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Annual Cancer Services Report 2013

Advanced Medicine, Extraordinary Care

Message from Leadership I am pleased to present the 2013 Rush-Copley Care Institute 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 on our Lung Cancer Program. This certainly was an exciting year. Our programs and services have continued to grow; we welcomed talented new clinical and administrative staff to our team; we were overwhelmed with community support; and we have made great progress in the expansion planning of our center. We have also built exemplary outreach, screening and prevention services to address disparities in cancer incidence and mortality. Through these programs we have collected data that drives population research helping us answer fundamental questions about improving the value and efficiency of care, especially to our underserved communities. While we make progress…  Over 40 percent of Americans will be diagnosed with cancer during their lifetimes, and 150,000 cancer patients will succumb to their disease this year.  At least 20 percent of Americans continue to smoke cigarettes. Too many people continue to be at risk for cancer because of their lifestyles and their environment.  Many individuals are at increased risk for developing cancer simply because of hereditary factors that we are just beginning to understand and address.  The aberrant genes and molecular pathways that lead to cancer are not fully defined or understood. What this means is that while the cancer care community has made great advances in the prevention, diagnosis and treatment of cancer, there still is much more to be done. But we are well positioned to move forward and tackle these issues head on. At the end of each day, what really matters to all of us at Rush-Copley is what we have accomplished to help improve and extend the lives of patients living with cancer. To do this, we know we must be innovative, compassionate and focused on excellence. Sincerely,

Judi Bonomi, RN, MS, MSN, OCN, NE-BC Director, Rush-Copley Cancer Care Institute

Rush-Copley Cancer Care Center Annual Report

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Contents 1

Message from Leadership

3

Rush-Copley Cancer Institute Program Overview

6

Cancer Genetics Program

8

2013 Highlights

10

Cancer Registry Report and Analytic Data

12

Lung Cancer Report

15

Oncology Committee

Rush-Copley Cancer Care Institute Clinical Excellence. Innovation. Compassionate Care. Clinical excellence, compassionate care and a collaborative approach to fighting cancers is what distinguishes Rush-Copley’s Cancer Care Institute from other cancer programs in the region. Our teams include 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 treatment plan. That’s why RushCopley has made a significant investment in stateof-the-art diagnostic testing, imaging and pathology technologies.

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 and Intensity Modulated 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.

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.

Rush-Copley Cancer Care Center Annual Report

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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 our outpatient offices and inpatient units as direct care providers, research nurses, advanced practice nurses, nurse navigators and numerous other roles. They also work in our community coordinating education, outreach and screening programs.

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.

Specialized Support

Cancer Genetics Program

Cancer Care Institute Nurses

Patient care at Rush-Copley extends beyond the most advanced treatment options for cancer. Each patient also gains access to extraordinary support and complementary services to help manage life during treatment and recovery. Nutritional services are provided by certified dieticians who have extensive experience counseling patients. Our dieticians work closely with our clinicians to identify problems and assist patients who may have special dietary needs and weight issues. Our dieticians are 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.

Behavioral Health Program Cancer may be one of the most difficult challenges a person can face. Along with the

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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.

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 to start complex chemotherapy treatment, for intensive symptom management, multiple blood product transfusions, 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.

Rush-Copley Cancer Care Center Annual Report

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. Rush-Copley invites eligible patients to participate in clinical trials and contribute to the development of new medical knowledge. Patients at Rush-Copley have access to NCIsponsored, pharmaceutical-sponsored and investigator-initiated studies with the goal of improving the treatment of cancer.

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. 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.

Recognized for Outstanding Cancer Care Rush-Copley Cancer Care Institute is respected both regionally and nationally for our excellence. We are accredited by the American College of Surgeons’ Commission on Cancer as a Comprehensive Community Cancer Program, the highest level a community program can achieve.

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Cancer Genetics Program For someone with a family history of breast and other cancers, Melanie was acutely aware of the disease that could one day strike her next. Breast cancer took Melanie’s mother as well as a cousin. Her sister was diagnosed with ovarian cancer at age 35. “I always felt that there should be something that I could be doing,” says Melanie. “I wanted to be proactive with my health.” When Melanie’s mother was being treated at Rush-Copley, Melanie was introduced to RushCopley’s Cancer Genetics Program. The Cancer Genetics Program at Rush-Copley offers genetic testing, risk education and prevention to people who are concerned about their personal and family histories of cancer and who might have a genetic alteration that greatly increase their risk of getting the disease. “Our program specializes in making cancer genetics understandable,” say Mira Vujovic, an APN and certified genetic counselor at RushCopley. “We provide the information people need in order to make their own decisions about testing and medical management. If the results identify a mutation that predisposes him or her to cancer, we work with that person to develop a personalized plan of care which includes prevention and screening and then partner with the patient’s healthcare team to implement it.” As Mira explains, all cancers are due to changes in genes, called mutations. If a person is born with a gene mutation that leads to cancer, it is called a hereditary cancer. It is important to identify families with a genetic predisposition to cancer because, in many cases, they may take steps to reduce their risk or prevent cancer from occurring. 6

Many genes have been identified that may contribute to the development of multiple types of cancer including breast, ovarian, colorectal, endometrium, thyroid, pancreatic and melanoma. Genetic counseling, however, involves much more than just taking a test to see whether a gene mutation is present. There are many factors that contribute to a person’s risk for cancer, such as family history, lifestyle and age. Genetic counselors look at all of these at once to determine who would benefit best from genetic counseling. During Melanie’s first meeting with Mira, she learned about the blood tests, possible risks such as the psychological implications, and what a positive or negative result means. At her next visit, Melanie had blood taken for genetic testing. Melanie tested positive for the BRCA1 gene mutation, which significantly increases a person’s risk of developing breast or ovarian cancer. Although Melanie had no physical signs of either cancer, the gene’s presence compounded by her family history increased her risk for cancer.

With the results, Mira and Melanie discussed the options and doctors who could help with the next steps Among the options for Melanie were a prophylactic mastectomy and oophorectomy to remove breast tissue and the ovaries before cancer developed. “Patients who opt for this choice can lower their risk of cancer greatly,” Mira says. “But women struggle with weighing the loss of these

Rush-Copley Cancer Care Center Annual Report

body parts against the potential benefits. And there are other ways for us to manage a patient’s risk.” For Melanie, preventive surgery felt like the right choice. She underwent an oophprectomy and is considering having a preventive mastectomy within the next year. In the interim, she is diligent about having yearly mammograms and breast MRI’s. “I want to be around longer for my children,” says Melanie, a mother of a teenage daughter and son. “My only thought was ‘How do I minimize my chance of getting cancer?’” Melanie has also become a fierce proponent for genetic testing with both family and friends. Due to her encouragement, Melanie’s 30-year old niece underwent testing and found that she has the BRCA-1 gene mutation. Melanie’s older sister chose not to be tested. Melanie is also insisting both of her children to be tested when they reach adulthood.

Family members of patients react to genetic testing in different ways, Mira describes. Even though parents, children and siblings of people with these mutations have up to a 50 percent chance of having the same mutation, deciding whether or not to be tested is a personal choice. “It was all done at Rush-Copley,” says Melanie. “I wouldn’t have gone anywhere else. The support and resources received from the program were personal, individualized and empowering.” “While no one can predict exactly who will develop cancer, knowing what your risk is allows us to help you reduce it,” adds Mira. To start, speak to your doctor about meeting with a cancer genetics professional for a complete cancer risk assessment. This process may help you better understand your true cancer risk. Knowing your risk level will help you make the healthcare choices that are best for you and your family members.

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2013 Highlights

This past year has been an exciting one for Rush-Copley’s Cancer Care Institute. We have

recruited accomplished clinicians and staff to our team, invested in new technologies, expanded our support services, provided

clinicians, patients and the community with innovative education programs, improved our facilities and workflow

operations and positioned our program for the next phase of our growth.

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Rush-Copley Cancer Care Center Annual Report

Rush University Medical Center

Navigation Support Expanded

Our center is a strategic collaborator with Rush University Medical Center. This year we launched cancer patient conferences that are designed to improve care by allowing physicians from both organizations to consult one another on cases via real-time, state-of-the-art teleconferencing that includes patient pathology and imaging. Physicians from both hospitals have the opportunity to present cases each week in up to as many as 11 different cancer subspecialties. These forums allow for collaboration to develop the best treatment plans and medical management for each patient.

Navigation of cancer treatment is highly complex. In addition to our current Breast Cancer Nurse Navigator, we have added a navigator for all cancers as well as a survivorship navigator that will focus on post-treatment care. Our speciallytrained oncology-certified nurses are available to patients whether newly diagnosed, in treatment, post-treatment or dealing with recurrence or end-stage disease.

This multidisciplinary approach to cancer care is just one way Rush-Copley is connecting academic medicine to the Fox Valley region.

Groundbreaking for Radiation Oncology Expansion In September, construction crews broke ground to expand the cancer care center on the main hospital campus. This expansion will include a second vault that will house a state-of-the-art linear accelerator that has advanced capabilities not often found at community cancer programs. The new system opens the door to new possibilities for the treatment of challenging cases such as cancers in the lung, breast and head and neck as well as other cancers that are treatable with radiotherapy. Our new technology makes it possible to deliver fast, accurate imageguided treatments within just a few minutes a day. With advanced imaging, physicians can deliver treatment more accurately by enabling them to “see” the tumor they treat and target tumors with sub millimeter accuracy. We anticipate the expansion to be complete by Summer 2014.

Our navigators serve as consistent and knowledgeable clinical resources throughout the treatment continuum. They identify the ongoing learning needs of patients and families and ensure those needs are met. They serve as links between healthcare providers and treatment settings (including surgery, chemotherapy, radiation therapy, inpatient, outpatient, physicians’ office) and connect patients and families to resources for disease management or treatment-related problems.

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. Our oncology physician offices, infusion and radiation departments and inpatient unit all participate in the survey process. In 2013, our center’s patient satisfaction scores continuously improved due to innovative patient care and process improvement initiatives created and implemented by staff.

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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,

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radiation and surgical methods of treatment for 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, in determining community education and outreach initiatives and in 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 our 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 2012 Analytical Cases Total

%

Stage 0

Stage 1

Stage 2

Stage 3

Stage 4

Other

Breast

222

32%

48

84

62

21

3

4

Lung & Bronchus

76

11%

0

11

8

25

32

0

Colorectal

68

10%

23

0

14

16

0

0

Other Digestive

47

7%

1

0

7

12

0

5

Prostate

45

7%

0

14

22

4

5

0

Endocrine System

39

6%

0

26

2

2

2

7

Brain & CNS

35

5%

0

0

0

0

0

35

Urinary System

28

4%

3

14

0

3

6

2

Lymphoma

30

4%

0

5

2

6

15

2

Female Genital System

24

3%

0

17

1

4

2

0

Oral Cavity

16

2%

1

1

1

2

11

0

Skin (excluding Basal & Squamous)

16

2%

2

7

4

2

1

0

Other

36

5%

0

0

2

4

0

22

Total

690

78

204

125

101

97

85

Site

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L u n g C a n c e r R e p o r t : Review of Diagnosis, Treatment and Survival of Non-small Cell Lung Cancer at Rush-Copley Dr. Syed A. Akbar, MD INTRODUCTION

therapeutic strategy thus far.

In 2012, an estimated 230,000 new cases of lung cancer (non-small cell and small cell combined) will be diagnosed. It is estimated that nearly 172,500 American men and women will die of lung cancer in 2012, making it the leading cause of cancer-related deaths for Americans. Unfortunately, lung cancer accounts for 15% of all cancers diagnosed in America annually and the corresponding 5-year observed survival rates for lung cancer, all stages, are uniformly less than 20%. Even more troubling is the fact that overall lung cancer survival over the last 30 years has not improved significantly. Specifically, 5-year observed survival rates for lung cancer, all stages, for patients diagnosed during 1984-1986 were 13%. More recently, 5-year observed survival rates, all stages, for the period 2001-2005 had improved slightly to 16%. Stage specific observed survival analysis suggest more optimistic results for patients diagnosed with Stage I disease, with slightly less than 50% of those patients surviving five years. Therefore, these statistics underscore the importance of screening and early detection with lung cancer.

Quitting smoking, or not starting at all, is by far the best way to prevent lung cancer. 87% of lung cancer deaths in this country are directly linked to cigarette smoking. According to the American Cancer Society, those who successfully quit smoking reap health benefits at any age. Only one to nine months after quitting, coughing and shortness of breath decrease and lung function improves; one year after quitting, the risk of heart disease is cut in half and five years after quitting, the risk of stroke is reduced. For those who have quit smoking for 10 years, the risk of dying from lung cancer is cut in half; and the risk of cancer of the mouth, throat, esophagus and pancreas decrease. Second hand smoke should also be avoided. All of our Rush-Copley facilities and campuses are smoke free and we offer smoking cessation programs to employees and the community throughout the year.

EARLY DETECTION AND PREVENTION As with all cancers, prevention and early detection are critical components of improving survival and longevity with lung cancer. Unfortunately with lung cancer, an early detection strategy is difficult because patients are often asymptomatic until the disease has progressed. In fact, many early lung cancers are diagnosed incidentally, discovered as a result of tests performed for an unrelated medical condition. Because of the aggressive nature of the disease, the generally poor prognosis for lung cancer patients and the challenges with early detection, prevention has been the best 12

LOW-DOSE CT LUNG CANCER SCREENING CT screening addresses an urgent need for improved lung cancer screening and early diagnosis of disease, when it is most treatable. The National Lung Cancer Screening Trial (NLST) was the largest study to date evaluating the effectiveness of two different imaging studies (chest x-ray versus chest CT) to detect lung cancer in patients without symptoms. Given the high prevalence of the disease, researchers wanted to know if screenings saves lives. Results from the study, published in 2011, showed that among people at high risk for developing lung cancer, those screened with low-dose CT scans showed a 20 percent reduction in lung cancer-related mortality compared to those who were screened with standard chest x-rays.

Rush-Copley Cancer Care Center Annual Report

Until recently, only some major medical organizations recommended screening for lung cancer for high risk groups. However, this year, the United States Preventative Services Task Force issued a statement recommending that certain individuals at high risk to get a low-dose CT scan every year. Current guidelines recommend CT screening for patients who meet the following criteria:  Ages 55 to 74  1 pack or more a day, each year for 30 years  Are current smokers or individuals who quit less than 15 years ago

the risk of developing a radiation-induced cancer is extremely low. The NLST found that approximately 25 percent of patients who have CT screening have a “positive” screen, meaning that a nodule is found in the lung. The vast majority of these nodules are benign (not cancer), which means that most positive screening studies will be a “false positive.” Additional testing is often necessary to determine which nodules represent lung cancer. Rush-Copley is currently developing a lung cancer screening program, with the hopes of launching this service to patients in 2014.

Or  Ages 50 or older  1 pack or more a day, each year for 20 years  Have one additional risk factor for lung cancer -Exposure to radon, asbestos, silica, or other carcinogen -Personal history of prior lymphoma or smoking-related malignancy (ie. head and neck cancer) -Family history of lung cancer -COPD or pulmonary fibrosis CT screening for lung cancer is safe and noninvasive; however , there are some risks associated with the screening. CT screening uses a low dose of radiation in order to produce images of the lungs. Cumulative radiation exposure, even in low doses, can damage cells, which may result in cancer later in life; however,

LUNG CANCER AT RUSH-COPLEY Based on 2012 data, Rush-Copley diagnosed 76 cases of new lung cancer, which represents 11 percent of all cancer cases diagnosed by the center for the year. 44% of those cases were male and 56% were female, compared to 52% men and 48% women diagnosed nationally according to the National Cancer Database. Nonsmall cell lung cancer accounted for 92% of lung cancer cases diagnosed, with 8% classified as small cell lung carcinoma. Of the non-small cell lung cancer patients, 25% were diagnosed in the early stages of the disease. Compared to Illinois and the US, Rush-Copley has the opportunity to diagnose lung cancer at earlier stages as seen in Figure 1 below. Stage

RushCopley

Illinois

US

I

17%

23%

25%

II

8%

9%

10%

III

22%

20%

20%

IV

51%

45%

40%

Unknown

2%

3%

5%

Figure 1. Non-Small Cell Lung Cancer diagnoses by stage at Rush-Copley compared to Illinois and US from the National Cancer Database 2010

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Findings on first course of treatment options for lung cancers, compared to data from the National lung cancer patients at Rush-Copley suggest Cancer Database. For local disease at diagnosis, physicians favor regimens containing 52% of patients treated at Rush-Copley were living chemotherapeutic agents either alone or in five years after diagnosis versus 46% of patients combination with other modalities when treated at centers nationwide. compared to national and state normative data. Year Year Year Year Year Specifically, 59.5% of Rush-Copley patients 1 2 3 4 5 chemotherapy alone or in conjunction with other Rushtreatments versus 47.4% and 42% of patients at 52% 34% 23% 18% 16% Copley other centers in the state and the nation, respectively. Upon case review of 25 patients by US 46% 30% 24% 19% 17% Rush-Copley physicians it was determined that 100 percent of those patients are receiving the Figure 2. Observed 5-year survival for Non-Small Cell correct course of treatment as defined within Carcinoma of the Lung at Rush-Copley and for the US from the National Cancer Database the NCCN guidelines. The data demonstrates that approximately 10.7% CONCLUSION of patients at Rush-Copley do not receive any first It appears from the data that Rush-Copley line therapy versus 17.2% and 20.7% of patients patients have more advanced disease at at state and national centers, respectively. Due diagnosis than other state and national centers. to the higher incidence of later stage disease as This conclusion is somewhat uncertain because compared to state and national averages, it is other centers have notably more patients staged likely that patients at Rush-Copley choose not to as “unknown� versus the 2% at Rush-Copley. seek treatment because the growth of the Regardless, the data shows the need to actively disease. Often, patients have a better screen patients to find the disease at an earlier, performance status at the earlier stages of the more treatable stage that has more favorable disease, where they are likely to receive more survival rates. aggressive therapies to try and achieve a cure. Overall, survival rates for lung cancer patients at Rush-Copley are favorable to national norms. Data to demonstrate the finding were 5-year cumulative observed survival for non-small cell 14

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

Julia Choo, MD

Radiation Oncology

Alice Danielle, MD

Palliative Medicine

Ted Kulczycki, MD

Internal Medicine

Joseph Meschi, MD

Hematology/Medical Oncology

Ho Myong, MD

Hematology/Medical Oncology

Craig Szafranski, MD

General Surgery

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 and CNO

Jeff Coleman, RN, MSN, CMSRN, CNML

Clinical Manager, CCC, Quality Coordinator

Minh Nguyen, MHA

Business Manager, CCC, Community Outreach Coordinator

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

Prema Ramakrishnan, RHIT, CTR

Tumor Registry

Mira Vujovic, APN, MSN, CBCN

Breast Care Navigator and Genetics Counselor

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Rush-Copley Medical Center Cancer Care Center 2000 Ogden Avenue Aurora, IL 60504 630-978-6252 www.rushcopley.com


Cancer Care Center Annual Report 2013