Annual Report 2012with 2011 Statistics

Cancer Program

Coping with Tomorrow,Today

Flavio Kruter, M.D.Chairman, Cancer Committee

Carroll Hospital Center’s cancer program has experienced another successful year, and I would like to share a few of the developments and achievements highlighting our commitment to our patients.

I am pleased to announce that Carroll Hospital Center was awarded the Commission on Cancer’s Outstanding Achievement Award. This award is given to Commission on Cancer-accredited cancer programs showing excellence in clinical and support service delivery to patients.

Our hospital also achieved high concordance with the National Quality Forum-endorsed quality measures for breast and colon cancer, and it led in comparisons of other Commission on Cancer-approved cancer programs nationally, regionally and statewide.

The cancer navigation team is in the midst of developing a comprehensive cancer survivor-ship program that addresses the specific needs of cancer survivors, including, but not limited to, physical, nutrition, exercise and psychosocial needs. Specialized screening tools were recently implemented that identify those patients experiencing psychosocial distress and those who have nutritional support needs. These screening tools allow patients to be identified and referred for support and services earlier.

The team has developed a process for a multidisciplinary breast conference, slated to start in January 2013. This weekly conference will bring together medical oncologists, radiation oncologists, oncology nurse navigators, radiologists, pathologists and other specialists to review breast cancer cases prospectively and make recommendations for the plan of care.

In closing, I would like to thank all of the dedicated health care providers and cancer committee members who make sure our objectives are met each year. It is a pleasure to work with these talented individuals in our shared mission of providing quality cancer care.

Flavio Kruter, M.D.Chairman, Cancer Committee

Letter from the ChairmanFlavio Kruter, M.D.

Cancer Liaison PhysicianDavid J. Salinger, M.D., is a board-certified radiation oncologist at the Carroll Regional Cancer Center. In addition to his busy radiation oncology practice, he voluntarily serves as the cancer liaison physician (CLP) for the hospital’s cancer program.

As CLP, Dr. Salinger provides leadership and supervision in monitoring and overseeing activities to improve the quality of the hospital’s cancer program. This includes evaluating and analyzing Carroll Hospital Center’s cancer program performance using National Cancer Data Base (NCDB) data and regularly reporting his analysis of NCDB data to the hospital’s cancer committee at large. The CLP serves as the official physician liaison to the Commission on Cancer, the entity overseeing accreditation for the hospital’s cancer program, and is also the hospital’s liaison to the American Cancer Society.

Also serving as the cancer program’s cancer conference coordinator, Dr. Salinger oversees the content and format of the hospital’s multidisciplinary cancer conferences that bring together physicians from multiple cancer diagnostic and treating specialties to share expert advice.David J. Salinger, M.D.

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Flavio Kruter, M.D.Chairman, Cancer Committee

Cancer Care for Carroll County and the Region

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Multidisciplinary Cancer CareCarroll Hospital Center is proud of its Commission on Cancer (CoC)-approved cancer program. CoC accreditation is awarded to cancer centers that volunteer to comply with the CoC established standards, ensuring the finest quality of cancer care.

In 2012, Carroll Hospital Center continued to provide the highest level of clinical and supportive services, addressing the full con-tinuum of cancer patient care. The hospital was recognized for these efforts when it was awarded the Commission on Cancer’s Outstanding Achievement award, the highest level of award given to Commission on Cancer-approved cancer programs

Our multidisciplinary medical team is staffed by caring and dedi-cated board-certified physicians specializing in cancer diagnostics, surgical management of cancer, systemic cancer treatments (che-motherapy, hormone therapy, immunotherapy) and radiation therapy.

The multidisciplinary team works collaboratively to customize treatment plans for each patient. Experienced certified nurses trained in oncology care also care for patients and compassionately oversee and guide patients through all phases of their cancer diag-nosis, management and recovery. In collaboration with the University of Maryland Marlene and Stewart Greenebaum Cancer Center, the team is enhanced by a certified genetic counselor who counsels patients at high risk for genetically related cancer and other diseases.

The hospital’s palliative care team ensures that patients receive the needed therapies for relief of pain or symptoms resulting from their cancer diagnosis and/or cancer therapy. Further rounding out the medical team are the professionals who concentrate on the spiri-tual and emotional well-being of our patients in keeping with a patient-centered philosophy that recognizes the necessity of treat-ing the “whole” patient to achieve the very best clinical outcomes.

Cancer ServicesState-of-the-Art Diagnostics: • PET/CT • CT • MRI • Digital Mammography • Stereotactic Breast Biopsy • Ultrasound • Nuclear Medicine • Digital X-ray • Colonoscopy • Esophagogastroduodenoscopy (EGD)• Endoscopic Retrograde Cholangiopancreatography (ERCP)• Interventional Radiology

Therapeutic Services with Personalized Treatment Planning:• Surgery, including advanced surgical procedures and

minimally invasive techniques

• Systemic therapies, including chemotherapy, hormone therapy, immunonotherapy, blood transfusions, medication management and bone marrow biopsies

• Radiation therapy, including brachytherapy, a minimally invasive alternative to surgical tumor removal

• Mammosite 5-day targeted radiation therapy, an outpatient treatment that lets early-stage breast cancer patients get back to their daily lives faster

Support Services:• Nurse Navigation Services

• Genetic Counseling (in partnership with the University of Maryland Greenebaum Cancer Center)

• The Boutique at The Women’s Place (specializing in merchandise for people with cancer)

• Palliative Care (services designed to optimize quality of life)

• Lymphedema Treatment Program (featuring a certified lymphedema therapist)

• Complementary Health Services (massage, acupuncture, integrative reflexology)

• Oncology Resource Library

• Lodging Services (in partnership with the American Cancer Society)

• Transportation Services (in partnership with the American Cancer Society)

Cancer Care for Carroll County and the Region, continued

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Community OutreachCarroll Hospital Center continues its extensive community out-reach efforts to educate the community about cancer. Working in conjunction with community partners, our team of nurse educa-tors develops cancer awareness programs that teach preventive measures and lifestyle changes—such as smoking cessation, dietary modifications and exercise—that aid in reducing incidents of cancer. Outreach is conducted in a variety of ways, including lec-tures, broadcast media, web-based media, health fairs, brochures and other written media.

The team stresses the importance of having regular cancer screen-ings to detect cancer in its earliest stages, when it’s likely to be curable. In 2012, the community outreach team held or facilitated many cancer awareness and prevention programs, which included cancer screening events. The palliative care team also held events to educate patients, physicians and community members about palliative care and the availability of palliative care services at the hospital.

In addition, the hospital sponsors or facilitates access to support groups for cancer patients and their families on and off campus. We continually assess the needs of our community and design programs and strategies to address those needs.

For more information about cancer outreach, please call 410-871-7000 or visit www.CarrollRegionalCancer.org.

2012 Community OutreachPrevention, Education & Screening Programs • Breast Cancer/Breast Health Educational Presentation • Chemotherapy—An Overview• Colorectal Cancer Education • Cooking with the Doc: Reducing Your Risk of Cancer • Great American Smokeout • Health Fairs and Seminars• Lose to Win: Wellness Challenge• Lymphedema Education and Prevention Program• Meatless Cooking• Nutrition Education and Screening• Palliative Care Lecture and Presentation for Physicians • Prostate Cancer Education • Pink Fling Luncheon (Breast Cancer Awareness)• Reducing Your Risk of Cancer through Good Nutrition• Relay For Life• Skin Cancer Education and Screening• Tobacco Cessation • Tool Kit for Recovery

(for breast cancer patients who completed treatment) • Vitamin D: What You Need to Know• Health Benefits of Herbs & Spices

Support Groups/Services• Breast Cancer Support Group• Bereavement Luncheons• Camp TR• Cancer Support Group• Cancer Survivors Day• Caregiver Support Group• Grief Counseling• I Can Cope:

Cancer Education Series• Look Good, Feel Better• Lymphedema Support• Man to Man (Prostate Cancer

Support Group)• Ostomy Support Group

• Pastoral Care• Pathways Support Group• Pink Fling WISH Fund

Support Day• Reach to Recovery

(ACS program that pairs breast cancer patients with area survivors)

• Road to Recovery (ACS program that provides transportation to and from treatment for cancer patients)

• The Red Devils• Widows/Widowers

Support Group

2012 Carroll Hospital Center Cancer Program Activity – Moving Forward

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Carroll Hospital Center continues to merge processes and func-tions with the recently acquired Carroll Regional Cancer Center to expand and improve the delivery of cancer services across all systems. The hospital also continues to forge partnerships in the community and region that enhance cancer service provision and improve our patients’ outcomes.

• Carroll Regional Cancer Center nurse navigators worked with the hospital to streamline the navigation process to make delivery of navigation services more efficient and timely. In addition, assess-ments, services and resources were added to provide a better continuity of patient care from prior to diagnosis, through diag-nosis, treatment, recovery, survivorship and/or end of life. Three nurse navigators were added to the team to focus on Carroll Regional Cancer Center patients in addition to the three nurse navigators who focus on resources and support services for all community cancer patients.

• This year’s cancer program quality improvement teams evaluated the nutritional screening process for outpatient cancer patients and found no standardized method for outpatient screenings. Now using the European Society for Clinical Nutrition and Metabo-lism (ESPEN) guidelines for nutrition screening, patients are assessed to ensure that outpatient cancer patients in need of nutritional support are being identified and offered services to improve nutritional outcomes. The new process is being carefully monitored and reviewed on a monthly basis. The team also is reviewing turnaround times from radiation oncology consulta-tion appointments to radiation treatment simulation appointments. Additionally, data collection was undertaken to assess timely availability of radiation oncology services.

• Because palliative care—focusing on pain relief and symptom management during any stage of a disease—is often confused with hospice care, the cancer program’s palliative care team continued to provide education to physicians, patients and the community. Efforts included two educational events and the creation and distribution of an informational brochure. The team also has put into place a new way to identify inpatients in need of palliative care and a new way to ensure that these consultations are offered within 48 hours of hospital admission.

• A psychosocial assessment process was implemented in 2012 to identify cancer patients and/or their caregivers experiencing high levels of stress and anxiety and in need of social work refer-rals or referrals for immediate intervention or counseling.

• Lung cancer was the number one primary cancer site for Carroll Hospital Center in 2011. With this in mind, in 2012 the community outreach team initiated a viability study in hopes of developing a lung cancer screening program in accordance with the National Comprehensive Cancer Network (NCCN) guidelines. Efforts to establish partnerships in the community to help offset the costs of a lung cancer screening program are in process. Carroll Hospital Center community outreach continued with skin cancer screenings and sponsorship of numerous education and cancer prevention programs in 2012.

• In addition to genetic counseling services, the hospital plans to collaborate further with the University of Maryland Medical System to expand the availability of services closer to home for our patients.

• Pastoral Care• Pathways Support Group• Pink Fling WISH Fund

Support Day• Reach to Recovery

(ACS program that pairs breast cancer patients with area survivors)

• Road to Recovery (ACS program that provides transportation to and from treatment for cancer patients)

• The Red Devils• Widows/Widowers

Support Group

Chukwuma Anyadike, M.D. Colorectal Surgeon

Q&A with Chukwuma Anyadike, M.D., Colorectal SurgeonColon Cancer

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Colorectal cancer continues to be in the top five of the most prevalent cancers in the United States; however, colorectal screenings have served to reduce the morbidity and mortality of colorectal cancers. Screenings can detect colon lesions when they are in the pre-cancerous states or in very early stages of cancer when the disease is curable.

What is colon cancer?Most colon cancers arise from the glands within the colon and are known as adenocarcinoma of the colon. It can vary in aggressiveness from well-differentiated (least aggressive) to poorly dif-ferentiated (most aggressive). The majority of these are moderately differentiated. Colon cancer typically arises from polyps.

What are the risk factors for colorectal cancer?Age is a big risk factor. Over 90 percent of colon cancers occur in patients older than 50 years of age. African Americans have a greater risk of colon cancer than other races. Personal history of colon polyps or colon cancer also increases the risk. Inflammatory bowel disease and inherited pol-yposis syndromes are others. A family history of colon cancer or polyps can significantly increase the risk of colon cancer. Other risk factors include a high-fat and low-fiber diet, obesity, smoking, heavy alcohol use and sedentary lifestyle.

When should I be screened for colon cancer?Average-risk patients should have a colonoscopy starting at age 50. Average risk includes those without a family history of colon cancer, personal history of polyps, inflammatory bowel disease or polyposis syndromes. Other methods of screening include fecal occult blood testing, f lex-ible sigmoidoscopy, barium enema and virtual colonoscopy. Colonoscopy is the preferred way to screen for colon cancer because precancerous polyps can be biopsied and removed at the same time. Furthermore, suspicious masses can be biopsied.

What are the symptoms of colon cancer?The symptoms include rectal bleeding or blood in the stool, change in bowel habits, fatigue, unexplained weight loss, abdominal cramping and difficulty having a bowel movement. Advanced cases may present with obstruction, abdominal distension, ascites (fluid in the abdomen) or perforation.

How is colon cancer diagnosed?It is typically diagnosed with a colonoscopy. A colonoscopy is usually done as an outpatient procedure in which a long scope with a camera at the end is inserted. Sedation is given and any polyps or masses are biopsied to obtain tissue which is sent to pathology for analysis. Other tests such as CAT scans, PET scans and X-rays are used to look for metastatic disease.

How is colon cancer treated?The treatment is predominantly surgical. Surgery involves resecting the segment of colon containing the cancer. This can be done open (larger incision) or minimally invasively (multiple small inci-sions). The number of colon resections being done by a minimally invasive approach is increasing in the United States. Furthermore, the outcomes are equivalent between minimally invasive and laparoscopic surgery versus traditional surgical techniques. If the lymph nodes are involved, then chemotherapy is given. For patients with metastatic disease, chemotherapy may be given with surgery reserved to palliate symptoms such as obstruction or pain. Some distant metastases—or cancers that have spread from one place to another—may be amenable to resection.

Chukwuma Anyadike, M.D. Colorectal Surgeon

2011 Collection of Data and Outcomes

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The most common American Joint Committee on Cancer (AJCC) stages at diagnosis for newly diagnosed colon cancer at Carroll Hospital Center for the 2011 data year are stage II and stage III, representing a combined rate of 67.5 percent of all 2011 Carroll Hospital Center colon cancer cases. The highest rate of Carroll Hospital Center colon cancer patients, 37.5 percent, presented with stage III disease in 2011. Comparatively, stage III colon cancer rates are 22.6 percent and 25.0 percent for combined data for National Community Cancer Programs and Maryland Community Cancer Programs data, respectively. Carroll Hospital Center ’s stage IV disease was lower than the state and national rates. The Carroll Hospital Center stage IV colon rate was 12.5 percent, which represents a lower rate of stage IV disease than reported nationally and statewide. Stage IV colon cancer rates nationally and statewide were 15.9 percent and 17.1 percent, respectively.

Carroll Hospital Center Maryland

Carroll Hospital Center Colon Cancer AJCC Stage at Diagnosis VS. Maryland

Stage 0

100%

80%

60%

40%

20%

0% 010%

20%

6%

25%

38%

13% 8% 17%

7%

25%30%

Stage I Stage II Stage III Stage IV UNK

Carroll Hospital Center NCDB

Carroll Hospital Center Colon Cancer AJCC Stage at Diagnosis VS. NCDB

Stage 0

100%

80%

60%

40%

20%

0% 0

10%20%

8%

23%

38%

13% 8% 16%

7%

25%30%

Stage I Stage II Stage III Stage IV UNK

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The cancer registry is a fundamental component of Carroll Hospital Center’s American College of Surgeons’ Commission on Cancer (ACoS-COC)-approved cancer program. Collecting uniform clinical data allows us to measure clinical performance and outcomes and identify improvement areas. The hospital’s can-cer registry collects data on all cancer patients diagnosed or receiving all or at least a portion of their first course therapy at the facility for patients diagnosed January 1, 2003 and forward.

Under Carroll Hospital Center’s cancer committee physician leadership and in accordance with national standardized cancer data collection rules, cancer data management professionals known as certified tumor registrars (CTRS) create clini-cal abstracts that include patient demographics, primary tumor site, tumor histology, cancer stage at diagnosis and all first course treatment modalities used to cure or control cancer or reportable central nervous system (CNS) tumors. Patients receive annual lifetime follow up to monitor survival and disease status to measure the efficacy of treatments.

The cancer registry now contains data on 4,556 cancer cases. The cancer pro-gram’s medical staff routinely performs quality audits of cancer registry data to ensure that timely and accurate data are available for assessment of treatment outcomes and to monitor cancer trends in the community that assist the hospital in developing vital clinical cancer services and cancer screening and prevention programs.

In strict compliance with the Health Insurance Portability and Accountability Act (HIPPA), cancer registry data are reported to a variety of entities dedicated to cancer control efforts. Cancer registry data are reported to the National Cancer Data Base (NCDB). The Commission on Cancer, in partnership with the American Cancer Society, maintains the NCDB. Cancer registry data are submitted annually to the NCDB to combine aggregated cancer registry data to use for monitoring cancer prevalence and trends nationally. The Commission on Cancer also uses the hospital’s cancer registry data to verify the facility’s adherence to effective and evidence-based cancer treatments. Additionally, all cancer diagnosing and treating facilities located in the State of Maryland are required by the Code of Maryland Regulations (COMAR) to report newly diagnosed cancer cases to the state’s central cancer registry, The Maryland Cancer Registry (MCR). The MCR uses these data to measure cancer prevalence and trends statewide and to develop cancer screening, education and other intervention programs to alle-viate cancer burdens for all Maryland residents. MCR reports aggregated data to the Center for Disease Control and Prevention’s (CDC) National Program of Cancer Registries. The CDC combines this aggregated state cancer registry data with data from the Surveillance, Epidemiology and End Results (SEER) Program to produce the United States Cancer Statistics (USCS) Incidence and Mortality reports (www.cdc.gov/cancer/npcr/uscs/qa.htm).

The Cancer Registry

Cancer Registry Data Analysis2011 Data Year

Primary Site Total Cases American Joint Committee on Cancer (AJCC) Stage 0 I II III IV Unknown N/A

Lung/Bronchus 101 0 17 10 13 58 3 0

Breast 98 14 39 23 12 7 3 0

Colorectal 54 0 11 13 17 8 5 0

Prostate Gland 43 0 14 24 1 4 0 0

Bladder 36 17 7 9 2 1 0 0

Melanoma Skin 35 14 13 3 1 1 3 0

Blood & Bone Marrow 30 0 0 0 0 0 0 30

Corpus Uteri 22 0 14 1 1 4 2 0

Lymphatic System 21 0 9 0 5 7 0 0

Pancreas 16 0 0 3 0 12 1 0

Kidney/Renal Pelvis 14 1 7 2 0 2 2 0

Unknown Primary 12 0 0 0 0 0 0 12

Other Digestive Organs* 11 0 0 2 0 4 3 2

Brain & CNS 11 0 0 0 0 0 0 11

Thyroid 11 0 9 0 0 0 2 0

Ovary 9 0 1 3 1 3 1 0

Esophagus 6 0 1 1 1 3 0 0

Testis 6 0 5 0 0 0 0 1

Anus/Anal Canal 5 0 1 2 1 0 1 0

Stomach 3 0 0 1 0 2 0 0

Oral Cavity 2 0 0 0 0 2 0 0

Nasal/Sinus 2 0 0 0 1 1 0 0

Connect/Soft Tissue 2 0 1 0 0 0 1 0

Cervix Uteri 2 0 0 0 0 2 0 0

Other Male Genital Tract* 2 1 0 1 0 0 0 0

Other Endocrine System* 2 0 0 0 0 0 0 2

Liver 1 0 1 0 0 0 0 0

Larynx 1 0 0 0 0 1 0 0

Other Respiratory Organ* 1 0 1 0 0 0 0 0

Total 559 47 151 98 56 122 27 58

*Details available upon request.

The 2011 data year measured cancer program growth. As a result of Carroll Hospital Center’s cancer service line expansion, the number of reportable cases grew by 15 percent from the previous data collection year. A total of 559 newly diagnosed cancer cases were added to the cancer registry for the 2011 accession year.

The top 10 cancer sites diagnosed or treated at Carroll Hospital Center in 2011 were lung (18.1 percent), breast (17.5 percent), colorectal (9.8 percent), prostate (7.7 percent), melanoma of the skin and urinary bladder (tying at 6.4 percent), malignan-cies of the blood and bone marrow (5.2 percent), Corpus Uteri (3.4 percent), non-Hodgkin’s lymphoma (3.2 percent), pancreas (2.9 percent) and kidney (2.5 percent) (see primary cancer site chart for details.)

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20%

15%

10%

5%

0%

18% 18% 18%

7%

17%14% 14%14% 15%

10% 9%

6% 6% 5%4% 4% 4% 4%3% 3% 3%3%

2%3% 3%

1%.5% 1%

9%

7%

Breast Lung Prostate Colorectal Bladder NH Lymphoma

Corpus Uteri

Melanoma Leukemia Cervix

Carroll Hospital Center Maryland National

2011 Collection ofData and Outcomes

Carroll Hospital Center 2007-2011 Analytic Cases

2007 2008 2009 2010 2011

500

600

400

300

200

100

445480 471 472

559

In 2011 Carroll Hospital Center’s analytic cancer case volume rose 20% across the past five years, with 15% growth occurring from 2010-2011.

*Analytic cases includes cases that are diagnosed and/or administered any of the first course of treatment at the acessioning facility after the registry’s reference date. Includes a network clinic or outpatient center belonging to the facility. Per the Commission on Cancer 2012 Facility Oncology Registry Data Standards manual (COC-FORDS).

Comparing Carroll Hospital Center’s 2011 Cancer Prevalence with the American Cancer Society’s Fact and Figures:

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Ten Most Prevalent Cancer Sites Diagnosed in 2011

Carroll Hospital Center’s cancer case prevalence differs slightly from that documented in ACS. Although the top five cancers reported nationally are the top five cancer cases for Carroll Hospital Center, they are in different positions.

Top 10 Cancer Sites for Carroll Hospital Center 1. Lung 2. Breast 3. Colorectal 4. Prostate 5. Bladder/Melanoma Skin 6. Combined Hematopoietic Malignancies 7. Corpus Uteri 8. Non-Hodgkin Lymphoma 9. Pancreas 10. Kidney

Top 10 Cancer Sites Nationally (per ACS – Facts and Figures) 1. Breast 2. Lung 3. Prostate 4. Colorectal 5. Bladder 6. Non-Hodgkin Lymphoma 7. Corpus Uteri 8. Melanoma Skin 9. Leukemia 10. Cervix Uteri

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2011 Collection ofData and Outcomes

In 2012, the Commission on Cancer (CoC) posted Cancer Program Practice Profile Reports Data Reports (CP3R). These reports used the 2010 Carroll Hospital Center cancer registry data submitted to the National Cancer Database in 2011 to measure the hospital’s concor-dance with the National Quality Forum (NQF) standards of care measures for breast and colon cancer.

Standard of Care Measure

Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast-conserving surgery for breast cancer. [BCS/RT]

Commission on Cancer’s Minimum Required Concordant Rate

Carroll Hospital Center’s Concordant Rate

Performance Rate > = 90% or Upper Bound of the 95% CI > = 90%

Performance Rate > = 90% or Upper Bound of the 95% CI > = 90%

Performance Rate > = 90% or Upper Bound of the 95% CI > = 90%

Performance Rate > = 90% or Upper Bound of the 95% CI > = 90%

100%

100%

100%

80%

96%

Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1c N0 M0, or Stage II or III ERA and PRA negative breast cancer. [MAC]

Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1c N0 M0, or Stage II or III ERA and/or PRA positive breast cancer. [HT]

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

At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. [12RLN]

Performance Rate > = 80% or Upper Bound of the 95% CI > = 80%

Quality Improvement MeasuresCommission on Cancer’s Minimum Required Concordant Rate

Carroll Hospital Center’s Concordant Rate

200 Memorial Avenue | Westminster, MD 21157410-848-3000 | www.CarrollHospitalCenter.org

Karen Alban, R.N., B.S.N., O.C.N. (Oncology Nurse – Quality Improvement Team Member)

Sharon Baker, O.T. (Rehabilitation Representative)

Janet Blank, R.N., B.S.N., M.A. (Oncology Nurse – Quality Improvement Team Member)

Angela Boggs, M.S., M.A., B.C.C. (Pastoral Care Representative)

Earlene Bradford (ACS Representative)

Jen Burdette (ACS Representative)

Sherry Epperson, R.N. (Oncology Nurse – Nurse Navigator Team Member)

George Grillon, D.M.D. (Other Medical Specialty)

Christopher Grove, M.D.(Pathologist – CAP Compliance Manager)

Christine Cochran, R.N., B.S.N.(Quality Improvement Coordinator)*

Corilynn Hughes, R.N., B.S.N., O.C.N. (Oncology Nurse – Clinical Research Coordinator)*

Gregory Kirby, P.T. (Rehabilitation Representative)

Flavio Kruter, M.D. (Medical Oncologist – Cancer Committee Chairman)

Terri Mack, L.C.S.W.-C. (Social Work – Psychosocial Services Coordinator)*

Marcia McMullin, R.N., B.S.N., M.A. (Palliative Care Coordinator – Community Outreach Team Member)

Helen O’Sullivan, Pharm. D. (Pharmacy)

Eileen Overfelt, R.N., B.S.N. (Nurse Navigator Team Member – Community Outreach Team Member)

Bertan Ozgun, M.D.(Diagnostic Radiologist)

Mary Peloquin, R.N., B.S.N. (Community Outreach Coordinator)*

Darlene Price, B.S., R.H.I.T., C.T.R. (Certified Tumor Registrar – Cancer Registry Quality Coordinator)*

Stephanie Reid, R.N., B.S.N., M.B.A. (Cancer Program Administrator)

David Salinger, M.D. (Radiation Oncologist – Cancer Liaison Physician – Cancer Conference Coordinator) *

Stuart Shindel, M.D.(Surgeon)

Dawn Van Der Stuyf, R.N. (Hospice Care Representative)

Trisha Wagman, R.N. (Health Educator)

Sherry Watts (Cancer Registry Assistant)

Julie Wright, R.N., B.S.N. (Palliative Care Team Member)

Kathy Yowell, R.N., C.C.M. (Case Management Representative)

*required cancer committee coordinators

Cancer Committee Members