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Hardin Memorial Health | Oncology Services 2017 Annual Report | Page: 1

Annual Report 2017

Hardin Memorial Health Oncology Services


TABLE OF CONTENTS:

Mission, Vision, Uniqueness . . . . . . . . . . . . . . . 3

Comments from Cancer Committee Chair . . . . . 4

Comments from Cancer Liaison Physician. . . . . . 5

Meet Our Cancer Care Providers . . . . . . . . . . . . 6

2016 Data . . . . . . . . . . . . . . . . . . . . . . . . . . 7 - 8

Multidisciplinary Breast Cancer Care . . . . . . . . . 9 - 10

Multidisciplinary Lung Cancer Care . . . . . . . . . . 11 - 12

Clinical Trials. . . . . . . . . . . . . . . . . . . . . . . . . 13 - 14

Community Outreach . . . . . . . . . . . . . . . . . . 15 - 21

Survivorship . . . . . . . . . . . . . . . . . . . . . . . . . 22

Hardin Memorial Health Cancer Care Services


HMH Cancer ProgramHardin Memorial Health is pleased to present its 2017 Cancer Program Annual Report. This report outlines the activities of the Cancer Program and newly diagnosed analytic cancer cases for 2016. Analytic cases are those that were either diagnosed and/or treated at our facility.

MissionTo exceed the physical, emotional and spiritual needs of our patients and their families by providing comprehensive, state-of-the art cancer treatments and therapies.

VisionTo provide hope and healing as the premier community cancer center in Kentucky.

Our UniquenessOur medical, surgical and radiation oncology specialists incorporate multidisciplinary treatments to provide advanced, cutting edge cancer expertise close to home.

As an affi liate of the University of Kentucky’s Markey Cancer Center, the only National Cancer Institute (NCI) designated cancer program in Kentucky, we off er patients, when appropriate, access to clinical trials and NCI medical center expertise.

We are Commission on Cancer (CoC) accredited which recognizes our integrated continuum of care. Our comprehensive resources include prevention and screening, genetic counseling, nurse navigation, social work, fi nancial counseling, an onsite dedicated pharmacy, survivorship and palliative care.

We value our caring relationships with our patients and families.


Comments from Karen Johnson, M.D. Cancer Committee Chair

At Hardin Memorial Health, cancer care is a top priority. We utilize advanced

technology and have access to the most current treatment regimens available.

Hardin Memorial Health’s cancer program is a Commission on Cancer accredited

program which is a special designation for centers meeting strict quality criteria

for cancer care. In addition, we are accredited by the American College of

Radiology as a Breast Imaging Center of Excellence.

Hardin Memorial Health’s cancer program has a long history of excellence with

tumor conferences allowing physicians from multiple specialties an opportunity

to discuss complex cancer patients with one another and coordinate care. We

also are a part of the University of Kentucky’s Markey Cancer Center’s clinical trial

program which allows us to off er clinical trials to our cancer patients and keeps

patients close to home while receiving comprehensive care.

Karen Johnson, M.D.


Hardin Memorial Health is dedicated to providing

state-of-the-art cancer care in a community setting,

allowing our patients to stay close to home for their

care. Our physicians are committed in the fi ght against

cancer including utilization of cutting edge diagnostic

technology and treatment. We are proud to be an active

affi liate of the University of Kentucky Markey Cancer

Center, which is the only NCI designated cancer center

in the Commonwealth of Kentucky.

Adam Lye, M.D. Cancer Liaison Physician

Adam Lye, M.D.


Adam Lye, M.D.Specialty: Medical OncologyBoard Certifi ed in Internal Medicine/Medical OncologyMedical School: University of KentuckyPracticing since 2013

Meet Our Cancer Care Providers

Chandler Park, M.D.Specialty: Medical OncologyBoard Certifi ed in Internal Medicine/Medical Oncology/Hematology Medical School: University of LouisvillePracticing since 2016

Richard Seither, M.D.Specialty: Radiation Oncology Board Certifi ed in Radiation Oncology Medical School: Louisiana State University Practicing since 1992

Cora Veza, M.D.Specialty: Medical OncologyMedical School: University of Santo Tomas, Manila, Philippines Practicing since 1985

Kathryn Francescon, APRNSpecialty: Medical OncologyGraduate School: Spalding University, MSN

Kelly White, APRNSpecialty: Medical OncologyGraduate School: Spalding University, MSN


2016 Top 5 Diagnoses

160

140

120

100

80

60

40

20

0

Lung Breast Prostate Bladder Colon 147 126 118 45 45

2012-2016 Top 5 Cases Top 5 Cancer Diagnoses by Year

180

160

140

120

100

80

60

40

20

0

2016 Data

Prostate

2012 2013 2014 2015 2016

Breast, female & male Trachea, bronchus, lung

Colon Bladder


2016 Stage Breakdown: All Diagnoses

200

175

150

125

100

75

50

25

0

Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage Unk. 56 208 172 122 164 91

K E N T U C K Y

Hardin

Breckenridge

Grayson

Hart

Larue

MeadeBullitt

Nelson

Taylor

Green

AdairMedcalfeBarren

EdmonsonButler

Warren

Muhlenburg

OhioMcClean

Daviess

Hancock

Jeff erson

Spencer

Shelby

Anderson

Washington

Marion

Casey

Pulaski

Lincoln

Boyle

Mercer

Woodford

Franklin

HarrisonPerry

SpencerWarrick

I N D I A N A

43

54

453

66

716

8

63

64

20

Primary Secondary Tertiary

2016 Cases by Service Area


1122

33

44

55

66

7788

99

1010

Annual Screening

HMH Women’s Care Center, Elizabethtown

Diagnostic Imaging, Bardstown

Diagnostic Center

Biopsy

HMH Women’s Care Center

Coordinationof Care

HMH Nurse Navigator

Breast Clinic& Case Review

HMH Radiologist, Surgeon, Pathology, Radiation Oncologist, Medical

Oncologist, & Plastic & Reconstructive Surgeon

Cancer Treatment HMH Surgeon, Medical

Oncologist & RadiationOncologist

BreastReconstruction

HMH Plastic & Reconstructive

Surgeon

MULTIDISCIPLINARYBREAST PROGRAM

BreastConcern

Clinical or Self Exam

Pathology Results/

Diagnosis

SupportServices

Cancer Care Center

Audrey Cleaver, BSN, RNNurse Navigator – Multidisciplinary Breast Program

Hardin Memorial HealthO�ce: (270) 706-6904 | Mobile: (270) 734-3194

111111

SurvivorsClinic

Cancer Care Center

DiagnosticMammogram,

MRI or Ultrasound

HMH Women’s Care Center & Elizabethtown

Diagnostic Imaging

Multidisciplinary Breast Cancer CareHMH pioneers new tool for cancer patients

Hardin Memorial Health recently began utilizing

a new device to help cancer patients prevent hair

loss while undergoing chemotherapy treatments.

Funding from the HMH Foundation allowed HMH

to be the fi rst in Kentucky to off er the Paxman®

Scalp Cooling System.

The system uses a “cold cap” to reduce the scalp

temperature immediately before, during and after

a chemotherapy treatment. The cooling reduces

the blood fl ow to hair follicles which helps to

prevent or minimize the loss of hair.

HMH Cancer Care Medical Director Adam Lye, M.D.

touted the technology as an additional benefi t

HMH can off er patients who are facing an

emotional cancer journey.

“Patients often ask me if they are

going to lose their hair,” Lye said.

“With the Paxman® Scalp Cooling

System, we can try to alleviate

that stressor and allow the

patients to focus on their

treatment.” Lye said taking care

of the whole patient is critically

important. “We know when

we also take care of patients’

emotional and spiritual needs, it

helps to optimize healing.”

Jamie OwenFirst patient to use Paxman Cooling Caps


Multidisciplinary Breast Cancer Care Team

Audrey Cleaver, BSN, RN Nurse Navigator

Sarah Callahan, M.D.Radiology

Gwen Godfrey, D.O.Pathology

Karen Johnson, M.D. General Surgery

Ashley Kerekes, M.D.Plastic & ReconstructiveSurgery

Adam Lye, M.D.Hematology/Oncology

Chandler Park, M.D. Hematology/Oncology

Richard Seither, M.D.Radiation Therapy

Sidney Verble, M.D.Pathology


Multidisciplinary Lung Cancer Care

A multidisciplinary lung clinic began in November 2016

to support the large number of new annual lung cancer

cases in the Lincoln Trail District to improve the timeliness

of care for newly diagnosed patients with cancer. The

clinic minimizes the number of visits the patient requires

while providing comprehensive multidisciplinary cancer

care close to home.

Patients with lung nodules, worrisome diagnostic fi ndings,

or a new diagnosed lung cancer are seen on Tuesday

afternoons following a lung tumor board. The clinic is

led by Hardin Memorial physicians Dr. William Cundiff ,

Dr. Aaron Mulhall, and Dr. Navin Kaini (pulmonology), Dr.

Jordan Miller (University of Kentucky thoracic surgery), Dr.

Richard Seither (radiation therapy), and Dr. Adam Lye and

Dr. Chandler Park (medical oncology). The comprehensive

team also includes radiologists, pathologists, a nurse

navigator, oncology social worker, and others.

Since its inception, volumes have increased from two

new cancer cases monthly to greater than 10 new lung

cancers monthly. The clinic will expand from a half day

clinic to a full day clinic beginning in January 2018 to be

able to accommodate the increase in case volume. Dr.

Lye noted that all participating physicians and patients

appreciate the one stop service and obtaining cutting

edge comprehensive care closer to home. Dr. Park added

the multidisciplinary clinic is instrumental for patients

who wish to remain in the 10 county service area of HMH.


Adam Lye, M.D.Hematology/Oncology

Multidisciplinary Lung Cancer Care Team

William Cundiff , D.O. Pulmonary/Critical Care

Navin Kaini, M.D.Pulmonary/Critical Care

Kelli Mathew, D.O.Pulmonary/Critical Care

Aaron Mulhall, M.D. Pulmonary/Critical Care

Chandler Park, M.D. Hematology/Oncology

Jordan Miller, D.O.Cardiothoracic SurgeryUK HealthCare

Richard Seither, M.D.Radiation Therapy

Connie Barnes, MSN, RNNurse Navigator

Gwen Godfrey, D.O.Pathology

Sidney Verble, M.D.Pathology

Ronald Wurth, M.D. Radiology

Jessie Bryant, M.D. Radiology


Clinical Trials

The National Comprehensive Cancer Network (NCCN)

“Believes the best management for any cancer

patients is in a clinical trial.” Clinical trials play a major

role in advancing the science of fi ghting cancer at

all levels. HMH oncologists follow NCCN guidelines

in the treatment of their cancer patients and HMH’s

Cancer Center is accredited by the American College of

Surgeon’s Commission on Cancer.

The mission of the clinical research program is to reduce

the impact of cancer by increasing awareness of new

evidence, trends and practice standards. It is our goal to

increase the involvement of those in the community to

participate in cancer research activities creating more

opportunities for community based research services.

When patients receive care at HMH Cancer Center,

they also have access to information on clinical trials

– upcoming new treatments that seek to improve

responses in cancer treatment, prolong live and improve

quality of life. Expert care close to home.

Each clinical trial asks specifi c questions, such as: Is

this more durable; is it less toxic with same outcome;

or better outcome? Cancer clinical trials are strictly

governed by protocols that outline each step. Every

detail of the trial is reviewed to determine need,

usefulness, and importance of the data collected. Each

individual trial is evaluated to ensure patient safety by

an Institutional Review Board (IRB), consisting of medical

experts, scientists, and other impartial members.

Cancer treatment clinical trials are studies involving research to fi nd more durable and successful ways to treat cancer.


As an affi liate of the University of Kentucky Markey

Cancer Center, the state’s only NCI-designated Cancer

Center, we off er patients access to national clinical trials

and NCI medical expertise. HMH participates in the NCI

and National Clinical Trial Support Unit (CTSU) through

the University of Kentucky.

We are also affi liated with the Kentucky Clinical

Trial Network (KCTN), sponsor for one of our current

trials, “Optimization of Smoking Cessation Strategies

Concurrent with Treatment of Tobacco Related

Malignancies (MOST).” This trial focuses on patients

currently undergoing treatment for tobacco related

cancers wanting to stop smoking. HMH has consistently

remained the top enroller for this trial among nine other

sites in the state for three years.

A recent trial opened is the Kentucky Lung Education

Awareness Detection and Survivorship (LEADS) Trial in

collaboration with the University of Kentucky, University

of Louisville, Kentucky Cancer Consortium, and Lung

Cancer Alliance, and is funded by a grant from Bristol-

Myers Squibb Foundation. This trial focuses on provider

education and importance of low dose CT in early

detection and survivorship care in regards to lung cancer.

In searching for a cure for cancer, knowledge increases

leading to new therapies and constantly evolving

treatments; that is why clinical trials research is important

to the patient diagnosed with cancer. Clinical trials

potentially off er access to therapies that could be years

away from public use before they become available as

standard of care. The clinical trials of yesterday are the

standard of care today. New and better therapies are

unattainable without the generosity and caring of those

cancer patients who want to give a little more.

Talk to your doctor about clinical trials, and for more

information or to learn about eligibility requirement for

the trials we off er, call the Clinical Trial Offi ce at

(270) 706-5470, and ask for the Research Coordinator.

“We look forward to increasing our clinical trial portfolio with the exciting future and promise of clinical trials, and in the improved survival and quality of life of our patients.”

Chandler Park, M.D.


Community Outreach

Public Reporting Outcomes

Community Health Initiatives: Cancer Prevention and Screening Awareness

WOW Wellness on WheelsSM mobile health unit provides regional monthly preventive

health and wellness screenings in Hardin, Meade, LaRue, Nelson and Grayson counties.

From January – September, 338 community clients visited the WOW, and 152 clients

voluntarily shared they are up to date regarding preventive cancer screening for breast,

colon, skin and lung. Noting, 45% of the clients are following the American Cancer Society

recommended guidelines for cancer preventive screenings for breast, colon, skin and lung.

Cancer Health Initiatives on WOW

150

125

100

75

50

25

0 Breast Colon Skin Lung Counseled regarding

preventive screeningInformationdistributed

Follow up to encourage appointment


Tobacco/Smoking CessationAdult Focus

Hardin Memorial Health off ers a variety of assistance to help individuals become tobacco

free: Cooper/Clayton Method of Stop Smoking, and Live Smoke Free! smoking cessation

support group. However, no courses were implemented due to lack of registration.

Tobacco cessation resource packets were mailed in conjunction with telephonic

counseling for 12 community participants who inquired about assistance along with

referrals to the Quit Line.

Wellness coaching through a Well@Work worksite wellness provided assistance to a local

employer working with employees to earn health insurance incentives for becoming

tobacco free. Ninety clients indicated they were tobacco users. Clients were referred to

the 1-800-QUIT NOW Kentucky tobacco cessation assistance phone line. Ten employees

completed the Quit Line earning a certifi cate for telephonic tobacco cessation. Of the

10 employees, one employee became tobacco free and two other clients indicated a

signifi cant decrease in tobacco usage continuing on the path to becoming tobacco free.

CANCER PREVENTION % SCREENED COUNSELED INFORMATION FOLLOW UP INITIATIVES

BREAST HEALTH 91% 90 25 15

COLON HEALTH 91% 139 48 16

SKIN HEALTH 38% 57 55 3

LUNG HEALTH 39% 60 10 4

Demographics: Male: 53 • Female: 99 • African American: 11 • Hispanic: 0 • Caucasian/Other Nationality: 141

Regarding Preventive Screenings


Youth Focus

Recognizing smoking is the leading cause of lung cancer linked to 80-90% of lung cancers, in

January 2017 Hardin Memorial Health implemented Botvin Life-Skills Training evidence-based

tobacco prevention program for middle school students; reaching an average of 180 6th

grade students at LaRue County Middle School. The initial pilot focused on the comprehensive

approach of health information, life skills and drug resistance skills specifi cally addressing the

dangers of tobacco abuse and promoting healthy alternatives to risky behaviors teaching

activities to resist social (peer) pressures to smoke.

Botvin LifeSkills prevention program cuts tobacco use by up to 80% with eff ect lasting up to

6 years. Therefore, for the 2017-2018 school year, 194 incoming 6th grade students started the

program with the returning students from 2016 now in 7th grade continuing the program

this winter.

Pre-Post Test Results from 2016-17 school year 6th grade students:

Pre-Tests with the following results to the question: How likely would you be to say “No” when

someone off ered you a cigarette were administered to Group 1 and Group 2.

Group 1: 91 pre-tests administered, however post-test was unavailable due to teacher not

returning post-tests.

Group 2: 93 students participated in pre & post-testing.

PRETEST RESULTS GROUP 1 | GROUP 2 POSTTEST RESULTS GROUP 1 | GROUP 2

Defi nitely Would Say “No”: 77.0% 87.1%. Defi nitely Would Say “No: 0.0% 89.0%

Probably Would Say “No”: 2.0% 3.2% Probably Would Say “No”: 0.0% 5.0%

Not Sure If I Would Say “No”: 2.0% 0.0% Not Sure If I Would Say “No”: 0.0% 1.2%

Probably Would Not Say “No”: 0.0% 1.0% Probably Would Not Say “No”: 0.0% 0.0%

Defi nitely Would Not Say “No”: 8.0% 7.5%. Defi nitely Would Not Say “No”: 0.0% 2.4%

No Answer To The Question: 2.2% 1.2% No Answer To The Question: 0.0% 2.4%

The 7th grade students (previously) 6th grade students, will be pre-tested and not post-tested

until after the completion of the entire program. Additionally, we plan to ask if they would

choose to smoke; if they have tried; or if they are currently using any tobacco products. Upon

conclusion of the entire pilot, a post-test will be administered to 8th grade students which

includes the questions regarding life skills content.


• 26 kits distributed

• Kits returned testing negative: 12 female, 5 male

• Kits returned testing positive: 1 female (had colonoscopy follow up-all clear)

• Kits never returned: (patient was contacted by Kentucky CancerLink three times and last attempt letter was mailed with no response)

• 5 females

• 2 males

• 1 male did not complete the kit, however he completed a colonoscopy (results: client had 2 polyps removed).

Other Prevention AndScreening Initiatives

Dress in Blue DayMarch 3, 2017

In recognition of Colorectal Cancer Awareness Month, HMH collaborated with Kentucky

CancerLink to provide OC-Light® FIT fecal immunochemical test screening method

for hemoglobin in stool as an early screening method to detect colorectal cancer. The

community outreach awareness event encouraged individuals to learn risk factors for

colorectal cancer and discover recommended prevention screening guidelines for

colorectal cancer. Starting in March, 26 FIT kits were distributed with 19 kits returned to

KY CancerLink for follow up regarding test and discussion of fi ndings.

Results from 3/3/17 - 10/25/17


Purses, Pumps and Prevention: A Cancer Awareness Social April 20, 2017

Recognizing April is National Cancer Control Month, Hardin Memorial Health held its

second annual community cancer prevention awareness program featuring a fashion

show, dinner and educational program for participants to learn about breast, colorectal,

cervical, skin and lung cancer prevention to the 190 attendees. Cancer prevention

educational handouts were provided in addition to local support and resources. A pre

and-post cancer survey was administered to participants to encourage adult individuals

to recognize cancer prevention screening recommended guidelines and seek appropriate

medical assistance.


Purses, Pumps and Prevention: A Cancer Awareness Social Statistics

Average Age: 50

Ethnic Origin: Caucasian: 68 • Hispanic: 2 • Asian: 1 • Mixed: 2 • Native American: 1

Pre-Event Questionnaire

Background Yes No N/A

Do you have a family history of cervical cancer? 6 87 0

Do you have a family history of colon cancer? 24 71 1

Do you have a family history of skin cancer? 24 66 0

Do you have a family history of breast cancer? 25 65 1

Do you have a family history of lung cancer? 18 74 0

Do you use tobacco products? 3 89 0

I am a cancer survivor 10 60 18

*1 is a current cancer patient

Within the past year, I have completed:

Annual physical by my primary care provider (PCP) 83 9 0

Pap Smear 69 17 2

Colonoscopy 26 61 4

Routine skin self-exam 72 18 0

Mammogram 62 28 2

Monthly breast self-exam 67 22 2

Post-Event Questionnaire

Yes No AlreadyScheduled

Annual physical by my primary care provider (PCP) 33 8 20

Pap Smear 29 12 15

Colonoscopy 11 39 5

Routine skin self-exam 41 8 8

Mammogram 26 18 14

Monthly breast self-exam 46 7 0

*About 50% of participants turned in a questionnaire. Of these 50%, numerous questions were left unanswered.


Screening Programs

Screening Program: Skin Cancer Screening June 9, 2017

In recognition of National Skin Cancer Detection and Prevention Month, a free skin

cancer screening was provided: 64 community members screened following the

American Academy of Dermatology (AAD) screening guidelines with the assistance

of 3 local dermatologists. Educational materials from the American Academy of

Dermatology and National Cancer Institute were distributed to promote skin cancer

prevention. Demographics below:

Average Age: 50

General Cancer Awareness/Prevention Activities

Numerous regional festivals and organizational health fairs off ered the opportunity

to provide 10 educational cancer prevention encounters reaching over 3,000

community members.

Topics of focus from colorectal, skin, breast and lung aligned with the National Cancer

Awareness Health Observance months. Healthcare professionals also shared prevention

tips from dietary, exercise and behavior modifi cation to encouraging early detection

through screening.

Submitted by: Karen G. Blaiklock, MS, RN Communications and Community Relations Director, HMHCommunity Outreach Coordinator, Cancer Committee

22 42

30 referred for follow-up

(15 males and 13 females)

10 biopsies recommended


Survivorship At Hardin Memorial Health (HMH), patients completing curative treatment receive

a survivorship care plan and treatment summary. The cancer committee develops,

monitors and evaluates the dissemination process of these care plan and treatment

summaries, annually.

The Institute of Medicine report “From Cancer Patient to Cancer Survivor” outlines the

importance of providing cancer survivors with a comprehensive summary of treatment

received, post treatment needs and follow-up care to improve health and quality of life.

The American Society of Clinical Oncology (ASCO) defi nes the minimum data elements

to be included in the treatment summary. The HMH Cancer Center uses Journey

Forward disease specifi c templates.

A survivorship nurse navigator identifi es appropriate patients who have completed

curative therapy. Curative therapy includes surgery, chemotherapy, immunotherapy,

and or radiation. The survivorship nurse navigator meets with the patient to review the

survivorship care plan within the requirements for timely delivery. A copy of the care

plan is shared with the Primary Care Physician.

The Commission on Cancer introduced this standard in 2012 with a gradual roll out

beginning in 2015. For 2017, 50% of the patients completing curative treatment must

receive a survivorship care plan.

DeAnna Werle, RN, BSN, OCNSurvivorship Nurse Navigator


521 Robinbrooke BlvdElizabethtown, Kentucky 42701

www.hmh.net

hardin memorial health...at hardin memorial health, cancer care is a top priority. we utilize...

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