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AT BEEBE HEALTHCARE ONCOLOGY SERVICES, our patient-centered cancer care prioritizes treating the whole person and healing illness by creating physical, mental, emotional, and spiritual wellness. The evolving standard of cancer care extends beyond the treatments of surgery, radiation, and chemotherapy. With this approach, care plans address nutrition, exercise, and stress management as well as beliefs, social support, positive thinking and mindset, and spirituality. Patients become active members of their own care team, contributing to their health and optimizing the potential for healing and recovery while maintaining a better quality of life. Understanding that body, mind, and spirit are not separable and that the patient is a partner in their care are the foundations of integrative oncology. From the initial diagnosis through treatment and beyond, every patient is treated as an individual. Since its inception in 1995, people affected by cancer have come to expect an individualized approach at Tunnell Cancer Center; but, this whole person care now extends to all of Beebe Healthcare’s Oncology Services, including the recently opened South Coastal Cancer Center near Millville, Delaware.

Oncology Services

every patient is treated as an individual –

the whole person – healing illness by creating physical, mental, emotional, and spiritual wellness. Annual Report 2019-2020


CHAIRMAN’S MESSAGE

Community Care

OVER THE PAST YEAR, the global health crisis that is COVID-19 has brought enormous challenges to our community. These challenges are ongoing, and I am so proud of Beebe Healthcare’s commitment to be the proactive community health leader that Sussex County needs. Beebe has spearheaded community screening events, provided remarkable education services, and has maintained comprehensive health care services throughout this year.

CANCER DOES NOT WAIT Here at Beebe Healthcare Oncology Services, we understand that cancer does not wait. We have continued to provide our existing comprehensive cancer services throughout the pandemic, while modifying our work environment to ensure patient and staff safety. In addition, we have continued to evolve these services with a goal of providing even better care going forward, meeting the needs of our growing community and making high quality care even more accessible. With that, one of our most notable achievements of this past year has been the successful opening of the South Coastal Cancer Center, located near Millville, DE. Beebe’s second comprehensive cancer center provides all services offered at the Tunnell Cancer Center in a new, high technology facility that is conveniently located for our patients who live in the southernmost part of coastal Delaware or adjacent Maryland. The building is frankly beautiful, with an infusion center that features a fireplace and 12 treatment areas. Spacious windows allow natural light to fill the room and provide clear views to a healing garden and the surrounding natural landscape. Patients have a choice of private, semi-private, or public infusion seating. Patients in need of radiation treatment at the South Coastal Cancer Center are treated on a new, state-of-the-art linear accelerator that allows for tightly focused, rapidly verified, and quickly and safely administered radiation treatment.

EXPANDING OUR SERVICES In addition to growing our physical footprint in Sussex County, 2020 has been a year of expanding a number of services with an emphasis on providing holistic care to our patients throughout the continuum of their journey. We now provide on-site, physician-supervised outpatient Palliative Care Services at the Tunnell Cancer Center. Palliative Care aims to relieve suffering and improve the quality of life by preventing or treating, as early as possible, the symptoms and side effects of advanced cancer and its treatment, in addition to any related practical, psychological, social, and spiritual needs. Unlike hospice, Palliative Care is provided as part of a person’s cancer treatment care plan; the Palliative Care team works closely with the clinical team and offers care at the same time as all other treatments. Palliative Care does not mean a person no longer has the option for cancer treatments – this is a common misunderstanding. Individuals can work with Palliative Care for varying lengths of time. It is all based on the individual’s needs, goals, experience, and health outcomes. Cancer Navigation is a nursing directed service that provides one-on-one assistance to patients from the earliest aspects of their care, screening and diagnosis, through treatment, recovery, and long-term follow-up. The diagnosis and treatment of cancer and living with the disease may be overwhelming for an individual and their family members or caregiver. There are often many tests and appointments, especially at the beginning, and a lot of information to process about one’s care. As a partner, we have a responsibility to assist our patients, their families, and their caregivers through all of this, and we have done so through a navigation program developed by Beebe Healthcare Oncology Services nearly a decade ago. We have expanded those services over the past year and now offer a Breast Health Nurse Navigator, GI Navigator, and Owen Thomas, MD Thoracic, Head, and Neck Navigator.

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continued from previous page As part of our whole person cancer care approach, we have launched our integrative health initiative and now offer on-site Integrative Health services. Integrative Health focuses on managing the mind, body, and spirit using integrative modalities in combination with conventional cancer treatment plans. These integrative modalities include practices such as movement, yoga, nutrition, breathing techniques, music therapy, guided imagery, meditation and mindfulness, and aromatherapy. These modalities can help decrease symptoms and side effects, decrease anxiety and stress, and improve overall quality of life and well-being. We know well-being is not one-sizefits-all, so we work one-on-one with individuals to discuss goals and needs and set action steps that are right for them. It is about meeting people where they are… and helping them with where they want to go.

STAYING HOPEFUL, TOGETHER Even during a global pandemic, the need to engage and provide education to one’s community does not go away. And in many ways, it has almost become even more necessary, as we know this pandemic has affected individuals on many different levels. We have been able to continue many of our annual events while modifying them to honor social distancing requirements. The 17th annual Miracle Mile was adapted to a drive-through celebration and turned out to be one of our most successful events to date, raising over $20,000 to benefit our Cancer Patient’s Special Needs Fund.

We would like to thank the Beebe Medical Foundation for its continued commitment to support Beebe’s Oncology Services and our patients’ journeys. Most importantly, we are extremely grateful to the generous donors. Donations to the Medical Foundation support an array of services to individuals impacted by cancer and without this assistance, many may have to make choices between treatment and basic life needs or not be able to receive treatments at all. Any of this year’s successes would not be possible without the dedication of our committed team members, including physicians, nurses, clinicians, therapists, ancillary staff, volunteers, and all the other team members that greet you with a smile when you walk in the front door. We are dedicated to fighting this disease and treating the entire patient: mind, body, and spirit. We are honored to serve the members of our community, and it is our goal to continuously provide our patients and their families with the very best care. Thank you for supporting us and believing in Beebe.

Owen Thomas, MD

Chairman, Beebe Healthcare Cancer Committee

Beebe’s Breast Health Program remains the only accredited breast program in the state of Delaware through the National Accreditation Program for Breast Centers (NAPBC). Additionally, the Oncology program maintains its accreditations through Quality Oncology Practice Initiative (QOPI®) as well as the Commission on Cancer (CoC).

Tunnell Cancer Center


Outreach

Screening and Prevention

Beebe Healthcare is focused on helping people in our community stay healthy – including providing education and services to prevent cancer.

BEEBE HEALTHCARE ONCOLOGY SERVICES provides outreach, education, and screening programs to help our community learn about cancer, its causes and risk factors, and prevention strategies, such as screening tests. Even during the global pandemic, Beebe has remained committed to providing the community with educational events like our annual Think Beyond Pink – a women’s health and wellness conference that was held virtually via Zoom. While we were not able to hold a typical in-person screening event, Take a Breath focused on lung health education and early detection lung screening. The event was held on Facebook live, and helped people learn more about the lung screening process – including specifics about where to go and what to do.


Key Screening for You SCREENING TEST

BREAST mammogram

Ages 18-39 Discuss breast cancer screening with your doctor if you have a family history.

Cancer screenings are key to detection. Screenings can help find cancer at an early stage, before symptoms appear. When abnormal tissue or cancer is found early, it may be easier to treat or cure. By the time symptoms appear, the cancer may have grown and spread. Ages 40-49

Ages 50-64

Starting at age 40, have a mammogram every year to determine risk of breast cancer.

Get a Pap test every 3 years if you are 21 or older, have had vaginal sex, and have a cervix.

CERVICAL pap test

PROSTATE

COLON using fecal occult blood testing, sigmoidoscopy, or colonoscopy

LUNG

Ages 65 & Older

For men of higher risk (African American men or any man with a family history of prostate cancer) screening can begin before the age of 55 and decisions should be individualized.

Ask your doctor or nurse if you need to get a Pap test.

For men of average risk, consider testing between the ages of 55 and 69. Patients should discuss the risks and benefits of testing with their physician.

Starting at age 50, get screened for colorectal cancer. Talk to your doctor or nurse about which screening test is best for you and how often you need it.

Patients should be asked about their smoking history. Patients who are 55 to 74 years old, in fairly good health, have at least a 30 pack-year smoking history, and are either still smoking or have quit smoking within the last 15 years should talk to their doctor about a lung screening.


Cancer Prevention at Beebe Healthcare

At Beebe Healthcare, we offer outreach screenings throughout the year, in addition to the ones that people have completed through their healthcare providers.

2019 COMPLETED CANCER SCREENINGS

The chart below shows the number of outreach screenings completed for breast, cervical, prostate, colon, skin, and lung cancer between 2017-2019.

2000 1500

2003

1564

1361

55

48

95

21

39

47

18

31

34

57

85

223

305

272

500

80

1000

0 2017 2018 2019 BREAST

CERVICAL

PROSTATE

2019 KNOWN CANCERS DIAGNOSED

COLON

SKIN

LUNG

From the outreach screenings completed, the chart below illustrates the known cancers diagnosed between 2017-2019.

0

1

1

1

4

1

1

10

32

20

20

25

30


LUNG CANCERS BY STAGE Specifically looking at lung cancers, the chart below illustrates diagnosed lung cancers by stage and shows the majority of cancers found were diagnosed at Stage 1 due to early screening tests.

20

STAGE 1

15

21 8

21

14

8

6

5

14

10

0 2015

2016

2017

2018

2019

5 4 3

0

Stage 2

Stage 3

Stage 4

Unknown

Small Cell

3

1

2

1

4

2

2

1

2

2

3

5

3

4

1

1

1

4

2


Treatment

Analytic Cases at Beebe Oncology Services in 2018

THE AMERICAN JOINT COMMISSION ON CANCER (AJCC) staging system is a classification system describing the extent of disease progression in cancer patients. As a participant in the national cancer registry, Beebe Healthcare reviews and categorizes patient information and reports on the cancer cases we diagnosed and/or contributed to the first course of treatment. These cases are called “analytic cases.”

864

total analytic cases treated by Beebe Oncology Services

Top 5 Cancer Locations Treated

BREAST

LUNG

PROSTATE

COLON

BLADDER


Beebe Healthcare 2018 Case Distribution - All Sites - Analytic Cases Only PRIMARY SITE

Case

AJCC Stage

Analytic Cases

Mix %

Male

Female

0

I

II

III

IV

N/A

BREAST

201

23.3%

3

198

31

124

24

6

7

9

RESPIRATORY

159

18.4%

85

78

0

61

10

35

48

5

6

0.7%

4

2

0

3

0

2

1

0

153

17.7%

81

72

0

58

10

33

47

5

Trachea Pleura

0

0.0%

0

0

0

0

0

0

0

0

DIGESTIVE

137

15.9%

77

60

3

28

27

25

35

19

Esophagus

7

0.8%

3

4

0

1

1

0

2

3

Stomach

13

1.5%

10

3

0

3

3

1

4

2

Small Intestine

2

0.2%

1

1

0

0

0

1

1

0

Colon

55

6.4%

27

28

1

7

16

13

12

6

Rectum / Rectosigmoid

18

2.1%

11

7

2

4

3

5

2

2

Anus / Anal Canal

7

0.8%

5

2

0

3

1

3

0

0

Liver / Gallbladder

10

1.2%

6

4

0

1

0

1

4

4

Pancreas

23

2.7%

12

11

0

9

3

1

10

0

Other Digestive Organs

2

0.2%

2

0

0

0

0

0

0

2

MALE ORGANS

114

13.2%

114

0

0

31

45

20

14

4

Prostate

112

13.0%

112

0

0

30

45

20

14

4

Other Male Genital

1

0.1%

1

0

0

0

0

0

0

1

Testis

1

0.1%

1

0

0

1

0

0

0

0

FEMALE ORGANS

43

5.0%

0

43

0

19

1

9

5

9

Cervix Uteri

5

0.6%

0

5

0

3

1

1

0

0

Corpus Uteri

26

3.0%

0

26

0

15

0

3

2

6

Ovary

7

0.8%

0

7

0

1

0

4

2

0

Other Female Genital / Vulva

5

0.6%

0

5

0

0

0

1

1

3

2018

Larynx Lung


URINARY

53

6.1%

41

12

15

23

6

1

4

4

Bladder

41

4.7%

33

8

15

16

5

0

2

3

Kidney / Renal Pelvis

12

1.4%

8

4

0

7

1

1

2

1

LYMPHOMA

28

3.2%

17

11

0

6

6

9

6

1

1

0.1%

1

0

0

0

0

0

1

0

Non-Hodgkin

27

3.1%

16

11

0

6

6

9

5

1

MULTIPLE MYELOMA

10

1.2%

5

5

0

0

0

0

0

10

MELANOMA

29

3.4%

18

11

1

17

4

3

2

2

HEAD + NECK

22

2.5%

15

7

0

9

5

2

5

1

Tongue

6

0.7%

3

3

0

4

0

1

1

0

Parotid Gland / Salivary Gland

4

0.5%

1

3

0

2

1

1

0

0

Oropharynx

3

0.3%

3

0

0

0

2

0

1

0

Tonsil

9

1.0%

8

1

0

3

2

0

3

1

LEUKEMIA

14

1.6%

9

5

0

0

0

0

3

11

OTHER ENDOCRINE

1

0.1%

1

0

0

1

0

0

0

0

THYROID

14

1.6%

4

10

0

9

1

0

0

4

URETER

1

0.1%

1

0

0

0

0

1

0

0

BONE + CONNECTIVE TISSUE

4

0.5%

3

1

0

0

0

2

1

1

BRAIN / CNS

2

0.2%

1

1

0

0

0

0

0

2

OTHER SKIN

3

0.3%

2

1

0

1

0

0

0

2

ALL OTHER / UNDEFINED / UNKN

29

3.4%

16

13

0

0

0

1

2

26

TOTAL ANALYTIC CASES

864

100.0%

412

456

50

329

129

114

132

110

TOTAL NON-ANALYTIC

7

Hodgkin’s

TOTAL CASES ABSTRACTED

871

Note: N/A represents no staging scheme or no staging scheme done; X represent DX only


Members of the Beebe Healthcare Oncology Services Medical Staff

Andrejs V. Strauss, MD radiation oncologist

James Spellman, Jr., MD surgical 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

Venkateswar Veerapalli, MD medical oncologist

William Ryan, MD medical oncologist

Jennifer Hung, MD radiation oncologist

Alec Chase, PA-C oncology physician assistant

Kelly Felix, PA-C oncology physician assistant

Rhonda Owens, APRN oncology nurse practitioner

Elizabeth Wilson, FNP-BC oncology nurse practitioner

Katie Johnson, DO hospitalist, palliative care


Leadership Beebe Healthcare Oncology Services Maurice Winkfiel MBA, CHAM, Executive Director of Oncology Services

Ellen Huntington MBA, Manager – Radiation Oncology

Rita Karapurkar Williams MA, CHES, NBC-HWC, Manager – Psychosocial Services

Maurice joined Beebe as the Director of Patient Access in 2014, before transitioning to Director of Operational Improvement in 2018 and then joining the Cancer Center this summer. Maurice obtained his bachelor’s in Finance from Temple University and a MBA from Wilmington University. Prior to moving to Delaware with his family, Maurice spent over 15 years in healthcare finance in Texas and Pennsylvania. As the Director of Patient Access/Revenue Cycle Operation at Baylor Scott & White Healthcare, he was instrumental in planning and implementing the newly constructed 126-bed hospital. Maurice began in finance with both Paoli Memorial and Abington Memorial Hospitals. Maurice’s goals for Beebe Healthcare Oncology Services include developing quality improvement initiatives to ensure the best care and experience for the patients, as well as unifying the oncology team to create an environment that is effective, efficient, and purposeful.

Ellen comes from Missouri with more than 11 years of experience in the field of Radiation Oncology. She moved to Rehoboth Beach to pursue the opportunity to expand her knowledge of Oncology Services and learn new ways of operating in healthcare. After successfully opening a second Radiation Oncology department at South Coastal Cancer Center in 2020, Ellen’s goal for 2021 is to collaborate with Patient Financial Services and the Business Office to improve and develop a more efficient billing process, reducing duplicate work and expediting services. Ellen holds a bachelor’s degree in Applied Science and Arts from Southern Illinois University and her MBA from University of Cincinnati. Ellen loves to travel and try new foods of all kinds. In her downtime, you’ll mostly find her in the outdoors with her dog, Gus.

Rita is local to Southern Delaware. After finishing her master’s in Health Education and Behavior Change from Columbia University and spending many years working and living in New York, she returned to Lewes with her husband and two sons. Beyond her degrees, Rita is a board certified health and wellness coach, Health Education Specialist, and holds a certificate in Integrative Health and Lifestyle from Arizona Center for Integrative Medicine, amongst various professional trainings in topics such as mindfulness, breathwork, food as medicine, and coaching. Rita is continuously learning and growing, both personally and professionally, and is committed to the Beebe mission and vision. Her collaborative vision for 2021 is to further embed the whole person approach and extend Palliative Care, Integrative Health, and Survivorship services into our continuum of care offered at Beebe Oncology Services.


Sue McCauley MSN, Manager – Oncology

Ella Mae Shupe MSN, Nursing Manager – Oncology

Susan Chalmers Manager – Business Office

Sue joined Beebe Healthcare’s Oncology team from the beautiful Berkshires in Massachusetts. She holds a master’s degree in Nursing Management and Leadership. With 20 years of oncology experience, including leadership roles at several large academic institutions in Boston, Sue most recently worked at Dana Farber Cancer Institute and Beth Israel Deaconess Medical Center in the Breast Cancer service line. Sue is very passionate about patients and their care. As such, her goals for 2021 include respectfully implementing clinical change that benefits both patients and staff, as well as exploring the Southern Delaware beaches and getting to know her coworkers.

Ella Mae brings over 30 years of nursing experience to her role as Oncology Nursing Manager at Beebe Healthcare. Ella Mae’s nursing career started in the Emergency Department with a specialty in pediatrics. Moving on to Oncology in 2002, she spent 13 years at John’s Hopkins. Most recently, Ella Mae held the role of Clinical Specialist for five ambulatory infusion centers under the umbrella of AdventHealth in Central Florida; responsible for 87 nurses and the five infusion centers. Ella Mae obtained her master’s degree in Nursing and is certified with Oncology Nursing Certification Corporation (OCCN). She is also very involved with the Oncology Nursing Society. Ella Mae moved to Southern Delaware from Central Florida with her husband. They have five children and four grandchildren with one on the way.

Susan has been in Healthcare Management for over 20 years. She started as a Respiratory Therapist in Scranton, and has experience as a HIPAA Compliance Officer and Manager/ Administrator for Primary Care in Yardley, Orthopedics with the Rothman Institute in Philadelphia, Dermatology in Princeton, and most recently at the University of Colorado Hospital’s Cancer Center, where she was an integral part of the Cancer Center’s management team. Susan moved to Lewes two years ago as a Division Manager for BMG overseeing the Dermatology, Endocrinology, Infectious Disease, Pulmonology, Women’s Health Bayside, Advanced Care Clinic and Palliative Care, Walk-ins, and School-Based Wellness Centers. She currently is the manager of Beebe’s Oncology Business Office. She lives with her husband, Doug, and their three Australian Shepherds and a Black lab. They have five children and two granddaughters. They love to travel, cook, and entertain.


Support

The Beebe Medical Foundation

$

160 Donors Made Tribute Gifts

20,108

THE FOUNDATION, ALONG WITH our generous community, has demonstrated a deep commitment in supporting Beebe’s Oncology Services and our patients’ journeys. Donations to the Medical Foundation support an array of services to individuals impacted by cancer who may, without this assistance, not be able to receive treatments or may have to make choices between receiving treatments and providing basic needs. Below is a summary of the generosity of our community, including patients and families who have been part of our Beebe Healthcare Oncology Services family.

673

$

$

984 825

Donors Gave , to Beebe Healthcare Oncology Services

534,878

Donated to Oncology Services in Bequests through Donors’ Wills

14 Patients Gifted Thank Yous through

Celebrate Excellent Care $ ,

15 496

It is because of our special community, our committed team members, and donors that we are able to grow and evolve our services and help address the special needs of our patients. Thank you.


hopeful I AM

BECAUSE...

THE VERY DEFINITION OF HOPE is in the future tense – a feeling or expectation for a certain thing to happen. And while it is important to make plans for a better future, we need to focus on instilling hope in the present. Having hope is important to the essence of being human. For 17 years, Beebe Healthcare’s Tunnell Cancer Center has hosted a celebration to honor the hope of cancer survivors and their caregivers with a 1-mile walk on the Rehoboth Beach boardwalk. The Miracle Mile, a morning full of commemoration, music, food, and festivities, has become a staple in the community; but, with the global pandemic, things looked very different this year. The 2020 Miracle Mile was a true testament to the community’s strength, solidarity, and resilience. Participants drove the Miracle Mile through Hudson Fields. The 1-mile drive was lined with messages of hope and enthusiastic supporters cheering and celebrating along the way. Each sign completed the phrase, “I am hopeful because…”. This created a theme of undeniable hope and gratitude.

Drive the Miracle Mile 2020 was a huge success in many ways! Through the generosity of 261 donors, over $20,000 was raised to support our Cancer Patient Special Needs Fund. The fund assists patients who have limited financial resources and need help in covering emergent expenses such as prescriptions or copays for medications, medical supplies, nutrition, essential living expenses, and transportation. Without the availability of this fund, some patients would not have access to their basic needs while undergoing cancer treatments. We are especially grateful to our community for this support in this unprecedented time when so many things are unknown. Hope is a match in a dark tunnel, a moment of light, just enough to reveal the path ahead and ultimately the way out. This community brought hope to the present moment by setting intentions for loved ones, friends, and community and creating an amazing message of hope to share.

Thank you!

TERRY WARRINGTON

“The Miracle Mile was amazing this year. I go with my mother every year and always enjoy catching up with survivors and seeing their strength and support systems. Having the teams around the field to cheer – wow! You all do amazing things each and every day!”

Connect with Beebe Healthcare Oncology Services by calling 302-645-3770 or visiting www.beebehealthcare.org.