Building on a strong foundation
BAYHEALTH ONCOLOGY SERVICES 2019 ANNUAL REPORT
TABLE OF CONTENTS 4 CANCER REGISTRY: TOP CANCER SITES 5 WELCOMING NEW ONCOLOGISTS 6 A SPECIAL CELEBRATION FOR CANCER SURVIVORS
14 A MULTIDISCIPLINARY APPROACH TO COLORECTAL CANCER 16 REDUCING LUNG CANCER MORTALITY
8 FIGHTING CANCER WITH COMPASSION
17 RECOGNIZING AND GIVING THANKS TO OUR GENEROUS DONORS
10 JOINING TOGETHER TO BRING HOPE TO CANCER PATIENTS
18 CONNECTING WITH THE COMMUNITY IN NEW WAYS
12 RAISING MONEY AND AWARENESS FOR BREAST CANCER
19 KEY PARTNERS
DEAR COMMUNITY MEMBERS AND COLLEAGUES: We are pleased to present the Bayhealth Oncology 2019 Annual Report to the communities we serve. We want to extend our sincere appreciation to all team members at Bayhealth for their work toward the opening of the new Bayhealth Hospital, Sussex Campus. Their dedication, time and effort to transition our patients was incredible. This state-of-the-art facility incorporates the best features for our cancer patients, starting with the new 20,000-square-foot Bayhealth Cancer Center, Sussex Campus. Bayhealth has committed vast resources for the health of our community and specifically cancer care. We have grown our Bayhealth Cancer Center medical team, with the additions of Dr. Tony Lee, radiation oncologist, and Dr. Abeer Alfaraj, hematologist-oncologist, this past year. In addition, Dr. Pranitha Naini has joined Dr. Rishi Sawhney and Dr. Priya Singh in our Telegenetics Program, expanding access for patients to our medically managed genetic counseling program. We partner with Penn Medicine’s Abramson Cancer Center Telegenetics Program to provide genetic testing and counseling as appropriate, which further guides the development of the patient’s personalized treatment plan. Outreach to targeted at-risk groups was a key focus area in 2019. Bayhealth implemented colorectal and lung navigator programs to reduce barriers for patients accessing screening and early detection of cancer. Additionally, this past year, we held our first annual Survivors Event to recognize our patients and their caregivers. The event was a great success and brought everyone together to reconnect and recognize these special individuals. Lastly, we appreciate the work and dedication of our community partners and ambassadors who continue to raise awareness of our programs and services in the community. Our signature event, Runway of Hope, raised more than $83,000 for our Survivorship Program and our Go Pink! event raised more than $28,000 for our cancer screening assistance program. Bayhealth’s Cancer Committee continues to provide the leadership for the future direction of cancer care in our communities and we are grateful for their work.
Iftekhar Khan, MD Bayhealth Cancer Committee, Cancer Liaison Physician
John Lahaniatis, MD Bayhealth Cancer Committee, Chair
Cancer Registry: Top Cancer Sites The Bayhealth Cancer Registry is responsible for reporting accurate and timely data to the National Cancer Database and the State of Delaware Cancer Registry. These efforts support a better understanding of cancer incidence and mortality to direct and support programmatic development of services for cancer patients. Below are the top cancer sites at Bayhealth Hospital, Kent Campus and Bayhealth Hospital, Sussex Campus in 2018.
BAYHEALTH HOSPITAL, KENT CAMPUS: 2018
24%
BREAST
19%
LUNG
11%
PROSTATE COLORECTAL
7%
BLADDER
7% 32%
OTHER
BAYHEALTH HOSPITAL, SUSSEX CAMPUS: 2018
22%
BREAST
13%
COLORECTAL
12%
PROSTATE LUNG BLADDER OTHER
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9% 7% 37%
Welcoming New Oncologists Bayhealth welcomed two new oncologists in 2019. Radiation Oncologist Tony T. Lee, MD, joined Bayhealth Radiation Oncology Associates in the spring, and Medical Oncologist Abeer Alfaraj, MD, joined Bayhealth Hematology/Oncology Associates in the fall.
TONY T. LEE, MD Dr. Lee earned his Doctor of Medicine degree from Temple University School of Medicine. He completed an internship in internal medicine at Pennsylvania Hospital and a residency in radiation oncology at Thomas Jefferson University Hospital. Dr. Lee is a fellow of the American College of Radiation Oncology and is a member of the American Society for Therapeutic Radiology and Oncology. He serves as an adjunct assistant clinical professor for Indiana University School of Medicine and is a former primary investigator for the Radiation Therapy Oncology Group. Dr. Lee has been rated one of “America’s Top Doctors” year after year.
ALBEER ALFARAJ, MD Dr. Alfaraj earned a bachelor’s degree in medicine and surgery (MBBS) from the Jordan University of Science and Technology. She completed a residency in internal medicine at The George Washington University Hospital and a fellowship in hematology/oncology at the University of Virginia. Dr. Alfaraj is a member of the American Society of Clinical Oncology, the American Society of Hematology and the American College of Physicians.
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A Special Celebration for Cancer Survivors The Bayhealth Cancer Institute hosted a red carpet event celebrating cancer survivorship on Tuesday, June 4, 2019, from 3 to 5 p.m. at Bayhealth Hospital, Kent Campus. Many attended the inaugural celebration for local cancer survivors and their loved ones. Attendees had the opportunity to walk the red carpet and get a souvenir photo taken. They also enjoyed a variety of refreshments, heard remarks from a local cancer survivor and Bayhealth Cancer Institute staff, and mingled with Bayhealth medical staff and leaders and other guests. “It was wonderful to have an event that brought together our patients, their caregivers and the treatment team in one location to reconnect,” said John D. Shevock, FACHE, FACMPE, senior director of operations oncology service line and executive director of the Bayhealth Cancer Institute. “Our team in the cancer
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center establishes relationships with the patient and their families early on and it was a wonderful experience to share a few stories with one another.” A special video featuring Bayhealth Cancer Center staff sharing how honored and grateful they are for the opportunity to care for their patients also aired during the recognition program. You may go to Bayhealth.org/Cancer to watch it.
“ OUR TEAM IN THE CANCER CENTER ESTABLISHES RELATIONSHIPS WITH THE PATIENT AND THEIR FAMILIES EARLY ON AND IT WAS A WONDERFUL EXPERIENCE TO SHARE A FEW STORIES WITH ONE ANOTHER.” — JOHN D. SHEVOCK, FACHE, FACMPE
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Fighting Cancer with Compassion Milford resident Mary Van Bergen was an oncology nurse for 20 years. Less than three months into her retirement in early 2018, she found herself in the direct opposite role as an oncology patient. Van Bergen started having lower back pain and noticed blood in her urine in late 2017. “I went to my primary care physician who thought I was having postmenopausal bleeding,” she said. When tests ruled that out, Van Bergen decided to schedule an appointment with Urologist Antoinette Ptak, MD, who did a bladder biopsy. The results showed she had bladder cancer. Shortly after, Van Bergen began chemotherapy at Bayhealth Cancer Center, Milford Memorial. She says she decided to receive treatment at Bayhealth because of the cancer center’s close proximity to her house and support systems. Van Bergen says her experience, especially with staff, soon assured her she made the right decision. “From the registration staff to the volunteers to the nurses and the physicians, they all got to know me and call me by name,” said Van Bergen. “There’s a great sense of belonging and that everyone really cares about me. I feel like I’m part of a second family. For example, the nurses who work in the cancer center are outstanding and the social worker is always so helpful. Dr. Sawhney is also very kind and caring, but what impresses me most about him is his honesty. He also came to see me while I was getting my infusions.”
Van Bergen had three cycles of chemotherapy. After these cycles, the regimen needed to be changed due to disease progression, and immunotherapy was prescribed. Unfortunately, the immunotherapy wasn’t effective and Dr. Sawhney referred Van Bergen to Johns Hopkins. There was a specific clinical trial offered only at Johns Hopkins for Van Bergen’s cancer. She’s still receiving that treatment, which involves an oral drug, and also goes to Bayhealth Cancer Center, Sussex Campus for management of her cancer by local oncologists as well as supportive care. “It’s no secret nurses can be some of the worst patients, but I have no complaints. I was a little bit concerned at first because they were doing things differently than what I was used to. But I quickly realized that ‘different’ doesn’t mean ‘wrong.’ And when I got to Johns Hopkins, they also confirmed what I already knew — Dr. Sawhney and the rest of the team had treated my cancer the same way they would’ve recommended.”
“ THERE’S A GREAT SENSE OF BELONGING AND THAT EVERYONE REALLY CARES ABOUT ME. I FEEL LIKE I’M PART OF A SECOND FAMILY.” — MARY VAN BERGEN
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Van Bergen’s journey is unique in some ways, but it has similarities with that of most Bayhealth cancer patients — as they have access to new technologies, innovative treatments and clinical trials through a comprehensive program provided at Bayhealth Cancer Center, Sussex Campus in Milford and Bayhealth Cancer Center, Kent Campus in Dover. Bayhealth is
also affiliated with Penn Medicine’s Abramson Cancer Center. As a member of the Penn Cancer Network, Bayhealth is the only cancer program in Delaware affiliated with a National Cancer Institute–designated Comprehensive Cancer Center.
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Joining Together to Bring Hope to Cancer Patients Runway of Hope — a fundraiser featuring a silent auction, luncheon and fashion show that supports the Bayhealth Cancer Institute’s Survivorship Program — is one way the community makes a positive impact on the lives of cancer patients. Each year, Bayhealth’s physicians and medical staff also play an important part in the fundraiser’s success by making monetary donations and by volunteering to join a group of professional models who walk the runway during the fashion show. Bayhealth hosted its ninth annual Runway of Hope fundraiser on Friday, Aug. 2, 2019, at Rehoboth Beach Country Club. The event raised over $83,000 for the Survivorship Program. Since its inception in 2010,
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Runway of Hope has raised over half a million dollars towards Bayhealth’s Survivorship Program. Bayhealth Family Medicine Residency Program Director Brintha Vasagar, MD, MPH, FAAFP, was one of several doctors and other medical staff who supported or participated in this year’s event. “The Bayhealth community is so lucky to have access to comprehensive cancer services, including the Survivorship Program,” said Dr. Vasagar. “It was an honor to support my patients and family members who have been affected by cancer by raising money for programming that treats the individual. Seeing our community come together in support of such a great cause was so heartwarming, and I am looking forward to next year!”
The Survivorship Program supports cancer patients as they transition from cancer treatment to cancer survivorship. A nurse navigator, in collaboration with the patient’s oncologist, creates an individualized plan for each patient that includes information on follow-up care and meets with the patient to review it and address any concerns they may have. The nurse navigator also offers referrals for on-going counseling and any other resources or support the patient needs. “Runway of Hope is a wonderful event for our physicians and community to unite and support a great local cause,” said Rishi Sawhney, MD, medical director of the Bayhealth Cancer Institute. “This year’s event was very impactful since we had a cancer survivor speak about their personal journey and remind us all of the importance of the survivorship programs and services supported by Runway of Hope.”
RUNWAY OF HOPE COMMITTEE MEMBERS Shalini Sawhney, Co-chair (pictured here on left) Susan Chinnici, Co-chair (pictured here on right) Syreeta Adams-Harris Patti Andrew Caroline Andrews Diane Andrews Susan Ebaugh
Connie Fisher Katie Killen Pam Marecki Jeanne Mazzatenta Barbara Rutt Donna Stinson Danielle Vincent Clarke Wright 11
Raising Money and Awareness for Breast Cancer For the fourteenth consecutive year, Bayhealth held its annual Go Pink! campaign to raise money and awareness for breast cancer. Funds raised during the campaign are split between Bayhealth and the Delaware Breast Cancer Coalition to provide breast screenings and education programs to the local community. The majority of the funds are generated via the sale of specially designed Go Pink! T-shirts. In 2019, approximately 4,800 shirts were sold and more than $28,000 was raised.
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The Go Pink! campaign also includes a free health fair, which is held on the first Friday of October in the parking lot of the Bayhealth Women’s Center in Dover. The community event features information on cancer treatment and survivorship programs as well as clinical breast exams and screening mammograms. This year approximately 350 people attended the health fair and nearly 21 women were screened on-site for breast cancer.
Many Bayhealth staff also participated in this year’s campaign by purchasing and wearing Go Pink! T-shirts on Fridays in October.
BREAST CANCER QUALITY MEASURES: 2016 Radiation therapy is administered within 1 year of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer
90% 100% 100% 95% 93%
Tamoxifen or third generation aromatase inhibitor is recommended or administered within 1 year (365 days) of diagnosis for women with AJCC T1c or Stage IB–III hormone receptor positive breast cancer
90% 89% 89% 96% 94%
Radiation therapy is recommended or administered following any mastectomy within 1 year (365 days) of diagnosis of breast cancer for women with ≥ 4 positive NO DATA regional lymph nodes Image or palpationguided needle biopsy to the primary site is performed to establish diagnosis of breast cancer
90% 100% 100%
90% 80% 94% 91% 89% 92%
● BENCHMARK ● B AYHEALTH HOSPITAL, KENT CAMPUS ● B AYHEALTH HOSPITAL, SUSSEX CAMPUS ● STATE ● ALL COC PROGRAMS
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A Multidisciplinary Approach to Colorectal Cancer Colorectal cancer is the third-most common type of cancer and the second-leading cause of cancer death. Screening plays an essential role in the early detection of all cancers, especially colorectal cancer. “Early screening and detection can produce better patient outcomes for the treatment of colorectal cancer,” said Bayhealth Lung and Colorectal Nurse Navigator Trina Turner, MSN, RN-BC, LNC. “An important part of my role as a nurse navigator is to help schedule cancer screenings for patients and provide follow-up help — whether they have health insurance or not.”
Turner says too many people skip doctor’s visits or their regular screenings because they’re uninsured or underinsured. “Screening for Life is a program designed to help these patients get the care and treatment they need,” she said. “It provides assistance in finding a primary care provider, if needed, and provides payment for cancer screening tests to qualified Delaware adults.” Bayhealth Colorectal and General Surgeon Assar Rather, MD, FACS, FASCRS, adds that although colorectal cancer is the second-leading cause of cancer death, it’s completely treatable and preventable in most cases. According to Dr. Rather, risk factors for colorectal cancer include a Western-style diet or one low in fiber, obesity, lack of exercise, smoking, inflammatory bowel diseases such as Crohn’s or ulcerative colitis, and a family history. Dr. Rather recommends people start regular screening at age 50. “Newer research suggests that African Americans should begin regular screening at age 45. Patients with family history of colorectal cancer may need earlier screening. Screening can be done by a gastroenterologist or a colorectal surgeon,” he said. The most common colorectal screening methods are a fecal occult blood test in which stool samples are tested for the presence of invisible blood; Cologuard®, which also detects blood in the stool and looks for DNA cell changes; a flexible sigmoidoscopy; and a colonoscopy. If blood or an abnormality is found as a result of the other methods, a colonoscopy will be required. Also, the American Society of Colon and Rectal Surgeons considers a colonoscopy to be the “gold standard” when it comes to colorectal screening and says it’s the preferred method unless medical conditions don’t allow for it.
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TREATING COLORECTAL CANCER ONE STEP AT A TIME For those diagnosed with colorectal cancer, at Bayhealth, patients receive a specific treatment course, based on their individual needs. During a multidisciplinary Tumor Conference, surgeons, oncologists, radiologists, pathologists, and other medical providers come together for a multimodality review of the patient’s case history and make recommendations for treatment and follow-up care based on national guidelines. As Dr. Rather also explained, a few steps typically apply to all Bayhealth colorectal cancer patients as outlined below. Step One: See a specialist. This may include a surgeon, a medical oncologist and/or a radiation oncologist. If the patient requires surgery, it’s usually performed using minimally invasive techniques — either laparoscopic or robotic.
COLORECTAL CANCER QUALITY MEASURES: 2016 At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer
85% 93% 100% 92% 93%
● BENCHMARK ● B AYHEALTH HOSPITAL, KENT CAMPUS ● B AYHEALTH HOSPITAL, SUSSEX CAMPUS ● STATE ● ALL COC PROGRAMS
Step Two: Attend Colon Camp. This is an educational opportunity for patients before they undergo surgery. It’s an hour-long appointment with a nurse who explains how the surgery works, how to prepare for surgery and what to expect after surgery. Step Three: Undergo colorectal surgery followed by the ERAS protocol. ERAS (enhanced recovery after surgery) is a set of perioperative procedures and practices that are applied to all patients undergoing colorectal surgery to improve patient outcomes and satisfaction. Positive outcomes include freedom from nausea, freedom from pain at rest, early mobilization, early return of bowel function, improved wound healing, and early hospital discharge.
“ EARLY SCREENING AND DETECTION CAN PRODUCE BETTER PATIENT OUTCOMES FOR THE TREATMENT OF COLORECTAL CANCER.” — TRINA TURNER, MSN, RN-BC, LNC
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Reducing Lung Cancer Mortality In 2019, Bayhealth’s Research Committee held their Annual Research Conference titled “Discover the Wonders of Research.” The goal of the conference is to gain knowledge related to research in a community hospital as well as to learn about what other areas of the hospital and nursing are looking at to create research projects. The Bayhealth Cancer Institute participated with a poster presentation titled “Reducing Lung Cancer Mortality with Early Lung Screening.” The poster highlighted the work that is being done to reduce lung cancer mortality in the state of Delaware, specific to Bayhealth’s service areas. The data on lung cancer screening shows that 30 percent of all cancer deaths in Delaware are lung cancer and that early lung cancer screening can reduce mortality by 20 percent. The Cancer Institute highlighted the work that Bayhealth Lung and Colorectal Nurse Navigator Trina Turner, MSN, RN-BC, LNC, is doing to leverage technology and help meet the demands of patients in our community.
LUNG CANCER QUALITY MEASURES: 2016 Systemic chemotherapy is 85% administered within 4 months to day preoperatively or 100% day of surgery to 6 months postoperatively, or it is NO ELIGIBLE CASES recommended for surgically resected cases with pathologic NO DATA lymph node -positive (pN1) 93% and (pN2) NSCLC
Surgery is not the first course of treatment for cN2, M0 lung cases
100% 100% 96% 94%
● BENCHMARK ● B AYHEALTH HOSPITAL, KENT CAMPUS ● B AYHEALTH HOSPITAL, SUSSEX CAMPUS ● STATE ● ALL COC PROGRAMS
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85%
Recognizing and Giving Thanks to our Generous Donors Each year, members of the local community make generous gifts and donations that are used to help provide or enhance the services and programs offered to Bayhealth cancer patients. Here are a few examples of how community members supported cancer patients in 2019.
Experience Guides from Dogfish Head Craft Brewery in Milton donate the tips they receive in the tasting room to nonprofit and charitable organizations across Delaware. The Bayhealth Cancer Institute was selected as a recipient of one of these tips donations in 2019. The donation was in the amount of $1,964.77, and the money was put into a benevolence fund that helps assist cancer patients during times of financial hardship.
For the second consecutive year, Safeway Foundation granted $4,000 to support cancer programs and services. More specifically, the Bayhealth Cancer Institute received the funds to provide free biopsies to women in need in central and southern Delaware.
In 2019, C.F. Schwartz Toyota in Dover gave another generous gift in the amount of 10,000 to support Oncology Services at the Bayhealth Cancer Center, Kent Campus.
For the fourth consecutive year, Bayhealth cancer patients received donations from Winner Subaru in Dover and the Delaware Chapter of the Leukemia & Lymphoma Society as part of the Subaru Loves to Care Initiative. Winner Subaru customers were invited to share messages of hope, and for every vehicle purchased, blankets and other items were donated to the Bayhealth Cancer Center. The purpose is to provide comfort and support to cancer patients. 17
Connecting with the Community in New Ways In 2019, Bayhealth cancer care team members and leadership connected with the community to bring awareness and education on important cancer-related topics in ways they never had before.
RAISING AWARENESS FOR COLORECTAL CANCER AT DELAWARE AGRICULTURE WEEK Bayhealth attended the 14th annual Delaware Agriculture Week in January 2019. Lung and Colorectal Nurse Navigator Trina Turner, MSN, RN-BC, LNC, raised awareness for colorectal cancer and the importance of screening and early detection among Delawarean farmers and other members of the agricultural community. “We were able to connect with Delaware’s agricultural community to highlight the importance of screenings and early detection of this disease,” said Turner. “Having this opportunity was very exciting and we are looking forward to working together to increase awareness and prevention of this serious illness.” Bayhealth staff and leadership also had the opportunity to meet Delaware Secretary of Agriculture Michael T. Scuse at the event.
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BAYHEALTH PARTICIPATES IN HOPE DAY Bayhealth participated in Hope Day that was held on Legislative Mall in Dover in July 2019. The event was hosted by Convoy of Hope, an international organization whose goal is to provide hope and help to those in need. Convoy of Hope travels and partners with communities to offer Hope Day to individuals and families in need at no charge. Hope Day reached more than 3,500 people in Kent County. The Bayhealth Cancer Center, along with Bayhealth Occupational Health and Bayhealth Human Resources Recruitment, attended the event to provide services to the community. The Cancer Center was able to conduct free clinical breast exams with the help of an RV that was donated by Delmarva RV Center. In addition to clinical breast exams, the Cancer Center did facial skin screening assessments for more than 400 individuals, as well as gave information and education on prostate, colorectal and lung cancer screenings, smoking cessation, and skin health.
Key Partners 2019 BAYHEALTH CANCER INSTITUTE BOARD OF DIRECTORS Susan Chinnici, Vice Chairman
Lindsay Rhodenbaugh, Ex Officio
Peter Y. Chiou, MD
Barbara Rutt, Secretary
Connie Fisher
Rishi Sawhney, MD, Medical Director
Iftekhar Khan, MD
Priya Singh, MD
Gregory Moore, Ex Officio
Michael Tretina, Treasurer
Terry Murphy, FACHE, Ex Officio
Michael Twining
Khanh H. Nguyen, MD
Deborah Watson, FACHE, FACMPE, President
Assar Rather, MD, FACS, FASCRS, Chairman
2019 BAYHEALTH CANCER COMMITTEE MEMBERS David Brenner, MD
Jenni Glick, MSN, RN, OCN
Kathrina Chua, MD
Patricia Isherwood, FACHE
G. Chitiki Dhadham, MD
Renee Hall, RN
Freeman Hwang, MD
Bradley Kirkes, MBA, MHA, OTR/L, CHT, FACHE
Iftekhar Khan, MD, Cancer Liaison Physician
Theresa Latorre-Tegtmeier, FNP-C
Anita Sgrignoli, MD
Cynthia Martin, APRN, ANP-BC, MSN, AOCNP
Rajesh Kurpad, MD
Stephanie McClellan, MBA, MSN, RN, CMSRN, NE-BC
John Lahaniatis, MD, Chair
Jennifer Nack, CTR
Khanh Nguyen, MD
Holly Patronik, RD, LDN
Antoinette Ptak, MD
Carl Popelas, PharmD
Assar Rather, MD
Scott Richards
Rishi Sawhney, MD
Cheryl Rogers, RN, CPHQ
Priya Singh, MD
Laura Ryan, RTT (R) (T)
Peter Wong, MD
Susan Shaw, MSN, RN, OCN
Daniel Wood, MD
John Shevock, FACHE, FACMPE
Miaohou Xu, MD
Cindy Stern, RN, MSN, CCRP
Arthur Aduma, PharmD
Meredith Sullivan, MBA, MS, CCC-SLP
Linda Case, CTR
Deborah Watson, FACHE, FACMPE
Melissa Dulin, RN, BSN, OCN
Debbie Watson, MSW
COMMUNITY PARTNERS Heather Capezio, DE Hospice Sean Kelly, American Cancer Society Lois Wilkinson, Delaware Breast Cancer Coalition
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The mission of the Bayhealth Cancer Institute is to deliver the best cancer care in Delaware by providing state-of-the-art treatment, clinical research, education, and prevention to the people of our region.
BAYHEALTH CANCER CENTERS Bayhealth offers a wide range of cancer care services and programs at its two integrated cancer centers.
Bayhealth Cancer Center, Kent Campus 640 S. State Street, Dover, DE 19901
Bayhealth Cancer Center, Sussex Campus 100 Wellness Way, Milford, DE 19963
BAYHEALTH IS A MEMBER OF THE PENN CANCER NETWORK Bayhealth is affiliated with Penn Medicine’s Abramson Cancer Center, which provides our patients with access to university-level cancer care. As a member of the Penn Cancer Network, Bayhealth is the only cancer program in Delaware affiliated with a National Cancer Institute-designated Comprehensive Cancer Center. Patients and the cancer care team have ongoing access to new technologies, innovative treatments and clinical trials, as well as the expert opinions from physicians at the Abramson Cancer Center.
N#3769 12/2019