Bronson Battle Creek Cancer Care Center 2016 Annual Report

2016AnnuAl RepoRt

with a special focus onBReAst CAnCeR

Battle Creek

Bronson Battle CreekCanCer Care Center

2016AnnuAl RepoRt

with a special focus onBReAst CAnCeR

2016 annual RepoRt

BRonson BAttle CReekCAnCeR CARe CenteR

special focus onBReast canceR

Breast Cancer screening . . . . . . . . . . . . . . 3 Gender statistics new technology Improves Detection Rates Your Breast Cancer screening schedule . . . . . . . . . . . . 4

Breast Cancer surgery . . . . . . . . . . . . . . . . 4 staging Breast Cancer . . . . . . . . . . . . . 5

nationally Recognized Cancer Care . . . . . . . . . . . . . . . . . . . . . 5

Chemotherapy for Breast Cancer . . . . . . . 6 Advancing treatment for Research Introducing the DigniCap® . . . . . . . . . 7

Advances in Breast Cancer Radiation . . . . 8 Cover Costs About the Cancer Care Center nurse navigation and Cancer . . . . . . . . . . 9 Inherited Risk support Groups and programs

A survivor’s story . . . . . . . . . . . . . . . . . . . 10

Advanced Illness Management . . . . . . . . 11 Recognizing stress

Dr . stephen smiley Retires . . . . . . . . . . . . 11

Dear Friends,

I am proud to introduce Bronson Battle Creek Cancer Care Center’s

Annual Cancer Report for 2016. With a special focus on breast

cancer, this report highlights our comprehensive approach to breast

health. From testing and diagnostics, to treatment, to survivorship

planning, our exemplary team works together closely to provide

our patients with the best possible care. In this report, we’ve also

included local and national cancer data so you can see how well our

performance compares to others.

Since 1995, Bronson Battle Creek has been recognized by the

Commission on Cancer of the American College of Surgeons. We are

also proud to be recognized by the National Accreditation Program

for Breast Cancer. With an outstanding staff, leading technology and

research, we have the utmost confidence in the programs and clinical

outcomes we deliver.

I hope you find our 2016 annual report informative. If you have

any questions about The Cancer Care Center and our capabilities,

contact us at (269) 245-8056 (radiation oncology) or (269) 245-8660

(medical oncology).

Sincerely,

Jim McKernan

Chief Operating Officer

Bronson Battle Creek

A Word from the COO

2

A screening mammogram is part of routine preventive healthcare. For many women the result will be normal and she will never meet the physician who interpreted her exam. For some, however, a mammogram may lead to additional tests. It may even signal the beginning of her breast cancer journey. Although screening can’t prevent breast cancer, it can help find breast cancer early when it is easier to treat.

Bronson has made a commitment to meeting the highest standards in breast health. Our team provides education and support services as well as screening and diagnosis of breast diseases. From the time a woman enters a Bronson mammography center, she has a team of technologists, nurses and doctors specialized in breast health participating in her care. An important part of the screening process is a health evaluation form designed in part to assess a woman’s risk for breast cancer. Women identified as high risk are offered a free detailed risk assessment and counseling with a breast nurse navigator or genetic specialist. It is important to remember, however, that all women are at risk for breast cancer regardless of family history.

If a screening mammogram shows a possible abnormality, the patient is asked to return for diagnostic testing. The majority of these women are found to have nothing of concern. A woman experiencing a possible symptom of breast cancer — such as a lump — will also be scheduled for a diagnostic examination. The diagnostic evaluation will be supervised by a breast radiologist, a physician trained in medical imaging interpretation, and subspecialty trained in diagnosing breast diseases. The radiologist will work together with the technologists to tailor the exam to address the individual patient’s situation. When the breast imaging is completed, the patient will receive her results and will have the opportunity to discuss them with the radiologist before leaving the facility. A woman who needs a biopsy for further diagnosis will meet with the radiologist to review results. In most cases at Bronson, the breast biopsy is a low-risk, minimally-invasive needle biopsy.

When a breast cancer is diagnosed, a nurse navigator will help the patient navigate her breast cancer journey and will be part of her cancer care team. Our team of breast care experts includes nurses, social workers, radiologists, pathologists, surgeons, oncologists, radiation oncologists and others who work together to provide the best possible care available.

(continued on page 4)

Breast Cancer ScreeningBy Christina Jacobs, MD, Bronson Health Imaging Director, Bronson Healthcare

Breast tissue is composed of fatty and fibroglandular tissue. About 50 percent of the U.S. screening population have significant amounts of fibroglandular tissue, which is defined as dense breast tissue. Breast cancers can be hidden from view by dense tissue in conventional mammography and women with dense tissue may have a higher risk of breast cancer.

3D mammography exams outperform conventional mammography for women with dense and non-dense breasts. This cutting edge technology improves the detection of invasive cancers by 40 percent compared to traditional mammograms. And, it reduces the likelihood of a calling a woman back for a non-cancer abnormality on the exam by 15 to 60 percent. Insurance coverage varies; women should check with their carrier.

New Technology Improves Detection Rates

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BRonson BAttle CReek CAnCeR CARe CenteR 2016 AnnuAl RepoRt

Breast cancer is primarily a women’s disease, but men get breast cancer, too. Slightly less than 1 percent of breast cancers affect men, however it tends to be discovered at more advanced stages and therefore has a higher associated mortality rate.

Gender Statistics

A mammogram is a low-dose X-ray used to detect breast cancer. Some medical societies disagree on guidelines for screening. Bronson’s breast health experts recommend yearly mammogram screening starting at age 40 for women of average risk because studies show this saves the most lives from breast cancer. Women with dense tissue may choose additional screening tests to improve cancer detection such as tomosynthesis and ultrasound. Women of every age are encouraged to conduct monthly breast self-exams and discuss their breast health with their primary doctor.

Some women have a high risk for developing breast cancer. There are clear guidelines for screening high-risk women which include yearly mammography and MRI. Depending on the individual, recommendations may include beginning screening before age 40.

Your Breast Cancer Screening Schedule

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Breast Cancer Screening(continued from page 3)

The Mary Coleman Breast Center at Bronson Battle Creek is an American College of Radiology Breast Imaging Center of Excellence (BICOE) in recognition of meeting the highest breast imaging and diagnostic standards. Bronson Battle Creek is accredited by the National Accreditation Program for Breast Centers (NAPBC). This accreditation is a comprehensive distinction recognizing our entire team of breast care specialists from screening and diagnosis to treatment. And it assures that our center is held to the highest standards of care for patients with diseases of the breast. l

As a surgeon, after a patient is diagnosed with breast cancer, I am often the first physician she sees. Once upon a time, surgery was the only option for breast cancer. And a radical mastectomy — the removal of the entire breast — was the standard of care. Fortunately,

this is no longer true. We’ve learned so much about breast cancer that what used to be a one-approach-for-all is now highly individualized. Women have many more options.

Not every woman will have surgery. There are some cases where radiation or neoadjuvant chemotherapy may be the best course of action as a first step before surgery. These are among the many things we discuss. Still, most women with breast cancer will undergo surgery. A mastectomy is still an option and remains the best course of treatment for some patients with advanced stages of breast cancer.

Another option is breast-conserving surgery. This is also called a lumpectomy. My practice has an outstanding lumpectomy rate of around 70 percent. This surgery removes cancerous tissue only and seeks to conserve as much healthy breast tissue as possible. It can also conserve the nipple when appropriate. Breast conserving surgery most often requires radiation with a few exceptions. Among these exceptions are some elderly patients who meet other criteria. Bronson Battle Creek Cancer Care Center has both excellent radiation technology and an exceptional radiation oncology team.

When a lumpectomy is performed on an invasive cancer, the question of how much healthy tissue to remove has been a matter of debate. Some surgeons

Breast Cancer SurgeryBy Kerri Murray, MD, Bronson General Surgery

“We’ve learned so much aboutbreast cancer that what used to be

a one-approach-for-all is nowhighly individualized. Women have

many more options.”

5


believed it was better to remove additional tissue as a margin of safety. But it has been my practice to save as much healthy tissue as possible. In 2014, a guideline published by the Society of Surgical Oncology and American Society of Radiation Oncology supports my conservative approach. That guideline recommends a margin of 2 millimeters for invasive in situ cancer.

In another advancement, research shows that removal of the lymph nodes under the armpit of the affected breast may not be necessary. This location is one of the first places breast cancer spreads, and it was often routine to remove the lymph nodes there as a precaution. Studies have shown, however, that chemotherapy or hormonal therapy after surgery may be just as effective in keeping cancer at bay.

Among the many decisions a woman will face with surgery — even with a breast conserving approach — is whether or not to have reconstructive surgery performed. We have an

Breast cancer is staged using a combination of numbers and letters to identify its characteristics, such as how localized or invasive it is and whether or not it has spread to other parts of the breast or other organs. Broadly, stage 0 describes non-invasive cancers that remain in their original location. At this stage, the most common form of non-invasive cancer is ductal carcinoma in situ (DCIS), cancer in the lining of the breast milk duct.

At the other end of the spectrum is stage IV, which describes invasive cancer that has spread from the breast to other parts of the body. A primary letter attached to each stage refers to what the American Joint Committee on Cancer calls the TNM system, which looks at three factors:

• (T)Thesizeofthebreasttumorandifithasgrownintosurroundingareas;• (N)whetherlymphnodesareaffected;and• (M)whetherthecancerhasmetastasizedorspreadtootherpartsofthebody.

Advances in the detection and treatment of breast cancer have enabled doctors to look at subcategories of each of these stages. For this reason, your doctor may refer to stage 1A or 1B, for example, and a combination of numbers attached to each letter — again, for example, T0, M1, NO as one possibility. While this sounds complex, to doctors, it provides a precise description of your particular breast cancer and helps guide treatment recommendations. It is one more example of how individualized breast cancer treatment has become.

Staging Breast Cancer

aggressive plastic surgery program and work closely with local reconstructive specialists who do outstanding work. They are part of an extended team of multi-disciplinary experts who work in tandem with each patient in her fight against breast cancer.

This extended team includes cancer specialists at every stage of treatment. Often when I see a patient for the first time, she has already been the focus of one of our breast cancer conferences — formerly called our breast cancer tumor board. At these twice-monthly meetings, we discuss each patient’s unique case and identify how we can collectively best treat her breast cancer.

Among the healthcare providers at our conferences is our nurse navigator. It is her job to support a woman throughout her treatment journey. When I conduct those first meetings after a woman has received a cancer diagnosis, it’s not unusual to find our navigator waiting outside my office ready to help a patient with her next steps. l

Bronson Battle Creek Cancer Care Center is accredited by The Joint Commission, having earned its Gold Seal of Approval. The Commission on Cancer Comprehensive Community Program ranks the Center among the top cancer centers in the nation. The Center is one of only 25 hospitals in the country to receive an outstanding achievement award from the American College of Surgeons Commission on Cancer three times in a row.

Nationally Recognized Cancer Care

Clinical trials are critical to improving patient outcomes. The Cancer Care Center is part of the Research Consortium of West Michigan — a combined effort of healthcare organizations in Michigan providing patients with access to national clinical studies without the need to travel long distances. Our participation ensures that patients in our community have access to the very latest treatments available. At the same time, we play an important role in advancing the body of scientific knowledge surrounding cancer treatment.

Among the prestigious phase II and phase III breast cancer studies we currently offer, we’re assessing a host of new drug therapies. They address a range of stages and variations of breast cancer that includes cancers with *BRCA 1 and 2 mutations, high-risk triple negative breast cancers, and cancers that are node-positive or node-negative. These are but a few of the leading studies available to patients of The Cancer Care Center here within our community. For a complete list of available trials, visit ClinicalTrials.gov.

(*BRCA 1 and 2 are genes that are linked to increased risk of breast and ovarian cancer.)

Advancing Treatment Through Research

As research deepens our understanding of breast cancer, we are able to treat it through new combinations of therapies, including new and standard chemotherapy drugs. These are sometimes used individually or in conjunction with other drugs. They may be delivered before or after surgery. Each patient’s treatment recommendation is unique because we now recognize the individualized nature of each instance of breast cancer.

Our team of medical oncologists, surgeons, radiation oncologists, nurse navigators and genetic counselors work together to customize breast cancer treatment that is the least-invasive, most advanced and comprehensive, highest quality cancer care possible. Our experts are supported by an extensive team of highly-trained dietitians, therapists, social and financial counselors. We work together to make sure patients receive personalized cancer care at every step of their treatment journey.

The Commission on Cancer (CoC), a program of the American College of Surgeons (ACoS), has accredited Bronson Battle Creek since 1995. This recognition challenges cancer programs throughout the nation to deliver patient-centered, state-of-the-art care. Accreditation ensures that patients are treated according to nationally-accepted quality guidelines. It measures quality and outcomes, including overall survival, through a rapidly expanding panel of quality measures for cancers of the breast, colon, rectum, lung, esophagus, stomach, gynecologic and urologic malignancies. The Cancer Care Center is also part of the Cancer Quality Improvement Program (CQIP), the newest quality report of the National Cancer Database, which confidentially compares nation-wide data from all 1,500 CoC-accredited hospitals.

Since 2014, Bronson Battle Creek has also been accredited by the National Accreditation Program for Breast Cancer (NAPBC). This accreditation is granted only to breast centers committed to providing the best care to patients with diseases of the breast. These centers undergo a rigorous assessment of performance and demonstrate compliance with NAPBC standards.

Among the tools available to us through the ACoS (CoC) is participation in the web-based Cancer Program Practice Profile Reports known as CP3R. This helps us measure our compliance in a number of quality categories and compares us to other cancer centers around the country. The 2013 CP3R report was released in February of this year, making it the most recent breast cancer quality data available. Through the CQIP, we can compare The Cancer Care Center to CoC programs within the state of Michigan and nationally. In both comparisons, we are a clear leader in compliance.

Chemotherapy for Breast CancerBy Nidhi Mishra, MD, Medical Oncology & Hematology

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The Commission on Cancer

(CoC) … has accredited

Bronson Battle Creek since

1995. Accreditation ensures

that patients are treated

according to nationally-

accepted quality guidelines.

In January, Bronson Battle Creek Cancer Care Center was among the first hospitals in the country to offer the DigniCap® — a scalp-cooling system that helps reduce hair loss in breast cancer patients undergoing chemotherapy. Approved by the U.S. Food and Drug Administration in December 2015, the DigniCap remains available in a limited number of cancer centers across the nation. It is available at The Cancer Care Center free of charge thanks to the generosity of the community and the Bronson Health Foundation.

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Data also shows that we are diagnosing early breast cancer through our robust screening program. This is in line with state and national statistics.

Our accreditation by the NAPBC and the CoC ensures that women in our community receive the excellent care they deserve close to home.

Breast Cancer Quality Data from theCancer Quality Improvement Program (CQIP) 2013

Higher percentages are better

100 98 96 94 92 90 88 86 84 82 80 MASTRT BCSRT MAC HT nBx

BBC 100% 100% 100% 96% 94%

MI State 91% 91% 92% 91% 91%

All CoC Programs 88% 92% 92% 91% 90%

Perc

ent

of C

ases

CoC Measurements explained (2013)

MASRT — Radiation is therapy considered or administered following mastectomy within 1 year of diagnosis of breast cancer with 4 or more positive regional lymph nodes

BCSRT — Radiation therapy is administered within 1 year of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer

MAC — Combination chemotherapy is recommended or administered within 4 months of diagnosis for women under 70 with AJCC T1cN0M0, or Stage II or III hormone receptor negative breast cancer

HT — Tamoxifen or third-generation aromatase inhibitor considered or administered within 1 year of diagnosis for women with AJCC T1cN0M0, or stage IB-III hormone receptor positive breast cancer

nBx — Image or palpation guided needle biopsy (core or FNA) performed to establish diagnosis of breast cancer

American College of Surgeons. (CP3R data as of 11/02/2015).Quality Measure Reports.Retrieved from https://m.facs.org/NCDB.CQIPDS.

Stage of Cancer at Diagnosis2009–2013

60 50 40 30 20 10 0 0 I II III IV NA UNK

BBC 15% 48% 24% 8% 2% 0% 3%

NCDB 19% 43% 23% 8% 4% 0% 3%

Perc

ent

of C

ases

Distance Traveled2009–2013

45 40 35 30 25 20 15 10 5 0 <5 Miles 5-9 Miles 10-24 Miles 25-49 Miles 50-99 Miles >100 Miles UNK

BBC 15% 42% 23% 17% 1% 2% 0%

NCDB 16% 25% 34% 16% 6% 3% 1%

Perc

ent

of C

ases

Introducing the DigniCap®


8

For the treatment of breast cancer, radiation therapy is most commonly used after breast-conserving surgery. Its purpose is to kill any cancer cells that remain in the breast or armpit. In the past, this

was a one-size-fits-all approach that required six weeks of radiation. Today, however, as science has deepened our understanding of the personalized nature of breast cancer — and with advances in radiation treatments and technology — radiation can be tailored to a patient’s individual needs.

Many factors affect a patient’s recommended course of radiation treatment. Among the considerations are the patient’s age, the stage of cancer, whether chemotherapy is planned, and whether the breast cancer gene is present. For example, while some patients may still require a full six-week course of radiation, others — some women over age 50 who have early stage favorable breast cancer — may be candidates for an abbreviated three- to four-week course of radiation.

In addition to fighting cancer, recent technology advances also help reduce the adverse effects of radiation treatment and enhance the patient’s safety and overall experience. Among the greatest risks of radiation is long-term damage to the heart and lungs because of their closeness to the

Advances in Breast Cancer RadiationBy Randy Mudge, MD, Medical Director, Radiation Oncology

breast. To address this, The Cancer Care Center acquired Vision RT in 2015, which eliminates radiation exposure to the lungs and minimizes or eliminates exposure to the heart.

Using 3D imaging and an infrared camera, we use Vision RT to measure the patient’s breasts, lungs, and chest before and during the delivery of radiation. We set specific guidelines for radiation delivery. In this way, radiation is given only when the lungs are expanded, the breasts are at their greatest distance from the heart, and the targeted tissue is within specific delivery range. When the patient inhales, the machine goes on. When she exhales, the machine stops. It is customized to the individual patient’s breathing pattern and provides greatly enhanced safety.

For patients with favorable early-stage breast cancer, we also offer accelerated partial breast irradiation. This technology uses a high dose radiation source and is a shorter alternative to traditional whole-breast irradiation. It is performed in conjunction with the surgeon, who places a catheter in the breast at the time of the lumpectomy. Radiation treatments are then delivered twice a day over a period of five days. It is a shorter treatment than traditional radiation and because there is less radiation exposure can provide excellent cosmetic results. This procedure is just one example of the many ways our multidisciplinary team approaches individualized breast cancer treatment. l

Most health insurance plans cover the cost of mammograms. For qualifying women without personal health coverage, the Calhoun County Cancer Control Coalition (5Cs) workswith Bronson Battle Creek Hospital and the Cancer Care Center to provide free mammogram screening each October. Learn more atcalhouncancer.org.

Covering the Cost

Bronson Battle Creek Cancer Care Center provides individualized patient treatment plans to support the body, mind, and spirit of its patients. Conveniently located next to Bronson Battle Creek Hospital, The Cancer Care Center specializes in a broad range of cancer services. They include diagnostics, genetics assessment, hematology, medical oncology and chemotherapy, pathology, radiation oncology and technology, and surgical oncology. Conferences for breast, thoracic and all other tumor sites regularly bring expert physicians together to review and discuss treatment options for individual patients. The Cancer Care Center is a member of the Cancer Research Consortium of West Michigan — a combined effort of healthcare organizations in Michigan providing patients access to national clinical studies while remaining in their communities.

About the Cancer Care Center

As a nurse navigator, I am among a team of nurses who work hand-in-hand with breast cancer patients from the time they are alerted to a questionable mammogram result throughout their treatment. We want women to know that they are not alone on their journey. We are specially trained in cancer treatment, breast cancer in particular — and in all aspects of navigating a patient through the complicated world of cancer care.

It is my job to help patients understand their treatment options as explained by their oncologist or surgeon. I coordinate care by helping schedule appointments, and assisting with referrals to nonmedical resources such as social workers and financial aid support, or help with transportation through the American Cancer Society’s (ACS) Road to Recovery program. I even work with community-led volunteer groups that provide emotional support, raise money to fight cancer, and provide help with skin, hair, and makeup during treatment.

Women — and men — who have undergone treatment for breast cancer understand that it is a very personal experience. The affect of breast cancer is unique to each patient, and the journey from diagnoses through treatment and survivorship is a very individual one. And yet survivors also recognize that there is strength in working together. Cancer survivors in our community are an active, generous and compassionate group. They meet regularly to help each other — wherever each happens to be on his or her survivor path.

Assessing Genetic RiskFor most women, genetic testing for breast cancer isn’t necessary. But for some, it can play a vital role in early detection and treatment. It may also be recommended for men who are at risk based on their family history or other health factors.

Less than 10 percent of breast cancers are caused by an inherited gene mutation. Among these, BRCA1 or BRCA2 are the most common gene abnormalities. Everyone has these genes. When they are normal, they perform an important function — they repair cell damage and keep breast, ovarian and other cells growing normally. Having one or both abnormal BRCA genes does not mean you will get cancer, but it may increase your chances.

(continued on page 10)

Nurse Navigation and Breast CancerBy Susan Swank, RN, BS, CN-BN, OCN

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Women with an abnormal BRCA1, BRCA2 or both genes have up to an 80 percent risk of developing breast cancer. This is much higher than the average risk of 12 percent or one woman in eight without the gene abnormality. Cancers associated with these gene mutations tend to develop in younger women who are also at an increased risk for ovarian, colon and pancreatic cancers. Men with an abnormal BRCA2 gene have an eight percent risk of developing cancer.

Inherited Risk

Breast Cancer Support GroupThe One Day at a Time Breast Cancer Survivor Group meets on the last Thursday of each month from 6 to 7:30 p.m. at The Cancer Care Center. Specialists from around the region often speak on a variety of topics from advances in treatment to dietary health and local resources including cosmetics, undergarments, and prosthetics. Some meetings offer simple camaraderie and conversation among the survivors and their families where they share their experiences and learn from one another. The Center partners with the American

Support Groups and Programs

Cancer Society (ACS) and benefits from the philanthropy of individuals and local organizations.

Look Good Feel Better The American Cancer Society is an active and vocal partner in our community’s fight against cancer and coordinates many services to support breast cancer patients. Among these is the Look Good Feel Better program, which provides skin care and makeup classes for women undergoing active treatment.

Together FitWorking with the Calhoun County Cancer Control Coalition (5Cs) and a grant through Susan G. Komen, The

Cancer Care Center has launched a pilot program to determine the effects of social interaction and positive life changes on the recurrence of breast cancer. A group of 14 cancer survivors were given memberships to Planet Fitness and Fitbit™ fitness trackers. They were connected to one another through a closed Facebook group. The Cancer Care Center will regularly monitor changes in body mass index, blood pressure, glucose and cholesterol levels to see if positive changes emerge. This program is one way researchers are learning about the effects of healthy life choices on cancer.

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After Surviving Breast Cancer

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Watch Jill’s story and learn more about our nationally recognized cancer care center at bronsonpositivity.com/cancer.

“ Learning you have breast cancer is something nobody wants to hear. But being able to get treated here in Battle

Creek made things easier, and helped me feel more normal in a very abnormal situation. I was able to be there for

my son, to keep working, and someone from my family was always with me for chemo treatments. I found out later

that the Bronson Battle Creek Cancer Care Center is nationally recognized, and I can see why. My doctors were all

really, really good, and two years out, I’m still cancer-free. I’d recommend The Cancer Care Center to anybody.”

Jill, Battle Creek, Michigan

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Nurse Navigation and Breast Cancer(continued from page 9)

One way to become better informed about your genetic risk is through genetic testing. Your need for testing is determined by a screening questionnaire at the time a mammogram is performed. An oncologist or surgeon may also recommend it.

Genetic testing is painless, but it can be complex and confusing. Each patient is different, each case is unique, and the specific testing ordered is personalized to the patient’s individual needs. For this reason, genetic counselors work with patients before testing is ordered. After speaking with a counselor, you may decide to move forward with testing, to wait, or that testing is not right for you. These specialists also explain the findings and ensure that the patient’s medical team is copied on the results so they may coordinate any next treatment steps.

It is part of my role as a nurse navigator to facilitate this process and to work with the patient’s insurance company if needed. Genetic counseling is provided free of charge to all high-risk patients. l

This year, Bronson Battle Creek featured a patient’s personal story and her journey through breast cancer. After a double mastectomy, chemotherapy, radiation and the beginning of reconstruction, Jill is proud to say she is cancer free. In a devastating and scary situation, Jill was glad to find the aggressive treatment she needed close to home. Learn more about Jill’s story at bronsonpositivity.com/breastcancer.

“Going to Bronson Battle Creek was a great decision” — A Survivor’s Story

Advanced illness management is a term many patients may not be familiar with. My job is a relatively new type of work that provides specialized care — supportive care outside a particular treatment regimen— for patients with complex illnesses. Not every patient needs my help. For those who do, our work together plays an important role in their health and well-being during treatment and after.

Hearing that you have any severe illness is life altering. Treatment can be intense and affects all aspects of your life. My job is to help patients manage their illness. Together, we work to relieve symptoms, improve the patient’s quality of life and coordinate care. I work with patients at every stage of their disease, from those diagnosed with stage 0 to those with advanced metastatic disease — anyone who needs extra help managing care. Patients are often referred to me at the time of diagnosis, but my help can come at any time throughout treatment.

Patients learn how to eat nutritiously, treat and manage pain, and deal with issues related to faith/spiritual practice, sexuality and personal relationships. This is especially important for patients battling breast cancer. Our bodies are a vital part of our self-image. When surgery or other treatments change our physical appearance, our mind and spirit must readjust too. An important part of my work is letting patients know that what they are thinking and feeling is a completely normal part of their illness. Cancer is a personal journey, but it doesn’t have to be walked alone.

One of the important conversations I have with each patient starts with difficult questions like, “What if you can no longer make decisions for yourself?” What do you want your family and your care providers to do?” This is a conversation everyone should have, but many people don’t think about it until faced with a health crisis. As a result of our discussion, I help patients create an advanced directive. Some people call this advanced care planning. This document ensures that a patient’s personal wishes are honored in a time where they might not be able to make decisions for themselves.

Helping patients in their fight against breast cancer and other advanced illnesses is both humbling and rewarding. It’s my honor to be part of a team that provides outstanding healthcare as well as compassion for a patient’s mind and spirit as well. l

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One of the tools recently introduced at The Cancer Care Center is a screening assessment for distress. Just as we ask patients, “On a scale of 1-10, what is your pain level today?” we now also ask what is your level of distress or anxiety? This tells our care team that the patient may need more help managing the stress of their treatment. This is especially helpful for our nurse navigator or advanced illness management teams who will bring the most appropriate resource to each patient’s care. This may include financial aid counseling, emotional counseling, pain management, family education or self-help therapies.

Recognizing Stress


Advanced Illness ManagementBy Timothy Sparling, DNP, RN, AGPCNP-BC, ACHPN

Thank youDr. StephenSmileyfor 33 yearsof service!

It’s with great regret we announce the retirementof Stephen Smiley, MD,after 33 years of partnership with Bronson Battle Creek. During his time, Dr. Smiley also served as medical director of medical oncology for Bronson Battle Creek Cancer Care Center.

We greatly appreciate Dr. Smiley’s contribution to the advancements in cancer treatment and his dedication to providing his patients with superior care. Join us in wishing him the best in his retirement!

Good luck, Dr. Smiley!

Battle Creek

Getting screened for cancer is something that is often done because it is recommended by your physician and by the American Cancer Society. Doctors take family history and risk factors into consideration when making individual recommendations, but the American Cancer Society has a standard set of guidelines for everyone.

For more information on cancer screening guidelines, visit the American Cancer Society’s website at cancer.org.

Screening for Cancer

bronsonhealth.com

Health & Medicine

Bronson Battle Creek Cancer Care Center 2016 Annual Report