentive to
patients and their families through each step of their journey, from diagnosis to completion of therapy and
survivorship.
19
Oncology Patient Navigation Program
at the Kennedy Cancer Center
A cancer diagnosis can be a life-altering experience for both patients and their loved ones. Kennedy’s
Cancer Program offers a variety of supportive services to assist during their treatment, and beyond.
The Kennedy Cancer Center’s Patient Navigation
Program offers the services of a dedicated
Oncology Certified Nurse to eliminate or reduce
barriers to cancer care, while providing needed
support. Our Nurse Navigator assists patients in
“navigating” through the healthcare system, from
diagnosis to treatment, and during follow-up care.
The Nurse Navigator is a patient advocate,
ensuring that any questions or concerns are
addressed by the oncology multidisciplinary
team. As an active member of this oncology team,
our Nurse Navigator is both a resource to the
physicians at the Kennedy Cancer Center, as well as
to the community physicians.
Supportive services include:
✚✚ Scheduling appointments with physicians within Kennedy Health, as well as healthcare services
✚✚ Scheduling second opinion appointments with the University of Pennsylvania Abramson Cancer Center
✚✚ Assisting patients in keeping track of their various medical appointments
✚✚ Assisting patients in getting answers regarding their healthcare questions, which can include, but is
not limited, to: health insurance coverage and accessing Disability and Social Security benefits
Through this collaborative and multi-disciplinary approach, the Patient Navigation team “bridges the gap”
to help patients, their caregivers, and their families, access the care and support they need.
20
Psychosocial Services
at the Kennedy Cancer Center
The Kennedy Cancer Center’s Oncology Social Work Department provides caring support and assistance
for each patient’s continuum of care. Working in collaboration with physicians, nurses, and other healthcare
professionals, from diagnosis through survivorship, our Oncology Certified Social Worker offers individuals
and families psychosocial services, coordination of biomedical and psychosocial care services, while
engaging and supporting patients in the management of their illness as well as their health and well-being.
In an effort to provide a well-rounded program for our patients and families, the Social Work Department
coordinates and actively participates in many community and fundraising activities throughout the year.
These events support the Hope & Healing Patient Assistance Fund, which helps to ease the financial
burden patients may experience during their cancer journey. Funds are used for necessities, such as rent,
mortgage, utilities, transportation, and food. Each year our annual per patient support increases due to the
generosity of our community partners and increasing amount of fundraising activities.
21
Oncology Clinical Research
As part of the larger initiative to ensure that patients at Kennedy have access to state-of-the-art care close to
home, our clinical and administrative leaders have developed an infrastructure to support a comprehensive
oncology clinical research program. In collaboration with our Penn Cancer Network colleagues, the Kennedy
Cancer Center offers cutting-edge therapies for patients within their own communities. Clinical trials assist
physicians in better identifying individuals at-risk for developing cancer, as well as establishing new and
improved ways to prevent, diagnose and treat the disease.
Through participation in clinical trials, Kennedy physicians and patients contribute to the evolution of
personalized medicine, which enables us to recognize the unique characteristics of each person’s cancer
and potentially treat them with the latest technology, procedures and medications.
In 2013, Kennedy Cancer Center was the first pilot site for the Women in Steady Exercise Research (Wiser)
Study, funded by the National Cancer Institutes and led by renowned researcher Dr. Kathryn Schmitz. As part
of the Penn Cancer Network, this study was offered to us by the University of Pennsylvania and examines the
effects of exercise and/or weight loss on Lymphedema, risk factors for breast cancer, and quality of life.
The Kennedy Cancer Center is one of the nation’s many community-based cancer centers contributing
to patient enrollments in cooperative group studies, such as ECOG, NSABP, RTOG, and SWOG. Through
our affiliation with the Penn Cancer Network, patients with highly specialized needs – or with rare forms
of cancer – have access to numerous and extensive clinical trials available through the Abramson Cancer
Center of the University of Pennsylvania. The Research Department also participates in Accrual.net, an NCI project to help boost accruals through shared interactions.
22
Center for Hope & Healing
The Center for Hope & Healing, located on the second floor of the Kennedy Cancer Center provides a
comforting and caring environment. With a “living room” atmosphere, the Center is not only a place for
individual reflection, but also a haven where patients can share their experiences with other survivors, as
well as speak with oncology professionals about their concerns.
Unique to our Center for Hope & Healing is a large multi-purpose room where cancer patients and their family
members can participate in various activities. Geared specifically towards survivors, activities are offered for
patients who are either actively undergoing or have completed cancer treatment. Free to patients, activities
include: yoga, massage, mindfulness, chair yoga, dance, visualization, art therapy and much more.
Being diagnosed with cancer is a life-changing experience and, with that in mind, the Kennedy Cancer
Center offers free monthly educational activities and events. Presentations highlight all types of cancer and
cancer-related topics, including: prevention, detection and treatment. The Center for Hope & Healing also
has a resource library and a web-source library with valuable information for patients and their families.
The Kennedy Cancer Center’s programs and activities have expanded significantly over the years and our
goal is to continue offering new and different programs which enrich and enhance the lives of our patients,
their family members and caregivers.
Art Therapy Class
23
Pathology at Kennedy
The most effective cancer treatment starts with an accurate diagnosis. Kennedy University Hospital’s
Department of Pathology uses state-of-the-art laboratory techniques, providing timely and accurate results
and diagnoses. Kennedy surgeons and oncologists rely on their expert pathology opinions to determine
surgical procedures and to aid them in understanding their patients’ disease and determine treatment options.
With the use of new and cutting-edge tools -- including monoclonal antibodies and immunohistochemical
staining, molecular testing (PCR, FISH, etc), cytogenetics and flow cytometry -- our highly trained Kennedy
pathologists participate in day-to-day care of patients. They provide detailed information regarding the nature
of the cancer, which helps in understanding and predicting the biological behavior of the cancer, as well as
monitoring the effects of therapy. Due to the expanding volume of new and highly complex tests, clinicians will
need the consultation of the pathologists in selecting relevant new tests and interpreting test results.
Medical Imaging at Kennedy
Kennedy offers a full-range of diagnostic imaging services using state-of-the-art equipment at its three
hospital campuses and Outpatient Medical Imaging Center located in the Kennedy Cancer Center. Whether
it’s an advanced test – such as a helical CT scan – or a more routine test, such as a mammogram, our staff
provides each patient with the finest medical imaging technology and personalized care. Services include,
but are not limited to:
✚✚ Mammography
✚✚ PET/CT
✚✚ MRI including Breast MRI
✚✚ Low Dose CT Scan for Lung Cancer
✚✚ Nuclear Medicine
✚✚ Dexascan
✚✚ X-Ray
✚✚ Ultrasound
For more information or to schedule testing, please call 856-582-2736.
24
Lung Cancer Screening
In 2009, the results of a large, eight-year National Cancer Institute research study were released, which
showed that screening of certain groups of current and former smokers with a low-dose CT scan, lung
tumors can be detected early and reduce lung cancer mortality by 20 percent.
In earlier stages, people do not usually show signs and symptoms of lung cancer, and this program is
designed to detect lung cancer at an earlier stage. Until now, most individuals with lung cancer have been
diagnosed with late-stage disease. Earlier detection provides an opportunity for more effective treatment.
Low-dose CT imaging is a non-invasive scan that allows for a better view of the lungs, and the ability to
detect disease at an earlier stage
In 2012, the Kennedy Cancer Program and Outpatient Imaging Center at Kennedy began a program to
offer the community free LDCT Lung Screenings. 52 eligible individuals were enrolled in 2014, and 46
were screened. For various reasons, six chose not to continue with the LDCT program. Of the 46 LDCT’s
performed, 20 were identified as having lung nodules, five were found to have incidental masses and two
were identified as having lung masses needing further testing.
COMPLETED SCREENINGS
Coronary Artery
Calcification, 7
46
Normal
6
ADDITIONAL STUDIES
PET/CT
2
MRI
1
Ultrasound
1
Nodule
20
6 did not complete due to PCP refusal to
*
Lung Disease
12
give script (1), No Show (1), and not returning
calls to schedule after multiple attempts
Lung Mass
Needing
Work Up, 2
Incidental
Masses, 5
Recent CT
Scan/Xray
5
Age
9
INELIGIBLE PARTICIPANTS
Recent Respiratory Infection
0
History of Lung CA
0
Reasons for Ineligibility
16
Not a
30-Pack
Smoker, 2
25
Skin Cancer Screening
Kennedy Cancer Center offers annual Skin Cancer Screening, an event that is free and open to the community.
The goal is to educate and screen for early detection of skin lesions which may require further testing. In May
2014 local board-certified dermatologists volunteered their time at the Kennedy Cancer Center to perform skin
cancer screening. Full and partial body skin cancer screening was offered to each individual.
Recommendations were made to participants and the navigation department followed up with participants
on these recommendations. A total of 33 individuals participated in the skin screening. Of the 33 screenings, 11
were recommended to follow-up with a dermatologist for biopsy. Three people out of the 11 followed up the
recommendation of a biopsy. Of the three biopsies, one individual was identified with a malignant pathology
and two were normal pathology.
25
20
15
10
5
0
No Rec.
26
No Biopsy Rec.
Biopsy Rec.
Completed Biopsy
(1 positive dx)
Urinary Bladder Cancer Screening
In 2014, the Cancer Committee, and upon recommendation of the Cancer Physician Liaison based on cancer
registry data and approval of the Medical Executive Board, conducted a preliminary screening to identify urinary
bladder cancer. A pilot group of 20 hospitalized patients, >50 year-old males who smoked, and were found to
have micro-hematuria, without cystitis or calculi, underwent cytopathology examination of voided urines. This
screening showed no evidence of early or advanced malignancy. The screening did show cytologic atypical
findings. Primary physicians were notified of the atypical findings for potential follow-up with their patients.
25
Total number of
atypical findings
20
Total number of
patients screened
15
10
5
0
Urine Cytology to Detect Malignancy
27
Kennedy
University
Hospital’s
Trina Poretta, DO
Cancer
Committee
2013 - 2014
Bill Klinepeter, CTR Frances G. Atkinson, M.Ed., BFA Louise Baca, MSN, RN Nora Bollinger, MSN, RN, CMSRN Eduardo Careaga, MD Kathy Caruso Larry Cohen, DO James D’Amico, DO VP, Marketing
Cancer Program Administrator
Nursing Education
Breast Program Director, Breast Surgeon
Cancer Registrar Director
Radiation Oncology
Surgeon
Internal Medicine/Palliative Care
Trina Darrow, RN Nursing – Same Day Surgery
Lori DePersia, MD
Radiology
Brian Duffy, PT, DPT, MSPT Rev. Thomas Emmitt, ARRT (R) (CT) B.S., MDIV
Janusz J. Godyn, MD Eric Gonzalez, BSN, RN, OCN
Abigale Hassel, MSW, LCSW, OSW-C Carolyn Horowitz, MD, PhD Deanna Janora, MD
Richard Koss, MBA, CPA Thomas Mueller, MD James Patterson, Pharm.D
Dawne Piotrowicz, RN Karen Swenson, RN, OCN Colleen Thornton 28
Medical Director, Medical Oncology
Elizabeth Wilkie Diane Whilleson, RD Director, Rehabilitation Services
Chaplain
Pathology
Oncology Nurse Navigator
Oncology Social Worker
Radiation Oncology
Pain Management
Senior VP, Ambulatory Services
Urology
Pharmacy
Performance Improvement
Clinical Research
American Cancer Society
Administrator, Penn Cancer Network
Food & Nutrition
Kennedy Cancer Center Directory
American Cancer Society Programs at
Oncology Nurse Navigator Program
Kennedy’s Center for Hope & Healing
Oncology Certified Nurse and Oncology Certified
ACS Look Good Feel Better
Social Worker assist patients in navigating through the
800/227-2345
healthcare system, from diagnosis to treatment, and
follow-up care.
Cancer Registry
856/218-5324
The Cancer Registry captures a complete clinical and
demographic summary of patients’ history, diagnosis,
Outpatient Imaging Center at the Kennedy
treatment, health status, providing a lifetime follow-up
Cancer Center
for Kennedy cancer patients.
Offers a complete array of outpatient imaging services,
856/218-5236
including: PET Scan, Magnetic Resonance Imaging (MRI),
Computed Tomography (CT), Ultrasound, Radiography,
Center for Hope & Healing at Kennedy
DEXA, Digital Mammography. Weekend and evening
Support Groups & Cancer Education programs for
hours available.
patients and their families.
856/582-3130
856/218-5777
Pathology & Laboratory Medicine
Clinical Trials & Research
Provides diagnosis and prognostic data, employing
Provides patients access to clinical research and
microscopic examination and molecular techniques,
prevention trials.
on biopsy tissue and surgically removed tumors.
856/218-5790
856/488-6560
Comprehensive Breast Center
Penn Radiation Oncology at Kennedy
Provides supportive care in a clinically advanced
Provides advanced technology – including 3-D
environment for various conditions of the breast,
treatment planning, High-Dose Rate Brachytherapy
both benign and malignant.
(HDR), and Intensity Modulated Radiation Therapy
856/218-2100
(IMRT) – to treat certain types of cancer with both
internal and external modalities.
Comprehensive Cancer & Hematology Specialists, PC
856/582-3008
Practice located in the Kennedy Cancer Center provides
an array of individualized medical treatment options
Oncology Social Work Services
for those battling cancer and blood disorders.
Oncology Certified Social Worker provides caring
856/582-0550
support and assistance in resolving insurance and
financial difficulties, obtaining medications, and
Fighting Men/Fighting Cancer
facilitating transportation.
Prostate Cancer Support Group
856/218-5322
This confidential education and support group
offered by the Kennedy Cancer Center provides
Nutritional Support Services
helpful information to men and their caregivers.
Outpatient Registered Dietitians provide nutritional
856/218-5777
support and counseling to patients undergoing
cancer treatment.
Lymphedema Specialists at Kennedy
866/224-0264
Provides early and continuing treatment
for patients with Lymphedema.
856/256-7871
29
Kennedy Cancer Center
900 Medical Center Drive
Sewell, NJ 08080
856.218.5777