s cancer c n - sentara healthcare

Sentara CanCer network

2 0 1 2 annual r e p o r t

CA

NC

ER

6,000More than

cancer patients treated each year

66,000More than

patients documented in Cancer Registry since 1995

9,961Cases Presented in Cancer Conferences (2007-2011)

13 facilities providing care to cancer patients

17,921More than

community members reached through outreach programs in 2011

70 clinical trials available for patients

More than

Sentara Cancer Network - By the Numbers

3 Sentara Cancer Network 7 Colorectal Cancer 10 Breast Cancer 14 Thoracic Cancer 16 Pancreatic Cancer 18 Prostate Cancer 20 Head and Neck Cancer 22 Hematology/Oncology 24 2011 Primary Site Data 26 Network Cancer Conferences

Contents

Note: The data shared in this report is the most currently available from the National Cancer Database and the Sentara Cancer Network registries.

w w w . s e n t a r a . c o m / c a n c e r 3

A positive patient experience is critical. We believe our patients deserve the very best every time they walk through our doors.

Breast: 1,235 25%

Prostate: 468 9%

Lung 673 13%

Colon: 329 7%

Kidney/Renal Pelvis: 184 4%

Non-Hodgkin Lymphoma: 169 3%

Rectum: 96 2%

Pancreas: 142 3%

Stomach: 64 1%

Uterus: 110 2%

All Other Sites: 824 16%

Thyroid: 175 4%

Bladder: 199 4%

Melanoma – Skin: 239 5%

Brain 88 2%

Figure 1. 2011 Sentara Cancer Network Top 15 Analytic Cancer SitesBreast cancer is the leading primary site, accounting for 25% (1,235 cases) of the total analytic cancer caseload (4,995 cases). Breast cancer is followed by lung cancer, prostate cancer, colon cancer, and melanoma as the top five sites for 2011. Other sites account for 16% of the total caseload and include all primary sites not in the top 14 for the Sentara Cancer Network.

4 S e n t a r a C a n c e r N e t w o r k 2012 A n n u a l R e p o r t

Collaboration. Sentara Cancer Network physicians and healthcare

professionals work together using their skills, knowledge and experience

to help deliver the best quality outcome and personalized care

for cancer patients in the community.

The Sentara Cancer Network:

n Partners with Eastern Virginia Medical School and Virginia Oncology Associates, allowing patients to tap into a comprehensive network of multi-disciplinary cancer care, from diagnosis to recovery.

n Offers quality care with a collaborative approach and access to extensive clinical research.

n Includes a vast network of physician experts, an invaluable resource to the Hampton Roads community. n Treats more than 6,000 cancer patients each year.

No matter where you enter the Sentara Cancer Network, you have the support and combined expertise of cancer specialists

working together to provide a dedicated approach to care.

A proven track record of quality, advanced care – One of the largest in the nation, the Sentara Cancer Network is the only accredited cancer network in Virginia, a distinction from the American College of Surgeons Commission on Cancer, which means we are held to the highest standards in delivering cancer care to our community. The Sentara Cancer Network was re-accredited in 2012 with all eight of the possible commendations.


Figure 2. Sentara Cancer Network Cancer Conference Program - Number of Cases Presented 2007 – 2011During these conferences, physicians meet to share expert knowledge and create individualized care plans to ensure the best possible patient outcomes.

0

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1,144

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2,188

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2,290

Cancer patients can rest assured that the most Innovative, sophisticated Technology is being deployed to diagnose and treat cancer. The Sentara Cancer Network is helping more

patients in our community survive cancer every day.

The Sentara Cancer Network is at the forefront of cancer advances, providing services comparable to the nation’s most highly regarded hospitals and medical centers. n National Accreditions from the American College of Surgeons’ Commission on Cancer, the National Accreditation Program for Breast Centers, and the American College of Radiology. n Fellowship Trained Physicians n Comprehensive Team Approach to Cancer Diagnosis and Treatment n Access to Clinical Trials and Genetic Counseling Services n Advanced technology that is comparable to the nation’s most highly regarded hospitals and medical centers, including CyberKnife®, daVinci®, IntraBeam® and other surgical and radiation oncology therapies.

At Sentara, our Commitment is to provide innovative services to promote the improvement

of personal health throughout Hampton Roads. With multiple convenient locations throughout the region, a myriad physician experts and innovative technology,

the Sentara Cancer Network provides the resources the community needs for prevention,

diagnosis and treatment of cancer.

PhysiciansThomas Alberico, MD – Medical Oncology, Cancer Committee ChairJames Schneider, MD – Surgical Oncology, Cancer Liaison PhysicianVictor Archie, MD – Radiation OncologyBruce Booth, MD – Medical OncologyJoseph Dalton, MD – General SurgeryKrista Dobbie, MD – Palliative CareEric Feliberti, MD – Surgical OncologyMark Fleming, MD – Medical OncologyRichard Hoefer, DO – Surgical OncologyLester Johnson, MD – RadiologyJohn Patterson, MD – Hospice and Palliative MedicineMarc Silverberg, MD – PathologyScott Williams, MD – Radiation OncologyJason Wilson, MD – Surgical Oncology

Non-PhysiciansCynthia Allen – Vice President, Ongology ServicesDeb Anderson – StrategyJoani Brough – Administration, SPAHConnie Bush – Community OutreachJanet Creef – Oncology Social WorkKimberly Dorsch – Clinical ResearchNicky Dozier – Clinical Research, VOACindy Estes – Oncology NursingPennie Faircloth – American Cancer SocietyCynthia Freeman – Cancer RegistryMichael Gentry – Corporate Vice PresidentJames Hoy – Pastoral CareVonia Ickes – Clinical NutritionJoanne Inman – Administration, SVBGH

Brad Kirby – Administration, Sentara Cancer NetworkTifany Lewis – VOA GeneticsKathleen Marcia – Cancer RegistryMaureen McGrath – Administration, VOALinda McKee – Administration, SCH/SWRMCSylvia Richendollar – Administration, SNGHJune Robertson – Administration, SVBGHMeredith Strand – Administration, SNGHJennifer Taylor – Oncology NursingRose West – MarketingLynne Whitlock – Administration, SOHEric Young – Administration, SLH

Sentara Healthcare is an acknowledged leader in patient safety and quality innovation. Founded in 1888 as the Retreat for the Sick in Norfolk, Virginia, Sentara has ranked for more than a decade among the nation’s top integrated healthcare systems by Modern Healthcare magazine

and was the #1 most integrated health care system for two years consecutively in 2010 and 2011. Sentara, a not-for-profit

health system, operates more than 100 sites of care serving residents across Virginia and northeastern North Carolina.

The system is comprised of 10 acute care hospitals, including 7 in Hampton Roads, 1 in Northern Virginia, and 2 in

the Blue Ridge region, advanced imaging centers, nursing and assisted-

living centers, outpatient campuses, a home health and hospice agency, a

3,680-provider medical staff, and three medical groups with 618 providers.

Sentara also offers medical transport ambulances and Nightingale, the first

air ambulance serving Hampton Roads. Optima Health, an award winning

Sentara owned health plan, serves 440,000 members in Virginia.

Sentara Network Cancer Steering Committee Members


Team of Dedicated Specialists As part of the Sentara Cancer Network, the Colorectal Cancer Program offers a comprehensive network of dedicated specialists who meet regularly to collaborate and make recommendations on patient treatment. At each hospital, patient cases are discussed at a very high, multi-disciplinary level with many different opinions put into the equation. All the slides and x-rays are reviewed, along with details of the patient’s history, and a consensus is determined followed by the development of a specific care plan. Collaboration for Quality ImprovementThe number one accomplishment of the colorectal program this year is the reflective pathology testing (Immunohistochemical stains for mismatch repair proteins) of all colorectal specimens to identify those patients that need genetic testing for Lynch Syndrome. This testing was implemented in all Hampton Roads hospitals in July. This change will increase the ability to identify patients with high risk factors that need additional testing to determine the best long term treatment planning for them and their immediate family members.

The Colorectal Cancer Program also launched a project to reduce surgical site infections related to cancer and non-cancer colorectal surgery. By improving the communication process between the circulator and the surgeon, the accurate identification of wound class can be correctly benchmarked for national statistics.

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Stage O n = 17,262 Stage I n = 52,216 Stage II n = 57,012

Stage III n = 57,458 Stage IV n = 44,462

The graphs below are a comparison between the 5-year survival for colon cancer in the National Cancer Data Base 2003-2005 and the 5-year survival for the Sentara Cancer Network 2003-2005. Stage I, II, and IV are lower in Sentara than at the NCDB. Stage 0 and III are slightly higher than the National Cancer Data Base.

Figure 4. Observed Survival for Colorectal Cases - National Cancer Data Base for 2003 - 2005

Figure 3. Observed Survival for Colorectal Cases - Sentara Cancer Network 2003 - 2005



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Stage O n = 47 Stage I n = 218 Stage II n = 195

Stage III n = 196 Stage IV n = 159

5 Years 5 Years


Figure 5. Sentara Cancer Network - % of Colon Resections With 12 or More Lymph Nodes Sampled 2005 - 2011The Commission on Cancer (CoC) and National Quality Forum (NQF) endorse this quality indicator. Figure 5 demonstrates Sentara Cancer Network’s compliance by hospital. Source: Cancer Registry.

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Educating the Community The Sentara Cancer Network is passionately committed to improving the diagnosis and outcome of colorectal cancer in our region. Tremendous amounts of resources are deployed in educating the community and encouraging early diagnosis, from hosting community education programs to encourage early detection, to providing access to colonoscopy screening. In March 2012 we had an increased community focus on the disease and the benefits of early detection through screening, and living with a healthy life style to decrease the chances of developing cancer.

The 1st annual Sentara Don’t Sit on Colon Cancer 5K on the Sentara Princess Anne Hospital campus attracted more than 200 runners, including many survivors and their supportive family and friends. Plans are already underway for the 2013 events.

As a result of the outreach efforts, awareness about colorectal cancer in the service area was increased by

27%, as measured by Pilot Media research.

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Dennis Rowley, MD – PathologyWilliam Rudolph, MD – Colorectal Surgeon (facilitator)Scott Stanley, MD – PathologyJohn Sayles, MD – Colorectal SurgeonDavid Stockwell, MD – Gastroenterology

Celeste Bremer, MD – Medical OncologyDavid Chang, MD – Medical OncologySuhas Deshmukh, MD – GastroenterologyJonathon Eisner, MD – GastroenterologyGregory FitzHarris, MD – Colorectal SurgeonRichard Hoefer, DO – Surgical OncologyDavid Johnson, MD – Gastroenterology

Sentara Colorectal Program Physician Leadership

Figure 6. Sentara Cancer Network 2008-2011 Colon Cancers by Stage at DiagnosisFigure 6 illustrates the stage at diagnosis for Sentara Cancer Network colon cancers between 2008 and 2011. Early stage diagnosis is only slightly greater (2%) than the NCDB percentage. Source: Cancer Registry

Sentara Cancer Network - 2008-2011

National Cancer Data Base 2010

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Figure 7. Colorectal Cancer Analytic Case Volumes 2005 - 2011This graph shows colorectal cancer volumes for each Sentara Cancer Network hospital from 2005 to 2011. Volumes are highest at Sentara Virginia Beach General during this time period.

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Innovative Technology and Clinical ExcellenceAll comprehensive breast centers in the Sentara Cancer Network have achieved accreditation from the National Accreditation Program for Breast Centers, a program of the American College of Surgeons. These centers also meet the rigorous requirements to be designated as Breast Imaging Centers of Excellence by the American College of Radiology. These accreditations reflect more than passing a survey, they are the standard of care and operations in every day that these centers provide service to Hampton Roads. And it is an ongoing pursuit of excellence. The Sentara Cancer Network is at the forefront in innovative technology, platforms and standards. Recent achievements in the program that will benefit the community include:

n Approval of digital tomosynthesis and the first steps in an implementation plan to introduce this service to Hampton Roads. Tomosysthesis is an imaging modality for performing high-resolution, limited angle tomography of the breast. It is particularly helpful for studying dense breast tissues.

n Adoption of the Magview® radiology information system for mammography.

n Participation in clinical trials.

n Response to new Commonwealth of Virginia legislation requiring patient notification about dense breast findings.

n Best practice standardization as demonstrated through specimen radiography systems in all Sentara ORs where breast surgery is performed.

Figure 8. Observed Survival for Breast Cases Diagnosed -Sentara Cancer Network - 2003 - 2005

Figure 9. Observed Survival for Breast Cases - National Cancer Data Base - 2003 - 2005


Dx 1 Year 2 Years 3 Years 4 Years 5 Years0%

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Stage O n = 77,643 Stage I n = 156,118 Stage II n = 113,508


The graphs below illustrate the 5-year survival of all breast cancer cases 2003-2005 in the National Cancer Data Base and the 5-year survival of all breast cancer cases in the Sentara Cancer Network Cancer Registries from 2003-2005. Sentara Cancer Network’s Stage 0 survival rate is slightly lower than the National Cancer Data Base. Sentara Cancer Network’s Stage I, II, and III, and IV rates are similar to national data.



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Outreach and ActionWhile pink ribbons have become ubiquitous around the country in October for breast cancer awareness month, the staff and volunteers connected to the Sentara Cancer Network celebrate outreach and survivorship throughout the year. Through Get Pink with Sentara outreach events, social media and online appointment requests, the teams have focused on urging women

to schedule their screening mammograms on time annually. Partnerships with the Susan G. Komen Foundation and the American Cancer Society remain strong throughout Hampton Roads with many

collaborative initiatives. In particular, the network is the proud recipient of grants to reach underserved women with mammography at Sentara Obici Hospital and Sentara Norfolk General Hospital from the Susan G. Komen Foundation; and from the American Cancer Society via a Wal-Mart donation to reach women in the City of Portmouth. The Sentara Comprehensive Breast Centers also acknowledge the ongoing support they receive from the dedicated hospital auxiliaries who over the years have funded the Sentara Mobile Mammography Van, new imaging equipment and direct patient services.

Figure 10. % of Eligible Patients with Sentinel Lymph Node Biopsy Goal: 90% (NAPBC) - 2008 - 2011Standard 2.4 of the National Accreditation Program for Breast Centers (NAPBC) standards states, “Axillary sentinel lymph node biopsy is considered or performed for patients with early stage breast cancer (Clinical stage I, II).” Figure 7 illustrates each breast center’s compliance with this standard.

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Figure 11 Breast Re-Excision rate – Goal: < 25% (Sentara) – 2007-2011

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Figure 12. Needle Biopsy Before Surgery Rate Goal: 90% (NAPBC) - 2007 - 2011

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Standard 2.9 of the National Accreditation Program for Breast Centers (NAPBC) standards states, “Palpation Guided or image-guided needle biopsy is the initial diagnostic approach rather than open biopsy.” Open surgical biopsy as an initial approach should be avoided as it does not allow for treatment planning and is associated with a high re-excision rate. Figures 11 and 12 demonstrate Sentara’s performance with the Needle Biopsy before Surgery rate as well as the Re-excision rate at each breast center in the Network. Source: Cancer Registry

Sentara Cancer Network 2008-2011


Figure 13. 2008-2011 Sentara Cancer Network Breast Cancer Stage at Diagnosis vs. National Cancer Data Base 2010Figure 13 illustrates the stage at diagnosis for Sentara Cancer Network breast cancers between 2008 and 2011. Early stage diagnosis (Stage 0/I) within the Sentara Cancer Network is approximately 5% greater than the NCDB percentage.

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Figure 14. Screening Mammogram Volume

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23,942 Figures 14 and 15 show the increase in volume of screening and diagnostic mammography within in Sentara Cancer Network. Sentara’s screening and diagnostic mammography have both increased significantly between 2008 and 2011.

Eric Feliberti, MD - Co-Chair, Surgical OncologyKevin Halista, MD - RadiologyRichard Hoefer, DO - Surgical OncologyAndrew Loiacono, MD - RadiologyJennifer Reed, MD - SurgeonMark Sinesi, MD - Radiation OncologyTerryl Times, MD - SurgeonScott Williams, MD - Radiation Oncology

Thomas Alberico, MD - Medical OncologyKelley Allison, MD - MammographyVictor Archie, MD - Radiation OncologyMary Blumberg, MD - PathologyThomas Clifford, MD - SurgeonMichael Danso, MD - Medical OncologyMelinda Dunn, MD - MammographyNina Fabiszewski, MD - Co-Chair, Mammography

Sentara Breast Program Physician Leadership



Figure 16. Observed Survival for Lung Cases - Sentara Cancer Network - 1998 - 2002



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Figure 17. Observed Survival for Lung Cases - National Cancer Data Base - 1998 - 2002



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Stage O n = 534 (Insufficient Data) Stage I n = 53,001 Stage II n = 17,567


These graphs illustrate the 5-year survival of all non-small cell lung cancer cases 2003-2005 in the National Cancer Data Base and the 5-year survival of all non-small cell lung cancer cases 2003-2005 in the Sentara Cancer Network Cancer Registries. Stage I, II, III, IV are all similar to the NCDB survival rates.

5 Years

Pioneering Vision AchievedThe Thoracic Cancer Committee has grown from a handful of surgeons to a dedicated and subspecialized team in Hampton Roads who work collaboratively to deliver the best possible diagnostics and treatment plans for thoracic cancer patients.

Recent achievements made by the Committee include: n Increase in the number of lung cancer patients presented at a multidisciplinary conference.n Development and implementation of a High Risk Lung Cancer Screening Program, with self-referral CT Scans for appropriate patients for the Hampton Roads region.n Partnership in the Society of Thoracic Surgeons (STS) has grown to include all hospitals in the network where thoracic surgery is performed.

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Sentara Thoracic Program Physician Leadership

John Bowers, III, MD - PulmonologyScott Cross, MD - Medical OncologyJeffrey Forman, MD - PulmonologyRichard Hoefer, DO - Surgical OncologyWilkes Hubbard, MD - Co-chair - Thoracic SurgerySteve Julian, MD - AdministrationPeter Moy, MD - Thoracic SurgeryJoseph Newton, MD - Thoracic SurgeryVijay Subramaniam, MD - Co-chair - PulmonologyBethany Tan, MD - Thoracic SurgeryScott Williams, MD - Radiation Oncology


Figure 19. Society of Thoracic Surgeons (STS) Lobectomy In-Hospital MortalitySentara Cancer Network vs STS National AverageFigure 19 illustrates the Sentara Cancer Network’s in-hospital lobectomy mortality from 2009 to 2011. Of the 128 patients entered into the Society of Thoracic Surgeons (STS) database in 2011, 0 patients expired, accounting for a 0% mortality rate. The STS national average for the 2009-2011 time period is 1.20%.

Note: Sentara Cancer Network includes data from the Thoracic Surgery Center at Sentara Heart Hospital, Sentara Leigh Hospital, Sentara CarePlex Hospital, Sentara Virginia Beach General Hospital and Sentara Obici Hospital

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Sentara Cancer Network(2009 - 2011)

(n = 66, n = 97, n = 128)

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(2009 - 2011)(n = 21, 279)

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Figures 20 and 21 illustrate esophagus and lung cancer volumes by Sentara Cancer Network hospital. Sentara Norfolk General Hospital represents the highest volume of lung cancer among hospitals in the Sentara Cancer Network and Sentara Leigh Hospital represents the highest volume of esophageal cancer.

Figure 20. Lung Cancer Volumes – Sentara Cancer Network - 2008-2011.

Figure 21. Esophagus Volumes – Sentara Cancer Network - 2008-2011.

Sentara Bayside Hospital/Sentara Princess Anne Hospital Sentara CarePlex Hospital Sentara Leigh Hospital Sentara Norfolk General Hospital*

Sentara Obici Hospital Sentara Virginia Beach General Hospital Sentara Williamsburg Regional Medical Center

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Figure 18. Sentara Cancer Network - 2008-2011 Non Small Cell Lung Cancers by Stage at DiagnosisFigure 18 illustrates the stage at diagnosis for Sentara Cancer Network lung cancers between 2008 and 2011. Early stage diagnosis is higher within the National Cancer Data Base. The NCDB also has a much higher unknown stage percentage than Sentara Cancer Network.

N/AN/A

Sentara Pancreatic Program Physician Leadership

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Collaborative Consortium While pancreatic cancer accounts for only 2.7% of all new cancers in the United States, it is the fourth leading cause of cancer deaths. The Pancreatic Cancer Consortium, formed by physician leaders from Sentara, Eastern Virginia Medical School, Virginia Oncology Associates and community physicians is comprised of highly skilled specialists committed to improving the long-term survival for pancreatic cancer patients This multi-disciplinary Consortium of experienced physi-cians and clinicians work closely together to deliver the highest quality diagnostics and treatments for each patient. Patients also have the opportunity to work one-on-one with a patient navigator.

“Virtual” Bi-Weekly ConferencesPhysicians meet bi-weekly via a web-enabled forum to discuss pancreatic cancer cases prospectively, in order to jointly develop the appropriate care plans. During the bi-weekly meetings, physicians:

n collaborate and discuss complex cancer cases

n review patient eligibility for clinical trials

n recommend appropriate courses of treatment

Annual Pancreatic Lecture SeriesThe Consortium has also joined together to provide an annual Pancreatic Lecture Series which brings national and local experts together to present pertinent pancreatic cancer topics, including the latest in pancreatic clinical practice and research.

Quality Care Advances and Clinical ProcessesThe multidisciplinary team focuses on achieving and maintaining excellent clinical outcomes, providing access to innovative national clinical trials, and educating clinical providers on pancreatic cancer care and management. Recent efforts to improve quality care and processes include:

n Participation in two national clinical trials

n Standardization of processes, including the approach to care for the resectable, borderline resectable, and metastatic pancreatic patient

n Adoption of a CT protocol for the interpretation of CT scans

n Increase of the detail provided in diagnostic reporting

n Benchmarking the Consortium’s clinical results against national results

n In-depth retrospective review of processes for continuous quality improvement


Rebecca Alston, MD - PathologyGlen Arluk, MD - GastroenterologyDavid Chang, MD - Medical OncologyScott Cross, MD - Medical OncologyEric Feliberti, MD - Surgical OncologySteven Foxx, MD - RadiologyValerio Genta, MD - PathologySteven Hall, MD - RadiologyRichard Hoefer, DO - Surgical Oncology, Co-Chair Pancreatic Cancer ConsortiumKelvin Hornbuckle, MD – GastroenterologyDoug Howerton, MD - Gastroenterology

Song Kang, MD - Radiation OncologyDavid Marcheschi, MD - PathologyDean McGaughey, MD - Medical OncologyMichael Montileone, MD - RadiologyJohn Paschold, MD - Medical OncologyRoger Perry, MD - Co-Chair – Surgical Oncology, Pancreatic Cancer ConsortiumSteven Pietruzynski, MD - RadiologyJames Primich, MD - RadiologyWilliam Richie, MD - RadiologyKishore Rao, MD - RadiologyDennis Rowley, MD - PathologyMozhdeh Salour, MD - Radiology

Niria Sanchez, MD - PathologyJames Schneider, MD – Surgical OncologyRavi Shamaiengar, MD - RadiologySarah Shaves, MD - RadiologyMark Sinesi, MD - RadiologyBen Skinner, MD - RadiologyJames Sparrer, MD - PathologyScott Stanley, MD - PathologyAudrey Steck, MD - PathologyEdward Trapani, MD - RadiologyJeffrey Vandesand, MD - RadiologyHarlan Vingan, MD - RadiologyMarshall Weissberger, MD - RadiologyScott Williams, MD - Radiation Oncology

Figure 25. 10 or More Lymph Nodes at Pancreatic Resection - 2009 to 2011 - Sentara Cancer NetworkIn late 2009, the Sentara Cancer Network Pancreatic Consortium adopted a benchmark of 10 or more lymph nodes harvested at the time of resection. The graph below illustrates the compliance with this standard from 2009 to 2011. Source: Cancer Registries

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Figure 22. Sentara Cancer Network Pancreatic Cancer Volumes 2005 - 2011Pancreatic cancer volumes are shown in figure 22. Sentara CarePlex Hospital, Sentara Leigh Hospital, Sentara Virginia Beach Hospital, and Sentara Norfolk General Hospital have the highest volume of pancreatic cancers in the Network. Source: Cancer Registries

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4%

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5%

Figure 23. Pancreatic Surgical Procedure Volume 2009-201172 pancreatic cancer resections (partial and total) were identified in 2009, 48 in 2010, and 73 in 2011. Pancreatic cancer resections include partial and total pancreatectomies. Source: CareDiscovery

Figure 24. Pancreatic Surgical Procedure Mortality Rate 2009 to 2011Since 2009, the mortality rate for pancreatic procedures has decreased from 7% to 5% within the Sentara Cancer Network. The internal benchmark was set at 5% in 2009 by the Pancreatic Cancer Consortium. Source: CareDiscovery

Advanced Prostate Cancer CareEach individual patient is presented with guidance on the treatment that is best matched with his age, lifestyle, and overall health conditions. The nationally accredited Sentara Cancer Network includes several sub-specialty trained oncologic urologists, medical oncologists.

Bringing New Treatment OptionsThe Sentara Cancer Network contributed to the approval of new medical treatment options for prostate cancer. Through local research and collaboration, there have been several new drugs approved and available to local patients.

The Prostate Cancer Program offers:n Board-certified, fellowship-trained prostate cancer specialists

n Leading-edge minimally invasive surgery using the da Vinci robot

n Advanced treatments including external beam radiation, cryoablation and seed therapy

n Access to the latest prostate cancer research and clinical trials in partnership with Eastern Virginia Medical School

n Patient navigators and ongoing support groups

One of the Top Ranking Urology Programs in the U.S.Within the network, Sentara Norfolk General Hospital was recently ranked among the Top 50 Urology programs in the country by U.S. News & World Report. In order to meet the criteria for this ranking, a hospital must excel across a range of difficult cases within the specialty. Scoring is based upon reputation, patient survival, patient safety and care-related services provided by nurses and physicians.


Figure 27. Observed Survival for Prostate Cases - National Cancer Data Base2003 - 2005

The graphs below are a comparison between the 5-year survival for prostate cancer in the National Cancer Data Base 2003-2005 and the 5-year survival for the Sentara Cancer Network 2003-2005. Stage I, II, and IV are lower in Sentara than at the NCDB. Stage 0 and III are slightly higher than the National Cancer Data Base.

Figure 26. Observed Survival for Prostate Cases - Sentara Cancer Network 2003-2005


Stage O n = 158 Stage I n = 13,350 Stage II n = 391,022



Stage O (Insufficient Data) Stage I (Insufficient Data) Stage II n = 1,939


0%

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Figure 28. Sentara Cancer Network - 2008-2011 Prostate Cancers by Stage at Diagnosis vs. National Cancer Data Base 2010

Figure 28 illustrates the stage at diagnosis for Sentara Cancer Network prostate cancers between 2008 and 2011. Early stage diagnosis (Stage I/II) within the Sentara Cancer Network is approximately 7% greater than the NCDB percentage.

Sentara Cancer Network - 2008-2011


0%

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6.4%10.0%

IV

5.3% 6.0%

UNK

2.5% 3.3%

Figure 29. Prostate Cancer Analytic Case Volumes 2005 - 2011This graph depicts the prostate cancer volumes for each Sentara Cancer Network hospital from 2005-2011. Volumes are highest at Sentara Norfolk General Hospital where most of the prostatectomies are performed.

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Unique Services for Hampton Roads The Sentara Cancer Network provides the only regional referral center for the treatment of head and neck cancer. Treatment strategies may include surgery, radiation and/or chemotherapy. Patients can be confident that an entire team of head and neck cancer specialists work together on their behalf, recommending the appropriate treatment and care, with 100 percent of cases reviewed at weekly cancer conferences.

Experience and ResourcesThe Sentara Cancer Network head and neck cancer team offers unmatched expertise and state-of-the-art care as well as community outreach efforts:

n Fellowship-trained head and neck oncologic and reconstructive surgeons including microvascular reconstruction, oncologic surgical pathologist, head and neck oncology research nurse, medical oncologists, radiation oncologists, endocrinologists, radiologists, plastic and reconstructive surgeons, dentists, social worker and dieticians.

n TransOral Robotic Surgery (TORS) program which uses the minimally invasive, precision instruments and fiber-optic camera of the daVinci™ robotic surgery.

n Partnership with the Eastern Virginia Medical School, collaborating with endocrinology experts to ensure the most comprehensive, advanced approach for treating thyroid cancer.

n Participation in Radiation Therapy Oncology Group clinical trials.

n Community outreach efforts with American Cancer Society partnerships, screenings and an active monthly oral, head, and neck support group.

n Advanced microvascular reconstruction which involves harvesting flaps of healthy tissue with their blood supply from remote sites in the body and implanting the tissue in the surgical site to reconstruct head and neck areas.


Sentara Head and Neck Program Physician LeadershipMatthew Bak, MD – Otolaryngology – Head and Neck Surgery

Daniel Karakla, MD – Otolaryngology – Head and Neck Surgery

Barry Strasnick, MD – Otolaryngology – Head and Neck Surgery


Figure 30. Sentara Cancer Network Head and Neck Cancer Volumes - 2005 - 2011The accompanying graph demonstrates the head and neck cancer volumes from 2005 to 2011. Head and neck cancer includes oral cavity/pharynx, larynx, nasal/sinuses, and thyroid. Sentara Norfolk General Hospital sees the vast majority of head and neck cancer in the Sentara Cancer Network.

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Figure 31. Sentara Norfolk General Hospital Head and Neck Cancer Conference - 2007 - 2011 Case PresentationsThe pie graph shows the breakdown of head and neck cases presented at the Head and Neck Cancer Conference at Sentara Norfolk General Hospital between 2007 and 2011.

Tongue: 192 18%

Major Salivary Glands: 93 9%

Tonsil: 104 10%

Oropharynx: 12 1%Hypopharynx: 31 3%

Thyroid: 116 11%

Nasal Cavity, Middle Ear and Accessory Sinuses: 108 10%

Other Buccal Cavity and Pharynx: 34 3%

Larynx: 217 20% Floor of Mouth: 36 3%

Gum and Other Mouth: 103 10%

Nasopharynx: 24 2%

2005 2006 2007 2008 2009 2010 2011

*** Head and Neck cancers include Oral Cavity/Pharynx, Salivary Glands, Larynx, Nasal/Sinuses, and Thyroid

Hem

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Multidisciplinary Approach The Sentara Cancer Network adopts a multidisciplinary approach to the diagnosis and treatment of leukemia and lymphoma, as well as other blood disorders. The Hematology/Oncology team consists of highly skilled physician leaders and health care specialists who work together to deliver the best possible outcome, and are committed to patient comfort and recovery. The dedicated Hematology/Oncology team meets bi-weekly to review and discuss each patient’s case and recommends the most appropriate treatments.

Hematopathology AdvancesThe hematopathology services of the Sentara Cancer Network continue to make advances. Expanded laboratory services now include Flow Cytometry, Fluorescence in Situ Hybridization, Cytogenetics, Immunohistochemistry, and Molecular Labs. A sustained year-over-year growth in referred cases is a testament to the clinical expertise and commitment to high quality. In 2012, the projected number of referred cases is:

n 1,007 Mone Marrow

n 3,191 Flow

n 2,904 Fluorescence in Situ Hybridization

n 1,491 Marrow Cytogenetic

n 591 Constitutional Cytogenetic

Innovation and TechnologyThe Sentara Cancer Network Hematology/Oncology cancer program offers innovative technologies, methods and standards. Team members frequently collaborate with Eastern Virginia Medical School and Virginia Oncology Associates on case reports and full clinico-pathologic research projects, demonstrating a continued commitment to medical student/resident education and translational research. Other recent accomplishments include:

n Improvements and standardization of coagulation lab testing

n Standardization of pathologic work up and clinical care of patients, applying current recommended guidelines



Figure 32. Sentara Cancer Network Hematology Quality Indicators - SCN vs. Benchmark - 2009-2011The Sentara Cancer Network Hematology Committee developed quality indicators for hematology and set internal Sentara goals for each. The graph below describes the quality indicator and shows the Network’s performance, which is over the set benchmark for each indicator.

86%

94%

90%

88%

92%

96%

98%

100%

Hematology: percentage of patients aged 18 years and older with a diagnosis of

chronic lymphocyticleukemia (CLL) who had

baseline flow cytometry studies

performed.

95.7%

97.4%

90.0%

Hematology: percentage of patients aged 18 years and

older with a diagnosis of multiple myeloma, not in

remission, who were prescribed or received intravenous

bisphosphonate therapy within the 12-month

reporting period.

91.2%90.4% 90.0%

Hematology: percentage of patients aged 18 years and

older with a diagnosis of myelodysplastic syndrome (MDS) or an acute leukemia

who had baseline cytogenetic testing performed on bone

marrow.

94.4%

97.9%

90.0%

2009 - 2010 2011 Sentara Benchmark

Lora Herman, MD – PathologyScott Kruger, MD– Medical OncologyH. Raymond Tahhan, MD – Transfusion Service

Burton Alexander, MD – Medical OncologyDaniel Atienza, MD – Medical OncologyScott Cross, MD – Medical OncologyStephen Fisher, MD – Hematopathology

Hematology/Oncology Physician Leadership

Watch videos of physicians and patients onlineat sentara.com/cancer

twitter.com/sentarahealth

youtube.com/sentarahealthcare

facebook.com/sentarahealth

facebook.com/sentaracolon

facebook.com/getpinkwithsentara

2011 Sentara Cancer Network Primary Site Table

Sentara Careplex Hospital

Sentara Leigh Hospital

Norfolk General Hospital


Grouping Primary Site Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Head/Neck Lip 1 1 0 0 1 1 0 0 0 0 0 0 0 0 2 2 Tongue 5 5 0 0 24 20 1 1 0 0 9 6 6 5 42 34 Salivary Gland 2 2 1 1 13 12 2 1 0 0 4 4 1 1 19 17 Floor of Mouth 1 1 0 0 5 5 1 1 0 0 2 2 0 0 8 8 Gum/Other Mouth 1 1 1 1 17 14 0 0 0 0 3 2 0 0 22 18 Nasopharynx 1 1 0 0 5 4 0 0 0 0 0 0 0 0 5 4 Tonsil 4 4 1 1 18 15 1 1 0 0 4 4 1 1 25 22 Oropharynx 2 2 0 0 8 5 1 1 1 1 1 1 0 0 13 10 Hypopharynx 2 2 3 1 10 8 1 0 0 0 4 2 0 0 18 11 Other Oral Cavity and Pharynx 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0Digestive Esophagus 9 9 24 20 19 16 4 4 8 7 10 7 3 2 71 59 Stomach 9 8 11 8 27 21 4 4 4 3 17 13 10 10 77 64 Small Intestine 4 3 8 7 5 4 2 2 6 6 8 8 2 2 33 30 Colon 59 55 69 60 74 61 35 30 44 41 79 72 32 29 372 329 Rectosigmoid Junction 3 3 2 1 5 3 1 1 1 1 5 5 2 2 18 15 Rectum 26 21 20 17 25 20 11 10 4 4 31 26 5 5 115 96 Anus, Anal Canal, and Anorectum 6 5 7 6 10 3 0 0 0 0 6 4 1 0 30 18 Liver 8 7 6 6 13 13 0 0 2 1 5 4 0 0 31 28 Intrahepatic Bile Duct 2 2 2 1 2 1 2 2 0 0 3 3 0 0 11 9 Gallbladder 5 5 4 4 6 6 1 1 0 0 4 4 1 1 21 21 Other Biliary 2 1 7 7 9 6 1 1 5 5 8 7 2 2 31 26 Pancreas 29 28 39 30 64 56 15 12 6 5 27 21 7 4 171 142 Retroperitoneum 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 Peritoneum, Omentum, and Mesentery 0 0 2 2 1 0 0 0 0 0 0 0 0 0 3 2 Other Digestive Organs 0 0 0 0 4 4 0 0 2 2 3 3 0 0 9 9Respiratory Nose, Nasal Cavity and Middle Ear 0 0 1 0 16 14 2 2 0 0 2 2 0 0 20 17 Larynx 8 8 5 4 44 42 9 7 2 2 8 6 3 3 66 59 Lung, Bronchus, - Small Cell 27 24 11 6 31 23 7 7 6 4 26 21 16 14 113 89 Lung, Bronchus - Non Small Cell 105 98 135 100 260 210 71 66 46 32 105 98 48 40 673 555 Lung, Bronchus - Other Types 5 5 8 6 16 13 5 5 2 2 5 4 1 1 33 29 Pleura 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Trachea, Mediastinum, Other Respiratory 1 1 0 0 1 1 0 0 0 0 0 0 0 0 2 2Bones and Joints Bones and Joints 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 1Soft Tissue Including Heart Soft Tissue Including Heart 7 6 9 5 23 19 4 3 3 3 9 7 0 0 50 38Skin Excl Basal and Squamous Melanoma - Skin 54 49 15 11 134 107 18 15 22 14 60 39 9 8 301 239 Other Rare Skin Types 4 4 5 5 12 7 1 1 1 1 2 1 0 0 24 18Breast Breast 269 253 314 273 494 286 94 83 146 127 245 196 152 146 1572 1235Female Genital System Cervix 2 2 2 2 9 8 7 6 2 2 6 5 4 3 28 24 Uterus 12 10 39 38 13 9 12 12 5 5 19 14 41 40 123 110 Ovary 5 4 11 10 12 5 4 3 4 2 19 15 17 17 66 51 Vagina 0 0 0 0 1 0 0 0 1 1 2 1 0 0 4 2 Vulva 1 0 7 3 5 0 0 0 0 0 2 1 3 2 18 6 Other Female Genital Organs 0 0 0 0 0 0 1 1 0 0 2 2 1 0 4 3Male Genital System Prostate 112 83 10 4 660 300 35 22 68 59 40 22 31 19 911 468 Testis 0 0 1 1 8 7 1 1 4 3 3 3 2 2 18 16 Penis 1 1 1 0 2 1 0 0 0 0 1 1 0 0 5 3 Other Male Genital Organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Urinary System Bladder 36 33 39 29 115 81 11 7 11 11 35 32 20 17 254 199 Kidney/Renal Pelvis 18 11 12 8 156 145 5 3 2 2 17 10 14 11 217 184 Ureter 1 0 2 2 11 10 1 1 2 2 2 2 1 1 18 16 Other Urinary Organs 0 0 1 0 1 1 0 0 0 0 0 0 0 0 2 1Eye and Orbit Eye and Orbit 0 0 1 0 4 2 0 0 0 0 1 0 0 0 6 2Brain and Other CNS Brain 7 6 3 3 81 64 8 7 3 3 15 15 0 0 107 88 Other CNS 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 1Endocrine Thyroid 17 16 31 30 96 88 20 19 0 0 20 18 18 18 187 175 Other Endocrine, Thymus 1 0 0 0 2 2 0 0 0 0 0 0 0 0 3 2Lymphoma Hodgkin Lymphoma 7 5 3 2 12 8 1 1 1 1 6 3 0 0 28 19 Non-Hodgkin Lymphoma 45 32 45 29 92 40 24 14 14 9 56 45 15 12 272 169 Myeloma 14 9 18 15 60 8 7 6 2 1 15 11 1 0 113 47Leukemia Leukemia 15 11 15 8 107 19 8 7 6 2 20 17 3 2 166 64Mesothelioma/Kaposi Sarcoma Mesothelioma 5 3 4 3 3 2 3 3 2 1 0 0 1 1 18 13 Kaposi Sarcoma 1 1 1 1 3 3 0 0 0 0 1 1 0 0 5 5Miscellaneous Miscellaneous 25 20 14 9 90 16 16 13 6 3 10 8 8 4 163 70

TOTAL TOTAL 986 861 970 780 2942 1842 458 387 444 368 990 800 482 425 6741 4995

Sentara Obici Hospital


Sentara Virginia Beach General Hospital

Sentara Williamsburg Regional Medical Center

Sentara Cancer

Network Total

Caseload

Sentara Cancer

Network Total

Analytic Caseload


Analytic cases are cases diagnosed and/or treated during the first course of treatment at the assigned institution. Total cases include cases that enter the institution for recurrences or later courses of treatment as well.

Data Compiled by Sentara Cancer Network Registry Subcommittee:

Jane Allmaras Gastrointestinal

Tammy Berryhill, CTR Gynecology Oncology

Karrie Brickhouse, CTR Hematology/Neuro-oncology

Kristy Bridgeman Head and Neck/Skin

Rhonda Despinis, CTR Breast, Rapid Quality Reporting System

Taquilla Diggs-Wright Urology

Sandra Edwards Follow-up

Cynthia Freeman, CTR Team Leader, Peninsula

Holanda Harding Breast

June Harlow Cancer Conferences/Follow-up

Kathleen Marcia, CTR Team Leader, Southside

Cressetta Peterson Breast

Terry Reich Casefinding

Lana Tyree, CTR Breast

Grouping Primary Site Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Total Analytic Head/Neck Lip 1 1 0 0 1 1 0 0 0 0 0 0 0 0 2 2 Tongue 5 5 0 0 24 20 1 1 0 0 9 6 6 5 42 34 Salivary Gland 2 2 1 1 13 12 2 1 0 0 4 4 1 1 19 17 Floor of Mouth 1 1 0 0 5 5 1 1 0 0 2 2 0 0 8 8 Gum/Other Mouth 1 1 1 1 17 14 0 0 0 0 3 2 0 0 22 18 Nasopharynx 1 1 0 0 5 4 0 0 0 0 0 0 0 0 5 4 Tonsil 4 4 1 1 18 15 1 1 0 0 4 4 1 1 25 22 Oropharynx 2 2 0 0 8 5 1 1 1 1 1 1 0 0 13 10 Hypopharynx 2 2 3 1 10 8 1 0 0 0 4 2 0 0 18 11 Other Oral Cavity and Pharynx 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0Digestive Esophagus 9 9 24 20 19 16 4 4 8 7 10 7 3 2 71 59 Stomach 9 8 11 8 27 21 4 4 4 3 17 13 10 10 77 64 Small Intestine 4 3 8 7 5 4 2 2 6 6 8 8 2 2 33 30 Colon 59 55 69 60 74 61 35 30 44 41 79 72 32 29 372 329 Rectosigmoid Junction 3 3 2 1 5 3 1 1 1 1 5 5 2 2 18 15 Rectum 26 21 20 17 25 20 11 10 4 4 31 26 5 5 115 96 Anus, Anal Canal, and Anorectum 6 5 7 6 10 3 0 0 0 0 6 4 1 0 30 18 Liver 8 7 6 6 13 13 0 0 2 1 5 4 0 0 31 28 Intrahepatic Bile Duct 2 2 2 1 2 1 2 2 0 0 3 3 0 0 11 9 Gallbladder 5 5 4 4 6 6 1 1 0 0 4 4 1 1 21 21 Other Biliary 2 1 7 7 9 6 1 1 5 5 8 7 2 2 31 26 Pancreas 29 28 39 30 64 56 15 12 6 5 27 21 7 4 171 142 Retroperitoneum 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 Peritoneum, Omentum, and Mesentery 0 0 2 2 1 0 0 0 0 0 0 0 0 0 3 2 Other Digestive Organs 0 0 0 0 4 4 0 0 2 2 3 3 0 0 9 9Respiratory Nose, Nasal Cavity and Middle Ear 0 0 1 0 16 14 2 2 0 0 2 2 0 0 20 17 Larynx 8 8 5 4 44 42 9 7 2 2 8 6 3 3 66 59 Lung, Bronchus, - Small Cell 27 24 11 6 31 23 7 7 6 4 26 21 16 14 113 89 Lung, Bronchus - Non Small Cell 105 98 135 100 260 210 71 66 46 32 105 98 48 40 673 555 Lung, Bronchus - Other Types 5 5 8 6 16 13 5 5 2 2 5 4 1 1 33 29 Pleura 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Trachea, Mediastinum, Other Respiratory 1 1 0 0 1 1 0 0 0 0 0 0 0 0 2 2Bones and Joints Bones and Joints 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 1Soft Tissue Including Heart Soft Tissue Including Heart 7 6 9 5 23 19 4 3 3 3 9 7 0 0 50 38Skin Excl Basal and Squamous Melanoma - Skin 54 49 15 11 134 107 18 15 22 14 60 39 9 8 301 239 Other Rare Skin Types 4 4 5 5 12 7 1 1 1 1 2 1 0 0 24 18Breast Breast 269 253 314 273 494 286 94 83 146 127 245 196 152 146 1572 1235Female Genital System Cervix 2 2 2 2 9 8 7 6 2 2 6 5 4 3 28 24 Uterus 12 10 39 38 13 9 12 12 5 5 19 14 41 40 123 110 Ovary 5 4 11 10 12 5 4 3 4 2 19 15 17 17 66 51 Vagina 0 0 0 0 1 0 0 0 1 1 2 1 0 0 4 2 Vulva 1 0 7 3 5 0 0 0 0 0 2 1 3 2 18 6 Other Female Genital Organs 0 0 0 0 0 0 1 1 0 0 2 2 1 0 4 3Male Genital System Prostate 112 83 10 4 660 300 35 22 68 59 40 22 31 19 911 468 Testis 0 0 1 1 8 7 1 1 4 3 3 3 2 2 18 16 Penis 1 1 1 0 2 1 0 0 0 0 1 1 0 0 5 3 Other Male Genital Organs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0Urinary System Bladder 36 33 39 29 115 81 11 7 11 11 35 32 20 17 254 199 Kidney/Renal Pelvis 18 11 12 8 156 145 5 3 2 2 17 10 14 11 217 184 Ureter 1 0 2 2 11 10 1 1 2 2 2 2 1 1 18 16 Other Urinary Organs 0 0 1 0 1 1 0 0 0 0 0 0 0 0 2 1Eye and Orbit Eye and Orbit 0 0 1 0 4 2 0 0 0 0 1 0 0 0 6 2Brain and Other CNS Brain 7 6 3 3 81 64 8 7 3 3 15 15 0 0 107 88 Other CNS 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 1Endocrine Thyroid 17 16 31 30 96 88 20 19 0 0 20 18 18 18 187 175 Other Endocrine, Thymus 1 0 0 0 2 2 0 0 0 0 0 0 0 0 3 2Lymphoma Hodgkin Lymphoma 7 5 3 2 12 8 1 1 1 1 6 3 0 0 28 19 Non-Hodgkin Lymphoma 45 32 45 29 92 40 24 14 14 9 56 45 15 12 272 169 Myeloma 14 9 18 15 60 8 7 6 2 1 15 11 1 0 113 47Leukemia Leukemia 15 11 15 8 107 19 8 7 6 2 20 17 3 2 166 64Mesothelioma/Kaposi Sarcoma Mesothelioma 5 3 4 3 3 2 3 3 2 1 0 0 1 1 18 13 Kaposi Sarcoma 1 1 1 1 3 3 0 0 0 0 1 1 0 0 5 5Miscellaneous Miscellaneous 25 20 14 9 90 16 16 13 6 3 10 8 8 4 163 70

TOTAL TOTAL 986 861 970 780 2942 1842 458 387 444 368 990 800 482 425 6741 4995

Cancer ConferencesSentara

TThe Sentara Cancer Network is one of the largest in the nation and is the only accredited cancer network

in Virginia. This distinction from the American College of Surgeons Commission on Cancer means we are

held to the highest standards in delivering cancer care to our community.

Comprehensive services are provided at centers across the region by a team of specialists who share information via a growing number of Multi-disciplinary Cancer

Conferences. If you are a physician who would like to join any of the conferences, please contact the coordinators at the numbers provided.

Pancreatic Cancer Conference

Breast Cancer Conference

General Cancer Conference



1st and 3rd Mondayof every month7:00 - 8:00 am

Every Tuesday7:00 - 8:30 am

Every Thursday7:00 - 8:30 am

1st and 3rd Wednesdayof every month7:15 - 8:15 am

2nd or 4th Fridayof every month7:00 - 8:00 am

WebEx

First Floor Conference Room B


Jamestown Room

Jamestown Room

(757) 827-2206

(757) 259-6652

(757) 259-6652

(757) 259-6652

(757) 259-6652

Yes

Yes

Yes

Yes

Yes

ConferenCe room ContaCt CmeapprovedSite date &

time

Sent

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Care

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Hosp

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www.sentara.com/cancer Your community, not-for-profit health partner


Cancer ConferencesSentara

TThe Sentara Cancer Network is one of the largest in the nation and is the only accredited cancer network

in Virginia. This distinction from the American College of Surgeons Commission on Cancer means we are

held to the highest standards in delivering cancer care to our community.

Comprehensive services are provided at centers across the region by a team of specialists who share information via a growing number of Multi-disciplinary Cancer

Conferences. If you are a physician who would like to join any of the conferences, please contact the coordinators at the numbers provided.

Pancreatic Cancer Conference





1st and 3rd Mondayof every month7:00 - 8:00 am

Every Tuesday7:00 - 8:30 am


1st and 3rd Wednesdayof every month7:15 - 8:15 am

2nd or 4th Fridayof every month7:00 - 8:00 am

WebEx



Jamestown Room

Jamestown Room

(757) 827-2206

(757) 259-6652

(757) 259-6652

(757) 259-6652

(757) 259-6652

Yes

Yes

Yes

Yes

Yes


time

Sent

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Care

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Hosp

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www.sentara.com/cancer Your community, not-for-profit health partner


time

Sentara Cancer Conferences



Head & Neck Conference

Multidisciplinary Cancer Conference

Liver Cancer Conference

Thoracic Oncology

Neuro-Oncology Tumor Conference

Surgical Pathology Breast Conference

Urology Conference



Cancer Grand Rounds



GI Conference &Lung Conference

Hematology Conference


1st, 3rd and 5th Wednesday of every month7:00 - 8:00 am

4th Tuesdayof every month 7:00 - 8:00 am


2nd Friday of every month

9:15 am

1st and 3rd Wednesdayof every month 7:00 - 8:00 am

4th Wednesday of every month 7:00 - 8:00 am

2nd Thursday of every month 7:00 - 8:00 am

2nd and 4th Thursdayof every month7:00 - 8:00 am

1st Monday of every month5:00 - 6:00 pm


2nd Wednesdayof every month

7:00 am

1st Tuesday of every month12:30 - 1:30 pm

Every Other Thursday7:00 - 8:00 am

1st and 3rd Thursdayof every month7:00 - 8:00 am

1st Wednesday of every month

6:00 pm

2nd and 4th Wednesday of every month

6:00 pm

3rd Wednesdayof every month

6:00 pm

Breast Center Conference Room

Breast CenterConference Room

EVMS Hofheimer Hall

EVMS Hofheimer Hall

Webex

Sentara Heart Hospital 1st Floor

Conference Room II

Sentara Heart Hospital 6th floor

Dept of Neurology

Sentara Heart Hospital 1st Floor

Conference Room 1

Sentara Heart Hospital 1st floor

Conference Room 1

Garden Level Classroom C & D

2nd FloorLarge Administration

Conference Room

SVBGH Health & Education Center

Rooms A & B

SVBGH Cancer Resource/Diabetes Conference Room

SVBGH Cancer Resource/Diabetes Conference Room

3rd Floor Multi-media roomVirginia Oncology Associates



(757) 261-5404

(757) 261-5405

(757) 388-2442

(757) 388-2442

(757) 388-2442

(757) 388-2442

(757) 388-2442

(757) 388-2442

(757) 388-2442

(757) 934-4791

(757) 507-1099

(757) 395-8686

(757) 395-8686

(757) 395-8686

(757) 459-9229

(757) 459-9229

(757) 459-9229

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

CME Varies

CME Varies

CME Varies

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Sentara Gloucester Medical Arts

Sentara BelleHarbour

Sentara Greenbrier HealthPlex

Sentara St. Luke’s

Sentara Independence

13

Hospitals

Outpatient Centers

Sentara Port Warwick

www.sentara.com/cancer

Sentara Cancer Network – Points of Care

SSentara’s unique program is recognized for the strength of its vast network of cancer experts, coupled with the personal care of its many community cancer centers conveniently located throughout the region. When you receive care at any one of these locations, you access a comprehensive network of cancer care. And the most impressive feature of that network is its ability to collaborate and provide a multidisciplinary approach that leads to better quality – and a better patient experience.

Need answers to your cancer questions? You’re one call away.

Call Toll Free: 888-220-2214Speak with a cancer expert who will answer your questions and provide you with the resources you need for cancer prevention, detection,

treatment and support.

s cancer c n - sentara healthcare

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