2012 Annual Report - Sentara.com

CANCER
Sentara
Cancer Network
2 0 1 2
Annual R e p o r t

Sentara Cancer Network - By the Numbers
More than
6,000
cancer patients
treated each year
More than
66,000
patients documented
in Cancer Registry
since 1995
9,961
Cases Presented in
Cancer Conferences
(2007-2011)
13
facilities providing care
to cancer patients
Contents
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
Note: The data shared in this report is the most
currently available from the National Cancer Database
and the Sentara Cancer Network registries.
More than
70
More than
17,921
clinical trials
available for patients
community members reached
through outreach programs in 2011

A positive patient experience is critical.
We believe our patients deserve the very best
every time they walk through our doors.
Figure 1.
2011 Sentara Cancer Network Top 15 Analytic Cancer Sites
Breast 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.
All Other Sites: 824 16%
Breast: 1,235 25%
Stomach: 64 1%
Brain 88 2%
Rectum: 96 2%
Uterus: 110 2%
Non-Hodgkin Lymphoma: 169 3%
Pancreas: 142 3%
Thyroid: 175 4%
Kidney/Renal Pelvis: 184 4%
Bladder: 199 4%
Melanoma – Skin: 239 5%
Colon: 329 7%
Lung
673 13%
Prostate: 468 9%
www.sentara.com/cancer 3

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.
4 Sentara Cancer Network 2012 Annual Report

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.
Figure 2.
Sentara Cancer Network Cancer Conference Program -
Number of Cases Presented 2007 – 2011
During these conferences, physicians meet to share expert knowledge and create
individualized care plans to ensure the best possible patient outcomes.
3,000
2,500
2,000
1,970
2,188
2,399
2,290
1,500
1,000
1,144
500
0
2007
2008
2009
2010
2011
www.sentara.com/cancer 5

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.
Sentara Network Cancer Steering Committee Members
Physicians
Thomas Alberico, MD – Medical Oncology,
Cancer Committee Chair
James Schneider, MD – Surgical Oncology,
Cancer Liaison Physician
Victor Archie, MD – Radiation Oncology
Bruce Booth, MD – Medical Oncology
Joseph Dalton, MD – General Surgery
Krista Dobbie, MD – Palliative Care
Eric Feliberti, MD – Surgical Oncology
Mark Fleming, MD – Medical Oncology
Richard Hoefer, DO – Surgical Oncology
Lester Johnson, MD – Radiology
John Patterson, MD – Hospice and
Palliative Medicine
Marc Silverberg, MD – Pathology
Scott Williams, MD – Radiation Oncology
Jason Wilson, MD – Surgical Oncology
Non-Physicians
Cynthia Allen – Vice President,
Ongology Services
Deb Anderson – Strategy
Joani Brough – Administration, SPAH
Connie Bush – Community Outreach
Janet Creef – Oncology Social Work
Kimberly Dorsch – Clinical Research
Nicky Dozier – Clinical Research, VOA
Cindy Estes – Oncology Nursing
Pennie Faircloth – American Cancer
Society
Cynthia Freeman – Cancer Registry
Michael Gentry – Corporate Vice President
James Hoy – Pastoral Care
Vonia Ickes – Clinical Nutrition
Joanne Inman – Administration, SVBGH
Brad Kirby – Administration, Sentara
Cancer Network
Tifany Lewis – VOA Genetics
Kathleen Marcia – Cancer Registry
Maureen McGrath – Administration, VOA
Linda McKee – Administration, SCH/SWRMC
Sylvia Richendollar – Administration, SNGH
June Robertson – Administration, SVBGH
Meredith Strand – Administration, SNGH
Jennifer Taylor – Oncology Nursing
Rose West – Marketing
Lynne Whitlock – Administration, SOH
Eric 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 assistedliving
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.
6 Sentara Cancer Network 2012 Annual Report

Colorectal Cancer Program
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 Improvement
The 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.
Figure 3.
Observed Survival for Colorectal Cases -
Figure 4.
Observed Survival for Colorectal Cases -
Sentara Cancer Network 2003 - 2005
National Cancer Data Base for 2003 - 2005
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.
Cumulative Survival Rate
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dx 1 Year 2 Years 3 Years 4 Years
Years from Diagnosis
Cumulative Survival Rate
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
5 Years Dx 1 Year 2 Years 3 Years 4 Years 5 Years
Years from Diagnosis
Stage O n = 47 Stage I n = 218 Stage II n = 195
Stage III n = 196 Stage IV n = 159
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
www.sentara.com/cancer 7

Colorectal Cancer Program
CONTINUED
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.
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.
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.
www.facebook.com/sentaracolon
Figure 5.
Sentara Cancer Network - % of Colon Resections With 12 or More Lymph Nodes Sampled 2005 - 2011
The 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.
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
86 87
Sentara Bayside
Hospital/
Princess Anne
Hospital
53
92
Sentara
CarePlex
Hospital
39 41
69
97
88
86
80
Leigh
Hospital
49
40
98 100 98 98
100 100
97
95 97
95
91
90 91
95
90 92
88 87
83
80 82 2005
81
75
74
2006
68
68
60
61
2007
Sentara
Norfolk General
Hospital
Sentara
Obici
Hospital
35
Sentara
Virginia Beach
General
Hospital
Sentara
Williamsburg
Regional
Medical Center
44
Sentara
Cancer
Network
2008
2009
2010
2011
100 98 95 100 100 Sentara
8 Sentara Cancer Network 2012 Annual Report

Figure 6.
Sentara Cancer Network
2008-2011 Colon Cancers by Stage at Diagnosis
Figure 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
30%
25%
23% 23%
20%
15%
20%
17%
Sentara Cancer Network - 2008-2011
National Cancer Data Base 2010
0%
0
26% 25%
IV
III
I
II
22%
20%
UNK
10%
5%
7% 7%
2%
8%
Figure 7.
Colorectal Cancer Analytic Case Volumes 2005 - 2011
This 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.
Number of Cases
140
120
100
80
60
40
20
0
17
35
44
Sentara Bayside
Hospital/
Princess Anne
Hospoital
115 118 104
79 81 82
78 72 73
77
64
Sentara
Sentara
CarePlex
Leigh
Hospital
Hospital
91
68 78 82 90
64
Sentara
Norfolk General
Hospital
82
40 36
27
40
Sentara
Obici
Hospital
122
101
79
96
120
109
98
Sentara
Virginia Beach
General
Hospital
45
32
44 53 45
23 33
Sentara
Williamsburg
Regional
Medical Center
2005
2006
2007
2008
2009
2010
2011
Sentara Colorectal Program Physician Leadership
Celeste Bremer, MD – Medical Oncology
David Chang, MD – Medical Oncology
Suhas Deshmukh, MD – Gastroenterology
Jonathon Eisner, MD – Gastroenterology
Gregory FitzHarris, MD – Colorectal Surgeon
Richard Hoefer, DO – Surgical Oncology
David Johnson, MD – Gastroenterology
Dennis Rowley, MD – Pathology
William Rudolph, MD – Colorectal Surgeon
(facilitator)
Scott Stanley, MD – Pathology
John Sayles, MD – Colorectal Surgeon
David Stockwell, MD – Gastroenterology
www.sentara.com/cancer 9

Breast Cancer Program
Innovative Technology and
Clinical Excellence
All 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
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.
100%
100%
90%
90%
Cumulative Survival Rate
80%
70%
60%
50%
40%
30%
20%
10%
Cumulative Survival Rate
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dx 1 Year 2 Years 3 Years 4 Years 5 Years
0%
Dx 1 Year 2 Years 3 Years 4 Years 5 Years
Years from Diagnosis
Years from Diagnosis
Stage O n = 338 Stage I n = 657 Stage II n = 521
Stage III n = 185 Stage IV n = 76
Stage O n = 77,643 Stage I n = 156,118 Stage II n = 113,508
Stage III n = 43,066 Stage IV n = 15,362
10 Sentara Cancer Network 2012 Annual Report

Outreach and Action
While 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 - 2011
Standard 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.
100%
90%
80%
70%
100
97
92
92
94 94
88
90
90
85 87
88
81
76
100
98
95 94 94
95 96 96
91
93
95
89
91 92
86
88
85
Rate
60%
50%
40%
30%
20%
2008
2009
2010
2011
10%
0%
Sentara
Princess Anne
Hospital
Sentara
Norfolk General
Hospital
Sentara
Leigh
Hospital
Sentara
Obici
Hospital
Sentara
CarePlex
Hospital
Sentara
Virginia Beach
General
Hospital
Sentara
Williamsburg
Regional
Medical Center
Sentara
Cancer
Network
www.sentara.com/cancer 11

Breast Cancer Program
CONTINUED
Rate
Figure 11
Breast Re-Excision rate – Goal: < 25% (Sentara) – 2007-2011
100%
90%
80%
70%
60%
50%
47
56
49
2007
2008
40%
30%
20%
10%
35 34
28 27 27
21
23
34
27
22 21
17
27 30 25
11
17 15 11 7
8
38
21 22
17
7
16 13 11
30
23 27 19 17
2009
2010
2011
0%
Sentara
Princess Anne
Hospital
Sentara
Norfolk General
Hospital
Sentara
Leigh
Hospital
Sentara
Obici
Hospital
Sentara
CarePlex
Hospital
Sentara
Virginia Beach
General
Hospital
Sentara
Williamsburg
Regional
Medical Center
Sentara
Cancer
Network
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
Rate
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Figure 12.
Needle Biopsy Before Surgery Rate Goal: 90% (NAPBC) - 2007 - 2011
91
91 91 95 92
95 93
88
80 84 74
74
Sentara
Sentara
Sentara
Princess Anne Norfolk General Leigh
Hospital
Hospital Hospital
95
89 90
77 80
Sentara
Obici
Hospital
98 98 93 97 97
Sentara
CarePlex
Hospital
49
61
91 94 96 93 93 97 93
93 94
88 87
75
77
Sentara
Cancer
Network
Sentara
Virginia Beach
General
Hospital
Sentara
Williamsburg
Regional
Medical Center
2007
2008
2009
2010
2011
12 Sentara Cancer Network 2012 Annual Report

Figure 13.
2008-2011 Sentara Cancer Network Breast Cancer Stage at Diagnosis
vs. National Cancer Data Base 2010
Figure 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.
45%
40%
5%
0%
0
37.9% 40.6% I
II
7.5% 8.5% 3.3% 3.9%
III
IV
2.0% 2.7%
Unk
35%
30%
25%
20%
25.4%
20.6%
23.8% 23.7%
Sentara Cancer Network 2008-2011
National Cancer Data Base 2010
15%
10%
100,000
90,000
80,000
70,000
60,000
50,000
40,000
30,000
20,000
10,000
0
Figure 14.
Screening Mammogram Volume
69,968
2008
70,331
2009
74,906
2010
86,973
2011
25,000
24,000
23,000
22,000
21,000
20,000
19,000
18,000
Figure 15.
Diagnostic Mammogram Volume
20,560
22,245 22,366
2008 2009 2010 2011
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.
Sentara Breast Program Physician Leadership
Thomas Alberico, MD - Medical Oncology
Kelley Allison, MD - Mammography
Victor Archie, MD - Radiation Oncology
Mary Blumberg, MD - Pathology
Thomas Clifford, MD - Surgeon
Michael Danso, MD - Medical Oncology
Melinda Dunn, MD - Mammography
Nina Fabiszewski, MD - Co-Chair, Mammography
Eric Feliberti, MD - Co-Chair, Surgical Oncology
Kevin Halista, MD - Radiology
Richard Hoefer, DO - Surgical Oncology
Andrew Loiacono, MD - Radiology
Jennifer Reed, MD - Surgeon
Mark Sinesi, MD - Radiation Oncology
Terryl Times, MD - Surgeon
Scott Williams, MD - Radiation Oncology
www.sentara.com/cancer 13

Thoracic Cancer Program
Pioneering Vision Achieved
The 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.
Sentara Thoracic Program
Physician Leadership
John Bowers, III, MD - Pulmonology
Scott Cross, MD - Medical Oncology
Jeffrey Forman, MD - Pulmonology
Richard Hoefer, DO - Surgical Oncology
Wilkes Hubbard, MD - Co-chair - Thoracic Surgery
Steve Julian, MD - Administration
Peter Moy, MD - Thoracic Surgery
Joseph Newton, MD - Thoracic Surgery
Vijay Subramaniam, MD - Co-chair - Pulmonology
Bethany Tan, MD - Thoracic Surgery
Scott Williams, MD - Radiation Oncology
Figure 16.
Observed Survival for Lung Cases -
Sentara Cancer Network - 1998 - 2002
Figure 17.
Observed Survival for Lung Cases -
National Cancer Data Base - 1998 - 2002
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.
100%
100%
90%
90%
Cumulative Survival Rate
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dx 1 Year 2 Years 3 Years 4 Years 5 Years
Years from Diagnosis
Cumulative Survival Rate
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dx 1 Year 2 Years 3 Years 4 Years
Years from Diagnosis
5 Years
Stage O n = 0 Stage I n = 173 Stage II n = 69
Stage III n = 263 Stage IV n = 363
Stage O n = 534 (Insufficient Data) Stage I n = 53,001 Stage II n = 17,567
Stage III n = 67,301 Stage IV n = 101,618
14 Sentara Cancer Network 2012 Annual Report

Figure 18.
Sentara Cancer Network - 2008-2011 Non Small Cell Lung Cancers by Stage at Diagnosis
Figure 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.
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
N/A
23.8%
25.9%
40.2%
Sentara
Cancer Network
24.2%
8.0% 7.2%
2.0%
N/A
23.7%
35.6%
National Cancer
Data Base
(2000 - 2010)
9.1%
0
I
II
III
IV
UNK
5.0%
4.5%
4.0%
3.5%
3.0%
2.5%
2.0%
1.5%
1.0%
0.5%
0%
4.54%
1.00%
0 %
Sentara Cancer Network
(2009 - 2011)
(n = 66, n = 97, n = 128)
1.20%
STS National
Average
(2009 - 2011)
(n = 21, 279)
2009
2010
2011
Figure 19.
Society of Thoracic Surgeons (STS) Lobectomy In-Hospital Mortality
Sentara Cancer Network vs STS National Average
Figure 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
Number of Cases
Figure 20.
Lung Cancer Volumes – Sentara Cancer Network - 2008-2011.
Figure 21.
Esophagus Volumes – Sentara Cancer Network - 2008-2011.
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.
300 30
28
250 246
25
233
200
200 20
180
150 147
15
15
15
14
14
128 13
121
117
126
13
13
13
114
124
104
110
100
99
10
10
88 80
83 10 9
79 84
78
8
8
65
7
55 6 6
6
6 6
50 40
30
38
5
4
4
23
26
2
1
0 0
2008 2009 2010 2011 2008
2009
2010
2011
Number of Cases
18
22
21
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
* Includes the Sentara Thoracic Surgery Center at Sentara Heart Hospital
www.sentara.com/cancer 15

Pancreatic Cancer Program
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 physicians
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 Conferences
Physicians 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 Series
The 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 Processes
The 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
Sentara Pancreatic Program Physician Leadership
Rebecca Alston, MD - Pathology
Glen Arluk, MD - Gastroenterology
David Chang, MD - Medical Oncology
Scott Cross, MD - Medical Oncology
Eric Feliberti, MD - Surgical Oncology
Steven Foxx, MD - Radiology
Valerio Genta, MD - Pathology
Steven Hall, MD - Radiology
Richard Hoefer, DO - Surgical Oncology,
Co-Chair Pancreatic Cancer Consortium
Kelvin Hornbuckle, MD – Gastroenterology
Doug Howerton, MD - Gastroenterology
Song Kang, MD - Radiation Oncology
David Marcheschi, MD - Pathology
Dean McGaughey, MD - Medical Oncology
Michael Montileone, MD - Radiology
John Paschold, MD - Medical Oncology
Roger Perry, MD - Co-Chair – Surgical
Oncology, Pancreatic Cancer Consortium
Steven Pietruzynski, MD - Radiology
James Primich, MD - Radiology
William Richie, MD - Radiology
Kishore Rao, MD - Radiology
Dennis Rowley, MD - Pathology
Mozhdeh Salour, MD - Radiology
Niria Sanchez, MD - Pathology
James Schneider, MD – Surgical Oncology
Ravi Shamaiengar, MD - Radiology
Sarah Shaves, MD - Radiology
Mark Sinesi, MD - Radiology
Ben Skinner, MD - Radiology
James Sparrer, MD - Pathology
Scott Stanley, MD - Pathology
Audrey Steck, MD - Pathology
Edward Trapani, MD - Radiology
Jeffrey Vandesand, MD - Radiology
Harlan Vingan, MD - Radiology
Marshall Weissberger, MD - Radiology
Scott Williams, MD - Radiation Oncology
16 Sentara Cancer Network 2012 Annual Report

Number of Cases
60
55
50
45
40
35
30
25
20
15
10
5
0
Figure 22.
Sentara Cancer Network Pancreatic Cancer Volumes 2005 - 2011
Pancreatic 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
4
11
5
Sentara
Bayside
Hospital
25 25 27 21 23 36
Sentara
CarePlex
Hospital
28
7
13
7
29
Sentara
Leigh
Hospital
27 26
42 43 41
34
56
Sentara
Norfolk General
Hospital
8 10 4
11
Sentara
Obici
Hospital
18
14
24
34
27
Sentara
Virginia Beach
General
Hospital
19 20 8 8 9 8
5 4
Sentara
Williamsburg
Regional
Medical Center
4
2005
2006
2007
2008
2009
2010
2011
80
70
60
50
40
30
20
10
Figure 23.
Pancreatic Surgical Procedure Volume
2009-2011
72 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
71
48
73
8%
7%
6%
5%
4%
3%
2%
1%
Figure 24.
Pancreatic Surgical Procedure Mortality Rate
2009 to 2011
Since 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
7%
Cancer Consortium.
Source:
6%
CareDiscovery
5%
0
2009 2010 2011
0%
2009
2010
2011
Figure 25.
10 or More Lymph Nodes at Pancreatic Resection -
2009 to 2011 - Sentara Cancer Network
In 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
100%
95.2
90%
81.0
80%
70%
60%
54.2
50%
40%
30%
20%
10%
0%
2009 2010 2011
www.sentara.com/cancer 17

Prostate Cancer Program
Advanced Prostate Cancer Care
Each 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 Options
The 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 26.
Observed Survival for Prostate Cases - Sentara Cancer Network
Figure 27.
Observed Survival for Prostate Cases - National Cancer Data Base
2003 - 2005
2003-2005
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.
100%
100%
90%
90%
Cumulative Survival Rate
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dx 1 Year 2 Years 3 Years 4 Years 5 Years
Years from Diagnosis
Cumulative Survival Rate
80%
70%
60%
50%
40%
30%
20%
10%
0%
Dx 1 Year 2 Years 3 Years 4 Years 5 Years
Years from Diagnosis
Stage O (Insufficient Data) Stage I (Insufficient Data) Stage II n = 1,939
Stage III n = 119 Stage IV n = 46
Stage O n = 158 Stage I n = 13,350 Stage II n = 391,022
Stage III n = 45,798 Stage IV n = 27,034
18 Sentara Cancer Network 2012 Annual Report

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.
90%
80%
76.3%
70%
60%
60.9%
Sentara Cancer Network - 2008-2011
50%
40%
National Cancer Data Base 2010
30%
20%
19.8%
10%
0%
9.4%
I
II
6.4% 10.0% III
IV
5.3% 6.0%
2.5% 3.3%
UNK
400
Figure 29.
Prostate Cancer Analytic Case Volumes 2005 - 2011
This 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.
Number of Cases
350
300
250
200
150
100
50
0
76
52 59
Sentara Bayside
Hospital/
Sentara Princess
Anne Hospital
82 76
99 97
Sentara
CarePlex
Hospital
138
118
83
9 4
2 4
Sentara
Leigh
Hospital
338
300
307
300
280
231 243
Sentara
Norfolk General
Hospital
25 22 29 22
Sentara
Obici
Hospital
56 63 51 44 30 22 22
Sentara
Virginia Beach
General
Hospital
52
37
53 54
39 32
19
Sentara
Williamsburg
Regional
Medical Center
2005
2006
2007
2008
2009
2010
2011
www.sentara.com/cancer 19

Head and Neck Cancer Program
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 Resources
The 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 Leadership
Matthew Bak, MD – Otolaryngology –
Head and Neck Surgery
Daniel Karakla, MD – Otolaryngology –
Head and Neck Surgery
Barry Strasnick, MD – Otolaryngology –
Head and Neck Surgery
20 Sentara Cancer Network 2012 Annual Report

Number of Cases
250
200
150
100
50
0
Figure 30.
Sentara Cancer Network Head and Neck Cancer Volumes - 2005 - 2011
The 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.
3 3 3
Sentara Bayside
Hospital/
Sentara Princess
Anne Hospital
32 34
51 38
27 34 49 44 57 48 43
Sentara
Sentara
CarePlex
Leigh
Hospital
Hospital
197
175
157
235 233
224
203
Sentara
Norfolk General
Hospital
16 21 32
18
Sentara
Obici
Hospital
26 31 45 45 50 46 46
Sentara
Virginia Beach
General
Hospital
37
21 23 21 24 28 28
Sentara
Williamsburg
Regional
Medical Center
2005 2006 2007 2008 2009 2010 2011
*** Head and Neck cancers include Oral Cavity/Pharynx, Salivary Glands, Larynx, Nasal/Sinuses, and Thyroid
Figure 31.
Sentara Norfolk General Hospital Head and Neck Cancer Conference - 2007 - 2011 Case Presentations
The 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.
Thyroid: 116 11%
Tongue: 192 18%
Major Salivary Glands: 93 9%
Larynx: 217 20% Floor of Mouth: 36 3%
Nasal Cavity, Middle Ear
and Accessory Sinuses: 108 10%
Other Buccal Cavity and Pharynx: 34 3%
Hypopharynx: 31 3%
Gum and Other Mouth: 103 10%
Tonsil: 104 10%
Oropharynx: 12 1%
Nasopharynx: 24 2%
www.sentara.com/cancer 21

Hematology/Oncology Cancer Program
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 Advances
The 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
Innovation and Technology
The 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 clinicopathologic
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
n 3,191 Flow
n 2,904 Fluorescence in Situ Hybridization
n 1,491 Marrow Cytogenetic
n 591 Constitutional Cytogenetic
22 Sentara Cancer Network 2012 Annual Report

100%
Figure 32.
Sentara Cancer Network Hematology Quality Indicators -
SCN vs. Benchmark - 2009-2011
The 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.
98%
97.4%
97.9%
96%
94%
95.7%
94.4%
92%
90%
90.0%
91.2%
90.0%
88%
86%
Hematology: percentage of
patients aged 18 years and
older with a diagnosis of
chronic lymphocytic
leukemia (CLL) who had
baseline flow
cytometry studies
performed.
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.
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.
2009 - 2010 2011 Sentara Benchmark
Hematology/Oncology Physician Leadership
Burton Alexander, MD – Medical Oncology
Daniel Atienza, MD – Medical Oncology
Scott Cross, MD – Medical Oncology
Stephen Fisher, MD – Hematopathology
Lora Herman, MD – Pathology
Scott Kruger, MD– Medical Oncology
H. Raymond Tahhan, MD – Transfusion Service
facebook.com/getpinkwithsentara
Watch videos of
physicians and patients online
at sentara.com/cancer
facebook.com/sentaracolon
facebook.com/sentarahealth
twitter.com/sentarahealth
youtube.com/sentarahealthcare
www.sentara.com/cancer 23

2011 Sentara Cancer Network Primary Site Table
Sentara Careplex
Sentara Leigh
Norfolk General
Hospital
Hospital
Hospital
Grouping Primary Site Total Analytic Total Analytic Total Analytic
Head/Neck Lip 1 1 0 0 1 1
Tongue 5 5 0 0 24 20
Salivary Gland 2 2 1 1 13 12
Floor of Mouth 1 1 0 0 5 5
Gum/Other Mouth 1 1 1 1 17 14
Nasopharynx 1 1 0 0 5 4
Tonsil 4 4 1 1 18 15
Oropharynx 2 2 0 0 8 5
Hypopharynx 2 2 3 1 10 8
Other Oral Cavity and Pharynx 0 0 0 0 0 0
Digestive Esophagus 9 9 24 20 19 16
Stomach 9 8 11 8 27 21
Small Intestine 4 3 8 7 5 4
Colon 59 55 69 60 74 61
Rectosigmoid Junction 3 3 2 1 5 3
Rectum 26 21 20 17 25 20
Anus, Anal Canal, and Anorectum 6 5 7 6 10 3
Liver 8 7 6 6 13 13
Intrahepatic Bile Duct 2 2 2 1 2 1
Gallbladder 5 5 4 4 6 6
Other Biliary 2 1 7 7 9 6
Pancreas 29 28 39 30 64 56
Retroperitoneum 0 0 0 0 1 1
Peritoneum, Omentum, and Mesentery 0 0 2 2 1 0
Other Digestive Organs 0 0 0 0 4 4
Respiratory Nose, Nasal Cavity and Middle Ear 0 0 1 0 16 14
Larynx 8 8 5 4 44 42
Lung, Bronchus, - Small Cell 27 24 11 6 31 23
Lung, Bronchus - Non Small Cell 105 98 135 100 260 210
Lung, Bronchus - Other Types 5 5 8 6 16 13
Pleura 0 0 0 0 0 0
Trachea, Mediastinum, Other Respiratory 1 1 0 0 1 1
Bones and Joints Bones and Joints 0 0 0 0 1 1
Soft Tissue Including Heart Soft Tissue Including Heart 7 6 9 5 23 19
Skin Excl Basal and Squamous Melanoma - Skin 54 49 15 11 134 107
Other Rare Skin Types 4 4 5 5 12 7
Breast Breast 269 253 314 273 494 286
Female Genital System Cervix 2 2 2 2 9 8
Uterus 12 10 39 38 13 9
Ovary 5 4 11 10 12 5
Vagina 0 0 0 0 1 0
Vulva 1 0 7 3 5 0
Other Female Genital Organs 0 0 0 0 0 0
Male Genital System Prostate 112 83 10 4 660 300
Testis 0 0 1 1 8 7
Penis 1 1 1 0 2 1
Other Male Genital Organs 0 0 0 0 0 0
Urinary System Bladder 36 33 39 29 115 81
Kidney/Renal Pelvis 18 11 12 8 156 145
Ureter 1 0 2 2 11 10
Other Urinary Organs 0 0 1 0 1 1
Eye and Orbit Eye and Orbit 0 0 1 0 4 2
Brain and Other CNS Brain 7 6 3 3 81 64
Other CNS 0 0 0 0 1 1
Endocrine Thyroid 17 16 31 30 96 88
Other Endocrine, Thymus 1 0 0 0 2 2
Lymphoma Hodgkin Lymphoma 7 5 3 2 12 8
Non-Hodgkin Lymphoma 45 32 45 29 92 40
Myeloma 14 9 18 15 60 8
Leukemia Leukemia 15 11 15 8 107 19
Mesothelioma/Kaposi Sarcoma Mesothelioma 5 3 4 3 3 2
Kaposi Sarcoma 1 1 1 1 3 3
Miscellaneous Miscellaneous 25 20 14 9 90 16
TOTAL TOTAL 986 861 970 780 2942 1842
24 Sentara Cancer Network 2012 Annual Report

Sentara Obici
Hospital
Sentara Princess
Anne Hospital
Sentara Virginia Beach
General Hospital
Sentara Williamsburg
Regional Medical Center
Total Analytic Total Analytic Total Analytic Total Analytic
Sentara
Cancer
Network
Total
Caseload
Sentara
Cancer
Network
Total
Analytic
Caseload
0 0 0 0 0 0 0 0 2 2
1 1 0 0 9 6 6 5 42 34
2 1 0 0 4 4 1 1 19 17
1 1 0 0 2 2 0 0 8 8
0 0 0 0 3 2 0 0 22 18
0 0 0 0 0 0 0 0 5 4
1 1 0 0 4 4 1 1 25 22
1 1 1 1 1 1 0 0 13 10
1 0 0 0 4 2 0 0 18 11
0 0 0 0 1 0 0 0 1 0
4 4 8 7 10 7 3 2 71 59
4 4 4 3 17 13 10 10 77 64
2 2 6 6 8 8 2 2 33 30
35 30 44 41 79 72 32 29 372 329
1 1 1 1 5 5 2 2 18 15
11 10 4 4 31 26 5 5 115 96
0 0 0 0 6 4 1 0 30 18
0 0 2 1 5 4 0 0 31 28
2 2 0 0 3 3 0 0 11 9
1 1 0 0 4 4 1 1 21 21
1 1 5 5 8 7 2 2 31 26
15 12 6 5 27 21 7 4 171 142
0 0 0 0 0 0 0 0 1 1
0 0 0 0 0 0 0 0 3 2
0 0 2 2 3 3 0 0 9 9
2 2 0 0 2 2 0 0 20 17
9 7 2 2 8 6 3 3 66 59
7 7 6 4 26 21 16 14 113 89
71 66 46 32 105 98 48 40 673 555
5 5 2 2 5 4 1 1 33 29
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 2 2
0 0 0 0 1 1 0 0 1 1
4 3 3 3 9 7 0 0 50 38
18 15 22 14 60 39 9 8 301 239
1 1 1 1 2 1 0 0 24 18
94 83 146 127 245 196 152 146 1572 1235
7 6 2 2 6 5 4 3 28 24
12 12 5 5 19 14 41 40 123 110
4 3 4 2 19 15 17 17 66 51
0 0 1 1 2 1 0 0 4 2
0 0 0 0 2 1 3 2 18 6
1 1 0 0 2 2 1 0 4 3
35 22 68 59 40 22 31 19 911 468
1 1 4 3 3 3 2 2 18 16
0 0 0 0 1 1 0 0 5 3
0 0 0 0 0 0 0 0 0 0
11 7 11 11 35 32 20 17 254 199
5 3 2 2 17 10 14 11 217 184
1 1 2 2 2 2 1 1 18 16
0 0 0 0 0 0 0 0 2 1
0 0 0 0 1 0 0 0 6 2
8 7 3 3 15 15 0 0 107 88
0 0 0 0 1 1 0 0 1 1
20 19 0 0 20 18 18 18 187 175
0 0 0 0 0 0 0 0 3 2
1 1 1 1 6 3 0 0 28 19
24 14 14 9 56 45 15 12 272 169
7 6 2 1 15 11 1 0 113 47
8 7 6 2 20 17 3 2 166 64
3 3 2 1 0 0 1 1 18 13
0 0 0 0 1 1 0 0 5 5
16 13 6 3 10 8 8 4 163 70
458 387 444 368 990 800 482 425 6741 4995
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
www.sentara.com/cancer 25

Cancer
Sentara
Conferences
The 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.
Site
ConferenCe
date &
room ContaCt
time
Cme
approved
network
Pancreatic Cancer
Conference
1st and 3rd Monday
of every month
7:00 - 8:00 am
WebEx
(757) 827-2206
Yes
Sentara
Careplex
Hospital
Breast Cancer
Conference
General Cancer
Conference
Every Tuesday
7:00 - 8:30 am
Every Thursday
7:00 - 8:30 am
First Floor
Conference Room B
First Floor
Conference Room B
(757) 259-6652
(757) 259-6652
Yes
Yes
Sentara
Williamsburg regional
medical Center
Breast Cancer
Conference
General Cancer
Conference
1st and 3rd Wednesday
of every month
7:15 - 8:15 am
2nd or 4th Friday
of every month
7:00 - 8:00 am
Jamestown
Room
Jamestown
Room
(757) 259-6652
(757) 259-6652
Yes
Yes
26 Sentara Cancer Network 2012 Annual Report
www.sentara.com/cancer
Your community, not-for-profit health partner

Sentara Cancer Conferences
Site
ConferenCe
date &
room ContaCt
time
Cme
approved
Sentara
Leigh
Hospital
Breast Cancer
Conference
General Cancer
Conference
1st, 3rd and 5th Wednesday
of every month
7:00 - 8:00 am
4th Tuesday
of every month
7:00 - 8:00 am
Breast Center
Conference Room
Breast Center
Conference Room
(757) 261-5404
(757) 261-5405
Yes
Yes
Head & Neck
Conference
Every Thursday
7:00 - 8:00 am
EVMS Hofheimer Hall
(757) 388-2442
Yes
Multidisciplinary
Cancer Conference
2nd Friday
of every month
9:15 am
EVMS Hofheimer Hall
(757) 388-2442
No
Sentara
norfolk General
Hospital
Liver Cancer Conference
Thoracic Oncology
Neuro-Oncology
Tumor Conference
1st and 3rd Wednesday
of 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
Webex
Sentara Heart Hospital
1st Floor
Conference Room II
Sentara Heart Hospital
6th floor
Dept of Neurology
(757) 388-2442
(757) 388-2442
(757) 388-2442
Yes
Yes
Yes
Surgical Pathology
Breast Conference
2nd and 4th Thursday
of every month
7:00 - 8:00 am
Sentara Heart Hospital
1st Floor
Conference Room 1
(757) 388-2442
Yes
Urology
Conference
1st Monday
of every month
5:00 - 6:00 pm
Sentara Heart Hospital
1st floor
Conference Room 1
(757) 388-2442
Yes
Sentara
obici
Hospital
General Cancer
Conference
Every Thursday
7:00 - 8:00 am
Garden Level
Classroom C & D
(757) 934-4791
Yes
Sentara
princess
anne
Hospital
Breast Cancer
Conference
2nd Wednesday
of every month
7:00 am
2nd Floor
Large Administration
Conference Room
(757) 507-1099
Yes
Sentara
virginia Beach
General Hospital
Cancer Grand Rounds
General Cancer Conference
Breast Cancer Conference
1st Tuesday
of every month
12:30 - 1:30 pm
Every Other Thursday
7:00 - 8:00 am
1st and 3rd Thursday
of every month
7:00 - 8:00 am
SVBGH Health &
Education Center
Rooms A & B
SVBGH Cancer Resource/
Diabetes Conference Room
SVBGH Cancer Resource/
Diabetes Conference Room
(757) 395-8686
(757) 395-8686
(757) 395-8686
Yes
Yes
Yes
virginia
oncology associates
Lake Wright
GI Conference &
Lung Conference
Hematology Conference
Breast Cancer Conference
1st Wednesday
of every month
6:00 pm
2nd and 4th Wednesday of
every month
6:00 pm
3rd Wednesday
of every month
6:00 pm
3rd Floor Multi-media room
Virginia Oncology Associates
3rd Floor Multi-media room
Virginia Oncology Associates
3rd Floor Multi-media room
Virginia Oncology Associates
(757) 459-9229
(757) 459-9229
(757) 459-9229
CME Varies
CME Varies
CME Varies

Sentara Cancer Network – Points of Care
17
Sentara Gloucester Medical Arts
64
13
Sentara Port Warwick
17
Sentara St. Luke’s
64
Hospitals
Outpatient Centers
Sentara BelleHarbour
664
464
264
Sentara
Independence
264
Sentara’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.
17
Sentara Greenbrier
HealthPlex
168
Need answers to your cancer questions?
You’re one call away.
Call Toll Free: 888-220-2214
Speak with a cancer expert who will answer your
questions and provide you with the resources
you need for cancer prevention, detection,
treatment and support.
www.sentara.com/cancer