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Beebe Healthcare–Cancer Services Annual Report 2017–2018

Tunnell Cancer Center

Tunnell Cancer Center

Since its inception in 1995, more than 15,620 newly diagnosed patients have received care at Tunnell Cancer Center.

The mission of the Robert & Eolyne Tunnell Cancer Center at Beebe Healthcare is to provide both hope and a cure. From diagnosis through treatment and beyond, the patients at the Tunnell Cancer Center are never alone. Physicians, nurses, and staff, as part of the multidisciplinary approach, are here to listen, support, and encourage. Every patient is treated as an individual, and a multidisciplinary team meets weekly to discuss each newly diagnosed case to consider treatment options and to establish the most appropriate treatment protocol.

In Fiscal Year 2018

Thank You! We would like to thank each of you who have supported Beebe Healthcare’s Tunnell Cancer Center and our multidisciplinary team. Your donations have allowed us to purchase modern technologies and equipment so important to patient care and also have made it possible for us to help many of our patients with special needs incurred during their cancer journey. Your generosity and commitment have made an important and welcome difference to all of us and to those we serve.

(July 1, 2017–June 30, 2018) You Shared with Tunnell Cancer Center: • 281 donors gave to a Memorial and/or Honorarium for a total of $30,935. • 450 donors gave to the Tunnell Cancer Center for a total of $430,513. • Four golf tournaments raised more than $371,000.

Beebe Healthcare Cancer Committee Roster 2018 Martin Blood Deborah Campbell, msn, rn Alexander Chase, pa-c Xiaoli Chen, md Allison Clobes, rn, ocn Lisa Collord, rn Kathy Cook, rn, msn

Brian Costleigh, md Nisarg Desai, md Allison Gil Lisa Giorgilli Rev. Keith Goheen Barry Hamp Lisa Henderson, rn, ocn

Luanne Holland Jennifer Hung, md Carol Hunt Jude Johnson-Shupe Selvi Lingam, md Donna Miskin, rn, ocn Helen Moody, ctr

Srujitha Murukutla, md Kiernan Quay Kristen Rahn, rt (r) (t) Judith Ramirez, edd Michael Ramjattansingh, md Anis Saliba, md James Spellman, Jr., md

Members of the Tunnell Cancer Center Medical Staff

Andrejs Strauss, md Owen Thomas, md Lynne Van Pelt, rn Kim Westcott, ms, rd Clare Wilson, rn, lmhc Elizabeth Wilson, fnp-bc

(left to right): Andrejs V. Strauss, MD, radiation oncologist; James Spellman, Jr., MD, surgical oncologist; Selvi Lingam, MD, medical oncologist; Nisarg Desai, MD, medical oncologist; Owen Thomas, MD, radiation oncologist; Srujitha Murukutla, MD, medical oncologist; Brian Costleigh, MD, radiation oncologist; Srihari Peri, MD, medical oncologist; and Jennifer Hung, MD, radiation oncologist. Not pictured: Isabel Benson, NP-C, AOCNP, oncology nurse practitioner; Alec Chase, PA-C, oncology physician assistant; and Liz Wilson, FNP-BC, oncology nurse practitioner.


receptive, to participate in clinical trials, and our enrollment of patients in clinical trials has increased substantially over the past year. We are proud of the care and treatment that we provide our patients and their families. Our multidisciplinary team meets regularly to discuss individualized treatment plans for each patient and to ensure that we provide our patients with the latest in cancer care. Beebe Medical Foundation, the fundraising arm of Beebe Healthcare, is working tirelessly to reach and even exceed our goals, as well as to offer the best services and care to our patients. We thank the Foundation for its commitment to support us and, most importantly, the generous donors. We also thank our dedicated volunteers, our team members, our patients and their families, and those in the communities that we serve for believing and supporting us.

We are proud of the care and treatment that we provide our patients and their families.

30 20 10 0

20 25 30 35 40 45 50 55 60 65 70 75 80 85+ AGE $ $ $ $ $ $ $ $ $ $ $ $ $ 24 29 34 39 44 49 54 59 64 69 74 79 84 Source: Beebe Healthcare Tumor Registry Database, Rocky Mountain Cancer Program

BREAST 80% 70% 60% 50% 40% 30% 20% 10% 0

In Situ Stage I Stage II Stage III Stage IV Unkn

In Situ Stage I Stage II Stage III Stage IV Unkn

LUNG

PROSTATE

COLON

MELANOMA

In Situ Stage I Stage II Stage III Stage IV Unkn

40

Breast Lung Prostate Colon Melanoma

In Situ Stage I Stage II Stage III Stage IV Unkn

NUMBER OF CASES

50

Analytical Cases

In Situ Stage I Stage II Stage III Stage IV Unkn

Analytical Cases

Chairman, Beebe Healthcare Cancer Committee

Beebe Healthcare/Delaware State—2017 Top 5 Sites

n Beebe Healthcare n Delaware Cancer Registry

In Situ Stage I Stage II Stage III Stage IV Unkn

Beebe Healthcare—2017 Top 5 Sites

Owen Thomas, MD

Comparison Report by AJCC Stage Percentages

In Situ Stage I Stage II Stage III Stage IV Unkn

Comparison Report by Age

In Situ Stage I Stage II Stage III Stage IV Unkn

With the improvements in cancer care, more people are surviving cancer long term.

In Situ Stage I Stage II Stage III Stage IV Unkn

This past year has been an exciting one for Beebe Healthcare’s Tunnell Cancer Center. Beebe Healthcare is thoughtfully investing and expanding our presence in Sussex County—making excellent, innovative, and accessible care a reality for our friends, families, and neighbors for future generations. It has been 23 years since the Tunnell Cancer Center was opened on the grounds of Beebe Healthcare in Lewes and 12 years at our current site at the Rehoboth Beach Health Campus. To better serve our patients in our ever-growing community, we are proud to be expanding into the South Coastal region with a second comprehensive state-of-the-art cancer center on Route 17 near Millville. We received state approvals to move forward with our plans and break ground in November 2018, with completion expected in 2020. The expanded services build on our mission to provide the most advanced treatments for our patients, right here, close to where they live, so they do not have to travel far for great care. Screening and prevention efforts continue to lead to early diagnosis when treatment works best. Since its inception in 2015 at Tunnell, the low-dose CT Lung

Cancer Screening program continues to help in the discovery of lung cancer in early stages when the chances for successful outcomes are greatest. Notably, in 2017, 20 lung cancer diagnoses were made out of the total 1,361 lung cancer screenings completed. We are active in the community with outreach and education programs throughout our service area, with annual events such as Think Beyond Pink, Not Just for Men, After Ringing the Bell, Miracle Mile, and new this year, the Pink Ribbon Open House for survivors of breast cancer. Our nurse navigators continue to provide better pathways to care and ease the patient’s journey. In addition, our clinical performance groups for breast and thoracic/lung 60% help measure quality improvement and set 50% standards while enhancing physician collabora40% for ways to improve tion. We are looking our efficiencies, as this is critical for 30% patient success rates. With the improvements in cancer 20%are surviving cancer. care, more people In many cases it is being managed as a “chronic disease,” requiring long-term 10% monitoring and continued psychosocial support. Our patients 0 have the opportunity, whenever they are eligible and

In Situ Stage I Stage II Stage III Stage IV Unkn

Chairman’s Message

Source: Beebe Healthcare Tumor Registry Database, Rocky Mountain Cancer Data Program Delaware Cancer Registry, RMCDS software program (out-of-state residents included)


Cancer Registry

Beebe Healthcare 2017 Case Distribution (All Sites—Analytic Cases Only)

Data on cancer incidence, type, stage at diagnosis, treatment, and survival is collected by the Cancer Registry and reported to the Delaware State Central Registry. Registry data is also submitted to the National Cancer Database, which uses this information to monitor cancer 350 trends, plan cancer prevention programs, help set 300 priorities, and advance medical research efforts. 250 200

Beebe Healthcare Cancer Registry Follow-up 150

350 100 300 50 250 0 200 Cases Diagnosed From Reference Date 2000–October 2018 150 Total cases in registry since reference date (2000) 12,243 100 Less foreign residents 8 50 Less patients over 100 years of age not 0 contacted in 12 months 7 Subtotal 12,228 Less number expired 5,880 Subtotal (number living) 6,348 Number living with current follow-up (within 15 months) 4,086 Patients lost to follow-up 2,262 Percent of successful follow-up rate 81.5%

Cases Diagnosed Within 5 Years (Month Ending October 2018) Total patients in registry for last 5 years 3,397 Less foreign residents 0 Less patients over 100 years of age not contacted in 12 months 0 Subtotal 3,397 Less number expired 867 Subtotal (number living) 2,530 400 350Number living with current follow-up (within 15 months) 2,233 300 250Patients lost to follow-up 297 200 150Percent of successful follow-up rate 91.3%

100 50 ** 0Source: Beebe Healthcare, Tumor Registry, RMCDS database cancer program Insitu

Stage I

Stage II Stage III Stage IV

N/A

Unknown

Comparison Report 2017 Lung Cases by AJCC Stage Beebe Healthcare/Delaware State

NUMBER OF CASES

Analytical Cases

400 300 200 100 0

n Beebe Healthcare n Delaware Cancer Registry

** Insitu

Stage I

Stage II Stage III Stage IV

N/A

Unknown

N/A = No staging scheme • UNKN= Dx only, and/or not staged • ** Suppressed due to small case counts Source: Beebe Healthcare Tumor Registry Database, Rocky Mountain Cancer Program Delaware Cancer Registry Database, Rocky Mountain Cancer Program

PRIMARY SITE

ANALYTIC CASE Mix % CASES

GENDER F M

0

AJCC STAGE DISTRIBUTION I II III IV 9*

BREAST RESPIRATORY Larynx Lung Pleura (Malig. Mesothelioma) Pyriform Sinus DIGESTIVE Esophagus Stomach Small Intestine Other Biliary Colon Rectum/Rectosigmoid Anus/Anal Canal Liver/Gallbladder Pancreas Peritoneum MALE ORGANS Prostate Penis Testis FEMALE ORGANS Cervix Uteri Uterus Corpus Uteri Ovary Other Female (vulva) URINARY Bladder Kidney/Renal Pelvis Ureter LYMPHOMA Hodgkin’s Non-Hodgkin MULTIPLE MYELOMA MELANOMA HEAD & NECK Tongue Major Salivary Gland Floor of Mouth Tonsil Oropharynx Mouth & Gum LEUKEMIA THYROID BONE & SOFT TISSUE Soft Tissue Bones & Joints BRAIN/CNS OTHER SKIN CANCER ALL OTHER/UNDEFINED/UNKN

168

19.8%

3

165

24

90

35

4

10

5

134

15.8%

67

67

0

43

13

19

47

12

Total Analytic Cases Total Non-Analytic TOTAL CASES ABSTRACTED

9

1.1%

7

2

0

4

1

0

3

1

125

14.7%

60

65

0

39

12

19

44

11

0

0.0%

0

0

0

0

0

0

0

0

0

0.0%

0

0

0

0

0

0

0

0

133

15.7%

87

46

1

17

28

20

30

37

15

1.8%

13

2

0

0

3

3

5

4

8

0.9%

5

3

0

3

0

0

2

3

5

0.6%

4

1

0

1

0

0

3

1

4

0.5%

1

3

0

1

0

0

0

3

56

6.6%

38

18

0

3

20

12

9

12

12

1.4%

6

6

0

4

4

3

0

1

2

0.2%

2

0

1

0

0

1

0

0

12

1.4%

7

5

0

2

0

0

3

7

17

2.0%

11

6

0

3

1

1

8

4

2

0.2%

0

2

0

0

0

0

0

2

106

12.5%

106

0

0

15

66

3

10

12

103

12.1%

103

0

0

15

66

3

10

9

0

0.0%

0

0

0

0

0

0

0

0

3

0.4%

3

0

0

0

0

0

0

3

43

5.1%

0

43

1

13

1

7

7

14

8

0.9%

0

8

0

3

0

1

1

3

2

0.2%

0

2

0

0

0

0

1

1

23

2.7%

0

23

1

9

1

4

1

7

8

0.9%

0

8

0

1

0

2

4

1

2

0.2%

0

2

0

0

0

0

0

2

64

7.5%

50

14

5

26

8

1

13

11

40

4.7%

32

8

5

19

7

0

4

5

23

2.7%

17

6

0

7

0

1

9

6

1

0.1%

1

0

0

0

1

0

0

0

35

4.1%

21

14

0

10

4

7

10

4

2

0.2%

1

1

0

1

0

1

0

0

33

3.9%

20

13

0

9

4

6

10

4

14

1.7%

7

7

0

0

0

0

0

14

53

6.3%

35

18

11

26

7

1

2

6

19

2.2%

14

5

0

2

1

6

8

2

6

0.7%

4

2

0

0

0

1

4

1

4

0.5%

2

2

0

1

1

2

0

0

2

0.2%

1

1

0

0

0

0

1

1

3

0.4%

3

0

0

0

0

1

2

0

2

0.2%

2

0

0

1

0

1

0

0

2

0.2%

2

0

0

0

0

1

1

0

15

1.8%

9

6

0

0

0

0

0

15

7

0.8%

0

7

0

1

1

0

1

4

3

0.4%

2

1

0

0

0

1

0

2

2

0.2%

1

1

0

0

0

1

0

1

1

0.1%

1

0

0

0

0

0

0

1

6

0.7%

3

3

0

0

0

0

0

6

5

0.6%

5

0

0

0

0

1

0

4

43

5.1%

22

21

0

0

0

0

2

41

848

100.0%

431 417

42

243 164

23 871

NUMBER OF CASES

*Note: 9 represents no staging scheme or unknown stage

350 250 150 50

Tunnell Cancer Center’s Cancer Screening Nurse Navigator Deb Campbell, MSN, RN, partners with residents in our community to provide resources for cancer screenings. Ms. Campbell enrolls individuals in cancer screening programs, including Delaware’s Screening for Life, and helps connect the uninsured with the Choose Health Delaware Marketplace. In addition, as Cancer Screening Nurse Navigator, she follows patients with abnormal cancer screening results for future screening needs and helps coordinate cancer care.

**

70

140 189


Celebrating Quality Care Focusing on Outcomes for Beebe Healthcare’s Cancer Prevention & Screening Programs Beebe Healthcare’s Cancer Services has an active outreach, prevention, and screening program which aims to reduce the number of late-stage cancer cases diagnosed in Sussex County. Our multiple cancer prevention and screening programs are consistent with evidence-based national guidelines, interventions, and various sources of Delaware community assessment data. The Delaware Cancer Consortium’s Early Detection and Prevention Committee reports indicate Delaware ranks 42 out of 50 states and the District of Columbia with a lung cancer incidence of 72 per 100,000 people, which parallels the current smoking rate of 18 percent or 127,300 adult smokers. Additionally, in Delaware, only 20 percent of lung cancer cases were diagnosed at early stages, when it is most likely to be curable. Lastly, Delaware ranks 1 out of 50 states and the District of Columbia, with 21 screening centers per million people. The primary cancer screening programs offered in 2017–18 included low-dose CT lung cancer screening,

mammography screening, and skin cancer screening. In 2017, a total of 1,361 lung cancer screenings of community residents were done at Beebe Healthcare, with all results being monitored by Tunnell Cancer Center’s Cancer Screening Nurse Navigator Deb Campbell, who followed them through to resolution or diagnosis. Through these screenings, 20 lung cancers and five other cancers were detected. Additionally, nearly 1,000 residents who have had barriers or obstacles to screenings were also monitored and assisted as needed to complete screenings by the cancer screening nurse navigator. As a result, 263 mammograms, 70 cervical screenings, 14 prostate screenings, and 34 colon screenings were completed by these patients utilizing the guidelines for recommended screenings for each age group. Detected from these screenings were one breast cancer and one colon cancer. Lung cancer is the most frequently diagnosed cancer in Delaware. Smoking is the number-one risk factor for lung

Beebe Cancer Services: Closer to Home

Telephone Directory

Beebe Healthcare broke ground on its South Coastal Health Campus on Route 17 near Millville on November 1, 2018. In addition to a freestanding Emergency Department, this campus will include a second location for Beebe’s renowned cancer program, including medical oncology, radiation oncology, and chemotherapy. The new cancer center will provide better access to medical care and treatment for cancer patients in the South Coastal area within our ever-growing region. The anticipated completion of the new center is in 2020.

Healing bodies, minds, and spirits every day.

cancer. In the United States, cigarette smoking is linked to about 90 percent of lung cancers. In 2015, Beebe began using low-dose CT scanning, approved to help detect lung cancer at an early stage when it is most treatable. We developed our low-dose CT lung cancer screening guidelines based on the National Lung Screening Trial, a landmark study that used new ways to identify those at risk and test them for cancer. The study’s methodology led to an impressive 20% drop in lung cancer deaths. The use of our low-dose CT lung cancer screening led to 20 diagnoses of lung cancer in 2017, 12 of which were detected at Stage 1, when we can offer more effective treatment. The cancer screening navigator ensures that positive findings are directed to next steps per evidence based guidelines. Navigation is provided for breast, cervical, prostate, colorectal, skin, and lung cancer screenings, easing the patient’s access and journey along the way.

Medical Oncology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (302) 645-3770 Radiation Oncology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (302) 645-3775 Clinical Trials . . . . . . . . . . . . . . . . . . . . . . . . . . (302) 645-3100 (ext. 2635) Nutrition Services. . . . . . . . . . . . . . . . . . . . . . (302) 645-3100 (ext. 2636) Psychosocial Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . (302) 645-3087 Support Groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (302) 645-3087 Cancer Screening Care Coordinator. . . . . . . . . . . . . . . . . . (302) 645-3169 Breast Health Nurse Navigator. . . . . . . . . . . . . . . . . . . . . (302) 645-3630

For additional information about Tunnell Cancer Center, please visit our website, www.beebehealthcare.org/tunnell-cancer-center. TUNNELL CANCER CENTER 18947 John J. Williams Hwy. (Rt. 24), Suite 101, Rehoboth Beach, Delaware

Tunnell Cancer Center

Data follows the American College of Surgeons Commission on Cancer Standards, prepared November 2018.

Tunnell Cancer Center Annual Report  

The mission of the Robert & Eolyne Tunnell Cancer Center at Beebe Healthcare is to provide both hope and a cure. From diagnosis through trea...

Tunnell Cancer Center Annual Report  

The mission of the Robert & Eolyne Tunnell Cancer Center at Beebe Healthcare is to provide both hope and a cure. From diagnosis through trea...