Regional Cancer Center

2012

Cancer CareAnnual Outcomes Report

MAKING THE G

RADE

Cancer

Progra

m Meet

s Nati

onal

Standar

ds

ACCOUNTABILITY M

EASURES

Perfor

mance

Rates

CANCER STATISTICS

MCCH

A SURVIVOR’SSTORY

When Murray native, Kenny

Darnell was told he had cancer he didn’t have far to

go to get the best treatment. He chose Murray.

2  CANCER REPORT  2012

Darnell’s focus on health was influ-enced in part by his role in serving on the hospital board for over seven years. In his role guiding the hospi-tal’s course, he became more aware about the importance of screenings, routine check-ups, and the benefits of leading a healthy lifestyle.

In July 2012, he went for his regu-lar check-up and a prostate specific antigen (PSA) was drawn. The PSA level normally increases as a man’s prostate enlarges with age, but it may also increase because of inflamma-tion of the prostate gland (prostati-tis). It may be the first indication that a prostate cancer is present.

Darnell’s PSA level was elevated from the “normal” range. This alerted his primary care physician to refer him to a Urologist. He met with Steve L.Trevathan, M.D., who examined him and informed him that there was some swelling present. His first consideration was that an infec-tion had developed. Dr. Trevathan recommended a course of antibiotics. He had hoped that this would end up lowering the PSA. After complet-ing the medicine prescribed, another PSA was drawn. Unfortunately, or perhaps fortunately as it turned out, the PSA remained high. Darnell was asked to then move forward with a biopsy.

“I was apprehensive all day and had prepared myself and expected the worse, but you never expect it to be cancer. It was hard to come to terms with the fact that cancer is in your body even if it’s at an earlier stage.”

It was at his first post-biopsy follow up where he heard the words one never wishes to hear “we found can-cer.” Dr. William Giese, Radiation Oncologist at the Regional Cancer Center, was soon called. He met with Mr. & Mrs. Darnell, and helped al-leviate their fears by explaining this cancer was concerning, but that it may not be aggressive. After several additional tests were completed, Dr. Giese delivered some positive news. The cancer has a high likelihood of successfully being managed by a time-tested technology known as brachytherapy.

Prostate “seed” implants have been performed around the world for de-cades. For the right patient, with low-risk prostate cancer, they represent a convenient and cost-effective option for this disease. For intermediate-risk and high-risk patients, this method can be integrated with external beam irradiation as a brachytherapy “boost”.

Brachytherapy entails surgically inserting radioactive sources within the tumor and surrounding it. At the procedure, encapsulated “seeds”, smaller than a cooked grain of rice, are methodologically inserted under

real-time ultrasound guidance. The protective titanium capsule prevents absorption of the radioisotope, while allowing the short-range ionizing ir-radiation to “bathe” the tumor cells. This damages their cellular DNA, and that leads to their “death.” During his treatment Darnell says many of the procedures necessary were sometimes “uncomfortable,” but that he experi-enced no debilitating pain. Once the diagnosis had been made, and the further testing completed, Darnell went on to the implant planning procedure, where his prostate gland was precisely mapped. From this, a plan was for-mulated with the help and advice of world-class experts in the brachyther-apy field at their Seattle, Washington clinic. A few weeks later, he underwent the “seed” implant.

The I-125 “seeds” that were placed will remain permanently within Dar-nell’s prostate gland. These delivered the majority of the irradiation (called “decay”) over the following five months. The “seeds” are linked togeth-er by spacers at the implant, and placed by the Urologist and Radiation Oncolo-gist working in tandem. Typically, the implant procedure itself takes less than a half hour to complete.

“We use the exact same techniques and radioisotope that is the sole way brachytherapy is performed at the famous MD Anderson Cancer Cen-ter in Houston, Texas,” notes Giese. “There are other ways of doing this that are publicized on the internet and in the popular press, but this method has by far the longest track record, and results in the best likelihood of a cure, with the least side effects. Every implant we perform is a month later scrutinized by the experts in Seattle, Washington who helped us plan it. Our grades, they tell us, remain A+!”

Darnell found the schedule to prepare for the procedure and the checkups following it a bit draining, but the care was great, and he felt the physicians and staff were meticulous in their ef-forts to make sure everything went just as it was supposed to do.

DARNELL’S JOURNEY THROUGH PROSTATE CANCERFor many men going to the doctor is not high on their priority list. However, for Kenny Darnell he made sure that regular check-ups ranked right up there with duck hunting on his list of things to do. Although his love for going to the doctor did not carry the same weight as his love for the outdoors, he still made sure he didn’t miss his annual appointment.

PERSONALIZED TREATMENT

CLOSE TO HOMECancer CommitteeThe membership of the Cancer Committee is multidisciplinary, representing physicians from the diagnostic and treatment specialties and non-physicians from support services. This team works together to provide cancer patients with access to a full scope of services required to diagnose, treat, rehabilitate and support our patients.

Physician Members:

Dr. David Koelsch

General Surgeon

Dr. Mehdi Ahmadi

Medical Oncologist

Dr. Bill Giese

Radiation Oncologist

Dr. John Bright

Dermatologist

Dr. Casey HinesRadiologist

Dr. Dewey Dean

Pathologist

Dr. Gene Cook

Gynecologist

Maintaining the CoC Standards and the required reporting of information about MCCH diagnosed cancers is a cooperative effort led by Judy Moore, RN, Cancer Program Coordinator, and Marsha Tucker, Cancer Registrar.

For more information on the Cancer Registry, call 270.762.1193 or visit www.MurrayHospital.org.

“Drs. Trevathan and Giese collabo-rated closely in my care. They showed me they had an in-depth knowledge about the procedure, the preparation for it, and how to get the job done! Dr. Giese networked with the Chairman and Chief Oncologist at Vanderbilt University to precisely hone my treat-ment plan. I feel that we are fortunate to have these expert doctors and staff within our community,” said Darnell.

A few months following the implant, Darnell had another PSA drawn. The re-sults showed that his level had dropped dramatically. His treatment plan con-tinues to include periodic checkups with his Urologist. He currently has a repeat PSA drawn every 6 months. His most recent test, completed in September of this year, showed his PSA well within the expected range (undetectable).

“I’m thankful that I wasn’t so stubborn that I didn’t do routine exams and was able to catch my prostate cancer early through a PSA screening. I think men are stubborn because they would just rather not know. The scary part is I had no symptoms and through just a regular screening it was caught early. I know if left untreated prostate cancer can be very aggressive and metastasize to the bone.”- Kenny Darnell

Early prostate cancer has no symptoms and by the time symptoms occur, the disease may have spread beyond the prostate, and be incurable. The impor-tance of early detection is significant and Darnell’s personal story should encourage men to schedule their annual physical checkups each year. Now, he’s back to life as normal and was able to enjoy the outdoors this fall doing what he enjoys most – duck hunting.

3  CANCER REPORT  2012

MAKING THE GRADE

• 100%ofcaseshadthecorrectstageofdisease

• 100%ofcasesfollowedtheNCCNGuidelinesforthework-uprecommended

• 99%ofthecaseswereincompliancewiththeNCCNPrimaryTreatmentGuidelines

M C C H C A N C E R P R O G R A M M E E T S N A T I O N A L S T A N D A R D S

Murray-CallowayCountyHospitalhasbeenaccreditedbytheCommissiononCancersince2005,demonstratinghighquality

careforourcancerpatients.In2003,theCancerCommitteeatMCCHelectedtofollowtheNCCN(NationalComprehensive

CancerNetworkGuidelines)asthestandardofcareforallofourpatients.TheseguidelineshaveinsuredthattheRegional

CancerCenteratMCCHmaintainsanefficientprocessformonitoringandstayingincompliancewithsetstandards.

STAGEOFDISEASEAUDITEDATMCCH    Stage 0  None    Stage I  22%    Stage II  33%    Stage III  29%    Stage IV  16% In2012,30chartsofpatientsdiagnosedwithcanceratMCCHandwerereviewedwith

100%complianceinallareas.

Ayearlyreviewof10%ofMCCH’sanalyticalcasesofcancersdiagnosediscompleted.In2011,230casesofcancerwerediagnosedand

treatedatMurrayHospital.Ofthose,24caseswerereviewedforcompliancewithNCCNGuidelinesbythephysicianmembersofthe

cancercommitteeandthefollowingwasdetermined:

Coping with cancer is stressful enough, and a ongoing course of treatment, in an unfamiliar hospital in a far-away city, only adds to the anxiety. Fortunately, cancer patients can reap the benefits of the most effective treatments here at home provided by cancer physicians who live in our community and perform cancer treatment techniques that are positively second to none.

Murray-Calloway County Hospital’s Regional Cancer Center was awarded a three-year approval with commendation by the Commission on Cancer of the American College of Surgeons. This coveted commendation represents the nation’s recognition of our dedication, professionalism, and hard work in providing patient care.

The Regional Cancer Center at Murray-Calloway County Hospital utilizes excellent technology, along with medical literature reviews of the latest research results, to provide new treatment options for our patients. Our integrated, multidisciplinary ap-proach to cancer treatment maximizes the changes of a favorable result, while in a comfortable and familiar setting.

With early detection and prompt treatment, cancer growth can be halted. Quality of life can be preserved and treatment side effects can be minimized. The Regional Cancer Center,

located across from the hospital’s West En-trance on 9th Street, offers patients and their families hometown care from highly skilled specialists.

Top cancer specialists - a medical oncologist, Mehdi Ahmadi, M.D., and a radiation oncolo-gist, William Giese, M.D., provide specialized cancer care in their respective fields. Team-

work allows for timely and complete collaboration in the review of data, result-ing in the best of care. The tools we use can be debilitating, and we take our job seriously. We strive to minimize the trauma of cancer treatment... by stewarding and guiding patients through each step of treatment!

If chemotherapy is re-quired, specialized oncol-ogy nurses - under the

direction of our medical oncologist, Dr. Mehdi Ahmadi - administer treatments in a comfort-able, soothing environment. In the relaxed atmosphere, you can sleep, read or watch TV in comfort. And when treatment is done, home is just minutes away.

Dr. Ahmadi has been treating patients at Murray-Calloway County Hospital for over 20 years. He attends numerous cancer care educa-tional events throughout the year and brings the benefits of new chemotherapy treatments and

research back to his patients.

The American Board of Radiology has granted Dr. William Giese permanent certification as a specialist in radiation therapy. Since completing his training over twenty-five years ago, Dr. Giese has been faculty at a number of universities, and on staff at numerous hospitals throughout the nation. He is skilled in the treatment of all cancer types!

Most patients obtain referral from their physician, however, you may wish to call and arrange to be evaluated as a ‘walk-in’ to discuss your case and concerns. All are welcome at the Regional Cancer Center!

“The Regional Cancer Center offers

personalized treatment plans using advanced

technology with a personal approach to each family and

patient,” Jerry Penner CEO of MCCH.

PROVIDING QUALITY

CANCER CARE

4  CANCER REPORT  2012

Progressive Treatment you can count on.The Regional Cancer Center represents a major investment in technology - offering the latest in cancer treatments. If a cancer can be treated by radiation, then it can be treated here. With early detection and prompt treatment, cancer growth can be halted. Quality of life can be preserved. Treatment side effects can be minimized. MCCH has made a major commitment in the Regional Cancer Center to insure the newest technology and specialized cancer treatments and care are available now in Murray.

Advanced imaging services include:• PET/CT• Digital Mammography• 64-Slice CT

Precise Radiation Therapy, including:• IMRT - Intensity Modulated Radiation Therapy (IMRT) reduces healthy tissue injury as it targets less tissue with higher doses of radiation. The IMRT 

uses pencil-thin radiation beams to pinpoint the exact size and shape of cancerous tumors.• Brachytherapy - to certain prostate cancer patients and for other select tumor types. At this brief outpatient surgical procedure, tiny radioactive 

seeds, no bigger than a grain of rice, are implanted directly within the tumor. This enables high dose irradiation to be delivered over time.

Treatment Simulator and Treatment Planning CT Scanner - a simulator and a treatment planning CT are types of x-ray machines that provide data for targeting radiation beams, taking into account the size of the tumor, its location within the body, and its proximity to sensitive structures, such as the heart, the lung, the liver, the kidneys, and the spinal cord.

Linear Accelerator - technology that utilizes high-energy rays to reach deep-seated tumors. The linear accelerator also allows the option of using electrons to give superficial treatment with minimal radiation doses to protect surrounding tissue and deeper organs. The depth and strength of radiation beams, the angle of impact and frequency are all precisely controlled by the linear accelerator. Since treatments are more precise, patients are more likely to experience fewer and less severe side effects.

Chemotherapy - innovative, multi-modality therapies offer patients the latest approaches, while minimizing side effects. We offer the most advanced methods of chemotherapy and hormonal therapy treatment in a comfortable lounge equipped with a television, DVD players, iPods, and Wi-Fi for laptop access.

ACCOUNTABILITY MEASURESMurray-Calloway County Hospital focuses on evaluating the cancer program’s performance according to nationally accepted compliance measures, such as the current Commission on Cancer’s (CoC) quality reporting tool Cancer Program Practice Profile Reports (CP3R).  Our focus is quality and measuring the standard of care based on clinical trial evidence, thus ensuring that our hospital maintains a high level of quality care.

In 2011 there were six quality measures being followed, and MCCH had 100% compliance in four of these measures. Two measures were below the CoC recommended levels and the cancer committee members determined that this was beyond the physician’s control such as patient refusing recommended treatment, not recommended due to patient’s co-morbidities, and the many factors that determine whether there are a sufficient number of lymph nodes available for retrieval during a colon resection.  In 2014, the Cancer Registry will begin collecting three new breast measures for reporting purposes.

Below you will see a report with specific data estimating the performance rates for breast, colon, and rectal cancers diagnosed 2009-2011.

Select Breast & Colorectal MeasuresEstimated Performance Rates

2009 2010 2011Radiation therapy is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast conserving surgery for breast cancer.

100% 100% 75%

Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1c NO MO, or Stage II or III ERA and PRA negative breast cancer.

100% 100% 100%

Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1c NO MO, or State II or III ERA and/or PRA positive breast cancer.

77.8% 100% 100%

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.

100% 100% 100%

At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. 77.8% 81.8% 56.3%

Radiation therapy is considered or administered within 6 months (180) days of diagnosis for patients under the age of 80 with clinical or pathologic AJCC T4NOMO or Stage III receiving surgical resection for rectal cancer.

100% N/A 100%

5  CANCER REPORT  2012

KEEPING YOU

INFORMEDMCCH KEEPS OUR COMMUNITY  INVOLVED AND INFORMED

CANCERPatient Fund

  Going through cancer treatment is not cheap.  That’s why programs like the one Murray-Calloway Endowment for Healthcare has is such a tremendous asset to our community members in their time of need.  The Cancer Patient Fund has money set aside to help patients with minor expenses that might otherwise keep them from receiving cancer treatment.  

“ The Endowment is thrilled to partner with our local schools, Calloway County High School and Murray High, along with Murray State University in fundraising efforts for this worthwhile cause,” said Keith Travis, VP of Institutional Development at MCCH. “Brett Miles, Chief Radiation Therapist at the Regional Cancer Center calls our office almost every week with a request to help a patient or a patient’s family with miscellaneous expenses that may occur during cancer treatment, such as, gas money or money for a hotel so they will have a place to stay during their time of treatment. I can guarantee that every donation to the Endowment that is used for the Cancer Center is most definitely being used for a worthwhile cause,” said Keith Travis, VP of Development at MCCH.

  

 

If you are interested in making a 

donation to a cancer patient in 

need, contact the  

Murray-Calloway  

Endowment for Healthcare at 

270.762.1908 or visit us online at  

www.MCCHEndowment.org

BREAST CANCER AWARENESS MONTH

FACES OF CANCERLocal photographers and survivors share their 

cancer experience.  The exhibition was unveiled and showcased in the lobby at Murray Hospital to 

create awareness and educate the community.

ORAL CANCER SCREENINGSDr. Art Allen, ENT, offered FREE oral cancer screenings to the community. Forty-seven 

community members participated in the screenings. Three individuals were sent for 

referral and two individuals were sent for follow-up regarding a lesion suspicious for 

cancer. Participants were asked about tobacco   use - 25% answered YES, 45% answered NO, 

and 30% had quit tobacco use. 

SURGERY OPEN HOUSE & FREE SCREENING EVENT

K for the CureMurray High School & Calloway County High School donated $1,246.75 towards the patient cancer fund in their “Strike Out Cancer” crosstown rivalry game.

MCCH hosted an open house and free screening event to more than 140 community members. Individuals toured the surgery department, learned more about minimally invasive surgeries and took advantage of the following free screenings: A1C Diabetes Screening, Blood Sugar & Lipids, Blood Pressure Checks, Body Mass Index, Waist Circumference and Breast Exams.

Results were mailed with recommendations to the participants following the event.

GO BLUE DAYColon Cancer Awareness

MCCH staff dress in blue to create awareness during National Colorectal Cancer Month.

THE INCREDIBLE COLONThis exhibit was an interactive way of informing the community about colon cancer, including risks, prevention, early detection and treatment.

In recognition of National Breast Cancer Awareness Month, the entire mammography department decorated in pink with educational material provided about the importance of early detection and regular screenings. Trees on the front lawn were wrapped in ribbon and a breast cancer survival testimonial video featuring Sharon Carter, Mammography Coordinator, was shared on our website and social media. An ad campaign about digital  mammography was also publicized, and pictured above are staff members dressed in pink on National Mammography Day.

6  CANCER REPORT  2012

Demographics

White: 34,815 (92.5%)Black: 1,463 (3.9%)Am. Indian & Alaska Native: 116 (0.3%)Asian: 716 (1.9%)Native Hawaiian & Other Pacific Islander: 16 (0%)Other/Multi-Race: 529 (1.4%)Hispanic Origin> 941 (2.5%)

County    Population   %Below Poverty    %Unemployed   Per Capita Income  Calloway    37,655    17.2%       6.9%        $28,889  Trigg      14,447    16.4%       8.7%        $37,315  Marshall    31,344    13.3%       8.6%        $33,315  Graves    37,544    19.7%       8.5%        $29,543

Population - Calloway County Cancer Diagnosis by GenderGender PercentageMale 53.3%Female 46.7%

Cancer Diagnosis by Age Group

Age Group    Number  Percentage      Under 20    1    0.44%      20-29     1    0.44%  30-39     4    1.76%  40-49     10    4.41%  50-59     59    25.99%  60-69     60    26.43%  70-79     67    29.52%  80-89     23    10.13%  90 and over   2    0.88%    

M O S T C O M M O N C A N C E R F O U N D A T M C C H I N M E N I N 2 0 1 2

Type MCCH

Prostate 34%

Lung - NSC & Small 15.54%

Colon 11.49%

Malignant Melanoma 8.11%

Bladder 8.11%

Type MCCH

Breast 42.86%

Lung - NSC & Small 16.54%

Colon 9.77%

Endometrium  6.02%

Rectum/Anus 4.51%

CANCER

STATISTICS

M O S T C O M M O N C A N C E R F O U N D A T M C C H I N W O M E N I N 2 0 1 2

M O S T C O M M O N C A N C E R F O U N D A T M C C H I N M E N I N 2 0 1 1

Type MCCH KY US

Prostate 13.4% 22% 25%

Colon 8.3% 11% 7%

Lung 7.8% 20% 13%

Bladder 5.6% 6% 4%

Melanoma 3.9% 7% 3%

M O S T C O M M O N C A N C E R F O U N D A T M C C H I N W O M E N I N 2 0 1 1

Type MCCH KY US

Breast 12.6% 27% 29%

Colon 9.5% 10% 5%

Lung 5.7% 16% 8%

Cervix, Uterine, Ovarian 3% 23.6% 24.1%

Bladder 3% 22.6% 8.9%

*KY & US comparison data unavailable for 2012

7  CANCER REPORT  2012

The Commission on Cancer (CoC) recently granted a Three-Year Accreditation with Commendation to the Cancer Program at Murray-Calloway County Hospital’s Regional Cancer Center. A facility receives this accreditation following the on-site evaluation by a physician surveyor during which the  facility demonstrates a high level of compliance with one or more standards that represent the full scope of the cancer program:  cancer committee leadership, cancer data management, clinical services, research, community outreach and quality improvement.

The American Cancer Society estimates more than 1.6 million cases of cancer were diagnosed in 2012.  There are currently more than 1,500 CoC-accredited cancer programs in the US, close to 30% of all hospitals.  This  percentage of hospitals diagnoses and/or treats 70% of newly diagnosed cancer patients each year.

CoC CORE FUNCTIONSSettingQualityStandards

MultidisciplinaryCancerPatientCare

EvaluationofFacilitiesCompliancewithCoCStandards

CollectingStandardized&QualityDatafromAccreditedFacilities

UsingDatatoDevelopEffectiveEducationalInterventionstoImproveCancerCareOutcomes

“The accreditation survey is not obtained by one person but many individuals throughout MCCH. They have provided much needed information about care provided to our cancer patients in their respective departments. The cancer committee members, radiation therapy, medical oncology, and the cancer registry staff, were all very instrumental in obtaining the 3-Year Accreditation with Commendation from the Commission on Cancer,” Judy Moore, Cancer Program PI Coordinator.

Comprehensive care, including a range of services and equipment

A multi-specialty team approach to coordinate specialized treatment options

Information about on-going clinical trials and new treatment options

Access to cancer-related information, education and support

A cancer registry that collects data on type of cancer, stage of disease and treatment 

results

On-going monitoring and improvement of care

Quality care...close to home 

Cancer patient data is reported by each accredited program to the National Cancer database and the American Cancer Society program.  This database currently contains patient demographics, tumor characteristics, and treatment and outcomes for more than 18 million cancer patients diagnosed and treated at hospital cancer programs in the US.  This data is crucial to cancer studies and accounts for approximately two-thirds of newly diagnosed cancer cases in the US each year.

Receiving caRe at a coc-accRedited canceR PRogRam ensuRes Patient access to the Following:

Murray-Calloway County Hospital is very fortunate to partner with the American Cancer Society in providing Road to Recovery 

transportation to and from treatment for patients who have no way of getting to therapy.  Volunteer drivers are verified before 

they are assigned patients who need assistance with transportation to and from treatment.  If you or someone you know is in 

need of this service, the request form is available at the Regional Cancer Center.  Volunteer drivers are also needed, if you’re 

interested in being a volunteer driver, please contact the American Cancer Society at 270.444.0375.   

CANCER CENTER RECEIVES THREE-YEAR ACCREDITATION

ROAD TO

RECOVERY

Transportation grants provide a limited amount of funds from the American Cancer Society for gas cards to help those that 

are self-pay, on Medicaid or drive long distances for their treatments.  

AMERICAN CANCER SOCIETY

GRANT

Regional Cancer CenterSouth 9th Street - Murray, KY 42071

270.762.1506www.MurrayHospital.org/regionalcancercenter