Cancer Annual Report 2004 - The Medical Center

The Medical Center
CANCER TREATMENT CENTER
FOR SOUTHERN KENTUCKY
250 PARK STREET BOWLING GREEN, KY 42101 WWW.THEMEDICALCENTER.ORG
Hope on the Horizon
ANNUAL REPORT 2004

Message from the chairperson
I present this report to you with a thankful heart for the diligent
efforts of our Cancer Committee, our Cancer Care Staff and our
Tumor Registry Staff.
We were gratified by our recognition as an accredited cancer program
by the American College of Surgeons. This year we worked to
expand the services to our patients and the community.
Technological advances in cancer care are critical for achieving the
highest rates of symptom control and cure. The new radiation therapy
equipment is a step in that direction. The personal side of cancer
care is no less important. The Palliative Care initiative and ongoing oncology staff training in
pain control are directions toward maximizing quality of life.
We are proud to be a part of the community effort towards early diagnosis, prevention, and
research with the goal to decrease the impact this disease has on families. I am grateful for
the opportunity to have been part of this team.
We all appreciate the trust patients and their families have given to The Medical Center
Cancer Care Team and we will strive to continue to earn that trust.
Jane R. Bramham, M.D.
Committee Chairperson
Cancer Committee Members
Jane Bramham, M.D.
Medical Oncology
Committee Chairperson
Jake Barrick
Medical Staff Coordinator
Irene Bates
Director – Marketing Communications
James Beattie, M.D.
Pathology
David Bergamini, M.D.
Urology
Georgena Brackett
Director
Health Information Management
Raymond P. Cloutier, M.D.
Internal Medicine
Chris Desmarais
Senior Vice President
M. James Gaffney, M.D.
Family Practice and Palliative Medicine
Kendra Garvin
Tumor Registry
Daniel Geis, M.D.
Pathology
Tumor Conference Coordinator
Gerri Glenn
Director - Social Services
Tage Haase, M.D.
General Surgery
Physician Liaison
Bridget Kilpatrick
Clinical Manager – Oncology
Sarah Moore
Vice President
Linda Rush
Director - Community Wellness
Richard McGahan, M.D.
Radiation Oncology
Paul Ramsingh, M.D.
Chief of Radiology
Eddie Scott
Director
Departments of Radiation Oncology
and Radiology
Jana Thornton
Tumor Registry
Sandra Webb
Medical Staff Coordinator
Laura Williams
Supervisor
Health Information Management
Michael Zachek, M.D.
Pulmonary and Critical Care Medicine

Case Counts By Year
BOWLING GREEN COMBINED
Reporting Accession Years: 1999 to 2004 — Case Classes Included: 0, 1, 2
Site 1999 2000 2001 2002 2003 2004
Lip 2 0 1 0 0 0
Tongue 2 6 2 5 3 5
Salivary glands 1 0 1 2 3 5
Gum & hard palate 0 0 2 1 0 0
Floor of mouth 0 0 3 0 1 3
Buccal mucosa 1 1 1 0 0 0
Oropharynx 0 2 1 7 7 4
Nasopharynx 1 0 2 0 3 3
Hypopharynx 1 0 0 3 0 1
Other oral cavity 0 1 0 0 0 0
Esophagus 4 4 13 7 6 10
Stomach 7 4 6 6 5 3
Small Intestine 2 0 3 1 1 4
Colon 51 65 51 46 51 48
Rectum/Anus 15 19 33 22 36 23
Liver 3 3 5 2 4 1
Gallbladder 1 5 4 4 5 0
Pancreas 9 12 7 10 12 11
Other digestive tract 1 1 0 2 0 0
Nasal cavities,sinuses,ear 0 2 0 0 1 1
Larynx 15 8 12 21 20 20
Trachea,bronchus,lung-small 32 32 41 39 42 41
Trachea,bronchus,lung-NSC 86 109 133 152 158 151
Other respiratory 0 1 0 1 3 3
Bone 0 0 0 2 1 0
Connective & soft tissue 5 6 2 0 3 6
Malignant melanoma 18 23 21 24 17 16
Other skin 2 5 9 3 1 1
Breast, female & male 105 118 121 161 124 149
Cervix 4 11 6 14 7 8
Endometrium (corpus uteri) 10 24 7 12 11 16
Ovary 4 5 3 7 6 8
Other female genital organs 1 6 5 4 2 9
Prostate 33 48 56 84 73 74
Testis 5 3 6 1 4 10
Other male genital organs 0 1 3 3 0 2
Bladder 12 23 17 27 36 24
Kidney 15 6 14 16 14 13
Other urinary organs 2 1 2 2 1 1
Brain 6 7 8 10 15 12
Thyroid 28 25 24 18 14 16
Other endocrine 0 1 0 0 0 0
Hodgkin’s 2 11 6 4 4 3
Non-Hodgkin’s Lymphomas 19 24 22 26 22 19
Plasma cell tumors 6 8 4 7 4 5
Lymphocytic leukemias 9 7 5 8 3 2
Myeloid leukemias 3 9 5 2 6 2
Other leukemias 0 1 2 2 2 0
Myeloprolif. & myelodysplas. 0 0 0 2 0 1
Unknown primary 15 30 23 22 21 16
Benign/borderline brain,cns 0 0 0 0 0 9
Total 538 678 692 792 752 759
Top Five Cancer Sites – 2004
(Comparing The Medical Center top five sites with Kentucky and National data)
Site The Medical Center Kentucky National
Lung 26% 19% 13%
Breast 19.40% 17% 16%
Prostate 10% 9% 17%
Colon 6% 10% 8%
Bladder 3% 4% 5%

Skin Cancer
“Fry now…pay later” could refer to the personal cost of sunburns
and deliberate sun exposure/tanning. Harmful ultraviolet
rays from the sun cause most skin cancers. This damage is generally
accumulated over many years. Blistering sunburns in
childhood may be the initial step toward skin cancer in later
years but every unprotected sun exposure over a lifetime adds to
the risk of eventually developing a skin cancer. Other less frequent
causative factors for skin cancer include repeated x-ray
exposure, scarring from certain skin conditions or burns, certain
occupational hazards (coal, arsenic) and family history. People
at greatest risk for skin cancers are those with fair skin, light
hair and eyes who sunburn easily. However, even someone with
much darker skin and little tendency for sunburn may develop
skin cancer with repeated significant prolonged sun exposure.
There are three types of skin cancer: basal cell carcinoma,
squamous cell carcinoma and malignant melanoma. Basal cell
skin cancers usually appear as small shiny, translucent or pigmented
bumps that slowly increase in size and may become a
bloody, non-healing “sore.” This type of cancer is the most common
skin cancer and rarely spreads internally but may cause significant
local destruction. Squamous cell cancer, the second
most common skin cancer, may appear as red, scaly patches or
large bumps and is capable of spreading internally. Malignant
melanoma may develop within a pre-existing mole or may
develop on normal appearing skin. A melanoma is usually
darkly colored but in rare instances may be skin-toned, reddish
or even white. Melanoma has a strong tendency to spread and
may be fatal if allowed to spread.
Like any other cancer, early detection of skin cancer is
essential for best outcome. Examine your skin monthly for new
or changing skin lesions. Look for new, persistent unusual
bumps, new persistent scaly patches on any skin surface but
especially on the sun-exposed skin. With moles, look for change
in size, shape, color, spread of color from the mole into surrounding
skin and new sensation in a mole such as itching,
tenderness or pain.
You can decrease your risk for skin cancer. Avoid deliberate,
prolonged unprotected sun exposure, especially between
10 a.m. and 4 p.m. Apply a sunscreen with SPF at least 15 with
UVA/UVB coverage every day. Wear a hat with a brim and
other protective clothing when possible. Be aware if any of your
prescribed oral medications cause increased sensitivity to sunlight.
Avoid tanning in the sun or in tanning beds. Examine your
skin on a regular basis. See a dermatologist annually for a full
skin exam.
Jo Ann D. Jones, M.D.
Dermatology/Graves-Gilbert Clinic
Story of a Survivor: Shawn Rhodes
On February 16, 1999 Shawn Rhodes was at Graves Gilbert
Clinic for an appointment with Dr. Stephen Slaughterbeck
regarding a few spots on his face that he believed were suspicious
and cause for concern. The spots Shawn was worried
about were not dangerous, but some other spots were of great
concern to Dr. Slaughterbeck. Shawn’s examination was more
intense than he expected and at 9:38 a.m. he was diagnosed with
a very aggressive type of melanoma skin cancer. Shawn was
scheduled for surgery on Thursday, two days later. He was to
have lesions removed on his lower back, right buttock, and
right calf.
Shawn’s surgery on Thursday, February 18, 1999 was just
the first of many. His series of surgeries totaled 30, some
smaller and less intense than others. These surgeries allowed
Shawn to avoid radiation and chemotherapy; for that he felt very
fortunate. The largest spot of cancer was located on his lower
calf. To regain strength in his leg, he attended rehabilitation. He
was forced to walk with crutches for one month, but soon
moved to one crutch and then a single cane for several weeks.
Shawn experienced a slight depression with the scare of
facing cancer. Melanoma runs in his family and had been the
cause of his aunt’s death when he was 12. His grandfather’s
death was also cancer related. Thinking about the losses due to
cancer, Shawn was overcome with fear because of his young
age and the life he had always been looking forward to.
With his family’s support and on-going spiritual life, Shawn
came out of his depression and began looking into all of the
positive aspects of his life.
He became more involved
in his church and community
and continued to
change his life in a positive
way. Becoming more
physically active and improving
his health has
brought Shawn to where
he is today. He is currently
involved in triathlon and
marathon training and will
soon be involved in a 150-
mile bike ride.
Looking back on his
cancer experience, Shawn
sees how much more he
appreciates life. Lance
Armstrong’s writings have
contributed to his inspiration
of making himself an
all around better person
and helps him know he can conquer anything. Shawn lives by the
belief that knowledge is power and attitude is everything. Now
at 32 years of age, Shawn is cancer free and schedules checkups
every six months. He is the father of two young children.
Shawn is living life to its fullest and enjoying every minute of it.

2004 Cancer Registry Report
A cancer registry is an information system designed for the
collection, management, and analysis of data on persons with
the diagnosis of a malignant or neoplastic disease (cancer).
Cancer registries maintain a wide range of demographic and
medical information including diagnostic findings, cancer therapy,
and follow-up. Since the initiation of the cancer registry at
The Medical Center more than 9900 cases have been abstracted
into the Kentucky Cancer Patient Data Management System
(CPDMS). CPDMS is a computer-based system for collecting,
managing and analyzing information related to the diagnosis,
and treatment of cancer patients in Kentucky. The CPDMS system
meets all of the requirements for an American College of
Surgeons approved cancer program. The registry is maintained
by two full time Certified Tumor Registrars who are responsible
for casefinding, abstracting, and lifetime follow-up on all cancer
patients diagnosed and/or treated at The Medical Center.
Tumor conferences are held weekly and are attended by
medical staff and other ancillary personnel. Radiological and
pathological reports are reviewed and an open discussion is held
among the physicians regarding management and staging for
each individual case presented.
The cancer committee meets quarterly and includes participation
from a multi-disciplinary team to assure quality care to
all cancer patients. The information included in this report summarizes
data for the year 2004. For more information regarding
the Cancer Registry or related data, call 270–745–1288 or
270–796–5104.
Jana Thornton, RHIT, CTR
Kendra Garvin, RHIT, CTR
American Cancer Society Report
Since 1913, the American Cancer Society, through the tireless
efforts of supporters like The Medical Center, has offered
hope, progress, and answers to millions of cancer patients and
their families. The five-year relative survival rate of cancer
patients has gone from 25 percent in 1946 to approximately 64
percent for all cancers diagnosed between 1995 and 2000. But
the American Cancer Society won’t rest until the fight to end
cancer is over.
The Medical Center and American Cancer Society serve as
partners on many levels, including;
Patient services:
• The Medical Center is a recipient of a transportation grant
that assists patients receiving treatment at their cancer
centers in Bowling Green and Glasgow.
• Staff refers patients to the American Cancer Society programs
such as I Can Cope education sessions; Look Good
…Feel Better, Man to Man, Reach to Recovery, and Road
to Recovery.
• Sessions (such as Look Good…Feel Better and I Can
Cope) are held at The Medical Center and their Health
& Wellness Center located in the Greenwood Mall.
• The Medical Center staff also refers patients to the
American Cancer Society’s Information Center,
1–800–ACS–2345 and to the local office for information,
financial assistance and personal items (i.e. wigs,
mastectomy bras and breast forms.)
Volunteerism:
• Employees from The Medical Center are involved in
advocacy efforts on the local and state level.
• Employees from The Medical Center form teams and
raise money for Relay For Life and serve on the statewide
Relay Leadership Committee.
• Employees serve as speakers for American Cancer
Society education and patient support programs.
• Employees serve as local leadership volunteers
2004 Melanoma Cases
100 -
90 -
80 -
70 -
60 -
50 -
Survival %
40 -
30 -
20 -
10 -
0 -
0 8 16 24 32 40 48 56
Months Past Diagnosis
Types of Therapy 2004
Surgery (72%)
Surg/Rad (21%)
Surg/Chemo/Rad (7%)

2004 Cancer Prevention, Education
& Screening Series
Programs that are available monthly throughout the year
include Mammography Days, Cancer Patients & Family Support
Group meetings and Man to Man Prostate & Testicular Support
Group meetings (ASC) and Cooper Clayton Smoking Cessation
classes.
January
• Health & Wellness Expo (cancer prevention educational materials,
colon cancer screening kits, breast & testicular detection,
demonstrations, oral cancer screenings)
• Body Fat Screenings (Health & Wellness Center)
• Nutrition/Exercise – Behavioral Lifestyle Changes for Health
Class (Health & Wellness Center)
• Weigh to Wellness (eight-week weight loss program)
• American Cancer Society Services Class (information on
nutrition, pain relief, money management, support groups and
programs presented at the Health & Wellness Center)
• Promotion of age specific screenings and diagnostic test for
men to Men’s Health Alliance members
• Cancer Prevention and Detection materials distributed at
Dollar General Health Fair
February
• Fit for Life (program for children focusing on development of
healthy eating habits and basic activity patterns)
• Catholic Church Health Fair
• Cancer Prevention and Detection materials distributed at Holy
Spirit
• Colorful Choices: 5 A Day Fruits & Vegetables Program promoted
to the City of Bowling Green (benefit of increasing
intake is cancer prevention)
• Breast Self-Exam and Testicular Self-Exam Education for students
at Warren Central High School
March
• Three-day food diary analyzed by dietitian (Health &
Wellness Center)
• Eat Smart, Stay Healthy Class (promotion of Five-A-Day)
• Look Good Feel Better session (Health & Wellness Center)
• MOPS (Mothers of Preschoolers) presentation on Women’s
Health with a focus on Breast Cancer awareness
• BRASS (Barren River Area Safe Space) Presentation on
Colorful Choices: Five-A-Day Fruits & Vegetables Program
(benefit of increasing intake is cancer prevention)
• Breast Cancer Awareness program for women’s group at
Broadway Methodist Church
April
• Fit for Life (8 week program promoting good nutrition &
activity for children)
• Rollout of The Medical Center’s Healthy Kids Club (focus on
good nutrition, physical activity, adapting healthy lifestyle
habits including not smoking)
• Nutrition for the Person With Cancer Class (Health &
Wellness Center)
• Humor & Health Class
• “Hazards of Smoking”/YMCA Scottsville Children’s event
• Breast Cancer Awareness session Scottsville Senior Center
May
• Senior Health & Fitness Day (cancer prevention & educational
materials distributed)
• Lung Health Screening (Health & Wellness Center)
June
• Why Positive Living Matters (Women-in-Charge Luncheon)
• PSA screenings (Health & Wellness Center) – 230 men
screened/22 elevated
• Dermascan/Sun damage screening (KCP) – 136 screened
• ACS Look Good…Feel Better Program (Health & Wellness
Center)
July
• Can Five A Day Keep Cancer Away (Women-in-Charge
Luncheon/Scottsville & class at Health & Wellness Center)
• Men’s Health Update
• Quebecor/Franklin Health Fair—booth on breast and testicular
cancer awareness
• Radio interview/Franklin WKFN on breast health
• Healthy Kids Club promotion in mall food court—
weight/BMI
August
• Steps to Breast Health/Marilyn Wheat (Women-In-Charge
luncheon, Franklin)
• Making the Right Decision: Cancer Prevention &
Detection/Dr. Jane Bramham (Women in Charge Luncheon,
Bowling Green)
• Promotion of Healthy Kids Club/distribution of HKC water
bottles at Briarwood Elementary, Bowling Green
• Promotion Healthy Kids Club/Franklin – Garden Spot Run
September
• Oral Cancer Screening
• Can Five A Day Keep Cancer Away (Health & Wellness
Center
October
• Women’s Conference (oral cancer screenings, educational
material, speaker on breast health & cancer awareness, dermascan)
• Breast Cancer Awareness (Health & Wellness Center)
• Promotion/education of screening mammography (WellNews
newsletter)
• Lung Health Screening
• The Anti-Cancer Lifestyle Class (Health & Wellness Center)
• ACS Look Good…Feel Better Class (Health & Wellness
Center)
November
• Community Health Fair (Scottsville)
December
• Twelve Days of Wellness (Health & Wellness Center – nutrition,
tea, stress mgt, setting healthy goals, controlling holiday
eating, exercise, etc)
• Avoiding Excessive Weight During the Holidays/Health &
Wellness Center class
• ACS Look Good/Feel Better Class (Health & Wellness
Center)
• Wellness Diary’s for holiday gift to Women’s Center members
with cancer prevention, early detection information.