Adena Oncology 2019 Community Report

A Department of Adena Regional Medical Center

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On the Road to greater cancer care access

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Are We There Yet?If you’ve ever been on a road trip with kids, it’s a question you’ve heard many times. At Adena Cancer Center, we’re not quite “there” yet. But that’s because each year, we re-evaluate exactly where “there” is. We are constantly striving to go further — to have more providers, to offer more and better treatments, to care for more patients in more communities in our region — all while making every patient feel at home.

This year’s annual report looks at all the ways Adena Cancer Center took its services on the road in 2019 — from mobile mammography and telehealth to the opening of a new chemotherapy infusion clinic in collaboration with Fayette County Memorial Hospital in Washington Court House. Plus, we built our survivorship program to ensure that patients have a map forward after treatment.

Adena Cancer Center has put together an amazing team to deliver all that and more. We currently have the most oncology providers we’ve ever had. Locked arm in arm with our nurses, technicians, pathologists, navigators, and other support staff, we spent the year not just delivering care but focusing on measuring and improving the quality of that care.

Over the past year, we worked on building the infrastructure needed to obtain certification from the American College of Radiology (ACR) and the American Society of Clinical Oncology (ASCO). We have met all the ACR standards, and we’re now preparing for the organization’s on-site visit.

We know the road from diagnosis through treatment feels long. But we feel privileged to be on this journey with you, no matter where in south central and southern Ohio your home is.

Thank you for the honor of serving you,

William Alexander Wilson, MDMedical Director, Adena Cancer Center

William wilson

Mobile mammography makes screenings more accessible.

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New Adena oncologist in Washington Court House.

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Trusting your instincts: a survivor’s story.

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Adena Health System was awarded the 2019 American Cancer Society Health Systems

Excellence Award. This award recognizes

health systems that demonstrate

exemplary support in advancing the fight

against cancer.

— Amy Magorien, ACA Health Systems Manager

Across the RegionAdena Cancer Center serves patients from 66 ZIP codes across south central and southern Ohio. In 2018, cancer patients were evenly divided between men and women, with lung and breast being the top two diagnoses.

88 (20.1%) LUNG 86 (19.86%)

0 (0.00%) BREAST 143 (33.03%)

47 (10.76%) MELANOMA 27 (6.24%)

40 (9.15%) COLORECTAL 40 (9.24%)

76 (17.39%) PROSTATE N/A

38 (8.70%) BLADDER 7 (1.62%)

24 (5.49%) LEUKEMIA 18 (4.15%)

13 (2.97%) KIDNEY 12 (2.77%)

26 (5.95%) HEAD/NECK 11 (2.54%)

14 (3.20%) PANCREAS 9 (2.08%)

9 (2.06%) NON-HODGKIN’S 11 (2.54%) LYMPHOMA

N/A GYNECOLOGIC 20 (4.61%)

12 (2.75%) ESOPHAGUS 2 (0.46%)

50 (11.47%) ALL OTHER SITES 47 (10.81%)

All results based on 2018 data taken from the Adena Cancer Registry and reported by Jaime Wisecup, RN, CTR.

*Percentages are based on the total number of patients of that gender.

ADENA CANCER CENTER INFORMATION FOR 2018 TOTAL ANALYTIC CASES870

FEMALETOP 5 SITES

1. Breast 2. Lung

3. Colorectal 4. Melanoma

5. GYN

MALETOP 5 SITES

1. Lung 2. Prostate

3. Melanoma 4. Colorectal

5. Bladder

* Percentages based on all male and female patients combined. Does not add up to 100% due to rounding.

TOTAL MALES

437

FEMALE

50%MALE

50%

61% TOP 5 SITES account for over half of all cancers at Adena.c

Lung

All OtherBreast

Melanoma

ColorectalProstate

All Analytic Cases for 2018

Cancer cases seen by Adena Health System in

2018 break down like this:*

Lung . . . . . . . . . . . . .20%Breast . . . . . . . . . . . .16%Melanoma . . . . . . . .9%Prostate . . . . . . . . . . .9%Colorectal . . . . . . . . .7%Bladder . . . . . . . . . . .5%Leukemia . . . . . . . . .5% Head/Neck . . . . . . . .4%Kidney . . . . . . . . . . . .3%Pancreas . . . . . . . . . .3%Lymphoma . . . . . . .2% GYN. . . . . . . . . . . . . . .2%Esophagus . . . . . . . .2%Other . . . . . . . . . . . .11%

20%

16%

9%

7%9%

Occurrence of Cancer by Site and Sex 2018*

All of the analytic statistics are based on cases that are either diagnosed at Adena Health System or receive their first treatment at Adena. These are called analytic cases.

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TOTAL FEMALES

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Adena Hits the RoadIn the time it takes for a coffee break, women can now get a mammogram, and peace of mind. In 2019, Adena Health System rolled out its new mobile mammography bus. On Mondays and Fridays, the mobile unit partners with local

businesses to provide on-site 3-D mammograms.

“We’re setting up outside these businesses, so women who don’t normally take time for themselves can take just 15 minutes to run outside and get their mammogram,” says Jamie Kelley RT (R)(M), Adena radiology operations

manager. “Patients are so happy they don’t have to take time off work to have their screening done.”

In addition to visiting businesses, the mammo bus spends two days a week on the road, providing community screenings in Circleville, Washington Court House, and Wellston. It also visits Jackson and Greenfield on a weekly basis, where the mobile mammography has replaced fixed units to offer the more accurate 3D technology, Kelley says.

Three-dimensional mammography, also known as tomosynthesis, provides a series of breast images, allowing radiologists to better evaluate

breast tissue, layer by layer. The result is improved visualization of abnormalities that are no

longer hidden by overlapping tissue.

Missed Screenings Result in More Advanced CancersUnlike breast cancer screenings, tests to detect lung, colorectal, and prostate cancer are not being widely used by people in south central and southern Ohio until late in the game. The result is cancer being detected at much later — and deadlier — stages. “A large number of our patients are being diagnosed with more advanced stages of lung, colorectal, and prostate cancer,” says Erin Woltz, Adena’s oncology service line director.

“ If we can educate the public to get regular cancer screenings, we would see these numbers go down.”

Over the past three decades, an intense public education campaign has resulted in more women getting mammograms. Just over 65 percent of women 40 and over have had a mammogram in the past two years, according to the Centers for Disease Control and Prevention. As a result, breast cancer is being found when it is much more treatable.

Adena Cancer Center patients diagnosed with late-stage cancer (Stages 3 and 4) by type:

300miles per week on

the road

15-20mammography

screenings per day

15minutes per screening

MAMMO MILES

0 0 3 0 0

Breast Lung Colorectal Prostate

9%

56%

39%45%

by a Cancer Diagnosis

DETOURED

Penny Hutchinson wasn’t scheduled for a mammogram. She’d skipped the annual screening in 2017 and never followed up. But lucky for her, she came down with a nasty virus in the late spring of 2018 that landed her in the doctor’s office. Lucky because in addition to a CT scan of her chest, her primary care physician convinced her to get that missed mammogram at the same time.

“I figured, I’ll be there anyway, might as well do the mammogram, too, and get it over with,” Hutchinson recalls.

When a 3D mammogram revealed a lump in her breast, she was overwhelmed with the anxiety of suddenly knowing she may have cancer and with selecting and scheduling appointments with her new team of physicians.

Faced with several forks in the road, Hutchinson chose general surgeon Christin Spahn, MD, of Adena Surgical because the doctor’s compassionate style helped put her at ease during her first appointment.

Spahn acknowledges how overwhelming and scary a cancer diagnosis can be, and she takes it upon herself to be supportive and empathetic.

“For any new patient, I give everyone the time they need, which is often not just the allotted time,” Spahn says. “I sit down and explain the basics. I draw pictures. We talk about all of the potential options, the specific type of treatment for the patient — even if the patient isn’t a candidate, so they understand why they weren’t a candidate. These are life-altering decisions that can’t be made in the span of 10 minutes.”

After a lumpectomy and a follow-up surgery, Hutchinson is doing well. While her story has a happy ending, she doesn’t recommend other women follow her lead. She knows that an annual mammogram could have helped detect her cancer earlier.

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Penny Hutchinson is looking forward to a bright and healthy 2020 after successful treatment for breast cancer at Adena Cancer Center.

If the traffic is good, driving from Washington Court House to Adena Cancer Center in Chillicothe will take 43 minutes.

Not bad. Unless you have to make that drive every day for weeks on end to receive cancer treatment. Thankfully, people who live in or near Washington Court House no longer have to make that drive to get cancer care.

Adena Cancer Center and Fayette County Memorial Hospital (FCMH) in August announced a partnership for Adena to provide cancer treatments at FCMH. The 3,000-square-foot center, which opened in fall 2019, provides infusions and injections, including chemotherapy, immunotherapy, and targeted therapy for patients with cancer or blood disorders. Patients also will benefit by having easier access to follow-up appointments, with an on-site medical oncologist, Shylaja Mani, MD.

The Ohio Department of Health estimates that 200 people each year in Fayette County will be diagnosed with cancer. Many of them will require weeks or months of frequent care, says Alex Wilson, MD, Adena Cancer Center medical director.

Cancer care comes to Washington Court House

Patients at Adena Cancer Center hailed

from 66 ZIP codes in 2018.

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New Roads to CareOpening

Having chemotherapy and immunotherapy infusion closer to home will benefit the many patients who require these longer treatments,” Wilson says.

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Alternate Routes to TreatmentOver the past year, more and more Adena Cancer Center patients are benefiting from drugs that ramp up the body’s own immune system to kill cancer cells.

Currently, immunotherapy is being used to treat patients with lung, kidney, bladder, and/or head and neck cancers, as well as melanoma, says Ganapathy Krishnan, MD, a medical oncologist with Adena.

One of the major benefits of immunotherapy is that it has fewer side effects than chemotherapy. That makes it an option for “patients who are not in the best shape, even if the cancer is in a very advanced state,” Krishnan says. “In the past, we had nothing to offer them. Now we do.”

Patients who respond to this treatment also tend to live longer than those who receive chemotherapy only. However, Krishnan says that only about 25 percent of patients respond to immunotherapy. That’s because each patient’s cells vary, and the cancer cells need to contain the right type of receptors for the white cells to kill them.

“It would be nice to know exactly who will respond to immunotherapy, but we are not there yet,” he says. “We have PDL1 testing and tumor proportion score testing that helps guide us, but it’s not foolproof.”

Dr. Shylaja Mani is seeing patients in Washington Court House, which means they can stay closer to home for their cancer care.

A simple thank you. Some days that’s what reaffirms the decision Shylaja Mani, MD, made to go into medicine — and make the move in August 2019 to Adena Cancer Center. Mani, who specializes in hematology and oncology, completed her residency at Cleveland Clinic and a fellowship at Ohio State University before heading south. And she’s loving the small-town community feeling Adena offers.

“My patients are very grateful for the care they receive,” she says. “They thank you

every time you do something for them. That doesn’t happen in the

city very often, and it feels good.”

What doesn’t feel good is that many of her patients are being diagnosed at very advanced

stages of cancer. “Sometimes that makes their body really

weak, and precludes some treatments for them,”

she says.

For many of the cancers she treats, there’s no screening protocol — so it’s more about being aware and listening to your body. “These people are hard workers, so they often ignore symptoms or blame an odd pain on a strain,” she says. “By the time they see a doctor, the cancer has had time to advance.”

For those patients and the many older patients she’s seeing in her practice newly diagnosed with cancer, she’s excited about targeted therapy. Targeted therapy are drugs that specifically target mutations that exist only in the cancer cells. By attacking just the cancer cells, targeted therapy has fewer and less severe side effects than chemotherapy, which attacks all fast-growing cells, including healthy ones.

“Targeted therapy gives these patients an option for treatment, where if you just had chemotherapy available, they probably would not be eligible based on how weak they are,” Mani says.

Mani is also excited to be part of Adena’s care coordination program that is provided to all newly diagnosed patients. “It’s very helpful for the patient and for us because they get to meet the whole team right away — the financial coordinator, social workers, the clinical trials nurse, and the nurse practitioner. It helps with communication and gives the patient the opportunity to have all these resources in hand.”

And for that, she’s thankful.

A Few Words Go a Long Way

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Adena Cancer Center may be considered on the smaller side when compared to other cancer institutions in the state. But it is having a big impact on research into how cancer care is being delivered.

In 2019, the Columbus site of the National Cancer Institute’s Community Oncology Research Program (NCORP) was recognized at the Silver Level for Cancer Care Delivery Research (CCDR). That distinction placed it in the top four NCORP sites in the nation.

“The award was for Columbus,” explains Alex Wilson, MD, medical director of Adena Cancer Center, “but Adena does a majority of that type of research for the Columbus NCORP, so we are the No. 1 component, making it predominantly our recognition.”

The main focus of CCDR is ensuring that previously determined scientific advances are being implemented at the community level, particularly through more local centers such as Adena. The program also aims to identify the barriers and opportunities to bring those advances to patients wherever they are, while also meeting quality standards.

Wilson says that 2019 was a landmark year for clinical trials at Adena Cancer Center.

“We’ve had a lot of accruals before,” he says, "but our research staff has been working hard at recruiting even more. We’ve accrued more than 40 patients on a cancer care delivery trial this year. That’s about half what all of Columbus NCORP does for all trials — at 16 hospitals throughout Ohio!”

Driving Excellence in Cancer Care Delivery With Research

ADENA RESEARCH TRIALSAdena Cancer Center participates in dozens of clinical trials. Some of the current trials include:

Implementation of Smoking Cessation Services Within NCI NCORP Community Sites With Organized Lung Cancer Screening Programs (OaSiS). This study is to evaluate a multifaceted training program to improve short-term smoking cessation rates and sustained abstinence among patients who obtain a lung cancer screening.

TrACER: Trial Assessing CSF (Colony Stimulating Factor) Prescribing Effectiveness and Risk. This randomized clinical trial is evaluating the effectiveness of an automated system to alert doctors to use CSF when needed to help patients avoid febrile neutropenia, a condition that involves fever and a lower number of a particular type of white blood cell.

Androgen Deprivation Therapy and High Dose Radiotherapy With or Without Whole-Pelvic Radiotherapy in Unfavorable Intermediate or Favorable High Risk Prostate Cancer: A Phase III Randomized Trial. This trial studies androgen deprivation therapy and radiation therapy in treating patients with prostate cancer. Androgen deprivation therapy may stop the adrenal glands from making androgens, which can cause the growth of prostate cancer cells.

Breast Cancer Weight Loss (BWEL) Study. This study aims to test whether overweight or obese women who take part in a weight loss program after being diagnosed with breast cancer have a lower rate of cancer recurrence as compared to women who do not take part in the weight loss program.

CHARM (Cancer Health Assessments Reaching Many). This trial assesses the utility of a hereditary cancer risk assessment program in healthy 18- to 49-year-olds in primary care settings and how it affects care in diverse populations.

Lung-MAP. This is a collaborative cancer clinical trial that uses genetic screening to match patients to investigational new treatments for non-

small-cell lung cancers.

Increasing the Dose of Survivorship Care Planning in Improving Care and Outcomes in Prostate Cancer Survivors Receiving Androgen Deprivation Therapy. This trial evaluates whether increased support and coordination of follow-up care between the patient’s

radiation oncologist and primary care provider improves care and outcomes for these patients.

Learning Collaborative vs. Technical Assistance in Delivering a Palliative Care Program to Patients With Advanced Cancer and Their Caregivers. This trial studies the delivery of the ENABLE palliative care program by two different methods to help doctors determine the best ways to include palliative care services into their practices and the impact of palliative care on quality of life of cancer patients and their caregivers.

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Going to work, doing laundry, having a date night. Life gets back to normal after cancer treatment — and that can be unsettling for survivors who are accustomed to seeing an oncologist regularly or spending three days a week getting chemo. Sometimes patients need help finding their way back to normal and transitioning to primary care in a way that makes them feel comfortable and confident. That’s the goal of the Adena Cancer Center survivorship clinic.

Angela Wellman, a certified nurse practitioner at Adena, meets with cancer patients for their first survivorship appointment after they finish treatment. During that visit, she reviews their medical history and performs a thorough exam. She also spends a lot of time listening.

Cancer has touched Wellman’s own family multiple times, including her brother, mother, and grandmother. “I’ve seen cancer treatment from a lot of perspectives,” she says. “I feel like I can talk to people and help them understand things from several different levels.”

Navigating the Twists and Turns of Life After Cancer Treatment

Nurse NavigatorsCancer treatment is not an

easy road. There are multiple appointments, multiple

doctors, multiple treatments, and more than multiple

questions. Nurse navigators are specially trained nurses who

help cancer patients find their way through this maze while lending a strong shoulder of

support. The nurse navigators at Adena Cancer Center are:

Jina Fields, BSN, RNGI/Head and Neck

Barb Short, RN

GI/Head and Neck

Ashley Gilbert, BSN, RNLung/Thoracic

Tammy McManus,

BSN, RN, OCNNLung/Thoracic

Holly Hooks, BSN, RN, OCNN

Women’s Health/Breast

Carrie North, BSN, RNWomen’s Health/Breast

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Many patients don’t tell their physician what’s been going on in terms of side effects, especially when it comes to their mental and emotional health,” she says. “Mental health is a large component of the survivorship program. Many patients have been focused on their cancer treatments, and now we can turn our attention and energy on a holistic approach to health.”

She says the biggest benefit to patients is that during the appointment, they receive a summary of all their treatment — chemo, radiation, surgery dates. “Those things can be hard to remember the further out they get,” she says, adding that many people also don’t know the follow-up schedule for scans or what to expect in terms of ongoing side effects.

Before each appointment, Wellman works with Adena’s nurse navigators to gather more information about patients. After the visit, she provides the patient’s primary care physician with information about the treatment and care plan. And she contacts patients’ primary oncologist or radiation oncologist if they don’t have a

follow-up scheduled.

Wellman would like to see the survivorship clinic continue to grow so patients can be seen on an ongoing basis. “We don’t want it to be a one-and-done appointment,” she explains. “We’d like patients to come back at least on a yearly basis, or more often if needed.” She also wants to connect survivors with the right resources, whether that’s

a counselor to help with depression, a nutritionist to suggest a healthier diet, or a support group. “We’d like 100 percent of patients to participate. We want it to be Adena’s culture that the next natural step after treatment is done is to have a survivorship appointment.”

Angela Wellman

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9 Adena Cancer Center

Tackling TreatmentRose started Barger on six rounds of intense chemotherapy that required one week of inpatient treatment, followed by two weeks off before the next round.

Barger lost all his body hair after round two, and started to feel worn down after round four. Normally busy year-round coaching youth sports teams in Oak Hill with his kids who were 9, 12, and 15 at the time, he spent a good part of the year on the bench.

But being treated at Adena meant that his wife and three kids were nearby to buoy his spirits. “It meant absolutely everything to have them near me,” he says. “My wife could jump on 35 and drive 40 minutes to see me. I probably saw her 70 to 80 percent more than I would have if I had been at The James.”

On the Road to SurvivorBarger’s lymphoma responded well to the chemotherapy, but he wasn’t done yet. During round four, he battled a serious bout of diverticulitis, resulting in a few extra days in the hospital on IV antibiotics. And, during a CAT scan to

check on that condition, they found a mass on his left kidney.

In round six, his doctors revisited the kidney problem, which they thought could be cancer. They gave him the option of watching and waiting to see if it grew, doing a biopsy, or removing the kidney. Option three offered a 95 percent chance of a cure.

“It was a pretty easy decision,” Barger says. “So six weeks after I finished chemo, they removed my left kidney.”

I just want to totally get back to normal, and I’m so close,” Barger says. “With the support of my community and my faith in God as well as Adena's staff, I am certain 2020 will be a new beginning!”

Thanks to being diagnosed early and Adena’s cancer treatments, Flint Barger could stay closer to his family for treatment.

Sometimes you have to trust your gut.

That’s a lifesaving lesson that Flint Barger learned in 2018. He wasn’t swallowing properly; things would get stuck in his throat. It seemed an odd symptom, particularly since, at age 43, he’d had no health problems at all up until then.

Barger went to the ENT (otolaryngologist), who performed a scope procedure through his nose and saw evidence of acid reflux. “Hey, that’s great,” Barger thought, “but I’ve never even had heartburn.” So, he told the doctor that he wasn’t comfortable with just getting a prescription for reflux and being done. He asked if they could continue to look.

It’s a good thing Barger trusted his gut that it wasn’t just his gut giving him problems. He was sent to another doctor a few days later for a more extensive scope of his stomach and intestines. Things looked good, but the doctors did remove three polyps, which they biopsied.

Three days later, Barger got the life-changing results. The polyps tested positive for lymphoma, a type of blood cancer.

“My head exploded right then and there,” he says. Barger met with Adena oncologist Jeffrey Rose, MD, the next week. His cancer was Burkitt’s lymphoma, a rare and aggressive form of the disease that attacks your brain, spinal column, and nervous system.

The silver lining was that Barger’s lymphoma was found at Stage 1E, a very early stage. That’s the key factor that made it possible for his treatment to be done at Adena Cancer Center in Chillicothe instead of two hours away at The Ohio State University’s James Cancer Hospital.

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Extending Support Beyond Treatments

Telehealth Bridges the Distance for Patients Who Need Genetic Counseling

Hitting the Road for Cancer FundEvery year for the past eight years, the Cigar Band of Chillicothe gets outside for the Annual Bike Night For Mike to raise funds for the Adena Health Foundation’s Cancer Care Fund. The event honors Mike Porter, a former club member and Adena patient who passed away due to cancer. This year, the Cigar Band raised $2,000.

Make a GiftThe Adena Health Foundation helps support cancer patients and cancer projects through community gifts, with 100 percent of every gift going directly to cancer care. To make a gift, please go to adena.org/givenow.

Video teleconferencing has made keeping in touch with far-flung relatives easier and reduced the need for business travel. But at Adena Cancer Center, it’s also saving lives. Through a telehealth connection with genetic counselors at The Ohio State University’s James Cancer Hospital, Adena patients are receiving vital information about genetic mutations that could drastically raise their cancer risks.

Doug Smith, a certified nurse practitioner at Adena who coordinates the genetic counseling program, says telehealth allows patients and family members to receive expert care without having to drive one or two hours to Columbus.

Adena Cancer Center patients come in for a consult with Smith after being referred by their medical oncologist. He sits down with them for a one-hour video telehealth consult with Kate Shane-Carson, MS, LGC, a genetic counselor at The James.

Shane-Carson explains hereditary cancer syndrome and talks with patients about their family history to determine what genes are appropriate to test and why. Not all patients who come in for a consultation will have genetic testing recommended. If a patient is recommended and agrees to be tested, his or her blood is drawn and sent to a genetics lab.

Patients whose results are positive meet again with Smith to have another video consult with Shane-Carson to go over the results and recommendations. Recommendations may include further testing for family members and earlier or more frequent cancer screenings. Sometimes,

like in the case of BRCA1 or BRCA2 gene mutations that increase the risk for breast and ovarian cancers, recommendations may include prophylactic surgery such as bilateral mastectomies or hysterectomy to prevent the development of those cancers.

For patients such as those who rely on gas cards from Adena’s social work department for transportation or those who can’t get enough time off work, making the trek to Columbus for a genetic consultation would be impossible. In addition to the convenience, genetic testing is covered by insurance. Plus, if a patient tests positive for a gene mutation and is diagnosed with a hereditary cancer syndrome, his or her brothers, sisters, children, and grandchildren also can receive free genetic testing and follow-up recommendations based on their results.

When someone becomes a patient at Adena Cancer Center, they are likely to wind up with a few new friends.

“Being in cancer care is special,” explains Erica Beery, radiation therapist. “We see these patients a lot, and we build relationships with them.”

And when you’re friends, you can’t do enough to help, Beery explains. “It’s just really nice to be able to give back to our patients.”

So outside of their normal jobs, Adena Cancer Center employees have begun to host events to raise money for the Adena Health Foundation’s Cancer Care Fund. This fund provides financial assistance to cancer patients, such as gas cards or help with paying a utility bill.

In 2019, Beery and a team of cancer center employees organized a fish fry at the hospital. The food was donated and staff members cooked, plated the meal, and delivered it throughout the hospital campus. The event raised nearly $2,500.

“It was pretty successful,” Beery says modestly. “We all really have a common love for our patients. It goes beyond the normal job description.”

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RADIATION ONCOLOGYGreg Thompson, MDSpecialty: Radiation OncologyMedical School: Wright State University Boonshoft School of MedicineInternship: Kettering Medical CenterResidency: University of Cincinnati

William Alexander Wilson, MDAdena Cancer Center Medical DirectorSpecialty: Radiation OncologyMedical School: University of Kentucky College of MedicineInternship: University of Kentucky Residency: UK HealthCare Markey Cancer Center

Adena Cancer Center offers a comprehensive team of specialists to care for cancer patients and provide support for their families. View biographies and videos of our team at adena.org/cancer.

CLINICAL NURSE PRAC TITIONERS

Brandi Bogard, CNPSpecialty: Medical OncologyGraduate School: Ohio University

Angela Wellman, CNPSpecialty: Medical Oncology/SurvivorshipGraduate School: Walden UniversityCertifications: Advanced Practice Registered Nurse (OH), AANP Family Nurse Practitioner Certification

Doug Smith, CNS, CNPSpecialty: Hematology/ Medical Oncology

MEDICAL ONCOLOGYVamsi Koduri, MD, MPHSpecialty: Hematology/ Medical OncologyMedical School: Wright State University Boonshoft School of MedicineResidency: The Christ Hospital Internal Medicine Residency Program

Fellowship: University of Tennessee Health Science Center/West Cancer Center

Ganapathy Krishnan, MDSpecialty: Hematology/ Medical OncologyMedical School: Thanjavur Medical CollegeResidency: Michigan State UniversityFellowship: Michigan State University,

Ingham Regional Medical Center

Shylaja Mani, MDSpecialty: Hematology/ Medical OncologyMedical School: PSG Institute of Medical Sciences and ResearchResidency: Cleveland ClinicFellowship: The Ohio State University’s James Cancer Hospital

Jeyanthi Ramanarayanan, MDSpecialty: Hematology/ Medical OncologyMedical School: Sri Ramachandra Medical College and Research InstituteResidency: Mount Sinai School of Medicine

Fellowship: Roswell Park Cancer Institute

Jeffrey Rose, MDSpecialty: Hematology/ Medical OncologyMedical School: University of Nebraska Medical CenterResidency: Wake Forest University Baptist Medical Center

Fellowship: University of Iowa

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Richard Ash, PharmDPharmacy Manager

Jennifer BandyHospice Manager

Heidi Bell, RNPsychosocial Services Coordinator;Medical Oncology Manager

Paula Benner, RNQuality Improvement Coordinator

Diana Bond, RNCommunity Outreach Coordinator

Bryan Borland, MDDiagnostic Radiologist

Brooke Burns, MHACancer Program Administrator

Rhonda Elliott, CNSPalliative Care Nurse Specialist

Tisha Farrell, DOPathologist

Janine Gabis, RN, CTRCancer Registry

Tina Hollis, MHARadiology Services Director

Holly Hooks, BSN, RN, OCNNCancer Conference Coordinator

Lisa Hughes, LSWSocial Worker

Laura Jackson, RDNutritionist

Stephen Johnson, MDUrologist

John Karlson, ChaplainPastoral Care

Brandon Keys, MDSurgeon

Vamsi Koduri, MD, MPHMedical Oncologist

Ganapathy Krishnan, MDMedical Oncologist

Thomas Lewis, MDDermatologist

Amy MagorienAmerican Cancer SocietyRepresentative

Julie Moore, RNCDI Specialist

Elise Ngalle, MDPalliative Care Medical Director

Tammy Ninnemann, MLT, CTRCancer Registry

Jeffrey Rose, MDMedical Oncologist

Ray Seitz, RNClinical Research Coordinator

Kate Shane-Carson, MS, LGCGenetic Counselor

Michele Sigler, LSWSocial Worker

Doug Smith, CNS, CNPGenetic Counseling Coordinator

Christin Spahn, MDSurgeon

Mark Stiteler, RTTRadiation Oncology Manager

Greg Thompson, MDCancer Committee Chair; Cancer LiaisonPhysician; Radiation Oncologist

Richard Villarreal, MDObstetrician/Gynecologist

Alex Wilson, MDCancer Center Medical Director;Radiation Oncologist

Jaime Wisecup, RN, CTRCancer Registry Quality Coordinator

Erin Woltz, BSN, RNOncology Nurse; ChemotherapyInfusion Manager

2019 Cancer Committee

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12 Adena Cancer Center • 2019 Community Report