2012 Annual Report - Randolph Hospital

2012
Randolph Cancer Center
Annual Report
Based on data from 2011
A Service of Cone Health & Randolph Hospital

Table of Contents
Letter from the Chairman____________________________ p. 2
Letter from the Medical Director______________________
p. 3
Breast Navigation Over the Last Year___________________ p. 4
Randolph County Relay for Life_______________________
Tumor Conference_________________________________
Cancer Center Registry______________________________
Lymphoma Study__________________________________
Randolph Cancer Center Recieves QOPI Accreditation_____
p. 5
p. 6
p. 7-10
p. 11-14
p. 15
Randolph Cancer Center Thank Yous___________________ p. 16
1
www.randolphcancercenter.org

Letter from the Chairman
by Robert McGee, Ph.D., MD
Robert McGee, MD, PhD, Chairman,
Randolph Cancer Center
During 2012, three
important events, among many
others, occurred that I would like
address in my Chairman’s Letter.
First, our Clinical Trials
program underwent a significant
review process during 2011 and
into early 2012 which led to a major
reorganization and the hiring of
additional staff members to meet
the goals and standards of the
Commission on Cancer. Leading the
Clinical Trials program is Virginia
Deaton, an experienced Clinical
Trials Research Coordinator who
joined us in the spring. She has
instituted a number of processes
and procedures to review and
capture newly diagnosed cancer
patients earlier in the patient’s
medical treatment plan in order to
identify and assess their eligibility
for participation and enrollment in
a clinical trial offered at Randolph
Cancer Center, as well as other
clinical trials available at nearby
institutions. With the strengthening
and expansion of the Clinical
Trials program, we have been
able to expand the number of
clinical trials offered to our patient
population. Although review of the
implemented processes is still early
and on-going, the initial data shows
a significant increase in the number
of patients being screened for and
accrued into clinical trials.
Secondly, in early 2012,
a subcommittee of the Cancer
Committee was formed to explore
and review the requirements to
obtain national accreditation of the
Randolph Hospital Breast Center
by the National Accreditation
Program for Breast Centers
(NAPBC). The NAPBC is a
separate yet integral part of the
national Commission on Cancer
which specifically addresses and sets
the standards for optimal diagnosis
and treatment/management of
breast cancer patients. In addition,
it provides guidance on addressing
the many psychosocial issues faced
by patients, male and female,
when dealing with a diagnosis of
breast cancer. In mid 2012, the
Cancer Committee accepted the
subcommittee’s recommendation
to move forward with
accreditation. The subcommittee
was further expanded to form a
multidisciplinary team including
breast radiologists, medical
oncologists, pathologists,
surgeons, radiation oncologists,
nurse navigators, social workers,
chaplaincy and others involved
with this project. This group has
been meeting bi-weekly and has
expended an exceptional amount
of time in preparation for the initial
accreditation inspection which will
occur in March 2013. I would like
to personally thank these individuals
for their excitement and devotion to
providing quality breast cancer care
to our community by seeking this
national accreditation recognition.
And finally, speaking of
accreditation, the Randolph Cancer
Center will undergo its three-year
accreditation review in March
2013 as well. A subcommittee of
the Cancer Committee has been
meeting monthly - bi-weekly
throughout 2012 in preparation
for this inspection process. Again,
I would like to thank all of the
involved members for their
time and effort in this major
endeavor.
The Cancer Committee
is looking forward to showing the
Commission on Cancer inspection
team the commitment our Cancer
Committee members have for
providing quality cancer care and
the advances we have made in
providing that care since our last
accreditation inspection.
www.randolphcancercenter.org
2

Letter from the Medical Director
by Christine McCarty, MD, Medical Director, Randolph Cancer Center
Chrstine McCarty, MD,
Medical Director,
Randolph Cancer Center
Randolph Cancer Center
is now in its thirteenth year and
continues to grow in its services
for cancer patients and their
caregivers. We are proud to present
this annual report which outlines
some of our accomplishments and
quality initiatives. We applied for
and received our certification in the
Quality Oncology Practice initiative
(QOPI) on the first attempt. This
involves a rigorous evaluation of
our practices and documentation
through detailed chart review and
on-site review. There is a detailed
summary of this process later in this
report but I was extremely proud of
the glowing evaluation we received
from our on-site investigator,
commenting on our personalized
and detailed care.
Another report at the end
of this document is a study looking
at non-Hodgkin’s lymphoma in
terms of histologic types, stages,
treatment and survival rates.
We were awarded renewal
of our grants from the Susan G.
Komen and Avon organizations to
assist our program in providing
all women with mammograms
regardless of insurance and financial
situations. Once again Cox Harley-
Davidson partnered with Randolph
Cancer Center to raise funds
through our “Biker for Boobs”
event. This year we experienced
a light rain which cut back on
participation. Despite that, each
year the amount of money raised
has increased for all 3 years since
the inception of this event. The
£¤£¦£¤¦£¤££¦§§¦ ¤§¦£¨¥¨£©£¢£¤£¦ §¦¨£¦¤¦¤£¦¨£¦§¦¦¤££§¢§ ¡¢£¤¥¦§¨£©¦££¦¤¦£¤¦
¨££©¦¤£¥§¨¤¦¦¦¨£ ¤¨
past two years we have had dreary
weather, so we are hoping for sunny
skies and looking forward to next
year’s event.
We also started a new
tradition of holding our Cancer
Survivor’s Day at the North
Carolina Zoo. This was a lively
event with good participation and
enjoyed by all. We plan to make this
an annual event to celebrate the
hundreds of survivors, with growing
numbers every year.
And so we continue to
strive to constantly improve
our multidisciplinary care and
personalized compassion for all who
enter Randolph Cancer Center.
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3
www.randolphcancercenter.org

Breast Outreach and Navigation Program
by Leigh Anna Johnson, Public Relations Coordinator
Randolph Cancer Center
offers an array of services to cancer
patients and their families including:
chemotherapy and radiation
treatments, alternative therapies
such as music therapy and support
groups and most recently a breast
cancer navigation program. The
service was made possible through a
grant from the Avon Foundation and
has touched hundreds of lives since
its implementation.
Sherry Tate, the Breast
Cancer Navigator at Randolph
Cancer Center, follows breast
cancer patients from the time
they are diagnosed through their
remission period. Additionally, she
is responsible for hosting events,
seminars and support groups to
help patients and their families that
are in the midst of a breast cancer
diagnosis.
In 2012, Tate helped to
navigate over 60 patients through
the healthcare system providing
a variety of services including:
helping patients understand their
treatment options, referring them
to the mammography fund (financial
assistance) and recommending
the Breast and Cervical Cancer
Control Program (BCCCP), a
service provided through the North
Carolina Department of Health.
Additionally, Tate hosts support
groups for those faced with breast
cancer, provides patients with
needed supplies, recommends
counseling services and facilitates
access to screening
mammograms for patients
who could not otherwise
afford them.
Tate was able to
provide four breast cancer
screening clinics for women
who were underinsured or
uninsured, over 30 years
of age and who had not a
mammogram during the
previous year. Three of the
screenings clinics were held at
Randolph Cancer Center and the
other was held at Asheboro Day
Care.
The Breast Outreach &
Navigation Program is just one
piece of the full continuum of
care patients receive at Randolph
Hospital’s Breast Center of
Excellence. The dual-functioning
program seeks to educate women
of Randolph County about routine
and traditional breast health as
well. Tate has been able to educate
women in the community by
attending community events such
as the Randolph Cancer Center’s
Survivor’s Day Celebration, the
Randolph Community College
Health Fair, the Bikers 4 Boobs
celebration, and speaking at
Asheboro High School to students
about the importance of breast
cancer awareness, presenting
at the Randolph County School
Nurses meeting on breast health,
hosting “The Latest in Breast Care”
by partnering with Dr. Christine
Sherry Tate helps women navigate through the
healthcare system. She also promotes early
detection and awareness through education,
community classes and hosting breast screenings.
McCarty as well as the distribution
of breast health materials to Merce
Clinic and the Randolph County
Health Department.
Through funding from
organizations like the Avon
Foundation, Susan G. Komen
Race for the Cure, and Bikers 4
Boobs, Randolph Cancer Center
is able to provide a breast cancer
navigation service that not only
helps women understand their
breast cancer diagnosis, but also
equips them and their families with
the tools necessary to overcome the
diagnosis, whether it be a financial
resource, a therapeutic service
or help with getting supplies. In
addition, the Breast Outreach &
Navigation Program is a valuable
tool that helps educate women
about breast health in Randolph
County. Randolph Cancer Center
is privileged to be able to provide
this service to its patients and the
community, in order to provide the
full spectrum of care to those faced
with breast cancer.
www.randolphcancercenter.org
4

Randolph Relay for Life Breathes New Life
by Leigh Anna Johnson, Public Relations Coordinator
Randolph Cancer Center
was excited to be part of the 2012
Relay for Life celebration again this
year. The event not only celebrated
the lives of cancer survivors
everywhere, but also memorialized
those who had passed. It was a day
filled with joy, remembrance and
above all hope.
There was a renewed feeling
at this year’s Relay for Life. A new
location was chosen and a different
path was taken. The new location
took place in the heart of Randolph
County at Bicentennial Park in
Asheboro. It provided easier access
for survivors and their families to
come to the event.
Randolph Cancer Center
and Randolph Hospital partnered
this year to host a meal for cancer
survivors and their families.
Volunteers helped at the event
which celebrated survivorship,
remembered the lost, and
encouraged the fight for those still
suffering from various forms of
cancer.
“Randolph County’s
Relay for Life has been extremely
successful in years past and it
was no different this year,” said
Amy Castlebury, RN, co-chair of
the team from Randolph Cancer
Center. “The event in Randolph
County has been so successful that
Randolph Cancer Center was the
first in the South Atlantic division to
receive funding through American
Cancer Society grants to build a
local Cancer Resource Center.”
Relay for Life events are
different in various communities,
but there are some traditions that
hold true at each event. Relay for
Life always has a Survivor’s Lap in
which all survivors are encouraged
to walk the initial lap of the event.
“The Survivor’s Lap is one of the
Cheryl Jones, breast cancer survivor
shows her supports at Randolph County’s
Relay for Life in 2012.
most moving parts of the event,”
said Castlebury. “When you see the
sea of purple walking together, you
know it’s hope,” she added.
Another tradition at Relay
for Life is the Luminary Ceremony.
It usually takes place after the sun
has gone down and participants
are encouraged to light candles to
honor those who were lost due
to the disease. Additionally, it’s
a time to recognize all the lives
that have been touched by cancer.
“The Luminary Ceremony is an
emotionally moving experience.
It is really beautiful to see all the
lights that are lit in remembrance of
cancer survivors,” noted Castlebury.
Relay for Life is just
one way Randolph Hospital and
Randolph Cancer Center are
able to show their support in the
battle against cancer. Through
community events such as Relay
for Life, Randolph Cancer Center
and Randolph Hospital have
the opportunity to partner and
continually build stronger, lasting
relationships with those who have
been touched by their disease.
The physicians and staff
from Randolph Hospital and
Randolph Cancer Center were
excited by the response from
survivors and their families or
caregivers at this year’s event. Relay
for Life is not simply a fundraiser,
it is a life-changing experience for
those who have faced or have loved
people who have been faced with
cancer.
Randolph Hospital,
Randolph Cancer Center and
the American Cancer Society
are thankful to everyone
who celebrated survivorship,
remembered the lost and stood-up
for the efforts to battle cancer at
this year’s event. There is strength in
numbers and the more purple shirts
attending Relay for Life events,
the more hope is provided to those
facing a cancer diagnosis. The funds
raised from the event ensure more
and more birthdays for cancer
patients everywhere.
5
www.randolphcancercenter.org

Tumor Conference 2011
by Robert McGee, MD, PhD, Chairman, Randolph Cancer Committee
The Tumor Conference
is a multi-disciplinary conference
composed of oncologists,
radiologists, surgeons,
pathologists, radiation oncologists,
primary care physicians and
other healthcare professionals
involved in cancer care. The
conference meets weekly to
present, review, discuss and
offer recommendations for the
management and/or treatment
of patients who will receive their
treatment at Randolph Cancer
Center, meeting all guidelines
outlined for accredited cancer
programs through the American
College of Surgeons.
Based on data derived
from the Tumor Registry at
Randolph Hospital, there were
410 analytical cases in 2011.
An analytical case is defined as
a patient with cancer who was
diagnosed and/or received all
or part of his/her course of
treatment at our facility between
January 1 and December 31,
2011. The five most common
malignancies in order of frequency
were: breast, lung, prostate, colon
and lymphoma cancers.
The following table
illustrates the most frequently
presented cases as well as the total
number of cases presented at the
Tumor Conference for 2011,
which met the requirements for
an accredited program through
the American College of Surgeons.
2011 Tumor Conference Case
Presentations
Primary Site
Number
of cases
Breast 79
Lung 48
Colon 18
Lymphoma(Non-Hodgkin’s) 8
Bladder 7
Esophagus 7
Melanoma 6
Prostate 6
Unknown primary 6
Remaining sites 45
TOTAL (all sites) 230
2011 Analytical Cases
Five Most Common Sites
of Malignancy:
Breast 89 cases
Lung 68 cases
Prostate 46 cases
Colon 41 cases
Lymphoma 20 cases
www.randolphcancercenter.org
6

Cancer Center Registry
by Adaline Brown, RHIT, CCS, CTR, Cancer Center Registry Coordinator
by Robert McGee, MD, PhD, Chairman, Randolph Cancer Committee
The Cancer Registry for
Randolph Hospital was established
January 1, 1998 to collect, manage,
and analyze statistical data on all
cancer patients diagnosed and/or
treated at Randolph Hospital and
Randolph Cancer Center.
The registry’s program is
patterned to meet the requirements
of the American College
of Surgeons Commission
on Cancer and is designed
to describe characteristics,
modalities of therapy
14
and patient survival
experiences.
The main objective
of the cancer registry is to
collect and abstract basic
cancer information related
to Randolph Hospital’s
cancer population that
will assist the various
members of the medical
community in evaluating
the effectiveness of cancer
treatments, which in turn
can be used to improve patient
outcomes.
Physicians and hospital
administrators use this data to
evaluate staffing and equipment
needs, cancer rates in our patient
population, and diagnostic and
therapeutic trends. This data is also
used to evaluate compliance with
national standards of care.
A total of 482 cases were
accessioned into the database in
2011. Of these, 410 were analytical
cases (Table 1, pages 9-10).
Analytical cases include
all reportable cases first diagnosed
and/or receiving all or part of
their initial treatment at Randolph
Hospital and/or Randolph Cancer
Center in 2011. This includes
patients receiving part of their initial
therapy elsewhere. The remaining
Randolph Hospital
Analytical Cases by County
2011
335
15 3
19
72 cases were non-analytical cases,
which includes cases seen for the
first time at Randolph Hospital
and/or Randolph Cancer Center
for subsequent treatment, but who
received at least one complete
course of treatment elsewhere.
The cancer registry
maintains lifetime follow-up on
patients entered into the database.
It also serves as a reminder to
physicians and patients to schedule
physical examinations to assure
continued medical surveillance in
hopes of improving early detection
of recurrent or metastatic disease.
Since January 1, 1998 a total of
5,197 cases have been accessioned
into the database. Of these, 2,112
patients have expired with a total of
3,085 to be followed.
The American College of
Surgeons Commission on Cancer
requires at least an 80 % followup
rate on all analytical patients
accessioned in the database since
it was established. Our current
follow-up rate is 87.5%.
The American College of
Surgeons Commission on Cancer
also requires at least a 90% followup
rate on all analytical patients
accessioned into the database in
the last five years. Our current
follow-up rate is 93%.
In an effort to keep abreast
of the many changes and current
issues, the staff attends various
educational meetings throughout
the year provided by the National
Association of Cancer Registrars,
Commission on Cancer and the
North American Association of
Central Cancer Registries.
The Randolph Cancer
Center continues to show an
upward trend in the total number of
analytical cases and, by extension,
the patients it serves. Graph
1, page 8, shows the number of
analytical cases from 1998, the year
in which the cancer center was
established, through 2011.
7
www.randolphcancercenter.org

H
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7
H
Cancer Center Registry
Continued from page 7
As the graph indicates,
there has been a general upward
trend in the number of analytical
cases through this time period
from 194 cases in 1999 to 410
cases in 2011.
In 2011, there was
an increase in the number of
analytical cases compared to 2010.
As shown in Graph 1, there were
410 cases in 2011 compared to
395 analytical cases in 2010.
As shown in the diagram
of analytical cases by county, there
was an increase in the number of
analytical cases, especially those
originating in Chatham County.
As shown in Graph 2,
the number of analytical cases
from the surrounding geographic
counties including Randolph,
remained stable or showed a slight
increase. The notable exception
is Montgomery County, which
revealed a significant decrease
in cases from 2010 to 2011.
However, the number of 2011
cases is still similar to years prior
to 2010.
The Randolph Hospital
Cancer Committee will continue
to investigate and monitor the
frequency of the most common
cancers treated at the Center
and monitor the outcomes of
its patients. With this data, the
Cancer Committee and Randolph
Cancer Center can continue to
explore opportunities to grow and
improve its services to Randolph
and surrounding county residents.
Graph 1
Total Analytical Cases
HI JKLI JM NOI JPIQRQ
FG
377 477 277 577
077
Graph 2
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Randolph HospitalTotal Analytical Cases
1998-2011
Graph 1
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89:;:
Randolph Hospital Analytical Cases by County
2006-2011
Graph 2

Cancer Center Registry
Continued from page 8
Primary Site - Major Groups
For Staging
2011 Randolph Analytical Cas
Alamance Chatham Davidson Forsyth Guilford
Breast 1 3 1 1
Lung 5 1 3
Prostate 2 6 2 2
Colon/Rectum 3 2 2
Hodgkin / Non-Hodgkin Lymphoma 1
Urinary Bladder 2 2
Pancreas 1 1
Corpus Uteri 1
Larynx 1
Oropharynx
Liver
Melanoma of the Skin 1
Ovary 2
Brain / Spinal Cord
Esophagus
Lip / Oral Cavity
Kidney
Cervix Uteri
Hypopharynx
Renal Pelvis/Ureter 1
Skin Carcinoma
Anus / Anal Canal
Gallbladder
Soft Tissue Sarcoma
Stomach 1
Bone
Fallopian Tube
Intrahepatic Bile Ducts
Major Salivary Glands
Testis
Thyroid
Vulva
All Others 1
Grand Total 2 19 14 1 13
9
www.randolphcancercenter.org

Cancer Center Registry
es Sites By County (Table 1)
Montgomery Moore Randolph Rockingham Stanly Suffolk,
VA
Wake Grand
Total
1 1 78 1 1 1 89
59 68
7 26 1 46
2 32 41
1 2 14 1 1 20
1 13 1 19
9 11
9 10
7 8
8 8
6 6
4 1 6
4 6
5 5
5 5
5 5
4 4
3 3
3 3
1 1 3
3 3
2 2
2 2
2 2
1 2
1 1
1 1
1 1
1 1
1 1
1 1
1 1
25 26
15 3 335 2 4 1 1 410
www.randolphcancercenter.org 10

Lymphoma Study
by Christine McCarty, MD, Medical Director, Randolph Cancer Center
by Robert McGee, MD, PhD, Chairman, Randolph Cancer Committee
11
Lymphomas represent
a diverse malignancy affecting
either B or T cells. For pathological
classification and for clinical
management, the lymphomas are
divided into 2 groups: Hodgkin’s
lymphoma (HL) and non-Hodgkin’s
lymphoma (NHL). Both HL and
NHL can be further divided into
subtypes based on the histological
pattern or phenotypic expression of
surface markers.
Non-Hodgkin’s lymphoma
represents approximately 4% of
all malignancies in both men and
women and accounts for 3% and
5% of deaths due to malignancy
in men and women, respectively.
An estimated 74,000 new cases
of lymphoma are expected to be
diagnosed in 2010 with 8,500 cases
being classified as HL and 65,000
being classified as NHL. In 2010, an
estimated 21,500 deaths will occur
due to lymphoma in the US with
20,000 of these deaths due to NHL.
In North Carolina, it is estimated
that there were 1,800 new cases of
NHL in North Carolina and 570
deaths due to this disease in 2010.
The incidence of NHL in
males has been steady since 1991;
however, it has been increasing by
1%/year in females. In contrast,
the rate for HL has decreased in
men (0.6%/year) but has increased
slightly in women (0.4%/year) over
the past 30 years.
The death rate from HL
has been decreasing in both men
and women for more than three
decades. In contrast to HL, the
death rate from NHL has been
decreasing since 1997 by 3%/
year in men and by 3.7%/year in
women.
For this year’s study, the
Cancer Committee selected the
topic of NHL, in particular the
histological subtypes of follicular
lymphoma and diffuse large B-cell
lymphoma, to review the following
data from a select group of NHLs
diagnosed and treated at Randolph
Cancer Center:
• Histology
• Age at time of diagnosis
• Stage at time of diagnosis
• Comparison of first
course treatment
modalities
• Five-year survival rates
The data for Randolph
Cancer Center and this study was
abstracted from the Randolph
Hospital Tumor Registry for the
years 2000-2011. For comparison,
similar parameters for state and
national community cancer centers
were obtained from the national
cancer data base for the years 2000-
2008 (most recent available data).
Histology
The various histological
classification of non-Hodgkin
lymphoma for Randolph Cancer
Center compared to other
community cancer centers in North
Carolina and the US is shown in
Table 1 (page 12).
www.randolphcancercenter.org
In comparing the
histological subtypes of NHL at
Randolph Cancer Center, North
Carolina and in the US, the most
common cases were diffuse large
B cell lymphoma (27.61% vs.
37.54% vs. 32.81%, respectively).
Another common histological type
of NHL at Randolph Cancer Center
is malignant lymphoma, non-
Hodgkin’s NOS (, 15.67%).
This rate is markedly
higher than the rate observed in
North Carolina (10.76%) and
in the US (9.86%). The higher
rate of malignant lymphoma,
non-Hodgkin’s NOS at Randolph
Cancer Center may be related
to other institutions classifying
this histological type as diffuse
large B cell lymphoma, or these
cases were diagnosed earlier in
the establishment of our cancer
program (18 of 21 cases were
diagnosed prior to 2006, data not
shown) and may reflect a hesitancy
to be more specific in the pathologic
diagnosis.
The second most common
histological type is follicular
lymphoma, which encompasses
several of the above categories
(follicular malignant lymphoma,
NOS; mixed small cleaved and large
cell follicular lymphoma; small
cleaved cell, follicular lymphoma;
and large cell, follicular malignant
lymphoma, NOS). The total number
of follicular lymphomas observed at
Randolph Cancer Center is 35 cases
Continued to page 12

Lymphoma Study
Continued from page 11
Table 1
Histology RH % All States % NC %
Malignant Lymphoma, NOS 3.00% 5.67% 5.85%
Malignant Lymphoma, Non-Hodgkin's NOS 15.67% 9.86% 10.76%
Small Lymphocytic Malignant Lymphoma 5.22% 8.44% 9.71%
Lymphocytic, Intermediate Differentiation, Diffuse Malignant 5.98% 4.33% 2.92%
Large Cell, Diffuse Malignant Lymphoma, NOS 27.61% 32.81% 37.54%
Follicular Malignant Lymphoma, NOS 8.20% 10.26% 8.77%
Mixed Small Cleaved and Large Cell Follicular Lymphoma 3.73% 5.02% 4.80%
Small Cleaved Cell, Follicular Lymphoma 5.98% 6.61% 3.86%
Large Cell, Follicular Malignant Lymphoma, NOS 8.20% 3.91% 4.21%
Monocytoid B Cell Lymphoma 5.22% 3.55% 3.86%
Other Specified Types 11.19% 9.54% 7.72%
between 2000-2011 which
represents 26.12 %, which is line
with observed rates at the state
Continued to page 12
(21.64%) and national level
(25.80%). One point worth
noting is the higher percentage of
follicular lymphoma, grade 3, at
Randolph Cancer Center (8.20%)
compared to the state (4.21%)
and national rates (3.91%). One
possible explanation for this
higher rate may be related to
the number of cases (i.e. n=10)
classified as this type so the data
may be biased or skewed in this
regard.
In reviewing the data
for the other types of non-
Hodgkin lymphomas, Randolph
Cancer Center has a similar rate
compared to state ans national
rates for monocytoid B cell
lymphoma, which includes the
malt lymphoma and marginal zone
lymphoma histological subtypes.
For classification purposes by
the Tumor Registry, mantle
cell lymphoma is designated
as lymphocytic, intermediate
differentiation, diffuse malignant
type.
The rate of mantle cell
lymphoma at Randolph Cancer
Center is 5.98% which is
higher than the state (2.92%)
and national (4.33%) rate. The
observed rate of mantle cell
lymphoma at RCC reflects a
recent increase in the number
of these cases (4 cases in 2011)
which may due to more accurate
classification of this lymphoma as
opposed to placing it in a lesser
defined histological subtype.
Age at Time of Diagnosis
The age at the time of
diagnosis was also reviewed and
compared to state and national
figures (Graph 1, page 13).
The age distribution at the time
of non-Hodgkin Lymphoma
diagnosis at Randolph Cancer
Center is similar to the age
distribution at the state and
national levels.
Stage at Time of Diagnosis
A review of the clinical
stage at the time the diagnosis
of non-Hodgkin lymphoma
was made was also undertaken
(Graph 2, page 13). Randolph
Cancer Center has more Stage
I and Stage III non-Hodgkin
lymphoma (35.3% and 27.7%,
respectively) compared to North
Carolina (17.3% and 22.3%,
respectively) and national rates
(18.4% and 19.4%, respectively).
Continued to page 13
www.randolphcancercenter.org
12

Lymphoma Study
Continued from page 12
Graph 1
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Stage II rates are similar at Randolph
Cancer Center compared to state
and kihhj lhihhj
national
data (18.5% vs. 18.7% vs.
opqrs }~€~
15.0%,
respectively). Randolph Cancer
Center has fewer cases of Stage IV
non-Hodgkin lymphoma compared
to state and national percentages
(16.8% vs. 30.2% vs. 29.7%,
respectively).
The most striking
disparity in the
Graph 3
staging percentages
is the number of
unknown stages at
Randolph Cancer
Center (1.7%). One
possible explanation
for this variation is
that Randolph Cancer
Center may be focusing
more effort to clinically
À¼½¼¼¾ Á¼½¼¼¾ ¼½¼¼¾ ÉÊËÌÊÍ ÎÏÐ ÎÊ
stage its patients
¿¼½¼¼¾
prior to treatment
²zpq{³´µ · ¸³³¹ºzºr»
compared to other state and
national community facilities. The
lower percentage of unknown stages
at Randolph Cancer Center may
explain the observation of
{|rs
higher
percentages in Stages I and III at our
institution compared to state and
national data.
Comparison of First Course
Treatment Modalities
A comparison of the first
course of treatment for non-
Hodgkin lymphoma was reviewed
(Graph 3, page 14). In general,
the two most common approaches
to treatment of non-Hodgkin
lymphoma are based on the
severity of the disease at the time
of diagnosis. One can either initiate
chemotherapy treatment in order to
treat the disease and symptoms, or
take a more conservative approach
and follow the patient (i.e “watchful
waiting”) in the earlier stages of the
disease and initiate treatment at a
later date.
In comparing these
two options, the initiation of
chemotherapy alone as the first
course of treatment at Randolph
Cancer Center is similar and in
line with other state and national
community cancer centers (30.6%
vs. 32.4% vs. 27.8%, respectively).
The majority of these
patients were given chemotherapy
Continued to page 14
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13
www.randolphcancercenter.org

Lymphoma Study
Continued from page 13
only, which is an appropriate
treatment modality for this disease
process. In the second population
of patients assigned to watchful
waiting, Randolph Cancer Center
percentages are in line and similar
to state and national figures
(20.9% vs. 18.7% vs. 21.2%,
respectively). Overall, Randolph
Cancer Center is on par with state
and national first course treatment
modalities.
Graph 3
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567 51 [NNPCMOF>C>LFNN>FC>\]^SWA>V_`I@\TaWA>V_
Five -Year Survival Rates
The five year observed
survival rate by stage at Randolph
Cancer Center was compared
to state and national statistics
(Graph 4, page 14). Randolph
Cancer Center has a higher
survival rate in Stages I and II
compared to state and national
rates (100% vs. 74.8% vs. 72%,
respectively and 100% vs. 67.9%
vs. 64.9%, respectively), and a
lower rate of 5-year survival in
Stages III and IV (40% vs. 55.1%
vs. 58%, respectively and 0% vs.
48.4 % vs. 47.9%, respectively).
Some possible
explanations for this difference
in survival include: 1) more
unknown cases at Randolph
Cancer Center assigned to a
specific clinical stage rather
than unknown, 2) patient comorbidities,
and 3) fewer number
of non-Hodgkin lymphoma
cases in our tumor registry for
comparison to state and national
data.
012314
Graph 4
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www.randolphcancercenter.org 14

Randolph Cancer Center Receives
QOPI Accreditation
by Leigh Anna Johnson, Public Relations Coordinator
If you were faced with a
cancer diagnosis, what are some
of the criteria you would look for
when choosing where to go for your
cancer treatment Some patients
might want to find the center with
the most convenient location, while
others might seek out a center
that offers both chemotherapy and
radiation treatments. Most likely the
most important factor for choosing
a cancer center would be the quality
of patient care. Patients can find
all of these things and more at
Randolph Cancer Center.
The Quality Oncology
Practice Initiative (QOPI®)
Certification Program, an affiliate
of the American Society of Clinical
Oncology (ASCO) recognized
Randolph Cancer Center with
a three-year certification for
outpatient hematology-oncology
practices for meeting the highest
standards for quality cancer care.
“We’re very excited to receive this
certification from ASCO and QOPI
which highlights our dedication
to quality care for our patients.
Randolph Cancer Center is one
of only 10 cancer centers in the
state of North Carolina to receive
this accreditation. We feel that the
accreditation speaks volumes about
the quality of care we provide each
and every day,” said Dr. Christine
McCarty, medical director of
Randolph Cancer Center.
¡¢£¤¥¦§¢¨¤©§¢ª«£¡ª¬£ §¡©§¬¥©¦¥­¦ª®¢¯¢«°§¡¥ ±¥£§§¦¥©§²¥«§©«¯¤©¦¥ ­ª££¢±³¥§ªª´¦­©§¢¥«§£ Ÿ
¤ª²²¢§²¥«§§ª¥µ¤¥³³¥«¤¥ ©«¯ª«°ª¢«°´©³¢§· ©«¯¯¥²ª«£§¦©§¥£ª´¦
ª´§­©§¢¥«§­¦©¤§¢¤¥¹º
- Dr. Christine McCarty
Medical Director,
Randolph Cancer Center
To become certified,
Randolph Cancer Center underwent
a rigorous evaluation of
¢²­¦ª®¥²¥«§¢«§¡¥
the entire
practice and of
¡¥²©§ª³ª°·¸ª«¤ª³ª°·
documentation
standards. The QOPI Certification
Program staff and steering group
then verified that the evaluation and
documents were correct and that
the practices met core standards in
all areas of treatment, including:
• treatment planning;
• staff training and education;
• chemotherapy orders and drug
preparation;
• patient consent and
education;
• safe chemotherapy
administration;
• monitoring and
assessment of patient
well-being.
Randolph Cancer
Center is a collaborative effort
of Randolph Hospital and Cone
Health and provides quality
comprehensive cancer care. “This
certification shows that we are
providing the best treatment and
care possible to our patients and
demonstrates our commitment
to excellence and ongoing quality
improvement in the hematologyoncology
outpatient practice,”
added McCarty.
Whether patients are
seeking a facility for its convenient
location, specialized treatment
options or its dedication to quality
cancer practices, all three can be
found at Randolph Cancer Center.
Randolph Cancer Center offers
exceptional treatments right here
in Randolph County, making it
easier and faster for patients to
receive exactly the care they need
in a facility specifically designed
to provide comprehensive cancer
care.
15
www.randolphcancercenter.org

Randolph Cancer Center
Would Like to Thank the Following
for Contributing to the
Annual Report:
Adeline Brown, RHIT, CCS, CTR
Sharon Brookbank, RN, OCN
Virginia Deaton, CPhT, CCRP
Sherry Farster, RN,BSN, MBA
Karen Hall, BA, MDiv, CMC
Jeff Hazel, MBA, FACMPE
Sherry Keck-Doty, RN, BSN, MSN, CNS-BC, CWOCN, Alumnus CCRN
DeQuincy Lewis, MD
Michael Lininger, MD
Christine McCarty, MD
Robert McGee, MD, PhD
Sandra Mitchell, MD
Sherry Tate, RN
Randolph Hospital
Steven Reid, MD
Randolph Cancer Committee Members - L to R, Dr. Robert McGee,
Pathologist, Dr. DeQuincy Lewis, Medical Oncologist, Dr. Christime McCarty,
Medical Oncologist, Dr. Sandra Mitchell, Radiation Oncologist and
Dr. Michael Lininger, General Surgeon.
Not pictured - Adeline Brown, Sharon Brookbank, Virginia Deaton,
Sherry Farster, Karen Hall, Jeff Hazel, Sherry Keck-Doty, Dr. Steven Reid,
and Sherry Tate.
www.randolphcancercenter.org 16

2012
Randolph Cancer Center
Annual Report
Based on data from 2011