South SacramentoMedical Center

Annual Cancer Report 2017

The Permanente Medical GroupCommission on Cancer Committee

VisionSouth Sacramento’s Comprehensive Community Cancer Program is

committed to improving the survival, quality and effectiveness of care provided to people diagnosed and living with cancer.

Our Cancer Care Mission is SimpleSupport our specialists in providing the best in personalized cancer care. Kaiser Permanente’s

integrated health care system brings together a team of specialized physicians and cutting-edge technology to provide each patient with the best in personalized care.

OUR COMMITMENT to PatientsCancer care touches our lives both professionally andpersonally. It is a top priority at Kaiser Permanente. All of our physicians work on cancer in one way or another—whether to prevent it, detect it early, treat it when we findit, care for the survivors, or comfort those who may passaway as a result of the disease. We’ve made huge stridesand continue to challenge ourselves through ourcommitment to every patient.

Appendix……………………….….……14OUR WORLD-CLASS Cancer Care Team includes:

• Experienced specialists who treat high volumes of patients

• Support at every step of care: risk reduction, screening, diagnosis, treatment, and survivorship

• Seamless and timely care coordination• Cutting-edge technology• Patient-centered care

Our specialists work collaboratively to ensure world-classcancer care treatment and outcomes for every patient, byleveraging our expertise, investing in cutting-edgetechnology, and pushing the boundaries of what’s possible.

Cancer Care AchievementsIntegrated Approach to Cancer Care..6

Commission on Cancer Accreditation..9

Kaiser Permanente’s Cancer ResearchPaves the Way forImproved Outcomes…………… 12

Trends in Cancer Diagnosis…………..13

Cancer Care AchievementsCancer care is complex. We simplify screening, diagnosing, and treating

patients with cancer through our integrated approach to care.

We continuously weave advancements in equipment and techniqueswith each patient’s medical history, preferences , and unique needs.This means we can automatically review incidental findings, such as athoracic imaging study that can be reviewed by various experts. Thisprocess facilitates rapid and consistent follow-up on unexpectedcancer discoveries at imaging.

Our expert care team will work together to:• Review newly flagged cases• Meet with each patient to discuss next steps, treatment

options, and personalized care recommendations

It is the same as getting a second, third, and fourth opinion at thestart of the process.

Our integrative approach to care also allows us to apply the most effective screening protocols to save more lives, such as using universalreflex genetic testing for Lynch Syndrome of all newly diagnosedcolorectal cancer patients.

Our multidisciplinary physician team will:

• Recommend multiple ways to provide patient centered care• Bring cutting-edge treatment to patients

This multidisciplinary approach is distinctive of our medical group anddoesn’t exist in the fragmented fee-for-service health care sector.We’re able to standardized the best possible care, giving our patientstheir best chance to beat cancer.

Integrated Approach to Cancer Care

As one of the largest integratedhealth care systems in the UnitedStates, we can quickly adapt toadvances in treatment. We bringthose benefits to our patientsevery day to perform thousandsof treatments each year. At the same time, we create trulytransformational innovations.Both rapidly adapting anddeveloping new advancement s isonly possible by leveraging our specialists’ knowledge from manydisciplines and medical centerslinked together by our electronic health record system.

Integrated Approach to Care

Kaiser Permanente South Sacramento ‘s comprehensive and integrated approach to care ensures cancer specialists work together to evaluate each patient’s case and then meets with the patient to discuss treatment options and recommendations.

For the newly diagnosed patients with cancer, the Nurse Care Navigator is the point of contactwho works to ensure our members are connected with each of the disciplines (MedicalOncologist, Radiation Oncologist, Psych, Dietician, Radiology, etc.)A treatment plan that couldnormally take weeks to develop is completed in days and treatment can begin quickly.

Multidisciplinary Tumor Boards• North Valley and South Sacramento: Joint Lung Cancer LNP• North Valley and South Sacramento: Joint Hepatobiliary• Breast Cancer• Lower and Upper Gastrointestinal Cancer• General

At Kaiser Permanente, we take pride in our ability to consistentlydeliver comprehensive care toour cancer patients. The complexity of this disease requires the close collaboration of our entire care team workingtogether to design treatment plans using the best available medical expertise andtechnology. Our robust electonicmedical record system andunique integrative model of care,which encompasses the healthplan, hospitals, and medicalgroup providers, enables us toseamlessly coordinate the care provided by our dedicatedphysicians, specialists, and staff. This coordination ensures our patients receive superior care from experienced health care professionals in a safe and secure environment.

Primary Care Surgery

Radiation Oncology

Medical Oncology

Radiology: Diagnostic& Intervention

GI/Pulmonary

Patient-Centered Care

PATIENT

CANCER CARE represents a large portion of our work at Kaiser Permanente. Only heart disease affects more people than cancer in the United States, and the number of cancer cases is quicklygrowing to surpass heart disease soon. We have an opportunity that other health care systems

may not–to change that trajectory. The Commission on Cancer provides a foundation to focusonkey quality care standards and our cancer program can lead this change.

Commision on Cancer AccreditationThere are more than 1,500 Commission on Cancer (CoC)accredited cancer programs in the United States, representingonly 30 percent of all hospitals and more than 70 percent ofall cancer patients. All Kaiser Permanente facilities areaccredited or pursuing accreditation. To earn this prestigiousaccreditation, a cancer program must meet or exceed 34quality care standards, be evaluated every 3 years, andmaintain levels of excellence in the delivery of comprehensivepatient-centered care.

When cancer patients seek care at a CoC accredited cancercenter, they gain access to comprehensive, state-of-the artcancer care close to home. Kaiser Permanente takes this onestep further. Our integrated health care system allows for truemultidisciplinary, end-to-end care, and treats cancer as acomplex group of diseases treated by a team of specialists.Because of this approach, patients have access to clinicaltrials, new treatments, genetic counseling, and patient-centered services, including psychosocial support, patient navigation, and a survivorship care plan. We improve ourpatients’ quality of life―both before and after cancer. Theseintegrated partnerships result in improved patient care.

Clinical Trials Matter to UsWe’re proud to offer cancer patients access to cutting-edge treatment through

participation in clinical trials.

TRENDS in Cancer Diagnosis

The cancer registry is an essential component of the Commission on Cancer (CoC) accreditedcancer program and an invaluable tool in the fight against cancer. Like all CoC-accreditedfacilities, Kaiser Permanente maintains a cancer registry and contributes data to the NationalCancer Database (NCDB). This nationwide oncology outcomes database is the largest clinicaldisease registry in the world. All types of cancer are tracked and analyzed through the NCDBand used to explore trends in cancer care. CoC-accredited cancer centers, in turn, have accessto information derived from this type of data analysis, which is used to create national, regional,and state benchmark reports.

Our cancer registry data aids in identifying trends, assists in program planning, and allows ourcontinuous evaluation of cancer care.

Specialists at this hospital interface with patients throughout our system. Our specialists’experience within the system is summarized in Table 1.

Table 1. Kaiser Permanente, Northern California Region

All Cancer Cases Diagnosed 2011―16: All Behaviors, All StagesLeading Diagnoses by Year of Diagnosis (Ranked for 2016 Diagnoses)

Cancer Screening and Prevention

Lung Cancer Screening Using a Low-Dose CT ScanKaiser Permanente South Sacramento implemented the Lung Cancer Screening Using a Low-Dose CT Scan Program in 2017. We have made screening and early detection a top priority. Patients eligible for lung cancer screening must be:• Between the ages of 55-80 years old• A 30 pack-year history of smoking• Current smoker, or a former smoker who has quit within the past 15 years• Healthy enough and willing to undergo surgery if needed

Eligible patients are referred to a pulmonologist-led class to better understand the process of lung cancer screening, including the benefits and risks.

Following the class, patients meet one-on-one with a pulmonologist to decide if lung cancer screening is the best choice for them. If it is beneficial for a patient to pursue this screening opportunity, he/she receives a low-dose CT exam annually to screen for lung cancer.

Colorectal Cancer Prevention- House CallsEach month, Kaiser Permanente physicians and other clinicians host telephone group visits on a variety of health topics. The program, called House Calls, allows members to learn how to prevent and manage health conditions and ask questions during recorded sessions. “Colon Cancer Shouldn’t Happen” was the topic in April 2017. A total of 2,841 participants joined in on the call.

Colon cancer (52%) is one of the overall cancer mortality and cancer incidence rates that are high within the South Sacramento hospital service area. The screening rates are particularly low among the African-American (13.09%) and Latino (25.7%) member population, per the South Sacramento Kaiser Permanente community needs assessment.

In the Community

Sacramento Kings Cancer Caregiver Night• Cancer patient testimony video shown to

17,000 Kings fans• Caregivers recognized• Videos posted on KP Twitter,

YouTube, and websites

Earned Media• FOX 40 interviewed KP physicians and

clinical staff in a series of breast cancer stories during Pink Week in October, including stories that covered the importance of mammograms, coping emotionally with breast cancer, and breast cancer recovery exercises and stretches.

Lung Cancer PreventionThrough our “ Don’t Buy the Lie” anti-smokingprogram, students from local elementary, middle and high schools can participate in assembliesand a billboard/poster design contest to:• Influence teens to not start smoking• Make the connection between smoking and

lung cancer• Increase teen & community awareness of the

dangers of smoking• Influence smokers to quit

Skin Cancer PreventionSunscreen bars and cancer prevention educationalmaterials featured at high-profile KP-sponsoredcommunity events, including ...• Elk Grove Multicultural Festival• KP Women’s Fitness Festival• Downtown Walk to Thrive• Running of the Elk Half Marathon• Kids Ninja Warrior and Family Fitness Festival• California State Fair• Farm-to-Fork Festival

Health Education Brochures Distributed in theCommunity and in Health Education CentersOpen to Non-Members• Eat Well Be Well• A Healthy Diet and Physical Activity Help

Reduce Your Cancer Risk• Kitchen Tips To Get You Eating Plant-Strong• What is Healthy Plate? Picture Diagram• Phytochemicals in Your Diet• ACS: Get Your Tests! Men & Women Age

Range Cancer Screening• Food, Nutrition, Physical Activity, and the

Prevention of Cancer: A Global Perspective• Vegetarian Starter Kit

Classes and Support Groups offered at SouthSacramento:

• Pathways to Emotional Wellness - Your thoughts and emotions canaffect your physical well-being

• Mindfulness Meditation - Teaches mindfulness meditation techniques andgentle movement (Tài Chi) to increase mind- body awareness and coping

• Yoga/Pilates - Provides physical and emotional centering, increasedendurance, and maximized energy

• Life Care Planning - Focuses on Advance Health Care Directive,helps ensure that your wishes are respected

• Cancer Support Group - Provides information, education and supportregarding illness, treatment, care planning and access to communityresources

• Breast Cancer Survivorship Class - This one time class addresses some ofthe most common issues of cancer survivorship including fear ofrecurrence, ways to decrease recurrence risk through lifestyle choices, andlate and long- term side effects of breast cancer treatment

• Chemo Introductory Class - Preparation for chemotherapy, understandingthe administration of drugs, and the type and frequency of treatment

• Nutrition during Cancer Treatment- Good nutrition can help boost your immune system, increase strength and energy, maintain body’s store of nutrients, and help recover faster from cancer treatment.

• Physical Therapy- For all patients who have had breast cancer surgery or for patients who have completed their treatment and have questions about getting back to life, work and leisure activities

• Coping with Cancer and treatment- can impact lives in ways never imagined. As many expect, it can cause a full range of emotions, but can also trigger changes at home and work, with relationships, memory problems and much more. Sometimes these changes can also effect physical functioning and recovery. Whether you know you need support or just have questions, our behavioral medicine psychologist who specializes in oncology is available for referral upon request.

Survive and Thrive, an ongoing cancer support program, providingclasses and resources tohelp nourish the mind, body and spirit in allstages of cancer treatment, survivorshipand healthy lifestyles.

Cancer Care Team

Oncology/Infusion Team Members

• Ahdia Herawi• Cawauna Newton• CatherineGuider• Catalina Siewert• Christiana Kallon• Christian Elders-Owens• Delilah Peppers• Elizabeth Notestine• Heather Fuentes• Hilary McConaghy• Jennifer Watts• Jessica Dakan• Joseph Elmer• Lan Ngo• Maria-Sandra Montecillo• Maria Plan• Megan Morris• Melanie Heatwole• Melody Jemmett• Patrice Jarreau• Shavonne Green• Rocio Duenas• Rosemarie Jensen• Samantha Figueroa• Teresa Costanza• Terri Cook• Terry Phan• Thelma Flores• Tina Rolak

Cancer Committee Members

Karin Hartkamp

Kaiser Permanente South Sacramento6600 Bruceville Road

Sacramento, CA 95823

kp.org/southsacramento