Why Does It Take So Long.. Who Am I?

Why Does It Take So Long...
BY: JACKIE WITT, RN, MS
Just to abstract one case, the CTR has to consult
multiple resources, manuals and databases. On their
desks and computer desktops they have the following
printed or electronic manuals: The American College of
Surgeons, 2011 Facility Oncology Registry Data Standards
(FORDS) manual, the International Classification of
Diseases for Oncology Third Edition (ICD-O) for coding
the site (topography) and the histology (morphology)
of the neoplasm, several editions of the American Joint
Commission on Cancer’s Cancer Staging Manual (the
most recent is the seventh edition), and the Surveillance,
Epidemiology and End Results SEER Program Coding and
Staging Manual 2011 for the extent of disease.
However, it doesn’t stop with printed resources. Also used
is the Hematopoietic Database v1.6.2, the always changing
Collaborative Stage Data Collection System Coding Instruc-
tions version 02.03, Multiple Primary and Histology Coding
Rules, links to the National Plan & Provider Enumeration
System the (NPI Registry), SEER’s Rx (the Cancer Registrar’s
interactive Antineoplastic Drug Database) and the Florida
Cancer Data System’s Data Acquisition Manual 2011
(DAM). In 2002, there were four manuals and abstracting
now, in 2011, too many resources to count! This only
touches the surface of the resources available to registrars
today. If your hospital is an accredited facility, like LCI, you
need to follow the current Commission on Cancer’s Cancer
Program Standards 2009 revised and the 2012 Ensuring
Patient-Centered Care v1.0 Standards.
By the time the CTR navigates through the electronic
medical record and consults all the numerous resources
to abstract the case, the quality of the data collected has
never been more accurate and complete.
Who Am I?
QUIZ
Name:
Department:
Job Title:
Name:
Department:
Job Title:
Name:
Department:
Job Title:
Name:
Department:
Job Title:
Let’s get to know our Lynn Cancer Institute colleagues!
Submit your answers to DMcnally@brrh.com by February
1st. A drawing will be held for either parking for the month
in the Sandler Pavilion front lot or a prize.
2 | THE FYI @ LCI | WINTER 2012

Birthdays, Anniversaries, Highlights & Accomplishments
LCI-DELRAY BIRTHDAYS
Ken McIntyre: Jan 13
Lavern Encarnacion: Jan 27
Chris Massengill: March 1
Kim Emerson: March 4
Salina Ramirez: March 21
LCI-DELRAY ANNIVERSARIES
Sheila Lewis: 30 years
MMC/SUPPORT SERVICES
BIRTHDAYS
Kathy Valenzi: February 15
Vivian Zadkovich: March 16
Kara Murray: March 20
MMC/SUPPORT SERVICES
ANNIVERSARIES
Darci McNally: 12 years
Kara Murray: 7 years
Michelle Doney: 10 years
Vivian Zadkovich: 10 years
RAD ONC BIRTHDAYS
Ron Silversmith: February 28
Madeline Guerrero: March 5
Dr. Kasper: March 15
Helen Berggren: March 24
RAD ONC ANNIVERSARIES
Diane Williams: 5 years
Ty Mendez: 3 years
Michele Pollack: 3 years
IVOP BIRTHDAYS
Diane Voss: Jan
Cynthia Rennick: Jan
Korey Chodash: Jan
Karen Skinner: Feb
Joyce Strazds: Feb
CHO BIRTHDAYS
Sharon Thurman: Jan 4
Michele Belanger: Jan 27
Leanna Farquhar: Jan 29
Sandra Hensley: Feb 2
Ruthe Wagner: Feb 4
Junior Rigo: Feb 12
Karen Powers: Feb 14
Delia Finkel: Feb 19
Ana Hipolit: Feb 19
Maxine Jones: Feb 24
Glenda Peter: Feb 25
Bonnie Pesacov: Mar 2
Fay Donovan: Mar 15
Leah Murphy: Mar 20
Isabel Nunez: Mar 23
Pamela Graham: Mar 25
Eliza Guerra: Mar 25
Laurie Delucia: Mar 27
Kristin Gillig: Mar 29
CHO ANNIVERSARIES
Anne Marie Clennan: 20 years
Chanel Rolle-Brown: 14 years
Carolyn Holzer: 12 years
Jamie Alberga: 5 years
Maxine Jones: 5 years
Delia Finkel: 5 years
Audrey McGrady: 5 years
Barbara Pearl: 5 years
Oscar Sanchez: 4 years
Lariza Tineo: 4 years
Sharon Thurman: 2 years
Michele Hegyi: 2 years
Teresa Paredes: 2 years
Gloria Seidell: 1 year
Leanna Farquhar: 1 year
CDC BIRTHDAYS
Patricia Atchley: March 6
Janice Alexander: March 9
Making Strides
AGAINST BREAST CANCER
Happenings at Sandler Pavilion
JANUARY THROUGH MARCH
JANUARY 19
A Focus on Gynecological
Cancer: Lecture, Screenings
and Mini Health Fair
MARCH 22
A Focus on GastrointestinaI
& Colorectal Cancers: Lecture
and Mini Health Fair
The Walk was held on Saturday, October
22 and it was a huge success! The Lynn
Cancer Institute team had 865 walkers and
to date has raised $31,223.69 for breast
cancer research. This amount surpasses our
goal by over $6,000. Congratulations to
everyone who participated and a special
thanks to our team captains.
JANUARY 28
Susan G. Komen
Race for the Cure
FEBRUARY 14
CINDY Workshop
“A Legacy of Love”
MARCH
National Nutrition Month
FOR MORE INFORMATION, CALL 561.955.LYNN (5966)
WINTER 2012 | THE FYI @ LCI | 3

Lung Cancer
SCREENING PROGRAM
The Lynn Cancer Institute initiated a new low-dose computed
tomography (CT) lung cancer screening program
following a research study from the National Lung Screening
Trial (NLST), which examined the difference in cancer
detection ability between a spiral CT scan and a regular
chest X-ray. The study revealed that detecting small lung
cancers with spiral CT, reduces lung cancer specific mortality
by 20 percent.
The NLST was a randomized national trial involving 53,000
current and former heavy smokers without signs, symptoms
or history of lung cancer. These individuals were randomly
assigned to either a spiral CT scan, a very low dose
CT scan of the chest, versus a regular chest X-ray. The results
showed a dramatic improvement in lung cancer survival
rates due to the detection of tumors at early stages.
Spiral CT uses low-dose X-rays to obtain a high resolution
in depth two-dimensional view of the entire chest, while a
standard chest X-ray produces a single image of the whole
chest in which anatomic structures overlie one another.
The overall survival rate of lung cancer is about 16 percent,
which is significantly lower than most other cancers;
colon, breast and prostate cancer have survival rates of 65
percent, 89 percent and 99 percent respectively.
The lung cancer screening program is a comprehensive,
self-referral program that teams experts in radiology, pathology,
thoracic surgery, radiation oncology, pulmonary
and medical oncology and who have developed a program
to better detect, treat and educate high-risk individuals
against lung cancer.
The screening program is available to smokers between
the ages of 55 to 74 years-old, with a 30 pack-a-year history
and either are currently smoking or have quit smoking
within the past 15 years.
For more information about lung cancer screenings or to
schedule a chest CT, please call the Lynn Cancer Institute
at 561. 955.6627.
New Multimodality Clinic
FOR MELANOMA/ADVANCED SKIN CANCER
In October 2011, we launched the Melanoma/Advanced
Skin Cancer Multimodality Clinic. This new clinic is the sixth
MMC here at LCI. Currently we have: Thoracic, Breast, GI,
Head& Neck, & Urological.
The Clinic will be held once a month on Friday mornings,
with an Oncology Conference at 7:30am followed by the
Multimodality Clinic with the patients present for consult/
recommendations. Please call 955.6627 for the specific
dates each month. John Strasswimmer, MD, a local MOHS
Dermatologic Surgeon, has spearheaded this initiative
and will be working with our CHO and RO doctors, as well
as our ancillary services including, social work, nutrition
and research. This patient centered approach in the
Multimodality Clinics continues to show extremely high
patient satisfaction and much better coordinated care!
4 | THE FYI @ LCI | WINTER 2012

Bill Harders
NEW DIRECTOR OF OUTPATIENT IMAGING
Bill Harders is originally from New York and
has been in Florida for the past 20 years. He
has spent the last 15 and half years at Jupiter
Medical Center as Director of Imaging Services.
Bill has two boys currently in college up in the
Orlando area and is recently married to his wife
Betsy. Some current hobbies include golf and
racquetball. He is currently pursuing his Masters in radiology
from Midwestern State University. Bill’s office is located in the
Sandler Pavilion ... stop by and welcome him to our team!
IVOP FACTS:
DID YOU KNOW?
• Diane Voss, RM, MSN, ARNP is the new IVOP
clinical manager.
• IVOP consists of a total of 12 staff members.
• IVOP raised over $800 for Making Strides
(team captain was Karen Skinner).
• IVOP has five certified PICC nurses
(led by Michele Houfek and includes
Karen Skinner, Julie Thompson, Sue Nicklaus
and Marilyn Greenberg).
• IVOP services include, but are not limited to,
blood transfusions, chemotherapy, hydration,
antibiotics and injections.
• IVOP is open Saturday and Sunday from 8:00am
to 10am (limited services but accommodates
patients needing daily injections/antibiotics.
• IVOP is located near outpatient services, down
the hall from SICU, stop by and visit!
The Sugar & Cancer
Connection
BY: MARIE MORANDE, RD, CSO, LD
The number one question I am asked
by patients and family is “Does sugar
feed cancer?” Unfortunately the media
and internet hype the sugar cancer connection
and make it very confusing for
people to understand the truth.
My quick answer is sugar feeds every
cell of the body. However, cancer cells
can make their own glucose. So, can you
stop eating sugar and stop your cancer
growth? NO!
So what is the sugar cancer connection?
Research is finding increased cancer risk
among people with high insulin production.
All of these conditions lead to
cancer promotion. The key then is controlling
insulin production through diet
and exercise to reduce risk of encouraging
cancer growth. Here are some take
home strategies for healthy carbohydrate
intake for cancer patients:
1. Limit simple sugars. Increase consumption
of high fiber foods including
fruit, vegetables, beans, and whole
grains. These are the foods that fight
cancer best.
2. Concentrate on foods with low Glycemic
Load. Complex carbohydrates
high in fiber control insulin production.
3. Don’t eat “naked” carbohydrates.
Combine carbohydrates with protein,
fat, and fiber to slow absorption and
produce less insulin.
4. Exercise 30 minutes daily most days
of the week but also take exercise
“breaks” meaning get up from the desk
and walk for 1-2 minutes every half hour
throughout the day.
5. Be as lean as possible. Lose weight
through calorie restriction and exercise.
WINTER 2012 | THE FYI @ LCI | 5

Patient Navigation Services
BY: JACKIE WITT, RN, MS
When a patient is diagnosed with cancer he or she can
become overwhelmed. Undergoing various treatments
and dealing with healthcare professionals from different
specialties like surgeons, radiologists, pharmacists, and
medical and radiation oncologists can be a lot to handle.
Because of this, the Lynn Cancer Institute is implementing
a Navigation program to assure patients are identified and
guided through their plan of care within the Lynn Cancer
Institute system, and to act as a liaison with physicians,
including the referring physician and primary care, assuring
timely correspondence regarding their patients. The
Oncology Nurse Navigator will offer medical guidance,
and walk patients and their families through the cancer
treatment process.
The role of an Oncology Nurse navigator may include:
• Planning and educating patients and families about
their individual cancer diagnosis and treatment options
• Supporting and navigating each patient through
treatment by reinforcing education and coordinating
information and care with a team of physicians and
allied healthcare professionals
• Participating in the weekly cancer conferences with the
LCI team of physicians, genetic counselors, and nurses
to discuss and determine the best treatment plan for
each newly diagnosed patient with cancer
• Referring patients to appropriate cancer support
programs at the LCI and resources in their communities
• Teaching about cancer prevention, screening guidelines,
diagnosis, treatment options, and the importance of
early detection
Growth
BY: HELEN BERGGREN, MHA
It is conflicting to write about growth when what we do
is treat and support cancer patients. I doubt there is
one among us who wouldn’t be glad to be out of a job
because someone found the cure. Having said that, cancer
is a reality. At LCI we have the opportunity to provide
the highest quality, compassionate care to patients. We
have staff and technical resources second to none and an
array of support services that far exceeds what is provided
elsewhere. And yet, the number of patients coming to us
is dropping compared to last year.
We have excellent patient satisfaction scores at LCI and
that’s because every person working here is focused on
patients being treated with dignity and compassion. Each
of us needs to continue to remain aware that every day the
patients are the number one priority of our day.
Patients like our facilities, but they come for our people.
They talk to their families and friends about our people.
While there are many large issues that we can’t influence,
there are the kind words and smiles that we can give. So,
keep caring and taking that extra step like you always do.
We’re working on the other issues and combined we can
make it happen!
The easy responses are that there is increased competition,
not enough marketing and the economy. All these issues
are being addressed. But, I would like to discuss how each
of us has the opportunity to play a role in growth. Growth
is important because it enables us to keep pace with the
increasing costs of drugs, technology, supplies and people.
6 | THE FYI @ LCI | WINTER 2012

Critical Drug Shortages
BY: SIGAL NADULEK, RPH, CTH
Drug shortage in the United States has reached an all
time high. There were 210 drugs added to the shortage
list so far this year. That number is expected to reach
over 300 by year’s end. According to the Institute for
Safe Medication Practice, the number of drugs that are
on short supply are triple the number listed in 2006.
The topic of drug shortage has recently made national
headlines when chemotherapeutic medications became
unavailable. Chemotherapy agents account for 16% of
the shortage, other medications that are on the list range
from antibiotics, blood pressure medications, anesthetics,
as well as pain medications, trace elements and vaccines.
The factors leading to the shortages vary as widely
as the indication for the medications affected. Many
medications are made by only one or two manufacturers.
When manufacturing problems arise such as lack of
natural raw product or a suspension of usage of a facility;
the burden of increased production falls on the remaining
manufacturer, who cannot keep up with the demand. The
cost of production of generic medication has increased
leading to insufficient financial incentive to continuing
the manufacturing of these drugs. Many manufacturers
choose to cease production on the medications that are
not profitable and begin production on medications that
are more economically sound. Another factor leading
to the shortage is the recent merger of manufacturing
companies. When the only two companies that produce
a medication merge, the production of the medication is
cut in half since only one of the plants will be assigned to
continue the manufacturing the medication.
The CHO Pharmacy has been diligent in their response to
the shortage. The shortage list is reviewed on a daily basis
and countless hours are spent searching and locating
the medications. The CHO Pharmacy communicates
regularly with our physicians and oncology nurses so that
patient care remains the priority despite these difficult
circumstances. In October 2011, the FDA issued a letter to
the drug industry expressing their concern and extending
their assistance when a potential shortage is expected.
We hope that the FDA’s intervention will help ease the
crisis. For now, we will continue our vigilance in attempt to
ensure that disruption in patient care is minimized.
Mission & Vision
LYNN CANCER INSTITUTE
Outstanding Press Ganey Scores
BY: BARBARA MCINTYRE, MHA, RTT
MISSION:
The Lynn Cancer Institute is focused on
elevating the level of care and setting
the standard for quality cancer care in
our region by providing professional
excellence, offering multidisciplinary
subspecialty clinics, integrating advances
in science, technology and clinical
research; and building a comprehensive
support team for patients and families.
VISION:
To be recognized as a national leader and
the premier provider of cancer care in
South Florida.
The Radiation Oncology Department were recognized, by the Boca
Regional Board of Directors, for their outstanding accomplishments
in the Press Ganey Survey for fiscal year 2011. They completed the
year in the 94th percentile nationwide, up from the 70th percentile
the previous year! To accomplish this high achievement, a total
department effort was instituted. Action plans, scripting, personal
cards with contact names, monthly meetings, bubbles and bells at the
end of a course of treatment, and creating a positive encounter with
every patient, and their family, made this possible. It was truly a team
effort. Great job and keep up the outstanding work!
WINTER 2012 | THE FYI @ LCI | 7

Jan Dymtrow
LYNN CANCER INSTITUTE EMPLOYEE SPOTLIGHT
Jan Dymtrow, Community Services Coordinator
at Boca Raton Regional Hospital, is also the
Lynn Cancer Institutes designated Community
Outreach Coordinator. Jan is the key point
persion in making sure that all of our events,
lectures and walks are a success. Recently, Jan
was selected as the 2011 Soroptimist Health
and Education Woman of Distinction and was honored at the
38th Annual Women of Distinction breakfast on October 12,
2011. The Soroptimists honor the many outstanding local women
who give back to the community through leadership, volunteer,
professional and educational efforts.
Soroptimist International is an organization that was formed
in 1921 in Oakland, California and today boasts over 40,000
members in 19 countries around the globe. The word Soroptimist
is derived from Latin words meaning “women” and “the best,”
which literally means “best for women.”
They raise funds to help women in need, as well as providing
educational opportunities for women who do not have the
resources to further their education. The Soroptimist Club of Boca
Raton–Deerfield Beach was founded in 1960. Helen Babione, a
long-time supporter of Boca Regional, was one of their founders
and continues to be an active member of the Club.
“It gave us great pleasure to see Jan selected as the 2011
awardee,” said Jan Savarick, President of the Boca Raton
Regional Hospital Foundation and who nominated Jan Dymtrow
for the award. “She has touched hundreds, perhaps thousands,
of lives with her compassion and courage and has inspired
countless others.”
Jan has been employed by Boca Raton Regional Hospital since
1994. As community services coordinator, she creates health
education and screening programs for patients and underserved
families in our community.
Through the years, she has prepared and donated food for
needy school children, provided and organized meals for the
sick and comforted patients and families in Hospice. In her role
as a Eucharistic Minister at St. Joan of Arc, she visits patients
at Boca Raton Regional Hospital once a month. She is also a
member of the Advisory Council of the Spirit of Giving Network.
Important
Anniversaries
THE LYNN CANCER INSTITUTE
AT THE SANDLER PAVILION
It is hard to believe that in November
2011 the Lynn Cancer Institute at the
Sandler Pavilion celebrated its third
anniversary! It seemed as though it was
an eternity of planning and after many
years in the “making” we now feel as
though this has always been our home.
The feedback consistently from the
patients is how beautiful, bright and
welcoming the building is. They report
how it makes coming for treatments that
much easier. We of course realize that
the building is just the surface, it is all
of you who care for our patients that
make the Lynn Cancer Institute at the
Sandler Pavilion the exceptional caring
experience it is. Congratulations and
Happy Anniversary!
LOUISE MORRELL, MD
MEDICAL DIRECTOR
Happy one year anniversary to Louise
Morrell, MD, our medical director. Dr.
Morrell has been with the Boca Raton
Regional Hospital family for over 15
years. We know her well from her years
of championing the breast program at
the Lynn Women’s Health & Wellness
Institute. However, Dr. Morrell was also
one of the key people in the proposal
and approval of the board to build
the Sandler Pavilion, grow our cancer
program and the mastermind behind
the MultiModality Clinic (MMC) concept.
With her official move into the Sandler
Pavilion she brought with her a thriving
genetics program, which has been very
successful. With her unyielding passion
towards cancer care, it seems as though
Dr. Morrell has always been our leader.
We appreciate her dedication and look
forward to celebrating many more years
to come.
WINTER 2012 | THE FYI @ LCI | 8