Interventional Oncology (IO), according to the National Institutes of Health (nih.gov), is “the youngest and most rapidly growing offshoot of interventional radiology . . . What began as a limited, almost abstract idea of a minimally-invasive image-guided tumor therapy became a comprehensive and creative new specialty, driven by seemingly unlimited technological innovation.”

George W. Daneker, Jr., MD, Chief Medical Officer, CTCA Medicine & Science, describes IO as the “ideal packaging for cancer patients.”

While many regional medical centers may offer interventional procedures in one or more areas, CTCA clinical teams offer patients a fully integrated approach to minimally-invasive treatment and care in four IO pillars: radiology, pulmonology, gastroenterology and pain management.

In the past, oncologists didn’t have the full understanding of the biology of cancer and believed that a radical surgical approach to removing the disease was prudent. Today, however, a more sophisticated understanding of how to treat cancer, together with advanced technology, allows patients to choose less invasive procedures. Interventional specialists with knowledge of computer-aided imaging and robotics, including guided x-rays, ultrasound, CTs and MRIs, are more proficient at approaches that offer numerous benefits to patients. Less invasive procedures result in less pain, quicker recovery times and fewer side effects.

Select physicians at all CTCA Comprehensive Care and Research Centers, according to Dr. Daneker, have received advanced training in at least one of the four IO pillars. “Many of our oncologists have completed Super Fellowships or specialized residencies to become proficient in IO,” says Dr. Daneker. “At CTCA, we offer a full portfolio of IO in our overall course of treatment for patients.”

CTCAINNOVATORQuarterly Insights for Patients of Cancer Treatment Centers of America®

I S S U E 6, FA L L 2018

Interventional Oncology Offers Less Invasive Choices

“Our hospital clinical teams are already accustomed to working together; therefore, we are able to provide cancer patients with more choices for less invasive procedures,” he explains. “We are able to meld the latest in clinical offerings in the areas of radiology,

pulmonology, gastroenterology and pain management to create many interventional options for patients.”

George Daneker, MD

The CTCA patient portal, myCTCA.com, is getting a face lift, thanks in part to feedback from patients and caregivers. Users will see a dramatic difference starting in January. Along with a cleaner, more usable format, patients and caregivers who rely on the portal for vital information will enjoy several new features and benefits, including a more mobile-friendly look and feel. Plus, schedules are printable in the same easy-to-read format available at the hospitals. New functionality allows users to customize views and see graphs that show trends in vitals such as weight and blood pressure.

While the portal has always been secure, additional sign-in requirements will ensure even greater safety. At the first sign-in, patients will be asked to create new, more complex passwords and change their usernames to an email address. Overall, the transition to the new site should be easy and seamless.

According to Tim Birdsall, ND, FABNO, Senior Vice President of Information Services, Chief Medical Information Officer and Naturopathic Physician at CTCA Phoenix, the myCTCA.com refresh reflects our continuing commitment at CTCA to the Mother Standard® of care.

“The new portal design helps create a more pleasant user experience for our patients,” he says. “It also sets the tone for the introduction of more advanced technology solutions in the future.”

When new mobile technology is introduced, patients will be able to use the same username and password for all web and mobile services. Plus, the new portal offers one-stop access to cancercenter.com resources, links to cancer support organizations and up-to-date news and information about CTCA. A myCTCA.com app, which will offer the option of fingerprint sign-in, is currently in development.

Welcome Fran Paschall, CTCA Chief Nurse Executive

A new voice for nurses across the CTCA comprehensive care network

Francine (Fran) Paschall, MBA, DNP, RN, CENP, recently joined CTCA as Chief Nurse Executive, based at the Boca Raton corporate headquarters. She will lead strategies to enhance patient care, quality and safety, working closely with our team of Chief Nursing Officers who were featured in the last issue of CTCA Innovator. Fran also will provide leadership to obtain and sustain Magnet Recognition® at all of our Comprehensive Care and Research Centers, the most prestigious distinction a health care organization can receive for nursing excellence.

Previously, Fran was the Chief Nursing Executive for HCA Healthcare’s (HCA) East Florida Division. She also worked as Senior Vice President of Patient Care Services/Chief Nursing Officer for HCA’s Riverside Community Hospital in California.

Fran says her decision to join CTCA was based largely on her attraction to our Mission and Vision. “Providing powerful and innovative therapies to heal the whole person, as well as providing hope and trust, are vital to care for our patients and their families,” she says. “Nurses are central to this commitment.”

In addition to being appointed by the Florida Governor in 2017 to serve on the State Board of Nursing, Paschall has been a passionate supporter of nursing education throughout her career. “Today’s nursing students are our future,” she says. “By supporting them in their shared mission to deliver care as a ‘calling’ versus a job, we help ensure a future of quality patient care. Nursing is a commitment that comes from the heart.”

Paschall holds a Doctor of Nursing Practice in Executive Leadership from American Sentinel University, a Master of Science in Acute and Critical Care Nursing from Case Western Reserve University and a Master of Business Administration from Tiffin University in Ohio.

NEW IMPROVED PATIENT PORTAL to Launch in January

For any technical issues related to the portal, a 24/7 Help Line is available at 877-448-1725.

Francine Paschall, MBA, DNP, RN, CENP

CTCA Atlanta Hosts Physicians from Latin America for Cancer Knowledge-Sharing Summit

Latin American oncologists are tasked with meeting a rising demand for cancer care, but may lack the necessary resources, especially in the areas of research and new treatment development. Educational programs and opportunities for physicians to come together and share best practices help close the gap.

At CTCA Atlanta, 20 oncologists from several Latin American nations gathered recently at the Breast Cancer Preceptorship to learn about the latest breast cancer treatments and the CTCA patient-centric model of care.

Ricardo H. Alvarez, MD, MSc, Medical Director of the CTCA Breast Cancer Institute and Director of Cancer Research at CTCA Atlanta, who organized the three-day event, says these gatherings are invaluable for patients everywhere.

“When we share our experiences with others, we help improve cancer care for patients around the world,” he says. “Many international oncologists see that we are leaders in unique programs like Cancer Fighters®, Mind-Body Medicine, and the Mother Standard® of care. They are also interested in learning how CTCA embraces a robust clinical research program as a tool for improving clinical outcomes and patient survivorship.

“Cancer doesn’t care who you are or where you live. We have to share knowledge and work together to beat this disease,” adds Dr. Alvarez.

The international educational gathering included presentations from Dr. Alvarez, CTCA Atlanta physicians

Damien Hansra, MD; John McKnight, MD, MBA; Mary Ninan, MD; Lily Shakibnia, MD and CTCA Chicago physician Eugene Ahn, MD. Cancer specialists from Harvard University–Dana Farber Cancer Institute and The University of Texas, MD Anderson Cancer Center also presented.

In addition, a hospital tour included an overview of various integrative care departments such as Mind-Body Medicine, Nutrition Therapy, Music Therapy, Naturopathy, Physical Therapy and Spiritual Support. The group also visited ICU and Pharmacy, and a clinical rotation allowed attendees to interact with the clinical team.

CTCA in the Media

Dr. Ankur Parikh in STAT News and Oncology TimesIn a recent issue of STAT News, Ankur Parikh, DO, CTCA Medical Director of Precision Medicine, discusses the need for increased study in immunotherapy clinical trials for elderly patients. Additionally, Dr. Parikh highlights next-generation sequencing (NGS) in leukemias and lymphomas in a recent feature in Oncology Times.

Dr. Ioana Bonta Featured in “14 Cancer Warning Signs Your Doctor Should Never Ignore” on msn.comIn a recent article on msn.com, Ioana Bonta, MD, medical oncologist at CTCA Atlanta, highlights cancer warning signs such as unexplained weight loss, prolonged low-grade fever, excessive night sweats, persistent heartburn or cough and irregular bowel patterns.

Dr. Maurie Markman Discusses Precision Medicine Challenges in Becker’sMaurie Markman, MD, President, CTCA Medicine & Science, discusses recent progress and obstacles in precision cancer treatment in Becker’s, calling on colleagues to “come together to build a more robust infrastructure…to help speed the adoption of new treatments based on genomic testing.”

Insider Features Dr. Julian Schink on Subtle Signs of Ovarian CancerJulian Schink, MD, Chief, CTCA Division of Gynecologic Oncology, examines potential ovarian cancer symptoms that are non-specific (attributed to other issues). These may include increase in belly size, abdominal or back pain, urinary changes, fatigue, constipation and changes in the menstrual cycle.

Attendees of the recent 2018 Breast Cancer Preceptorship at CTCA Atlanta attracted oncologists from Peru, Ecuador, Mexico, Colombia, Argentina, Costa Rica and the Dominican Republic.

Dr. Rob Hauser Presents Geriatric Oncology to Florida Chamber of Commerce Rob Hauser, PharmD, PhD, Vice President of Clinical Analytics at CTCA, authored a paper on geriatric

oncology (“Aging and Cancer: Why the State of Florida Needs to Pay Attention to the Science”) as part of the Florida Chamber of Commerce Florida Futures 2030 initiative. As part of this effort, Dr. Hauser is also featured in a four-part video series to be distributed to members of the Chamber statewide.

CTCA Philadelphia Team Receives “In Safe Hands” AwardCTCA Philadelphia recently received the “In Safe Hands” Award by the Hospital and Health System Association of Pennsylvania for the Antimicrobial Stewardship Program, which eliminated Clostridium Difficile infections (CDI) at the hospital. Mashiul Chowdhury, MD, Chief, CTCA Division of Infectious Disease, led the team, which also included Trisha Patel, PharmD, BCPS, BCCCP, Critical Care/Infectious Disease Pharmacist and Dean Miller, MT (ASCP) CIC, Infection Prevention Practitioner.

CTCA Announces Two Clinical PromotionsAlan Yahanda, MD, FACS, Chief of Staff at CTCA Atlanta, has been named Chair, CTCA Department of Surgery. Additionally, Arturo Loaiza-Bonilla, MD, MSEd, FACP, Chief of Medical Oncology and Medical Director of Research at CTCA Philadelphia, has been promoted to Vice Chair, CTCA Department of Medical Oncology.

CTCA Clinical Papers Accepted at ASHA National ConventionA case study (“Impact of Preventive Exercise on Feeding Tube Dependence Following Treatment of Oropharyngeal & Hypopharyngeal Cancer”) from CTCA Philadelphia speech-language pathologists, Erika Carachilo, MA, CCC-SLP, CLT and Sarah Fulcher, MS, CCC-SLP, has been accepted for oral presentation at the 2018 American Speech-Language-Hearing Association (ASHA) Convention this November in Boston. Additionally, Jennifer Cargile, MEd, CCC-SLP, speech-language pathologist at CTCA Atlanta, was accepted for poster presentation.

CLINICAL HIGHLIGHTS

Dr. Rabih Bechara Appointed to National Board of the American Lung Association Rabih Bechara, MD, FCCP, CTCA Chief of Interventional Pulmonology, Pulmonary and Critical Care Medicine,

has been appointed to the American Lung Association’s (ALA) National Board of Directors. He also serves as a member of the ALA’s Scientific Advisory Committee and Southeast Board of Directors and is Chairman of ALA Georgia’s LUNG FORCE.

CTCA Joins International Oncology ConsortiumCTCA has recently been accepted into NRG Oncology, a consortium of international research leaders including the National Surgical Adjuvant Breast and Bowel Project (NSABP), the Radiation Therapy Oncology Group (RTOG) and the Gynecologic Oncology Group (GOG). This membership allows CTCA patients even greater access to innovative research and clinical trials. For more information, visit nrgoncology.org.

Dr. Pamela Crilley appointed to Editorial Advisory Board for HemOnc TimesPamela Crilley, DO, Chair, CTCA Department of Medical Oncology, has joined the Editorial Advisory Board for

HemOnc Times, a new monthly supplement to Oncology Times, an independent clinical news source in hematology and oncology.

CTCA Abstracts Accepted for European Society of Medical Oncology MeetingTwo abstracts related to the precision medicine program at CTCA have been accepted for presentation at the 2018 European Society of Medical Oncology meeting in Munich this fall. The abstract by Ricardo H. Alvarez, MD, MSc, Medical Director of the CTCA Breast Cancer Institute and Director of Cancer Research at CTCA

Atlanta (“Mutational Landscape of Metastatic Cancers Discovered from Prospective Clinical Sequencing at a Community Practice Cancer Program”) was selected for oral presentation. The abstract from Ankur Parikh, DO, CTCA Medical Director of Precision Medicine (“Detection of Targetable Kinase Fusions in 7,260 Patients in an Integrated Cancer System”) was selected for poster presentation.

BEE AWARD Honors Clinical Team Members

Mary Bartolome, PT, CLT, WCCPhysical Therapist CTCA Phoenix First BEE Award Winner

Outsmarting Cancer: Insights into Precision Medicine GENETICS VS. GENOMICS

By Ankur Parikh, DO CTCA Medical Director of Precision Medicine

Understanding the difference between genetics and genomics can be challenging. While both are important in cancer care, each has a different meaning.

The internationally-known DAISY Award has been used to recognize the extraordinary clinical skill and compassionate care given by nurses every day at CTCA and throughout the health care industry. Knowing that so many other team members also impact a patient’s exceptional experience, CTCA is introducing another popular industry honor, The BEE – Being Exceptional Everyday – Award, which honors non-nursing, or “ancillary,” clinical team members. As the industry description states, “you can’t have a DAISY without a BEE!”

The BEE Award is driven by recommendations from patients, as well as caregivers, visitors or fellow Stakeholders who have been touched by excellence in care and want to recognize those who have helped deliver a special experience. CTCA Phoenix was the first CTCA site to use this industry award, which will be implemented enterprise-wide in the coming months. It will be presented quarterly to one Stakeholder from each site who demonstrates “exemplary patient care, compassion and empathy.” Please watch for nomination forms so you can recognize a BEE!

Ankur Parikh, DO

“Receiving the very first BEE award was an honor and a blessing. It validates that no matter how big or small, if we act with true compassion and kindness, our care will positively impact our patient’s lives. We should strive to provide excellent care, every day, with heart,” says Mary.

A CTCA Phoenix Rehabilitation department Stakeholder for almost six years, Mary plays an active role in helping patients with all aspects of patient safety, strengthening, balance, gait and other mobility concerns. She specializes in treating patients with lymphedema, or those who are at risk for the condition, and holds a WCC credential, which allows her to assist patients with skin and wound care.

Every cell in the human body has a complete strand of DNA containing genes that carry instructions for certain traits: eye color, hair color and even inherited genetic mutations that increase cancer risk. Genetic testing is done to identify these inherited genes, most commonly BRCA1 and BRCA2. These genes generally stay the same over the course of a person’s life and are passed on from generation to generation.

Cancer cells have unique DNA containing genes too, carrying instructions that drive various behaviors of the cancer – how it grows, and how aggressively it spreads to other locations in the body. Genomic testing aims to identify those mutations, and more importantly, identify a treatment that will target that mutation and potentially halt the tumor’s progression. Unfortunately, because cancer cells are so fast-growing, the genes within them may continue to mutate over time and develop resistance to treatment. Fortunately, these new mutations could be identified in subsequent genomic tests. As a result, new treatments could become available to overcome this resistance.

Current CTCA clinical trials are available for patients whose tumors harbor certain genomic mutations. For example, all CTCA Comprehensive Care and Research Centers participate in the Targeted Agent and Profiling Utilization Registry (TAPUR™) Study, the American Society of Clinical Oncology’s (ASCO®) first-ever clinical trial.

Ask your physician if genomic testing is appropriate for you.

“Genetics” refers to a person’s genetic makeup – the genes inherited at birth.

“Genomics” refers to the genetic composition of a tumor.

WHAT’S THE DIFFERENCE?

Would you like to meet other CTCA patients and receive regular information to help you on your healing journey? Stop by the Cancer Fighters® Corner at your hospital or visit cancerfighter.com.

© 2018 IPB

Please send all comments and questions about this newsletter to CTCAInnovator@ctca-hope.com. The newsletter is now also available on myctca.com.

However, and especially for longer-term issues such as cardiovascular disease, hometown doctors may be better trained and equipped to recognize signs and either treat or make a referral to a specialist. Oncologists and primary care physicians working as a team can do a great deal more for cancer survivors.

Although loved ones play a vital role in survivorship support, they must remember there is likely no back-to-life-as-usual after cancer. Unintentionally, loved ones can contribute to survivor guilt—the feeling that “I should be happier, feel stronger, be more appreciative and less concerned with the physical effects of cancer treatment”—and the survivor may push down these feelings. My advice for loved ones is to take your cue from the survivor—listen, validate and ask how you can provide support.

SURVIVING CANCER After You’ve Survived Cancer

By Anthony Perre, MD Chief, CTCA Division of Outpatient Medicine

It’s your last day of treatment. Surrounded by nurses and loved ones you ring a celebratory bell. What a great moment, right? A few weeks later you have your scan, your oncologist gives the all-clear…no sign of cancer…see you in six months. More celebration. It’s time to get back to life as you know it. Nothing could be better.

I’m willing to bet that anyone who has dealt with cancer will agree that this isn’t exactly the experience of a cancer survivor. Certainly, these milestones bring happiness and relief. But there may also be a great deal of anxiety, fear and loneliness when you find yourself suddenly no longer under the intense care of your treatment team. While friends are very happy for you, you may feel like you are in limbo. You’re no longer a cancer patient but may need specialized care due to the impact of cancer treatment on your body. The question looms, “Who takes care of me now?”

As both a survivor of Hodgkin lymphoma and a CTCA physician, I have a unique set of experiences allowing me to answer that question. Making sure survivors have the best care and quality of life—especially during post-treatment transition—requires the coming together of oncologists/cancer treatment teams, primary care physicians, insurance providers, loved ones and survivors.

More people are surviving and living longer after cancer treatment. Consequently, more people are dealing with the emotional and physical tolls of cancer, suggesting a new approach is warranted to provide survivors with the support they need.

While we’ve seen promising results from survivorship programs that prepare and empower the patient, this is only a piece of the puzzle. One challenge is that insurers may not always see these services as reimbursable. Also, some primary care physicians may be reluctant to “take back” a cancer patient too soon after treatment.

Anthony Perre, MD