Transforming Cancer Care for a

Hopeful Future2014 Annual Report

“I received the gift of life... now I can give back.“Lori (pictured on cover) had early stage cancer hidden in her breast tissue. She credits 3-D mammography

and the expertise of the comprehensive breast care team at Jupiter Medical Center with saving her life. Lori

experienced comprehensive breast care, from diagnostics, to breast surgery, to partial breast irradiation.

Today, Lori is healthy and thankful for the care she received at the Foshay Cancer Center.

Lori Cote Breast Cancer Survivor

“When the diagnosis is cancer, patients want world class care close to home.“

It is my pleasure to reflect on a year filled with many exciting accomplishments and initiatives. We are committed to providing our patients the highest quality physicians, cutting-edge technologies and the best standard of care—all in a world-class environment. As we move forward with our mission to evolve a comprehensive cancer care program, we are transforming how we care for our patients by modeling ourselves after top academic medical centers and employing a multi-disciplinary approach to patient care.

An astounding 1,665,540 newly diagnosed cancer cases and 585,720 cancer-related deaths occurred in the U.S. in 2014—these are startling figures. Our ability to impact cancer care in South Florida is unparalleled, and it starts with our highly trained health care team that includes some of the world’s best educated physician specialists who are experts in their field, compassionate in their work and wholly dedicated to cancer prevention, early detection and diagnosis, and treatment using the most advanced technologies available.

In 2014 we acquired our second surgical robot, making us one of the first programs in the world to offer the new da Vinci® Xi™ System, in addition to a breakthrough intraoperative radiation therapy method, e-IORT, which dramatically reduces treatment and recovery time for cancer patients. Another milestone was the groundbreaking of the new oncology campus— Phase 1: the Margaret W. Niedland Breast Center, which opened in April 2015.

The newest technologies combined with the latest in genetic screenings, research, clinical trials, molecular treatments and immuno-therapies help define us as a world-class regional cancer center.

Treating the disease is only one aspect of patient care. At the Foshay Cancer Center, we treat the whole person through our evolving oncology, health and wellness, and integrative medical programs that address the full spectrum of mind, body and spirit.

In these pages, we report on our impressive progress and the mission of cancer care for our patients, forging a future of hope to prevent, diagnose and treat all cancers for all patients in our region. We congratulate the many accomplishments achieved by our physicians and staff this past year and thank them on behalf of all of our patients with cancer and their families.

Abraham Schwarzberg, MD Chief of Oncology

Jennifer didn’t want a ‘one size fits all’ approach to treating her breast cancer. After having e-IORT, she felt

the same the day after surgery as she did the day before. She appreciated the forward looking, out-of-the-

box thinking that makes the cancer program unique.

“I met women from all over the state who came here because they knew something special was going on.“ Jennifer Munro, Breast Cancer Survivor

The latest technology in cancer care offers specialized treatment for cancer patients, particularly with breast cancer, enabling physicians

to deliver a single dose of radiation to patients during their surgery.

We set out to educate the community through discussions about the latest in imaging capabilities, such as the most advanced CAT scan,

PET and MRI, and the new technologies available at the Foshay Cancer Center to diagnose and treat cancer. The acquisition of Liac 12,

an Electron Beam Intraoperative Radiation Therapy (e-IORT) mobile linear accelerator, also was a great accomplishment in 2014.

It is these new technologies, medicines and treatments that make the Foshay Cancer Center successful in the management and treatment

of our cancer patients. Our focus as we look ahead is better imaging capabilities with combination anatomical/metabolic PET on active

tumors in order to spare as much normal tissue as possible with more accuracy and faster and fewer side effects. We are excited to

continue to provide the best of the best in health care professionals, facilities and technologies to our patients.

“The wave of the future is better imaging, and the ability to provide our cancer patients with the best technologies available puts us at the top of that wave.“

Anthony E. Addesa, MD Medical Director

Radiation Oncology

An annual report gives us the opportunity to take a moment to reflect on the past, look at our current status, and determine where we

would like to be in the future. Our goal is always to serve patients in the best way possible.

Our focus for 2014 was quality and physician relationships. In reflection, it was a year of building—adding new, highly educated and

expert physicians to our cancer care team, enhancing our surgical program with the newest technologies and solidifying our position of

excellence in program modeling and teaching of specialty surgical techniques.

As leaders, we are progressive in the technologies we use to help fight cancer. The Foshay Cancer Center is now a teaching site for

navigational bronchoscopy and da Vinci® robotic surgery. We seek out the best. We are committed and dedicated to obtain the most

advanced equipment and highly trained health care professionals needed to accomplish what we set out to do—provide world-class

cancer care to each patient every time.

“With our philosophy of best physicians, best technology and best outcomes for our patients, I see hope, not loss.“

Thoracic Surgery & Surgical Oncology

K. Adam Lee, MD Medical Director

Our Comprehensive Breast Care Program, comprised of the Margaret W. Niedland Breast Center for diagnostics and the Kristin Hoke

Breast Health Program for treatment, earned reaccreditation from the National Accreditation Program for Breast Cancer (NAPBC) for

another three-year term. This esteemed accreditation demonstrates our commitment to world-class care.

We furthered our commitment to transforming how we treat cancers with the implementation of the Liac 12 Mobile Electron Beam

Intraoperative Radiation Therapy (e-IORT) system—a new method of delivering radiation in the operating room immediately after a tumor

is removed. The use of electron beams protects the body from unnecessary radiation to healthy tissue and provides excellent outcomes

for our patients. The benefits of e-IORT include reduced radiation exposure, reduced treatment time and a faster return to a normal quality

of life. In fact, e-IORT can reduce weeks of radiation treatment down to a single dose for many patients.

Jupiter Medical Center broke ground in 2014 to construct the new free-standing Margaret W. Niedland Breast Center as phase one of

Jupiter Medical Center’s new oncology campus. In addition to new facilities and technologies to better serve our patients, educating the

community about breast health was at the forefront of our activity in 2014. Foshay Cancer Center physicians presented numerous lectures

and discussions to community groups and staff participated in many breast cancer fundraisers including Susan B. Komen Race for the

Cure, American Cancer Society Strides, Hot Pink in Palm Beach, Blue Water Babes and Dragon Boat events.

Kristin Hoke Breast Health Program

Cutaneous oncology services launched melanoma conferences in 2014, which provide the opportunity for the best treatment planning

for cancer patients. This gives a forum for physicians with newly diagnosed melanoma cases to access a panel of experts in a variety of

specialties and develop a personalized treatment plan. We continue to face challenges in how we determine the optimal treatments for

patients, and our conferences foster an attitude of pulling together for the greater good.

With skin cancer being the most commonly diagnosed cancer in the United States and melanoma being the most deadly form, mapping

and genetic testing will become more common in identifying patients at high risk for developing melanoma.

As more and more people are diagnosed with melanoma, it is imperative that we provide experts to care for these patients. We are excited

to add two new dermatologists to our program, as well as host one or two continuing medical education (CME) programs for the coming

year and further develop our multidisciplinary conferences to discuss individual patient cases. Also, we will continue our commitment to

be active in our outreach to educate and perform skin cancer screenings.

“Integration with other specialties is refreshing. We know we can do better by working together.”

Cutaneous OncologyDavid A. Lickstein, MD Medical Director

Genitourinary oncology services at Foshay Cancer Center experienced a successful 2014. We organized and implemented a

multidisciplinary monthly conference in which different specialties join together to help streamline cancer care and bring more immediate

attention to patient care issues. The conference aims to provide the best treatment plan for the individual patient.

In spring 2014 we attended the W. B. Ingall's Memorial Prostate Health and Cancer seminar at Scripps to explore options for community

programs as part of our outreach efforts. We began preparations for a 2015 prostate seminar and the introduction of blue light

cystoscopy, innovative technology to aid in the diagnosis and treatment of bladder cancer. Blue-light cystoscopy increases the visibility of

bladder tumors and reduces chances of cancer recurrence.

As a practicing urologist with an oncology focus, I envision Foshay Cancer Center's future to include a multidisciplinary environment in

which to treat patients with genitourinary malignancies.

“In speaking of the Cancer Center team and hospital administration, the energy and attitude are refreshing; I am hopeful for the future.“

Genitourinary OncologyR. Neill Borland, MD Medical Director

“It is our excellent patient outcomes, combined with our multi-disciplinary physician team, highly trained staff, a dedicated thoracic patient navigator and leading-edge technology that allow us to sustain our world-class status..“

Lung cancer is the leading cause of cancer deaths in both men and women. More people die of lung cancer then colorectal, prostate

and breast combined. Jupiter Medical center recognized this dilemma and established the thoracic surgery and lung program within

the Foshay Cancer Center. This strategic initiative designed a multidisciplinary approach for the diagnosis and treatment of lung and

esophageal cancer for patients in Palm Beach and Martin counties and other extended regional areas.

We are recognized nationally for one of the most sophisticated minimally invasive surgery centers in the world. Our team has pioneered

leading-edge minimally invasive and robotic procedures and early detection utilizing electromagnetic navigational bronchoscopy. The

first in the nation to offer the Veran™ Medical Technologies Total Navigation Oncology Solution—a comprehensive technology enabling

easier navigation to lung, liver and kidney biopsies—we became one of only seven hospitals in the nation to be named a Veran Center

of Excellence. Our Center of Excellence has been recognized nationally for a teaching site for navigational bronchoscopies as well as for

robotics and minimally invasive surgery.

Thoracic Surgery & Lung Center of ExcellenceK. Adam Lee, MD Medical Director

When Bud, a retired Marine, discovered he had lung cancer, a patient navigator walked him through the

entire experience – from pre-op, to surgery and rehabilitation. Today, Bud is cancer-free and credits the

entire Thoracic Surgery & Lung Center of Excellence team at Jupiter Medical Center with saving his life.

“I told Dr. Lee I needed somebody to not only cure my lung cancer, but to take me through the whole process.“ Harold “Bud” Stambaugh & best friend Freedom

We've made great strides in 2014. With a more formalized academic model of care and a surgical landscape exploding with potential, the

Foshay Cancer Center is taking advantage of every upgrade available at Jupiter Medical Center. We've enhanced our surgical technologies

by offering more minimally invasive techniques, including robotic surgeries. Gone are the days of radical surgeries requiring 8 - 12-week

recovery times and extensive scarring. Now, with robotics, our surgeons operate with steady, natural movements and enhanced ergonomics

using the latest technology available. With the da Vinci® Xi and Si Platforms assisting, the surgeon can remove tumors, gallbladders,

ovaries, and even perform full hysterectomies through a single-site one inch incision, or through three to five even smaller incisions.

The Foshay Cancer Center is at the forefront of transforming the delivery of cancer care to our communities. For instance, sentinel node

biopsy, a surgical procedure used to determine if cancer has spread beyond a primary tumor into an individual’s lymphatic system, is used

most commonly in evaluating breast cancer and melanoma. Recently, the use of sentinel node biopsy is increasing in cervical, uterine and

ovarian cancers, proving to be a valuable procedure and technique to obtain critical information and minimize side effects and scarring.

This is an exciting time in medicine—with state-of-the-art surgical tools, discoveries of new drug combinations and multi-modality

treatments, such as the use of neoadjuvant chemotherapy, which reduces the size of a tumor prior to surgery, thereby allowing for a

minimally invasive procedure. Patients are getting better care than ever with new advances available every day. Exciting work is being done

in the exploration of the human genome to help identify a family predisposition for cancer. Prevention in the form of vaccinations such as the

HPV vaccine and treatments will someday help eradicate many cancers, including many cervical, bladder and head and neck cancers. We

look forward to another great year at Jupiter Medical Center.

“Just as our grandparents never imagined a man could walk on the moon, I never imagined we would perform radical cancer surgery through tiny incisions or through a single site with robotic assistance—leaving a patient virtually scarless!“

Robotic SurgeryDonna Pinelli, MD Medical Director

Type of Surgery 2014

Open Approach, not otherwise specified (NOS) 386

Robotic Assisted 117

Robotic Converted to Open 7

Total 510

76%Open Approach

23%Robotic Assisted

1% RoboticConverted to Open

2014 Open vs Robotic Surgery

2014

The Gynecologic Oncology Program at the Foshay Cancer Center is different than others in South Florida. We operate with a true

multidisciplinary team which includes board-certified gynecologic oncologists, a nutritionist and geneticist to guide patients through each

aspect of treatment. Our program provides innovative treatments for women with gynecologic cancers, including cervical, endometrial,

ovarian, uterine and vulvar cancers.

Our gynecologic oncology program is one of the most highly personalized in the industry, meeting each woman’s individual needs

through custom treatment plans coordinated through a team approach, and a personal navigator to guide patients each step of the way.

We recently acquired leading-edge surgical technologies that allow us to perform procedures like hysterectomies, myomectomies

and others with optimal convenience and comfort for our patients. Advanced minimally invasive treatments are revolutionizing the way

we treat gynecologic cancers with more accuracy and precision than ever, providing shorter hospital stays, less discomfort and a shorter

recovery period.

This year we have focused on furthering our commitment to preventing gynecologic cancer, not just diagnosing and treating it. Our new

screening protocols for melanoma, lung and HPV came from the Jupiter Medical Center Health Needs Assessment. These screening

protocols set the standard of care for our patients, ensuring we exceed national standards and enhance quality. It is through the needs

assessment that we brought the No Evidence of Disease (NED) feature-length documentary to our community last year and have

purchased the film in 2015 for our patient reference library and future educational events. The inspirational movie is about NED, a rock

band of six gynecologic oncologists who seek to bring more attention and awareness to women's cancers. It tells a touching story about

their lives, as doctors and as musicians, and the lives of their patients and their families—all joining together to fight gynecologic cancer.

We have also seen a great increase in genetics activity within the genetics risk and testing department in the past year. Having a

dedicated Genetic Clinical Nurse who helps women to map their family’s cancer history and determine their risk through BRCA genetic

testing has been an important element in our mission for prevention. We are only in the beginning stages of genetic testing capabilities,

but we have been able to use our findings to develop specialized plans for at-risk women to help lower their risk and possibly prevent

cancer from developing.

“Cancer patients are the most courageous people. I am privileged to work with them.“

Gynecologic Oncology and Oncology ResearchAntonella Leary, MD Medical Director

The Frank E. & Mary D. Walsh Robotic Surgery Program

The Frank E. & Mary D. Walsh Robotic Surgery Program added a second robot, the da Vinci® Xi™ Surgical System, to its armor of surgical

tools to treat cancer through minimally invasive surgery. JMC's Foshay Cancer Center is one of the first facilities in the world to possess

this technology. Four years ago, only two surgeons at Jupiter Medical Center operated with the robot—Donna Pinelli, MD, Medical

Director of the Robotic Surgery Program, and K. Adam Lee, MD, Medical Director of the Thoracic Surgery and Lung Center of Excellence.

Jupiter Medical Center surgeons now use the da Vinci surgical robots for a variety of specialties including thoracic, urologic, colorectal,

gynecologic and general surgery. More than 1,000 patients have received treatment with this remarkable technology that results in less

invasive surgery, less pain, blood loss, and scarring, lower risk of infection, shorter hospital stay and quicker recovery. Being the first

facility in Florida to offer robotic thoracic surgery and robotic gynecologic surgery using the new da Vinci® Xi™ Surgical System speaks to

our commitment to transform patient cancer care and build a hopeful future in South Florida.

The Cancer Committee is a multidisciplinary team comprised of representatives from physician specialties, nursing, administration, quality

services and the cancer registry. The goal of the Cancer Committee is to encourage plans for improvement and change, evaluate all

cancer-related activities and further strengthen services available to our cancer patients. The group meets bimonthly to monitor and

assess the oncology program to maintain compliance and ensure the American College of Surgeons Commission on Cancer requirements

are met.

The Cancer Committee also reviews current program research projects and considers the latest in clinical trials, all in the hopes of finding

ways to diagnose cancers earlier, discover new medications that prolong survival, or implement new surgical techniques that offer quicker

and less painful recoveries—and, perhaps someday find the key to stop cancer.

We recognize that the standards of our program affect the survival and quality of life for our cancer patients and so we continue to strive

toward goals that exceed national benchmarks.

As the Cancer Liaison Physician (CLP), a leadership role within the cancer program and a member of the Cancer Committee, I am

responsible for evaluating, interpreting and reporting the program’s performance using National Cancer Data Base (NCDB) data to the

Cancer Committee at least four times annually. We use that information to set and follow standards of care not only recognized by our

governing bodies, but ones that will set us apart from others so that we can provide high quality world-class care to the communities we

serve. Below is one example of the quality improvement measures initiated by the Cancer Committee this year.

Evaluation and Treatment Planning Study – Comparison of the Number of Lymph Nodes Removed During Colorectal Surgery to the

National Standard (Commission on Cancer Standard 4.5 – Quality Improvement Measures)

Globally greater than 1 million people get colorectal cancer yearly resulting in about 500,000 deaths. The National Quality Forum (NQF)

selected as a quality improvement measure that at least 12 regional lymph nodes are removed and pathologically examined for resected

colon cancer. Quality improvement measures are intended to be used for internal monitoring of performance within an organization or

group so that analyses and subsequent remedial actions can be taken, as appropriate.

Based on the result of this study the recommendation was to educate physicians on the national standard for removing lymph nodes in

colorectal cancer patients. Having educated our colorectal surgeons of the NQF standards there has been a significant improvement in

the lymph node collections.

K. Adam Lee, MD Cancer Liaison Physician

“The war we wage on cancer is so much more than surgery, radiation, chemotherapy, hormones, vaccines or research... it is waged by holding someone's hand, looking them in the eyes and letting them know you really do care about what happens to them.“

Cancer CommitteeThomas Rowe, MD Cancer Committee Chair, 2014

Clinical Research Trials 2014 Annual Report

The Clinical Trials Program at Jupiter Medical Center, under

the medical direction of S. Raymond Golish, MD, Chair of the

Jupiter Medical Center Institutional Review Board, offered many

exciting clinical trials in 2014.

Our research department achieved commendation status

with the Commission of Cancer and the NAPBC (National

Accreditation Program for Breast Centers) for clinical trial

accrual. Clinical trials offered at Jupiter Medical Center include

oncology-related trials, disease-specific trials such as stroke

and surgery studies, biospecimen trials, hyperbaric oxygen

trials, infectious disease studies and prevention trials.

Clinical trials focused on new cancer drugs or drug

combinations, new approaches to radiation therapy, surgical

techniques, quality of life and genomic tissue are some of the

trials available to cancer patients.

Collaborations with major pharmaceutical companies have

offered cutting edge diagnostic and treatment trials to better

serve our community. Prevention trials test new approaches

with medicines, vitamins, minerals or other supplements that

may lower the risk of specific cancers. These trials may discover

ways to prevent cancer in people who have never had cancer

or to prevent the return of cancer in patients who have already

had cancer. Screening trials test the best way to find cancer in

its early stages and quality of life trials explore ways to improve

comfort and daily living for cancer patients.

Navigating the World of Cancer Care

The Cancer Navigation program is an invaluable resource for patients. A cancer diagnosis can be frightening and overwhelming.

Our patient navigators help patients address the challenges of a new diagnosis and assist those currently involved in cancer treatment.

Our extensive and comprehensive program also includes educational classes, support groups, community resources, special events and

follow-up through survivorship.

Highlights of 2014 Oncology Clinical Trials

Bard Equipment

A Prospective Multi-Center Clinical Study to Evaluate the Safety

of Progel® Pleural Air Leak Sealant in Video Assisted and

Robotic Assisted Thoracic Surgery.

Principal Investigator—K. Adam Lee, MD

Amgen Pharmaceutical

Chemotherapy Induced Anemia trial for patients receiving

blood transfusions. This study looks at patient’s symptoms and

treatment related to anemia while on chemotherapy.

Principal Investigator—Marcelle Bertrand, MD

Xeno 01/Scripps Florida

The study of surgical tissue specimens of the breast and the

lung to learn more about cancer mutations affecting DNA, RNA

and protein expression in tumors.

Principal Investigator—Paul Garen, MD

Clinical research continues to ensure Jupiter Medical Center

is on the forefront of the future of medicine. During 2014,

the research department participated in 30 new trials and

consented over 300 patients for participation. Clinical research

offers great potential for future cancer treatments that may

someday benefit patients. Results from these trials will help the

medical community better understand how therapies work and

how to most effectively manage and treat cancers—changing

cancer care.

Supporting Patients and Families

Cancer patients and their families have the opportunity to work closely with the Oncology Support Services as part of the patient

navigation team to manage psychosocial and practical needs. These activities include performing patient assessments, developing patient-

specific coping strategies utilizing evidence-based interventions, providing education and resources, coordinating with the interdisciplinary

team members to ensure patient needs are addressed.

2014 Support Service Accomplishments

The oncology support team launched a redesigned psychosocial distress screening tool to better assess the needs of our patients. The

team also developed the Strategic Plan to guide in the implementation of the Commission on Cancer (CoC) and National Accreditation

Program for Breast Centers (NAPBC) Survivorship program.

2014 Events and Presentations

• Annual Survivor’s Day Celebration

• Prostate Screenings

• Skin Cancer Screenings

• Lunch and Learn Meet the Navigators

• 2014 Komen Community Profile Kick Off

• Horticultural Experience (Edible Gardening, Healthful and

Flavorful Food Choices, Seeds to Supper and more)

• Hosted and presented at joint annual meeting of Southeast

Florida Cancer Control Collaborative and the Community

Cancer Council – Shared commitment to improving access

to care, decreasing burden of cancer through a collaborative

effort by providing education, advocacy and research within

the Southeast Florida region.

Pain Management

For some oncology patients with difficult-to-control pain issues, referral to Jupiter Medical Center's Pain Management Center, or

consultation with an in-house pain specialist is sometimes recommended. Other recommendations may include physical and occupational

therapy, radiation therapy, and complementary therapies such as meditation and acupuncture.

Hospice Care

When a medical provider estimates a patient has six months

or less to live, hospice care may be recommended. Committed

to assisting patients and their families to live as fully and

comfortable as possible, hospice professionals can care for

patients in their own homes, assisted living facilities and

nursing homes.

When patients have uncontrolled symptoms or are very near

the end of life and need comfort interventions, Hospice of Palm

Beach County, a division of TrustBridge Health, provides 24-

hour care in the 13-bed unit located in the Jupiter Pavilion.

Palliative Care

Palliative care is an approach that improves the quality of life

for patients and their families facing challenges associated

with life-threatening illness. The Foshay Cancer Center has

partnered with Harbor Palliative Care Services to provide

inpatient consultative services. Board-certified physicians

and nurse practitioner consultants strive to provide excellent

symptom management and assist the oncology patient to find

relief from symptoms. The expert consultants help the patient

and his or her family to determine patient care goals and

make recommendations to the attending physician regarding

medication adjustments, treatment interventions and advanced

planning. Assisting the physicians are hospital pharmacists,

social workers and a chaplain.

STAR Oncology Rehabilitation Program

Between 65 and 90 percent of cancer patients and survivors experience physical and psychological stressors that contribute to disability

and a lower health-related quality of life. These percentages are decreasing with the help of the STAR (Survivorship Training and Rehab)

Program, a nationally-certified program designed to meet the unique rehabilitative needs and interests of cancer patients and survivors. The

STAR Program, available at the Foshay Cancer Center, integrates a variety of therapeutic techniques under the direct supervision of licensed

physical, occupational and speech therapists, a dietician, oncology counselor, massage therapist, exercise specialists and oncology nurses.

All aspects of rehabilitation are coordinated with the approval and guidance of the patient’s physician. Patients enrolled in STAR experience

enhanced self-image and sense of control, improved endurance and increased muscular strength resulting in improved functional mobility.

A decreased incidence of anxiety and depression, and reduction of fatigue and pain also are among the benefits to patients. Participation in

STAR helps many cancer patients manage lymph edema and treatment side effects, improve tolerance to chemotherapy, shorten recovery

time after surgery and treatment, strengthen the immune system, decrease risk of infection, and improve quality of life.

Monthly Cancer Support Groups

• Newly Diagnosed? There is Strength in Numbers

• Living with Breast Cancer

• Oral Head & Neck Cancer

• Prostate Cancer

• Lung Cancer

• Cancer Survivorship Series

• Music Therapy

• Bereavement Support

Healthy Living Programs

• Integrative Therapies

• Look Good - Feel Better

• Medical Nutrition Therapy for Oncology Patients

• Smoking Cessation

Cancer Registry

The Cancer Registry is the department of the Foshay Cancer Center designated to collect, manage, analyze and report information on

every cancer patient diagnosed and/or treated at our center. The information collected for each patient includes routine personal and

demographic data, diagnosis, stage of disease at diagnosis, medical history, laboratory data, tissue diagnosis and initial course of treatment.

To protect the privacy of each patient, each case is de-identified

and coded by number rather than name, and personal/

demographic information is removed before it is reported to

the Florida Cancer Registry and the National Cancer Database

to help health officials to better monitor and advance cancer

treatments, conduct research and improve cancer prevention

and screening programs.

The Cancer Committee uses the cancer registry data to measure

compliance with evidence-based clinical practice guidelines

endorsed by the American College of Surgeons Commission

on Cancer through quality improvement studies. The integrity of

the data is closely monitored through dedicated quality control

measures while strict confidentiality is maintained to protect

patient privacy.

Multidisciplinary Cancer Conferences

Our strength lies in our multidisciplinary approach through cancer conferences, sometimes known as tumor boards. Breast, thoracic

and multidisciplinary conferences began in October 2013. January 2014 marked the addition of cutaneous, genitourinary and gynecologic

cancer conferences. The cancer conferences are attended by medical oncologists, radiation oncologists, surgeons, radiologists,

pathologists and other specialists who share ideas and knowledge, and work together to determine the best treatment for each patient.

Cancer conference discussions include an analysis of the disease stage, including prognostic indicators, research findings and treatment

plan using evidence-based and national treatment guidelines, options for clinical research trials, genetic testing and palliative care.

Psychosocial care and rehabilitation services also may be discussed. Nurses, genetic counselors, social workers, psychologists, chaplains

and dieticians also may attend the conference to provide consultative service for their patients.

In 2014, 454 cases were presented at cancer conferences, which follow standards set by the Commission on Cancer and the American

College of Surgeons. The collaboration of the cancer conferences are a positive influence in determining the optimal treatment plan for a

cancer patient unique to the individual. The monitoring of cancer conference activity may also identify opportunities to improve the patient

care process.

2014 Summary Site Breakdown

2014 Primary Site Groups Total

Digestive System 135

Respiratory System 151

Skin Excluding Basal & Squamous Cell 62

Breast 306

Female Genital System 159

Male Genital System 79

Urinary System 70

Brain & Other Nervous System 20

Lymphoma 65

Miscellaneous 97

1144

27% BREAST

13% RESPIRATORY SYSTEM

12% DIGESTIVE SYSTEM

12% FEMALE GENITAL SYSTEM

8% MISCELLANEOUS

7% MALE GENITAL SYSTEM

6% LYMPHOMA

6% URINARY SYSTEM

5% SKIN (excluding Basal & Squamous Cell)

2% BRAIN & NERVOUS SYSTEM

2014BODY SYSTEMS

27%

5%

13%

12%

8%6%

6%

7%

12%

2%

SEX CLASS OF CASE STATUS STAGE DISTRIBUTION - Analytic Cases OnlyPRIMARY SITE Total (%) M F Analy NA Alive Exp Stg 0 Stg I Stg II Stg III Stg IV 88 Unk Blank/InvORAL CAVITY & PHARYNX 14 (1.2%) 11 3 9 5 11 3 0 2 0 1 3 1 2 0

Lip 2 (0.2%) 1 1 1 1 2 0 0 1 0 0 0 0 0 0Tongue 2 (0.2%) 2 0 1 1 1 1 0 0 0 0 0 0 1 0Gum & Other Mouth 3 (0.3%) 2 1 0 3 3 0 0 0 0 0 0 0 0 0Nasopharynx 2 (0.2%) 2 0 2 0 1 1 0 0 0 0 1 0 1 0Tonsil 3 (0.3%) 2 1 3 0 2 1 0 0 0 1 2 0 0 0Hypopharynx 1 (0.1%) 1 0 1 0 1 0 0 1 0 0 0 0 0 0Other Oral Cavity & Pharynx 1 (0.1%) 1 0 1 0 1 0 0 0 0 0 0 1 0 0

DIGESTIVE SYSTEM 135 (11.8%) 75 60 120 15 105 30 4 20 31 19 29 3 8 6

Esophagus 11 (1.0%) 8 3 9 2 6 5 0 2 0 3 2 0 2 0Stomach 11 (1.0%) 5 6 10 1 8 3 1 2 2 0 3 0 2 0Small Intestine 5 (0.4%) 4 1 5 0 5 0 0 0 3 0 1 0 0 1Colon Excluding Rectum 58 (5.1%) 25 33 55 3 52 6 2 8 20 13 9 0 0 3Cecum 14 7 7 14 0 14 0 1 2 5 3 2 0 0 1Appendix 4 0 4 4 0 3 1 0 2 1 0 1 0 0 0Ascending Colon 10 7 3 10 0 8 2 0 1 4 2 3 0 0 0Hepatic Flexure 2 0 2 2 0 2 0 0 0 1 0 0 0 0 1Transverse Colon 7 0 7 6 1 6 1 0 1 2 2 0 0 0 1Splenic Flexure 4 2 2 4 0 4 0 0 1 1 1 1 0 0 0Descending Colon 3 2 1 3 0 3 0 0 0 2 1 0 0 0 0Sigmoid Colon 11 5 6 11 0 9 2 1 1 4 4 1 0 0 0Large Intestine, NOS 3 2 1 1 2 3 0 0 0 0 0 1 0 0 0Rectum & Rectosigmoid 13 (1.1%) 11 2 12 1 9 4 1 1 0 2 6 0 1 1Rectosigmoid Junction 3 2 1 3 0 2 1 1 0 0 0 1 0 0 1Rectum 10 9 1 9 1 7 3 0 1 0 2 5 0 1 0Anus, Anal Canal & Anorectum 3 (0.3%) 2 1 1 2 3 0 0 0 1 0 0 0 0 0Liver & Intrahepatic Bile Duct 12 (1.0%) 6 6 10 2 8 4 0 5 2 0 1 1 1 0Liver 11 6 5 9 2 7 4 0 5 2 0 0 1 1 0Intrahepatic Bile Duct 1 0 1 1 0 1 0 0 0 0 0 1 0 0 0Gallbladder 2 (0.2%) 0 2 2 0 2 0 0 1 0 0 1 0 0 0Other Biliary 2 (0.2%) 1 1 1 1 1 1 0 1 0 0 0 0 0 0Pancreas 14 (1.2%) 12 2 12 2 9 5 0 0 3 0 6 0 2 1Retroperitoneum 1 (0.1%) 1 0 0 1 1 0 0 0 0 0 0 0 0 0Peritoneum, Omentum & Mesentery 1 (0.1%) 0 1 1 0 0 1 0 0 0 1 0 0 0 0Other Digestive Organs 2 (0.2%) 0 2 2 0 1 1 0 0 0 0 0 2 0 0

RESPIRATORY SYSTEM 151 (13.2%) 63 88 137 14 113 38 1 45 13 23 49 1 4 1

Larynx 4 (0.3%) 2 2 3 1 4 0 0 0 1 0 1 0 1 0Lung & Bronchus 146 (12.8%) 61 85 133 13 109 37 1 45 12 23 48 0 3 1Trachea, Mediastinum & Other Respiratory Organs 1 (0.1%) 0 1 1 0 0 1 0 0 0 0 0 1 0 0

SOFT TISSUE 5 (0.4%) 3 2 5 0 5 0 0 0 1 1 1 1 1 0Soft Tissue (including Heart) 5 (0.4%) 3 2 5 0 5 0 0 0 1 1 1 1 1 0SKIN EXCLUDING BASAL & SQUAMOUS 62 (5.4%) 43 19 57 5 60 2 3 20 18 4 4 0 2 6

Melanoma -- Skin 55 (4.8%) 37 18 51 4 54 1 3 19 17 4 4 0 0 4Other Non-Epithelial Skin 7 (0.6%) 6 1 6 1 6 1 0 1 1 0 0 0 2 2

BREAST 306 (26.7%) 2 304 296 10 304 2 49 136 66 16 12 0 2 15Breast 306 (26.7%) 2 304 296 10 304 2 49 136 66 16 12 0 2 15FEMALE GENITAL SYSTEM 159 (13.9%) 0 159 151 8 154 5 4 70 10 37 13 4 0 13

Cervix Uteri 20 (1.7%) 0 20 18 2 19 1 0 7 3 5 1 0 0 2Corpus & Uterus, NOS 87 (7.6%) 0 87 85 2 86 1 0 55 5 13 3 0 0 9Corpus Uteri 83 0 83 81 2 83 0 0 54 5 11 2 0 0 9Uterus, NOS 4 0 4 4 0 3 1 0 1 0 2 1 0 0 0Ovary 27 (2.4%) 0 27 24 3 25 2 0 3 2 12 7 0 0 0Vagina 1 (0.1%) 0 1 1 0 1 0 1 0 0 0 0 0 0 0Vulva 13 (1.1%) 0 13 12 1 12 1 2 5 0 2 1 0 0 2Other Female Genital Organs 11 (1.0%) 0 11 11 0 11 0 1 0 0 5 1 4 0 0

MALE GENITAL SYSTEM 79 (6.9%) 79 0 66 13 75 4 0 21 25 2 9 0 0 9

Prostate 75 (6.6%) 75 0 62 13 71 4 0 17 25 2 9 0 0 9Testis 4 (0.3%) 4 0 4 0 4 0 0 4 0 0 0 0 0 0

URINARY SYSTEM 70 (6.1%) 51 19 66 4 67 3 19 22 13 4 5 0 1 2

Urinary Bladder 43 (3.8%) 35 8 39 4 41 2 16 10 10 0 1 0 1 1Kidney & Renal Pelvis 23 (2.0%) 12 11 23 0 22 1 0 11 3 4 4 0 0 1Ureter 2 (0.2%) 2 0 2 0 2 0 1 1 0 0 0 0 0 0Other Urinary Organs 2 (0.2%) 2 0 2 0 2 0 2 0 0 0 0 0 0 0

BRAIN & OTHER NERVOUS SYSTEM 20 (1.7%) 10 10 16 4 16 4 0 0 0 0 0 15 0 1

Brain 7 (0.6%) 5 2 4 3 4 3 0 0 0 0 0 3 0 1Cranial Nerves Other Nervous System 13 (1.1%) 5 8 12 1 12 1 0 0 0 0 0 12 0 0

ENDOCRINE SYSTEM 12 (1.0%) 4 8 12 0 12 0 0 5 3 1 0 2 1 0

Thyroid 10 (0.9%) 4 6 10 0 10 0 0 5 3 1 0 0 1 0Other Endocrine including Thymus 2 (0.2%) 0 2 2 0 2 0 0 0 0 0 0 2 0 0

LYMPHOMA 65 (5.7%) 35 30 55 10 56 9 0 13 10 8 19 0 3 2

Hodgkin Lymphoma 7 (0.6%) 4 3 6 1 7 0 0 2 3 0 1 0 0 0Non-Hodgkin Lymphoma 58 (5.1%) 31 27 49 9 49 9 0 11 7 8 18 0 3 2NHL - Nodal 42 22 20 33 9 35 7 0 6 5 8 10 0 3 1NHL - Extranodal 16 9 7 16 0 14 2 0 5 2 0 8 0 0 1MYELOMA 12 (1.0%) 8 4 12 0 8 4 0 0 0 0 0 12 0 0Myeloma 12 (1.0%) 8 4 12 0 8 4 0 0 0 0 0 12 0 0

LEUKEMIA 24 (2.1%) 15 9 20 4 18 6 0 0 0 0 0 20 0 0

Lymphocytic Leukemia 8 (0.7%) 6 2 6 2 7 1 0 0 0 0 0 6 0 0Chronic Lymphocytic Leukemia 6 5 1 4 2 5 1 0 0 0 0 0 4 0 0Other Lymphocytic Leukemia 2 1 1 2 0 2 0 0 0 0 0 0 2 0 0Myeloid & Monocytic Leukemia 15 (1.3%) 8 7 13 2 10 5 0 0 0 0 0 13 0 0Acute Myeloid Leukemia 9 5 4 8 1 6 3 0 0 0 0 0 8 0 0Acute Monocytic Leukemia 2 1 1 1 1 0 2 0 0 0 0 0 1 0 0Chronic Myeloid Leukemia 4 2 2 4 0 4 0 0 0 0 0 0 4 0 0Other Leukemia 1 (0.1%) 1 0 1 0 1 0 0 0 0 0 0 1 0 0

MESOTHELIOMA 3 (0.3%) 1 2 3 0 2 1 0 0 1 1 0 1 0 0Mesothelioma 3 (0.3%) 1 2 3 0 2 1 0 0 1 1 0 1 0 0MISCELLANEOUS 27 (2.4%) 14 13 24 3 18 9 0 0 0 0 0 24 0 0Miscellaneous 27 (2.4%) 14 13 24 3 18 9 0 0 0 0 0 24 0 0

TOTAL 1,144 414 730 1,049 95 1,024 120 80 354 191 117 144 84 24 55

For Jupiter Medical Center's 2012 and 2013 Cancer Registry data, please visit foshaycancercenter.com/registry-data.

1240 S. Old Dixie Hwy., Jupiter, FL 33458 foshaycancercenter.com 561-263-4400