Florida Cancer Specialists FCS Magazine Fall 2015

Fall 2015

Picture Perfect

Enhancing outcomes with imaging expertise and collaboration is the goal for Dr. Gerald Zemel

INSIDE

GET TO KNOW DR. JOEL GROSSMAN » ADMINISTRATIVE SPOTLIGHT: JEREMY BEHLING »

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Fall 2015

contents

Featured Physician: Dr. Mike Diaz, pictured with his wife, Stephanie. “My patients motivate me, give me my energy and give me my drive to help take care of them.”

in this issue

DEPARTMENTS

6 FCS News 15 Get to Know Dr. Grossman 19 Patient Letters 24 FCS Events 28 C.A.R.E./CORE Values 38 Radar Screen

SPOTLIGHTS 12 Office Spotlight: TAMPA CANCER CENTER 21

Center is a win for both FCS and the community it serves

Administrative Spotlight: JEREMY BEHLING Guiding FCS with GPS

23 Nurse Spotlight: CHERYL HOLM Caregiver strives to make patients’ lives a little better

FEATURES 8 Dr. Gerald Zemel

Imaging is everything

30 FCS Foundation

Bringing financial support to patients in need

32 FCS Volunteer Program

A win-win for everyone

34 Research Spotlight: DR. JUDY WANG Exciting times in the Drug Development Unit

36 Doctor Spotlight: DR. MIKE DIAZ This physician lives by example

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editor's

letter

FCS THE MAGAZINE PHYSICIAN LEADERSHIP

Message from

Shelly Glenn At this time of year, with Thanksgiving, the holidays and the New Year fast approaching, many of us may reflect on how thankful, blessed and privileged we are.

While so many of our patients are an inspiration – so are YOU! Some of our clinicians, doctors, staff members and their family members are personally battling cancer.

In some instances, after working with cancer patients or administering chemotherapy to a patient one day – the next day these same FCS doctors, nurses and staff members are sitting in a chair receiving an infusion themselves. They are some of the strongest, most inspirational people I know.

Along with so many of you, I am proud and honored to work with people who are the consummate professionals and true inspirations to their families, their friends, their community and to FCS! Over the past few years, our practice has supported, attended, sponsored and/or participated in over 200 events annually throughout Florida, including quite a few for the FCS Foundation. After working with cancer patients all week, many of our clinicians and staff members walk, fundraise and donate to increase awareness of a specific type of cancer or cheer on their patients, family members and colleagues.

If that’s not enough, there are FCS physicians and clinicians traveling to Haiti, Africa, Honduras and other countries during their “vacations” to provide medical support where it is truly lacking. And there’s more. We have physicians and staff members who currently sit on boards and provide leadership to various cancerrelated organizations throughout Florida and the United States.

While some medical practices and hospital personnel may serve their patients during the day and then go home and forget about their patients’ needs except for urgent calls, at FCS it’s apparent that cancer awareness, research and support is a mission. It’s the DNA and the make-up of why we work at Florida Cancer Specialists.

PRESIDENT

WILLIAM N. HARWIN, M.D. ASSISTANT MANAGING PARTNER, DIRECTOR, EXECUTIVE BOARD

STEPHEN V. ORMAN, M.D. MEDICAL DIRECTOR

MARK S. RUBIN, M.D. SCIENTIFIC DIRECTOR OF CLINICAL RESEARCH, DIRECTOR, DRUG DEVELOPMENT PROGRAM

LOWELL L. HART, M.D.

DIRECTOR OF RESEARCH OPERATIONS

ROBERT C. WHORF, M.D.

EXECUTIVE MANAGEMENT CHIEF EXECUTIVE OFFICER

BRAD PRECHTL

CHIEF FINANCIAL OFFICER

LIBBY SLATER

CHIEF OPERATING OFFICER

TODD SCHONHERZ GENERAL COUNSEL

TOM CLARK

CHIEF MARKETING & SALES OFFICER

SHELLY GLENN

CHIEF HUMAN RESOURCES OFFICER

SHARON DILL

SENIOR VICE PRESIDENT, RADIATION/RADIOLOGY AND PARTNERSHIP SERVICES

ED MERCADO

VICE PRESIDENT OF REVENUE CYCLE

SARAH CEVALLOS

VICE PRESIDENT OF CLINIC FINANCIAL SERVICES

CHRISTINA SIEVERT

SENIOR MANAGEMENT RAY BAILEY JEREMY BEHLING LOIS BROWN MELODY CHANG DAVID CURRY RICH DYSON JEFF ESHAM MICHAEL ESSIK INGA GONZALEZ KATIE GOODMAN CHRISTOPHER HOUSER SUE KEARNEY LOIS POEL JEFFREY RUBIN TARA RUSKA DENICE VEATCH SAMANTHA WATKINS

Shelly Glenn Chief Marketing & Sales Officer

IN PARTNERSHIP WITH

PUBLISHED BY

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TALLAHASSEE 10

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GAINESVILLE

• OUR LOCATIONS Altamonte Springs Apopka Atlantis Axelrod Bonita Springs Bradenton (3) Brandon Brooksville (2) Cape Coral (2) Clearwater (3) Clermont Crystal River Daytona Beach Deland Englewood Fort Myers (7) Gainesville Hudson (2) Inverness (2) Lady Lake (2) Lake Mary Lakewood Ranch Land O' Lakes Largo (2) Lecanto Leesburg (3) Naples (4) New Port Richey (2)

New Smyrna Beach North Port Ocala Orange City Orlando (2) Ormond Beach (2) Oviedo Palm Beach Gardens Palm Coast (3) Port Charlotte Port Orange Sarasota (3) Sebastian Sebring Spring Hill (3) St. Petersburg (3) Sun City Tallahassee (2) Tampa (3) Tavares The Villages (4) Venice (2) Vero Beach Wellington West Palm Beach Winter Park Zephyrhills

DAYTONA BEACH

OCALA

ORLANDO 4

TAMPA ST. PETERSBURG SARASOTA

SEBRING

WEST PALM BEACH

FORT MYERS

NAPLES

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Radiation Oncology Corporate Headquarters

For more information on a specific location, please visit FLCancer.com.

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FCS

news Valerie Vance named FCS Foundation director The Florida Cancer Specialists Foundation has promoted Valerie Vance to executive director. Valerie began volunteering with the FCS Foundation in 2014 and then joined as volunteer program manager in December 2014.

Brad Prechtl, CEO of Florida Cancer Specialists & Research Institute (FCS) and board chair of the FCS Foundation, said, “Val has done a remarkable job in building the volunteer program for the Foundation. She is a dedicated leader with a true heart for our mission.”

In her role as executive director, Valerie is responsible for all aspects of the FCS Foundation, including overall strategy and operations, supervising staff, program development and execution of FCS Foundation mission, vision and goals.

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FCS collaborating with Cigna to provide optimal patient experiences FCS, in partnership with Cigna, has established a care management program that aims to improve outcomes for cancer patients. The program, a part of Cigna Collaborative Care, utilizes cross-functional teams to engage health care professionals and drive improved health, affordability, and patient experiences. Jeremy Behling and Don Champlain will be working with all FCS sites to align roles and responsibilities of the new program to support FCS’ commitment to be the leading community oncology practice in the State of Florida.

Pair to present abstracts at ASTRO’s national meeting The American Society for Radiation Oncology (ASTRO) has selected two abstracts, co-authored by Dr. Janelle Park and FCS physicist Dr. Yuenan Wang, for presentation at its 57th annual meeting, which will be held in San Antonio, Texas, Oct.18-21. The annual meeting will bring together more than 11,000 radiation oncologists, medical physicists, radiation therapists and other professionals from around the world to discuss this year’s theme, Technology Meets Patient Care.

Park and Wang are presenting abstracts on the topics of using Volumetric Modulated Arc Therapy (VMAT) on synchronous bilateral breast cancer and on prone positioning in whole-breast irradiation.

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FCS Foundation reaches million dollar patient-grants milestone The FCS Foundation celebrated a significant milestone recently.

On June 19, the Foundation exceeded the million dollar mark in the amount of patient grants that have been distributed since its inception in 2012. The program benefits both FCS patients and others. Twenty percent of all patient grants have been awarded to non-FCS patients.

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FCS participating in USF acupuncture study FCS has announced its participation in a University of South Florida (USF) study to research the effects of group acupuncture on chemotherapy-induced peripheral neuropathy (CIPN).

Dr. Cindy Tofthagen, assistant professor of nursing at USF, is principal investigator for the study. She will be working closely with FCS medical oncologist Dr. Nuruddin Jooma, medical director of the Integrative Oncology Program, and Dr. Gene Healy, a Florida-licensed acupuncture physician who offers group acupuncture at two FCS cancer centers.

Chemotherapy-induced peripheral neuropathy affects large percentages of cancer patients who receive chemotherapy drugs that can damage peripheral nerves.

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Dr. Judy Wang joins Drug Development Unit at FCS Institute Judy Wang, MD, has joined FCS and will be working in the FCS Drug Development Unit (DDU) / Cancer Research Center located in Sarasota.

Dr. William Harwin, founder and president of FCS, said, “We are delighted that Dr. Wang will be joining Dr. Manish Patel in our Phase 1 Clinical Trials Program, which puts FCS on the cutting-edge of identifying newer targeted therapies that are changing the future of cancer treatment.”

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FCS patient advocates honored by COA FCS physicians, staff and patient advocates were honored recently at the annual conference of the Community Oncology Alliance (COA), held in Orlando. The FCS chapter of the Community Oncology Alliance Patient Advocacy Network (CPAN) was recognized for its outstanding support of CPAN and its commitment to advocacy for cancer patients.

FCS research presented at ASCO meeting FCS announced that nine physician investigators from the practice co-authored 23 abstracts and/or poster sessions that were presented at the recent American Society of Clinical Oncology (ASCO) annual meeting, held in Chicago. Among the FCS physician investigators whose abstracts were presented at the annual meeting are Drs. Janice Eakle, Lowell Hart (FCS Scientific Director of Clinical Research), William Harwin, Maen Hussein, Joseph Mace, Michael McCleod, Manish Patel (FCS Associate Director of Drug Development), Waide Weaver and Gail Wright.

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FCS highlighted in national online publication Focusing on the experience of Drs. Raul Storey and Noor Merchant, two of FCS’s newest physicians, OncLive, the highly-respected online publication of Dr. Raul Storey Oncology Business Magazine, described reasons why many smaller practices have sought to merge with FCS in recent years.

Dr. Storey points out that one of the most compelling reasons his practice joined FCS was because of the outstanding clinical trials program, which Dr. Storey calls “a dream come true for hematology-oncology.”

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Dr. Napoleon Santos Joins FCS Family in Palm Beach County Napoleon Santos, DO, has joined FCS and will be seeing patients at the FCS cancer center in West Palm Beach, Wellington and JFK. Dr. William Harwin said, “We are delighted to welcome Dr. Santos to Florida Cancer Specialists. He comes to us with excellent credentials and a strong interest in clinical research. He will be a great addition to our network in West Palm Beach.”

FCS CEO Brad Prechtl added, “Dr. Santos will be able to offer added convenience for our patients in Palm Beach County. We are very pleased to have him join the FCS family.”

During his Hematology/Oncology Fellowship at the University of Florida, Dr. Santos was named Most Outstanding Fellow in 2014. He is a strong believer in the importance of clinical research, having served as primary investigator for a research project at the Malcolm Randall VA Medical Center in Gainesville, Florida.

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FCS

news

Ribbon Cutting Held at New Smyrna Beach Cancer Center FCS physicians and staff welcomed community leaders, patients and referring physicians to a Ribbon Cutting Ceremony at the new clinical location in New Smyrna Beach. The event, which was held on May 20, celebrated the fourth FCS cancer center in Volusia County, as well as a new partnership with Florida Hospital in Volusia and Flagler county locations.

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Among those present to celebrate at the Ribbon Cutting ceremony for the new FCS location in New Smyrna Beach were: Dr. Kathleen Doughney, Dr. Eric Harris, CEO Bradley A. Prechtl, Dr. Karin Bigman, and Dr. Mudussara Khan.

Dr. Rakesh Rohatgi Merges Practice With FCS Rakesh Rohatgi, M.D., is merging his practice (Tri-County Hematology & Oncology) with FCS and will be seeing patients at FCS cancer centers in both Ocala and The Villages.

FCS CEO Brad Prechtl commented, “Dr. Rohatgi has established a reputation for being a highly skilled and extremely compassionate oncologist and we are very pleased to have him join the FCS family.”

Added Dr. William Harwin, “Dr. Rohatgi comes to us with excellent credentials. He will be a great addition to our network in Marion and Sumter counties.”

Dr. Rohatgi has practiced in Ocala and The Villages for more than 20 years and works closely with other physicians, major teaching hospitals and other facilities. Originally from India, Dr. Rohatgi was awarded a fellowship in oncology/hematology at the University of California Irvine Medical Center in Orange, California, where he also completed a research fellowship in the Division of Immunology.

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Dr. Blessy Jacob Joins FCS; will see patients in Venice, Englewood Blessy Jacob, M.D., has joined FCS and will be seeing patients at the FCS cancer centers in Venice and Englewood.

Dr. Jacob completed her fellowship in Oncology/Hematology at the USF College of Medicine/Moffitt Cancer Center, where she was selected for the Fellows Recognition Program in 2014. She also served on the Quality Committee at Moffitt Cancer Center.

Dr. Jacob has a keen interest in clinical research and has been published in such prestigious journals as the American Journal of Clinical Oncology and the International Journal of Hematology and Oncology.

FCS CEO Brad Prechtl said, “Dr. Jacob is joining an outstanding group of physicians and will be able to offer added convenience for our patients in the Venice and Englewood communities. We’re happy to have her as part of the FCS family.”

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Oviedo Office Hosts Ribbon Cutting and Physician Open House FCS physicians and staff welcomed community leaders, patients and referring physicians to a Ribbon Cutting Ceremony and Open House at the new clinical location in Oviedo on April 29. The event celebrated the fourth FCS cancer center in Seminole County, which provides added convenience for patients in the Oviedo community.

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Dr. Shilpa Oberoi joins FCS; bolsters network in Marion County, Florida Shilpa Oberoi, M.D., has joined FCS and will be seeing patients at the FCS cancer center in Ocala.

Dr. Oberoi has been in practice in Florida since 2005. After completing her fellowship in Oncology/ Hematology at M.D. Anderson Cancer Center in Orlando, she began her private practice with Tri-County Hematology & Oncology, which recently merged with FCS, and practiced in The Villages and Ocala. Throughout her career, Dr. Oberoi has been involved in oncology research and has published numerous articles in peer-reviewed journals.

Dr. William Harwin said, “We are delighted Among those in attendance at the Oviedo Ribbon Cutting and Open House (left to right): Shelly Glenn, Chief to welcome Dr. Oberoi to Florida Cancer Marketing & Sales Officer; Inga Gonzalez, Regional Director; Janet Livingston, Administrator of Oviedo ER; Dr. Specialists. She comes to us with excellent Ernesto Bustinza, Medical Oncologist; Dr. Victor Melgen, Medical Oncologist; Mayor Dominic Persampiere; credentials and she has been an outstanding Rhonda Webster, Physician Liaison; Dr. Regina Flores, Medical Oncologist; Bradley A. Prechtl, Chief Executive participant in clinical research throughout Officer; Dr. Ralph Gousse, Medical Oncologist; Todd Sykes, President/CEO of Oviedo–Winter Springs Regional Chamber of Commerce; Sara Jones, Customer Experience Manager. her career. She will be a great addition to our network in Marion County.”

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COVER STORY

Endovascular and Oncologic Intervention

Enhancing outcomes with imaging expertise and collaboration

BY ZANDRA WOLFGRAM

I

maging is everything to Gerald Zemel, M.D. So to speak.

A board-certified interventional radiologist with a focus in endovascular therapy, Dr. Gerald Zemel’s expertise is in providing minimally invasive surgical techniques that are imageguided. And where Zemel is concerned, bigger is not better. His delicate work requires making tiny incisions to gain access to the body while utilizing a CT scan, ultrasound or fluoroscopy to guide the procedure.

The challenge of this medical specialty suits this dark and dashing, 56-year-old Montreal native who now calls North Palm Beach, Florida, home. “I always was a tinkerer,” Zemel says. “I liked doing things with my hands. And I like problem solving, it’s the nature of my personality, so it’s a good fit.”

Zemel and his wife, Karla, have two sons.

Ryan, 28, manages an upscale restaurant and Mason, 24, is contemplating medical school.

After receiving his medical degree from the University of Pittsburgh School of Medicine (UPMC), Zemel did his internship at Western Pennsylvania Hospital, returned to

UPMC for a four-year residency in diagnostic radiology and then completed a fellowship at the Miami Vascular Institute.

Known internationally for his involvement in clinical research on transjugular intrahepatic portosystemic shunts (TIPS), peripheral vascular disease (PVD), carotid stenting and aortic aneurysm therapy, Zemel has lectured extensively and has trained other physicians in a variety of interventional and minimally invasive techniques. He has been published in numerous medical journals and is a fellow of the Society of Interventional Radiology and the American Heart Association.

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COVER STORY

Zemel, who has been practicing for 26 years, aligned with Florida Cancer Specialists & Research Institute (FCS) in 2013 when it merged with the Palm Beach Cancer Institute. Since the merger, about half of his time is dedicated to applying his trade on oncology cases for FCS. He sees about 30 patients a week during his two half-days in the office, but the vast majority of his 60-hour work week is spent in an operating room, CAT scan room or doing something procedurally related that impacts about 100 patients.

The application for endovascular therapies is wide ranging and constantly evolving, but the end goal is helping a patient move forward toward positive outcomes.

One patient—a male in his 50s— had developed lung cancer. His primary

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oncology physician ordered chemotherapy, but was uncomfortable in doing so because the patient’s platelets were too low. Zemel found the reason the platelets were low was because the patient had hypersplenism from liver disease. He treated the liver disease with TIPS; the platelet count went back up and the patient was then treated for lung cancer.

Another male patient in his 60s was diagnosed with cancer that was obstructing his colon. Normally he would go to surgery immediately, but adjuvant chemotherapy was preferred to try to limit the tumor burden, so Zemel put in a stent to open the colon so the patient could get chemotherapy. Six weeks later he was able to have colon surgery.

“I am a goal-oriented person who thrives on anticipating future issues far in

advance of the present,” Zemel says of his approach. “My goal is always to take all of the information and create a plan for the patient. It’s innate and if it wasn’t, I just couldn’t do what I do.”

Zemel is passionate about the pursuit of a higher standard of care in order to provide better outcomes to patients with fewer complications by using a multidisciplinary approach. First, by using the superior skills of the interventional radiologist with endovascular experience, the critical step of patient selection is enhanced.

Next, when operating alongside other surgeons, the outcome surpasses that which could be achieved by a single operator.

By collaborating, Zemel says outcomes consistently elevate “a cut above the rest.”

In time, case volume more than doubles.

FCS’s progressive and inclusive company

culture seems to be a match for this specialist. “It has definitely enhanced my practice enormously, because the communication—me, the patient and the primary oncologist—is so much stronger than a strictly referral basis—we all work side by side. So it’s been a win-win for everybody,” he says.

Zemel works alone, but he doesn’t act alone. He looks forward to seeing fellow physicians at weekly conferences that may include a lung cancer clinic or a GI clinic. “Really, the best way to practice is to have a group of sub-specialists handle a patient’s disease collaboratively—day-to-day and weekly collaboration—we may take it for granted, but it’s incredible what it does for patients,” he says.

“They may be tough to organize, but they are extremely effective.”

For Zemel, being able to use his training to help doctors find creative solutions to the most challenging of medical problems is what it’s all about. “I went into this field to be a consultant to the physician,” he says. “My practice now is what I dreamed of.”

Being a part of a field that is moving forward at an unprecedented pace is part of what motivates this compassionate caregiver. “It’s exciting, because I am now part of the movement toward therapies that we never would have thought of— whether they be given by an oncologist in the form of medical therapy or by myself with something more procedurally related—either way it’s remarkable.

For example, right now people with primary liver cancer are regularly treated in a way that didn’t even exist 10 years ago.”

Though mastering techniques with state-of-the-art technology is thrilling, and collaborating with fellow physicians is inspiring, patient interaction is Zemel’s greatest reward. “Every week I’ll get a card or letter from a patient expressing their appreciation and that’s enough right there,” he says.

I am a goaloriented person who thrives on anticipating future issues far in advance of the present.”

— DR. GERALD ZEMEL

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OFFICE SPOTLIGHT

Tampa Cancer Center’s success is ‘evident’

$10 million center is a collaborative hub for multidisciplinary care, continuing education, community outreach and more

BY ZANDRA WOLFGRAM

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s part of the FCS lineup, the Tampa Cancer Center is surely a fullback—a massive, solid player that continually gains ground for the team as it marches to its goals.

The handsome 35,000 squarefoot, two-story facility—located directly next to the practice fields where the Tampa Bay Buccaneers train—broke ground in September 2011.

The design challenge of the modern $10 million facility was put to Optimal Outcomes, LLC, a St. Petersburg-based healthcare facilities firm that specializes in evidence-based design. The idea is to achieve functional and aesthetic outcomes that increase operational efficiencies for providers while also creating environments that enhance patient experiences and reduce stress.

“Our approach considers the impact our buildings will have on those who utilize and occupy them,” says Patrick Marston with Optimal Outcomes. “We take proven design elements that are effective and appreciated elsewhere, then use them, enhance them and supplement them to create an environment that is most beneficial to the needs of patients, physicians and staff members.”

Samantha Watkins has risen through the ranks over her sevenyear tenure at FCS to become a Regional Director responsible for the management of daily operations for five clinics, including the Tampa Cancer Center. She was a member of the dedicated,

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hands-on team that helped make the consolidation of services in Tampa seamless.

The Clearwater native fully anticipated there would be some “growing pains” involved in merging three separate practices with their own unique cultures and integrating three medical services into one central location.

But she is pleased with the results.

The presence of medical oncology, radiation oncology and PET/ CT imaging makes the center truly multi-disciplinary and the staff and patient response to the three-year-old facility has been overwhelmingly positive.

“It’s wonderful to have everything under one roof,” Watkins says. “Patients love it because they don’t have to drive to different locations. Referring physicians love it, because they can send their patients to one location to receive full care, and, for the staff, being in the same building lends to a collaborative environment, which only adds to collegiality.”

Muted blues and greens and a stunning accent wall create a soothing and welcoming vibe within the modern space. A calming atmosphere is a necessity for the hub that swells to upwards of 80 staff in order to care for more than 400 patients a day.

The center, which has won a healthcare architecture award, has two stories. The first floor houses the treatment room, the PET/CT scanner and the technologically advanced Varian Medical Systems iX

linear accelerator. Patient exam rooms and offices for the 14-member physician team are on the second floor.

Jeff Esham, Vice President of Radiation Oncology and Radiology, working in conjunction with his leadership team—Levester Jones, Director of Radiology Services, and Kristi McComak, Radiation Oncology Services Manager—is responsible for the success of the radiology oncology and imaging service lines.

The medical oncology clinical team and services are led by head nurse Tammy Harden, RN, OCN, a six-year staffer with FCS who decided to pursue oncology after her mother went through treatment for breast cancer seven years ago. “We have a great group of nurses here,” she says.

“We all work together as a team. If I had to undergo treatment, there is not one person here I would not want to care for me.”

Day-to-day operations are managed by Senior Office Manager Helga Von Greiff and Assistant Manager Lynda Nazir. Von Greiff, who has worked for FCS for 23 years, likens the new and improved facility as a “one-stop shopping” for patients. “We love it as much as they do,” she says.

When caring for patients, Von Greiff says the Tampa Care Center staff regularly applies the “mom principal” to its standard of care. “We are constantly asking, ‘What if it were my mom, my brother or my sister? Are we providing the best care?’”

The management team, along with Physician Liaison Monica Clark, comprise a “dream team” that coordinates year-round functions and events within the Tampa Cancer Center such as quarterly continuing education courses and workshops, a Thanksgiving “thank-you” dinner buffet for 600 patients and their families and an annual Tampa Bay Bucs Breast Cancer Awareness Tailgate party, held each October prior to a Buccaneers game.

After three years, how does the Tampa Cancer Center team maintain its collaborative approach? “It takes great communication to be on the same page,” Watkins says. “And everyone on our staff knows we are in it together,” says Von Greiff.

The center is clearly a win for both FCS and the community it serves.

The mayor, other dignitaries and a number of physicians from Florida Cancer Specialists were on hand for the opening event, including Dr. Julio Lautersztain, who serves on the Executive Board of Directors for FCS. “We currently have 13 locations and serve almost 30,000 patients annually in the Tampa Bay region,” Lautersztain says. “The Tampa Cancer Center facility has increased our ability to offer unique, stateof-the-art, multidisciplinary oncology treatments that deliver new and personalized cancer therapies, providing renewed hope to an even greater number of cancer patients. This approach, in conjunction with our cutting-edge clinical trials program, allows us to bring to our patients the most up-to-date cancer treatments available.”

Brad Prechtl, CEO of FCS, said, “The Tampa Cancer Center, coupled with the growth of our practice in Hillsborough and Pinellas Counties, is indicative of our commitment to set a new standard in cancer treatment and to demonstrate the true power of what community oncology can be.”

As for keeping the staff positive and motivated, Watkins says, “Management sets the tone. We always bring a positive attitude and show the staff we are all in this together, working side by side with them.

“The staff at TCC does a great job at keeping smiles on their faces while welcoming our patients and helping them through every aspect of their difficult journey.”

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A cancer diagnosis changes everything.

Fighting cancer is a long journey. Florida Cancer Specialists Foundation helps make the road a little easier.

W

e deeply care about our patients and their struggles.

Florida Cancer Specialists Foundation was created to help patients who need financial assistance while undergoing treatment. The Foundation allows those fighting their battle with cancer to concentrate on recovery rather than their overdue rent, mortgage, electric or water bill.

Please call (941) 677.7181 or visit Foundation.FLCancer.com for more information or to donate.

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Q&A Profile

get to know your doctor

Baseball fan sometimes scrubs the pans

Dr. Joel Grossman answers some of our questions called him that. Ruth would have been Helene, but my great aunt Ruth, famous for her unbelievably good brownies and chocolate ice-box cake, died not long before she was born.

Dr. Grossman practices in Naples Goodlette.

What are the names of your children and names that were actually on the “possible names list” before the final choices were made?

My son, Karl Liam, is 8 and my daughter, Ruth Helene, is 3. There really were no other possibilities for Karl. That was my grandfather’s middle name and sort of his professional name. When he was a young doctor, he noticed many other doctors who used their first initial and then middle name, so he started doing that too. My dad was amused when other doctors called the house and asked for “Karl” because no one else ever

What is one fact about your childhood that people would be surprised to hear?

People who don’t know me are surprised when they learn that I grew up in a small town in Northeast Tennessee. When patients meet me, they guess New York or something. I was born in Baltimore but lived there only three years.

When my dad was stationed in Korea during the Vietnam War, my mom moved us to her hometown of Asheville, North Carolina, but when he came back, he wasn’t happy there, and we moved to Johnson City, Tennessee, where they were building a new VA hospital and medical school.

Do you always, sometimes or never speak with drug reps about their products when they bring lunch?

Always, but I tend to do all of the talking. I don’t have the patience to listen to a recited commercial. I’ll tell them my experience with their product

and they can chime in if they have tips about side-effect management. I’m a moving target with them.

Baseball, football or soccer?

Football and soccer are good exercise, but I’ve been a baseball fan my whole life. I played as a kid and then when I turned 30, I started playing in adult baseball leagues, which I did regularly until a couple of years ago. I won a batting title and MVP honors in 2001-2002 thanks in part to pitching that was not so good. Now, I mainly get my baseball fix by coaching my son’s team, the Florida Cancer Specialists and Research Institute Orioles—yes, I have them put the whole name on the jerseys. And I am signed up as a free agent for a 45+ tournament in February.

Any sports teams that you travel to see?

Duke football—I’ve seen them play at Notre Dame, the Naval Academy, West Point, Miami every time they’ve played there, Clemson, Tennessee, and more. I

BY DR. SCOTT TETREAULT

don’t get to Duke basketball games as much anymore but I once went to seven ACC tournaments in a row. I’ve seen the Baltimore Orioles play in both Yankee stadiums, Anaheim, Seattle, Atlanta, Miami, of course, Tampa.

What was the last nice thing you did for your wife?

The nicest things are just what we do for each other to help get through the day. One evening last week I got home a little late, around 6:30. They had just finished dinner and she had started getting the kids bathed.

The temptation, of course, is to just flop down on the couch, but instead I ate fast, walked the dog, fed the goats, watered the chickens, fed the fish, and did all the dishes including that hideous, hard-to-clean pan she uses for cooking the salmon. And I got all that done in the time she was dealing with the kids.

Do you have any pets?

You don’t have enough room in your magazine for that long story.

We have a cockatiel who I’ve had since 1995 when he was 6 weeks old. I also have a very sweet, mature American Staffordshire terrier, a 28-gallon saltwater aquarium (five fish, one shrimp, one very large anemone), two leopard geckos, five goats, three horses, 11 hens and six ducks.

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GO DEEPER INTO MULTIPLE MYELOMA ISSUES TODAY DEBATINGMYELOMA.COM • Get access to the latest clinical thinking from multiple myeloma experts • Hear arguments for both sides of a featured debate question from your peers and share your perspective

Should long-term therapy be the standard approach for patients with multiple myeloma?

Yes, it may provide continuous disease suppression.1,2

No, there is inconsistent evidence to support this approach.3-5

FIND OUT WHAT YOUR PEERS ARE SAYING AT DEBATINGMYELOMA.COM

REFERENCES: 1. Palumbo A, Niesvizky R. Sustained disease control in transplant-ineligible patients: the role of continuous therapy. Leuk Res. 2012;36(suppl 1):S19-S26.

2. Borrello I. Can we change the disease biology of multiple myeloma? Leuk Res. 2012;36(suppl 1):S3-S12. 3. McCarthy PL, Palumbo A. Maintenance therapy for multiple myeloma. Hematol Oncol Clin North Am. 2014;28(5):839-859. 4. Moreau P, Hulin C, Facon T. Frontline therapy for patients with multiple myeloma not eligible for stem cell transplantation. Hematol Oncol Clin North Am. 2014;28(5):829-838. 5. Ludwig H, Durie BGM, McCarthy P, et al; on behalf of International Myeloma Working Group. IMWG consensus on maintenance therapy in multiple myeloma. Blood. 2012;119(13):3003-3015.

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FCS

patient letters

It is gratifying always to receive letters from appreciative patients.

Their kind words remind us why we chose our careers in medicine and inspire us to do our best work. If you have a letter from a patient that you would like to see published, please submit it via e-mail to FCS Marketing at marketing@FLCancer.com.

Dear Dr. Kayali, I’m not sure if you remember me or not, but I am the daughter of one of your former patients.

From the time I met you at the hospital, to the last time I spoke with you over the phone, I’ve been wanting to thank you for all you did for my dad and our family. Given my dad has been gone for almost a year, I realize this letter is late in coming, but it doesn’t diminish the gratitude I have for you and all you did for my dad and our family during his illness.

Throughout the course of my dad’s treatment, I/we had so many questions, worries, concerns and emotional ups and downs. You were always available to provide clear information, an honest assessment of my dad’s treatment plan and goals, and most importantly, you were available not just as a doctor, but as a person who understood that our dad was someone we love and cared about.

You always took time from your busy schedule to talk with us. Despite the many demands on your time and your days being long and full, you consistently made room for us in a supportive and caring manner. I felt like my dad was not just “another number” as patients so often feel in medicine, but that you knew him as a person and someone who was so much more than his illness.

You are so gifted at what you do, Dr. Kayali. I’m grateful that you chose the field you chose as you have the heart and soul to compliment your medical knowledge, making the best combination of all.

My family and I will forever be thankful for all you did to prolong my dad’s life. We enjoyed every minute we had with him and are grateful to you for working so hard to maintain his quality of life for as long as possible.

When you’re having one of those especially long days at the hospital and you’re wondering if you’re making a difference in the lives of the people around you, know that you definitely are and that the care you provided to my dad and our family will never be forgotten.

With heartfelt thanks and warm regards, “The daughter of a former patient of Dr. Fadi Kayali”

Dear Dr. Rubin, I want to express my profound gratitude for all of your “above and beyond” efforts to find the cause of the problem I am having with the weakness in my legs and the difficulty I am having just walking very short distances. You had no obligation to take on the role of “quarterback” in an attempt to find the answers.

And yet you and your staff have continued to follow my case, refer me to other appropriate physicians and make every efforts to find the answers.

I still don’t have all of the answers, however, because of your efforst, we do have a great deal more information; and we have been able to rule out a number of possible conditions. I hope you will continue to ponder my situation.

Once again, I am so very grateful for all of your efforts.

Sincerely, “A patient of Dr. Mark Rubin”

Fall 2015

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ADMINISTRATIVE SPOTLIGHT

The Operator

Whenever Jeremy Behling is around, there always seems to be an elephant in the room

BY CHAY D. BAXLEY

H

e hasn’t been with Florida Cancer Specialists & Research Institute (FCS) all that long, but Jeremy Behling sure knows how to make an impression.

Since his first day in the spring of 2013, Behling has undertaken a top-secret mission. His assignment?

To encourage a unique blend of organization and innovation among the ranks at FCS. He calls it “operational excellence.”

“I’ve loved it ever since day one,” said Behling.

Behling was originally hired as senior director of operations, a role in which he has been called upon to execute FCS’s operational excellence strategy and program. Additionally, he took on the day-to-day management of Region Two, an ever-expanding area covering Port Charlotte to the south, Bradenton to the north and Sebring to the east, which includes nearly a dozen offices filled with a total of 200 employees in Southwest Florida.

After two years and two promotions, Behling is now officially the Vice President of Operations and Practice Innovation – a title that has responsibility for the operational excellence program, the customer experience program, central scheduling and the development of the care management program for the organization.

Together with his crew of 13, Behling examines the big picture topics from an objective perspective, putting each scenario through the organization’s “GPS.” “Growth, productivity and service,” he explained.

Efficiency and quality control are the chief priorities of this position. Utilizing the GPS method, he quickly assesses some of the key questions that plague nearly every industry: Are we looking toward the future? Are we being as efficient as possible? Are our patients, employees and providers satisfied?

“The GPS process helps us,” said Behling. “It’s the organization’s guide and it helps me figure out where we should be focusing our attention. When we have a new project, we take it through that process – growth, productivity and service. As long as it aligns with those areas, we can move forward and apply our efforts to improve the operation.”

“Our vision is that everything within the organization is an operation of excellence,” Behling concludes.

Always on the operations side of business, Behling’s resume includes everything from carpet to coffee companies. Majoring in microbiology as an undergraduate at the University of Alabama (UA), Behling had aspirations of becoming a pediatric oncologist. But unwilling to let go of his knack for business, he decided to pursue his master of business administration (MBA) at the University of Florida instead.

“The operations side of the business really intrigued me,” Behling said. “It’s a good fit for my personality. And after years in other industries, I wanted to get back to achieving a personal bottom line. “I had helped many companies to do well and succeed financially but it wasn’t as rewarding as going back to my roots, if you will. I wanted to get back into health care so that I could make a difference in a patient’s life and also to be able to add value to a category of business that is growing exponentially.”

As an undergraduate at UA, Behling discovered a passion for more than health care. Co-eds once kidded that Behling was ‘wise’ beyond his years, that he never forgot a thing—back then, it was more than just his pragmatic approach to business that earned him such comments. It was the giant elephant suit he was wearing.

“I was Big Al, the UA mascot,” Behling confessed. “It was a lot of fun, but I’ve calmed down a lot since then—I have traded my costume for business attire.”

Married now for nearly seven years, love struck the pair during a gymnastics meet near UA’s main campus in Tuscaloosa, Alabama. Big Al, of course, was the life of the party.

Today, Behling and his wife, Jennifer, have two young children – Jackson, 3, and Kate, 16 months – and, as he will tell you, absolutely no free time.

“I have a 1-year-old and a 3-three-year old, so I really don’t have any personal time anymore,” laughed Behling. “It’s filled with keeping them occupied.

Whenever I get home it’s about family time. We just like to have fun and spend our time together.”

Fall 2015

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NURSE SPOTLIGHT

It’s the Little Things

Cheryl Holm makes a big difference by developing a personal connection with patients

BY KIYO KAWAGUCHI

C

heryl Holm knew early on what career path she would take “I remember sitting on the couch at home when I was little, and my feet didn’t even reach the edge of the cushion of the couch,” she says. “Even that young, I knew I wanted to be in the health care field.”

Holm grew up in a suburb of St. Paul, Minnesota, until her family moved to Wisconsin around the time she graduated high school. She got her bachelor’s degree from the University of Wisconsin at Oshkosh and found a job at a nursing home. After gaining experience there for a year and a half, Holm decided to take a traveling job.

She joined a company that contracted with employers all over the country to perform health screenings. A crew of seven or eight women traveled across the nation in a large van, living in hotels or apartments, depending on the length of the contract. ”Our work area was actually a semi-truck that was modeled into a little clinic. It was kind of neat,” says Holm. The truck had a reception area, lab stations for drawing blood, spirometry testing, vision testing and everything else the crew would need to screen patients. “It was kind of fun, traveling with a group — we got to see a lot of the country, from California to Pennsylvania and a lot of places in between.”

After about a year and a half, Holm decided she no longer wanted to live out of a suitcase. She worked at a hospital until 1989, when she decided to make another change. She moved to Fort Myers, Florida, and worked at Lee Memorial Hospital. She especially enjoyed staff education. “That was one reason I went back to graduate school,” says Holm. “I wanted to be able to move more in that direction.”

In 1995, she moved to Tallahassee and began graduate school at Florida State University. After earning her master’s degree, she worked as a nurse practitioner in rheumatology for 16 years. Then her boss retired and Holm changed direction once more. When she found Florida Cancer Specialists, she knew it was the right fit. Holm balances her work schedule now between both the Tallahassee East and North locations.

Cancer has affected members of her family, including Holm herself — she is a breast cancer survivor. “I think oncology is just a very exciting place to be right now,” she says. “There are more treatment options available every day, new drugs, new advances in research. It’s looking a lot more promising for extending life and that’s really exciting.”

Since she has been working in oncology only nine months, Holm continues in a learning process. Compared to rheumatology, Holm sees oncology as a bigger field with a lot more treatments, but surprisingly, she says, it’s not as sad as she expected. Versus rheumatology, where there are very few cures, oncology often sees positive outcomes. “It’s more about hope than it is about doom and gloom. Patients I see are upbeat and hopeful and working hard to keep going.”

Holm says her favorite part of any health care job is getting to know the patients. Nursing is unique, she says, because it provides more opportunities to develop relationships.

“You get to know them over an extended period of time. You get to really take care of them, get really personal with these people.

Baths, helping them eat, meeting their basic needs. I think that carries on in my new role as a nurse practitioner. I still want to keep those basic aspects of patient care and feel a personal connection with the patients to make their lives a little better.”

Between work and family, Holm’s life is never dull — and it’s very active. Her husband of 21 years, Scotty, is a physical therapist. They met in the Lee Memorial Hospital fitness center, and they still enjoy exercising daily. Their 16-year-old son, Alex, is a soccer player at Leon High.

Holm also stays busy with three pets: Brandy, a miniature dachshund; Karma, a black cat; and Leo, a golden retriever. With a home near the Tom Brown Park bike trails, it’s easy to take them on walks — even Karma gladly submits to a harness and leash.

In the next year, Holm plans to start working on an oncology nursing certification. “I’ve had a long nursing career and plan to keep going a while longer,” she says. “You really appreciate how small things make such a big difference for someone. You don’t always have to do something phenomenal to leave a footprint.”

Fall 2015

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FCS

events 2.

1.

3.

4.

1. 5K ‘RUN FOR DAVID’ RACE IN BROOKSVILLE

2. AN ATHLETE MEET AND GREET IN NYC

3. FRIST HUMANITARIAN AWARD RECIPIENT

Local High School student, David Cotney, lost his battle with acute leukemia last year. This event, held at Crews Lake Park in Brooksville, FL, raises funds for David’s family and other leukemia patients. Pictured (L-R): Dr. Vikas Malhotra, Keith Slaman, Amy Jagger, Hank Malluck, Madison Malluck, Wendy Malluck, ARNP Ann Bute.

Pictured (L-R): Danielle Spears, Physician liaison; retired professional basketball player, Larry Bird; Dr. Meera Iyengar

Congratulations to Dr. Geetha Kamath (pictured left) for being awarded the very prestigious Frist Humanitarian Award at St. Petersburg General Hospital for excelling in humanitarian and volunteer efforts. Dr. Kamath has been with St. Petersburg General Hospital for the past 29 years. The Frist Humanitarian Awards are given annually in recognition of the caring spirit and philanthropic work of the late Dr. Thomas Frist Sr., a founder of HCA.

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FCS

events 5.

6.

7a.

4. FCS REGIONAL PHARMACY TRAINING The goal for the Regional Pharmacy Trainer Program is to standardize pharmacy practice within FCS. Pictured (L-R): Terri Ertley (Inverness and Ocala office), Sarah Sellars (TCC), Michelle Middleton (Pasadena), Stephanie Sabillon (Altamonte), Leonor Montano (County Line Road), Lori Whatton (Deland), Heather ‘Kitty’ Horens (Cay West), Camilo Rodriguez (Atlantis), Tracy Wuerth (TCC), Tamer Morghem (Tallahassee North)

7b.

5. TAMPA BAY LATIN AMERICAN MEDICAL SOCIETY GOLF TOURNAMENT First Place Winners! Pictured (L-R): Dr. Peter Park, Dr. Rand Altemose, Dr. Rafael Blanco 6. FRIDAY AFTERNOON ICE CREAM IN INVERNESS SOUTH Pictured (L-R): Dallas Thacker, Jaimee Gordon, Anthony Klement, Karen Genzardi, Christine Soldo, Dr. William Harrer, Sherree Scriven, and Chris Hightower in window.

7. ASK THE EXPERTS & DINE WITH THE DOCS EVENT Hosted by Florida Hospital North Pinellas on June 24, 2015, at Innisbrook Golf and Spa Resort in Palm Harbor, FL. 7a. Pictured: Dr. David Wenk, FCS Physician; and dinner guests 7b. Pictured (L-R): Maria Ramos-Person, FCS Physician Liaison Manager; and JoLynn Wright, FCS Physician Liaison Pasco County

Fall 2015

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FCS

events 8.

9a.

9b.

8. KNIGHTS OF COLUMBUS CHARITY BALL

9. RELAY FOR LIFE IN ST. PETERSBURG, FL

$6,750 was raised during the Knights of Columbus Charity Ball event in Inverness, FL on February 20, 2015. The proceeds from the Ball and Silent Auction support Veterans in the Citrus County community.

9a: Pictured: Anita Jenkins – Dr. Richard Knipe’s patient

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9b: Pictured (L-R): Physician Liaison Manager Maria Ramos-Person and her daughter.

FCS

events 10.

11.

10. SWAN PLAQUE DEDICATION Physicians, nurses and staff from Daytona Beach Cancer Center at Florida Hospital present a plaque to patient Mary Ann Young, who donated a live swan for the lake outside the facility.

Pictured (L-R): Dr. Sejpal (Radiation Oncologist) with Florida Hospital, Dr. Harris, Eve Vesely, LPN – FCS, Denise Norfolk, lung navigator – FH, Jenny Kertig, social worker - FH (behind Denise), Mary Ann Young, patient, Natalie Farber RN – FCS, Amy Youman Head Nurse – FCS, Jennifer Donahue RN - FCS

11. NEW MEMBER OF THE FCS FAMILY IN VENICE Congratulations to Dr. Mehnaz Juna and her family on the birth of their new baby girl!

Submit your recent event photos to FCS Marketing at marketing@FLCancer.com.

Fall 2015

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FCS

c.a.r.e/core values

Congratulations to our C.A.R.E./CORE Values Program monthly winners!

April Winners who “Continuously Support The Patient” §§ Jenni Fussell, PSS in Naples Goodlette §§ Alan Cabot, PET/CT Nuclear Med Tech in Lecanto

May Winners who “Always Do The Right Thing” §§ Jen Jessee, PSS in Port Orange §§ Pam Andres, Head Nurse in Bradenton

June Winners who “Respectfully Engage”

§§ Chad Steelmon, Pharm Tech in Mease §§ Nerissa Tewksbury, Patient Services Specialist in Wellington

July Winners who “Exceed Expectations”

§§ Betty Jenkins, MA in Wellington §§ Malia Keen, Head Nurse in Sebastian/Vero Beach

By personally demonstrating our C.A.R.E./CORE Values in everything you do, you help educate patients about Florida Cancer Specialists and represent the mission, vision and the very heart of our organization.

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It’s what’s inside that counts.

The molecular alterations that lead to cancer are unique to each patient. At Foundation Medicine, our approach tests for all clinically relevant alterations driving a patient’s cancer.

As a result, a FoundationOne® comprehensive genomic profile can identify 3 times more targeted therapy options than traditional hot spot testing.1 We are more than just a test provider.

We help you access these therapies so you can deliver the best possible care for your patients.

Open up more possibilities of precision treatment with FoundationOne.

1. Frampton GM, Fichtenholtz A, Otto GA, et al. Development and validation of a clinical cancer genomic profiling test based on massively parallel DNA sequencing. Nat Biotechnol. 2013;31(11):1023-1031. ©2015 Foundation Medicine, Inc. Foundation Medicine® and FoundationOne® are registered trademarks.

Fall 2015

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FCS FOUNDATION

The FCS Foundation Gives Back Foundation striving toward $1 million fundraising goal

W

BY TISHA CREWS KELLER

hat does it take to satisfy the philanthropic appetite of a world-class cancer treatment system? Financial support for patients in need, volunteerism and community service fit the bill quite nicely for FCS. The FCS Foundation is the vehicle for this community and patient reinvestment.

The FCS Foundation, now under the leadership of Foundation Executive Director Val Vance, is poised to surpass previous years’ goals and bring even more support to cancer patients statewide, even if they are not FCS patients. Vance’s staff is growing, as are her contribution and development goals.

Helping Patients in Need

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One of the primary ways the FCS Foundation gives back is through its AVAIL Fund. This program provides non-medical living expenses to cancer patients statewide.

Through an application process, anyone undergoing cancer treatment in Florida may receive a one-time grant of $1,500 in financial assistance for specific expenses such as rent/ mortgage payments, utilities, car payments and phone bills, if they meet the financial guidelines.

The 2015 AVAIL Fund goal is an ambitious $600,000 in patient grants. By the end of June, over half of that amount was already awarded.

To distribute that much in financial assistance, FCS Foundation staff and volunteers processed more than 515 applications and

FCS Foundation Executive Director Val Vance

Foundation Executive Director Val Vance and her staff processed more than 515 AVAIL Fund applications and helped more than 200 patients.

helped more than 200 patients. By mid-year, the team has surpassed last year’s distributions by $117,000 and processed 200 more applications than in the same time period in 2014.

Patients requesting assistance must meet certain criteria, including Florida residency and an annual household income at or below 200% of federal poverty guidelines. Within days, patients know if they can count on an FCS AVAIL Fund grant to help them through one of the hardest times in their lives.

There are numerous stories illustrating the wonderful impact of the grants. Romano Moglia received help when he was at a low point in his life.

“When you are short on money and fighting cancer, a foundation like yours is lifechanging,” he told Foundation staffers.

Typically, a patient receives an “account” of $1,500 at the time of the grant award per year.

They may submit expenses to be paid directly to the creditor (i.e. utility company) on their behalf, mitigating potentially devastating financial difficulties at a time when they may not be able to work. (Patients receive no direct money themselves.) As long as they are still in treatment and the grant has not been exhausted, FCS pays all allowable expenses up to the maximum amount. Once a grant has been exhausted, the patient can reapply the following year.

Receiving care at an FCS facility is not a requirement for assistance. In fact, about 20% of all recipients are treated at other facilities in the state. This is an example of the heart that beats behind the FCS Foundation mission.

Supported from Within The FCS Foundation began awarding AVAIL Fund grants in 2011. In 2015, the fundraising goal for the Foundation is $1 million; Vance believes they will reach that goal and possibly exceed it.

Through the tireless efforts of staff and volunteers, fundraising for 2015 has already exceeded the halfway point. This is due in no small part to the FCS staff and physicians who support the Foundation through payroll deductions and direct donations.

Outside fundraising is handled by Foundation staff, but nothing could be

accomplished without the support of clinical and clerical staff, as well as a large base of committed volunteers.

And because FCS supports the Foundation through salaries and administrative costs, virtually 100% of funds raised for the Foundation goes directly to patient grants.

Fundraising for Good The FCS Foundation relies on the philanthropic spirit of their doctors, who continually participate in community fundraisers and events, as well as a group of volunteers committed to event planning, fundraising activities and community awareness.

In 2015-2016, six major fundraisers will augment the payroll deductions and physician donations that fuel the FCS Foundation.

The aggressive event schedule encompasses events ranging in size from 150 people to 600 participants. Each individual event requires sponsorships, in-kind donations, business partners, media attention, planning, volunteers and more. Fortunately, the FCS Foundation Volunteer Program provides

enough hands—and hearts—to get the job done.

What Vance calls “accelerated growth” is gaining traction with this fundraising schedule.

From the annual “50 Shades of Pink” in Tampa (October 2015) to “Time to Remember” at the Naples Ritz-Carlton (April 2016) to the 5K “Jingle Run” in Lakewood Ranch (December 2015), and to the Foundation’s first-ever golf event, “Hope Fore the Holidays”, in Orlando with golf legend, Hale Irwin (December 2015), the stage is set for the foundation to reach its fundraising—and philanthropic— goals this year and beyond.

The FCS Foundation Board: Brad Prechtl – Chairman Michael Diaz, MD – Vice Chair J. Thomas Uhler – Treasurer Jackie Bearse – Board Member Richard Bergman – Board Member Shelly Glenn – Board Member Joe Part – Board Member

Fall 2015

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VOLUNTEER PROGRAM

Volunteers provide win-win for patients, staff

Successful program launching in multiple new locations

BY TISHA CREWS KELLER

F

lorida Cancer Specialists (FCS) centers are staffed by the most skilled and compassionate providers in the industry. Keeping patients comfortable and in good spirits is just as important to the FCS model as providing high quality care.

However, there is only so much a pair of hands can do in a day. That’s where the FCS Foundation Volunteer Program comes in.

FCS Foundation volunteers provide all types of non-medical care and support for patients.

Some volunteers work directly with patients in the clinical setting, while others assist with client service work at the Foundation headquarters. All volunteers provide assistance that, ultimately, enhances the quality of life for patients in the FCS system.

“The Foundation Volunteer Program is a win-win for everyone,” says Valerie Vance, FCS Foundation Executive Director.

“Patients love it, volunteers love it, and they are a big help to our staff so they can take care of administrative and medical needs.”

Administratively Speaking Client Services volunteers in the Foundation office work with staff to keep fundraising, donation acknowledgements, financial assistance grants and the volunteer program, itself, running smoothly.

Currently, 11 para-professionals donate three to four hours a day, one to three times per week to the Foundation. Many of them

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are retired and they work flexible shifts that accommodate their fluctuating calendars.

The majority of the client service volunteers process FCS Foundation patient financial assistance grant applications. Known as the AVAIL Fund, this financial support allows cancer patients to receive help with non-medical living expenses during their treatment. Volunteers assist patients with the application process, reviewing each and helping compile the documentation required for a successful award.

Other client services volunteers support the Clinic Volunteer program, helping process volunteer applications. Another person helps Vance with the Condolences Program, acknowledging donations made to honor and remember loved ones and maintaining the Foundation database. A third volunteer at headquarters supports the Foundation’s development program, cultivating in-kind and business donations for the many annual fundraising events.

Blerina Bruns, the FCS client services manager, oversees these volunteer positions and makes sure the volunteers are trained, challenged and appreciated every day. It’s obvious that she does a wonderful job.

At the Clinic Level On the clinical side, volunteers touch patient lives in tangible ways. Through this patient support volunteer program, family members, high school and college students, and retirees

work alongside clinical staff to ensure patient comfort during the treatment process.

Right now, the program is in nine clinics statewide and involves 59 volunteers.

These helpful folks deliver juice, water, a warm blanket and a snack to patients during treatment. They share hugs, change pillowcases, and provide meaningful conversation to FCS patients, making a world of difference in the lives of those fighting cancer. What’s more, clinical staff members are freed to enhance medical care of their patients—a critical component to the FCS clinical success.

Currently, the volunteer program is in only 10% of the 91 FCS clinics statewide, but it is growing rapidly. By the end of September, the clinical volunteer program will be launched in

six additional locations.

Vance hopes to have programs in 20-25 locations by year’s end, but recruiting, training and placing volunteers is a daunting task.

Volunteers help process program applications garnered from patient families, former patients, external organizations and websites such as volunteermatch.com and indeed.com Once selected, candidates are screened through a process very similar to a job application. Background checks and a personal interview are standard for every volunteer.

Once “hired,” every volunteer is trained oneon-one by a seasoned program member at the clinic. Volunteers also participate in a two- to three-hour training and orientation session that covers roles and responsibilities, forms, safety, a facility tour and staff introductions. Volunteers also are required to sign confidentiality agreements as well as a release of liability and other forms as required.

Meeting the Need To host a volunteer program, an FCS location must have ample patient counts, space, and support from clinic directors and doctors. The program itself is funded exclusively by FCS, which provides salaries and supplies so that nearly 100% of all donations the Foundation receives go directly to the patients it serves.

“Day to day, our Volunteer Program truly makes a difference in someone’s life,” Vance explains. “The Foundation office volunteers touch patients by helping them get the assistance they need, while the patient support folks get an immediate response as they help the patients undergoing treatment in the clinics.”

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RESEARCH SPOTLIGHT

A Momentous Addition

Dr. Judy Wang Joins Drug Development Unit in Sarasota

T

BY ZANDRA WOLFGRAM

hough she grew up in a household of civil engineers, Judy Wang, M.D., has always wanted to pursue a career in medicine, particularly oncology.

“I cannot think of another career where you truly earn the unconditional trust and admiration of your patients,” she says.

After receiving her medical degree from Pennsylvania State University College of Medicine in Hershey, Pennsylvania, Wang completed a clinical research fellowship funded by the Doris Duke Foundation at Columbia University School for Physicians & Surgeons in New York before doing her residency training at Thomas Jefferson University Hospital in Philadelphia.

In 2014, Wang was named interim chief fellow at Johns Hopkins, as well as the Ron Smith Endowed Fellow in Pancreatic Cancer Research.

She is a member of the American Society of Clinical Oncology and American Association for Cancer Research and has been published in such distinguished journals as the Journal of Clinical Oncology and the American Journal of Gastroenterology.

In just four years, Florida Cancer Specialists & Research Institute (FCS) has grown the Sarasota Drug Development Unit to more than 40 active early phase clinical trials. Manish Patel, M.D., and his team enrolled more than 160 patients last year. And now they’ve added even more hands-on research experience to the team with the addition of Wang as associate director of drug development, a role she fills for both FCS and the Sarah Cannon Research Institute, which is one of the leading clinical trial organizations in the world.

Wang relocated to Sarasota in June with her husband, Jon, and their dog, Yogi, from her hometown of Baltimore, where she completed a medical oncology fellowship at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University.

“I feel incredibly lucky to have this opportunity,” Wang said. “Being part of the Phase I Drug Development Unit with FCS and SCRI is truly the best of both worlds—you manage your trial patients, have access to developing drugs and therapy technologies and, ultimately, play a pivotal role in the maturation of those therapies.”

One of the things that distinguishes FCS from other community practices is its Phase 1 Clinical Trial program. Historically, a cancer patient only had access to Phase 1 trials through academic medical centers; however, because of FCS’s large statewide practice, it can offer promising new treatments to patients in their local communities so they do not need

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to travel to a university hospital or medical center.

“Dr. Wang’s addition to our program will allow more opportunities for our patients to obtain access to exciting trials,” Patel says.

The scope of FCS’s Early Phase Clinical Trials research program is comparable to those found at prestigious academic cancer centers around the country. In fact, 10 percent of the patient referrals are made by academic centers and practices outside of FCS. And the industry has taken note by citing many of FCS’s patient trials in abstracts presented at important national and international medical conferences, which has given the program more exposure and prestige.

Wang defines going “full time” during one of the most dynamic times in medicine as a “pinch-me” moment. “Developmental therapeutics in oncology has just exploded in the last decade,” Wang said. “Now, we’re able to turn survival rates for select cancers that were previously measured in months into survival rates that are measured in years; for some of these patients, disease control can be maintained on a pill a day with an excellent quality of life … and to be a part of that driving force is something I truly value.”

Wang says her patients unanimously describe her as always available, approachable, and having a knack for diffusing tense situations with a little humor. Although she has conducted research both in the basic science lab as well as the clinic, she says she has found her calling in the DDU, relishing in the opportunity to engage not only patients, but fellow oncologists and industry representatives.

“I love the collaborative nature of early phase clinical trials research,” she says. “Through various opportunities to work with other trial investigators and industry sponsors, you’re sharing new ideas, brainstorming together— as well as working with the elite in the field … then being able to test those new ideas as part of a trial with our patients, and see responses in real time, is incredibly exciting.”

Attracting new talent like Wang strengthens FCS’s standing in the community and enables the largest independent, privately held oncology practice in the United States to continue its trajectory of growth.

“We are delighted to welcome Dr. Wang to our practice,” says FCS CEO Brad Prechtl. “She comes to us with excellent credentials, as well as tremendous experience in clinical research. She will be a great addition to the DDU in Sarasota and will bring additional care and expertise to our patients who are participating in Phase 1 trials. We are pleased to have her join the FCS family.”

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DOCTOR SPOTLIGHT

The Crusader

Solving-Problems Is Almost Second Nature for Dr. Mike Diaz

M

BY ZANDRA WOLFGRAM

ichael Diaz, M.D., is a tireless champion for the greater good. From an early age, this self-professed “problem solver” was drawn to medicine, but it took him some hits and misses in an initial engineering career to find his true calling. It wasn’t that he was overcome by the rigors of chemical engineering, which he did for four years. It was that he wasn’t challenged enough.

“After securing three patents in my first year, I kind of hit a professional ceiling and I was bored,” he confessed.

Diaz went back to school and earned a medical degree in oncology and hematology at the University of Kentucky. He completed his internship and residency at the University Medical College of Virginia and his fellowship at the University of South Florida/Moffitt Cancer Center in Tampa, Florida.

Originally from Greenville, Kentucky, Diaz, 46, joined Florida Cancer Specialists & Research Institute (FCS) in 2011. He teams with four physicians and advanced practice registered nurses out of two offices in St. Petersburg (St. Anthony’s Professional Building and Pasadena Medical Plaza) to care for approximately 30 patients each day.

For Diaz the circuitous route to practicing oncology and hematology was worth it. “I never run out of challenging problems to solve and the relationships with the patients make it highly rewarding,” he said.

During his four years with FCS, Diaz has become actively engaged in leadership roles serving on the executive board and as director of patient advocacy for the practice. But his involvement in the field he loves extends well beyond FCS. He is president of the board of directors for the Florida Society of Clinical Oncology (FLASCO), active with the American Society of Clinical Oncology (ASCO) Payment Reform Work Group and recently was appointed to ASCO’s Clinical Practice Committee. Diaz also is a board member of Community Oncology Alliance (COA) and active on the Payment Reform Task Force working to champion medical oncology health care reform.

Being an advocate for change comes easily to soft-spoken Diaz. “We have to live by our ideals and represent them; it’s important. And if we don’t, no one else is going to,” he said matter-of-factly.

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For the past 10 years, this earnest physician has donated countless hours and personal funds for annual medical missions (usually in the winter) to Kingston, Jamaica. With staff, nurses and often as much as $12,000 in medicine in tow he often works alongside his father, a surgeon trained in the Philippines, and sometimes with his sister, who is a pharmacist and one of his four siblings. In one week’s time, they see upwards of 800 patients with a range of medical problems, the most chronic being high blood pressure, diabetes and worms.

“It was intimidating at first, because you have to treat a lot of conditions we don’t normally see in this country,” Diaz shared. “There can be cultural and language barriers and so you go into it with many unknowns.”

But after returning to the same impoverished area of Jamaica’s capital city for more than a decade, Diaz has seen many of his first patients grow into adulthood and into old age. He returns each year because he knows what not going may mean. “It’s about poverty; they just don’t have resources, so sometimes when we come it’s the one time a year they will see a doctor,” he said.

In addition to being able to help the underserved, the medical missions also have enabled Diaz to spend treasured time with his father.

“Every year I go, it’s an experience I will never ever regret,” he says.

When not spending time with his wife, Stephanie, Diaz is vigilant about maintaining his health by lifting weights, running or swimming five days a week, and yet the couple still manages to carve out free time for doing charity work for the FCS Foundation and local social clubs.

Diaz says “living by example” is something everyone can do. “The Foundation gives everyone an opportunity to help our patients out at home. It doesn’t take a lot of time or energy and I think it’s important for others to get involved to help show the rest of the world how to stand up for what you believe in so that everybody else recognizes the importance of the principles you value.”

For Diaz the payback for all of his hard work and good deeds comes not from invitations to sit on boards or give high visibility lectures, but from finding the best solutions for the patients he cares for each day.

“My patients motivate me, give me my energy and give me my drive to help take care of them,” he says.

Fall 2015

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what's on your radar?

the radar screen

When Do You Want to See Her Back?

BY DR. SCOTT TETREAULT

M

y partner, Paresh Patel, and I hired a lovely nurse practitioner a few months ago. Cheryl spent 20 years in rheumatology so she has excellent clinical skills. The “cancer stuff” is coming along nicely, but will take some time. We talk a lot about interesting cancer treatments, both new and old, but there is also a boring subject that we spend time on: appropriate follow-up intervals, aka “when do you want to see her back?” Of course, we are talking here about the patients we hope are cured, the ones who finished up their adjuvant treatment, not the patients with active (stage IV) disease.

The old-timers might tell you that the subject is irrelevant because they will see the patient back whenever they want to, and they will order any labs or scans that they think are needed. So there. And that attitude was fine once. But now we are called upon to deliver value to the patient, not just because we guess that we are doing the right thing, but because evidence-based guidelines support our plans.

Boring? Sure. But from a patient’s perspective, a fascinating and highly relevant subject. The NCCN guideline panels have done a fantastic job of writing down the rules in great detail. A doctor can break the rules, but, as the Dalai Llama says, “One must know the rules well in order to break them properly.” If you decide to exceed the guidelines, you risk harming the patient with insurance denials, extra expense, and falsepositive “goosechases.” If you do too little, you risk missing a “second chance for cure” and all the anger and pain that this scenario causes the patient and family. (Pain like that can lead to lawsuits.)

Of course, you can see a patient, and obtain labs, and obtain scans at any time if the patient has worrisome symptoms. But the subject of this “radar screen” is surveillance of the asymptomatic cancer patient after curative treatment.

Let’s look at “Dr. FCS” and see if he/she is doing it right in some common scenarios.

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1. Dr. FCS successfully treats Mr. A for Stage III head and neck cancer with chemoradiation. Our doctor orders a PET scan for four months after the end of treatment. That PET is normal and Mr. A is feeling fine. Dr. FCS arranges for follow-up in another four months with a PET scan a week before.

Our doctor is wrong. NCCN guidelines allow for one post-treatment PET within six months but if that PET is normal, no more. You can keep doing surveillance PET’s, though, until you get a normal one — provided you think that waiting and repeating the scan is better than immediate biopsy.

2. Dr. FCS treats Mr. B for Stage II lung cancer and things go well. Mrs. B wants to know, “How often will he be scanned?”

Dr. FCS tells her that he will scan him every six months for two years but if everything looks good, then just a CXR once a year out to five years.

Wrong again. The proper follow up is interesting: a chest CT with contrast or without contrast every six or 12 months for two years and then a CT without contrast

yearly — but no stopping point is listed.

3. Dr. FCS treats Mrs. C with TC x 4 for breast cancer and places her on Arimidex.

Mrs. C is surprised when our doctor says that her appointments will be once a year with no labs or scans.

This is correct, according to the guidelines. Clinical appointments for curable breast cancer can be one to four times a year out to five years. No labs, no scans for the healthy patient.

4. Our busy doctor guides Mrs. D through R-CHOP x 6 for a Stage III Diffuse Large B-cell Lymphoma. Post treatment scans show she is in complete remission. Mrs D. has read a lot about radiation from scans so she wants to be scanned as little as guidelines allow. Dr. FCS tells her the good news: If she feels fine, she doesn’t need any more scans at all.

Correct. For Stage I and II DLCL, scans in surveillance should only be done as “clinically indicated.” For Stages III and IV, CT scans can be done but “no more often than every six months” and they do not have to be done at all in the absence of symptoms.

5. Mr. E is now done with 12 cycles of Folfox for Stage III colon cancer and feels great.

He is busy and wants to know, “How often do I have to come in?” Dr. FCS tells him every six months for five years for a visit and labs, and a CT scan is needed every year out to five years.

Correct. NCCN guidelines changed recently in this setting. CT’s were recommended every year only to year three but now recs are out to five years (for high risk, but that is loosely defined). Also, the CEA can be done every three months in the first two years.

Now, I hope that even the old-timers learned a little something. I am often struck by how much paper and ink and energy we spend on adjusting the treatment plans in advanced cancer and how little we spend on the curable patient after our chemo is done.

For all session, event and hotel room information, please visit FLCancer.com/2015ClinicalSummit

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A Regional Symposium Focused on the Application of Emerging Research Information to the Care of Patients with Common Cancers

SAVE THE DATE — Saturday, October 24, 2015

Neil Love, MD and Research To Practice will be back at this year’s FCS Clinical Summit This daylong program will feature 16 renowned clinical investigators specializing in specific tumor types and use an informal, conversational style to review many of the year’s newest and most important data sets in a multitude of different cancers, including breast cancer, gastrointestinal cancers, genitourinary cancers, lung cancer, skin cancer, Hodgkin and non-Hodgkin lymphoma and multiple myeloma.

Additional information will be available on our website www.ResearchToPractice.com later this summer.

Sponsored by: This activity is being hosted in association with Research To Practice is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.