2015 Cancer Care Center Annual Report to the Community
Message from Leadership Dear Patients, Families and Community Members, I am pleased to present the 2015 Rush-Copley Cancer Care Center Annual Report. In this year’s Annual Report, you’ll find an overview of our programs and services, some of the highlights of the year, statistics from our cancer registry and a special report by Gynecologic Oncology Surgeon, Suzanne Bergen, M.D. This past year was an exciting one for our center. The Cancer Care Institute was surveyed by both the American College of Surgeons (ACOS) Commission on Cancer and the National Accreditation Programs for Breast Centers (NAPBC). I am proud to say we continued to receive accreditation from the ACOS Commission on Cancer and are newly accredited by the NAPBC. Both of these distinctions would not have been possible without the commitment and teamwork of our physicians, nurses and support staff. Another example of Rush-Copley’s commitment to its mission of providing advanced medicine with quality outcomes is the addition of Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiation Therapy (SBRT) treatment for patients. Both are highly precise forms of radiation therapy that deliver higher doses, fewer fractions (treatments), with millimeter accuracy to the tumor. New to our program is Waterford Place Cancer Resource Center. Waterford Place will provide psychosocial services and support not currently available within the Aurora and Kendall County areas. The center’s programs will include educational classes; counseling sessions; and workshops just to name a few. All programs and services are 100% supported by philanthropy and therefore free to participants. As the leading provider of health services in the greater Fox Valley area Rush-Copley continues to identify opportunities to expand upon our services and strives to provide a warm, compassionate environment for every patient at every interaction. Sincerely,
Judi Bonomi, RN, MS, MSN, OCN, NE-BC Director, Rush-Copley Cancer Care Institute
Rush-Copley Cancer Care Center Annual Report
1
Table of Contents 1 3-5 6
Message from Leadership Rush-Copley Cancer Care Center Overview Support Services – Patient Spotlight
7-8
2015 Highlights
9 - 10
Cancer Registry Report and Analytic Data
11 - 14
Endometrial Cancer Report
15 - 16
Oncology and NAPBC Committee
17
References
Rush-Copley Cancer Care Center
Clinical excellence, compassionate care and a collaborative approach to fighting cancer is what distinguishes Rush-Copley’s Cancer Care Institute from other cancer programs in the region. Our team includes medical and radiation oncologists, surgeons and nurses working in conjunction with their colleagues in pathology, radiology and other clinical specialties to provide patients with the most advanced diagnostic and treatment technologies available, access to clinical trials and dynamic patient-clinician relationships. This comprehensive care is further enhanced by a full complement of support services including nutrition counseling, genetic counseling and testing, palliative care, social work, physical rehabilitation, complementary medicine and behavioral health.
Advanced Detection and Diagnosis Accurate diagnosis is a crucial element in developing a cancer treatment plan. That’s why Rush-Copley has made a significant investment in state-of-the-art diagnostic testing, imaging and pathology technologies. Rush-Copley’s Breast Imaging Program has been recognized as a Breast Imaging Center of Excellence by the American College of Radiology for outstanding mammography, ultrasound and MRI breast services.
Personalized Medicine Cancer is a complex disease and often requires a multifaceted treatment approach that can include surgery, chemotherapy, radiation or a combination of therapies. At Rush-Copley, each patient has their own multidisciplinary team of cancer experts who work to develop a
personalized treatment plan based on cancer type and stage, and tailored to meet the patient’s personal needs and goals. Treatment plans are designed to not only fight disease but to control symptoms, manage pain and help cope with the emotional stress caused by cancer.
Advanced Technology Patients at Rush-Copley have access to some of the most innovative and advanced diagnostic imaging and treatment tools including high resolution breast ultrasound, CT-PET, MRI imaging and guided biopsy, digital stereotactic biopsy system, brachytherapy, image-guided radiation therapy, intensity modulated radiation therapy, rapidarc, stereotactic radiosurgery and stereotactic body radiation therapy. By offering patients the most accurately targeted and least invasive methods of diagnosis and treatment, we are able to help patients achieve the best possible outcomes.
Cancer Care Center Nurses Our oncology nurses are an integral component of our program. They have a wealth of experience and knowledge about cancer, cancer treatment and side effects and are sensitive to the needs of our patients. At Rush-Copley, our nurses work in outpatient offices and inpatient units as direct care providers, research nurses, advanced practice nurses, nurse navigators and other roles. They also work in our community coordinating education, outreach and screening programs.
Rush-Copley Cancer Care Center Annual Report
3
Specialized Support
Behavioral Health Program
Patient care at Rush-Copley extends beyond the most advanced treatment options for cancer. Each patient also gains access to support and complementary services to help manage life during treatment and recovery.
Cancer may be one of the most difficult challenges a person can face. Along with the physical illness, many individuals may feel overwhelmed by a range of emotions that without treatment can lead to social withdrawal, neglect of care, and in severe cases, selfdestructive behavior. At Rush-Copley, we understand that “getting better� means helping our patients learn the skills needed to cope with the psychological stress that may experience before, during and after their treatment. Together, our team works with patients, their family members and their treatment team to get the care needed to begin the healing process and restore hope for the future.
Nutritional services are provided by certified dietitians who have extensive experience counseling patients. Our dietitians work closely with our clinicians to identify problems and assist patients who may have special dietary needs and weight issues. They are also actively involved in community education initiatives throughout the year. Social services, post-surgical rehabilitation, lymphedema prevention and treatment, and pastoral care are further examples of Rush-Copley resources designed to help patients cope with their disease and how it affects their life. Each of these areas serves as an integral part of the comprehensive cancer care team.
Advanced Illness Support Clinic Dealing with a serious or life-limiting illness can be a physically and emotionally difficult experience. Even the most prepared person can feel overwhelmed and confused. Pain and other symptoms can often affect quality of life and can leave people lacking energy and motivation to pursue the things that bring them joy. The stress of a serious illness can have an impact on your family as well.
Cancer Genetics Program Some families have a hereditary, or genetic, factor that can greatly increase their chances of developing cancer. Identifying these families and educating them about available cancer screenings, risk reduction and prevention options can significantly reduce their risk for some types of cancer. Our genetics program provides risk assessment, genetic counseling and testing, and referral to a genetics specialist, if appropriate.
Rush-Copley, in collaboration with the independent licensed practitioners of Seasons Medical Group, is pleased to offer patients an Advanced Illness Support Clinic. The clinic provides a coordinated team approach to work in partnership with your physician throughout the course of a patient’s treatment.
4
Rush-Copley Cancer Care Center Annual Report
Inpatient Care While most cancer care is provided in the outpatient setting, some patients may need to be admitted to Rush-Copley’s inpatient oncology unit for complex chemotherapy treatment, intensive symptom management, multiple blood transfusions and IV antibiotic therapy and for patients going through treatments for leukemia, which may require extended stays. Through thoughtful design and continuous quality improvement efforts, the inpatient oncology unit supports our vision of truly comprehensive cancer care and gives cancer patients and their families a space that is supportive and healing.
Clinical Research Our clinicians are committed to finding and translating promising research into new and better options for the prevention, diagnosis and treatment of cancer. Our ongoing clinical trials are directed toward the evaluation of cancer risk, screening and prevention, new approaches and treatment options, and quality of life issues. RushCopley invites eligible patients to participate in clinical trials and contribute to the development of new medical knowledge. Patients at RushCopley have access to NCI-sponsored, pharmaceutical-sponsored and investigatorinitiated studies with the goal of improving the treatment of cancer.
In addition, Rush-Copley physicians, nurses and outreach staff conduct free or low-cost screenings and any necessary follow-up care for those who may not have the resources or access to these services. In many cases, these services provide a true lifeline of caring to the community we serve.
Survivorship Program At Rush-Copley, we are dedicated to helping cancer survivors live their lives to the fullest after treatment. Our team works with survivors to monitor for signs of cancer recurrence and focus on identifying, preventing and controlling any long-term and late effects associated with cancer and its treatment. Survivors receive a detailed care plan outlining their treatment as well as a plan for follow-up care that can be shared with the primary care physician. All survivors should continue scheduling regular checkups with a primary care physician to prevent, detect and treat any complications that may have resulted from treatment as well as receive routine screenings.
Recognized for Outstanding Cancer Care Rush-Copley Cancer Care Institute is respected both regionally and nationally for excellence. The center is accredited by the American College of Surgeons’ Commission on Cancer as a Comprehensive Community Cancer Program, the highest level a community program can achieve.
Outreach, Screening and Education Each year Rush-Copley hosts a wide variety of patient, community and professional education programs and participates in communitysponsored events throughout the Fox Valley region. In partnership with Susan G. Komen for the Cure, Rush-Copley has actively been working in the community to increase minority and lowincome women’s access to breast cancer education, screenings, navigation and support services.
Rush-Copley Cancer Care Center Annual Report
5
Support Services – Patient Spotlight In the course of most lives, few things can create more stress and isolation than a cancer diagnosis. Having resources available can make a huge difference as was the case for Sharron Fisher. In May 2013, Sharron Fisher thought she had been bitten by a spider and that this was causing the swelling in her left upper arm. As a busy single mom who also worked full time at her children’s elementary school, she became increasingly concerned that the swelling was not responding to the antibiotics that her primary care physician had prescribed. She then had a CT scan which revealed some abnormal lymph nodes in her armpit and a mass in her breast. On June 25, 2013, at the age of 36, Sharron was diagnosed with Stage III breast cancer. As testing and treatment planning progressed, Sharron’s tumor was found to be “triple negative” which is known to be aggressive in young women. Additionally, genetic testing showed that Sharron carried the BRAC 1 mutation. This finding carried a recommendation of bilateral mastectomies as well as a complete hysterectomy.
6
Sharron met with the center social worker frequently throughout those early days of diagnosis and treatment. She was experiencing heightened distress levels on a daily basis. She pondered so many questions. “How will I provide for my children? Who will care for them when I am having treatment? What if I don’t survive this cancer? Her younger children were ages 8, 9 and 10. Her oldest daughter had just turned 18. With the support of her family, friends and the cancer center staff, Sharron was able to apply for Social Security and other assistance programs. Through generous donations of Cancer Care Center employees, Sharron and her children were provided Christmas gifts during the holiday season. Sharron completed chemotherapy and radiation and went on to have breast reconstruction surgery as well as a hysterectomy. Today, she remains in remission and believes that she was able to complete all of her care as a result of the support of the Cancer Care Center and all of Rush-Copley Medical Center.
Rush-Copley Cancer Care Center Annual Report
2015 Highlights
This past year was an eventful one for Rush-Copley’s Cancer Care Center. The center added a
survivorship navigator and triage nurse, an Advanced Illness Support Clinic, Stereotactic radiosurgery and Stereotactic
body radiation therapy, provided colorectal and breast cancer awareness fairs for clinicians, patients and community
members, implemented management team rounding, and improved workflow operations in order to position
the program for future growth. 7
Rush-Copley Cancer Care Center Annual Report
Staff Recruitment
Care Awareness Health Fairs
Jennifer Aguina, RN, Nurse Navigator, received her Bachelor of Science degree in nursing from Chamberlain College of Nursing. Her primary function begins at the patient’s initial appointment, she assists in coordinating diagnostic studies, provides education at time of diagnosis, meets with patients throughout the course of treatment and prepares survivorship care plans.
In 2015, the Cancer Care Center partnered with GI, Midwest Centers for Advanced Imaging and surgery to host Colorectal and Breast Cancer specific awareness events. These events provide awareness, education and the opportunity for men and women to register for screenings.
Julie Carroll, RN, MSN, OCN, Oncology Nurse Navigator/Triage nurse, received her Bachelor of Arts degree in Biology from Lawrence University, Bachelor of Science degree in Nursing from Rush University, and Master of Science degree in Nursing Education from Lewis University. Her responsibilities include assisting oncology patients and caregivers through the continuum of care and serving as a liaison between physicians and patients. She functions as a resource to the staff, physicians, and patients and families in providing education and follow-up care.
Advanced Illness Support Clinic The clinic is a valuable outpatient resource for patients and offers supportive care from specialists trained to provide medical intervention through all phases of illness that focus on comfort, maintaining or improving daily function by reducing and controlling symptoms, as well as counseling and support services to assist with difficult medical decisions. The services offered include: • improved pain control and reduced discomfort • psychosocial and spiritual support • assistance with community services • resources and information regarding advance directives and • referrals for additional care and counseling including end-of-life decision making.
Customer Service Initiatives As a part of our continuing efforts to improve the patient experience throughout the cancer continuum, Rush-Copley participates in ongoing patient satisfaction surveying and feedback. Our oncology physician offices, infusion and radiation departments and inpatient unit evaluate survey results for opportunities to improve the patient experience. Additionally, our managers and directors participate in daily departmental rounding. This allows leadership to interact with patients and obtain valuable feedback on the patient experience.
Lung Cancer Screening Program In February 2015, the Centers for Medicare and Medicaid Services (CMS) issued a final national coverage determination that provides coverage of screening for Lung Cancer with Low Dose Computed Tomography (LDCT). This is an important new benefit as lung cancer is the third most common cancer and leading cause of cancer deaths in the United States. In addition to coverage for Medicare patients, Rush-Copley will be continue to offer grant funded low-dose lung CT screening for people at risk for lung cancer. All individuals interested in this screening will receive a consultation with a nurse navigator to explain the exam and determine if they meet the NCCN guidelines. After qualifying the individual is scheduled for a low-dose CT scan read by a board-certified radiologist. The nurse navigator then follows up with the patient once the results are available.
Rush-Copley Cancer Care Center Annual Report
8
Cancer Registry Report Rush-Copley’s Cancer Registry Department supports the activities of the Oncology Committee and the Cancer Care Institute. The Registry staff oversees the collection, quality assurance, lifetime follow-up and analysis of data from patients diagnosed with cancer who receive all or part of their care at Rush-Copley and those other deemed reportable. The Registry provides vital statistics and information to clinicians and researchers as well as local, state and national cancer databases and cancer-related organizations. This contribution of information advances the body of knowledge in the field of cancer and ultimately has a positive impact on cancer patient care. The world of a cancer registrar is ever changing, and so are the guidelines that registrars use to conduct accurate data abstracting. Cancer centers report specifics of diagnosis, stage of disease, medical history, patient demographics, laboratory data, tissue diagnosis and medical, radiation and surgical methods of treatment for
9
each cancer diagnosed at the facility. The data is used to observe cancer trends and provide a research base for studies into the possible causes of cancer with the goal of reducing cancer death and illness. Registry data also serves as an ongoing resource to the Oncology Committee in determining the most effective allocation of resources, for developing community education and outreach initiatives as well as monitoring program quality. For Rush-Copley’s data to be comparable to those collected at other programs around the country, the registrars adhere to data rules established by the collecting and credentialing organizations. Keeping up with these changes can be challenging, but Rush-Copley registrars understand the significance of their work and are experts in their field.
Rush-Copley Cancer Care Center Annual Report
Primary Site Distribution Rush-Copley 2014 Analytical Cases SITE
Total Analytical % Anal. Stage Stage Stage Stage Stage Cases Cases Cases 0 1 2 3 4
Unkn
Breast
240
231
32%
53
101
53
16
4
3
Colorectal
67
62
9%
15
7
12
13
12
3
Lung & Bronchus
87
82
12%
0
11
6
23
41
0
Endocrine System
55
55
8%
0
26
9
4
0
2
Other Digestive
38
37
5%
0
5
10
7
11
4
Female Genital System
56
53
7%
0
30
6
9
7
0
Prostate
45
30
4%
0
10
16
0
4
0
Brain & CNS
39
38
5%
0
0
0
0
0
0
Lymphoma
27
26
4%
0
6
5
6
9
0
Urinary System
29
21
3%
4
7
3
1
5
1
Skin (excluding basal & squamous)
12
10
1%
2
4
2
1
1
0
Oral Cavity & Pharynx
17
16
2%
0
2
0
5
8
0
Leukemia
13
11
2%
0
0
0
0
0
0
Myeloma
8
5
1%
0
0
0
0
0
0
Larynx
5
5
1%
3
1
1
0
0
0
Soft Tissue
3
3
0%
0
1
0
0
2
0
Testis
1
1
0%
0
1
0
0
0
0
Nose, Nasal Cavity & Middle Ear
1
1
0%
0
0
0
1
0
0
Miscellaneous
26
25
4%
0
0
0
0
0
0
Total
769
712
100%
117
217
142
101
100
24
Rush-Copley Cancer Care Center Annual Report
10
Endometrial Cancer Report Suzanne Bergen, M.D.
INTRODUCTION Endometrial cancer is cancer of the lining of the uterine cavity which is called the endometrium. In the Unites States, it is the most common cancer to effect the female reproductive tract. About 3% of women in the U.S. will be diagnosed with this cancer during their lifetime. The American Cancer Society estimates that in 2015 there will be about 54,870 new cases of cancer of the uterus.
RISK FACTORS The American Cancer Society defines a risk factor as anything that affects the chance of getting a disease, such as cancer. Some risk factors, like age, genetics, or race, can’t be changed. Others are related to environmental factors. Risk factors for endometrial cancer include hormone levels, age, diet and exercise, and family history. Estrogen use is a significant risk factor in the development of endometrial cancer, especially if taken without a second hormone called progesterone. Progesterone has a protective effect against estrogen’s stimulation of the endometrium. After menopause, the ovary no longer makes progesterone. If a post menopausal woman takes estrogen without taking progesterone or has high levels of estrogen, she is at great risk of developing endometrial cancer. Tamoxifen use also carries potential risk for the development of this cancer. A woman’s risk of endometrial cancer increases with age. Approximately 75% of endometrial cancers are found in women over age 55. Diet and exercise contribute to a woman’s risk for endometrial cancer as well. A common risk factor for the development of this cancer is obesity. Women who are obese have higher circulating levels of estrogen (Foundation for Women’s Cancer, 2015). 11
A small percentage of women with endometrial cancer have a genetic predisposition for this disease (Foundation for Women’s Cancer). This genetic mutation is called hereditary nonpolyposis colon cancer (HNPCC), or Lynch Syndrome. It increases a woman’s risk for both endometrial and colon cancer. In most cases, this disorder is caused by a defect in either the gene MLH1 or the gene MLH2. An abnormal copy of either of these genes reduces the body’s ability to repair damage to its DNA to regulate cell growth.
SIGNS AND SYMPTOMS About 90% of women diagnosed with endometrial cancer have abnormal vaginal bleeding as a symptom. This may be heavy or frequent bleeding, or bleeding between periods. This symptom can occur with non-cancerous conditions as well, but it is important to have a physician evaluate any irregular bleeding promptly. Any vaginal bleeding, spotting, or abnormal discharge in a postmenopausal woman is abnormal and should be evaluated by a physician immediately. In about 10% of cases, the discharge associated with endometrial cancer is not bloody (American Cancer Society, 2015). Pelvic pain, feeling a mass in the abdomen or pelvis, and unintentional weight loss are other symptoms of endometrial cancer.
SCREENING AND DIAGNOSIS When a woman experiences any of the above symptoms, a physician should perform a pelvic exam and general physical examination. A pelvic exam is performed as a way for doctors to identify any abnormalities within the female organs. If the exam is abnormal, then a pelvic ultrasound, office biopsy of the uterine lining, and/or a minor surgical procedure called a D&C (dilatation and curettage) may be performed. A pelvic ultrasound is a way to look at the uterus, ovaries, and fallopian tubes in women with a –
Rush-Copley Cancer Care Center Annual Report
SCREENING AND DIAGNOSIS possible gynecologic problem. Ultrasound tests use sound waves to take pictures of parts of the body. When attempting to identify a possible gynecologic abnormality, an ultrasound is performed transabdominally and/or transvaginally. In the case of the transabdominal pelvic ultrasound, a probe is placed on the skin of the lower part of the abdomen. For the transvaginal ultrasound, the probe is placed inside the vagina. This type of ultrasound may be uncomfortable, but typically results in better imaging than the transabdominal ultrasound. Ultrasound images are used to see if the uterus contains a mass, or if the endometrial lining is thicker than it should be, which can be a sign of endometrial cancer (American Cancer Society, 2015). The definitive way to determine whether endometrial cancer is present is by removing and examining some of the endometrial tissue. This can be done by performing an endometrial biopsy or D&C (dilation and curettage). An endometrial biopsy is the most commonly performed test to detect endometrial cancer and is very accurate in making this diagnosis. This test can usually be performed in a doctor’s office (American Cancer Society, 2015). If a biopsy does not provide enough tissue for adequate diagnosis, the results are uncertain, or the patient is not a candidate for an in-office procedure, a D&C is typically performed. This is a minor outpatient surgical procedure performed while the patient is under anesthesia. A special instrument is used to collect tissue from the inside the uterine cavity. Endometrial tissue samples removed by biopsy or D&C are evaluated under a microscope by a pathologist to see if cancer cells are present. Endometrial cancer is graded on a scale of 1 to 3, based on how aggressive the cells look. Grade 1 is the least worrisome. Women with lower grade cancers are less likely to have advanced disease
or recurrent disease (American Cancer Society, 2015).
STAGING The American Cancer Society describes staging as the process of looking at all of the information about the tumor to determine the extent of the cancer in the body and what treatment plan is best for each patient. The two systems used for staging endometrial cancer are the FIGO (International Federation of Gynecology and Obstetrics) system and the American Joint Committee on Cancer TNM staging system. Both classify cancer on the basis of three factors: the extent of the tumor (T), whether the cancer has spread to the lymph nodes (N), and whether it has spread to distant sites in the body (M). Generally, the smaller the tumor and a lack of spread to other structures, the better the prognosis and overall survival. Staging may also involve the use of MRI or CT scans in more advanced cases. In 2014, 25 new cases of endometrial cancer were diagnosed at Rush-Copley. The vast majority of these cases, 71%, were diagnosed as being stage 0 or stage I. This is above both the state and national average for the NCDB in 2013 as seen on the next page (Figure 1). Additionally, it was discovered that Rush-Copley patients were more often diagnosed in the 40 – 59 year age range when compared to state and national averages (Figure 2). Upon further analysis, it was verified that all patients received the appropriate course of treatment under the guidance of a gynecologic oncologist and in accordance with evidence-based national treatment guidelines.
TREATMENT Treatment decisions for endometrial cancer are made by the patient and the physician after careful consideration of the optimal treatment for the patient’s specific cancer. This is determined based on the stage, biological characteristics –
Rush-Copley Cancer Care Center Annual Report
12
RushCopley 0 4% I 67% II 4% III 4% IV 8% N/A 0% Unknown 13% Stage
Illinois
US
1% 68% 6% 11% 8% 0% 7%
1% 69% 5% 12% 7% 0% 7%
Figure 1. Endometrial Cancer diagnoses by stage at RushCopley compared to Illinois and U.S. from the NCDB 2013
Age RushGroup Copley Under 20 0% 20-29 0% 30-39 0% 40-49 13% 50-59 25% 60-69 29% 70-79 33% 80-89 0% 90+ 0%
Illinois
US
0% 1% 2% 9% 27% 36% 17% 8% 1%
0% 0% 3% 8% 27% 35% 18% 7% 1%
Figure 2. Endometrial Cancer diagnoses by age at RushCopley compared to Illinois and U.S. from the NCDB 2013
TREATMENT
health conditions, the patient’s personal wishes, and the risks and benefits associated with each treatment protocol.
SURGERY For most patients with a diagnosis of endometrial cancer, surgery is the initial treatment. This typically consists of a hysterectomy, which is the removal of the uterus, along with removal of the ovaries, fallopian tubes, and possibly lymph nodes as well. For many early stage endometrial cancer patients, surgery is the only treatment they will need. If a patient is suspected or proven to have a late stage endometrial cancer, other treatment options include radiation and/or chemotherapy prior to surgery. For those patients who are not surgical candidates or who wish to avoid surgery at all costs, hormone therapy is an option used with the goal of controlling the disease and managing its symptoms.
RADIATION THERAPY The American Cancer Society defines radiation as the use of high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to destroy or damage cancer cells. Based on the final surgical pathology findings, some patients may be recommended radiation therapy after surgery. This can consist of either radiation This can consist of either radiation externally to the –
of the cancer itself, the patient’s age and other 13
Rush-Copley Cancer Care Center Annual Report
RADIATION THERAPY whole pelvis, and/or brachytherapy, which is internal radiation applied directly to the vagina. External radiation to the pelvis is typically administered several days a week for approximately four to six weeks for endometrial cancer treatment. This is essentially administering high powered x-rays to the pelvis. Possible side effects of external radiation include loose stools, bladder irritation and fatigue. Sometimes chemotherapy, a cancer fighting drug, is given along with external radiation which helps kill cancer cells more efficiently. Brachytherapy, or internal radiation, is typically administered as three to five sessions over a few weeks time. A small cylinder is placed in the vagina at each session and radiation is delivered through this. Brachytherapy can cause changes to the vagina after treatment is complete.
CHEMOTHERAPY Chemotherapy involves the use of medicine or drugs to treat cancer. This can be in the form of an oral tablet or injected directly into a vein. For endometrial cancer treatment, chemotherapy is given into a vein using an IV, typically after surgery has already been performed.
14
Chemotherapy can be used to shrink tumors before surgery or radiation, after surgery or radiation to help kill any remaining cancer cells, or with other treatments if the cancer returns. There are several options for which drug or combination of drugs may be recommended, based on the specifics of each patient’s individual cancer. Side effects from chemotherapy can include hair loss, fatigue, nausea and loss of appetite. Chemotherapy can not only affect the cancer cells targeted, but may also temporarily effect the healthy blood cells in the body as well which help fight infection and cause normal clotting. Side effects are usually temporary and can be managed with the help of your physician.
CONCLUSIONS Rush-Copley strives to provide each and every patient advanced medicine and extraordinary care. This is achieved by continuously educating patients , screening and diagnosing early and providing the latest treatment options available. Rush-Copley Medical Center truly offers the full continuum of care to its patients.
Rush-Copley Cancer Care Center Annual Report
Oncology Committee Oncology Committee is a designated multidisciplinary body for the administrative oversight, development and review of cancer care services at Rush-Copley. Members include physician representatives from diagnostic and treatment specialties along with representatives from supporting services involved with the care of patients with cancer.
Physician and Ex-Officio Members of Oncology Committee Kaushik Patel, MD
Hematology/Medical Oncology, Chairman
Salitha Reddy, MD
Radiation Oncology, Vice-Chair
Kurian Abraham, MD
Pathology, Cancer Liaison Physician
Syed Akbar, MD
Diagnostic Radiology
Suzanne Bergen, MD
Gynecologic Oncology Surgeon
Alice Daniele, MD
Palliative Medicine
Ted Kulczycki, MD
Internal Medicine
Joseph Meschi, MD
Hematology/Medical Oncology
Ho Myong, MD
Hematology/Medical Oncology
Non-Physician Members of Oncology Committee
Judi Bonomi, RN, MS, MSN, OCN, NE-BC
Director, Inpatient Nursing and Cancer Care Center
Mary Shilkaitis, RN, MS, MBA
Vice President, Patient Care Services & Chief Nursing Officer
Jeff Coleman, RN, MSN, CMSRN, CNML
Clinical Manager, Cancer Care Center, Quality Coordinator
Ryan Alvarez, MS
Business Manager, Cancer Care Center
Laura Rollins, LSW
Oncology Social Worker, Psychosocial Services Coordinator
Marianna Arroyo
Community Health Outreach Coordinator
Amanda Baker, CCRP
Clinical Research
Stephanie Beam, PharmD
Pharmacy
Vickie Burdick, RHIT, CTR
Tumor Registry
Jennifer King, RN, MSN, OCN
Oncology Nursing
Ashley Lach
American Cancer Society Representative
Prema Ramakrishnan, RHIT, CTR
Tumor Registry
Jillian Smallwood
Living Well Representative
Mira Vujovic, APN, MSN, CBCN
Breast Care Navigator and Genetics Counselor
Jeni Aguina, RN
Patient Navigator
Katie Giudice, MS, RD, LPN
Nutritionist
Leanne Brand, RN, BA, MA, CGRN
Pain Clinic
Mona Seaver, APN
Gyencologic Oncology
Rush-Copley Cancer Care Center Annual Report
15
Breast Program Leadership Committee Breast Program Leadership Committee is a designated multidisciplinary body committed to improving the quality of breast health care by coordinating the best care and treatment options available at RushCopley. Members include physician representatives from diagnostic and treatment specialties along with representatives from supporting services involved with the care of patients with breast cancer.
Physicians and Breast Program Leadership Team Committee Members Kurian Abraham, MD
Pathology, Cancer Liaison Physician
Mohsen Anwar, MD
Imaging Services
Ho Myong, MD
Hematology/Medical Oncology
Salitha Reddy, MD
Radiation Oncology
Nancy Whereatt, MD
Surgeon
Judi Bonomi, RN, MS, MSN, OCN, NE-BC
Director, Inpatient Nursing and Cancer Care Center (CCC)
Allen Bloom, MD
Surgeon
Joseph Meschi, MD
Hematology/Medical Oncology
Kaushik Patel, MD
Hematology/Medical Oncology
Joseph Meschi, MD
Hematology/Medical Oncology
Non-Physician Breast Program Committee Members
Mary Shilkaitis, RN, MS, MBA
Vice President, Patient Care Services & Chief Nursing Officer
Ryan Alvarez, MS
Business Manager, Cancer Care Center
Jeff Coleman, RN, MSN, CMSRN, CNML
Clinical Manager, Cancer Care Center, Quality Coordinator
Marianna Arroyo
Community Health Outreach Coordinator
Amanda Baker, CCRP
Clinical Research
Vickie Burdick, RHIT, CTR
Tumor Registry
Michelle DeHass
Nurse Navigator, Midwest Center for Advanced Imaging
Tisha Hailey
Manager, Therapy Services
Gloria Hall
Director, Midwest Center for Advanced Imaging
Julie Kwait
Therapy Services
Tom Markuszewski
Director, Imaging Services
Prema Ramakrishnan, RHIT, CTR
Tumor Registry
Laura Rollins, LSW
Oncology Social Worker, Psychosocial Services Coordinator
Mira Vujovic, APN, MSN, CBCN
Breast Care Navigator and Genetics Counselor
Rush-Copley Cancer Care Center Annual Report
16
References American Cancer Society. Endometrial (Uterine) Cancer Detailed Guide, 2015. Web. 23 November 2015. Foundation for Women’s Cancer. Understanding Endometrial Cancer A Woman’s Guide, 2015. Web. 25 November 2014. American College of Surgeons Commission on Cancer. National Cancer Database Benchmark Reports, 2015. Web. 23 November 2015.
Rush-Copley Cancer Care Center Annual Report
17
rushcopley.com