SISTER CARITAS CANCER CENTER

2015ANNUAL REPORT

MissionWe, the Sisters of Providence Health System and Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. We are sustained by an unwavering trust in God’s Providence.

Core Values

ReverenceWe honor the sacredness and dignity of every person.

Commitment to those who are poorWe stand with and serve those who are poor, especially those most vulnerable.

JusticeWe foster right relationships to promote the common good, including sustainability of Earth.

StewardshipWe honor our heritage and hold ourselves accountable for the human, financial, and natural resources entrusted to our care.

IntegrityWe are faithful to who we say we are.

2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

Chairperson’s Report

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The Cancer Committee at Mercy Medical Center oversees many aspects of cancer care under the guidance of the American College of Surgeons Commission on Cancer. Membership comprises physicians, nurses, social workers, pharmacists, hospital administrators, cancer registrars, and representatives from the American Cancer Society. We meet quarterly to discuss issues concerning cancer care, perform quality reviews, and find ways to improve our cancer center. The committee also runs multiple multidisciplinary cancer conferences, maintains a patient care database, helps organize community outreach and screening programs, and provides education and support to our patients, the community, and fellow clinicians.

We run multiple site-specific prospective cancer conferences including gastrointestinal, genitourinary, breast, thoracic, neuro-oncology, and hematology. Over 250 cases were presented, and the conferences have proved to be extremely helpful in

guiding patient management and keeping treatment plans up-to-date with the latest state-of-the-art advancements in the field. NCCN guidelines are routinely used, and the conferences are well attended by medical oncologists, radiation oncologists, surgeons, radiologists, pathologists, medical specialists, and interested medical staff.

This year saw the completion of the construction of a major expansion to our Sister Caritas Cancer Center, and it will be ready for treating patients early next year. There are beautiful new infusion suites, and our medical oncologists, radiation oncologists and oncology staff will for the first time be located in one place. In addition, we have continued to be a regional leader with the STAR program® (survivorship, training and rehab) and we have started a pre-operative rehabilitation program for our lung cancer patients. Both the STAR program and pre-operative rehabilitation programs are being led by Leonard Gonzalez, PA-C, who joined our cancer center this year. Finally, we welcomed Dr. Kim Ang as our new director of Palliative Care Services.

The staff at the Sister Caritas Cancer Center strives to deliver the best care to our patients, and this is apparent in the consistently high rankings the center receives in overall patient satisfaction. I would like to thank all the people involved who work together in our ongoing battle to cure and care for people with cancer. It takes a team, and we are dedicated to continuing to meet the highest standards of cancer care.

Neal Chuang, MD Cancer Committee Chairperson Chief of Thoracic Surgery

Neal Chuang, MD Cancer Liason Physician

2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

2015 Cancer Liaison Report

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2015 has been a year of considerable growth and differentiation for the Mercy Cancer Program. The addition of new physician and ancillary staff, integration of new programs such as the STAR Program and lung cancer screening as well as the construction of a state-of-the-art facility highlight this year’s developments.

The Cancer Program regularly receives facility specific data from the American College of Surgeons Commission on Cancer (CoC) through the National Cancer Data Base (NCDB). These reports are regularly reviewed by the Cancer Liaison Physician and reported to the Cancer Committee and hospital administration. These data permit assessment of compliance with oncology specific outcomes designated by the CoC and allow for comparison to other Commission on Cancer accredited facilities. Areas of significant underperformance are addressed with quality improvement initiatives, which is a prerequisite for reaccreditation by the CoC.

Cancer Program Practice Profile Reports (CP3R) evaluate the administration of adjuvant therapies for patients with breast, colon, rectum, gastric, lung, cervical and ovarian cancer. Additional outcomes evaluated are lymph node retrieval, needle biopsy and breast conservation rates. For 2013, the most recent year evaluated, Mercy Medical Center has demonstrated statistically superior rates of adjuvant therapy administration for patients with breast, colon, rectal and lung cancers.

In 2013 the CoC introduced the Cancer Quality Improvement Program (CQIP). These comprehensive, facility specific reports provide programs with expanded outcomes data for patients with breast, colorectal, prostate and lung cancers; recently malignant melanoma data has been added. In addition to the parameters included in CP3R, CQIP provides demographic and stage specific survival (including risk adjusted) statistics as well as data on complex surgical procedures. Reviewing demographic data, the Cancer Program gains insights into patient accrual, attrition and timeliness of treatment that allows us to better serve our community. The 2014 CQIP demonstrates that Mercy cancer patients experience survival rates similar to those at other CoC facilities.

Mercy Medical Center maintains a close relationship with the American Cancer Society (ACS). The local ACS representative regularly participates in the Cancer Committee meetings and serves as a liaison between the ACS and patients (supplying resource materials and access to ACS programs). This year the Mercy Cancer Program was recognized by the CoC as 1 of 5 facilities in Massachusetts with highest referral rates to the ACS.

James Frank, MD, FACS Cancer Liaison Physician

James Frank, MD, FACS Cancer Liason Physician

2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

Cancer Registrar’s Report

The Mercy Medical Center Cancer Registry is designed for the collection, management, and data analysis of individuals with the diagnosis of malignant tumors of all sites and benign tumors of the central nervous system. The data maintained in the Mercy Medical Center Cancer Registry includes demographic information, medical history, diagnostic findings, cancer findings (primary site, histology, cell type, and extent of disease and stage), cancer therapy (surgery, radiation therapy, chemotherapy, hormone therapy, immunotherapy, and endocrine procedures) and follow-up information related to additional treatment, recurrences, and current patient status.

In 2014, the cancer registrars at Mercy Medical Center accessioned 1126 analytic cases. These cases represent patients who were diagnosed and/or treated at Mercy Medical Center. Additionally, there were 106 non-analytic cases accessioned, representing patients diagnosed and treated elsewhere and treated at this facility in 2014 with recurrent disease.

We collect the required data items mandated by the American College of Surgeons, Commission on Cancer, Massachusetts Cancer Registry, and SEER (Surveillance Epidemiology and End Results). Our data is submitted monthly to the Massachusetts Cancer Registry and annually to the National Cancer Data base.

Barbara Lamy, CTR, RHIT Cancer Registrar

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2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

Evaluation of High Risk Stage II Colorectal Cancer Patients

BACKGROUNDCurrent NCCN guidelines recommend that all patients with stage II colon cancer be considered for postoperative adjuvant chemotherapy. This should consist of a discussion between the patient and his/her physician(s) regarding the relative risks and benefits of this treatment for the individual patient. Consideration of patient comorbidities as well as prognostic features modifying the individual risk of recurrence of a particular patient should form the basis for this discussion.

METHODSPatients with AJCC stage II colorectal cancer diagnosed between January 1 and December 31, 2013 were identified through a search of the Mercy Medical Center tumor registry. Pathology reports, medical oncology consultation and follow-up records were reviewed. Patients were screened for the presence of adverse prognostic features (listed in NCCN version 2.2015) to assess medical oncology referral, administration of adjuvant therapy and demographic factors that might explain reasons for non-referral or omission of chemotherapy in high risk patients.

RESULTS24 patients were identified. Sixteen patients had 1 or more adverse prognostic features. 18 patients were seen in consultation by medical oncology. Six patients received adjuvant chemotherapy for poor prognostic features. Eight patients with adverse prognostic features did not receive chemotherapy for the following reasons 1) age greater than 80 with significant co-morbidities (n=5); 2) solitary perineural invasion without other features (n=3). One young patient with lymphovascular and perineural invasion was referred to a tertiary facility and no follow-up data was available for review.

CONCLUSIONS Our review suggested that all patients with acceptable co-morbidities and available follow-up data were appropriately referred to a medical oncologist for consideration of adjuvant chemotherapy. We did not identify any patient with more than 1 risk factor who was an acceptable candidate for chemotherapy for whom this modality was omitted.

James Frank, MD FACS Sister Caritas Cancer Center

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Daniel Morrison, MD Sister Caritas Cancer Center

2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

Mercy Medical Center 2014 Analytic Cancer Cases Summary by Body System and Sex

Males Females

Oral Cavity & Pharynx – 19 (3%)

Lung & Bronchus – 63 (11%)

Pancreas – 13 (2%)

Kidney & Renal Pelvis – 38 (7%)

Urinary Bladder – 48 (9%)

Colon & Rectum – 78 (14%)

Prostate – 128 (23%)

Non-Hodgkin Lymphoma – 23 (4%)

Melanoma of the Skin – 29 (5%)

Leukemia – 6 (1%)

All Other Sites – 110 (20%)

Thyroid – 8 (1%)

Lung & Bronchus – 83 (15%)

Kidney & Renal Pelvis – 23 (4%)

Ovary – 17 (3%)

Uterine Corpus – 32 (6%)

Colon & Rectum – 44 (8%)

Non-Hodgkin Lymphoma – 14 (2%)

Melanoma of the Skin – 13 (2%)

Leukemia – 3 (1%)

Breast – 213 (37%)

All Other Sites – 121 (1%)

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2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

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Top Five Sites at Mercy Medical Center in 2014

2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

Mercy Medical Center, Sister Caritas Cancer Center Community Outreach Activity Summary 2015

DATE ACTIVITY 1/20/15 YMCA Cancer Education Series —“Lung Cancer: A Medical Oncologist’s Perspective”

with Dr. Philip Glynn

3/17/15 YMCA Cancer Education Series “Cancer Genetics: You Can’t Choose Your Parents but You Can Improve the Odds!”

with Dr. Michael Rosen

4/1/15 Cancer House of Hope Education Series “Phases of Cancer Care” with Dr. David Bishop

4/30/15 YMCA Cancer Education Series “Cancer Prevention: Ask the Experts” with Dr. Vatsala Kirtani and Tracy Kennedy, RN

5/11/15-5/15/15 Women’s Health Week Providence Prenatal Center and Mercy Care—Forest Park provided screenings for blood

pressure and diabetes, free physical and PAP screenings and STD testing for women without health insurance, HIV testing and counseling, and referrals for mammograms.

5/20/15 Cancer Awareness Symposium Westfield Athenaeum, Westfield, MA

6/3/15 Cancer House of Hope Education Series “Nature’s Follies vs. Precision Science: Cancer Treatment Beyond Chemotherapy”

with Dr. Subu Iyer

8/5/15 Cancer House of Hope Education Series “Cancer Survivorship” with Gale Mason, NP, MSN, MPH

9/13/15 Survivor Day

10/7/15 Cancer House of Hope Education Series “Cancer & Genetics” with Dr. Masih Farooqui

10/12/15 Wicked in Pink Motorcycle Run for Breast Cancer Awareness

10/15/15 Cancer Awareness Symposium Community House, Longmeadow, MA

10/18/15 Making Strides Breast Cancer Walk

12/2/15 Cancer House of Hope Education Series “How Can I Reduce My Risk of Cancer and Cancer Reoccurrence?” with Dr. Timothy Johnson

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2015 ANNUAL REPORT/SISTER CARITAS CANCER CENTER

The Cancer Committee

The membership of the cancer committee is multidisciplinary, representing physicians from the diagnostic and treatment specialties and non-physicians from administrative and supportive services. Coordinators who are responsible for specific areas of program activity are designated from the membership.

Cancer Committee Members include:

PhysiciansNeal Chuang, MD, Cancer Committee ChairJames Frank, MD, FACS, Cancer Liaison PhysicianPhilip Glynn, MD, Clinical Research RepresentativeMaria Gorgan, MD, PathologistMary Ann Lowen, MD, Radiation OncologistDaniel Morrison, MD, SurgeonMohammad Mostafavi, MD, UrologistShirin Nash, MD, Community Benefits RepresentativeJeffrey Ochs, MD, Medical OncologistLisa Planeta, MD, FACS, Breast Care CenterMichael Rosen, MD, Hospice/Palliative Care Representative Jayson St. Jacques, MD, Diagnostic RadiologistSubramony Subramonia-Iyer, MD, MPH, Community Outreach Coordinator

Non-Physician MembersMariellen Counter, RN, OCN, Nurse NavigatorLinda Everson, CTR, RHIT, Cancer RegistrarErica Gaeta, LCSW, Social WorkerPhilomena Gajda, MSW, Psychosocial Services CoordinatorBarb Lamy, CTR, RHIT, Cancer Registry Quality CoordinatorCynthia Leonard, RN, OCN, Oncology NurseLeonard Gonzalez, PA-C, Survivorship CoordinatorStan Kim, Pastoral Care RepresentativeFletcher Nehring, PharmD, PharmacistLaura Nunes, RTT, MHA, Quality Improvement CoordinatorYvonne Pola, Cancer Program Administrator Rachel Sapelli, RD, Registered Dietician Maria Scoville, RN, Performance Improvement RepresentativeAnn Stauble, Hospice Representative Allison Steinberg, MS, CCC-SLP, Rehabilitation Representative Francisca Turkson, MBA, MPH, American Cancer Society Representative Stephanie Velis, Cancer Conference Coordinator

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Sister Caritas Cancer Center271 Carew Street

Springfield, MA 01104 MercyCares.com

A member of the Sisters of Providence Health System and Trinity Health

Mercy 2016-024 • 2/16