Page 1

Adapting Care in Challenging Times








OUR MISSION The mission of the Bayhealth Cancer Institute is to deliver the best cancer care in Delaware by providing state-of-the-art treatment, clinical research, education, and prevention to the people of our region.

BAYHEALTH IS A MEMBER OF THE PENN CANCER NETWORK Bayhealth is affiliated with Penn Medicine’s Abramson Cancer Center, which provides our patients with access to university-level cancer care. As a member of the Penn Cancer Network, Bayhealth is the only cancer program in Delaware affiliated with a National Cancer Institute-designated Comprehensive Cancer Center. Patients and the cancer care team have ongoing access to new technologies, innovative treatments and clinical trials, as well as the expert opinions from physicians at the Abramson Cancer Center.

BAYHEALTH CANCER CENTERS Bayhealth offers a wide range of cancer care services and programs at its two integrated cancer centers.

Bayhealth Cancer Center, Kent Campus 640 S. State Street, Dover, DE 19901

Bayhealth Cancer Center, Sussex Campus 100 Wellness Way, Milford, DE 19963

Dear Community Members and Colleagues, 2020 has been a year unlike any we have ever seen in healthcare. As we set our goals for 2020, no one could conceive having to deal with a global pandemic and the impact COVID-19 would have on cancer care in the country. Our cancer program at Bayhealth, like every cancer program in the country, had to adjust to continue to deliver cancer care safely. We want to extend our thanks to everyone involved, including our physician partners, executive leadership, Bayhealth employees, and the community for their support. Most importantly, we want to thank patients and their caregivers for their strength and resiliency. The Bayhealth cancer program and staff responded and adjusted to the pandemic to ensure our standard of high-quality care was delivered to our patients in the safest possible manner. We added telehealth visits to ensure patients had an option to connect with their provider from home and reduce any barriers to access. Additionally, our program implemented virtual tumor boards and daily chart rounds to ensure continuity of care was maintained. Although our outreach efforts were limited this year due to the COVID-19 pandemic, we were able to target at-risk populations for colorectal cancer and partner with our friends in the agricultural business community during January’s Delaware Ag Week. Outreach will be a major initiative for Bayhealth’s cancer program in the coming year with a focus on providing access to important cancer risk education and preventative cancer screening for early detection to support our community’s well-being. Lastly, we want to recognize the Bayhealth cancer program’s community partners and volunteers, whose roles changed during the pandemic. Their dedication throughout this event cannot be understated and we appreciate their continued support. We are grateful to the Bayhealth Cancer Committee membership who provide the leadership and vision for cancer care in our communities, and we are honored to lead this outstanding group of cancer care experts.

John Lahaniatis, MD Bayhealth Cancer Committee, Chair

Iftekhar Khan, MD Bayhealth Cancer Committee, Cancer Liaison Physician


We are pleased to present the Bayhealth Oncology 2020 Annual Report.

Cancer Registry: Top Cancer Sites The Bayhealth Cancer Registry is responsible for reporting accurate and timely data to the National Cancer Database and the State of Delaware Cancer Registry. These efforts support a better understanding of cancer incidence and mortality to direct and support programmatic development of services for cancer patients. The pie charts below depict by percentage the most common types of cancer diagnosed and treated at Bayhealth Hospital, Kent Campus and Bayhealth Hospital, Sussex Campus in 2019.



◗ BREAST: 25%

◗ BREAST: 17%

◗ LUNG: 16%



◗ LUNG: 10%

◗ COLON: 8%

◗ COLON: 8%

◗ KIDNEY: 4%


◗ OTHER: 35%

◗ OTHER: 41%


To the patients, families, and caregivers served by Bayhealth’s cancer program, we want to take this opportunity to thank you for your patience and compassion for your fellow patients throughout the COVID-19 pandemic. We appreciate your thoughtfulness to the physicians and staff at Bayhealth’s cancer program. You are the true heroes during this pandemic. The response to the global COVID-19 pandemic quickly took over daily operations of the cancer program and our goals for 2020. The cancer care team’s fast response to adjust to new models of care delivery, like telehealth and virtual tumor boards, was impressive. In addition, we had to change our high touch interactions with patients and caregivers to ensure everyone in the facility was in a safe environment. While we had to pause our 2020 goals so the team could focus on the safe delivery of cancer care during a global pandemic, we did have the opportunity to spend time with our physicians and frontline staff to identify areas they wanted to emphasize post COVID-19. The thoughtfulness and insight from these conversations was inspirational and we appreciate our physicians and frontline staff for their feedback. We were excited to see some of these ideas begin during the pandemic, such as telehealth for patient convenience and virtual tumor boards to reduce barriers for the care team to access the multidisciplinary environment that doesn’t involve a trip to a conference room. We look forward to a future that includes Bayhealth’s UME and GME programs, increasing clinical research opportunities, continued expansion of telehealth offerings for patient access, prevention and screening outreach in the community, and the continued relationship with Penn Medicine through the Penn Cancer Network. We are committed to carrying out the vision of our physicians and staff to reduce the burden of cancer in the communities served by Bayhealth by advancing care every step of the way throughout a patient’s cancer journey. We again thank our cancer care team for their dedication and commitment to their patients and caregivers throughout our COVID-19 journey.

Brad D. Kirkes, MBA, MHA, OTR/L, CHT, FACHE Vice President of Ancillary and Clinical Services


Dear Community Members and Colleagues,

John D. Shevock, FACHE, FACMPE Senior Director, Oncology Service Line Executive Director, Bayhealth Cancer Institute


Screening During a Pandemic In the early days of the coronavirus (COVID-19) pandemic, many preventative services were rescheduled or postponed in order to preserve personal protective equipment (PPE) as well as protect the community and vulnerable patient populations. With breast and lung cancer screenings occurring daily in Bayhealth’s Imaging Centers prior to COVID-19, it became imperative to determine how preventative medicine and screening services could resume while protecting patients and staff. “Screenings are an important part of staying healthy. If screening and, subsequently, finding a cancer are delayed, the treatment gets more complicated. We always want to prevent that delay,” said Bayhealth Cancer Institute Manager Stephanie McClellan, MBA, MSN, RN, CMSRN, NE-BC. In order to introduce patients back into the screening setting as safely as possible, several procedural changes and protective measures were implemented. First, the lung

navigator became a liaison for the Imaging Center and the patient to establish an open line of communication between them. Similarly, calling patients to discuss their need for a lung cancer screening and the importance of not delaying this service became a priority. A similar setup was created for breast cancer screenings. The Imaging Centers also designed new ways to screen patients while protecting the patient and the care provider from potential COVID-19 exposure. While the screening methodologies did not change, the mechanisms surrounding them were modified to minimize risk and exposure for patients, which was imperative for life-saving screenings to resume and continue. A universal mask policy for patients, enhanced PPE for all providers, rigorous sanitation, and physical distancing are just a few of the changes Bayhealth’s Imaging Centers have made to ensure patient safety during a screening exam.

Understanding COVID-19 and Cancer Cancer care in the community has evolved over the years, and in 2020, this was no different. The Novel COVID-19 virus transformed the way we think about care delivery and the impact on patients and their exposure risk. With so much uncertainty and many questions unanswered, the American Society of Clinical Oncology (ASCO) opened a survey to collect information about patients who have cancer and are diagnosed with COVID-19. One of the primary goals of this COVID-19 registry is to help the cancer community identify and learn more about patterns of symptoms and the severity of COVID-19 in cancer patients. With so many variables to consider, the Bayhealth Cancer Institute decided to participate in the study. After enrolling, it was able to start contributing


real-time information to the registry. As of November 2020, Bayhealth was the only cancer program enrolled in Delaware. “Participating in the ASCO COVID-19 registry is about understanding symptoms and how those could have a correlation to patient outcomes. Understanding more about this will help us make the best possible decisions for the patients we care for and their treatment. Through baseline and follow-up data we will be able to see how delivery of cancer care is affected, the outcomes patients have and the long-term impact into 2021,” said Bayhealth Cancer Institute Medical Director Rishi Sawhney, MD.


Going Virtual Day-to-day healthcare operations changed very quickly in March 2020 when hospitals and physician practices had to alter appointment styles to ensure the safety and health of all patients. This urgent need for a shift created an opportunity for “virtual” face-to-face and telephone appointments to become options for patients. Overnight, Bayhealth’s Hematology Oncology and Radiation Oncology practices made the move from traditional in-person style appointments to virtual ones. For many patients, what could have been unpredictable and potentially scary was normalized overnight and became acceptable. “A virtual appointment allowed us to still see and talk to our patients without having to expose them to the unknown variables that exist with the coronavirus. It also helped us continue the patientphysician relationship and keep the dialogue open, so if there were elements of their care we needed to know about we were able to maintain that as well,” said Oncology Service Line Senior Manager of Operations Patricia Isherwood, FACHE, CSSGB. The transition from in-person to virtual appointments took place across the entire Oncology Service Line. Hematology patients, those needing telegenetics services

and patients receiving follow-up care, as well as new consults for Radiation Oncology and Medical Oncology, were given the option to have virtual appointments with their healthcare provider or physician. For patients where a virtual appointment wasn’t an option, such as those who were receiving treatment, they continued to come into the Cancer Center and protective equipment was put in place for them and the providers. “I think it’s awesome that we are now able to offer several avenues for our patients to visit with their doctor and staff,” said Oncology Service Line Registrar Kelly Sartin. “This gives them comfort, and allows them to choose how they receive their care. We’ve gotten a lot of positive feedback from patients, especially now with COVID.” Isherwood echoes Sartin and says telehealth has opened a realm of new possibilities and is likely here to stay. “It is often in times of pressure that we are forced to think outside of the box and find innovative ways to serve our patients,” she added. “Telehealth offers access for our patients and their families without disrupting their care or the quality of the care they receive.”


Celebrating the 15th Anniversary of Go Pink! In 2005, a team led by Breast Surgeon Wendy S. Newell, MD, FACS, decided to create an annual Go Pink! event to bring awareness to breast cancer and the importance of mammography screenings. That year and the following, their mission was supported with advertising and the identification of high-risk patient populations and helping to get these individuals connected to mammography screenings.

In 2020, approximately 4,200 Go Pink! T-shirts were sold.


In 2007, the Go Pink! team decided to create and sell specially designed T-shirts to help increase awareness and raise money to fund screenings for the underserved patient populations. A shade of pink is selected and a new design is created for the Go Pink! shirts each year. The T-shirts are sold to Bayhealth staff and members of the community for a donation of $10 or more. Proceeds after expenses are divided between breast screenings and education programs available through the Bayhealth Cancer Institute and the Delaware Breast Cancer Coalition (DBBC).

Since the inception of Go Pink! T-shirt sales, over $300,000 has been raised to support breast screening services for uninsured and underinsured women in Kent and Sussex Counties. Also, since Go Pink! began in 2005, 853 mammograms and 201 ultrasounds have been done in conjunction with the annual event and awareness campaign. Additionally, because of the momentum generated by Go Pink!, Bayhealth has been able to apply for and receive grant funding to help other women not represented in these numbers through its monthly breast screening clinics and also add breast navigation services to aid patients through the cancer care continuum.

GRANT RECEIVED FOR LOW-COST BREAST SCREENINGS The National Breast Cancer Foundation generously awarded $5,000 to Bayhealth to support its low-cost breast screening program. More specifically, the funds were used by the Bayhealth Cancer Institute to provide low-cost screening mammograms to women in need in central and southern Delaware. 8

Your Support Drives Our Success Bayhealth Cancer Institute is committed to providing support for our cancer patients and survivors throughout their treatment and recovery. Our success depends on grants, fundraising efforts, and contributions from people like you. These initiatives are not financed by patient charges or insurance plans. Many of our programs exist because of the generous gifts of our patrons, and no donation is too small to make an impact. There are many ways you can give your support: • Helping Hands Fund • Staff Education • Screening and Prevention Programs • Clinical Trials Support • In Memoriam • Celebrate • Volunteer

To learn more about these giving opportunities and how you can support Bayhealth cancer patients or to make a donation, call 302-744-7015 or visit


Expansion of Telegenetics With the opening of the Sussex Campus, Bayhealth had an opportunity to evaluate the expansion of its telegenetics counseling services — which it offers through a membership with the Penn Cancer Network — for both Oncology patients and those in need of preventative testing for genetic markers. As Bayhealth Cancer Institute Manager Stephanie McClellan, MBA, MSN, RN, CMSRN, NE-BC, explained, the increasing demand in preventative medicine, the evolving landscape of genetic testing, as well as advancements in knowledge of hereditary cancer syndromes made this extension of services from Kent into Sussex County possible. “Offering this service also gives patients access to care without having to travel, and it alleviates the barrier that could prevent a patient from receiving necessary testing for treatment and/or surgical options,” said McClellan.

The success of this expansion was so great that Bayhealth Medical Oncologist Pranitha Naini, MD (center), joined her colleagues Rishi Sawhney, MD (left), and Priya Singh, MD (right), in the Telegenetics Program. “Having an additional medical oncologist on the team has provided patients in Sussex County with further opportunities and easy access to genetic testing and counseling,” said McClellan. “Dr. Naini and her colleagues have been able to establish routine genetic counseling appointments with our Sussex County patients. Since these services are provided via a telehealth platform, they were able to be maintained even during the height of coronavirus.” In terms of genetic counseling and testing, these services are extended to any patient who may be interested in the program and, as a result of the recent expansion, with no limitation to campus preference.



New Molecular Tumor Conference Molecular testing, also known as “precision oncology,” analyzes how genes and proteins interact within a cell. The patterns can help understand certain changes in a gene or chromosome that may cause or affect the chance of developing specific cancers. Understanding these expression patterns can enhance our knowledge of cancer diagnosis, prognosis, and the development of targeted therapies to improve patient outcomes.

In fall 2020, Medical Director of the Bayhealth Cancer Institute Rishi Sawhney, MD, broke ground on a bi-monthly Molecular Tumor Conference, which he co-chairs with Medical Oncologist Abeer Alfaraj, MD. This conference allows expert pathologists, pharmacists, oncologists, and others to weigh in on findings, discuss treatments and educate one another on research that is impacting therapies.

In the last year, the National Comprehensive Cancer Network (NCCN) updated its guidelines to include molecular testing — both somatic and germline — as part of the standard of care treatment for specific cancers. This update allowed Bayhealth’s cancer care team to evaluate its model for ordering molecular based studies and expanded its understanding and interpretation of these studies.

“This conference is designed to examine data points as well as mutations in a tumor’s DNA sequence and evaluate the best course of treatment,” said Dr. Sawhney. “A comprehensive evaluation of a patient’s molecular markers and gene profiling is the future of oncology. I look forward to this multidisciplinary collaboration here at Bayhealth, with a goal of increasing awareness and understanding of precision oncology, and ultimately, improving outcomes for our patients.”

Continuing Medical Education Each year, Bayhealth physicians are given the opportunity to participate in a Continuing Medical Education (CME) program on the latest research and developments in Oncology as presented by faculty and researchers from Penn Medicine’s Abramson Cancer Center.

CARDIO-ONCOLOGY WITH A FOCUS ON BREAST On Sept. 10, Penn Medicine’s Associate Professor of Clinical Medicine Michael G. Fradley, MD, spoke to surgeons, cardiologists, primary care physicians, and oncology medical staff about short-term and delayed cardiotoxic effects of specific treatments for breast cancer and the current recommendations for monitoring and managing this patient population to optimize survivorship outcomes.

CANCER AND COVID-19: UPDATE FROM PENN’S ABRAMSON CANCER CENTER On Sept. 30, National Institute of Allergy and Infectious Diseases (NIAID) Director Anthony S. Fauci, MD, shared his latest insights on COVID-19, the state of the science, and the impact of the pandemic on cancer.

ESOPHAGEAL CANCER DISCUSSION On Oct. 28, Penn Medicine’s Assistant Professor of Clinical Surgery Francis E. Rosato, MD (left); Penn Medical Oncologist and Clinical Assistant Professor of Medicine Ryan Massa, MD (center); and Medical Director of Penn Presbyterian Medical Center, Radiation Oncology and Assistant Professor of Clinical Radiation Oncology Manuj Agarwal, MD (right), presented a lecture on esophageal cancer to surgeons, primary care physicians, medical students, and oncology medical staff. Specifically, they addressed how to identify the standard pathologic evaluation of esophageal cancer, how the result of pathologic testing may risk-stratify and impact therapeutic decision-making for esophageal cancer patients and how emerging molecular techniques may improve management of these patients in the future. 11

Lung & Colorectal Nurse Navigator Recognized Bayhealth has always had a great deal of pride in its nursing excellence. This year — more than any other — has been a year to celebrate and recognize the outstanding work done by nurses. Delaware Today and the Delaware Nurses Association also held their eighth annual Excellence in Nursing awards in September 2020 and Bayhealth’s Lung and Colorectal Cancer Screening and Outreach Nurse Navigator Trina Turner, MSN, RN-BC, LNC, was a dual nominee for Ambulatory Care and Volunteerism & Service.

In her role, Turner partners with the Delaware Health and Social Services Screening for Life program as well as the Delaware Quit Line for smoking cessation. Prior to COVID-19, Turner attended over 20 community outreach and educational events to help those who are underserved in Kent and Sussex County. “It was humbling to be a dual category nominee,” said Turner. “My goal has always been to be there for the community and those in need and to make a difference especially in the underserved areas. Being recognized validated all the work that has gone into the community over the last year.”

LUNG CANCER QUALITY MEASURES: 2017 Systemic chemotherapy is 85% administered within 4 months to day preoperatively or 100% day of surgery to 6 months postoperatively, or it is NO ELIGIBLE CASES recommended for surgically 94% resected cases with pathologic lymph node -positive (pN1) 90% and (pN2) NSCLC

Surgery is not the first course of treatment for cN2, M0 lung cases





Raising Awareness for Colorectal Cancer To recognize national colorectal cancer awareness month, on the first two Fridays of March some Bayhealth team members wore blue and Bayhealth Cancer Center staff and others shared information on colorectal cancer and the importance of screening and early detection.

COLORECTAL CANCER QUALITY MEASURE: 2017 At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer

85% 96% 100% 95% 93%




Oncologist and Nurse Practitioners Added Bayhealth Cancer Centers welcomed two new nurse practitioners and a new radiation oncologist in 2020. Nurse Practitioner LaTonya E. Mann, DNP, FNP-BC, OCN, joined Bayhealth Hematology/Oncology Associates, and Nurse Practitioner Heather Spung, NP-C, and Radiation Oncologist David B. Suh, MD, each joined Bayhealth Radiation Oncology Associates.

DAVID B. SUH, MD David B. Suh, MD (left), came to Bayhealth after working in the Department of Radiation Oncology and serving as the co-medical director at the Cancer Treatment Centers of America, Eastern Regional Cancer Center in Philadelphia, Pennsylvania. Dr. Suh earned his medical degree from the University of Pittsburgh School of Medicine and also did an internship in transitional medicine at the University of Pittsburgh Medical Center. Dr. Suh completed his residency in radiation oncology at Thomas Jefferson University Hospital, where he later served as medical director of Radiation Oncology at Methodist Hospital Division. Dr. Suh is board certified in radiation oncology.


HEATHER SPUNG, NP-C Heather Spung, NP-C (right), joined Bayhealth Radiation Oncology Associates as a nurse practitioner after working as a family nurse practitioner in the Medical Oncology department at Peninsula Regional Medical Center in Salisbury, Maryland. She is a certified nurse practitioner and a certified family nurse practitioner. She earned her bachelor’s degree in nursing from Ohio University and completed coursework to become a family nurse practitioner at the University of Cincinnati. She is a member of the American Academy of Nurse Practitioners (AANP) and the Oncology Nursing Society (ONS).

LATONYA E. MANN, DNP, FNP-BC, OCN LaTonya E. Mann, DNP, FNP-BC, OCN (center), joined Bayhealth Hematology/Oncology Associates as a nurse practitioner after working as a nurse practitioner in supportive and palliative medicine at ChristianaCare in Newark, Delaware. She is a certified nurse who earned her doctorate in nursing practice from Wilmington University and her Master of Science in nursing with a concentration as a family nurse practitioner from the University of Delaware.



Barbara Rutt

Connie Fisher

Rishi Sawhney, MD, Medical Director

Iftekhar Khan, MD

Priya C. Singh, MD

Gregory Moore

Michael Tretina, Treasurer

Terry Murphy, FACHE

Michael Twining

Assar Rather, MD, FACS, FASCRS, Chair

Deborah Watson, FACHE, FACMPE, President

Lindsay Allen Rhodenbaugh, DMin


Debrah Hagen, LCSW

G. Chitiki Dhadham, MD

Renee Hall, RN, ONN-CG

David Brenner, MD

Lori Hewitt

Freeman Hwang, MD

Brad D. Kirkes, MBA, MHA, OTR/L, CHT, FACHE

Iftekhar Khan, MD, Cancer Liaison Physician

Theresa Latorre-Tegtmeier, MSN, APRN, FNP-C

Raj Kurpad, MD

Jessica Taylor, RN

John Lahaniatis, MD, Chair

Cynthia Martin, APRN, ANP-BC, MSN, AOCNP

Tony Lee, MD

Stephanie McClellan, MBA, MSN, RN, CMSRN, NE-BC

Antoinette Ptak, MD

Jennifer Nack, RN, OCN, CTR

Assar Rather, MD

Holly Patronik, RD, LDN

Rishi Sawhney, MD

Carl Popelas, PharmD

Priya Singh, MD

Scott Richards

Anita Sgrignoli, MD

Cheryl Rogers, RN, CPHQ

Peter Wong, MD

Laura Ryan, RTT (R) (T)

Daniel Wood, MD

Susan Shaw, MSN, RN, OCN

Miaohou Xu, MD

John Shevock, FACHE, FACMPE

Arthur Aduma, PharmD

Joshua W. Smith, PT, DPT, MDT

Linda Case, CTR

Cindy Stern, RN, MSN, CCRP

Melissa Dulin, RN, BSN, OCN

Devon Vitti, MSW, LSCW

Jacyne Fransisco, MSN, RN, OCN

Deborah Watson, FACHE, FACMPE

Patricia Isherwood, FACHE

COMMUNITY PARTNERS DE Hospice, Heather Capezio American Cancer Society, vacant Delaware Breast Cancer Coalition, Lois Wilkinson


Oncology Joins Bayhealth’s GME Program As part of Bayhealth’s overall graduate medical education (GME) program, Oncology Services will be participating in the Internal Medicine Residency Program, which earned accreditation by the Accreditation Council for Graduate Medical Education (ACGME) in 2020 and is slated to begin in July 2021. More specifically, Iftekhar Khan, MD, and Rishi Sawhney, MD, have been selected to serve as subspecialty education coordinators for hematology and oncology, respectively, within the Internal Medicine Residency Program. “Being a part of resident education is very rewarding and very important,” said Dr. Khan. “The residents need the opportunity to learn and grow in an atmosphere

that is supportive of the learning process, and we are happy to foster that environment for them.” As part of the residents’ learning experience in Oncology Services both Dr. Khan and Dr. Sawhney have developed a curriculum that will allow each resident to expand their knowledge and start learning how to care for Oncology patients. “Oncology is excited to be a part of the Internal Medicine rotation,” said Dr. Sawhney.

“The residents need the opportunity to learn and grow in an atmosphere that is supportive of the learning process, and we are happy to foster that environment for them.” — Iftekhar Khan, MD

N#4049 01/2021