Oncology Program2013 Annual Report • 2012 Statistical Data • Colon/Rectal Cancer Focus

Message From Our ChairmanThe MedStar Good Samaritan Hospital cancer program continues to grow and add new patient care services. We are in the process of expanding and renovating our infusion center and patient care area by almost 100 percent.

Our cancer fatigue program, staffed by MedStar Good Samaritan Hospital Outpatient Rehab, continues to increase its referrals by about 10 percent per year. This program not only aids in decreasing a patient’s fatigue, but also improving their overall well-being. With the expansion of our psychiatric services, we have initiated a distress screening program to enable us to identify which patients are most in need of any specific services.

Our Radiation Therapy department has gotten a new CT scanner/simulator, which will allow us to treat larger patients in a more comfortable and safer environment.

The MedStar Health Cancer Network continues to expand. When completed, our patients will be able to obtain comprehensive, state-of-the-art therapy in a more convenient environment. Additionally, we have expanded our breast imaging services. Should the need arise, a breast biopsy can now be done the same day as a mammogram.

Soon, we will be converting to Aria (the electronic medical record), which will allow us to participate in more clinical research and monitor a patient with more efficiency.

Lastly, we have a new clinical program manager, Jackie Greene, RN, who has already had a positive impact on improving our patient services and care.

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Focus: Colon/Rectal Cancer Although there has been a 10 percent decrease in the incidence of colorectal cancer over the last two decades, it remains a major health problem in the United States. Approximately 143,000 patients will be diagnosed with colorectal cancer and one third of these will die from it in 2013. Routine colonoscopy screening once every 10 years or more often, if there is a positive family history, could reduce this number by 80 percent.

In 2012, a patient care evaluation study was performed at MedStar Good Samaritan Hospital to ensure that we are diagnosing and treating colorectal cancer with state-of-the-art therapy. Last year, there were 63 cases of colorectal cancer. At MedStar Good Samaritan Hospital, the median age was 69, with an age range from 19 to 92. Twenty-nine patients were male and 34 were female. Fifty-one percent had early colon cancer (Stage 0, I and II) as compared to 47 percent nationally, as can be seen on the graph on page 4. Our five-year survival rate was on par or exceeded

the national average with 87 percent versus 90 percent alive with local disease, 81 percent versus 70 percent alive with regional disease, 31 percent versus 12 percent alive with distant metastasis.

As was the case in the previous study, the majority of patients had early disease and, as a result, 36 of the 63 were able to be treated with surgery only. All the patients with Stage III colon cancer who were medically able were offered adjuvant chemotherapy. The remainder, as anticipated, required a combination of surgery, chemotherapy and radiation therapy.

This data serves to prove that MedStar Good Samaritan Hospital continues to offer state-of-the-art therapy in order to give patients their best chance at a cure.

Our goal for the future is to continue to expand our colon cancer screening services, so that we will prevent colon cancer from occurring or at least diagnose patients at an earlier stage.

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Comparison of CasesIn 2012, analytic cases accessioned equaled 353. For MedStar Good Samaritan Hospital, the top six sites seen were lung (73), breast (46), colon (42), prostate (20), brain CNS (15), and bladder (12), respectively. Maryland and national statistics indicated an increase in prostate, putting that diagnosis at the top of their site list and fourth on the MedStar Good Samaritan Hospital site. Breast was second across the board for all three lists. But while colon was third at MedStar Good Samaritan Hospital, it remained at number four in the nation and state. Bladder cancer was actually number six at MedStar Good Samaritan Hospital, but five for the nation and state.

Primary Sites # of Cases PercentDigestive System 94 26.6%Respiratory 82 23.2%Breast 46 13%Urinary 27 7.7%Male Genital 20 5.7%Brain/CNS 15 4.3%

Lymphoma 13 3.7%

Oral Cavity and Pharynx 9 2.6%

Endocrine 7 2%

Myeloma 6 1.7%

Leukemia 5 1.4%

Female Genital 5 1.4%

Skin 4 1.1%

Soft Tissue 3 0.8%

Bones and Joints 1 0.3%

Miscellaneous 16 4.5%

Total 353 100

Primary Site Ranking

Five-Year Survival: Colon/Rectal Cancer(ACS, 2013)

120

100

80

60

40

20

0Local Regional Distant

MedStar Good Samaritan HospitalNational

90%

81%

70%

12%

31%

87%

Perc

ent

Stage of Disease

25

20

15

10

5

00 1 2 3 4

8%7.5%

20.7% 21.8% 21.7%

15.8% 15%

22.3%

19.9%

22.2%

MedStar Good Samaritan Hospital

Perc

ent

Stage

National

Stage Comparison: Colon/Rectal Cancer(ACS, 2013)

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Lung73 (20.7%)Prostate

20 (5.7%)

Brain CNS 15 (4.3%)

Bladder12 (3.4%)

Colon 42 (11.9%) Breast

46 (13.0%)

National Casesestimated only (ACS, 2013)

Lung4,040

Bladder1,220

Colon2,410

Breast 4,760

Prostate4,880

Maryland Casesestimated only (ACS, 2013)

MedStar Good Samaritan Hospital Cases

2005 Five-Year Reference Year Reference

Total patients in registry 2,643 1,684

Class of case 10-14 and 20-22 less foreign residents and patients over 100 -1

Subtotal 2,642 1,684

Less deceased -1,360 -769

Subtotal (number living) 1,282 915

Less number current -1,108 -821

Lost to follow up 174 94

Percentage of follow up 93.41% 94.42%

Target 80% 90%

Follow-up Rates 2012

Follow up of all living patients is vital to the cancer registry.

This information assists physicians when accessing patients who may return for check-ups, aids in early identification of recurrences and helps to determine treatment. In 2012, the average follow-up rate at MedStar Good Samaritan Hospital was 93 percent for the registry reference year of 2005. The average follow up for the five-year reference date was 94 percent. Both reference dates were up by two percent for the year.

Lung228,190

Bladder72,570

Colon142,820

Breast 232,340

Prostate238,590

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Oncologic Surgery

Cryoablation

General, abdominal, thoracic, head and neck, neurologic, urologic and gynecologic surgery

Minimally invasive thoracic abdominal surgery

Sentinel lymph node biopsy for breast and melanoma

Medical Oncology

Biotherapy

Management of red cell, leukocyte and platelet disorders

Outpatient chemotherapy, hydration and infusion therapy

Oncology Nursing

Oncology Nursing Society (ONS) certification

Radiation Oncology

3D conformal therapy

Digital mammography

IMRT

Physics support

Radiation safety officer

Simulation, CT simulator

Transportation assistance

Varian 2100 EX Linear accelerator

Imaging

1.5 Tesla MRI

Nuclear medicine studies

PET scan

Spiral CT scan

Vascular interventional services

Home Care and Hospice

Rehabilitation

Acute Post–Breast Surgery Rehabilitation program

Inpatient and outpatient physical, speech and occupational therapy

Inpatient Comprehensive Rehabilitation program

Lymphedema management

Transitional Care Unit

Cancer fatigue program

Quality Management

Evaluation studies

Outcomes measurement, analysis and decision support

Performance improvement

Patient care

Quality of life studies

Research Program: Clinical Trials

Community Outreach and Support Services

Cancer Screening and Education program

Costa Memorial Support Services program

Palliative care

Parish Nurse program

Pastoral care

Patient resource navigator

Comprehensive Services

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Proud to be Recognized by the American College of Surgeons At MedStar Good Samaritan Hospital, our providers are focused on offering the best cancer care closer to home. In fact, our oncology program has been recognized by the Commission on Cancer of the American College of Surgeons. Only one in four hospitals that treat cancer receives this special approval. It is a recognition of the quality of our comprehensive, multidisciplinary patient care.

The Cancer Committee is a standing committee of medical staff that includes membership from diagnostic and therapeutic specialties, as well as allied health professionals and other staff involved with the cancer patient care team. The purpose of the Cancer Committee is to oversee all issues related to cancer care, and to identify, assess, organize, plan, and implement cancer–related activities at MedStarGood Samaritan Hospital. The Cancer Committee meets quarterly, maintains a permanent record of its findings, proceedings and actions, and reports to the medical executive committee.

Davis Hahn, MD Chairman Medical Oncology

Debbie Bangledorf Marketing and Communications

Terina Chen, MD Pathology

Kira Eyring American Cancer Society

Charlene Foote Outpatient Rehabilitation

Paul Fowler, MD Radiation Oncology

Francesco Grasso, MD Colorectal Surgery

Phyllis Gray Vice President Oncology Service Line, Baltimore Region

Jackie Greene, RN Oncology Clinical Program Manager

Jeffrey Hirsch, MD Radiology

Ann Kelemen Palliative Social Worker

Anne Krackow, PhD Patient Resource Navigator

Emily Kuchinsky, MS, CGC Certified Genetic Counselor

Moira Larsen, MD Pathology

Gail Lemaire, PhD, PMHCNS, BC Nurse Psychotherapist

Seferina Miley, PharmD, BCPS Clinical Pharmacist

Jeanette Nimon, RN, OCN Oncology Nursing

Charles Padgett, MD Medical Oncology

Howard Richard, MD Interventional Radiology

Elias Shaya, MD Psychiatry

Lynne Skaryak, MD Thoracic Surgery

Carol Stromberg Gilchrist Hospice

Chris Stromyer, RHIA, CTR Tumor Registry

Francis Velez, MD Surgery

Debbie Wagner, RN Nursing Education

Ken Walsch, AVP Quality Management

Jeremy Weiner, MD Surgery

Heather Williams, RN Research Coordinator

Thomas Wilson, MD Palliative Medicine

The Cancer Committee

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