Bon SecourS cancer InStItute - Bon Secours Richmond Health System

Outcomes 

2011 

Bon Secours Cancer Institute 

BON SECOURS CANCER INSTITUTE 

Bon Secours Richmond Health System 

®

What’s Inside 

Overview 4 

Letter from CEO 5 

Letter from Oncology VP 6 

Purpose of Report 7 

Bon Secours Cancer Institute Overview 8 

Oncology Volumes 9 

• zSt. Mary’s Hospital 10 

• zMemorial Regional Medical Center 14 

• zSt. Francis Medical Center 18 

Oncology Outcomes 22 

• zBreast Cancer 23 

• zColon Cancer 25 

Satisfaction Outcomes 27 

Survival Outcomes in Selected Cancers 32 

• zColon Cancer 33 

• zProstate Cancer 39 

Lung Cancer Site Study 47 

Research Study Outcomes 45 

Publications, Presentations, Research, Awards and Accreditations 53 

Contact Information 57 

St. Francis Cancer 

Institute Courtyard

Overview 

Letter from the C E O 

To promote quality improvement, Bon Secours 

Virginia Health System has created a series of books 

on Outcomes, similar to this one, for many of our 

service lines and individual facilities. Designed for 

a physician audience, the Outcomes books contain 

a summary of our surgical, medical and financial 

trends and approaches, data on patient volume and 

outcomes, and a review of new technologies and 

innovations. 

Although we are unable to report all outcomes for all 

treatments provided at Bon Secours Virginia facilities 

— omission of outcomes for a particular treatment 

does not mean we necessarily do not offer that 

treatment – our goal is to increase outcomes reporting 

each year. When outcomes for a specific treatment 

are unavailable, we often report process measures 

associated with improved outcomes. When process 

measures are unavailable, we may report volume 

measures; a volume/outcome relationship has been 

demonstrated for many treatments, particularly those 

involving surgical techniques. 

In addition to our internal efforts to measure clinical 

quality, Bon Secours Virginia Health System supports 

transparent public reporting of healthcare quality 

data and participates in the following public reporting 

initiatives: 

• zJoint Commission Performance Measurement 

Initiative (www.qualitycheck.org) 

I am pleased to present Outcomes 2011 in which key areas of service at Bon Secours Virginia Health System’s 

multiple state facilities are evaluated. We strive to provide the highest quality care and service for all our patients, 

and we believe that careful review and critical evaluation of our performance will allow us to make strides in 

those areas in the future. Only through meaningful and transparent self-evaluation, can we continue to provide 

convenient and accessible care, support our patients and their families, serve our referring doctors and institutions, 

and pursue excellence in clinical care. Highlighted in this issue are attentive evaluations of treatment and outcomes 

ranging from mortality rates to patient surveys to financial performance. 

At Bon Secours Virginia, our work 

builds upon our foundation of 

professionalism and is centered on 

the patient. We endeavor to meet 

and exceed all the expressed and 

unexpressed needs and expectations 

of our patients. The outcomes and 

performance assessments presented 

will allow Bon Secours Virginia to 

improve in all areas of clinical care, 

patient service, and community 

support. 

This issue highlights Bon Secours 

Cancer Institute and is the first 

oncology outcomes report of its kind 

in the Richmond area. In addition to 

outcome and volume data, publications 

and research of Bon Secours’ oncology 

staff is presented. Please enjoy this 

issue of Outcomes 2011. 

Fountain at St. Mary’s Hospital 

• zCenters for Medicare and Medicaid (CMS) Hospital 

Compare (www.hospitalcompare.hhs.gov) 

• zVirginia Health Information (www.vhi.org) 

• zHealthGrades (www.healthgrades.com) 

Our commitment to providing accurate, timely 

information about patient care will also help patients 

and referring physicians make informed healthcare 

decisions. We hope you find this data valuable. 

Peter J. Bernard 

Chief Executive Officer 

Bon Secours Virginia Health System 

4 5

Dr. Sherry Fox 

Dear Colleague, 

Measuring cancer outcomes is a complex and 

demanding process that requires careful classification 

and follow-up. In keeping with Bon Secours Cancer 

Institute’s continuous effort to improve the care we 

provide to our patients, we present Outcomes 2011 for 

the Bon Secours Cancer Institute. 

In the pages that follow, you will find an overview of 

the Cancer Institute, including patient volumes and 

outcomes for various cancer treatments, with relevant 

benchmarks for evaluating our results. Important 

innovations and professional activities of the past 

several years, including the publications authored 

by Bon Secours’ oncology staff from 2009–2011, are 

also included. Thanks to our extraordinary cancer 

registrars for their collection and assimilation of this 

data. 

On behalf of Bon Secours Virginia Health System, 

we are pleased to present Outcomes 2011. The 

primary purpose of our annual Outcomes book is 

to promote quality improvement at Bon Secours 

Virginia facilities, optimizing the care we provide 

our patients. Measuring and reporting outcomes 

reflects our organizational commitment to 

accountability, transparency and results. 

Dr. George Parker 

At Bon Secours Cancer Institute, we are dedicated 

to providing high-quality care. Excellence in clinical 

practice is part of our collaborative, multidisciplinary 

approach to finding better ways to care for our 

patients. By reporting our outcomes both thoroughly 

and transparently, we take a major step toward the 

best quality care and patient satisfaction we can 

provide. We hope that you find this report both 

informative and enlightening. 

Dr. Tim Bradford 

Sincerely, 

Dr. Sherry Fox, Vice President, Oncology 

Dr. George Parker, Cancer Committee Chairperson, 

St. Mary’s Hospital 

Dr. Tim Bradford, Cancer Committee Chairperson, 

Bon Secours Cancer Institute at St. Francis 

Dr. Robert Sprague, Cancer Committee Chairperson, 

Memorial Regional Medical Center 

Dr. Robert Sprague 

Bell tower at 

St. Francis Medical Center 

6 7


An Overview 


Oncology Volumes 

The mission of the Bon Secours Cancer Institute is to provide seamless, comprehensive, interdisciplinary, evidencebased 

cancer treatment, as well as support and survivorship programs for oncology patients. We are recognized 

for our compassionate and world-class staff, extraordinary care experiences, convenient, state-of-the-art 

diagnostic and treatment facilities, and accreditation by prestigious oncology organizations. 

Bon Secours Cancer Institute is comprised of highly skilled and specialized health care professionals who live the 

Bon Secours values every day. We employ a full spectrum of cancer specialists including surgical oncologists, 

medical oncologists and radiation oncologists. Our compassion sets us apart, but it’s our leading-edge, 

scientifically based cancer treatments — delivered by expert clinicians — that drive patient success. 

Oncology Specialists/Departments 

• zDiagnostic Imaging 

• zInterventional Radiology 

Support Programs 

• zOncology Nurse Navigators 

• zSocial Workers, Support Groups 

Bon Secours Cancer Institute maintains an extensive 

tumor registry, which is the source for much of the 

outcomes and volume data presented in this report. 

Data included in the outcomes graphs, derived from 

the tumor registry, are from patients receiving initial 

treatment at Bon Secours in 2010. 

The volume data in this section is presented for 

St. Mary’s Hospital, St. Francis Medical Center, and 

Memorial Regional Medical Center, although photos 

of all our cancer facilities are shown. 

Overall oncology volumes are presented by year. In 

addition to total volume, the top five types of cancer 

and their percentage of total cases is presented. 


• zSurgical Oncology 

• zSurgical Thoracic, Colorectal, Breast, Brain, Urologic, 

Dermatologic, Plastics, and ENT Specialists 

• zMedical Oncology 

• zRadiation Oncology 

• zOutpatient Infusion 

• zDedicated oncology inpatient nursing units 

Centers of Excellence 

• zLiver Institute of Virginia 

• zPalliative Care 

• zHospice 

• zPsychiatry 

• zBreast Cancer Survivorship Clinic 

• zEvery Woman’s Life 

• zCullather Brain Tumor Quality of Life Center 

• zHealing Vibrations (Yoga, Art Therapy) 

• zCancer Resource Centers 

Cancer Institute at 

Reynolds Crossing 


Memorial Regional 

Medical Center 

St. Francis Watkins Centre 

Richmond Community Hospital 

8 9





Sex Class of Case Status Stage Distribution - Analytic Cases Only 

Primary Site Total (%) M F Analy NA Alive Exp 0 I II III IV 88 Unk 

ORAL CAVITY & PHARYNX 17 (2.0%) 10 7 15 2 16 1 0 2 2 4 6 0 1 

900 

New Cancer Cases per Year 

844 

Tongue 4 (0.5%) 3 1 4 0 3 1 0 0 2 1 1 0 0 

Salivary Glands 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 0 0 1 

Floor of Mouth 1 (0.1%) 1 0 1 0 1 0 0 1 0 0 0 0 0 

800 

700 

687 

702 

730 

Gum & Other Mouth 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 1 0 0 

Nasopharynx 1 (0.1%) 0 1 0 1 1 0 0 0 0 0 0 0 0 

Tonsil 6 (0.7%) 4 2 6 0 6 0 0 1 0 3 2 0 0 

600 

500 

Hypopharynx 2 (0.2%) 1 1 2 0 2 0 0 0 0 0 2 0 0 

Other Oral Cavity & Pharynx 1 (0.1%) 1 0 0 1 1 0 0 0 0 0 0 0 0 

DIGESTIVE SYSTEM 111 (13.2%) 64 47 97 14 96 15 22 17 20 18 13 0 7 

400 

300 

200 

100 

0 

349 

2006 2007 2008 2009 2010 

Esophagus 7 (0.8%) 6 1 5 2 7 0 0 1 1 1 0 0 2 

Stomach 3 (0.4%) 2 1 2 1 2 1 1 0 0 0 1 0 0 

Small Intestine 4 (0.5%) 2 2 4 0 3 1 0 2 2 0 0 0 0 

Colon Excluding 62 (7.3%) 35 27 57 5 56 6 19 9 10 10 5 0 4 

Rectum 

Cecum 9 5 4 9 0 8 1 1 0 4 3 1 0 0 

Ascending Colon 17 10 7 17 0 17 0 5 6 2 4 0 0 0 

Hepatic Flexure 2 2 0 2 0 2 0 1 1 0 0 0 0 0 

Transverse Colon 8 4 4 7 1 7 1 4 1 1 0 0 0 1 

Descending Colon 4 2 2 4 0 4 0 0 1 2 1 0 0 0 

Sigmoid Colon 13 9 4 10 3 10 3 2 0 1 2 3 0 2 

The top five types of cancer cases and their percentage of total cancer cases 

Large Intestine, NOS 9 3 6 8 1 8 1 6 0 0 0 1 0 1 

Rectum & Rectosigmoid 22 (2.6%) 13 9 19 3 21 1 2 4 4 5 4 0 0 

Rectosigmoid Junction 2 1 1 2 0 2 0 0 0 0 1 1 0 0 

10.6% 

Rectum 20 12 8 17 3 19 1 2 4 4 4 3 0 0 

10.6% 

Breast 

Prostate 

Anus, Anal Canal & Anorectum 2 (0.2%) 0 2 2 0 1 1 0 0 1 1 0 0 0 

Liver & Intrahepatic Bile Duct 2 (0.2%) 0 2 2 0 1 1 0 1 0 0 1 0 0 

Pancreas 8 (0.9%) 6 2 5 3 5 3 0 0 2 1 2 0 0 

11.7% 

47.0% 

Lung 

Colon 

Peritoneum, Omentum & Mesentery 1 (0.1%) 0 1 1 0 0 1 0 0 0 0 0 0 1 

RESPIRATORY SYSTEM 93 (11.0%) 50 43 71 22 64 29 0 16 9 23 21 0 2 

Nose, Nasal Cavity & Middle Ear 3 (0.4%) 0 3 2 1 2 1 0 0 0 1 1 0 0 

20.3% 

Kidney/Renal 

Larynx 7 (0.8%) 5 2 6 1 7 0 0 4 0 1 1 0 0 

Lung & Bronchus 83 (9.8%) 45 38 63 20 55 28 0 12 9 21 19 0 2 

10 11








SOFT TISSUE 3 (0.4%) 1 2 3 0 2 1 0 2 0 1 0 0 0 

Soft Tissue (including Heart) 3 (0.4%) 1 2 3 0 2 1 0 2 0 1 0 0 0 

SKIN EXCLUDING BASAL & SQUAMOUS 12 (1.4%) 10 2 10 2 11 1 2 4 2 2 0 0 0 

Melanoma - Skin 12 (1.4%) 10 2 10 2 11 1 2 4 2 2 0 0 0 

BREAST 269 (31.9%) 3 266 254 15 264 5 55 91 73 23 10 1 1 

Breast 269 (31.9%) 3 266 254 15 264 5 55 91 73 23 10 1 1 

FEMALE GENITAL SYSTEM 14 (1.7%) 0 14 11 3 14 0 1 7 1 1 1 0 0 

Cervix Uteri 1 (0.1%) 0 1 0 1 1 0 0 0 0 0 0 0 0 

Corpus & Uterus, NOS 9 (1.1%) 0 9 8 1 9 0 0 7 0 1 0 0 0 

Corpus Uteri 8 0 8 8 0 8 0 0 7 0 1 0 0 0 

Uterus, NOS 1 0 1 0 1 1 0 0 0 0 0 0 0 0 

Ovary 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 1 0 0 


LEUKEMIA 6 (0.7%) 3 3 6 0 6 0 0 0 0 0 0 6 0 

Lymphocytic Leukemia 4 (0.5%) 3 1 4 0 4 0 0 0 0 0 0 4 0 

Chronic Lymphocytic Leukemia 3 3 0 3 0 3 0 0 0 0 0 0 3 0 

Other Lymphocytic Leukemia 1 0 1 1 0 1 0 0 0 0 0 0 1 0 

Myeloid & Monocytic Leukemia 2 (0.2%) 0 2 2 0 2 0 0 0 0 0 0 2 0 

Acute Myeloid Leukemia 1 0 1 1 0 1 0 0 0 0 0 0 1 0 

Chronic Myeloid Leukemia 1 0 1 1 0 1 0 0 0 0 0 0 1 0 

MESOTHELIOMA 5 (0.6%) 5 0 3 2 3 2 0 1 0 1 1 0 0 

Mesothelioma 5 (0.6%) 5 0 3 2 3 2 0 1 0 1 1 0 0 

MISCELLANEOUS 22 (2.6%) 12 10 16 6 15 7 0 0 0 0 0 16 0 

Miscellaneous 22 (2.6%) 12 10 16 6 15 7 0 0 0 0 0 16 0 

Total 844 387 457 722 122 764 80 93 224 204 97 62 31 11 

Vulva 3 (0.4%) 0 3 2 1 3 0 1 0 1 0 0 0 0 

MALE GENITAL SYSTEM 151 (17.9%) 151 0 114 37 147 4 0 24 84 5 1 0 0 

Prostate 146 (17.3%) 146 0 110 36 142 4 0 22 82 5 1 0 0 

Testis 3 (0.4%) 3 0 3 0 3 0 0 2 1 0 0 0 0 

Penis 2 (0.2%) 2 0 1 1 2 0 0 0 1 0 0 0 0 

URINARY SYSTEM 90 (10.7%) 58 32 79 11 83 7 13 40 10 10 5 1 0 

Urinary Bladder 29 (3.4%) 22 7 21 8 26 3 13 3 2 2 1 0 0 

Kidney & Renal Pelvis 60 (7.1%) 36 24 57 3 56 4 0 36 8 8 4 1 0 

Ureter 1 (0.1%) 0 1 1 0 1 0 0 1 0 0 0 0 0 

BRAIN & OTHER NERVOUS SYSTEM 3 (0.4%) 2 1 2 1 2 1 0 0 0 0 0 2 0 

Brain 3 (0.4%) 2 1 2 1 2 1 0 0 0 0 0 2 0 

ENDOCRINE SYSTEM 20 (2.4%) 4 16 17 3 20 0 0 10 1 3 2 1 0 

Thyroid 19 (2.3%) 4 15 16 3 19 0 0 10 1 3 2 0 0 

Other Endocrine including Thymus 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 0 1 0 

LYMPHOMA 26 (3.1%) 13 13 22 4 19 7 0 10 2 6 2 2 0 

Hodgkin Lymphoma 1 (0.1%) 0 1 1 0 1 0 0 0 1 0 0 0 0 

Non-Hodgkin Lymphoma 25 (3.0%) 13 12 21 4 18 7 0 10 1 6 2 2 0 

NHL - Nodal 19 11 8 17 2 12 7 0 7 1 5 2 2 0 

NHL - Extranodal 6 2 4 4 2 6 0 0 3 0 1 0 0 0 

MYELOMA 2 (0.2%) 1 1 2 0 2 0 0 0 0 0 0 2 0 

Myeloma 2 (0.2%) 1 1 2 0 2 0 0 0 0 0 0 2 0 

12 13

Oncology Volume Summary 







1,800 


1,741 

1,731 

Lip 1 (0.1%) 1 0 1 0 1 0 0 0 0 0 0 0 1 

Tongue 8 (0.5%) 6 2 7 1 7 1 0 3 0 2 1 0 1 


Floor of Mouth 3 (0.2%) 3 0 3 0 3 0 0 1 1 1 0 0 0 

1,700 

1,600 

1,500 

1,650 

1,492 1,495 

1,602 


Nasopharynx 2 (0.1%) 1 1 1 1 2 0 0 0 0 0 1 0 0 

Tonsil 2 (0.1%) 1 1 2 0 2 0 0 0 0 0 2 0 0 

Hypopharynx 2 (0.1%) 2 0 2 0 2 0 0 0 0 0 2 0 0 



1,400 

Esophagus 12 (0.7%) 8 4 11 1 4 8 0 1 2 3 1 0 4 

Stomach 20 (1.2%) 11 9 19 1 11 9 1 6 0 5 5 0 2 


1,300 

Colon Excluding Rectum 75 (4.4%) 41 34 73 2 66 9 4 21 12 15 19 0 2 

Cecum 17 11 6 16 1 15 2 1 5 3 3 4 0 0 

1,200 

2005 2006 2007 2008 2009 2010 

Appendix 1 1 0 1 0 0 1 0 0 0 0 1 0 0 





Splenic Flexure 1 1 0 1 0 1 0 0 1 0 0 0 0 0 


Sigmoid Colon 22 18 4 21 1 21 1 1 5 5 4 6 0 0 

4.4% 

6.6% 

6.9% 

25.3% 

Breast 

Prostate 

Melanoma 




Rectum 32 13 19 31 1 28 4 3 6 9 6 6 0 1 


Liver & Intrahepatic 13 (0.8%) 7 6 12 1 4 9 0 1 1 3 2 0 5 

18.4% 

Lung 

Corpus Uteri 

Bile Duct Other Biliary 10 (0.6%) 6 4 10 0 6 4 0 3 1 1 1 1 3 

Pancreas 41 (2.4%) 17 24 41 0 19 22 1 2 12 4 14 0 8 

Peritoneum, Omentum & Mesentery 8 (0.5%) 0 8 8 0 6 2 0 2 0 4 1 1 0 

Other Digestive Organs 1 (0.1%) 0 1 1 0 0 1 0 0 0 0 0 1 0 

14 15







Respiratory System 121 (7.1%) 53 68 111 10 75 46 0 23 13 18 43 0 14 

Larynx 9 (0.5%) 4 5 9 0 8 1 0 2 0 1 2 0 4 

Lung & Bronchus 112 (6.6%) 49 63 102 10 67 45 0 21 13 17 41 0 10 

BONES & JOINTS 2 (0.1%) 1 1 2 0 2 0 0 1 1 0 0 0 0 

Bones & Joints 2 (0.1%) 1 1 2 0 2 0 0 1 1 0 0 0 0 

SOFT TISSUE 10 (0.6%) 3 7 10 0 8 2 0 3 4 2 0 0 1 


SKIN EXCLUDING BASAL 

123 (7.2%) 75 48 120 3 114 9 25 69 13 4 3 2 4 

& SQUAMOUS 

Melanoma - Skin 118 (6.9%) 74 44 115 3 111 7 25 68 13 3 3 0 3 

Other Non-Epithelial Skin 5 (0.3%) 1 4 5 0 3 2 0 1 0 1 0 2 1 

BREAST 430 (25.3%) 0 430 424 6 423 7 123 156 87 37 6 0 15 

Breast 430 (25.3%) 0 430 424 6 423 7 123 156 87 37 6 0 15 


Cervix Uteri 13 (0.8%) 0 13 13 0 12 1 0 8 0 3 2 0 0 


Corpus Uteri 72 0 72 72 0 68 4 2 57 4 5 2 2 0 

Uterus, NOS 3 0 3 3 0 1 2 0 0 1 0 2 0 0 

Ovary 39 (2.3%) 0 39 33 6 33 6 0 7 5 17 3 0 1 

Vulva 9 (0.5%) 0 9 9 0 9 0 0 7 1 1 0 0 0 

Other Female Genital Organs 1 (0.1%) 0 1 1 0 0 1 0 0 0 0 0 1 0 

Male Genital System 323 (19.0%) 323 0 291 32 318 5 0 17 231 35 8 0 0 

Prostate 313 (18.4%) 313 0 281 32 309 4 0 10 229 34 8 0 0 

Testis 7 (0.4%) 7 0 7 0 7 0 0 6 0 1 0 0 0 

Penis 3 (0.2%) 3 0 3 0 2 1 0 1 2 0 0 0 0 





BRAIN & OTHER NERVOUS SYSTEM 39 (2.3%) 14 25 37 2 29 10 0 0 0 0 0 37 0 

Brain 17 (1.0%) 6 11 17 0 9 8 0 0 0 0 0 17 0 

Cranial Nerves Other Nervous System 22 (1.3%) 8 14 20 2 20 2 0 0 0 0 0 20 0 


Thyroid 24 (1.4%) 6 18 22 2 24 0 0 13 3 2 2 0 2 

Other Endocrine including Thymus 4 (0.2%) 1 3 3 1 4 0 0 0 0 0 0 3 0 

LYMPHOMA 68 (4.0%) 40 28 60 8 53 15 0 13 14 11 15 1 6 



NHL - Nodal 52 30 22 45 7 42 10 0 5 12 10 12 0 6 


MYELOMA 6 (0.4%) 2 4 4 2 4 2 0 0 0 0 0 4 0 

Myeloma 6 (0.4%) 2 4 4 2 4 2 0 0 0 0 0 4 0 

LEUKEMIA 13 (0.8%) 7 6 12 1 6 7 0 0 0 0 0 12 0 






Other Myeloid/Monocytic Leukemia 1 1 0 1 0 0 1 0 0 0 0 0 1 0 

Other Leukemia 1 (0.1%) 0 1 0 1 0 1 0 0 0 0 0 0 0 

MESOTHELIOMA 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 1 0 0 

Mesothelioma 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 1 0 0 



Total 1,702 749 953 1,602 100 1,476 226 175 455 434 194 158 108 78 


Ureter 4 (0.2%) 3 1 4 0 4 0 2 1 1 0 0 0 0 

Other Urinary Organs 1 (0.1%) 1 0 1 0 1 0 0 1 0 0 0 0 0 

16 17



Oncology Volumes Memorial Regional Medical Center 




850 

800 


827 

Lip 1 (0.1%) 1 0 1 0 1 0 0 1 0 0 0 0 0 

Tongue 8 (1.1%) 4 4 7 1 6 2 0 3 1 0 2 0 1 


Floor of Mouth 1 (0.1%) 1 0 1 0 1 0 0 1 0 0 0 0 0 


750 

Nasopharynx 1 (0.1%) 1 0 1 0 1 0 0 0 1 0 0 0 0 

Tonsil 2 (0.3%) 2 0 2 0 2 0 0 0 0 1 1 0 0 

700 

650 

670 

659 

697 

704 



Esophagus 6 (0.9%) 5 1 6 0 5 1 0 1 1 1 1 0 2 

Stomach 14 (2.0%) 10 4 13 1 6 8 0 3 4 3 2 0 1 

600 


Colon Excluding 65 (9.2%) 32 33 63 2 57 8 8 12 18 13 9 0 3 

550 

Rectum 

Cecum 16 4 12 16 0 14 2 3 2 5 5 1 0 0 

500 

2006 2007 2008 2009 2010 

Appendix 3 2 1 3 0 3 0 0 2 1 0 0 0 0 






Sigmoid Colon 21 11 10 21 0 19 2 1 4 7 2 7 0 0 



5.0% 


13.0% 

21.0% 

Lung 

Colon 

Rectum 28 15 13 28 0 24 4 1 8 10 5 3 0 1 


Liver & Intrahepatic Bile Duct 4 (0.6%) 3 1 2 2 3 1 0 1 0 1 0 0 0 

13.0% 

16.0% 

Prostate 

Breast 

Kidney/Renal 

Gallbladder 2 (0.3%) 2 0 2 0 2 0 0 0 1 0 1 0 0 

Other Biliary 1 (0.1%) 1 0 1 0 0 1 0 0 0 0 0 0 1 

Pancreas 25 (3.6%) 16 9 23 2 8 17 0 2 9 2 8 0 2 

Retroperitoneum 2 (0.3%) 0 2 2 0 2 0 0 1 0 1 0 0 0 

Other Digestive Organs 1 (0.1%) 0 1 1 0 1 0 0 0 0 1 0 0 0 

18 19







RESPIRATORY SYSTEM 155 (22.0%) 73 82 137 18 84 71 0 36 14 30 52 0 5 

Larynx 5 (0.7%) 4 1 4 1 3 2 0 1 2 0 1 0 0 

Lung & Bronchus 150 (21.3%) 69 81 133 17 81 69 0 35 12 30 51 0 5 

SOFT TISSUE 1 (0.1%) 0 1 1 0 1 0 0 1 0 0 0 0 0 


SKIN EXCLUDING BASAL & SQUAMOUS 3 (0.4%) 2 1 3 0 3 0 1 1 1 0 0 0 0 

Melanoma - Skin 2 (0.3%) 1 1 2 0 2 0 1 1 0 0 0 0 0 

Other Non-Epithelial Skin 1 (0.1%) 1 0 1 0 1 0 0 0 1 0 0 0 0 

BASAL & SQUAMOUS SKIN 1 (0.1%) 1 0 0 1 1 0 0 0 0 0 0 0 0 

Basal/Squamous cell carcinomas of Skin 1 (0.1%) 1 0 0 1 1 0 0 0 0 0 0 0 0 

BREAST 86 (12.2%) 0 86 80 6 78 8 8 32 21 12 5 0 2 

Breast 86 (12.2%) 0 86 80 6 78 8 8 32 21 12 5 0 2 



Corpus Uteri 15 0 15 15 0 14 1 1 12 1 1 0 0 0 

Uterus, NOS 1 0 1 1 0 1 0 0 1 0 0 0 0 0 

Ovary 2 (0.3%) 0 2 2 0 1 1 0 0 0 1 1 0 0 

Vulva 1 (0.1%) 0 1 1 0 1 0 0 0 0 0 0 1 0 

MALE GENITAL SYSTEM 89 (12.6%) 89 0 82 7 87 2 0 4 64 9 5 0 0 

Prostate 88 (12.5%) 88 0 81 7 86 2 0 3 64 9 5 0 0 

Testis 1 (0.1%) 1 0 1 0 1 0 0 1 0 0 0 0 0 




Ureter 3 (0.4%) 3 0 3 0 3 0 2 0 0 1 0 0 0 

Other Urinary Organs 1 (0.1%) 1 0 1 0 0 1 0 0 0 1 0 0 0 




LYMPHOMA 34 (4.8%) 20 14 27 7 27 7 0 7 7 3 10 0 0 


Hodgkin - Nodal 3 2 1 3 0 3 0 0 0 2 0 1 0 0 

Hodgkin - Extranodal 1 1 0 1 0 1 0 0 1 0 0 0 0 0 


NHL - Nodal 24 12 12 17 7 20 4 0 4 4 3 6 0 0 


MYELOMA 6 (0.4%) 2 4 4 2 4 2 0 0 0 0 0 4 0 

Myeloma 13 (1.8%) 3 10 9 4 11 2 0 0 0 0 0 9 0 

LEUKEMIA 13 (0.8%) 7 6 12 1 6 7 0 0 0 0 0 12 0 


Acute Lymphocytic Leukemia 2 0 2 1 1 0 2 0 0 0 0 0 1 0 





Chronic Myeloid Leukemia 2 1 1 1 1 1 1 0 0 0 0 0 1 0 

Other Myeloid/Monocytic 

Leukemia 

1 0 1 1 0 1 0 0 0 0 0 0 1 0 

Other Leukemia 3 (0.4%) 3 0 2 1 1 2 0 0 0 0 0 2 0 

Other Acute Leukemia 2 2 0 2 0 1 1 0 0 0 0 0 2 0 

Aleukemic, Subleukemic & NOS 1 1 0 0 1 0 1 0 0 0 0 0 0 0 

MESOTHELIOMA 4 (0.6%) 4 0 4 0 1 3 0 0 0 0 1 0 3 

Mesothelioma 4 (0.6%) 4 0 4 0 1 3 0 0 0 0 1 0 3 



Total 704 372 332 636 68 531 173 38 173 165 97 109 33 21 

Thyroid 9 (1.3%) 5 4 9 0 9 0 0 6 2 1 0 0 0 

20 21


Oncology Outcomes 

The public/private partnership led by the National Quality Forum (NQF) brought together payers, consumers, 

researchers, and clinicians to promulgate performance measures for breast and colorectal cancer. The 

Commission on Cancer, of which Bon Secours has three accredited hospitals, has been actively engaged in this 

process. Through a nationally driven parallel process, the American Society for Clinical Oncology (ASCO) and the 

National Comprehensive Cancer Network (NCCN) developed a similar set of measures for breast and colorectal 

cancer. Facilitated by the NQF, the CoC, ASCO, and NCCN agreed to synchronize their developed measures to 

ensure that a unified set were put forth to the public. 

Four of the measures included in the CP3R(v2) were endorsed by the NQF as accountability measures, meaning 

that these measures can be used for such purposes as public reporting, payment incentive programs, and the 

selection of providers by consumers, health plans, or purchasers. The measures relating to regional lymph node 

examination for resected colon cancers and radiation therapy for advanced stage rectal cancer are quality 

improvement measures and are intended to be used for internal monitoring of performance within an organization 

or group. These latter two surveillance measures can be used at the community, regional, and/or national level 

to monitor patterns and trends of care in order to guide practice change where appropriate, policymaking, and 

resource allocation. None of these measures are designed to assess individual hospital or physician performance. 


Oncology Outcomes: Breast Cancers 

Cancer Program Practice Profile Reports (CP 3 R) for Breast Cancers Diagnosed 2004 – 2008 

Standard: Radiation is administered within 1 year (365 days) of diagnosis for women under age 70 receiving breast 

conserving surgery for breast cancer. 

Perf. Rate St. Mary’s 95% CI Memorial Regional 95% CI St. Francis 95% CI 

Hospital Program 93.3 % 90% (83.8–96.2) 93.3% (80.6–106) * * 

State (VA) 93.3 % 90.7% 90.7 % 

ACS Division 

(South Atlantic) 

90.8 % 85.1% 84.8% 

Census Region 

(Southeast) 

88.8 % 81.3% 80.9 % 

Program Type 88.9 % 85.2% 81% 

All COC approved 

programs 

87.5 % 82.6% 82.% 

Standard: Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for 

women under 70 with AJCC T1cN0M0, or Stage II, or III hormone Receptor negative breast cancer. 

Perf. Rate St Mary’s 95% CI Memorial Regional 95% CI St. Francis 95% CI 

Hospital Program 92.3 % 92.3% (77.8–106.8) 100% (100–100) * * 

State (VA) 90.7 % 92.2% 91.0% 

ACS Division 


89.5 % 86.2% 85.7% 

Census Region 

(Southeast) 

87.9 % 82.2% 81.7% 

Program Type 89.1 % 83.7% 81.8% 


programs 

87.8 % 82.5% 82.1% 

* St Francis Medical Center Data unavailable due to less than 5 years worth of data. 

22 23


Oncology Outcomes: Breast Cancers 

Cancer Program Practice Profile Reports (CP 3 R) for Breast Cancers Diagnosed 2004 – 2008 


Oncology Outcomes: Colon Cancers 

Cancer Program Practice Profile Reports (CP 3 R) for Colon Cancers Diagnosed 2004 – 2008 

Standard: Tamoxifen or third generation aromatase inhibitor is considered or administered within 1 year (365 days) 

of diagnosis for women with AJCC T1cN0M0, or Stage II or III hormone receptor positive breast cancer. 

Standard: Adjuvant chemotherapy is considered or administered within 4 months of diagnosis for patients under 

the age of 80 with AJCC Stage III (lymph node positive) colon cancer. 

Perf. Rate St Mary’s 95% CI Memorial Regional 95% CI St. Francis 95% CI 

Hospital Program 83.5 % 83.5% (76.5–90.5) 48.4% (30.8–66) * * 

State (VA) 88.1 % 85% 84.8% 

ACS Division 


87.5 % 77.7% 76.9% 

Census Region 

(Southeast) 

83.5 % 72.3% 70.7% 

Program Type 83.7 % 75.6% 


programs 

82 % 73.3% 



Cancer Program 100 % 100% 100% (100–100) * 

State (VA) 97.6 % 95.6% 95.6% 

ACS Division 


93.6 % 92.3% 92.3% 

Census Region 

(Southeast) 

90.7 % 90.5% 90.5% 

CoC Program Type 89.8 % 87.1% 89.3% 


programs 

89.1 % 87.7% 87.7% 

Standard: At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. 


Hospital Program 83.3 % 83.3% (66.1–100.5) 86.1% (74.8– 97.4) * 

State (VA) 81.1 % 78.8% 78.8% 

ACS Division 82 % 78.3% 78.3 % 


Census Region 81.5 % 78.2% 78.2% 

(Southeast) 

Program Type 82.6 % 81.0% 76% 


programs 

82.3 % 79.85 79.8% 


24 25


Oncology Outcomes: Colon Cancers 

Cancer Program Practice Profile Reports (CP 3 R) for Colon Cancers Diagnosed 2004 – 2008 

Standard: Radiation therapy is considered or administered within 6 months (180 days) of diagnosis of patients 

under the age of 80 with clinical or pathological AJCC T4NON or Stage III receiving surgical resection for rectal 

cancer. 


Hospital Program 100 % 100% (100–100) 100% (100–100) * 

State (VA) 96.6 % 95.9% 95.9% 

ACS Division 


93.5 % 89.2% 89.2% 

Census Region 

(Southeast) 

90.6 % 85.5% 85.8% 

Program Type 90.2 % 86.4% 86% 


programs 

90.2 % 85.9% 85.9% 

Bon Secours Satisfaction Outcomes 

Patient Satisfaction is one of the most important outcomes for Bon Secours Oncology. The following graphs and 

tables reflect the satisfaction level of our cancer patients with our services. This data is collected directly from our 

patients. As you will note, on average Bon Secours Cancer Institute meets or exceeds the 90th percentile on all 

Oncology units and infusion centers within Bon Secours. 


26 27


Memorial Regional 


St. Francis 

90 th Percentile: 4.50 

75 th Percentile: 4.32 

Data current as of 10/12/11 1:24PM 

*Reporting date not available for December and April 

Oncology: 2nd Floor 

5.00 

4.90 

4.80 

4.70 

4.60 

4.50 

4.40 

Oncology: 5th Floor 

4.80 

4.70 

4.60 

4.50 

4.40 

4.30 

4.20 

4.10 

4.00 

4.30 

Sept. 

2010 

Oct. 

2010 

Nov. 

2010 

Dec.* 

2010 

Jan. 

2011 

Feb. 

2011 

Mar. 

2011 

Apr.* 

2011 

May 

2011 

Jun. 

2011 

Jul. 

2011 

Aug. 

2011 

FY 2011 

3.90 

Sept. 

2010 

Oct. 

2010 

Nov. 

2010 

Dec. 

2010 

Jan. 

2011 

Feb. 

2011 

Mar. 

2011 

Apr. 

2011 

May 

2011 

Jun. 

2011 

Jul. 

2011 

Aug. 

2011 

FY 2011 

28 29


St. Mary’s 


Infusion Center: Hanover and Bremo 

General Oncology: 6 East 

5.00 

4.50 

4.00 

3.50 

3.00 

2.50 

6E 

*Reporting requirements for OPIC- Hanover were not met for blank months. 

5 

4.9 

4.8 

4.7 

2.00 

1.50 

1.00 

0.50 

0.00 

4.6 

4.5 

4.4 

OPIC-H 

OPIC-B 

Sept. 2010 

Oct. 2010 

Nov. 2010 

Dec. 2010 

Jan. 2011 

Feb. 2011 

Mar. 2011 

Apr. 2011 

May 2011 

Jun. 2011 

Jul. 2011 

Aug-11 

FYTD 

4.3 

4.2 

Sept. 

Oct. 

Nov. 

Dec. 

Jan. 

Feb. 

Mar. 

Apr. 

May 

Jun. 

Jul. 

Aug. 

FY 2011 

Women’s Specialty Unit: 3 North 

3N 

2010 

2010 

2010 

2010 

2011 

2011 

2011 

2011 

2011 

2011 

2011 

2011 

6.00 

5.00 

4.00 

3.00 

2.00 

1.00 

0.00 

Sept. 2010 

Oct. 2010 

Nov. 2010 

Dec. 2010 

Jan. 2011 

Feb. 2011 

Mar. 2011 

Apr. 2011 

May 2011 

Jun. 2011 

Jul. 2011 

Aug-11 

FYTD 

Outpatient Infusion Center Staff 

30 31

Survival Outcomes in Selected Cancers 

Each year, as a part of outcomes reporting, the American College of Surgeons Commission on Cancer requires 

that hospitals report on their selected cancers and their survival data. These reports are called site studies. The 

following are the survival studies for 2010 for Memorial Regional Medical Center and St. Francis Medical Center. 


Colon Cancer Study, 2006–2010 

Colorectal cancer is the second most common cancer in the United States. Estimated new cases and death from 

colon cancer in the United States in 2011 

• zNew cases: 101,340 (colon cancer only) 

• zDeaths: 49,380 (colon and rectal cancers combined) 

Although colorectal cancer may occur at any age, more than 90% of the patients are over age 40. Cancer of the 

colon is a highly treatable and often curable disease when localized to the bowel. 

The number of cases per year diagnosed and/or treated for colon cancer at Bon Secours Memorial Medical Center 

from 2006–2010, the age at diagnoses, and stage of disease at diagnoses are shown in the following graphs . 

Total New Cases by Year 

120 

100 

101 101 

85 

91 

80 

67 

60 

40 

20 

0 

2006 2007 2008 2009 2010 

32 33





Age at Diagnosis 

120 

100 

80 

How does it start 

It is generally agreed that nearly all colon and rectal cancers begin in benign polyps. These pre-malignant growths 

occur on the bowel wall and may eventually increase in size and become cancer. Removal of benign polyps is one 

aspect of preventive medicine that really works. 

60 

40 

How is colorectal cancer treated 

20 

0 

0–29 30–39 40–49 50–59 60–69 70–79 80–89 90 & above 

Colorectal cancer requires surgery in nearly all cases for a complete cure. Radiation and chemotherapy are 

sometimes used in addition to surgery. 

Prognosis: 

State at Diagnosis 

150 

100 

50 

Between 80-90% of patients are restored to normal health if the cancer is detected and treated in the earliest 

stages. The cure rate drops to 50% or less when diagnosed in the later stages. 

The prognosis of patients with colon cancer is clearly related to the degree of penetration of the tumor through 

the bowel wall, the presence or absence of nodal involvement, and the presence or absence of distant metastases. 

These three characteristics form the basis of all staging systems developed for this disease. The American Joint 

Committee on Cancer and a National Cancer institute-sponsored panel recommended that at least 12 lymph 

nodes be examined in patients with colon and rectal cancer to confirm the absence of nodal involvement by 

tumor. Retrospective studies demonstrated that the number of lymph nodes examined in colon and rectal surgery 

may be associated with patient outcome. 

0 

Stage 0 Stage I Stage II Stage III Stage IV 

34 35



This graph is a depiction of the percentage of patients each year from 2006–2010 at Bon Secours Memorial 

Medical Center having 12 or greater lymph nodes removed. 



Data at Bon Secours Memorial Regional Medical Center compares favorably with the data from the National 

Cancer Data Base (NCDB) as seen in the graphs below. 

100% 

80% 

Memorial Regional Medical Center: 5-year Survival Rate 

120% 

60% 

100% 

Stage 0 

40% 

80% 

Stage I 

20% 

0% 

2006 2007 2008 2009 2010 

60% 

40% 

Stage II 

Stage III 

For Stage III colon cancer it is recommended that patients under the age of 80 receive adjuvant chemotherapy. 

This graph shows the percentage of patients under age 80 diagnosed with Stage III colon cancer at Bon Secours 

Memorial Regional Medical Center during the years of 2006–2010 that received chemotherapy. 

100% 

80% 

60% 

87% 

20% 

0% 

1 2 3 4 5 6 

NCDB: 5-year Survival Rate 

120 

Stage IV 

40% 

20% 

0% 

4% 

8% 

Received Chemo Refused Chemo Unk Reason No Chemo 

100 

80 

60 

Stage 0 

Stage I 

Stage II 

40 

Stage III 

20 

Stage IV 

0 

1 2 3 4 5 6 

36 37



Can colon cancer be prevented 

Colon cancer is preventable. Any new changes such as persistent constipation, diarrhea, or blood in the stool 

should be discussed with your physician. The most important step towards preventing colon cancer is getting 

a screening test. Health care providers may suggest one or more of the following tests for colorectal cancer 

screening: 


Prostate Cancer Study, 2006–2010 

An estimated 240,890 new cases of prostate cancer will occur in the U.S. during 2011 per American Cancer 

Society Facts & Figures 2011. Prostate cancer is the most frequently diagnosed cancer in men. For reasons that 

remain unclear, incidence rates are significantly higher in African Americans than in whites. At Memorial Regional 

Medical Center prostate cancer during in the years 2006–2010 showed a rate of 35% of the patients diagnosed 

and/or treated being African American while 65% of the patients diagnosed and/or treated were white as is shown 

in the pie graph in Fig 1. 

• zFecal occult blood test (FOBT) checks for hidden blood in the stool. 

• zSigmoidoscopy is a test using a lighted instrument called a sigmoidoscope for detection of precancerous and 

cancerous growths in the rectum and lower colon which may be removed during the procedure. 

• zColonoscopy 

Any abnormal screening test should be followed by a colonoscopy. Colonoscopy provides a detailed 

examination of the bowel. Polyps can be identified and can often be removed during colonoscopy. 

Memorial Regional Medical Center Prostate Cancer 2006–2010 by Race 

Screening for colon cancer should be a part of routine care for all adults aged 50 years or older, especially for 

those with first-degree relatives with colorectal cancer. 

Though not definitely proven, there is some evidence that diet may play a significant role in preventing colorectal 

cancer. As far as we know, a high fiber, low fat diet is the only dietary measure that might help prevent colorectal 

cancer. 

35% 

65% 

• White 

• African-American 

Follow up: 

Fig. 1 

Follow up after the diagnosis & treatment of colon cancer may include a carcinoembryonic antigen blood test 

(CEA) as a method to detect recurrence. CEA blood tests are not totally reliable and other follow up examinations 

include sigmoidoscopy, colonoscopy, chest x-rays, and CT scans or ultrasound tests. Follow up exams are done 

approximately every two to three months for the first two years as most recurrent cancers are detected within the 

first two years after surgery. Follow up is frequent during this time period. After five years, nearly all cancers that 

are going to recur will have done so. Follow up after five years is primarily to detect new polyps. It is advised that 

patients receive lifetime follow up. 

Early prostate cancer usually has no symptoms. With more advanced disease, men may experience weak or 

interrupted urine flow; inability to urinate or difficulty starting or stopping the urine flow; the need to urinate 

frequently, especially at night; blood in the urine; or pain or burning with urination. Advanced prostate cancer 

commonly spreads to the bones, which can cause pain in the hips, spine, ribs, or other areas. 

Michael MacDougall, MD, General Surgery 

Linda Grizzel, CTR, Cancer Registry Coordinator 


Bibliography 1, 2 

38 39





The only well-established risk factors for prostate cancer are age, race/ethnicity, and family history of the disease. 

Age is the strongest risk factor for prostate cancer. Prostate cancer is very rare before the age of 40, but the 

chance of having prostate cancer rises rapidly after age 50. Almost 2 out of 3 prostate cancers are found in men 

over the age of 65. 

The table below (Fig. 2) illustrates the age at diagnosis of patients seen at Memorial Regional Medical Center 

during the years of 2006–2010. 

Age at Diagnosis 

120 

100 

At this time, there is insufficient data to recommend for or against routine testing for early prostate cancer 

detection with the PSA test. The American Cancer Society recommends that, beginning at age 50, men who are 

at average risk of prostate cancer and have a life expectancy of at least 10 years receive information about the 

potential benefits and known limitations of testing for early prostate cancer detection. These men should have an 

opportunity to make an informed decision about testing. Men at high risk of developing prostate cancer (African 

Americans or men with a close relative diagnosed with prostate cancer before age 65) should have this discussion 

with their health care provider beginning at age 45. Men at even higher risk (because they have several close 

relatives diagnosed with prostate cancer at an early age) should have this discussion with their provider at age 

40. Results of two large clinical trials, one conducted in Europe and the other in the U.S., that were designed to 

determine the efficacy of PSA testing were published in 2009. The European study found a lower risk of death 

from prostate cancer among men receiving PSA screening while the U.S. study did not. Further analyses of these 

studies are underway. 

The following graphs (Fig 3 & Fig 4) illustrate the number of new prostate cancer cases seen each year at 

Memorial Regional Medical Center during the study years of 2006–2010 and the stage of disease at diagnosis. 

80 

60 

New Cases per Year 

40 

20 

100 

80 

74 

81 

0 

0-29 30 -39 40-49 50 -59 60 -69 70 -79 80 -89 90+ 

Genetic studies suggest that strong familial predisposition may be responsible for 5%–10% of prostate cancers. 

Recent studies suggest that a diet high in processed meat or dairy foods may be a risk factor, and obesity appears 

to increase risk of aggressive prostate cancer. 

Fig. 2 

60 

40 

20 

0 

20 19 

40 

2006 2007 2008 2009 2010 

Fig. 3 

40 41





Stage at Diagnosis 

200 

150 

178 

Surgery (open, laparoscopic, or robotic assisted), external beam radiation, or radioactive seed implants 

(brachytherapy) may be used to treat early stage disease; hormonal therapy may be added in some cases. 

Brachytherapy is not a service offered at Memorial Regional Medical Center, but when this treatment option 

is selected as the choice of treatment patients are referred to facilities that perform this service. All of these 

treatments may impact a man’s quality of life through side effects or complications that include urinary and 

erectile difficulties. 

100 

50 

0 

36 

2 

17 

Stage I Stage II Stage III Stage IV 

Accumulating evidence suggests that careful observation (“active surveillance” or “watchful waiting”), rather 

than immediate treatment, can be an appropriate option for men with less aggressive tumors and for older men. 

Hormonal therapy, chemotherapy, radiation, or a combination of these treatments is used to treat more advanced 

disease. Hormone treatment may control advanced prostate cancer for long periods by shrinking the size or 

limiting the growth of the cancer, thus helping to relieve pain and other symptoms. This pie chart, (Fig 6) illustrates 

the first course of treatment administered to patients diagnosed/treated at Memorial Regional Medical Center 

during the study period. 

Fig. 4 

Treatment options vary depending on age, stage, and grade of the cancer, as well as other medical conditions. The 

grade assigned to the tumor, typically called the Gleason score, indicates the likely aggressiveness of the cancer 

and ranges from 2 (non-aggressive, well-differentiated) to 10 (very aggressive, poorly differentiated). Fig. 5 graph 

shows the tumor grade of prostate cancer diagnosed/treated at Memorial Regional Medical Center during the 

study years of 2006–2010. 

Tumor Grade 

60% 

50% 

40% 

30% 

First Treatment 

SURGERY 

HORMONE 

SURGERY + HORMONE 

RADIATION + CHEMO 

RADIATION + HORMONE 

SURGERY + RADIATION 

20% 

10% 

Fig. 6 

0% 

Well Diff Mod Diff Poor Diff Unk Diff 

Fig. 5 

42 43



Prostate cancer is the second-leading cause of cancer death in men. Prostate cancer death rates have been 

decreasing since the mid-1990s in both African Americans and whites. Although death rates have decreased more 

rapidly among African American than white men, rates in African Americans remain more than twice as high as 

those in whites. The five year survival rate seen at Memorial Regional Medical may be somewhat skewed when 

compared to national survival data due to the type of elective cases seen at Memorial Regional Medical Center 

or admitted emergently. Survival rates seen at Memorial Regional Medical Center for localized or Stage I disease 

at diagnosis were somewhat better than that seen nationally. Stage II disease at diagnosis had a better survival 

rate nationally. Regional or Stage III disease is comparable to national data with survival being slightly higher 

at Memorial Regional Medical Center, and Stage IV or distant disease at diagnosis saw a higher survival rate at 

Memorial Regional Medical Center as illustrated in the line graphs (Fig 7 & Fig. 8). 

Memorial Regional Medical Center: 5-year Survival Rate 

Percent 

Fig. 7 

120 

100 

80 

60 

40 

20 

0 

1 2 3 4 5 6 

NCDB: 5-year Survival Rate 

Stage I 

Stage II 

Stage III 

Stage IV 

Lung Cancer Site Study: 2010 

Introduction 

Lung cancer accounts for more deaths than any other cancer in both men and women and is the second most 

diagnosed cancer per the American Cancer Society. In 2010, an estimated 222,520 new cases of lung cancer 

(Non-Small Cell Lung Cancer and Small Cell Lung Cancer combined) will be diagnosed in the United States with 

an estimated 157,300 deaths (per the National Cancer Institute). 

Smoking is still the leading risk factor for lung cancer. Other risks include occupational and environmental 

exposures, and in some cases, genetic predisposition is a factor, especially if the cancer is diagnosed at a young 

age. For the first time, a randomized study has proven that early detection and screening programs can reduce 

lung cancer deaths. 

Lung cancer screening and early detection 

Detailed analysis of a randomized trial confirmed earlier findings that a low-dose CT scan to screen for lung cancer 

in heavy smokers reduced deaths from lung cancer by 20% over simple chest x-rays. The report of the National 

Lung Screening Trial (NLST) was published online June 2011 in the New England Journal of Medicine. 

This trial included more than 53,000 current or former heavy smokers aged 55 to 74. Participants had no history 

or signs of lung cancer, and all had a smoking history equivalent to smoking at least a pack a day for 30 years. 

Participants were randomly selected to be screened once a year for 3 years with either the low-dose CT scan or 

standard chest x-ray. After an average of about 6 years, those getting CT scans were 20% less likely to die of lung 

cancer than those getting chest x-rays. 

However, the low-dose CT scans also found a lot more suspicious areas that turned out not to be cancer. Nearly 1 

out of 4 people getting CT scans, as opposed to only about 7% of people getting chest x-rays, had an abnormal 

finding that turned out not to be cancer, but they required further testing to be sure. In most cases this testing was 

more CT scans, but some people got more invasive procedures, which in rare cases caused serious problems. 

Eric Cote, MD, Virginia Urology 

Linda Grizzel, CTR, Cancer Registry 

Coordinator 


References 3,4 

Percent 

120 

100 

80 

60 

40 

20 

Stage I 

Stage II 

Stage III 

Stage IV 

More analysis of the data from this trial is now under way. Researchers are looking at the cost-effectiveness of the 

CT scans, and trying to determine how often and for how long people should be screened. Researchers also hope 

to develop models that may help indicate whether other groups of smokers, such as light smokers or younger 

smokers, would benefit from CT screening. 

Otis W. Brawley, MD, chief medical officer of the American Cancer Society, says, “This is a momentous time in the 

history of public health research, and the NCI investigators are to be congratulated. The National Lung Screening 

Trial study is the best designed and best performed lung cancer screening study in history. These are very 

important findings, and they will be considered as major groups including the American Cancer Society create 

recommendations for the early detection of lung cancer.“ 

Fig. 8 

0 

1 2 3 4 5 6 

44 45


Signs and Symptoms of Lung Cancer 

Signs and symptoms of lung cancer can include chronic cough, sputum with/without blood, chest pain, hoarse 

voice and reoccurring lung conditions such as pneumonia or bronchitis. All of these symptoms usually prompt a 

full work-up which includes (but is not limited to) history and physical examination, radiological imaging (chest 

x-ray, chest computed tomography scan), bronchoscopy, usually with bronchial washings and/or biopsy of a 

suspected lesion. Once a cancer diagnosis is made, a treatment plan can be customized to the type of lung cancer 

the patient has as well as the extent of disease. 

The Bon Secours Cancer Institute at St. Francis Experience 

The following sections highlight Bon Secours Cancer Institute at St. Francis’ experience in lung cancer. 

By gender 

Lung cancer death rates in women are falling for the first time in four decades, according to an annual report on 

the status of cancer published online March 31 in the Journal of the National Cancer Institute. The drop comes 

about 10 years after lung cancer deaths in men began to fall, a delay that reflects the later uptake of smoking by 

women in the middle of the last century. Here at Bon Secours Cancer Institute at St. Francis the percentage of 

male and female cases is illustrated in Fig. 1. 

2010 St. Francis Medical Center Lung Cancer 


By age 

Age is a critical factor in determining what, if any, treatment is possible for lung cancer patients. Usually the more 

advanced age of a patient, the more likely they will have multiple co-morbidities which will impact treatment 

options. The ages of patients diagnosed at Bon Secours Cancer Institute at St. Francis is shown in Figure 2. 

mean age=61 

n=60 

2010 SFMC Lung Cancer 


33% 

15% 

2% 

2% 

13% 

22% 

13% 

0–39 

40–49 

50–59 

60–69 

70–79 

80–89 

90–99 

By histology 

There are two main types of lung cancers: Small Cell Lung Cancer (SCLC) and Non-Small Cell Lung Cancer 

(NSCLC). Each type is treated differently, thus knowing the histology is critical for cancer treatment. Non-small 

cell is further divided into several other subtypes including squamous cell carcinoma and adenocarcinoma. Newer 

molecular testing available is further dividing adenocarcinoma into subtypes that are leading to more personalized 

cancer treatment options. Figure 3 shows the percentages of each type of lung cancer diagnosed at Bon Secours 

Cancer Institute at St. Francis. 

Fig. 2 


45% 

55% 

Sex at Diagnosis 

• Male 

• Female 

Number of Cases 

25 

20 

15 

10 

5 

21 

17 

12 

5 5 

Squamous Cell CA 

Adenocarcinoma 

Small Cell CA 

Non-Small Cell CA 

Other 

Fig. 1 

0 

Histology 

n=60 Fig. 3 

46 47




Molecular Testing and Personalized Cancer Therapy 

25 

Molecular testing in lung carcinoma is an exciting and rapidly evolving area of pathology, driven by new molecular 

discoveries, which is advancing the ideal of personalized therapy for lung cancer patients. Most of these tests 

focus on adenocarcinoma. These tests predict tumor response to a specific group of drugs called tyrosine kinase 

inhibitors (TKI) by way of certain gene mutations called EGRF (epidermal growth receptor factor). Approximately 

10% of adenocarcinomas contain a mutation in EGRF gene that confers responsiveness to tyrosine kinase inhibitor 

therapy (TKI). This mutation is most commonly found in young (40-55 years) females and Asian patients who 

never smoked or have a light smoking history (


Conclusion 

Lung cancer continues to be one of the most common and deadly cancers. Detecting lung cancer in its early 

stages is critical for better treatment outcomes and survival, and for the first time, we have data showing 

screening with CT scans saves lives. With the dedication and experience of the physicians, staff and employees, 

Bon Secours Cancer Institute at St. Francis strives to improve the diagnosis, treatment and management of lung 

cancer patients, allowing for optimal survival and quality of life for our patients. 

Research Study Outcomes 

Bon Secours Cancer Institute at St. Francis/ 

Radiation Oncology Associates 

Rectal Wall Dose-Volume Analysis in Prostate Cancer Patients 

Implanted with a Biodegradable Balloon 

Authors: Jo Anne Walker MD, Mark William MD, Jarethra Jones CTR 

Authors: Rice BK, Torre TG, Harmon JF, Koziol I 

Purpose: The purpose of this study is to evaluate dosimetric effects that result from the introduction of a 

biodegradable balloon implanted between the prostate and rectum. 

Materials/Methods: Six IMRT treatment plans were generated using CT scans acquired before and after 

placement of a biodegradable balloon in three prostate cancer patients (enrolled in protocol BPI-01). The purpose 

of the balloon is to create an artificial, temporary separation between the rectum and prostate during XRT. The 

balloons were implanted transperineally by the interventional radiologist and filled with sterile saline solution. 

The device provides 15 – 20 mm of separation between the prostate and rectum when fully inflated. The rectum, 

rectal wall, prostate, and bladder were contoured consistently on each CT by the same radiation oncologist. The 

IMRT plans created for the pre- and post-balloon plans shared the same number of beams, gantry angles and 

optimization iterations. A different objective function was used for the post balloon plans, the goal being to arrive 

at an optimal solution based on the new geometry. The reduction in dose to the rectal wall was evaluated by 

comparing dose-volume histograms calculated for the pre- and post-balloon IMRT plans. Specifically, the rectal 

wall V20, V40, V60, V70, V78, and mean doses were calculated and compared for each pre- and post-balloon 

treatment plan. Rectal wall volumes were calculated and reported in cubic centimeters. 

Results: The mean dose to the rectal wall decreased on average 36% in the post balloon IMRT plans. The rectal 

wall V60, V70 and V78 decreased on average 89%, 96% and 99%, respectively, for the post balloon IMRT plans. 

50 51

Research Study Outcomes 

Bon Secours Cancer Institute at St. Francis/ 

Radiation Oncology Associates 


Publications, Presentations, Research, Awards 

and References 2009–2011 

Patient 1 Patient 2 Patient 3 

V20 Gy -32% -33% 23% 

V40 Gy -74% -66% -96% 

V60 Gy -93% -73% -100% 

V70 Gy -96% -92% -100% 

V78 Gy -97% -100% -100% 

Mean Dose -33% -31% -44% 

Caption: Reduction in dose to rectal wall volume for patients implanted with biodegradable balloon. 

Conclusion: The rectum is a dose-limiting organ in prostate radiation therapy. Rectum and rectal wall dose-volume 

histogram parameters have been shown to be associated with gastrointestinal quality of life during and after 

radiation treatment for prostate cancer. The introduction of a biodegradable balloon between the prostate and 

rectum was shown to drastically reduce the dose to the rectal wall. This result may enable further dose escalation 

to the prostate and/or allow for increased planning margins. 

Bibliography 

1. http://www.fascrs.org/patients/conditions/colorectal_cancer 

2. http://www.cancer.gov/cancertopics/pdq/treatment/colon/HealthProfessional#Section_506 

3. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/ 

acspc-03+882.pdf 

4. http://www.cancer.org/Cancer/ProstateCancer/MoreInformation/ProstateCancerEarlyDetection/prostatecancer-early-detection-risk-factors-for-prostate-cancer 

Publications 

Bileyu, K.; Gumm, C,; Fitzgerald, J.; Fox, S.; Selig, P. Reducing the Use of potentially inappropriate medications in 

older adults. American Journal of Nursing. 2011, 111(1): 1-6. 

Corn, B.; Wang, M.; Fox, S.; Berkey, B.; Michalski, J.; Curran Jr. W.; Diaz D.; Mehta M.; Movsas, B. Health Related 

Quality of Life and Cognitive Status in Patients with Glioblastoma Multiforme Receiving Escalating Doses of 

Conformal Three Dimensional Radiation on RTOG 98-03. J Neurooncol . 2009, 95(2):247-257. Epub 2009 Jun 16. 

Fine RE.; Schwalke MA.; Pellicane JV.; et al. A Novel Ultrasound-Guided Electrosurgical Loop Device for 

Intraoperative Excision of Breast Lesions: an Improvement in Surgical Technique. The American Journal of Surgery. 

2009, 198(2): 283-286, August 2009. 

Ivanov O.; Dickler A.; Lum BYF.; Pellicane JV.; Francescatti DF. Twelve-Month Follow- Up Results of a Trial Utilizing 

Axxent Electronic Brachytherapy to Deliver Intraoperative Radiation Therapy for Early-Stage Breast Cancer. 

Annals of Surgical Oncology, August 2010. 

Liu, R.; Page, M.; Solheim, K.; Fox, S.; Chang, S. Quality of Life in Adults with Brain Tumors:-Current Knowledge and 

Future Directions. Neuro-Oncology, 2009, 11(3): 330-339. Epub 2008 Nov 10. 

M. Baer, BS.; C. J. Kuo BS; H. Donovan, PhD, RN; S. Fox, PhD; F. Lieberman, MD; A. Mintz, MD, MSC; P. Sherwood, 

PhD, RN, CNRN. Patient-Caregiver Congruence of Patient Symptoms in Persons with a Primary Malignant Brain 

Tumor. Proceedings of the Society of Neuro-Oncology Annual Meeting, 2009, New Orleans, Louisiana, October, 

2009. 

Mugel, M.; & Williamson, T. Reaching Out to Nursing Students A community cancer program devises an oncology 

rotation for nursing students. Oncology Issues. Sept/Oct. 2010, 32-33. 

Rashmi P. Pradhan-Vaidya, MD; Jill R. Dietz, MD, FACS. Book Chapter: Endoscopic Diagnosis and Treatment of 

Breast Diseases, in Minimally Invasive Cancer Management 2nd Edition Editors: Fredrick L. Green and B. Todd 

Henriford. 

Rice, B.; Torre, T.; Harmon, J. & Kozial, I. “Rectal Wall Dose-Volume Analysis in Prostate Cancer Patients Implanted 

with a Biodegradable Balloon” International Journal of Radiation Oncology * Biology * Physics, 2011 81(2): 

Supplement, S402. 

Robertson VL. (Lang Robertson Liebman); Anderson CS.; Keller FG.; Halkar R.; Goodman M.; Marcus RB. & 

Esiashvili N. “Role of FDG-PET in Definition of Involved- Field Radiation Therapy for Pediatric Patients with 

Hodgkin’s Lymphoma” IJROBP 2011 Jun 1;80(2):324-332. Epub 2010 June 18. 

Wallace TJ.; Anscher MS. Prostate cancer. BMJ Point-of-Care 2011; www.pointofcare.bmj.com 

52 53

Presentations 

Fox, S. Envisioning QOL Concept in Education, Practice, Research and Service. Convocation of the University of 

West Virginia School of Nursing. August 16, 2010, Morgantown, WV. 

Fox, S. Symptom Management and Quality of Life in Brain Tumor Patients. 19th Annual William R. Bliss Cancer 

Center Conference: Brain Tumors: The Continuum of Care. April 16, 2010. Ames, Iowa. 

Fox, S. Quality of Life at the End of Life in Brain Tumor Patients. 2009. Society of Neuro-Oncology Annual 

Education Day. October 22, 2009. New Orleans, LA. 

Fox, S. Cognitive Impairment in Brain Tumor Patients. 2009 William J. Smith Memorial Oncology Conference: 

Focus on Brain Tumors. May 1, 2009. Asheville, NC. 

Moore-Wilson, D. (2010) Bon Secours Breast Nurse Navigator Program, Every Woman’s Life State Conference, 

Richmond, Virginia. 

Rashmi P. Pradhan-Vaidya, MD and Jill R. Dietz, MD, FACS. Poster presentation at the 9th Meeting of the 

American Society of Breast Surgeons in San Diego April 22–26, 2009: Management and Outcomes of Patients 

with Margins Positive for DCIS after Mastectomy for Early Stage Breast Cancer. 

Awards/Accreditations 

American College of Surgeons, Commission on Cancer Accreditation and Outstanding Achievement Award. 

Bon Secours Cancer Institute at St. Francis Medical Center, Community Cancer Center, 2011. 

American College of Surgeons, Commission on Cancer Accreditation. Bon Secours Cancer Institute at St. Mary’s 

Hospital, Comprehensive Community Cancer Center, 2011. 

American College of Surgeons, Commission on Cancer Accreditation. Bon Secours Cancer Institute at Memorial 

Regional Medical Center, Community Cancer Center, 2010. 

American Academy of Radiology Breast Ultrasound Accreditation, 2010. American Academy of Radiology Breast 

Imaging Center of Excellence, 2010. 

American College of Surgeons, Commission on Cancer Outstanding Achievement Award. St. Francis Medical 

Center, Community Cancer Center, April 2011. 

National Accreditation Programs for Breast Centers (NAPBC) awarded to Bon Secours Cancer Institute at 

St. Francis, 2011. 

Research 

Fox, S. (2008-present). Co-investigator in Shewood, Paula (PI) Stress and Aging: Caregiver Outcomes in Neuro- 

Oncology. University of Pittsburg. NIH funded 1R01CA118711-01A1. 

Fox, S. (2005-present). RTOG co-investigator in 0424: A Phase II Study of a Temozolomide- Based 

Chemoradiotherapy Regimen for High Risk Low-Grade Gliomas. Close. Data currently in analysis, Oct. 2011. 

National Accreditation Programs for Breast Centers (NAPBC) awarded to Bon Secours Cancer Institute at 

St. Mary’s Hospital, 2011. 

U.S. News and World Report identified St. Mary’s Hospital and Memorial Regional Medical Center as two of four 

best regional hospitals in Richmond. The Cancer Program at both hospitals was ranked as “high-performing.” 

Fox, S. (2005-present). RTOG co-investigator in 0614: A Randomized, Phase III, Double-Blind, Placebo-Controlled 

Trial of Memantine for Prevention of Cognitive Dysfunction in Patients Receiving Whole- Brain Radiotherapy— 

RTOG-CCOP Study. Closed. Data currently in analysis, Oct. 2011. 

Fox, S. (2005-present). RTOG co-investigator in 0925: Natural History of Postoperative Cognitive Function, 

Quality of Life and Seizure Control in Patients With Supratentorial Low-Risk Grade II Glioma. Open study, Sept. 

2011. 

Pellicane, J. ACOSOG Z1072. A Phase II Trial Exploring the Success of Cryoblation Therapy in the Treatment of 

Invasive Breast Cancer, American College of Surgeons Oncology Group. Open study, Feb. 2011. 

54 55


Physicians 


Physicians 

Surgeons 

Plastic and Reconstructive Surgery 

Bon Secours General Surgery 

at St. Francis 

Dr. LaSandra Jackson 

Dr. Joseph Karch, Jr. 

13700 St. Francis Boulevard, 

Suite 301 

Midlothian, VA 23114 

804 423-8467 

Bon Secours Virginia Breast 

Center 

Breast Surgery 

Dr. James Pellicane 

Dr. Polly Stephens 

Dr. Rashmi Vaidya 

5875 Bremo Road, MOB South, 

Suite 701 

Richmond, VA 23226 

(804) 594-3130 

601 Watkins Centre Parkway, 

Suite 200 


(804) 594-3130 

8220 Meadowbridge Road, 

Suite 309 

Mechanicsville, VA 23114 

(804) 594-3130 

Colon and Rectal Specialists 

Colon and Rectal Surgery 

Dr. Bill Timmerman 

Dr. Andrew J. Vorenberg 

7425 Lee Davis Road 


(804) 559-3400 

5855 Bremo Road, Suite 309 


(804) 288-7077 

Dr. Crawford Smith 

8700 Stony Point Parkway, 

Suite 270 


(804) 249-2465 

Colon and Rectal Surgery 

Dr. Paul A. Ghaemmaghami 

5855 Bremo Road, S-101 


(804) 673-0080 

Commonwealth Gynecologic 

Oncology 

Gynecology; Gynecologic 

Oncology 

Dr. Charles Jones, III 

Dr. Johnny Hyde 

5875 Bremo Road, #G-7, 

MOB South 


(804) 288-8900 

Commonwealth Surgeons 

Oncologic Surgery; Breast 

Surgery 

Dr. Brennan Carmody 

Dr. Dennis Cohen 

Dr. George Parker 



(804) 285-3225 

Dr. Dennis Cohen 

1500 N. 28th Street, Suite 301 

Medical Office Building 

(804) 225-7364 

James River Surgical 

Associates – Hanover 

General Surgery; Breast Surgery 

Dr. Sophia D. Lee 

8266 Atlee Road, MOB II, Suite 

225 


(804) 764-7688 

Neurosurgical Associates 

Neurosurgery 

Dr. Peter Alexander 

Dr. Jackson Salvant 

Dr. William White 

Dr. Claude Wilson 

1651 N. Parham Road 


(804) 288-8204 

Surgical Specialists – 

Richmond 

General Surgery 

Dr. David Dougherty 

Dr. Amit N. Gogia 

Dr. Sophia D. Lee 

Dr. Michael MacDougall 

Dr. Broadie Newton 

8262 Atlee Road, 

MOB III, Suite 205 


(804) 559-0194 

Thoracic Surgery Associates 

Thoracic Surgery 

Dr. Gregory Lockhart 

8220 Meadowbridge Road, 

MOB 1, Suite 306 


(804) 764-7910 

Dr. Darius Hollings 


Suite 2205 


(804) 594-4890 

Virginia Ear, Nose & Throat 

Associates 

Otolaryngology 

Dr. Alan J. Burke 

3450 Mayland Court Richmond, 

VA 23233 

(804) 484-3700 

Virginia Urology Center, PC 

Urology; Urological Surgery 

Dr. C. Ryan Barnes 

Dr. Timothy J. Bradford 

Dr. Gary B. Bokinsky 

Dr. Eric P. Cote 

Dr. Michael E. Franks 

Dr. Charlie Jung 

Dr. David A. Miller 

Dr. Mark B. Monahan Dr. William 

R. Morgan Dr. David P. Murphy 

Dr. Kinloch Nelson 

Dr. Robert T. Nelson, Jr. Dr. 

David E. Rapp 

Dr. Scott J. Rhamy 

Dr. Anthony Sliwinski 

8228 Meadowbridge Road 


(804) 730-5023 

5224 Monument Avenue 


(804) 288-4137 


Suite 2201 


(804) 521-8700 

9105 Stony Point Drive 


(804) 330-9105 

Advanced Plastic Surgery Center 

Dr. Richard D. Redman 

7110 Forest Avenue, #101 


(804) 288-2444 

Innsbrook Plastic Surgery 

Dr. Louise Ferland 

4050 Innslake Drive, Suite 310 

Glen Allen, VA 23060 

(804) 346-8700 

James River Plastic Surgery 

Dr. Richard G. Lewis, Jr. 

1451 Johnston Willis Drive Richmond, VA 

23235 (804) 267-6009 

MCV Physicians – Plastic Surgery 

Dr. Stephen M. Chen 

7301 Forest Avenue, Suite 100 


(804) 288-5222 

MCV Physicians – Plastic Surgery 

Dr. Andrea L. Pozez 



(804) 288-5222 

MCV Physicians – Plastic Surgery And 

Reconstruction 

Dr. Douglas S. Rowe 

7301 Forest Avenue, #100 


(804) 288-5222 

Nadia Blanchet, M.D., Ltd. 

Dr. Nadia P. Blanchet 

9210 Forest Hill Avenue, Suite B1 


(804) 320-8545 

Retreat Hospital Wound Healing Center 

Dr. Leslie V. Cohen 

2621 Grove Avenue Richmond, VA 23220 

(804) 254-5403 

Richmond Aesthetic Surgery 

Dr. Neil J. Zemmel 

14051 St. Francis Boulevard, Suite 2209 


(804) 423-2100 

Richmond Plastic Surgeons 

Dr. Darrin M. Hubert 



(804) 285-4115 


Dr. Lewis T. Ladocsi, IV 



(804) 285-4115 


Dr. Mason M. Williams 



(804) 285-4115 


Dr. Isaac L. Wornom, III 



(804) 285-4115 

Richmond Surgical Arts, Inc. 

Dr. Gregory Lynam 

8700 Stony Point Parkway, Suite 230 


(804) 560-5260 

Robert DeConti, MD, Inc. 

Dr. Robert W. DeConti 



(804) 673-8000 

Sewell Plastic Surgery 

Dr. Nathan A. Sewell, MD 

8220 Meadowbridge Road, Suite 304 


(804) 427-7770 

Virginia Institute of Plastic Surgery 

Dr. Burton Sundin 

Dr. Reps Sundin 



(804) 290-0909 

Wyndell Merritt, MD 

Dr. Wyndell Merritt 



(804) 282-2112 

Zinsser Plastic Surgery 

Dr. John W. Zinsser 

1501 Maple Avenue, Suite S-101B Richmond, 

VA 23226 

(804) 474-9805 

56 57


Physicians 

Medical Oncologists 


Physicians 

Radiologists 

Oncology Associates (St. Mary’s) 

Dr. Susan Schaffer 

5875 Bremo Road, Suite G-11, MOB South 


(804) 287-7804 

Virginia Cancer Institute 

(Memorial Regional) 

Dr. M. Kelly Hagan 

Dr. Maurice C. Schwarz 

Dr. McDonald Wade, III 

7501 Right Flank Road, Suite 600 


(804) 559-2489 

Virginia Cancer Institute (Reynolds Crossing) 

Dr. Joseph Evers 

Dr. Joshua J. McFarlane 

Dr. Brian Mitchell 

6605 W. Broad Street, Suite A Richmond, VA 23230 

(804) 287-3000 

Virginia Cancer Institute (St. Francis) 

Dr. Sharon Goble 

Dr. Gisa A. Schunn 

14051 St. Francis Boulevard, #1200 


(804) 378-0394 

Commonwealth Radiology, PC 

1508 Willow Lawn Drive, Suite 117, Richmond, VA 23230 

(804) 281-8534 

Dr. Todd B. Baird 

Dr. Jessica Berliner 

Dr. Robert R. Beskin 

Dr. James Elam Bosworth 

Dr. Douglas E. Cook 

Dr. David G. Disler 

Dr. Mark S. Dixon 

Dr. Jean M. Dufour 

Dr. David P. Ekey 

Dr. Maurice F. Finnegan 

Dr. Robert A. Goldschmidt 

Dr. Amos Q. Habib 

Dr. Karen L. Killeen 

Dr. Pamela E. Kiser 

Dr. Karsten F. Konerding 

Dr. Susan Prizzia 

Dr. Turner M. Lewis 

Dr. Bobbette L. Newsome 

Dr. Alan Vaden Padget 

Dr. Brian J. Pacious 

Dr. Alex L. Sleeker 

Dr. Lori V. Smithson 

Dr. Richard A. Szucs 

Dr. Mark E. Vaughn 

Dr. Gregg D. Weinberg 

Dr. Janette L. Worthington 

Richmond Radiation Oncology Associates (St. Francis) 

Dr. Judy Chin 

Dr. Taryn Torre 

Dr. Jo Anne Walker 

14501 St. Francis Boulevard, Suite 1100 


(804) 594-4900 

Radiation Oncologists 

Richmond Radiation Oncology Associates (Reynolds Crossing) 

Dr. T. J. Wallace 

Dr. Lang Roberston-Liebman 

6605 W. Broad Street, Suite G-201 

Henrico, VA 23230 

(804) 266-7762 


Nurse Navigators 

Oncology Nurse Navigators 

These registered nurses guide patients and their families through the cancer treatment process and beyond 

Richmond Radiation Oncology Associates (St. Mary’s) 

Dr. Judy Chin 

Dr. George Trivette 

Dr. T. J. Wallace 

5801 Bremo Road 


(804) 281-8350 

Monument Pathologists 

5801 Bremo Road, Second Floor, Richmond, VA 23226-1907 

(804) 281-8100 

Pathologists 

Janet Cole, Rn, Bsn, Ocn, Cbcn 

St. Francis Medical Center Breast and General Oncology 

(804) 594-4950 

Sherry Fox, PhD, rn, cnrn 

St. Mary’s Hospital Brain Tumors 

(804) 287-7809 

Cathy Lantz, Ms, Rn 


GYN and General Oncology 

(804) 287-7563 

Jackie L. Sullivan, rn 

Memorial Regional Medical Center and 


General Oncology 

(804) 764-7506 

Donna Moore Wilson, BSn, rn, cBcn, cMSrn 


Breast and General Oncology 

(804) 281-8314 

The Cullather Brain Tumor & Quality of Life Center at St. Mary’s Hospital 

Provides complimentary nurse navigation, advocacy, education, counseling 

and therapies to those with a brain tumor. 



(804) 287-7809 

www.braintumorqol.org 

Dr. Melissa Burke 

Dr. David Capuzzi 

Dr. Zach Ellis 

Dr. Elaine Flanders 

Dr. Matt Graham 

Dr. John Harbour 

Dr. Beth Hewitt 

Dr. Samuel Hunter 

Dr. Jennifer Lorek 

Dr. Robert Sprague 

Dr. Mark Williams 

58 59


Additional Services 

Medical Care Teams 


Additional Services 

Cancer Registrars 

Outpatient Infusion Centers 

Bremo Outpatient Infusion Center 

(on St. Mary’s Campus) 

(804) 287-7227 

Hanover Outpatient Infusion Center 

(on Memorial Regional’s Campus) 

(804) 764-7930 

Financial Assistance for Screening Exams 

(Low-cost or free mammograms and clinical breast exams) 

(804) 594-4931 

Mammogram (804) 627-5660 Main Scheduling Line 

Breast Cancer Support 

St. Francis Cancer Institute – Main Lobby 

1st and 3rd Tuesday of each month, 6:00pm - 7:30pm 

Contact: Kathy Childers (804) 594-3130 

Prostate Cancer Support Group 

Reynolds Cancer Institute – Department of Radiation 

Oncology, Ground Floor 

3rd Tuesday of each month, 6:30pm - 7:30pm 

Contact: Teresa Crist, (804) 594-4944 

Contact: Reynolds Cancer Institute, (804) 266-7762 

Richmond Brain Tumor Support Group 

St. Mary’s Hospital – Education Center 

2nd Tuesday of each month, 7:00pm 

Contact: Carol Roberts (877) 284-3905 

Support For Women With Cancer 

St. Mary’s Hospital – Cancer Resource Center 

(MOB South, Suite 108) 

2nd and 4th Wednesday of each month, 6:00pm – 7:30pm 

Contact: Donna Moore Wilson (804) 281-8314 

Lymphedema Clinics 

(Prevent and treat complications from cancer surgery) 


(804) 594-4975 


(804) 281-8216 

(M-F 8:00am – 4:30pm) 

Women’s Care 

Mammography Sites (see addresses under “Facilities”) 

Laburnum Imaging Center 

Memorial Regional Medical Center Reynolds Crossing 


St. Francis Imaging 



Watkins Centre 

Bon SEcours Support 

Bon Secours Palliative Care 

Provides patient- and family-centered care that focuses on the physical, 

emotional and spiritual needs of patients throughout the continuum of 

an illness 

Site coordinators (804) 287-7875 or (804) 285-6090 

Bon Secours Hospice 

Oldest and only nonprofit hospice program in Richmond; provides endof-life 

support to patients and their families 

(804) 627-5360 

Courtesy Van Service (Mr. Parker) 

(804) 387-5496 

(For transportation to Richmond Community Hospital 

or Laburnum Imaging Center; courtesy van services 

can be scheduled 48 hours in advance to and from either facility) 

Bon Secours Richmond Health System Oncology Services 


Sherry Fox, Vice President, Oncology 

sherry_fox@bshsi.org 

(804) 287-7809 

(804) 353-HoPe (804) 353-4673 

www.richmond.bonsecours.com/cancercare 

Linda Grizzell, CTR 


Robert Hicks 


Yvonne Holder, CTR 


Jeretha Jones, CTR 


Taneka Mack 


Ray Mccawley 


Betty Tilman, CTR 


Katrina Owens, CTR 


Wanda Williams, BS, RHIA, CTR 


Cancer registrars are data management experts who report cancer statistics for various health care agencies and are instrumental in the 

accreditation status of the Cancer Program. Registrars work closely with physicians, administrators, researchers, and health care planners 

to provide support for cancer program development, ensure compliance of reporting standards, and serve as valuable resource for cancer 

information with the ultimate goal of preventing and controlling cancer. The cancer registrar is involved in managing and analyzing clinical 

cancer information for the purpose of education, research, and outcome measurement. Patient confidentiality is strictly maintained. 

Cancer Registrars are eligible for certification by the National Cancer Registrars Association’s Council on Certification (NCRA) after meeting 

eligibility requirements that include a combination of experience in the cancer registry field and educational background. After successfully 

completing the examination, the CTR credential is awarded. To maintain certified status, the current continuing education requirements of 

NCRA must be met. This continued education and training keeps the CTR abreast of new developments in the field of oncology and registry 

data management. 


Facilities 

Bon Secours Cancer Institute at Reynolds 

Crossing 

(Reynolds Radiation Oncology Center) 

6505 West Broad Street, Suite G201 

Henrico, VA 23230 

(804) 266-7762 

Bon Secours Cancer Institute at St. Francis 

14051 St. Francis Boulevard 


(804) 594-4900 

Laburnum Diagnostic Imaging Center 

4630 S. Laburnum Avenue, Suite C 


(804) 627-5660 


8260 Atlee Road 


(804) 764-6000 


1500 N. 28th Street 


(804) 225-1700 

St. Francis Imaging Center 

8013 Midlothian Turnpike 


(804) 330-4600 


13710 St. Francis Boulevard 


(804) 594-7300 

St. Francis Watkins Centre 

601 Watkins Centre Parkway, Suite 200 


(804) 594-3130 


5801 Bremo Road 


(804) 285-2011 

60 61

BON SECOURS CANCER INSTITUTE 

Bon Secours Richmond Health System 

®

Bon SecourS cancer InStItute - Bon Secours Richmond Health System

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