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John Stoddard Cancer Center

2013 Annual Report


Specialty Services Cancer is not an easy journey but at John Stoddard Cancer Center we are committed to making sure you have the services available to help make that journey as easy and positive as possible. We offer many specialty services to patients and their families, including: • Adolescent Young Adult Program (AYA) • Care Coordinators • Case Management • Chaplains • Child Life Specialists • Clinical Trials • Counseling Services • Education and Outreach • EmPowered • Genetic Counseling/Testing • Home Care • Hospice • Life Beyond Breast Cancer • Look Good...Feel Better • Lymphedema Clinic • Multidisciplinary Programs • Nutrition Services • Oncology Pharmacists • Palliative Care • Patient Education Classes • Social Workers • Support Groups • Survivorship Program For more information on Stoddard Specialty Services, visit johnstoddardcancer.org or call 515-241-3343.

Cancer Committee Members Steve Heddinger, MD (Chairperson) Medical Oncologist Kathleen Hansen, MD (Physician Liaison) Pathologist Dianne Alber, Ed.D. Clinical Psychologist Pati Berger RN, BSN, OCN Oncology Research Coordinator Dwight E. Deason, MSW, LISW Oncology Social Worker

Steven Elg, MD Gynecologic Oncologist

Liddy Hora American Cancer Society

Julie Meuler, CTR Oncology Registrar

Janet Eppard Freese, RHIA, CPHQ Clinical Quality Specialist

Anne Heun, MS Genetic Counselor

Andrew Nish, MD Interventional Radiologist

Robert Goebel, MD Radiation Oncologist Radiation Oncology Medical Director

Kathy Karpowicz BSN, RN, MA Director of Ethics, Palliative Care, and HRPP

Jay Rosenberger, DO Internist

Caleb Hegna UnityPoint Health Foundation

Daniel Kollmorgen, MD, FACS Surgical Oncologist Stoddard Medical Director

Carma Herring, RN, MS, OCN Executive Director

Gina Mandernach, RN, BSN, OCN Oncology Outreach Coordinator

Luci Shipley, BSN, RN, MHA Adult Oncology Inpatient Manager Ione Wilson Administrative Assistant Wendy Woods-Swafford, MD Pediatric Oncologist


Community Outreach Cancer Survivors Day

Philanthropy at Stoddard Rally Against Cancer

“Crush”ing Cancer with Friends and Laughter Once Judy Willis started to laugh, it did not take long for everyone else in the room to join her — and if you were sharing a glass of wine together, all the better! A proud Des Moines native, Judy loved her family, friends and community. She worked tirelessly to make a difference in many organizations, such as John Stoddard Cancer Center, where she helped to provide key services for cancer patients and their families. Little did Judy know that one day, she would need these services as well.

Cancer Survivors Day

Crush Colon Cancer

Cancer Survivors Day

Pink Days

Rally Against Cancer

This year’s Cancer Survivors Day, held at the Blank Park Zoo on Sunday, June 2nd, was a success. More than 900 total celebrated the day with us, 266 of which were survivors. Everyone had a chance to enjoy the zoo, refreshments, and to come together as a community.

Awareness and early detection are two of the most important tools in the fight against cancer — but for women who are uninsured or underinsured, access to mammogram screening is limited or nonexistent.

The Rally Against Cancer, John Stoddard Cancer Center’s largest annual fundraising event, was held in January. More than 500 members of the community came together to show their support and joined together in the fight against cancer, a disease that has affected us all in some way. The event raised more than $217,000 to support the Cancer Care Coordinator Program, which is provided free of charge to all patients of John Stoddard Cancer Center.

Cancer Survivors Day is a national event that John Stoddard Cancer Center celebrates locally every year with survivors and their families.

Through grant support from the National Breast Cancer Foundation and Bras for the Cause, John Stoddard Cancer Center is proud to offer free mammograms to uninsured and underinsured women, including follow-up diagnostic mammograms and breast ultrasounds. Increasing access to mammograms for those in need will help improve the likelihood of detecting breast cancer early and increase the likelihood of survivorship. In addition, providing mammograms also helps raise awareness about the importance of breast health among a segment of the population for which it is more difficult to deliver health messages. In 2013, more than 60 women benefited from this free service, known as Pink Days, at Stoddard.

The featured speaker was former pro football player Chris Draft, who spent 13 years in the NFL as a linebacker. Known for his toughness on the field, he discovered after he retired what it means to be really tough. Chris’s girlfriend LaKeasha, a fit, 37-year old nonsmoker, was diagnosed with Stage 4 lung cancer. In August 2011, eight months after her diagnosis, Chris proposed and they were married in November. Exactly one month later, on December 27, LaKeasha lost her battle with lung cancer, with Chris by her side as she took her last breaths. He continues the fight against cancer by helping others and raising awareness about the disease.

Rally Against Cancer

In May 2008, Judy was diagnosed with colorectal cancer. Throughout her journey, she showed grace and courage while focusing on the things she loved the most: spending time with family and friends. Even when she wasn’t feeling well, she made her time with loved ones fun and full of laughter – it was her medicine, and her gift. Unfortunately, Judy died after a valiant and courageous fight thirteen months after diagnosis. To continue her legacy and celebrate her life, Judy’s sister, Carolyn Bradley, joined forces with Judy’s good friend, Cathy Temple. Together, they decided to do what July loved most — gather friends and family for a glass of wine, some fun and lots of laughter, all to make a difference. They pulled together a committee of family and close friends, and founded Crush Colon Cancer in Judy’s honor to advocate for cancer patients and families. Crush Colon Cancer’s first fundraising event, held in 2010, showed how much people loved and wanted to continue Judy’s legacy. It raised $7,500 to support the Stoddard Care Coordinator Program, which ensures that all Stoddard patients and families have resources available to meet their needs throughout their journey. Three years later, the Crush Colon Cancer event continues to grow, contributing more than $50,000 in support of the Stoddard Care Coordinator Program. Judy would be proud to help so many patients and families receive the same kind of support she had during her own journey. As Carolyn and Cathy see it, if wine comes from crushing grapes, then working together can CRUSH cancer through awareness, early detection, support services and the best treatments possible.

Philanthropy plays an integral role in the full-continuum of care provided by the dedicated team at John Stoddard Cancer Center. Gifts from individuals, foundations, and organizations help to support programs that are provided free to patients and not reimbursed through insurance. Some of those programs include the Stoddard Care Coordinator Program, the What’s On Your Mind Program, the Compassion Fund and the Survivorship Program. In 2012, John Stoddard Cancer Center received $525,462 from individuals, foundations, and organizations. This philanthropic support builds on a tradition of philanthropy that began with John and Lilyan Stoddard and their commitment to build what has become one of the leading cancer centers in the Midwest.

2012 Charitable Contributions Individuals

$391,580

75%

25% Foundations and Organizations

$133,882


Number of Liver Cases by Year (2002-2012) 12

Primary Liver Cancer Survival (2003-2005)

JSCC NCDB

John Stoddard (JSCC) vs National Cancer Database (NCDB)

10

4 2

‘02 ‘03

‘04 ‘05

‘06

‘07 ‘08

Year

‘09 ‘10

‘11

‘12

Liver Incidence by Race (2002-2012)

White 76%

Percentage Surviving

6

Percentage Surviving

8

100% 80% 60% 40%

Male Liver Incidence by Age and Sex (2002-2012) Female

Percentage Surviving

Other 9%

Percentage Surviving

12 10 8 6 4 2 30-39

40-49

50-59

60-69

Age

70-79

80-89

AT DIAGNOSIS

20% 0% 0

1 Year

2 Years

3 Years

4 Years

5 Years

100% 80% 60%

STAGE 2

AT DIAGNOSIS

40% 20% 0% 0

Black 9% Asian 6%

STAGE 1

1 Year

2 Years

3 Years

4 Years

5 Years

100% 80% 60%

STAGE 3

AT DIAGNOSIS

40% 20% 0% 0

1 Year

2 Years

3 Years

4 Years

5 Years

100% 80% 60%

STAGE 4

AT DIAGNOSIS

40% 20% 0% 0

1 Year

2 Years

3 Years

4 Years

5 Years

Data Analysis Of Liver

Patient Volumes by Cancer Site (2012)

Stoddard Vs National Cancer Database (NCDB) Primary Liver Tumors Daniel Kollmorgen, MD, FACS, Surgical Oncologist, Stoddard Medical Director

Primary Site

The most common malignant tumors of the liver are metastatic lesions spread from other organs such as colon, pancreas, and other sites in GI tract. Primary liver tumors are those that start in the liver. These cancers arise in liver cells (hepatocellular carcinoma also known as HCC) or bile ducts (intrahepatic cholangiocarcinoma IHC). Although HCC is relatively uncommon in the US, it is one of the most common cancers in the world. Most HCC arises in abnormal livers - risk factors include cirrhosis, hepatitis B or C and fatty liver disease. HCC is staged based on tumor size and involvement of blood vessels. Surgery is the treatment of choice for small tumors and those not involving major vessels. Once the tumors involve major vessels, surgery is more difficult and complicated. Even in early stage lesions, the underlying liver disease (cirrhosis, steatohepatitis, etc) has a significant influence on prognosis and may make small tumors unresectable. Once the tumor character (size/location) or the underlying liver disease precludes surgical resection, there is a variety of regional (liver directed) or systemic treatments available. These include stereotactic radiation, chemoembolization, radioembolization,radio frequency ablation, cryotherapy, and even liver transplantation. Traditional chemotherapy is not effective in HCC. Systemic treatments may include monoclonal antibodies or drugs on clinical trial. In the last five years, John Stoddard Cancer Center has nearly doubled the number of primary liver tumors seen in the analytic years. This may be related to the increasing incidence of common risk factors such as hepatitis and morbid obesity. This may also be related to the ongoing development of liver disease treatment team with the successful recruitment of a transplant/hepatobiliary surgeon and two hepatologists. These specialists have joined the long standing Stoddard specialists (surgical oncology, radiation oncology, medical oncology, gastroenterology) to form a combination of local expertise unique in central Iowa. On review of the Stoddard data, the number of primary liver cancers in the study period is quite limited. Comparison to National Cancer Database is difficult to interpret due to the small number of cases and limited information on the underlying liver disease. Although the five year survival for stage I/II primary liver tumors are generally comparable, Stoddard has no long term survivors in stage III/IV. As mentioned, this may be due to small numbers of patients with the disease. This may also be related to underlying liver disease that is not accounted for in the staging system. Specifically, a patient with stage I disease may not be surgically resectable due to underlying cirrhosis. This makes direct comparison of outcome difficult to assess. Although the low incidence of this cancer and underlying liver disease in these patients limit detailed comparison, the availability of a multidisciplinary team, full spectrum of treatment options at Stoddard bode well for the future. Continued follow up of these findings will be encouraged and reviewed by the Stoddard Cancer Committee.

Total

Male

Female

Breast

318

5

313

Lung/Respiratory

267

144

123

Prostate

142

142

0

Colorectal

144

79

65

Urinary System

156

102

54

Leukemia/Lymphoma

141

80

61

Female Genital

136

0

136

Other Digestive

141

83

58

Skin

56

28

28

Thyroid/Endocrine

39

11

28

Brain/CNS

44

20

24

Oral Cavity

33

21

12

Other/Ill-Defined

23

13

10

Unknown Primary

17

9

8

TOTAL

1,657 737 920

Patient Satisfaction Scores (2012) Department

Score

Inpatient Unit

88.6

97th

Radiation Oncology

93.8

91st

Percentile Rank

How we compare to other cancer centers/ hospitals our size


2013 Stoddard Advisory Board Of Directors Frank Marcovis – Board Chair Denise Essman Robert Goebel, MD Carma Herring, RN, MS, OCN Kasey Johnson Steen Gary Kahn Dan Kollmorgen, MD, FACS Ted Lodden Jonathan Roth Jan Miller Straub Steve Stephenson, MD Tim Yoho

2013 Stoddard Co-Management Board Steven Heddinger, MD, Medical Oncology and Hematology Associates Robert Behrens, MD, Medical Oncology and Hematology Associates Michael Page, MD, The Iowa Clinic Andrew Nish, MD, Iowa Radiology Robert Isaak, MD, Stoddard Radiation Oncology David Stark, UnityPoint Health – Des Moines Tom Mulrooney, UnityPoint Health – Des Moines Daniel Kollmorgen, MD, FACS, Surgical Oncologist, Stoddard Medical Director

For more information about the programs and services of John Stoddard Cancer Center, visit JohnStoddardCancer.org

2013 John Stoddard Cancer Center Annual Report  

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