By any standard 2017 was an

eventful year for the Cancer

Centers of Southwest Oklahoma

(CCSO). There were new clinical

programs, the renewal of an im-

portant accreditation, our man-

agement of the 2017 Spirit of

Survival, physician loss and gain,

expansion to another city and

the continued growth of support

by all of Southwest Oklahoma.

Under the direction of

CCSO’s radiation oncologists,

Dr. LeAnn Smith and Dr. Mi-

chael Kerley, CCSO expanded

the brachytherapy program to

include not only breast cancer

treatments but gynecological

brachytherapy as well. This in-

volved extensive training and the

development of new competen-

cies by the staff. The program is

offered to women who in the

past had no choice but to have

the treatment provided in Okla-

homa City.

The American College of Sur-

geons (Commission on Cancer)

surveyed our cancer program in

April and for the fourth consecu-

tive survey, we received the highest

level of accreditation given by CoC.

This means that for twelve consec-

utive years our cancer program has

ranked among the top 10% of can-

cer programs in the United States.

Congratulations and thanks to Can-

cer Program Manager Alison

Green and physician liaison Dr.

Carol Dittmann for their leadership

in achieving this. Ours is the only

cancer program to have achieved

this level of accreditation for this

many years.

September 30 and October 1,

2017 were the dates for the ex-

panded 12th annual Spirit of Sur-

vival, which was for the first time,

directed solely by the staff of

CCSO. This year’s event saw the

addition of four bike tours ranging

from 13-62 miles. Just over 200

riders of all ages participated. They

were joined by 3,100 runners and

walkers on Sunday, October 1. This

event is the largest tourist event in

Southwest Oklahoma with partici-

pants coming from numerous

states and many cities within Okla-

homa.

In July, medical oncologist Dr.

Aman Garsa relocated to Oklahoma

City and is now working for CCSO

in our newest facility in Chickasha,

Oklahoma. While no longer working

in Lawton, she remains an integral

part of the CSSO medical staff. Her

position in Lawton was filled in Au-

gust by Dr. Narender Gorukanti,

who came to us from Ft. Smith, Ar-

kansas.

In August, we lost the services of

Dr. Mahakit Inklab, who due to fam-

ily illness, moved back to Thailand.

As of this writing, his position has

not been filled.

The annual screenings for skin,

prostate and head and neck cancer

brought in over 1,000 patients

through our three centers. Specialists

from all communities assisted in

these events. Also, we had the help

of 10 physicians from the CCMH

Residency Program to help with the

screenings. Many thanks to these

young doctors.

Continued on Pg.7

A Year in Review

December 29, 2017

Annual Report

By Lane Hooton, COO, Cancer Centers of Southwest Oklahoma

pg. 8 Screenings Pg. 2 Quality Measures Pg.4 Achievements

Quality, Accountability, and

Surveillance Measures

As the Cancer Liaison Physician it is my responsi-bility to provide leadership and direction to moni-tor, maintain, and improve quality within the cancer program. A part of the monitoring process includes evaluat-ing, interpreting and reporting the programs perfor-mance using the National Cancer Data Base (NCDB) data as well as monitoring the performance status of our program via the Cancer Program Prac-tice Profile Reports (CP3R). It is the cancer committee’s responsibility to en-sure that patients with cancer are treated according to nationally accepted measures by (in part) compli-ance with Commission on Cancer (CoC) quality re-porting tools, such as the Cancer Program Practice Profile Reports (CP3R). These standards enable CoC-accredited programs to demonstrate that patients receive care that is con-sistent with standards of care and good clinical prac-tice thereby promoting a better outcome for the pa-tients with cancer who are treated at Comanche County Memorial Hospital (CCMH) and The Can-cer Centers of Southwest Oklahoma. Expected Estimated Performance Rates (EPR) for accountability and quality measures assessed with Commission on Cancer (CoC) Standards 4.4 and 4.5 are established based on the year of survey.

These standards require performance levels be met an-nually according to the specified accountability and quality improvement measures defined by the CoC. When reviewing the most recent reported data I found CCMH to be within the confidence interval set by the CoC for all measures. I have recommended that a list of all measures be distributed to the medical staff so that any physician who is caring for cancer patients will have the most recent information from the Com-mission on Cancer. Current CP3R measures are as follows:

Bladder:

BL2RLN- At least two lymph nodes are removed in patients under 80 undergoing partial or radical cystectomy (Surveillance)

BLCSTRI- Radical or partial cystectomy; or Tri-modality therapy (Local tumor destruction/excision with chemotherapy and radiation) for clinical T234N0M0 patients, first treatment within 90 days of diagnosis (Surveillance)

BLCT- Neo-adjuvant or adjuvant chemotherapy of-fered or administered for patients with muscle invasive cancer undergoing radical cystectomy (Surveillance)

Breast:

BCSRT- Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer (Accountability)

MAC- Combination chemotherapy is recommended or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0M0, or stage IB – III hormone receptor negative breast cancer (Accountability)

HT- Tamoxifen or third generation aromatase inhib-

By: Carol Dittmann, M.D., Cancer Liaison Physician

Page 2

itor is recommended or administered within 1 year (365 days) of diagnosis for women with AJCC T1cN0M0, or stage IB – III hor-mone receptor positive breast cancer (Accountability)

MASRT- Radiation therapy is recommended or administered following any mastectomy with-in 1 year (365 days) of diagnosis of breast cancer for women with > 4 positive regional lymph nodes (Accountability)

NBx- Image or palpation-guided needle biopsy to the primary site is performed to establish diagnosis of breast cancer (Quality Improve-ment)

BCS- Breast conservation surgery rate for wom-en with AJCC clinical stage 0, I, or II breast cancer (Surveillance)

Gastric:

G15RLN- At least 15 regional lymph nodes are removed and pathologically examined for resected gastric cancer (Quality Improve-ment)

Cervix:

CBRRT- Use of brachytherapy in patients treat-ed with primary radiation with curative in-tent in any stage of cervical cancer (Surveillance)

CERRT- Radiation therapy completed within 60 days of initiation of radiation among women diagnosed with any stage of cervical cancer (Surveillance)

CERCT- Chemotherapy administered to cervical cancer patients who received radiation for stages IB2-IV cancer (Group 1) or with posi-tive pelvic nodes, positive surgical margin, and/or positive parametrium (Group 2) (Surveillance)

Colon:

ACT- Adjuvant chemotherapy is recommended or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC Stage III (lymph node positive) colon cancer (Accountability)

12RLN- At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer (Quality Improve-ment)

Endometrium:

ENDCTRT- Chemotherapy and/or radiation administered to patients with Stage IIIC or IV Endometrial cancer (Surveillance)

ENDLRC- Endoscopic, laparoscopic, or robot-ic surgery performed for all endometrial cancer (excluding sarcoma and lympho-ma), for all stages except stage IV (Surveillance)

Kidney:

PD1RLN- Pediatric measure: At least 1 region-al lymph node is removed and pathologi-cally examined for primarily resected uni-lateral nephroblastoma (Quality Improve-ment)

Non-Small Cell Lung:

10RLN- At least 10 regional lymph nodes are removed and pathologically examined for AJCC stage IA, IB, IIA, and IIB resected NSCLC (Surveillance)

LCT- Systemic chemotherapy is administered within 4 months to day preoperatively or day of surgery to 6 months postoperatively, or it is recommended for surgically resect-ed cases with pathologic, lymph node-positive (pN1) and (pN2) NSCLC (Quality Improvement)

LNoSurg- Surgery is not the first course of treatment for cN2, M0 lung cases (Quality Improvement)

Ovary:

OVSAL- Salpingo-oophorectomy with omentectomy, debulking; cytoreductive surgery, or pelvic exenteration in Stages I-IIIC Ovarian cancer (Surveillance)

Rectum:

RECRTCT- Preoperative chemo and radiation are administered for clinical AJCC T3N0, T4N0, or Stage III; or Postoperative chemo and radiation are administered within 180 days of diagnosis for clinical AJCC T1-2N0 with pathologic AJCC T3N0, T4N0, or Stage III; or treatment is recommended; for patients under the age of 80 receiving resection for rectal cancer (Quality Improvement)

Page 3

Page 4

Congratulations to Anita Moss RN-BC,

OCN at our Duncan facility. She success-

fully passed the Oncology Certified Nurse

exam December 11, 2017. She also has a

certification in Gerontology. Fantastic

work, Anita!

Congratulations to Lily Al-

varado RN, OCN at our Dun-

can facility as she has passed

her Oncology Certified Nurse

exam November 14, 2017.

Great job, Lily!

Janada Jenkins, RN, OCN,

CBCN, at our Duncan facility has

passed her Certified Breast Care

Nurse exam on November 13.

Congratulations Janada!

Morgan Johns, APRN-CNS,

OCN, at our Altus facility has

passed her Oncology Certified

Nurse exam on November 11,

2017. Excellent work, Morgan!

Congratulations to Jayne Gallimore, RN,

OCN at our Lawton facility. She success-

fully passed the Oncology Certified

Nurse exam November 29, 2017. Fantas-

tic job, Jayne!

Congratulations to Susie

McCoy BSN, RN, OCN,

CBCN, for passing her ONS

breast certification test on De-

cember 2 to become a Certi-

fied Breast Care Nurse. Way

to go, Susie!

Congratulations to James Puck-

ett RN, OCN at our Lawton

facility. He successfully passed

the Oncology Certified Nurse

exam December 5, 2017. Fabu-

lous work, James!

Achievements

The Cancer Centers of South-

west Oklahoma are pleased to

congratulate Stephanie Stewart,

RN, OCN at our Duncan facility

for obtaining her OCN certifica-

tion December 27, 2017. Excel-

lent job, Stephanie!

Over the course of the year, many outstanding clinical staff have added to their cre-dentials. We would like to take this opportunity to shine the spotlight on those pro-fessionals, who take the initiative and go above and beyond to provide the best care Right Here at Home.

Congratulations to Diandra Stew-

art, BS, CCRP, the newest Certified

Clinical Research Professional for

the Cancer Centers of Southwest

Oklahoma. Diandra passed this

difficult test from the Society of

Clinical Research Associates on

October 11th. Awesome job, Di-

andra!

Achievements continued...

Tori Hazel, RN, BSN, OCN,

CMC, ONN-CG, Nurse Manager

in Altus, passed her Oncology

Certified Nurse exam on October

27, 2017. She is also a certified

Case Manager and has tested and

obtained the Oncology Nurse

Navigator-Certified Generalist

certification. Fantastic work, Tori!

The Cancer Centers of South-

west Oklahoma are pleased to

congratulate Vonda Williams,

RN, OCN, CBCN, Nurse Man-

ager in Duncan for becoming

our first Certified Breast Care

Nurse. She passed this rigorous

exam on October 26, 2017. Con-

gratulations and job well done!

The Cancer Centers of Southwest Okla-

homa are pleased to congratulate Mon-

ica Rhodes, APRN, AGCNS-BC, OCN

upon graduating from The University of

Oklahoma Health Sciences Center and

passing her ANCC board certification

as an Advanced Practice Registered

Nurse Clinical Nurse Specialist

Adult/Gerontology in July of 2017.

Congratulations Monica!

Congratulations to Robert Darnell, RN,

OCN, Director of Nursing for Cancer

Centers of Southwest Oklahoma, as he

has passed the Certified Breast Care

Nurse exam given by the Oncology

Nursing Society on November 14,

2017. Way to go, Robert!

The Cancer Centers of Southwest

Oklahoma would like to congrat-

ulate Robyn Lewis, RN, OCN,

CBCN, Nurse Manager in Law-

ton, for passing her Certified

Breast Care Nurse exam on De-

cember 29. Congratulations,

Robyn!

Congratulations to Brody Barker,

CMD for passing the certification

exam of the Medical Dosimetrist

Certification Board. Amazing job,

Brody!

Page 5

On his way back from Duncan, Fran-cis had an unexpected encounter. A deer darted in front of the brand new van and left an impression on the van and an impression on Francis. Over the past 8 years, Francis has left an impression on patients and staff members alike. He has a great sense of humor and a heart of gold. Francis is one of several drivers who are cancer survivors. That has not slowed him down one bit. In his spare time, Francis enjoys working with stained glass and woodworking. He has also volunteered with Habitat for Humanity. He shares 4 sons, 7 grandchildren and 8 great-grandchildren with his wife Vera.

A Beloved Driver says Farewell

Not many people can say that they have been part of something from its inception. But Francis Sheets can. Francis Sheets, AKA Pillowcase, has touched many

lives over the past eight years. Francis has been volunteering with the Cancer Centers Transportation program since day one in September of 2009. And what an exciting first day he had!

Page 6

DAISY award presented to Jayne Gallimore

CCSO nurses created their own

headlines in 2017. At the start of the

year, we were very pleased that 38%

(8 of 21) of our nurses had taken

and passed the rigorous certification

test (OCN) for oncology nurses.

This is not an easy exam and gener-

ally takes years of experience before

a practicing nurse can expect to pass

it. In my previous position in Dallas,

less than 10% of our nurses were

OCN certified. However, as of De-

cember 31, 2017, we are very proud

to report that 71% (15 of 21) of our

nurses have achieved this high level

of certification.

Furthermore, five of our nurses

are now certified in breast cancer

care, two more hold certificates in

gerontology and nurse navigation

and we have two Advanced Prac-

tice Nurses on staff. This speaks

volumes of the professionalism of

the staff.

Because of the physician leader-

ship of Dr. Manal Robin-Hanna,

our Medical Director, Principal

Research Investigator, Dr. Eugenio

Najera, and the rest of the physi-

cians and staff, CCSO stands tall in

the oncology/hematology field in

Oklahoma.

Our statewide reputation for quali-

ty and access has been strong for

years but even more so now.

The paragraphs above show that

we had an eventful year but they do

not tell you that in 2017 the three

cancer centers of CCSO welcomed

over 1,600 new patients and per-

formed over 60,000 procedures. We

feel very comfortable in saying that

because of you, the patients and fam-

ilies of Southwest Oklahoma, we are

making a difference-Right Here at

Home.

A Year in Review Continued...

Jayne proceeded to put Tammy in a wheel-chair and took her down to the ER. Jayne helped the nurses once she got to the ER but didn’t stop there. She alerted Tammy’s family to the fact that she was having a heart attack and need-ed emergency surgery. When Tammy was facing incredible pain, Jayne pushed her to stay awake for her family that needs her. She made sure that Tammy was-n’t alone and that her family was aware of the situation. Tammy credits Jayne with saving her life. Jayne’s heroic actions and quick thinking that day are just one example of the incredible nurse and person that Jayne Gallimore is. Congratulations, Jayne!

Amazing nurses go to great lengths each day to ensure that their patients receive the best care possible. The Daisy award is an award given to rec-ognize the efforts of a nurse who has gone above and beyond in patient care. What happens when that patient is also a coworker?

Tammy Hardman was tired after physical therapy on August 28th but didn’t think anything of it. As she was preparing to go home, she developed a sharp pain across her chest that proceeded to get worse. She ran down the hall looking for Jayne Gallimore, her friend and colleague who has worked as a nurse at the Cancer Centers and the cath lab. She knew that Tammy was having a heart attack.

Page 7

The Colon Cancer Screening was held the entire month of March 2017. IFOB Fecal Occult tests dis-tributed to the public at the Cancer Centers of Southwest Oklahoma in Lawton, Duncan, and Altus. This year, approximately 179 IFOB tests were dis-tributed with 7 positive results requiring further test-ing, 102 negative results, 4 inconclusive results, and 66 not returned. The “Just Say Ahh” Oral Cancer Screening was held at the Leah M. Fitch Cancer Center in Lawton on Saturday April 8, 2017. We had 202 participants this year with 107 requiring further evaluation and 2 needing immediate follow up for suspected neo-plasm. The Skin Cancer Screenings in Altus were held at the Cancer Centers of Southwest Oklahoma on Sat-urday June 17, 2017. There were a total of 81 partici-pants, 13 requiring follow up and 12 requiring a bi-opsy. The Skin Cancer Screening in Lawton were held at the Leah M. Fitch Cancer Center on Saturday May 6, 2017 There were a total of 251 participants with 73 requiring follow up and 73 requiring a biopsy. The Skin Cancer Screening in Duncan were held at the Taylor Le Norman/McCasland Cancer Center on Saturday April 22, 2017. There were a total of 116 participants, with 55 requiring follow up.

Detection is the Best Prevention

2017 Cancer Screenings

The Prostate Cancer Screening in Lawton was held at the Leah M. Fitch Cancer Center on Saturday September 9, 2017. We had 364 participants with 12 Abnormal DRE’s and 90 with enlarged or BPH. The Prostate Cancer Screening in Duncan was held at the Taylor Le Norman/McCasland Cancer Center on Friday September 22, 2017. We had 40 participants with 2 Abnormal DRE’s.

The participants of each prostate screening were each given a copy of their DRE Exam at the screen-ing and instructed to provide this information to their PCP or Urologist. A letter was mailed with the PSA result also instructing the participants to take the lab result to their PCP/Urologist and have them interpret it in accordance to their history and com-pare to previous PSA’s.

Low Dose CT lung screenings are available year

round to individuals who meet the established high-

risk criteria. This year 221 patients were scanned in

Lawton with 190 negative results, 2 positive results

and 29 abnormal results in need of a follow-up.

In 2017, 74 patients were scanned in Altus with 60

negative results, 0 positive results and 14 abnormal

results in need of a follow-up.

By: Alison Green, Cancer Program Manager &

Sandy Foster, Community Outreach Coordinator

Page 8