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Cancer Annual Report

2016


Contents TABLE OF

1

2

Chairman’s Report

3

Cancer Services Overview | Looking Ahead

4

New Pardee Cancer Center Opens in 2017

5

Cancer Awareness Outreach Summary

6

Cancer Research Report

7

Cancer Incidences & Cases

9

Cancer Liaison Physician Report

10

Advanced Radiation Treatments

11

Lung Cancer Research Statistics

13

Caring for the Whole Patient

14

Cancer Registry & Accreditation

THOMAS L. EISENHAUER, MD, FACS

MARCIA C AGE, RN, BSN, OCN, CIM

JOHN K. HILL, MD

BENJAMIN WEINBERG, MD

THOMAS L. EISENHAUER, MD, FACS

C AROL P. BROWN, CTR, ABA


Chairman s ’ REPORT T H O M A S L . EISENH AUER, MD, FAC S During its 2015 accreditation survey, Pardee’s cancer program received a three-year accreditation from the American College of Surgeons Commission on Cancer. The accreditation process is a careful review of the entire scope of services that Pardee has to offer for cancer patients in Henderson and its surrounding counties. The surveyor, who represents the American College of Surgeons’ Commission on Cancer, evaluates all aspects of cancer services at Pardee for three years prior to the survey. This evaluation ensures that the hospital being surveyed provides up-to-date cancer care, enrolls patients in national clinical trials for the advancement of cancer treatment, educates physicians and patients regarding cancer, and reports their cancer cases to the National Cancer Database. Ultimately, Pardee excelled in all of these categories, receiving multiple awards with commendation. The Elizabeth Reilly Breast Center continues to serve individuals with breast disease. Since its opening, the Breast Center has been assisting women with their breast care by providing patient education for breast self examination, cancer risk assessment, and cancer treatment options. The breast care navigator is available to help each patient schedule follow-up mammograms, arrange appointments with the appropriate physicians, and prepare for surgical procedures. Breast cancer support groups meet regularly for the benefit of all survivors, whether diagnosed during the previous week or more than 20 years ago. The women report an overwhelmingly positive response to the services provided for this specific cancer. Weekly cancer conferences at Pardee provide a forum where multiple physicians of various specialties meet

to discuss unusual or difficult types of cancers. Attendance at the weekly conference continues to grow, and is one of the best of its kind in western North Carolina. This group allows members to anonymously review certain patients and gather a variety of ideas regarding patient care. These discussions benefit the patients, because their care is reviewed frequently by more than 30 physicians, nurses, and other allied health providers. The medical staff also benefits from these conferences because it is an ongoing educational process that allows each specialist to offer input regarding his or her area of expertise, thereby educating the rest of the team. Pardee’s cancer program continues to provide excellent cancer care. New techniques and treatments options are being utilized on a regular basis. Tracking patient outcomes with respect to their specific type of cancer allows us to assess our ability to care for cancer patients. Our statistics show that we provide excellent oncologic care for the patients that we treat. We consider it an honor and privilege to provide this service to you. We want to share this honor with you, our community, and trust you will allow us to care for your cancer needs. ◆

PARDEE CANCER ANNUAL REPORT 2016

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LOOKING AHEAD

2017

In January 2017, start the new year in the Pardee Cancer Center

By July 2017, hire a survivorship navigator

In March 2017, begin weekly multidisciplinary Lung Nodule Clinic

• •

Further collaborate with GI and urology practices in clinical trials, screenings and psychosocial and survivorship efforts Optimize availability of Four Seasons Palliative Care in the new Pardee Cancer Center Develop Cancer Exercise and Fitness program and explore collaboration with community partners Explore designated Cancer Conference for breast cases Improve availability of mental health counseling for cancer patients and caregivers

Cancer Services OVERVIEW

• An open house event for the new Pardee Cancer Center was held on November 29, 2016

• Met Commission on Cancer standards for both survivorship and psychosocial distress

• Exceeded commendation requirement for accrual of active patients for clinical trials

• Provided five community cancer screenings: 151 people screened, and 20 percent of those screened were referred for follow-up

• 623 people in total attended community prevention, outreach and screening offerings

• Pardee Hospital Foundation funded the unique For the Caregiver guide, developed jointly by one of the cancer navigators and Signature Care

• A reasonable self-pay offering became available for low dose CT patients that are referred by a physician

• A dedicated cancer dietitian joined our team • Pardee Hospital Foundation funded the purchase of a diagnostic

swallowing tower, which further enhances our multidisciplinary head and neck cancer program

• Made significant progress with clinical trials by collaborating with GI and urology practices

• Gary Rodberg, MD, a new pulmonologist who performs EBUS procedures, joined Pardee’s medical staff

• Annual “Celebration of Life” event for breast cancer survivors was held, along with a formal “Celebration of Life Tea”

Offer quarterly survivorship classes

• A volunteer program for the Cancer Center was planned in collaboration

Implement dedicated volunteer program for Pardee Cancer Center

• Benjamin Weinberg, MD, radiation oncologist, joined the Pardee team

with Pardee Volunteer Services

• Continued to provide monthly educational teleconference in partnership with UNC Lineberger

• Highly beneficial collaboration took place with UNC Lineberger in radiation oncology operations ◆

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New Pardee Cancer Center OPENS IN 2017

The Pardee Cancer Center will be open and fully operational in January 2017. An open house event was held on November 29, 2016 to showcase the full scope of services in the new center. Having all cancer services located under one roof will enhance the patient experience and facilitate the best cancer treatment possible for our community. Both patients and caregivers participated in the development of plans for the building. Features of the new Pardee Cancer Center: • Oncologists, radiologists and cancer navigators all located under one roof • State-of-the-art linear accelerator and CT simulation technology • Cancer navigator offices and caregiver support areas in close proximity • Cancer Registrar, Cancer Research, IRB and Four Seasons Palliative Care on-site • Pardee Surgical Associates’ new office is contiguous to the Cancer Center, with its own separate entrance • Dedicated head and neck treatment room on-site

• Sixteen chemotherapy chairs, including both private and semi-private options • On-site pharmacy for timely and convenient access to chemotherapy and other cancer related treatments • The beautiful Healing Garden may be viewed while receiving chemotherapy treatment • Comfortable and healing atmosphere with abundant natural light, soothing colors, and natural materials • Large waiting area at the entrance with comfortable seating, a gas fireplace and Wi-Fi connection to encourage relaxation • Volunteers available to assist patients throughout their stay • Chapel services available for patients and families seeking spiritual support • Overlook Café, located on the second floor of the Health Sciences Building, serves lunch and snack items • Patient concierge, stationed under a covered entrance, to assist patients upon their arrival • Dedicated parking available for cancer patients and their families ◆

PARDEE CANCER ANNUAL REPORT 2016

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Cancer Awareness OUTREACH

SUMMARY

Pardee Hospital has made great strides in raising cancer awareness in the surrounding community by offering screenings, giving educational presentations, and having information available at local events. These multifaceted opportunities offered valuable resources that were easy to access and cost little to nothing for participants. In order to reach a diverse population, Pardee provided educational resources across Henderson County by using a variety of business and industry venues, schools, senior centers and throughout the community. During 2016, approximately 520 individuals were reached through these programs: • 52 individuals participated in prevention programs • 132 individuals participated in cancer screening programs, and 20 were referred for follow-ups • 336 individuals participated in community education outreach programs The tremendous success of the cancer outreach program can be attributed to the time and dedication put forth from nearly 20 providers, nurses and other professionals. Another exciting addition this year was the resurgence of the Look Good, Feel Better program through the American Cancer Society. Thirteen women participated, and were provided with cosmetology tips and a take-home makeup kit that matched their individual skin tones. To further increase cancer awareness, as well as to help raise proceeds for the Pardee Hospital Foundation, our cancer navigators and Pardee Signature Care participated in downtown Hendersonville’s 14th Annual Bearfootin’ Art Walk. The city’s iconic bear was painted by Breanna Villars Collins, who is the niece of Leann Noakes, RN, CCRP, cancer care navigator. The statue was adorned with a spring floral theme, with the artist using cancer awareness ribbons to mimic flower petals, butterflies, and honeybees. Named “Bearing Courage,” the bear was auctioned on October 22, 2016, and raised $1,400 for the Foundation. The Foundation has a goal of raising $6 million for Pardee to improve the delivery of treatments, surgical care, and sustainability of cancer services and programs. The “Right Here, Right Now” capital campaign kicked off in April 2015 and, to date, $4.5 million has been raised for the new Pardee Cancer Center. ◆

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Participants in screeings, prevention, outreach programs throughout 2016

$1400 $4.5MM Raised for Pardee Hospital Foundation through Bearfootin’ Art Walk auction

Pardee Hospital Foundation has raised $4.5 million to date for the cancer center capital campaign


Cancer Research REPORT

MARCIA CAGE, RN, BSN, OCN, CIM PARDEE IRB COORDINATOR

Cancer Research at Pardee continues to play an important and active role in the care and treatment of our community. An important hallmark of the best cancer care is providing patients access to clinical trials. Through our affiliation with the Southeast Clinical Oncology Research Consortium, a National Cooperative Oncology Research Program funded by the National Cancer Institute, we are able to offer cancer research trials to treat specific malignancies, and to help manage symptoms related to cancer and cancer therapies. As an American College of Surgeons Commission on Cancer (COC) accredited cancer program, we are required to enroll a minimum of four percent of our patients onto cancer clinical trials. Pardee cancer research nurses, Cathy Jenkins and Lynn Jones, are dedicated to working closely with Pardee oncologists to meet this goal. Patients with a cancer diagnosis should not have to travel far from their homes and doctors to enroll in research that could provide them with a new and cutting-edge therapy. The efforts of the cancer research staff, and the support in cancer research by our oncologists, has resulted in nine percent of our patients enrolling in a cancer research trial in 2015. This effort far exceeds the COC benchmark, and demonstrates a dedication by Pardee to provide the optimum treatment choices for our patients, as well as our commitment to finding a cure for cancer.

The cancer research office is assisted by the Pardee Institutional Review Board (IRB), which is a federally mandated panel charged with reviewing any human subject’s research to ensure patient rights and safety are upheld. The IRB and Pardee cancer research work hand-in-hand to ensure that all subjects enrolled onto clinical trials receive cancer research therapy in an ethical and closely monitored manner. In 2015, 14 new cancer research studies were opened at Pardee. Of those studies, 11 were for cancer treatment and three cancer control trials – the treatment or management of symptoms experienced by the patient due to the cancer and/or cancer treatment. Ten subjects were enrolled into cancer treatment trials, treating cancers such as lung, colorectal, leukemia, head and neck, and breast. Forty-one subjects participated in cancer control trials, testing therapies and approaches to oral mucositis, nausea, and treatment related fatigue. Throughout 2015, a high of 53 and a low of 44 cancer research trials were open and available to patients being treated at Pardee for cancer. Cancer research nurses are enthusiastic about the move to the new Pardee Cancer Center. With all oncology disciplines working side-by-side in one location, the opportunity for enhanced collaboration and improved coordination of patient care will be paramount. Cancer research staff will be more readily available to assist physicians with information about available cancer research trials, and will be on site to support all phases of trial participation, from informed consent to study treatment and follow-up. ◆

PARDEE CANCER ANNUAL REPORT 2016

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Cancer Incidence BY SITE 2015

Head and Neck

MALE

FEMALE TOTAL

Base of  Tongue

4

0

4

Larynx

4

0

4

Lip

1

0

1

Nasopharynx

3

1

4

Oropharynx

3

0

3

Parotid Gland

1

1

2

Tonsil

2

0

2

Digestive System Anus/Anal Canal

1

3

4

Colon

15

14

29

Esophagus

3

2

5

Liver/Bile Ducts

4

2

6

Pancreas

13

7

20

Rectosigmoid Junction

1

1

2

Rectum

6

4

10

Small Intestine

1

0

1

Stomach

4

1

5

Heart/Mediastinum/ Pleura

1

0

1

Lung

27

31

58

Trachea

1

0

1

Blood/Bone Marrow

Breast

FEMALE TOTAL

Cervix

0

4

4

Corpus Uteri

0

12

12

Other

0

1

1

Ovary

0

9

9

Vulva

0

6

6

Prostate

43

0

43

Testicle

3

0

3

Bladder

22

11

33

Kidney

11

7

18

Male Genital

Urinary System

Central Nervous System Brain

5

2

7

Meninges

1

4

5

Thyroid

3

4

7

Other

1

2

3

13

17

30

Lymphoma Retroperitoneum/Peritoneum

31

26

57

11

9

20

Orbit/Eye

2

99

101

Unknown Primary

Connective/Subcutaneous 4

7

MALE

Endocrine System

Respiratory System

Skin

Female Genital

0

4

TOTALS

1

0

1

0

1

1

0

1

1

263

291

554


Cancer Cases

RACE

IN 2015

Under 20

1 5 8 21

20-29 30-39

AGE

40-49

BLACK

50-59

15

83

60-69

149 156

70-79 80-89

113

90+

18 0

40

80

120

160

Haywood - 4 Rutherford - 11

Henderson - 448

COUNTY

Polk - 43

WHITE

539

Buncombe - 14 Transylvania - 23 Out of State - 13

GENDER

Other NC - 3

10

Insurance, NOS Managed Care

115

PAYOR

Medicaid

15

Medicare

106

Medicare with Medicaid Medicare with Supplement

23 250

Other

263

291

MALE

FEMALE

4

Uninsured

23 0

50

100

150

200

250

PARDEE CANCER ANNUAL REPORT 2016

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Cancer Liaison Physician REPORT

JOHN K. HILL, MD

2015 was a very busy year for Pardee’s cancer program. We prepared for and successfully achieved reaccreditation of our cancer program through the American College of Surgeons’ Commission on Cancer and the National Accreditation Program for Breast Centers. Part of these accreditation processes is to regularly review our cancer registry data, which is compared to cancer programs nationwide, statewide and of similar accreditation category. This data gives us very valuable feedback and is regularly presented to the cancer committee so that it can be discussed as a group and any concerns that are identified can be addressed. The Cancer Program Practice Profile Reports (CP3R) evaluate breast, colon, rectal, gastric, lung, cervical and ovarian cancer treatments, lymph node removal, needle biopsy rates and breast conservation rates. Pardee Hospital continually exceeds the benchmarks set on these measures. New data is added once a year to this report, but corrections to this data can be made throughout the year.

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Rapid Quality Reporting System (RQRS) is real-time data on breast and colon cancers, which changes from day to day. This begins the movement towards concurrent abstracting. As treatment information comes in on patients in the RQRS database, these cases are updated and give us very current information on these specific measures. As you can see, data is a very important component of the cancer liaison physician’s responsibility. Regular reporting to the Cancer Committee, and keeping in close contact with the Commission on Cancer, is equally as important. We also maintain a close relationship with the American Cancer Society (ACS) and their programs and resources. Our ACS representative also reports regularly to the cancer committee and makes sure we have all of the most current information on programs and resources to share with our patients and providers. ◆


Advanced Radiation Treatments BENJAMIN WEINBERG, MD RADIATION ONCOLOGIST

Our new Pardee Cancer Center will soon be delivering advanced radiation treatments that previously required referrals to other counties or states. The investment we are making in this new facility will allow us to better serve our community, and make Henderson County a destination for world-class cancer care.

Linear Accelerator

The Linear Accelerator (Linac) is a very large machine at the heart of every radiation treatment facility. It delivers radiation treatments using high-powered x-rays and electron beams Dr. Weinberg demonstrates the Linac to destroy cancer cells. Many skilled professionals, including a part of a person’s body, that physicist and several radiation part must be immobilized therapists, are employed fulland scanned with this machine. time to maintain, calibrate The resulting images are used and operate this complex to make a three-dimensional device. We are very happy to model of the patient’s body be getting a brand new “Elekta in the computer, allowing me, Infinity” Linac for the Pardee the radiation oncologist, and a Cancer Center to replace our medical dosimetrist (another trusty Siemens Oncor machine, highly skilled professional) to which has served the community plan the treatment. This team well for over a decade. With calculates the exact angles, our new machine, we will be energies, shapes, and duration able to provide a greater variety of the multiple radiation of treatment options for our Big Bore CT Simulator patients, including an effective beams needed to treat the non-surgical treatment for early-stage lung cancers. patient. Our current CT simulator is an older model Also, current treatments will happen faster and with a small opening, or bore, for the patient to fit will be more accurate. The new Elekta linac will through. This limits the variety of positions our even have an on-board CT imager that will allow patients can assume during treatment. Our new CT us to conform the exact location of the patient’s simulator will have a much larger bore, allowing us tumor prior to each treatment. more options for patient positioning. For example, we will be able to treat some breast cancer patients on their stomachs on a special platform that allows the treated breast to fall away from the chest wall, reducing The CT simulator is a special CT scanner used for planning radiation treatments. Prior to treating any radiation exposure to the heart and lungs. ◆

Big Bore CT Simulator

PARDEE CANCER ANNUAL REPORT 2016

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Lung Cancer

SITE

SPECIFIC

STUDY

THOMAS L. EISENHAUER, MD, FACS Lung cancer continues to be a leading cause of cancer morbidity and mortality nationwide. Western North Carolina also identifies lung cancer as being the second most common cancer and the leading cause of cancer death. Like many other malignancies, when identified in an early stage, the prognosis for lung cancer in general is significantly improved. The difficulty with most lung tumors is that they fail to cause symptoms until they are in a more advanced stage. Here are the most recent statistics for Pardee’s cancer program patients with non-small cell lung cancer. We identified 48 new malignancies in 2015, with this number being evenly divided between males and females. Table 1 shows the distribution of the patient’s for their age at the time of diagnosis.

Age at Diagnosis Age Range 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90+

Number of Patients 2 8 9 11 17 1

Percentage 4.16% 16.66% 18.75% 22.92% 35.42% 2%

TABLE 1

Tobacco usage continues to be the leading cause of most lung cancers. Table 2 shows that most of our patients also have a history of tobacco use. The risk of developing a lung cancer for a former smoker actually equals that of a nonsmoker after ten years of abstinence. Hence, it is best for individuals to have never smoked, but if they do, they should quit immediately, regardless of the age. Nonmalignant damage to the lungs are irreversible, but the risk of malignancy does diminish with time.

Tobacco Usage User Type Current User Previous User Never User Unknown User

Number of Patients 16 20 6 6

Percentage 33.33% 41.67% 12.50% 12.50%

TABLE 2

Lung cancer prognosis is directly dependent upon the stage of the disease at the time of the diagnosis. Early stage disease is much more effectively treated and realistically can be cured. We have recently created a screening program for lung cancers using a low dose CT scan protocol. This is much more effective at finding smaller tumors than a routine chest x-ray. There are certain criteria that we follow in performing these screening exams. This has enabled us to start identifying some malignancies at an earlier stage of their development. Historically, 75 percent

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or more of our lung cancers were diagnosed at stage III or stage IV, when a cure is essentially unachievable. Through the hard work and diligence of our Radiology Department, these screening exams are now readily available to the public and at a very reasonable expense. Table 3 shows our last year of patients and the stage of disease that they presented to our program.

Stage at Diagnosis Stage

Number of Patients

Percentage

Stage I Stage II Stage III Stage IV Unknown Stage

10 4 5 25 4

20.83% 8.33% 10.42% 52.08% 8.33%

TABLE 3

As with most malignancies, lung cancer may be treated with surgery, radiation, or chemotherapy. The mainstay of treatment historically has been to surgically remove the malignant growth. This continues to be the best option for non-small cell lung cancers when they are relatively small and have not spread to other areas. Newer, more specific types of radiation therapy are sometimes indicated for these smaller cancers if the patient is an appropriate candidate. The majority of our patients, however, benefit from two or more of these various treatment options to more effectively treat their cancer. When a patient chooses to not actively treat his or her cancer, we have excellent palliative care or hospice team members that can be involved with the patient, the patient’s family, and maintaining good control of their symptoms. During 2015, our patients chose the options of care as documented in Table 4.

Treatment Options Treatment Surgery alone Chemotherapy alone Radiation therapy alone Surgery and chemotherapy Surgery/chemotherapy/radiation Chemotherapy and radiation Unknown Supportive care only

Number of Patients Percentage

2 4 12 1 1 10 2 16

4.18% 8.33% 25% 2.09% 2.09% 20.83% 4.18% 33.30%

TABLE 4

Non-small cell lung cancer, the most common type associated with tobacco usage, continues to be the leading cause of cancer deaths in the United States. Although our treatment options continue to improve for the more advanced stages of this disease, long-term survival for stage III and stage IV remains very limited. More recent research and emphasis has been directed towards identifying these cancers earlier when better treatments are more effective. Additionally, ongoing community programs by the Pardee outreach department are directed towards smoking cessation in current smokers. Successful participation in these programs should decrease the incidence of lung cancer in general. We have also directed efforts towards younger people and educating them in such a way that they never initiate tobacco activities. Pardee’s cancer program continues to help with the prevention, screening, and treatment of lung cancer in western North Carolina. ◆ PARDEE CANCER ANNUAL REPORT 2016

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Caring for the Whole Patient SURVIVORSHIP CARE Cancer care goes far beyond doctor’s visits, surgeries, medical procedures and prescribing medication. The patients we serve experience one of the most difficult challenges they’ll ever face in life. With the growing number of cancer survivors in our communities, it is our job to guide them comfortably towards finding their “new normal.” We must focus not only on treating their medical needs, but equally caring for their mental and emotional health throughout their journey to recovery. When a patient hears the dreaded “C” word, they generally feel a sense of fear, anxiety and loss of control. These fears are often lessened after treatment begins because of their increased knowledge related to the diagnosis and the caring medical team around them. Pardee’s cancer care team is committed to caring for each person’s individual needs from initial diagnosis through survivorship. We never want patients to feel like they are facing cancer alone. One of the ways we are able to achieve this is through our nurse navigator program. Our navigators walk beside patients during some of their hardest days and help them see that there is life after cancer. As part of Pardee’s commitment to survivorship, we hosted two events this year for our local cancer survivors and their caregivers. On June 2, 2016, an Evening of Laughter was held at the Pardee Signature Care Center. This event allowed patients and

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their caregivers a night of freedom from cancer. They were encouraged to laugh out loud and focus on the lighter side of life. There is something to be said for intentionally focusing on laughter and the great healing properties it possesses. On October 27, 2016, Pardee hosted the 7th Annual Celebration of Life tea party, which solely focused on honoring breast cancer survivors. Guests were transported into an 18th century ballroom with vintage tea cups and extraordinary fascinators. The underlying tone was so much more than just a party hat or a cute cup; it was a feeling of celebration that honored the fearlessness and the courage of each survivor. The survivorship care that we offer has come so far and is more meaningful to patients now than ever before. As exciting as this is for Pardee, we continue to strive for the best possible experience for our patients. Plans are already in the works to enhance our program by adding a new navigator who will focus exclusively on survivorship. We also look forward to working closely with our dietitian, focused specifically on oncology, and an on-site palliative care team in the new Pardee Cancer Center. We are committed to continuing our efforts and making sure cancer survivors at Pardee are able to make the most of every day and find courage, hope and strength. ◆


Cancer Registry & Accreditation CAROL P. BROWN, CTR, ABA

CANCER PROGRAM COORDINATOR

Pardee’s cancer registry was established in 1993, giving us a total of 22 years of cancer data on our patient population. The collection of this data is done by calendar year and information is taken from the hospital medical record, physician office records and from other facilities that may be involved in the care of the patient. Obtaining the most current and accurate information is of vital importance. Once all of the data is gathered on each patient, it is submitted to the national cancer database and to the North Carolina Central Cancer Registry. State law mandates that this information be reported on a regular basis, as cancer is one of the reportable diseases in our state. After the data is collected, we are able to create reports, graphs, and tables with very specific information to send to our hospital administration, cancer committee, cancer research staff and accrediting bodies. We must also continue to follow-up on each patient found in the database. This requires collaboration with other facilities and physician offices to ensure that we have the most current information on the patients at all times. In addition to data collection, it is the responsibility of the cancer program coordinator to maintain the documentation of activities required to be accredited by the American College of Surgeons’ Commission on Cancer (COC) and by the National Accreditation Program for Breast Centers (NAPBC). Pardee’s programs were surveyed in October 2015, and both were successfully awarded with full accreditation. This is a three year process, with collaboration being a key component for success. The members of our cancer committee are dedicated to maintaining accreditation and are willing to invest the time and effort required. We are already preparing for re-accreditation in 2018. Pardee’s cancer program is very strong and is excited about our services being located in the new Pardee Cancer Center. This will greatly benefit our patients, as well as our providers and ancillary personnel. We look forward to providing excellent care, clinical research, navigation, and survivorship to all of our cancer patients. ◆

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Cancer Services Breast Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (828) 698-7334 Cancer Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (828) 696-1341 Cancer Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . (828) 696-4716 Cancer Navigators Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . (828) 698-7334 General Cancer . . . . . . . . . . . . . . . . . . . . . . . . (828) 698-7317 Hendersonville Hematology and Oncology at Pardee . . . (828) 692-8045 Mammography Services . . . . . . . . . . . . . . . . . . . . . (828) 696-1305 Radiation Oncology . . . . . . . . . . . . . . . . . . . . . . . (828) 696-1330 Surgical Oncology . . . . . . . . . . . . . . . . . . . . . . . (828) 693-7230

800 North Justice Street Hendersonville, NC 28791 pardeehospital.org 9020-275 (12/16/2016)


Cancer Annual Report 2016