Sutter Health Cancer Services and Programs

A n n u a l S u m m a r y o f P r o g r a m A c t i v i t i e sMGHMarin General HospitalLloyd Miyawaki, MD, MPHMedical Director, Marin Cancer InstituteChair, Cancer CommitteeThe Marin Cancer Institute (MCI) continuesto provide excellent patient andcommunity service through a comprehensiveintegrated program of multidisciplinarycare. Accomplishments in2004 are best highlighted in the contextof its flagship Breast and GenitourinaryOncology Programs.Breast Health ProgramIn 2004, Marin General Hospital(MGH) served more than 2,800 peoplethrough 62 community educationevents, four screening events andseven breast cancer support groups.The Breast Cancer Tumor Boardreviewed 220 cases, discussing everypatient at initial diagnosis and eachsignificant change in management. Tobetter serve patients, the breast healthnurse navigator role was expanded tointervene at the time of biopsy, priorto any diagnosis. A comprehensivepathway was developed to guide andprovide support to women during thisstressful period.The Marin Cancer Institute continuedits focus on quality improvement,producing a breast cancer educationalsymposium for primary care providersthat featured speakers from eachdiscipline. It was extremely wellreceived and will be adapted forthe general public. MCI studiedmammography screening rates forprimary care providers and providedfeedback to individual providersas well as intervention strategies tomaximize screening rates. These rateswill be continually tracked to assessthe efficacy of our interventions.The MCI developed consensusWith early diagnosis and treatment, cancer patients cancontinue to enjoy a full life.guidelines for breast MRI indicationsand worked with local insurers tofacilitate approval. A research study ofhealing through horses (called EquineFacilitated Therapy) was developed toevaluate its effect on recovering breastcancer patients.Genitourinary Oncology ProgramIn 2004, MGH organized a weeklymultidisciplinary Genitourinary (GU)Tumor Board, where the managementof each patient at initial diagnosisand through every aspect of care isdiscussed. Recommendations are basedon consensus guidelines establishedthrough systematic literature reviews.A nurse navigator guides patientsthrough diagnosis, treatment andrecovery. Patients and their familiesare offered a unique multidisciplinaryconference with a comprehensive medicalteam (urology, radiation oncology,medical oncology, pathology, radiology,primary care, nursing, social workand cancer survivor/patient advocate).This year 75 patients were served, andpatient surveys demonstrated outstandingpatient satisfaction. Patient volumegrew substantially, including increasedreferrals from outside the county. Sincethe initiation of the program in 2003,radical cystectomies increased from 0to 17 per year. Between 2003 and 2004,prostate cancer procedures (surgery andradiation therapy) increased 75 percent.Marin General Hospital providedcommunity outreach through prostatehealth educational lectures, whichaddressed more than 350 peoplethrough nine community groups. MGHalso organized two free prostate cancerscreening events, serving 443 men atfive sites over four days, specificallytargeting minority and underservedpopulations. One-hundred-and-thirtymen were advised to undergo furtherevaluation.MGH Goals for 2005• Prepare for successful ACoS survey;• Launch GI Oncology Program.Initiate a GI Tumor Board andproduce a primary care providereducational event;• Implement Palliative Care Programin association with Hospice of Marin;• Implement digital mammographywith computer-aided diagnosis;• Enhance Radiation OncologyDepartment with new CT simulator;• Expand options for breastconservation therapy with theintroduction of Mammosite partialbreasttherapy; and• Develop Cancer Recovery Program,including plans for first annualwomen’s retreat for cancer survivorsin 2006.2005 Annual Cancer Center Report — 2004 Statistical Review | 7