2018 Cancer Center Annual Report

2018 Annual Report With 2017 registry data

CaroMont Cancer Center Cancer Center Annual Report

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Table of Contents Overview 1 Treatment 2 Services 4 Accreditations 7 Key Accomplishments 8 Cancer Committee 9 Cancer Registry Data 11 Quality Study 12 Survivor Story 15 Partnerships 16 Clinical Trials 16 Resource Directory 17

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Cancer Center Annual Report

Welcome At CaroMont Health, we strive for more than just the highest ratings, our intention is to provide the best possible cancer care for our community. This report provides an overview of the comprehensive oncology services provided by our multidisciplinary team of compassionate experts. We are proud to highlight our accomplishments and strategic initiative implementations from the past year.

Cancer can happen to anyone. Regardless of where patients are in their cancer journey, CaroMont Health is ready to assist in making the best decisions about their diagnosis and treatment.

The CaroMont Cancer Center is fully accredited by the American College of Surgeons Commission on Cancer as a Comprehensive Cancer Program and recently received the Outstanding Achievement Award. Our comprehensive Breast Center is accredited by the National Accreditation Program for Breast Centers and our Radiation Oncology Center is accredited by the American College of Radiology – Radiation Oncology Program Administration.

In the past year we have grown as we have expanded our services to include medical oncology with the development of CaroMont Hematology & Oncology. We have added expert medical staff through the addition of Sejal Dave, MD and Angel Yu, MD and we continue to grow our physician numbers to meet the needs of our community.

On behalf of our team of caring and compassionate healthcare professionals, it is with pleasure we present the 2018 Cancer Program Annual Report.

Sincerely, Jerome M. Butler, Jr, MD Oncology Service Line Physician Leader

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Overview Mission It is our mission to improve the health of the people and communities we serve by providing high-quality, timely, compassionate oncology services that are nationally-recognized and accredited.

Promise Our promise is to provide excellent care. The physicians and professional staff of the CaroMont Cancer Center take pride in providing the very best care for you and consider it a privilege to provide your treatments.

History The CaroMont Cancer Center was established in 1989 on the campus of CaroMont Regional Medical Center to address the need for comprehensive cancer services in Gaston County.

Since then, the program has grown significantly in staff and technology, and recently expanded into neighboring Lincoln County.

Founded on the principle of providing high-quality, convenient care to our community, CaroMont Cancer Center continues to work to improve the health of the people and communities we serve.

About CaroMont Cancer Program The CaroMont Cancer Center provides an overall system-of-care approach to the treatment of cancer. This includes prevention, early detection, education, treatment, follow up, symptom management and patient survivorship services. We focus on a patient-centric approach to cancer care, which places the patient and their family at the heart of decision making and treatment planning.

Our highly-responsive team of physicians and staff members initiate care in a coordinated manner with other necessary support services provided in the community. Our patients benefit from sophisticated technology and expertise, as well as a unique healing environment designed for wellness and hope.

We understand that patients prefer to stay close to home when receiving cancer treatment.

That’s why we offer nationally-accredited cancer care - in your community.

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Treatment Radiation Therapy Radiation therapy is one of the most effective weapons in the war against cancer. It is given as part of an initial treatment plan if necessary or as a means to lessen or control symptoms, such as cancer-related pain. This rapidly changing field, with several evolving technologies, offers the most advanced, precise and sophisticated cancer treatments available.

CaroMont Cancer Center uses a targeted therapy approach that utilizes specific treatment to limit side effects. CaroMont Cancer Center therapies include TrueBeam™ Stereotactic Radiosurgery and Stereotactic Body Radiosurgery (SBRT), Intensity Modulated Radiation Therapy (IMRT), Breast MammoSite® and Brachytherapy.

This advanced technology is available at our two locations: CaroMont Regional Medical Center and Lincoln Cancer Center. The treatment is highly technical and requires a special team of Radiation Oncologists, Dosimetrists, Radiation Therapists and Medical Physicists.

The Radiation Oncology program is nationally accredited by the American College of Radiology (ACR).

Surgery CaroMont Health has highly-trained, board-certified surgeons on staff to address the surgical needs associated with cancer treatment plans. These surgeons work closely with care teams to ensure the best possible outcomes.

Depending on the type of cancer, a patient could see one of the following: Ear Nose & Throat (ENT) Surgeon, General Surgeon, Colorectal Surgeon, Fellowship-Trained Breast Surgeon, Neurosurgeon, Plastic Surgeon, Thoracic Surgeon or Urologist.

Medical Oncology and Hematology Treatment may also involve medical oncology, and CaroMont Cancer Center’s accredited program offers compassionate care from board-certified medical oncologists.

CaroMont Cancer Center offers convenient on-site access to inpatient and outpatient infusion services. A specially-trained team of nurses provide chemotherapy and other systemic treatments in local physician offices and the CaroMont Cancer Center.

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Treatment (continued) Medical Oncology Unit CaroMont Regional Medical Center’s Medical Oncology Unit is focused on meeting the special needs of cancer patients. The nursing staff is comprised of Registered Nurses who have been specifically trained through the Oncology Nursing Society to administer chemotherapy and manage the care of patients receiving cancer therapies. Many have achieved national nursing certification in Oncology (OCN).

Infusion Center As with the Medical Oncology Unit, our Registered Nurses have extensive experience in infusion therapy and have received certification in chemotherapy and biotherapy administration through the Oncology Nursing Society. These nurses work collaboratively with physicians to address patient emotional and physical needs during treatment. Treatment is provided in private areas with reclining chairs, televisions and easy access from the parking deck.

A sample of the services offered in the Infusion Center include: Administration of intravenous medications and chemotherapy Administration of blood and blood component therapy Administration of hydration and antiemetics

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Services CaroMont Cancer Center recognizes that cancer can affect every aspect of a person’s life and the journey can be very challenging for the patient and their loved ones. CaroMont Cancer Center offers a number of support services to assist patients physically, psychologically, emotionally, socially and spiritually.

Counseling Services Oncology Counseling is available to assist patients and their family in coping with the emotional and psychosocial effects of the cancer experience.

Lung Nodule Program In 2018, as part of CaroMont's commitment to offer the best in cancer treatment to our community through early detection, the Incidental Lung Nodule Program was launched.

Currently over 60% of lung cancers diagnosed and/or treated at CaroMont Health are classified as Stage III or IV and studies have shown that identifying lung cancer as early as possible is key to offering the best options for curative treatment.

By facilitating interdisciplinary coordination between the primary care provider and specialist as well as supporting and assisting the patient with referrals to various disciplines and diagnostic work up. The goal of the program is to decrease the number of late stage diagnosis. Thus giving our patients an opportunity at better outcomes.

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Services (continued) CaroMont Comprehensive Breast Center Without leaving the community, breast cancer patients benefit from a personalized plan of treatment recommendations from a multidisciplinary team of radiologists, medical oncologists, pathologists, radiation oncologists and surgeons.

In ONE visit, newly-diagnosed breast cancer patients receive: A comprehensive evaluation A discussion of the diagnostic and/or treatment options A personalized plan of treatment recommendations An assessment for clinical trial eligibility A meeting with a nurse navigator and oncology dietitian An assessment for Genetic Counseling

Palliative Care Many people with chronic illness suffer symptom burden that impacts their quality of life. In an effort to improve the care of patients, CaroMont Regional Medical Center provides outpatient palliative care services to help with the elimination or lessening of their symptoms. The team works to create a plan of care that is individualized for the patient and incorporates cultural and spiritual needs.

Navigation Services The goal of navigation is to make sure that services offered through the CaroMont Cancer Center and the community are available to all patients. Navigators eliminate barriers that could interfere with or delay treatment. They educate patients and families and provide access to local and national resources. Navigation services are offered through the CaroMont Cancer Center by a team of nurses, social workers, financial counselors. These services are provided from diagnosis into survivorship.

Pastoral Care Chaplains are available to support cancer patients, families and friends in making use of faith or spiritual values to work through the challenges of cancer. Pastoral Care may include conversation, prayer, liturgy, worship, sacraments, scripture reading, reflection and program referral. The pastoral care service is interfaith, personal and specific for the individual and family in need. The William McKinley Roberts Memorial Chapel is located on the second floor of CaroMont Regional Medical Center and is open for personal meditation 24 hours a day.

Nutritional Counseling Nutrition services, specific to cancer patients and survivors, are offered by a registered dietitian with special training in oncology.

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Services (continued) Gaston Hospice CaroMont’s Gaston Hospice cares for people who have a life-limiting illness that is no longer responding to curative treatment. Hospice care helps to allow these patients to live at home as fully as possible. Since 1981, the highly experienced staff and volunteers have dedicated themselves to providing the most compassionate and highest quality hospice care for your loved one and you. Hospice also provides services at CaroMont Regional Medical Center, Robin Johnson Hospice House and local long-term care facilities.

To learn more, please visit www.gastonhospice.org.

P.R.I.D.E. Program - Oncology Wellness Program

Power to Recover through Individualized Development and Exercise P.R.I.D.E. is a wellness program designed to assist cancer survivors in managing the physical, social, psychological and spiritual side effects of cancer treatment.

The program, developed by the CaroMont Health and Fitness Center and the Cancer Center, provides both physical exercise and lecture-style educational presentations during and posttreatment.

The goals of P.R.I.D.E. include: Reducing fatigue Maintaining or improving strength and endurance Decreasing risk of depression Increasing Independence for normal activities Improving quality of life Educating and informing patients

P.R.I.D.E. CANCER WELLNESS PROGRAM

Power to Recover through Individualized Development and Exercise

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Accreditations CaroMont Health and CaroMont Cancer Center are proud to be recognized and accredited by a number of renowned professional healthcare organizations, including: American College of Surgeons (ACOS) - Commission on Cancer The Commission on Cancer's Outstanding Achievement Award National Accreditation Program for Breast Centers (NAPBC) American College of Radiology (ACR) Radiation Oncology Program The Joint Commission (TJC) College of American Pathologists American College of Radiology’s CT Accreditation Program American College of Radiology’s Mammography Accreditation Program American College of Radiology’s MRI Accreditation Program American College of Radiology’s Nuclear Medicine Accreditation Program American College of Radiology’s PET/CT Accreditation Program American College of Radiology’s Ultrasound Accreditation Program American College of Radiology’s Breast Center of Excellence

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2018 Key Accomplishments Expansion of Services To better meet the needs of our community we have expanded our services to include medical oncology with the development of CaroMont Hematology & Oncology. We have added expert medical staff through the addition of Sejal Dave, MD and Angel Yu, MD and we continue to grow our physician numbers.

Sejal Dave, MD

Angel Yu, MD

Commission on Cancer (CoC) Outstanding Achievement Award Established in 2004, the Commission on Cancer (CoC)’s Outstanding Achievement Award (OAA) is designed to recognize cancer programs that strive for excellence in demonstrating compliance with the CoC standards and are committed to ensuring high quality cancer care.

A CoC-accredited cancer program is eligible to earn the OAA after completing the accreditation survey and receiving a Performance Report that indicates an accreditation award of “Three-Year with Commendation.” Specifically, the program must receive commendation ratings for the seven commendation level standards and no deficiencies for the remaining 27 standards.

OAA recipients represent a multitude of health care facilities, including community-based facilities, academic hospitals, integrated network, pediatric hospitals, and freestanding cancer centers.

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Cancer Committee

The Cancer Committee is the designated multidisciplinary body for the administrative oversight, development and review of cancer care services at CaroMont Health. The group meets quarterly and is charged with assessing and evaluating the quality of the cancer program and making recommendations.

Cancer Committee Membership: Alec Akbarov, MD Rebecca Brown, MD Jerome Butler, Jr., MD Kathleen Besson, MSN, RN Diane Block, RN Michael Case, MD Mark Chaparro Jeannette Childers, RN Ashley Cloninger, MSN, RN Tammy Cozad, MSN, RN Sejal Dave, MD Todd Davis, MD Susan Deam, RTT Robert Doline, MD Lisa Ganem, CTR Wayne Gardner James Greelish, MD Heidi Hartman, DO Jay Hendler, MD Janice Hill, RN Donald Howard Amanda Johnson, RN Doug Johnson, DO Gayla Jones Richard Lahm Amanda Lee Steve Lemons Melody Lineberger-Moore Ashley Long, MSN, RN Paula Lundgren, MD

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Cardiothoracic Surgeon Quality of Life Coordinator/Palliative Care Radiation Oncologist, Service Line Physician Director Chief Operating Officer Oncology Nurse Navigator Medical Director, Gaston Hospice Director, Pharmacy Oncology Quality Coordinator Manager, Oncology Nursing Manager, Clinical Research Medical Director, Medical Oncologist Chief Medical Officer Lead Radiation Therapist Chairman, Radiation Oncologist, Interim CLP Certified Tumor Registrar (Cancer Registry Quality Coordinator) Lead Medical Physicist Cardiothoracic Surgeon Radiologist Pulmonologist Clinical Nurse Manager, South Manager, Outpatient Rehabilitation Oncology Quality Coordinator Diagnostic Radiologist Cancer Registry Executive Director, Gaston Hospice Exercise Specialist, PRIDE Program Director, Pastoral Care Clinical Research Senior Director, Patient Care Breast Surgeon

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Charles Meakin, MD Renee Merritt, RN Meredith Mills, RD Tristy Morrison, RN Chang K Oh, MD Margie Owenby Tamara Patterson Stephanie Perri Rici Reid, LCSW Stephanie Roberts Deanna Roe Hayley Rutkowski, RN Lindsay Sain, RN Sandra Schultz, MD Amelia Sloan Graydon Stallard, MD Brian Sutton, MD Hope Toney Steve Tracy, MD Rick Varterasian Angel Yu, MD

Medical Director, Radiation Oncologist Case Manager Oncology Dietitian Manager, Clinical Performance Improvement Gastroenterology Oncology Program Coordinator (Community Outreach Coordinator) Manager, Cancer Center Practice Manager, CaroMont Hematology & Oncology Oncology Social Worker (Psychosocial Services Coordinator) Executive Director, Cancer Services of Gaston County Director, Medical Imaging Oncology Nurse Navigator Oncology Nurse Navigator General and Breast Surgeon American Cancer Society General Surgeon Cancer Conference Coordinator, Pathologist Oncology Financial Navigator Pathologist Director, Oncology Service Line Medical Oncologist

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CaroMont Cancer Registry Data The Cancer Registry is an essential component of the CaroMont Health Cancer Program. The Cancer Registry staff works closely with the Cancer Committee to maintain accreditation as a Community Hospital Comprehensive Cancer Program by the Commission on Cancer of the American College of Surgeons.

Responsibilities of the registry include the accurate and timely collection of information on cancer diagnosed and/or treated at CaroMont Health, as well as the management and analysis of this data. The information collected, such as demographics, anatomic site, tests, treatment and extent of disease, has multiple uses which include outcome reporting, patient care reviews, physician education, clinical research and hospital planning.

The data collected by the Cancer Registry is electronically submitted to the State of North Carolina and the National Cancer Database (NCDB). This allows comparative analysis with other hospitals or databases. Data analysis for specific sites can be done to compare elements to other published state, regional or national data. This information provides the cancer program benchmarking opportunities to patterns of patient care and survival.

Chart CaroMont Health 2017 Cancer Cases Melanoma - Skin Melanoma 50 - Skin Brain Brain 50 5% 50 5% 50 5% 5% Colorectal 115 12%

Prostate 154 17%

Breast 305 33%

Colorectal 115 12%

Cancer Center Annual Report

Breast Lung Prostate Colorectal

Prostate 154 17%

Brain

Lung 257 28% Lung 257 28%

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Breast 305 33%

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Melanoma - Skin

2017 Quality Reports Commission on Cancer Quality Measures Cancer Program Practice Profile Reports (CP3R) The Commission on Cancer (CoC) and the CoC’s Quality Integration Committee approve quality measures to be reported in the National Cancer Data Base (NCDB) Quality Reporting Tools.

These measures use cancer registry data elements to track measure compliance allowing CoC-accredited cancer programs to benchmark their performance with other CoC-accredited programs.

Evidence-based measures or accountability measures promote improvements in care delivery and are the highest standard for measurement. These measures demonstrate provider accountability, influence payment for services and promote transparency. The quality improvement measure function is to monitor the need for quality improvement or remediation.

Generally, these measures are for individual program use. Surveillance measures are used to identify the status quo, generate information for decision-making, and/or to monitor patterns and trends of care.

CaroMont Cancer Centers 2016 CP3R Data Released November 27, 2018

Female Cancers

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2017 Quality Study (continued) Lung Cancer

Breast Cancer

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2017 Quality Study (continued) Colon Cancer

Gastric

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Patient Survivor Story A Warrior's Tale My story began in the fall of 2013. I had a sore throat and had been going to my primary care doctor, as well as the city nurse. I worked for the City of Gastonia at the time. After several rounds of antibiotics, the pain did not get any better.

I was then referred to an Ear, Nose and Throat specialist.

The appointment that took place on December 20, 2013 and changed my life forever. It was determined that I had a tumor on my larynx and it was stage four. I was left with a stoma in my neck and have a prosthesis to aid in speaking.

Jim Holland It was during my radiation treatment that I was first exposed CA NCER SURVIVOR to CaroMont Cancer Center. My treatment was headed up CA NCER CEN TER PATIEN T

by Dr. Doline. Anyone who has ever been through cancer treatment knows that this is when you become a warrior. You actually have to fight for your life. The treatments were rough but I was determined to that if cancer won it would have to catch me because I was going to be running. While I was at CaroMont everyday for treatments, I would see the volunteers there helping people with food, drinks, a warm blanket or just a listening ear. I told my wife that after I finished treatment, that's what I wanted to do, as well.

The Lord has blessed me and I have been able to be a volunteer for 2 ½ years. For some reason, it does my heart good to be around other people who are going through something that I have gone through before. I hope that they can relate to me and be encouraged to know that there is light at the end of the tunnel.

There was one more trial I faced in 2017. I was once again diagnosed with cancer. This time it was prostate cancer. Once again, I was on the receiving end of the Cancer Center. I had 44 treatments this time, but I was still able to come in and volunteer on my usual day. I can’t say enough about the friendly and helpful people at the Cancer Center. They have become almost like family. I like to tinker with woodworking in my spare time. If you look around the Cancer Center, you will see some of my handiwork. I have made nameplates for most of the staff.

During the holidays, you may see seasonal items like pumpkins, snowmen and Christmas trees on their desks.

I would like to sum this up by saying that if there was a bright spot in these difficult times, it was meeting and interacting with the wonderful staff at CaroMont Cancer Center. They truly care about the patients. Volunteering there has added so much to my life and I hope I have been able to help or make a difference to someone along the way.

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Partnerships CaroMont Cancer Center partners with the American Cancer Society, CaroMont Health Foundation, Cancer Services of Gaston County, and many other local, regional and national organizations to further enhance and support our mission.

We actively seek local and national cancer care partners to bolster our strengths and better enable us to carry out the vision of CaroMont Health. Continuous improvement is not a solo performance. It requires an orchestrated effort, and we are eager to team up with organizations that can boost quality, help control costs and provide opportunities to promote community wellness.

We are proud of our cancer care partnerships in the community and the outreach programs in which we participate. Our dedicated medical professionals and volunteers contribute many hours to the community and participate in many different health events.

From our support and involvement in CaroMont Health free screenings, to volunteering in our community, wellness events and educational classes, the Cancer Program is proud to participate in these activities because of their value to our community.

Clinical Trials Clinical trials are strictly controlled studies of new and emerging therapies. These students test whether a new drug, prevention strategy or screening option is safe and effective for patients.

CaroMont Cancer Center is part of a consortium of North Carolina cancer centers with access to a wide variety of clinical trials sponsored by government organizations such as the National Cancer Institute. This includes pharmaceutical trials and physician-initiated studies developed by our own physicians and research team.

In 2018, 6.8% of the new cancer patients at CaroMont Health were enrolled in clinical trials related to cancer prevent, diagnosis, screening, treatment, and quality of life or tissues studies.

Many of the patients enrolled in clinical trials in previous years continue to participate. This ensures that our patients are receiving the most up-to-date cancer care.

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Resource Directory Cancer Center Cancer Registry CaroMont Comprehensive Breast Clinic CaroMont Health CaroMont Heart CaroMont Hematology & Oncology CaroMont Rehab Clinical Research Gaston Hospice Infusion Center Inpatient Oncology Unit Inpatient Palliative Care Lincoln Cancer Center Lung Nodule Project Medical Imaging (Radiology) Oncology Nutritional Services Pastoral Care Patient Navigation P.R.I.D.E. Program Radiation Oncology Social Worker Volunteer Services

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Cancer Center Annual Report

704.834.2944 704.834.4375 704.834.3540 704.834.2000 704.834.3278 980.834.9600 704.834.5730 704.834.2810 704.861.8405 704.834.3545 704.834.5200 704.834.3403 704.735.6637 980.834.LUNG (5864) 704.671.5300 704.834.3966 704.834.2888 704.671.7783 704.671.7930 704.834.2944 704.671.7784 704.834.2256

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