Cancer Care2 3Breast HealthRadiation Oncology“There’s no institution internationally that’s everreported a higher local control rate for early-stagebreast cancer, meaning the odds that you’ll keepyour breast if you’re treated with breast-conservingtherapies at <strong>Evergreen</strong>,” says Michael Hunter, MD,medical director of the Cancer Program. “We’re at98 percent – and these results rank with the bestin the world – so we’re doing a pretty good jobhere,” he says.Staying free from cancer recurrence is associatedwith higher survival rates. “The idea that you canget MD Anderson-level care in your own backyardis foreign to many people,” Dr. Hunter says. Butthe impressive results show that it’s true.The successful outcomes aren’t all that’s new.“In 2008, we introduced stereotactic radiationtherapy, a program initially designed for treatingbrain tumors,” says Dr. Hunter. “The idea is to usemultiple beams from multiple angles that converge,so the dose is high where they overlap, ideal forcertain brain tumors. Our new technology willalso allow for better targeting of moving tumors,such as lung cancer.” A feature called respiratorygating synchronizes each dose with a patient’sbreathing cycle to hit the cancer while sparingmore healthy tissue.In 2008, <strong>Evergreen</strong> installed one of the moststate-of-the-art linear accelerators – the machinesused to deliver radiation – available anywhere inthe world. The new Varian Trilogy offers a newlevel of precision, with the ability to do stereotacticradiation therapy and image-guided radiationtherapy (IGRT). “Educated patients ‘google’these terms now,” says Sue Smiley, manager ofradiation oncology and cancer support services.“They look for cancer centers, like <strong>Evergreen</strong>’s,that offer this technology.”“There’s no institution internationallythat’s ever reported a higher localcontrol rate for early-stage breastcancer.”Comprehensive Cancer Care– Michael Hunter, MDOnly programs offering the best comprehensivecancer care are accredited by the AmericanCollege of Surgeons Commission on Cancer – arecognition that <strong>Evergreen</strong> has achieved everythree years since 1977.“Comprehensive care means we offer the fullscope of services, from state-of-the-art screening,detection, diagnostics and treatment to supportiveservices for patients and families,” says Sue Smiley,manager of radiation oncology and cancersupport services.In 2008, <strong>Evergreen</strong> achieved the highest honorgiven by the Commission on Cancer – theOutstanding Achievement Award – a recognitionthat only three other Washington hospitals earned.Cascade Cancer Center, the primary medicaloncology, or chemotherapy, provider for <strong>Evergreen</strong>,is a member of the Seattle Cancer Care Alliance,an affiliation that helps patients access clinicaltrials. <strong>Evergreen</strong>’s radiation oncology service offersleading-edge radiation therapy in an environmentthat ranks among the highest patient satisfactionscores in the nation.Cancer survivorship, a topic of growing nationalinterest, has become a unique field within cancercare. “A cancer survivor is anyone living with ahistory of cancer, from the moment of diagnosisthrough the rest of life,” says Smiley. To help meetsurvivors’ needs, <strong>Evergreen</strong> partners with nationaland community resources such as the AmericanCancer Society and Seattle’s Cancer Lifeline tooffer support groups, classes and exercise programs,and to host an annual survivorship retreatfor patients and families for celebration, educationand support.<strong>Evergreen</strong> Breast CenterDigital mammography has revolutionized breastcancer screening.Rather than peering at an X-ray film with amagnifying glass as they did a generation ago,radiologists such as Kara Carlson, MD, can nowmagnify, contrast and invert digital mammogramson high-resolution computer monitors.“Washington still ranks third in our country forthe incidence of breast cancers,” says Dr. Carlson,medical director of the <strong>Evergreen</strong> Breast Center.“Nearly 4,000 women will be diagnosed in our statethis year, so we really need to be at the forefront oftechnology for early detection.”In 2008, the Breast Center team designed betterways to identify women at high risk for developingInspired GivingDigital MammograpHy CoachThe <strong>Evergreen</strong> Breast Center uses the latest, mostadvanced digital mammography technology.breast cancer. “Some women benefit from high-riskscreening with breast MRI in addition to mammographyexams,” Dr. Carlson says. “We do a riskassessment on every woman coming in for routinescreening and calculate her five-year and lifetime risk,giving us an opportunity to educate women.”In January 2008, the Breast Center also launched amajor streamlining effort to fine-tune patient flowand provider workflow. After reversing a backlogin patient scheduling, the team now performs130 to 135 mammograms a day – and can focuson getting more women in for screenings and onexpanding services.“We’re down to next-day scheduling for ascreening mammogram and for diagnostic workups,”says Dennis Marlow, director of DiagnosticImaging.The comprehensive Breast Center offers digitalmammography, ultrasound, MRI, biopsies, andreferrals to surgery, radiation oncology, medicaloncology and genetic testing.“<strong>Evergreen</strong> has an incredible multidisciplinaryteam,” says Dr. Carlson. “We discuss new breastcancer cases in a forum that gives patients thebenefit of our pathologists, surgeons, medicaloncologists and radiation oncologists, all givinginput on the best treatment for each patient.”Signs of Growth: <strong>Evergreen</strong> Breast Center2007 / 2,200 mammograms and biopsies monthly2008 / 2,550 mammograms and biopsies monthlyA dream took shape, several years ago, among members of the Breast Center team. As radiologists, theyknew that the earlier a cancer was found, the better the prognosis.So to make it easier for more women to get breast cancer screenings, the team envisioned a way to take<strong>Evergreen</strong>’s high-tech, digital mammography out into surrounding communities. Their vision: Build a digitalmammography coach to drive out to each of the primary care clinics in the <strong>Evergreen</strong> Medical Group on arotating basis, so that women in outlying towns could see their local family doctors and get a mammogramwhile they were there.When the team presented its idea to the audience at the 2008 <strong>Evergreen</strong> Gala, several guests offereddonations ranging from $1,000 to $20,000, raising an initial $200,000 of capital support. Hearing of the need,Al and Donna DeYoung generously gave a matching gift of another $200,000.Digital mammograms on the coach offer the same state-of-the-art technology used at the <strong>Evergreen</strong> BreastCenter – a level of quality not often found in mobile units – and are performed by the same level of certifiedradiologic technologist. Set to begin seeing patients in summer 2009, the mobile coach is expected to increasethe Breast Center’s mammograms by 20 percent.