2015 Cancer Services ANNUAL REPORT
CANCER SERVICES
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Introduction 5
Lung Cancer Facts and Figures 6
Cancer Conference 7
Cancer Registry 8
Cancer Registry Feature Ar ticle 9
Cancer Registry Timeline 10
Comparison of Cancer Data 12
Primary Site Table 13
Cancer Committee Membership 14
Goals aand Accomplishments 15
Lung Cancer Ar ticle 16
Glossary of Terms 18
For Additional Copies 19
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Introduction I’m pleased to introduce Regional West Medical Center’s 2015 Cancer Services annual report. This year our focus is on lung cancer. According to the American Cancer Society, lung cancer is the second most common cancer in both men and women, and accounts for 14 percent of all new cancer diagnoses. In 2016, it’s estimated that over 224,000 people will be diagnosed with lung cancer in the U.S., and over 158,000 people will die from the disease. Lung cancer typically strikes older Americans. Approximately two out of three people diagnosed with lung cancer are 65 or older, while less than two percent are younger than 45. The average age at the time of diagnosis is about 70. In 2015, 47 people were diagnosed with lung cancer at Regional West Medical Center; 27 cases were men and 19 were women. Five cases were Stage I, three were Stage II, 12 were Stage III, 25 were Stage IV, and one was not staged. In 2013, lung/bronchus cancer was the third most diagnosed cancer at Regional West Medical Center, with 43 cases diagnosed during the year. The cases comprised six percent of that year’s cancer diagnoses for Regional West, compared with nine percent of Nebraska’s total lung cancer diagnoses, and eight percent of the nation’s total lung cancer diagnoses.
Vincent Bjorling, MD Co-Chairman Cancer Committee
Providing personalized, individualized cancer care is a team effort, and in this year’s annual report we spotlight Regional West’s Cancer Registry. At Regional West, we are committed to involving seasoned professionals in every facet of cancer diagnosis, treatment, and follow-up care to ensure the best possible outcome for our patients. For more information about cancer services, support programs, and activities for cancer survivors and their loved ones, call Regional West Physicians Clinic-Oncology at 308.630.2101, the Cancer Treatment Center-Scottsbluff at 308.630.1348, or the Dorwart Cancer Care Center-Sidney at 308.254.9192. Sincerely, Vince Bjorling, MD Co-Chairman, Cancer Committee
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Lung Cancer Did you know? • Overall, the chance that a man will develop lung cancer in his lifetime is about one in 14; for a woman, the risk is about one in 17. These numbers include both smokers and non-smokers. For smokers the risk is much higher, while for non-smokers the risk is lower. • Black men are about 20 percent more likely to develop lung cancer than white men. The rate is about 10 percent lower in black women than in white women. Both black and white women have lower rates than men, but the gap is closing. The lung cancer rate has been dropping among men over the past few decades, but only for about the last decade in women.
• The rate of new lung cancer cases over the past 37 years has dropped for men, with a 28 percent decrease, while it has risen for women, with a 98 percent increase. In 1984, the rate of new cases for men peaked (102.1 per 100,000) and then began declining. The rate of new cases for women increased further, did not peak until 1998 (52.9 per 100,000), and has now started to decline. • Smoking, a main cause of small cell and non-small cell lung cancer, contributes to 80 percent of lung cancer deaths in women and 90 percent of lung cancer deaths in men.
Nonsmokers have a 20 to 30 percent greater chance of developing lung cancer if they are exposed to secondhand smoke at home or work. - American Lung Association • Despite the very serious prognosis of lung cancer, some people with earlier stage cancers are cured. More than 430,000 people alive today have been diagnosed with lung cancer at some point. • In 2011, Kentucky had the highest age-adjusted lung cancer incidence rates in both men (112.2 per 100,000) and women (79.3 per 100,000). Utah had the lowest age-adjusted cancer incidence rates in both men and women (34.5 per 100,000 and 25.0 per 100,000, respectively). These statespecific rates were parallel to smoking prevalence rates.
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• Men who smoke are 23 times more likely to develop lung cancer. Women who smoke are 13 times more likely, compared to people who have never smoked. • Exposure to secondhand smoke causes approximately 7,330 lung cancer deaths among nonsmokers every year. Sources: American Cancer Society; American Lung Association
2015 Cancer Conference Cancer conferences provide a forum for formalizing the disease stage of the patients discussed using nationally recognized, evidenced-based treatment guidelines, when appropriate, and continuing medical education. Regional West Medical Center held 24 bimonthly multidisciplinary Cancer Conferences in 2015 to review and discuss current trends in the treatment of cancer. Pathologist Peter Schilke, MD, served as the 2015 coordinator. Physician representatives from all appropriate disciplines, as well as other cancer health care providers, attend and participate in these conferences. Average
attendance for physicians who actively participated in cancer care was 11. The multidisciplinary average attendance was 11. In 2015, 262 cases were presented. Sites discussed included: breast, lung, colon, corpus uteri, melanoma, esophagus, prostate, rectum, ovary, kidney, bladder, lymphoma, head/neck carcinoma, stomach, pancreas, and unknown primary. To arrange for case presentation at Cancer Conference or for further information regarding the Cancer Registry, please call 308.630.2421.
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Cancer Registry
By CTR By Cindy Cin indy dy y Keller, Kelle er, r, C TR TR Cancer Coordinator Canc Ca ncer Registry Re eg gis str try y Co C ord or din nato to or
The Cancer Registry is a component of the cancer program that is responsible for the accurate and timely collection of cancer patient data used for the evaluation of patient outcomes, research, and prevention. The Cancer Registry is responsible for monitoring and coordinating many of the activities of Regional West Medical Center’s cancer program and our participation in the American College of Surgeons (ACoS) Commission on Cancer (CoC) as an accredited program. Regional West’s Cancer Registry has been accredited since 1985. The Cancer Registry is responsible for the data collection and follow-up of all cancer patients diagnosed and/or treated at Regional West. These cases are part of the computerized database utilizing Rocky Mountain Cancer Data Systems in
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Salt Lake City, Utah. The updated registry computer system allows instant retrieval capabilities. The database includes information on demographics, anatomic site, extent of disease at the time of diagnosis, history, staging of the cancer, and treatment summary. There were a total of 388 analytic cases added to the registry in 2014. See the primary site table on page 13. In May, the Data Specialist attended the National Cancer Registrars Association’s 41st annual educational conference in San Antonio, Texas. In October, the registry staff attended the 38th Annual Tumor Registrars Association of Nebraska TRAN workshop in Omaha.
Reinventing Excellence Cancer Data Management Regional West Medical Center Cancer Registrar Cindy Keller has been the face of the hospital’s cancer registry program since 1993, and has worked with fellow registrar Joann Cervantes since 1998. They are in charge of collecting and compiling information that is vital to the prevention and treatment of cancer. “Working in the Cancer Treatment Center has helped me to broaden my knowledge of the causes of cancer, the treatments that lengthen disease-free intervals, and lifetime survivals,” says Cindy. She adds that her motivators are her peers, the continuing education, and support provided by the Tumor Registrars Association of Nebraska and the National Cancer Registrars Association. The Cancer Registry collects demographic, cancer identification, treatment, and follow-up data on each eligible cancer patient. The collected data is used to: • Determine the incidence of cancer in the state. • Conduct research and epidemiological studies. • Evaluate public health initiatives. • Assess the quality of hospital programs and patient care. • Set up cancer screening programs. The data contributes to treatment planning, staging, and continuity of care for patients. According to Cindy, without complete and accurate data, it would be difficult to develop effective comprehensive cancer prevention and control programs. Accurate and complete registry data allows for an optimal cancer program and administrative planning to allocate hospital resources, so it is vital to the continued health and productivity of Regional West.
Cancer Registries aren’t just a good idea – their existence is mandated by Nebraska State Statute 81-646. Each year, complete data for all requested analytic cases are submitted to the National Cancer Data Base (NCDB) in accordance with the annual call for data. Long-term follow-up is essential to evaluate outcomes of cancer care, and accurate follow-up data enables Regional West to compare outcomes with regional, state, and national statistics, as is evidenced by graphs in this annual report. Follow-up information is obtained at least annually for all living patients included in the cancer registry database. Regional West’s Cancer Registry began in January 1982 and has been an accredited facility since 1985. In 2004, the Commission on Cancer, American College of Surgeons implemented the Outstanding Achievement award for accredited cancer programs. The Outstanding Achievement award is designed to recognize cancer programs that strive for excellence in providing quality cancer care to cancer patients. A facility demonstrates a commendation level with seven standards that represent the full scope of the cancer program and also receives a compliance rating for the remaining 29 standards. Regional West has obtained this award four consecutive times 2004, 2007, 2010, and in 2013. “People will ask me, “How can you work in a cancer center for so many years?” My response has always been the same,” concludes Cindy. “The diagnosis and treatment modalities of cancer are constantly changing with improvements in both areas. These improvements make my job so interesting and rewarding.”
Regional West Certified Tumor Registrars Cindy Keller and Joann Cervantes.
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A Timeline of Regional West’s Cancer Program West Nebraska General Hospital’s name was changed to Regional West Medical Center and the community hospital evolved into a regional referral center.
Eighteen cancer survivors and their support persons attended the first anual Camp Hope, which provided the opportunity to meet one another in a creative, educational atmosphere of support to share, listen, learn, and have fun (Note: 25 years later, Camp Hope remains a unique opportunity for adult cancer patients to explore the hopeful side of cancer).
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1988
Dorothy Clemons became West Nebraska General Hospital’s (WNGH) first tumor registrar after successfully completing the national certification exam. The reference date for West Nebraska General Hospital’s (now Regional West Medical Center) Cancer Registry as documented in the 1983 annual report.
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1984
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January 1, 1982 02
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Early 1986
August 1991
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May 1991
Connie McDonnough Regional West’s Cance
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West Nebraska General Hospital received notific that its cancer program had received a full three approval from the American College of Surgeons Commission on Cancer.
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The Cancer Committee was organized. Dr. Edward Swartz was elected chairman.
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The Cobalt Unit had treated 400 patients, with cancer treatment that ranged fr cobalt therapy. Other activity that occurred during 1983 was the introduction radiation for brain tumors. In addition, The Social Service Department coordin housing, both in terms of motels as well as private homes, for families of patien chemotherapy.
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August 1981
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◄ December 1983
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Doro CTR, one o Canc state work Com Canc Duri Canc 6,26 in th datab main (pape abstr log, r cards
Regional West was awarded its fourth consecutive Outstanding Achievement Award for accredited cancer programs by the Commission on Cancer, American College of Surgeons. The program also achieved the Outstanding Achievement Award in 2004, 2007, and 2010.
othy Clemons, ART, , retired. Dorothy was of the first Certified cer Registrars in the e of Nebraska, and ked with the Cancer mmittee to organize the cer Registry program. ng her 17 years in cer Registry, a total of 3 cases were completed he Cancer Registry base. All records were ntained on hard copy er) including the ract, the accession request log, patient file s, and follow-up cards.
The Dorwart Cancer Care Center sees its first patient. In June, an outreach medical oncology clinic was added to the center.
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2003
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The Festival of Hope, a local grass roots 13 fund-raising event organized by volunteers committed to assist area cancer patients during May 2000 the treatment process, was founded. The 12 Festival of Hope is a non-profit organization Groundbreaking June 2000 was held for the new whose mission is to help 11 Dorwart Cancer Care cancer patients who live in western Nebraska and Center in Sidney, eastern Wyoming with The Cancer Neb. A discussion non-medical expenses Treatment between Radiation as they relate to their Center was Oncologist Mark cancer care and relocated to a Hartman, MD, and treatment. The event is new building, several Sidney area scheduled in June of with expanded cancer patients each year. facilities and a initially sparked the See festivalofhope.net. new state-ofconcept of cancer the-art treatment in the radiation southern panhandle. therapy The patients were equipment. often driving hundreds of round trip miles to Scottsbluff on a weekly basis for cancer treatment and time was taking a physical as well as an emotional toll.
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JoAnn Cervantes successfully completed the national certification exam for tumor registrars.
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April 2001
June 1998
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2013
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March 1998
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Cindy Keller successfully completed the national certification exam for cancer registrars.
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was named the new director of er Treatment Center.
cation e-year s
rom superficial skin to of interstitial nated a list of low cost nts undergoing
The rich traditions and success of Regional West Medical Center, Regional West’s Cancer Program, and Regional West’s Cancer Registry have been intertwined since the registry’s inception.
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2015 Comparison Compari son of Cancer Data In 2015, there were 388 cases of cancer and reportable tumors in the Regional West Medical Center Cancer Registry. Of these, 38 cases were non-analytic, and a total of 426 cases qualified for analysis (see primary site table on p. 13). Breast cancer is the most frequently diagnosed and treated primary site at Regional West. All graphs shown include analytic cases only.
Comparison - Top Five Sites For 2013
Comparison Charts Regional West 18%
Breast
12%
Prostate Breast 1 Lung/Bronchus Prostate 2 Colon Lung/Bronchus 3 Melanoma of Skin
47% 10% 6%
7%
National 227,096 105,208 159,773 71,341 51,981 616,236 1,231,635
All other sites
Dawes 21
17%
Sioux 2 9%
Breast Prostate Breast 1 Lung/Bronchus Prostate 2 Colon Lung/Bronchus 3 Melanoma of Skin
50% 13% 6%
Kimball 15
18%
Prostate Breast 1 Lung/Bronchus Prostate 2 Colon Lung/Bronchus 3 Melanoma of Skin
50% 13% 6%
SOURCE: American College of Surgeons, National Cancer DataBase (NCDB), Hosital Comparison Benchmark report, 2013.
Morrill 25
Cheyenne 31
Garden 5
Grant 4
Hooker 1
Arthur
McPherson
Keith 1
Deuel 2
Thomas
Logan
Lincoln
Perkins
Breast
9%
Box Butte 35
Banner 1
All other sites
Cherry 1
Sheridan 6
Scotts Bluff 190
National
4%
Nebraska 1,450 757 1,131 496 422 4,233 8,489
2015 Counts by County of Residence
Nebraska
5%
Reg. West 77 54 43 31 24 204 433
Breast Prostate Lung/Bronchus Colon Melanoma of skin All other sites Total
Total equals 388 cases for 2015
Chase
Out of state: 48
Dundy
All other sites
Hayes
Frontier
Hitchcock Red Willow
Top Five Incidences Sites-Men
Top Five Incidences Sites-Women
MEN
WOMEN
19% 36% Prostate
45% 15%
8% 6%
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6%
Lung and Bronchus Prostate 1 Bladder Lung and Bronchus2 Non-Hodgkin's Lymphoma Bladder 3 Melanoma of Skin
Other
Breast
38%
5%
5%
9% 7%
Lung and Bronchus Breast 1 Corpus Uteri Lung and Bronchus2 Non-Hodgkin's Lymphoma Corpus Uteri 3 Colon
Other
Cancer Incidence by Primary Site 2015 Cancer Treatment Center and Dorwart Cancer Care Center Cases Primary Site
ALL Cases Analytic Sex Best AJCC Stage (includes Cases M F Stage 0 Stage I Stage II Stage III Stage IV non-analytic) Buccal Cavity/Pharynx 13 13 8 5 0 3 3 2 5 Tongue 6 6 3 3 0 1 2 0 3 Major Salivary Gland 2 2 0 2 0 1 0 1 0 Gum/Other Mouth 3 3 3 0 0 1 1 1 0 Oropharynx 2 2 2 0 0 0 0 0 2 Digestive System 56 53 25 28 0 6 13 12 16 Esophagus 3 3 2 1 0 0 0 0 3 Stomach 4 4 2 2 0 0 1 1 2 Small Intestine 4 4 2 2 0 0 0 1 3 Colon, Excluding Rectum 18 18 7 11 0 5 5 6 2 Rectum & Rectosigmoid 9 8 3 5 0 0 5 2 0 Liver 4 2 1 1 0 0 0 1 1 Gallbladder 1 1 1 1 0 0 1 0 0 Pancreas 7 7 6 1 0 1 2 0 4 Peritoneum 1 1 0 1 0 0 0 0 1 Other Digestive Organs 5 5 1 4 0 0 0 0 0 Respiratory/System 51 50 30 20 0 6 3 13 27 Larynx 4 4 3 1 0 1 0 1 2 Lung, Bronchus 47 46 27 19 0 5 3 12 25 Soft Tissue 2 2 1 1 0 0 0 1 1 Skin (Exc. Basal & Sq. Ca) 20 16 11 5 9 1 3 1 2 Melanoma of the Skin 19 15 10 5 9 1 2 1 2 Other Skin Cancers 1 1 1 0 0 0 1 0 0 Breast 82 79 2 77 12 33 17 12 3 Female Genital 25 25 0 25 1 8 3 7 5 Cervix Uteri 1 1 0 1 0 0 0 1 0 Corpus Uteri 14 14 0 14 1 7 1 3 1 Uterus 1 1 0 1 0 1 0 0 0 Ovary 7 7 0 7 0 0 2 2 3 Vulva 2 2 0 2 0 0 0 1 1 Male Genital 56 37 37 0 0 12 19 2 4 Prostate 53 34 34 0 0 9 19 2 4 Testis 2 2 2 0 0 2 0 0 0 Penis 1 1 1 0 0 1 0 0 0 Urinary System 40 37 22 15 13 10 5 3 4 Urinary Bladder 23 21 14 7 12 3 5 1 0 Kidney & Renal Pelvis 17 16 8 8 1 7 0 2 4 Brain & Other Nervous Sys. 17 16 7 9 N/A N/A N/A N/A N/A Endocrine System 10 9 4 5 0 2 1 1 1 Thyroid Gland 6 6 3 3 0 2 1 1 1 Other Endocrine 4 3 1 2 N/A N/A N/A N/A N/A Lymphatic System 25 23 12 11 0 7 4 3 7 Hodgkin’s Disease 2 2 2 0 0 1 0 0 0 Non-Hodgkin’s Disease 23 21 10 11 0 6 4 3 7 Multiple Myeloma 7 7 6 1 N/A N/A N/A N/A N/A Blood/Leukemia 11 11 7 4 N/A N/A N/A N/A N/A Other, Ill-defined & Unk. 11 10 3 7 N/A N/A N/A N/A N/A All Sites Combined 426 388 175 213 35 88 72 57 75 M=male, F=female, AJCC Stage Grouping T, N, and M categories describe the anatomic extent of disease. Stage groupings gather cases into homogeneous categories to facilitate analysis. See glossary.
Not Staged 0 0 0 0 0 6 0 0 0 0 1 0 0 0 0 5 1 0 1 0 0 0 0 2 1 0 1 0 0 0 0 0 0 0 2 0 2 16 4 1 3 1 0 1 7 11 10 61
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2015 Cancer Committee Membership Required Physician Members and Non-Physician Members Cancer Committee Chair/CoChair • Vincent Bjorling, MD • Jason Walsh, MD, FACS Cancer Liaison Physician • Gitesh Chheda, MD • Jason Walsh, MD, FACS Medical Oncology • Vincent Bjorling, MD • David Johnson, MD, FACP • Regine Leconte, MD Radiation Oncology • Mark Hartman, MD
Quality Management • Margo Ferguson, MT (ASCP) • Kris Henkel, RN Clinical Research Coordinator • Michele Lambert, BSN, OCN Oncology Nursing • Sue Schoeneman, MSN, ACNP, AOCNP • Kim Croft, RN, BSN Community Outreach Coordinator • Paulette Schnell, BSN, RN • Deborah Keener, BSN, RN
Ad Hoc Program Members
Pathology • Peter Schilke, MD, FCAP • Randall Williams, MD, FASCP Diagnostic Radiology • Gitesh Chheda, MD • Stephen Johnson, MD, PhD Surgery • Jason Walsh, MD, FACS • Jason LaTowsky, MD Palliative Care Services • Connie Beehler, MD, MS, FAAHPM • Deborah Moore, GNP-BC Cancer Program Administrator • Jeff Kriewald, B.S. RT(R)(T) Certified Tumor Registrar • Keller, Cindy, CTR • JoAnn Cervantes, CTR Social Worker • Carol Diffendaffer, PMHP, PMSW, OCW-C • Jodi Willats, MSW
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• John Mentgen, FACHE President/CEO Regional West Health Services • Shirley Knodel, RN, MS Chief Nursing Officer/Vice President Patient Services • Jan Taylor, MT (ASCP) Vice President Ancillary Services • John Kabalin, MD, Urology • Chris Buhr, RN, Nursing Services • Kim Croft, RN, BSN, Cancer Services • Nichole Griffith, PT, DPT, Rehab Services • Kelsey Kriewald, Pharm.D, RPH, Pharmacy • Karen Johnson, RD, CSO, LMNT, Food Service • Jill Koch, American Cancer Society Representative • Sharon McKinney, Director, Imaging Services • Amy Potts, Medical Staff Office
Cancer Program 2016 Goals Clinical Goal – Implement lung cancer screening, along with the continued development of the smoking cessation program. Programmatic Goal – Establish a financial counselor position and work toward achieving the STAR (Survivorship Training and Rehabilitation) program designation.
2015 Accomplishments • Expanded the family history screening conducted through Invision Sally Jobe and Mary Frievogel to include clinics outside of the cancer service line. Implemented the use of rack cards through the Regional West Health Services Marketing Department highlighting available services. These cards have been distributed to all clinics and outlying areas. • Organized an in-house smoking cessation program committee to reside in the Pulmonary Clinic.
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Lung Cancer Reinventing Excellence in Cancer Data Management Similar to the powertrain in an automobile, the heart and lungs are the engine of the human body. The lung’s main purpose is to inhale oxygen from the surrounding air and oxygenate the body’s circulating blood. The average person inhales and exhales air 12 to 20 times a minute without even realizing it! Oxygen is the body’s energy currency to do tasks in everyday life – movement, thoughts, and even blinking requires oxygen. That being said, any problem in the lung that decreases the amount of breaths a person takes or decreases the lung’s ability to oxygenate the blood will significantly harm a person’s body.
Gitesh Chheda, MD Diagnostic Radiology
“Trends in cancer death rates are the best measure of progress against cancer. The total cancer death rate has dropped 23 percent over the last two decades because of reductions in smoking, as well as improvements in early detection and treatment.” Gitesh Chheda, MD
An abnormal growth in the lung is a tumor, and if it becomes malignant with the ability to spread, we then define it as a cancer. Both tumors and cancers occupy space inside the lung, not allowing it to hold as much oxygen as it previously did when it was healthy. Once cancer seizes a part of the lung, that section no longer oxygenates the blood, and may cause the patient to develop persistent cough, blood-streaked sputum, voice change, shortness of breath, chest pain, and recurrent pneumonias. Lung cancer is an expensive problem that is difficult to accept, as nearly $100 billion dollars was spent on health care related costs for all cancers in 2014. Overall, cancer is the second most common cause of death in the US, accounting for nearly 25 percent of all deaths. In Nebraska, lung cancer is the second most commonly diagnosed cancer in both men and women. An estimated 224,390 new cases of lung cancer are expected to be diagnosed in 2016 in the entire US, while an estimated 158,080 deaths are expected to occur in 2016.
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Shockingly, most lung cancer cases are preventable, as the leading cause worldwide is cigarette smoking. An individual who smokes is nearly 25 times more likely to develop lung cancer than a nonsmoker. Risk increases with both duration and quantity of smoking. But, there is good news on the horizon – smokers who quit, regardless of age, automatically increase their lifespan; those who quit before middle age have longevity similar to non-smokers. The number of young adults who currently These are images of a patie smoke cigarettes red, as seen on screening e has been cut over chest X-ray on the left, whe a half over the LDCT image on the right, w last 50 years. While cessation treatments can double or triple a smoker’s chance of long-term abstinence, only one in every three people who try to quit use counseling or medication. Smokers with more advanced education are more likely to quit completely. Trends in cancer death rates are the best measure of progress against cancer. The total cancer death rate has dropped 23 percent over the last two decades because of reductions in smoking, as well as improvements in early detection and treatment. Lately, more than 1,700,000 cancer deaths have been avoided. One of the main factors has been the adoption of smoke-free policies.
Currently, half of the US population is covered by a 100 percent smoke-free policy in workplaces, restaurants, and bars. Current cigarette smoking among US high school students has decreased from 36 percent in 1997 to nine percent in 2014. Additionally, second-hand smoke (SHS) exposure, which contains at least 69 carcinogens, dropped among nonsmokers, from 84 percent in 1988 through 1994, to 25 percent in 2011 through 2012.
However, the fight is not over. The use of e-cigarettes, hookahs, and cigars has become more popular, leading to nicotinedependence and increased risk of lung cancer development later in life. In addition, the least educated are the largest subset that continue to smoke ent with left lung cancer, highlighted in and are the least exams. Notice the difference between the likely to stop. ere the nodule is less clear, versus the Furthermore, where the nodule stands out. using smokeless tobacco products to substitute for the nicotine addiction from smoking causes a higher risk of tobacco-related death versus quitting completely. Because lung cancer does not typically cause symptoms until a more advanced stage, screening tests were created to detect cancerous lesions at an earlier stage. Earlier stage lung cancer has a five-year survival rate of 55 percent (as opposed to 17 percent for all lung cancers), because treatment is usually less extensive and can be more successful. Initially, the chest X-ray was thought to be easiest test to screen the lungs. Technology has advanced in the last few years, and CAT scan imaging is the newest and best test to detect a lung nodule, which is how lung cancer starts. A national lung screening trial (NLST) (released Nov. 2010 and published June 2011 in the New England Journal of Medicine) compared two ways of
detecting lung cancer: low-dose helical computed tomography (CT), and standard chest X-ray. The study included patients who were 55 to 74 years old, in good health, and had at least a 30-pack-year smoking history (including current smokers or those that had quit within 15 years). The study revealed that participants who received low-dose helical CT scans had a 15 to 20 percent lower risk of dying from lung cancer than participants who received standard chest X-rays. Screening is recommended every year the risk factors apply to the individual. While screening can find earlier cancers, above all else, smoking cessation counseling is strongly recommended. Screening should NOT be viewed as an alternative to smoking cessation. On our high quality, thin-section CAT scanner, we are able to scan the lung with the lowest radiation dose necessary. If we find a pulmonary nodule, we measure it, describe its features, and compare it with prior screening exams. Additionally, we use computer-assisted detection software to detect nodules that we may otherwise miss. For every 1,000 people who screen for lung cancer, three fewer people die of lung cancer. As always, you should have open communication with your doctor as to the benefits and any uncertainties you have with lung cancer screening. By screening more people, we find more nodules; some of the nodules require a needle biopsy, where we take a tissue sample for a pathologist to determine if the nodule is cancerous. While this can cause anxiety, the number of lives saved from this technique should give you comfort. To determine if you should be screened for lung cancer, consider the websites http://www.shouldiscreen. com/ or http://lungcancerscreeningsaveslives.org/. Source: American Cancer Society
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Glossary of Terms AJCC STAGE: American Joint Committee on Cancer Staging Scheme using tumor size, node involvement and metastases to distant sites, T=primary tumor size; N=regional lymph node involvement; M=metastasis or distant spread AJCC STAGE GROUPINGS (FOR MOST SITES): Stage 0: Carcinoma in-situ Stage I: Localized carcinoma Stage II: Limited local extension and/or limited regional lymph node involvement Stage III: More extensive local extension or regional lymph node involvement Stage IV: Involvement of distant sites ANALYTIC: Cancer cases initially diagnosed and/or having received all or part of the first course of treatment at Regional West Medical Center FIRST COURSE OF TREATMENT: Planned definitive therapy initiated within four months following initial diagnosis NCDB: National Cancer Data Base OBSERVED SURVIVAL RATE: The literal survival rate from counting each case in the Registry STAGE GROUPING PURPOSE: T, N, and M categories describe the anatomic extent of the disease. Stage grouping gathers cases into homogenous categories to facilitate analysis. UNKNOWN: Tumor is said to be unknown when the stage cannot be determined from the medical record or a medical authority.
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Additional Copies Call: Write:
308.630.2421
Regional West Medical Center Cancer Treatment Center 3911 Avenue B, Suite G100 Scottsbluff, NE 69361 Attention: Cindy Keller, CTR Cancer Registry Coordinator
Email: Cindy.Keller@rwhs.org Web:
Access the report at rwhs.org
2015 annual report published October 2016 Teresa Clark, Editor
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