Seby B. Jones Regional Cancer Center
2014 Annual Report
Cancer Committee
The Cancer Committee is a multidisciplinary committee comprised of, but not limited to,
representatives from surgery, medical oncology, radiation oncology, diagnostic radiology, pathology,
administration, nursing, social services, cancer registry, and quality assurance. The Cancer Committee is
responsible for establishing the quality improvement priorities of the cancer program.
Members
Damon Anagnos, M.D., Plastic Surgeon
Jennifer Anderson, RN, Cancer Center
Camile Andrews, D.O., Obstetrics & Gynecology
Anne-Corinne Beaver, M.D., Surgeon, Cancer Liaison Physician
Kim Bianca, RN, MSN, SVP, Clinical Services
Beverly Bowen, Pharmacist
Jeffrey Brown, M.D., Hospice & Palliative Care
Heather Casey, RD, Nutrition Services
Sandi Cassidy, Director, Oncology Services
Melanie Childers, Director, Pastoral Care
Tammy Crumpler, M.D., Radiologist
Amy Freeman, M.Ed., CTR, Cancer Registrar
Robin Fox, RN, Director, Care Management
T. Flint Gray, M.D., Medical Oncologist
Brent Hall, M.D., Pathologist
Melissa Hiatt, American Cancer Society
Angie Hicks, RN, VP Quality
Marjorie Hrozencik, RN, Clinical Trials Nurse
Nicole Housinger, CTR, Registry Partners
Candy Jones, RN, Community Outreach
Kenneth Kirksey, Cancer Resource Alliance
Yvonne Mack, M.D., Radiation Oncologist
Betty Mize, Cancer Registry
Carrie Phillips, American Cancer Society
Gary Pitts, M.D., Urologist
Emily Roberts, Rehabilitation Services
Tiffany Selong, D.O., Anesthesiologist
Tony Schlake, M.D., Urologist
Angie Shoemake, MSW, Cancer Center Social Worker
Anna L. Sobol, M.D., Cancer Committee Chair, Medical
Oncologist
Vicki Stevens, Director, Community Outreach
Kevin Wolfe, M.D., Pulmonologist
Paul Young, RN, OCN, Oncology Nurse Navigator
Cancer Resource Alliance
The Cancer Resource Alliance (CRA) is a comprehensive team of healthcare professionals, business partners,
cancer caregivers and cancer survivor volunteers. The Alliance was established in 2006 as an outreach arm
of Seby B. Jones Regional Cancer Center in Watauga County, the American Cancer Society and the Rural
Healthcare Initiative of Avery County. The CRA presence in Watauga and Avery counties is further committed
to helping Seby B. Jones Cancer Center cancer patients who qualify for assistance and their families with support
services and programs.
Cancer Resource Alliance Board
Members
Betty Mize, Secretary
Sandi Cassidy, Cancer Center Administrator
Jessica Powell, Treasurer
Vicki Stevens, Marketing & Communications
Joyce Watson, Community Member - Avery County
Doc (Randy) & Trina McCoy, Community Members Watauga County
Billy Elliott, Community Member
Advisory Committee Members
Betty Mize, Secretary
Sandi Cassidy, Cancer Center Administrator
Candy Jones, Community Outreach
Jean Sellers, UNC Cancer Network Liaison
Angel Mathis, ASU - Colleges Against Cancer Chair
Carrie Phillips, American Cancer Society Representative
Mary Morgan, Volunteer and Cancer Survivor - Avery County
Linda Nixon, Volunteer and Cancer Survivor - Avery County
Joe Sinford, Community Member - Survivor
Ad Hoc Members
Kim Bianca, RN, MSN, SVP and CRA Executive Sponsor
Dr. Yvonne Mack, Physician Champion
Josh Jarman, Marketing & Communications
Yetta Miller, Art Gala Consultant
Trina McCoy, Advisory Committee
Rhonda McCoy, Lighting of the Tree Consultant
Tyler Deal, Community Member
Amy Michaels, Community Member - Survivor
Mary Morgan, CRA Avery Volunteer - Survivor
Jennifer Ritter, Community Member - Survivor
Melanie Thomas, Lead Radiation Oncology RT
Brenda Barr, Medical Oncology RN
Melanie Childers, Chaplain and Behavioral Health Support
Angie Shoemake, MSW, Cancer Center Social Worker
Paul Young, RN Navigator
Jodi Cash, Director Wellness Center
Thank you to Ken Kirksey and his wife Deborah for their years of service and faithful dedication to the CRA.
Message from Dr. Godwin
It is my pleasure once again to share with you the progress of the Seby B. Jones Regional
Cancer Center (SBJRCC) during 2014. The Center continues to proceed along a
pathway of steady development with its continued growth and unwavering commitment
to high quality patient care.
Under the direction of Appalachian Regional Healthcare System, the Cancer Center,
Herman Godwin, MD
now in its twenty-first year of operation, has matured into a highly respected regional
facility providing broadly based cancer care to residents of the High Country and beyond. For
example, this year there have been 4733 patient visits and 8060 treatments at the center. A tangible
affirmation of the provision of quality cancer care is the designation as a Community Cancer Center
by the prestigious Commission on Cancer.
There has been a continued effective partnership with the Lineberger Comprehensive Cancer Center
at the University of North Carolina at Chapel Hill. As a result of the affiliation, SBJRCC is able to
provide patients with access to clinical trials when appropriate. This year alone, sixteen patients
were enrolled in these innovative programs. New studies are continually being added to the options
available locally, thus providing patients opportunities to participate in state-of-the-art research
trials.
The Cancer Center introduced in 2013 a new patient-centered Navigation Team consisting of
individual navigators for social resources, counseling, finances, and clinical nursing. This team
strives to identify and remove as many non-medical barriers as possible for each patient. During
2014, the team implemented several new “best practices” including performance of psychosocial
distress screenings for all cancer patients. The Survivorship Care Plan was launched and is to be fully
implemented in 2015. As in previous years, the Cancer Patient Emergency Fund provided monetary
resources for those patients most in need.
The ARHS Community Outreach Team, an extension of the Cancer Center, worked diligently during
the year to provide cancer information and education as well as cancer screenings for High Country
residents. Based on a remarkable level of coordination and collaboration, there were twenty-seven
community health events held in Ashe, Avery, and Watauga counties. In addition, a complimentary
head and neck screening examination was performed in July by Dr. Neil Goldman.
There is in the Cancer Program substantial energy and optimism as 2015 approaches. There will
be continued opportunities for improvement and challenges to be faced. Success, however, will be
assured as there will continue to be an unyielding focus on excellence of patient care.
Sincerely,
Herman A. Godwin, Jr., MD
Chief Medical Officer
www.apprhs.org/cancercenter • 2014 • 3
Dr. Yvonne Mack, Radiation Oncologist, Dr. T. Flint Gray, Medical Oncologist, and Dr. Anna Sobol, Medical Oncologist,
design customized treatment options for patients using radiation therapy and chemotherapy.
Medical Oncology
Working in tandem with the center’s oncology-trained nurses, are two fulltime, board certified medical oncologists. T. Flint Gray, MD and Anna Sobol,
MD are certified in Medical Oncology and Internal Medicine and also have
fellowships in Hematology. The expert team continually shares knowledge
through strategic clinical collaboration with other leading North Carolina
institutions. The emphasis and mantra to provide cancer patients with
excellent and personal medical care is further validated by their compassion
to maintain quality care in every aspect of their patient’s medical course of
treatment.
T. Flint Gray, MD
Dr. Gray has been with Seby B. Jones Regional Cancer Center since
1998. He is board certified in Medical Oncology, Internal Medicine and
Hematology by the American Board of Internal Medicine. He graduated
from Davidson College and then Emory University School of Medicine in
1987. After graduation he completed an internship and residency program
at the University of North Carolina Hospital at Chapel Hill, specializing in
Internal Medicine. He then completed Hematology and Medical Oncology
Fellowships at UNC Hospital in Chapel Hill.
Anna Sobol, MD
Dr. Sobol has been with Seby B. Jones Regional Cancer Center since 2009.
She is board certified in Medical Oncology and Internal Medicine by the
American Board of Internal Medicine. She graduated from the University of
Alabama School of Medicine in Birmingham, AL in 2003. After graduation
she completed an internship and residency program at the Mayo Clinic in
Jacksonville, FL and a fellowship specializing in Hematology/Oncology at the
Mayo Clinic.
Radiation Oncology
The radiation oncology staff, headed by Yvonne Mack, MD, utilizes a state-ofthe-art linear accelerator to provide Intensity Modulated Radiation Therapy,
or IMRT. Because all tissue reacts differently to radiation, IMRT varies the
radiation intensity from all angles to destroy cancer cells while minimizing risk
to normal tissues. The machine is also equipped with Image Guided Radiation
Therapy, or IGRT, to allow more precise adjustments to a patient’s treatment for
greater accuracy.
Yvonne Mack, MD
Dr. Mack has been with Seby B. Jones Regional Cancer Center since 1998.
She is board certified in Radiation Oncology by the American Board of
Radiology. She graduated from Wake Forest University School of Medicine
in Winston-Salem in 1988. After graduation she completed an internship at
Greenville Health System in Greenville, SC and a residency program at the
University of Florida College of Medicine in Gainesville, FL.
4 • Seby B. Jones Regional Cancer Center Annual Report
Cancer Center at a Glance
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Cancer Navigation Program:
RN Navigation, Financial Navigation,
Social Resource Navigation, Breast
Navigation, Counseling Navigation
Genetic Counseling Referral • Pharmacy
Nursing Quality Council • Support Groups
Pastoral Care Department • Medical
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Cancer Conference/Tumor Board
Nutrition Counseling
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www.apprhs.org/cancercenter • 2014 • 5
Teacher Battling Cancer Inspires Class to Action
by: Josh Jarman, Community Liaison, Receipt of 2014 Wallie Award at CHRPMS Conference
Corrie Freeman, a fourth grade teacher at Hardin Park
Elementary School, taught more than reading and
arithmetic to her class this year.
The story began last May when Freeman, a native of
Spruce Pine, was diagnosed with endometrial cancer.
Described by her colleagues as “selfless and just
awesome,” Freeman decided early on to look for the
silver linings.
Her physician, Dr. Beverly Womack of Harmony Center
for Women’s Health and Vitality, recommended that she
see a gynecological oncologist at Presbyterian Medical
Center in Charlotte.
“Through tears, I remember asking if it would be
possible for me to receive my consultations in Charlotte
and my radiation treatment here [in Boone] so I could
continue to teach,” said Freeman. “I was delighted to
find out that Seby B. Jones Regional Cancer Center,
located in Boone, was well equipped to provide state-ofthe-art care for my cancer.”
By the beginning of the school
year, Freeman, weary from a long
summer of trips to Charlotte and
radiation treatments in Boone, was
more resolved than ever to teach
her 16th year of fourth graders.
given to make a difference in the
world.
As the holiday season
approached, it became apparent
that Freeman’s positive outlook
on life proved to be contagious.
During a class discussion, a
Corrie Freeman
student raised his hand and
asked “Miss. Freeman, can
we do anything to fill the buckets of other people with
cancer this Christmas?”
After several minutes of brainstorming and a few phone
calls, the students were delighted to learn that they
could donate gifts for patients at the Cancer Center in
Boone where their teacher had been receiving care.
Like elves in Santa’s workshop the students all agreed to
purchase buckets of their own, 22 in all, and fill them
with Christmas candies, ornaments and gifts. They
also wrote cards with encouraging
words like “You’re brave, strong,
courageous, and you have a warrior’s
heart.”
As the sleigh, Freeman’s Toyota
Camry, was being loaded with
buckets the students were delighted
to learn that their teachers treatment,
“My goal from the beginning was
over the past seven months, had
to teach the class that cancer is not
worked and she would be considered
Gift buckets donated to the cancer patients
scary,” said Freeman. “I knew there
cancer free by Christmas.
would be questions, like when my hair began to fall out,
but I promised myself from the beginning that if God
“I am so thankful for the love and support of my
would allow me to continue to teach, I would continue
students,” said Freeman. “The fact that they rallied
to pour out His love for others.”
around me and wanted to help others battling cancer
had a huge impact on my own Christmas healing
One example of this can be found in a book Freeman
miracle.”
read to her class at the beginning of the school year
called “Fill a Bucket: A Guide to Daily Happiness for
Freeman, with two of her students at her side, made the
Young Children” by Carol McCloud. Freeman explained special Christmas delivery to the Cancer Center. As the
to her class that in the year ahead they would grow in
students distributed the buckets with hugs attached,
areas beyond that of the textbook. That they would
Freeman thanked the staff for their love, support and
learn the importance of using the time they have been
healing treatment.
6 • Seby B. Jones Regional Cancer Center Annual Report
Quilt of Valor Presented to Veteran
by: Josh Jarman, Community Liaison, Receipt of 2014 Wallie Award at CHRPMS Conference
Before June, Cathy Smith had never met John “Pete”
Absher. She was unaware that he was born and raised
in Ashe County, enjoyed Bluegrass music or had his
own Christmas tree farm. She did not know that he
was a father of two, loved to travel or even that he was
approaching his 87th birthday. All she knew was that
John was a veteran, who had recently been diagnosed
with cancer. For Cathy, that was all she needed to know.
As the Quality Analyst for Medical Records at
Appalachian Regional Healthcare System, Cathy
oversees the accuracy of all patient records at Watauga
Medical Center and Cannon Memorial Hospital. An
avid quilter, she can be found unwinding from a busy
day at work at her sewing machine in her Valle Crucis
home.
“Quilting is like cutting firewood,” said Smith with a
grin. “It warms you in so many ways.”
This year, Cathy decided to
participate in the Quilts of Valor
(QOV) program. Established
in 2003, its mission is to cover
service members and veterans
touched by war with comforting
and healing Quilts of Valor. Since
its inception, nearly 100,000 quilts
have been made and presented to
these service members.
From start to finish, it took Cathy
two months to put the final
touches on her Quilt of Valor.
Once complete, she began asking
her ARHS colleagues if they knew
of any current patients who had
served in the military. Her inquiry
led her to John “Pete” Absher at
the Cancer Center.
instruct the Reserve Officer
Training Corps (ROTC)
program. He taught at the
high school for three and a
half years before retiring for
good. On occasion, some
of his former students still
affectionately refer to him as
“Sarge” when they see him
around town.
Cathy Smith at her sewing
machine in her home in
Valle Crucis
Unfortunately, John’s carefree retirement years were
cut short earlier this year when he was diagnosed with
stage 4 Esophageal Cancer. He was referred to Seby B.
Jones Regional Cancer Center in April, where he began
chemotherapy treatments.
“Things were certainly starting to stack up against me,”
he said. “Looking back, I still find it hard to believe, that
while I was coming to grips with the toughest war I’d
ever been drafted into, there was a
guardian angel already looking out
for me.”
Before meeting for the first time
Cathy said, “I wasn’t sure what to
say or how to say it. I just wanted
him to feel loved and appreciated.”
The moment shared between the
two strangers ended in a friendship.
An uncommon friendship, woven
together with fabric, service, respect
and thanksgiving.
Cathy Smith presents John Absher
with a Quilt of Valor
“I remember a time when being a
serviceman was frowned upon,”
John said. “Today, after all of these
years, to be honored in this way feels
like a dream too good to be true.”
When John turned 18, the Army drafted him into World To learn more about the Quilts of Valor program visit
War II. After the war, he went on to serve in the military www.qovf.org. To read the full article, visit
for 20 years before retiring as a Master Sergeant in 1966. www.apprhs.org/mystory.
John was then hired by Ashe County High School to
www.apprhs.org/cancercenter • 2014 • 7
Community Involvement
Watauga Leadership Challenge
Appalachian Regional Healthcare System hosted the Boone Chamber of
Commerce’s Watauga Leadership Challenge “Health and Human Services
Day” on April 16, 2014. The Day featured several healthcare speakers, a health
fair and information about the surrounding health agencies. Sandi Cassidy,
Director of Seby B. Jones Regional Cancer Center and a 2013 graduate of the
Watauga Leadership Challenge, co-hosted the Health Day and spoke on behalf
of the Cancer Center.
Relay for Life
The Cancer Crusaders team, led by
Melanie Thomas, participated in the
Watauga County Relay for Life on June
20, 2014 at the Watauga High School.
The Cannon Cares team, led by Sheri
Cornett and Gail Haller, participated
in the Avery County Relay for Life on
July 26, 2014 at the Avery High School.
Congratulations to Seby B. Jones
Radiation Oncology For Decorating
The Winning Bra!
On October 1, 2014 Linda Vana and Jane Deavers of The Dande
Lion, Inc. in Banner Elk donated $3,011 to the Wilma Redmond
Mammography Fund. The fundraiser involved 14 bras decorated by
local businesses and organizations. Participants voted for their favorite
bra by placing donations in the container designated for their favorite.
8 • Seby B. Jones Regional Cancer Center Annual Report
Community Involvement
Pink Day
ARHS’s Second Annual
Friday, October 10
More than 200 ARHS employees, volunteers and community
members participated in Pink Day, which was held at both
Cannon Memorial Hospital and Watauga Medical Center on
Friday, October 10. This system wide event is a day to celebrate
breast cancer survivors and fighters. Additionally, the Imaging
Department, Cancer Center, Foundation and other local services
provided information about resources available to patients and
their families.
Mary Morgan, a breast cancer survivor and CRA volunteer, spoke
about her life-changing battle with the disease. Randy “Doc”
McCoy of Doc’s Rocks also shared about the various fundraisers
his business, Doc’s Rocks Gem Mine, coordinates to benefit the
Cancer Patient Emergency Fund. Doc and his wife, Trina, raised
more than $10,000 in 2014 to benefit this fund. In addition,
they donated the stones for 11 exquisite jewelry pieces for which
$1,210 in raffle tickets were sold. The earnings were divided
between the Wilma Redmond Fund and the Cancer Patient
Emergency Fund.
Nutrition Services prepared healthy, pink food for the occasion
and volunteers made and donated more than 40 door prizes,
which were given away throughout both events.
Thirteen mammograms were scheduled at
both locations during the Pink Day event.
The Outpatient Imaging and Lab Center
and CMH Imaging Department performed
a combined 857 screening and diagnostic
mammograms in October 2014.
Pink Heals Tour
Pink Heals Tours Pink Fire Truck visited Seby B.
Jones Regional Cancer Center on October 20, 2014.
This non-profit organization started in 2007 to
help people battling cancer with a focus on women
and what they mean to us in our daily lives! It has
evolved into a mission to keep fund
raising and donated dollars local
to support women and families
within the community. The
pink fire trucks bring the Pink
Heals Program to cities across
America.
www.apprhs.org/cancercenter • 2014 • 9
6 6 Stage III 42
5 42
5 5 5 Stage III 5 5 5 5 14
Observe ffor C
hanges
14
Observe or C
hanges
Stage IV 4 4 Stage IV 4 83 Recommended Treatment of Biopsy
4 83 Recommended T3 reatment of Biopsy
3 3 3 3 3 3 3 2 2 2 2 Education and prevention
are
essential
elements1 in the
Head & Neck Cancer Screening
1 1 1 ongoing fight against cancer.
The Community Outreach
July 25, 2014
0 0 team of Appalachian Regional
Healthcare
System
works
Hound Ears2011 Community2012 Health Fair
2008 2009 2010 2008 in the High
2009 2011 2012 to educate and provide screenings
Country 2010 42 42 Community Outreach: Health Fairs, Screenings & Programs
1 2 3 14 Screened by Dr. Neal Goldman
IIII H
IIncidence TTrend 2
to improve cancerStage awareness
and
early
detection.
Some
5
Stage II &
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Stage III & IV H
&N Incidence Trend 2008-­‐2012 9
19 Normal
nd 2008-­‐2012
Stage IIII
Stage of the activities used to reach that
goal
nd 2008-­‐2012
Stage IIhave included:
Stage IIV
V
IV
Stage I
II
Stage I
V
5 Abnormal, recommended follow up
IV
2
2008
2
2
IV 3 • Offering health screenings
2008 for Melanoma,
2 Head and 3
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2008
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3
2009
1
3
Neck and Prostate Cancers.
participants)
3
3
2009 (262 83 1
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Screening
2009
1
3
83 3 • Offered 27 community
health
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that
provided
2010
5
9
3
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9
9
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8
PSA
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14 2010
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9
information about cancer
prevention, healthy
9
14 2011
5
4
42
9
2011
5
4
42
4
Beech Mountain Health Fair
2011
5
4
lifestyles, nutrition, physical
activity,for smoking
4
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cessation and information
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5 oJuly,
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5
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5
83
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Regional Cancer Center. (2,953 Attendees)
Hound Ears Health Screening
10 10 cancer awareness program to
• Provided “Sun Safety”
10 August
20, 2014, 14 PSA done, 0 abnormal
9 Watauga and Ashe counties.
9 5th grade students in
9 9 9 Blowing
Rock Country Club Members
9 sunglasses, chapstick and
9 9 Each student received
8 9 8 October 20, 2014, 14 PSAs done, 0 abnormal
8 to protect the whole family.
information designed
7 Avery
(424 Attendees) 7 42 County School Employee Health Fair
7 42 6 • Hosted “Pink Day” 6 event to support Breast Cancer
3
78 Screened
6 Stage III 1
Awareness Month. (225
attendees;
13
mammograms
5 5 5 75 Normal 5 Stage III 1
Stage III 75
5 5 5 5 Stage III 5 5 5 Stage III 5 the
5 5 3 Abnormal 5 5 were scheduled
5 during
5 event)
Stage I
II Stage IV 2
4 4 5 5 5 Stage IV 2
4 4 Stage IV at the
• Participated4 in
the
“HeartShape”
event
held
Stage IV 4 4 Stage IV 4 3 3 3 3 Stage I
V 3
4 Smoking Cessation
Program
Paul H. Broyhill Wellness
Paul Young,
3 3 83 3 3 3
3 Center;
3 3 83 3 3 3 2 RN and Angie
RN, OCN, Marjorie2 Hrozencik,
Community
and
employee
education
using QuitlineNC
3 14 2 2 14 2 2 Shoemake, MSW provided
information about
and Counseling.
1 1 Seby
1 1 B. Jones Regional Cancer
Center. (112 attendees)
1 1 Registered Callers by County, QuitlineNC
0 0 shower hangers to educate
• Provided “Self Exam”
0 2008 2009 2010 2011 53 callers
2012 Watauga County
2008 and self2009 2010 2011 2012 2010 the community
2011 2012 about
self
breast
testicular
2008 2009 2010 2011 2010 2011 2012 Avery County 23 callers 2012 2010 examinations.
2011 Instruction
2012 was also provided to
790
Fax Referrals, QuitlineNC
children regarding how to perform monthly skin
WMC 26 referrals, 8 accepted services
checks.
76
CMH 7 referrals, 1 accepted services
33 • Provided monthly education about nutrition,
healthy lifestyles and cancer prevention to senior
ARMA Offices, EMR documentation
26
citizens at the senior centers
in Watauga County.
42
790 patients counseled to quit or cut down on tobacco use
42
42
(Average monthly attendance,
15)
14
ffor Appalachian Healthcare Project, One-on-One Counseling
14 Observe Observe or C
Changes
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es
fairs and
• Participated in School health
14 Recommended Observe for education
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83
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reatment o
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Recommended Treatment 13
of f B
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atment of Biopsy
2 stages of preparing to quit, 1 has quit
atment of BCareer
iopsy Day; 9th grade Health Fair; Back to School
ARHS Employee Wellness Program, One-on-One Counseling
Health Fair and Healthy Halloween event. (3660
participants)
8.2% ARHS employees are smokers
11 employees and 2 spouses counseled
Melanoma Cancer Screening
2 stages
42 of preparing
May 9, 2014
1 to quit, 5 has quit
42 42 42 42 Boone
925
42 Dermatology
1 Smoking Cessation Education
33 26
12 170
Skin Surveys by Boone Dermatology 76
1 1
1790 EMR documented
80
1 1
82
1 180 No treatment needed
2
790
76
Registered
callers
2
2 2
3 2
8
2 28 Continue to observe for changes
2 2
333 Fax referrals
83 3
3 382 Recommended treatment
or
biopsy
83 326
3 One-on-one counseling
3
4 83 3 3
14 14 14 10 •14 Seby B. Jones Regional Cancer Center Annual Report 14 1 2 1 2 1 2 3 1 2 1 2 790
76
33
26
1 2 3 14 1 2 1 2 3 4 Survivorship Story - Mary Morgan
by: Mary Morgan, Cancer Survivor
My husband and I retired and moved to Elk Park
in the summer of 2011. We left city life behind and
looked forward to slowing down and enjoying the cool
weather and beautiful surroundings in the Blue Ridge
Mountains. Our daughter, Michelle,
moved to Boone so we could all be
close.
it was for my family to get a break from all of the
driving and what special friends I had to take me to
appointments from time to time.
The only time I remember crying
throughout this whole process was
when my daughter Michelle shaved my
head. To show support, my husband also
shaved his head and my daughter cut
a foot of her own hair to send away for
making wigs for cancer patients.
We lived here one year when I was
diagnosed with breast cancer. Well,
that took the wind out of our sails.
A simple annual physical turned
into a two year process of surgeries,
My surgeries and chemotherapy were
chemotherapy appointments and then
carried out in Asheville. We have
radiation treatments. There were at
gracious friends that live in Asheville
least 70 of these appointments either
that let us stay with them when injections
in Asheville or Boone and I needed
were needed on consecutive days.
someone to go with me to most of
My radiation treatments and physical
them. My family provided tons of
therapy were carried out (at Seby B. Jones
Mary
Morgan
support and love through this whole
Regional Cancer Center) in Boone. My
process. I am additionally fortunate
daughter lived in Boone at the time and
that my husband’s career was devoted to medicine and
her apartment was my roost on bad weather days when
he could explain the goals of the various therapies as
I could not miss treatments. Thirty-five consecutive
well as potential outcomes and side-effects.
days of radiation were made more tolerable by the
wonderful (Cancer Center) staff that supported me with
I also made lots of new friends in the short time I had
smiles and humor while helping to save my life.
lived here and these wonderful people wanted to be a
part of my recovery. They sometimes cooked for us, and I have been cancer free a year and a half now, and my
cleaned for us and asked to take me to appointments.
last wound has been healed since February. When I
Exercise, or walking, had become an important part
look back at the last two years, I realize I’ve never played
of my treatment so chemo days were planned by my
so hard, made so many precious friends and spent so
friends as play days where we explored shopping and
much loving time with my family. Every day is special
markets and restaurants near the infusion center. We
to me and I look forward to helping as many people as I
dressed up and made each day special. What a relief
can who need the support of a cancer survivor.
Mary Morgan is an active volunteer with the Cancer
Resource Alliance’s Avery Cancer Resource Center with Linda
Nixon and Joyce Watson. Mary was a guest speaker at Pink
Day at Cannon Memorial Hospital.
from left: Linda Nixon, Sandi Cassidy, Mary Morgan and Joyce
Watson at Pink Day
www.apprhs.org/cancercenter • 2014 • 11
New Initiatives
New Furniture
Medical Oncology Lobby Furniture
Radiation Oncology Lobby Furniture
Blue Ridge Garden Club
The Blue Ridge Garden Club has joined forces with
the CRA! Founded in 1914, the Club’s long standing
purpose is to “…stimulate and encourage the
conservation of our environment, and to participate
in the beautification of the community.” By partnering
with the CRA, the club members have agreed to
volunteer their time to enhance, decorate and maintain
the grounds in and around the Cancer Center. Initial
projects include: placing fresh flower bouquets monthly
in the main patient waiting areas, decorating the
Blue Ridge Garden Club with Sandi Cassidy
existing bird sanctuary visible from the chemotherapy from left..Janice Lacapra, Dianne Dougherty, Marianne Suggs,
infusion room and potting flowers to grace the front
Kathleen Cascini, Pat Wilkie, Peggy Appleton, Marita Higgin,
Kathy Canady, Quincy Parham, Janet Stout
entrance ways of the Center.
Clinical Collaboration with Caldwell Hospice and Palliative Care
The clinical collaboration between Appalachian Regional From January to the end of September, CHPC’s High
Healthcare System and Caldwell Hospice and Palliative Country interdisciplinary team of nurses, medical
Care (CHPC) has experienced a successful first year.
social workers, certified nursing assistants, chaplains,
Caldwell Hospice and Palliative Care in the High
and volunteers, based at a work station in Boone,
provided palliative care services through AIM:
Country opened for service in January 2014.
Advanced Illness Management to 39 patients;
By March 2014, Palliative Care Physician, Dr.
Jeffrey Brown, began rounds two days a week
and hospice services to 50 patients in the High
at Watauga Medical Center, and in August,
Country. In addition, Dr. Brown conducted
he began “full time” work, making medical
48 palliative care and 6 hospice consults at
Watauga Medical Center, and 1 palliative
center rounds each weekday afternoon in
addition to seeing High Country palliative
care consult at Cannon Memorial Hospital.
Watauga Medical Center documented 43
care patients in their homes. CHPC in the
hospice referrals to CHPC this year.
High Country serves patients in Watauga,
Dr. Jeff Brown
Avery, and Ashe counties.
Physician Liaison
12 • Seby B. Jones Regional Cancer Center Annual Report
New Initiatives
Pet Therapy
PAWS (Pet Assisted Wellness Support) is the therapy
dog visitation program at Appalachian Regional
Healthcare System. The program offers patients an
opportunity to ‘pause’ and forget about their treatment
for a few moments while interacting with a registered
therapy dog.
Animals provide many therapeutic and health benefits.
According to the American Veterinary Medical
Association, pet therapy can aid in achieving human
physical, social, emotional and cognitive function
goals. Pet therapy visits typically last a few minutes
and can help reduce stress and anxiety, lower blood
pressure, promote
social interaction
and provide
encouragement and
motivation during
the treatment and
recovery process.
Knox with “mom” Brianne Harris
Pet Therapy dog, Knox the Great Pyrenees visits the
patients and staff of Seby B. Jones Regional Cancer
Center. Knox is a 7 year old Great Pyrenees who has
teamed up with “mom” Brianne to bring happiness and
healing to the High Country as a therapy dog team.
Art Classes
Seby B. Jones Regional Cancer Center and the Cancer Resource Alliance
offered Open Studio Painting Classes on Tuesday mornings from September
until November 2014. These classes were complimentary to cancer patients
currently in treatment or who had completed treatment. All materials
were donated by Cheap Joe’s Art Supplies. Local artist, Tyler Deal was the
instructor and facilitator. Tyler teaches part time in Appalachian State
University’s Art Department and at several community venues.
Survivorship Care Planning
completing the first course of treatment be ‘provided
Seby B. Jones Regional Cancer Center created a
survivorship care planning packet to be compliant with with a comprehensive care summary and follow-up
Standard 3.3. As taken from the Commission on Cancer, plan that is clearly and effectively explained.’ The
Cancer Program Standards 2012: Ensuring Patientrecommendation suggested that these plans would help
cancer survivors who may otherwise get “lost” in the
Centered Care, Standard 3.3 (Survivorship Care Plan),
states ‘The cancer committee develops and implements transitions from the care they received during treatment
a process to disseminate a comprehensive care summary through the phases of their life or stages of their disease
course.
and follow-up plan to patients with cancer who are
completing cancer treatment. The
Dealing with a new diagnosis of
process is monitored, evaluated,
and presented at least annually
cancer is complex, difficult, and very
emotional. With developing this
to the cancer committee and
documented in minutes.’ The
packet, we hope to help ease some
of these burdens for our patients.
Institue of Medicine (IOM) and
We want to provide our patients
National Research Council 2005
report, From Cancer Patient
with up to date information on
their specific type of cancer and
to Cancer Survivor: Lost in
Transition, recommends that
written information on their own
individualized treatment.
patients with cancer who are
Navigators with Care Planning Packets
www.apprhs.org/cancercenter • 2014 • 13
Community Partnership
This year has been special in so
many ways; it was a record setting
year for the event season of our
Foundation, who with the help of
numerous committee members,
volunteers, and other supporters
raised over $90,000 benefiting
Seby B. Jones Regional Cancer
Center. We have experienced
extraordinary engagement,
Rob Hudspeth
support, and contributions from
folks here in our area. I am extremely grateful to be part
of a community that cares so much for the residents of
the High Country and who go above and beyond to give
back to their family and friends alike. YOU are the ones
who are making the difference – without your help and
support, none of what we do, each and every day, would
ever be possible. Thank you.
Rob Hudspeth
Senior Vice-President of System Advancement
Additional 2014 External Fundraisers
42nd Annual Grover C. Robbins, Jr.
Memorial Golf Tournament
Blue Ridge
Energies
The 42nd Annual Grover C. Robbins, Jr. Memorial
Golf Tournament, held at Elk River Club, raised
over $25,000. Proceeds from this year’s tournament
benefited Seby B. Jones Regional Cancer Center’s
Cancer Resource Alliance (CRA). The CRA provides
music, art and massage therapy to patients in cancer
treatment; sponsors memberships to participate in the
Broyhill Wellness Center’s Thrive Oncology wellness
program; provides patient education materials and
assists patients in the coordination of obtaining access
to various medical, physical and social service resources.
Pretty in Pink
On June 19, 2014, the Pretty in Pink fashion show and
luncheon fundraiser, hosted at Camp Yonahnoka, raised
a record $8,000 for the
Avery County Cancer
Resource Center’s Patient
Emergency Fund. This
fund is available to our
patients in need who are
residents of Avery County. 2014 Pretty In Pink Models
This was also a record year for community led
fundraisers. The Grandfather Golf and Country Club
LGA, Blowing Rock Country Club LGA, Land Harbor
Game Day, Dande Lion Breast Buddies event, and Stori
Hughes Memorial Golf Tournament, all raised money to
benefit Seby B. Jones Regional Cancer Center. Together,
these events raised over $26,000 for the Cancer Center.
Doc’s Rocks
Randy and Trina McCoy, owners of Doc’s Rocks Gem
Mine, along with their son, D’Artagnan, recently
presented Sandi Cassidy, Director of Oncology Services
at Seby B. Jones Regional Cancer Center, with a check
for $10,585.37. This generous donation, represents
months of fundraising
at Doc’s Rocks to benefit
the Cancer Center’s
Patient Emergency
Fund.
Doc’s Rocks Check Donation
Blue Ridge Energies helped in “Fueling the Fight”
through a year long fundraising effort. They designated
a penny for every gallon of propane delivered by the
pink truck. Blue Ridge Energies donated $5,085 to Seby
B. Jones Regional Cancer Center.
The Park Foundation
The Park Foundation gifted $50,000 to the Cancer
Patient Emergency Fund. They have been very
generous, giving over $200,000 since 2007. The Cancer
Patient Emergency Fund provides patients in need with
fuel, housing, and medication.
Changes Hair
Salon
Changes Hair Salon
raised $560 for
the Cancer Patient
Emergency Fund.
14 • Seby B. Jones Regional Cancer Center Annual Report
Changes Hair Salon Donation
Community Partnership
Cancer Resource Alliance
In FY 2014, CRA funds were used for:
-Massage therapy
-Music therapy
-THRIVE Oncology
-Art Classes
Wilma Redmond Fund
The Wilma Redmond Fund supported breast cancer
prevention by providing free first time mammograms
to uninsured women. In 2014, 155 mammograms were
provided for a total cost of $35,030.
Lighting Of The Tree
Seby B. Jones Regional Cancer
Center’s Inaugural Lighting
of the Tree ceremony was
a success. Over 125 people
attended the ceremony and
250 ornaments were sold
which raised $2,813.
A special thanks to those who made the ceremony
possible - Melanie Childers, Randy (Doc) McCoy, ASU
Student String Ensemble under the Direction of Dr.
Eric Koontz , Mr. Joey Clawson of Panoramic View
Christmas Tree Farm, Center Resource Alliance (CRA)
Volunteers, The Blue Ridge Garden Club, Families and
Friends of Watauga High School (Kauner Michaels) and
Cove Creek Elementary School.
Volunteers
19 volunteers clocked a total of 2274.92 hours.
SBJRCC from 10/1/13 - 9/30/14
Ann Anderson
Dolores Amoroso
Andrea Long
Jane Flynt
Abigail Yates
Mary Lee Jones
Brianne Harris/Knox
Norma Meadows
Billy Elliot
Sandra Moretz
Chuck Gill
Erika Carton
Dema Spann
Francine Greenfield
Dianna Duffy
Shelby Gaskin
Avery Cancer Resource Center from 10/1/13 - 9/30/14
Mary Morgan Linda Nixon
Joyce Watson
Breast & Cervical Cancer Program
The North Carolina Breast & Cervical Cancer Control
Program (NC BCCCP) provides free or low cost breast
and cervical cancer screenings and follow-up to eligible
women in North Carolina. The Appalachian District
Health Department provides these services to women in
Watauga County.
7/1/2013 to 6/30/2014 Watauga County - 65 women
Colleges Against Cancer
Appalachian State University
Colleges Against Cancer (CAC) is a nationwide collaboration of college students, faculty and staff dedicated
to eliminating cancer by working to implement the
programs and mission of the American Cancer Society.
With hundreds of chapters nationwide, CAC is showing
the world that young people care and want to make a
difference.
The Appalachian State University chapter of Colleges
Against Cancer began in 2005. The major focus is
raising awareness and providing cancer education to
their campus and sponsoring the Relay For Life of ASU.
Colleges Against Cancer has approximately 150 members and had 1196 registered Relay participants in the
last Relay season. Students have also volunteered at an
American Cancer Society Hope Lodge for the past four
years. This group and their events are student led by
CAC president Angelene Mathis and planned with the
assistance of an American Cancer Society staff partner.
Demographics:
2012: 1007 participants (368 Male/639 Female)
77 teams raised $58,000
2013: 1408 participants (472 Male/936 Female)
69 Teams raised $62,000
2014: 1196 participants (370 Male/826 Female)
73 teams raised $35,078
This year, Rachel Benisvy, who serves as the clubs Athletic Event Coordinator, worked as a liaison between the
healthcare system and the athletic department at App
State. In her role, she worked to produce several public
service announcements (PSAs) which were read aloud
during sporting events to raise awareness of the Cancer
Center.
www.apprhs.org/cancercenter • 2014 • 15
Community Partnership
Education
2014 Nursing & Allied Health Oncology TeleHealth Lecture Series * January 8 Speaker 12:00 – 1:00 p.m. Lecture Topic Mimi Alvarez, RN, MSN, PMHCNS-­‐BC Follow t he yellow brick road: Cancer & psychotherapy Wake Forest School of Medicine in conjunction
at the end of life February 12 Theresa Gilliam, MS, OTR/L, ATP, CLT-­‐
Lymphedema Evaluation & Treatment with Northwest Area Health Education Center
LANA & Valerie Collins, PT, CLT-­‐LANA March 12 Jean Sellers, RN, MSN Making Your Patient Navigation Process a Win-­‐Win (AHEC):
for Patients & Providers April 9 Liz Sherwood, RN, MS, ANP-­‐C Intimacy and Sexuality Issues After Cancer • Watauga Medical Society Monthly Continuing
May 14 Adam Goldstein, MD, MPH 2014 Update on Tobacco Cessation in Cancer Settings Medical Education Lecture Series
June 11 Deborah Mayer, PhD, RN, AOCN, FAAN Distress Screening in the Cancer Patient • Lectures related to cancer topics for 2014 were:
July 9 Amy DePue, RN, OCN Breast Cancer • Hematuria Diagnosis and Management August 13 Barbara Koruda, RN, BSN Ostomy Care and Cancer Patients Donna Brickman, RN, CWOCN Anthony M. Schlake, MD
Juliet Idiagbonya, CWOCN September 10 Lyn Filip, RN, BSN, OCN Gynecologic Oncology in the News The University of North Carolina’s grant funded
October 8 Liz Sherwood, RN, MS, ANP-­‐C Adolescents and Young Adults and Cancer Tele-Health Medicine Education Program has
November 12 Deb Mayer, PhD, RN, AOCN, FAAN When an oncology co-­‐worker becomes the patient Jean Sellers, RN, MSN many benefits:
December 10 Jennifer Spring, RD, LDN Cancer and Nutrition • The dedicated conference room has bi-monthly
Mandy Holliday, MPH, RD, LDN, CNSC * CNE and ASRT credits awarded to participants “Lunch and Learn” Continuing Medical
2014 Medical Oncology TeleHealth Lecture Series ** Education (CME) and Continuing Nursing
12:00 – 1:00 p.m. Speaker Lecture Topic Education (CNE) webinars via the donated live January 22 Cary Anders, MD UNC/LCCC Multidisciplinary Brain Metastasis Program cam conferencing equipment.
Timothy Zagar, MD Muss, MD Optimizing Care for the Older Cancer Patient • 67 RNs and Allied Health staff professionals February 26 Hyman Trevor Jolly, MBBS March 26 Denniz Zolnoun, MD, MPH The Odyssey of Cancer Pain in Women from throughout the health system
April 23 Ronald Chen, MD, MPH Stereotactic body radiation therapy for Prostate participated, each earning 1.0 + Continuing
Cancer May 28 Donald Rosenstein, MD The Problem of Suicide in the Oncology Setting Education Credits (CEU) per session.
June 25 Tippu Khan, PharmD Crisis: The Rising Cost of Cancer Care in the United • The Oncologists, the Pathologist and the
Benyam Muluneh, PharmD States July 23 Karyn Stitzenberg, MD, MPH, FACS Impact of Centralization of Major Cancer Surgery Cancer Liaison Physician received desk top
August 27 Jason A kulian, MD, MC
PH Lung Cancer Transportation/Gas ards
$17,327.07
bi-directional live cam video conferencing unit
September 24 Hanna Sanoff, MD, MPH Pancreatic Cancer Housing
$10,076.35
facilitating real-time participation with the
October 2Medication
2 Frances Collichio, MD Melanoma $9,981.63
November 19 Lisa Carey, MD Neoadjuvant Approaches to Breast Cancer: When, UNC Lineberger Cancer Center physicians in
Electricity
$6,601.58
(third Weds.) David Ollila, MD Why and How Transportation/Gas
$18,605.40
Medical Care
$5,179.99
** CNE and CME credits awarded to participants Speakers & topics subject to change weekly Cancer (tumor)
Conferences.Cards
Fuel $13,593.08
$5,020.33
Medications
Medical $13,593.08
Supplies
Seby B. Jones Regional
Cancer Center has professional
relationships with$2,742.61
the
Electric Bills
Grocery Cards
$2,150.00
followingCards
organizations:
Medical Supplies $18,605.40
$5,385.48
Transportation/Gas
Miscellaneous
$719.56
• American
College of Surgeons Accredited
• University of NorthFuel
Carolina at Chapel$13,593.08
Hill
$4,925.85
Medications
by Commission
CancerHousing
Center
$4,216.99on Cancer Chart Title ElectricLineberger
Bills
$13,593.08
• American Cancer Society
• Wake Forest School of Medicine
Transport
Medical Care
$3,962.93
Medical Supplies
$5,385.48
• Cancer Resource Alliance
• Appalachian State University, College of
Housing $1,600.00
Fuel Health Sciences Grocery Cards
$4,925.85
MedicaHo
• Foundation: Cancer Emergency Fund
Electricity
Nutritional Supplements
$993.18
Housing
$4,216.99
1% 4% Medical C
4% Medical
Care PatientMiscellaneous
$3,962.93
Cancer
Emergency Fund
10/1/13 - 9/30/14 $839.00
Fuel Grocery Cards
$1,600.00
8% 29% Medical S
The Cancer Patient Emergency Fund provides financial
Grocery C
Nutritional
Supplements
$993.18
9% assistance
to cancer patients at Seby B. Jones
Regional
2% 1% Miscellan
2% Miscellaneous
$839.00
Cancer Center. It assists patients who cannot
afford items
11% such as medications, gas cards and medical supplies
17% 6% Transportation/Gas
Cards
at a time when they need it most. The Cancer6% Patient
28% 17% Medications
Emergency Fund is completely
through donations.
7% 2% 2% funded
1% Electric Bills
This year the fund has raised $59,799.12 with $17,323.91
Medical Supplies
supporting Ashe County,6% $10,425.548% supporting Avery
Transportation/Gas
Cards
$17,327.07
Transportation/Gas
Cards
Fuel
6% County, and $16,608.72
supporting Watauga28% County
Fuel $5,020.33
Housing
$10,076.35
Medications
Housing
7% 20% (balance supporting
surrounding counties). From the
MedicalCare
Supplies $2,742.61
Medication
$9,981.63
Electric Bills
Medical
20% inception8% of the Cancer Patient Emergency Fund
in
Grocery
Cards $2,150.00
Electricity
$6,601.58
Medical Supplies
Grocery Cards
Miscellaneous
$719.56
Medical
Care
$5,179.99
December 2007 the fund has raised a total of $410,384.07.
Fuel
Nutritional Supplements
20% Report
16 • Seby B. Jones Regional Cancer Center Annual
20% Housing
Medical Care
Grocery Cards
Miscellaneous
Top 5 Sites - Local, State & National Comparison
Breast, Lung, Colon, Leukemia & Non-Hodgkin Lymphoma
2013 Top 5 Sites - Local, State & National
25.00%
Percent of Cases
20.00%
15.00%
10.00%
5.00%
0.00%
SBJRCC*
NC**
US***
Breast
21.90%
14.40%
13.90%
Lung & Bronchus
15.30%
14.90%
13.40%
Colon & Rectum
7.10%
8.00%
8.20%
Leukemia
5.80%
2.90%
3.10%
Non-Hodgkin Lymphoma
4.50%
4.00%
4.20%
2013 Top 5 Sites - Local, State & National Comparison
Breast
Lung & Bronchus
Colon & Rectum
Leukemia
Non-Hodgkin Lymphoma
SBJRCC*
83
58
27
22
17
NC**
7580
7850
4230
1550
2110
US***
232,670
224,210
136,830
52,380
70,800
* Seby B. Jones Regional Cancer Center Registry - 2013 Analytic Cases
** American Cancer Society estimated new 2014 cancer cases in NC: from 2014 Cancer Facts & Figures
***American Cancer Society estimated new 2014 cancer cases in US: from 2014 Cancer Facts & Figures
www.apprhs.org/cancercenter • 2014 • 17
Breast Cancer Survival Report
Seby B. Jones Regional Cancer
Survival
Report:
Breast Cancer 2003-2007
Seby BCenter
Jones Regional Cancer Center Survival Report: Cumula&ve Survival Rate *SBJRCC Stage IV case numbers
were
not sufficient
for survival reports•
Breast Cancer 2003-­‐2007 105 100 95 90 85 80 75 70 65 60 0.0 yr 1.0 yr 2.0 yr 3.0 yr 4.0 yr 5.0 yr Stage 0 100 98.4 98.4 98.4 98.4 95.3 Stage I 100 99.1 99.1 99.1 98.2 97.2 Stage II 100 98.8 95.2 93.9 90.1 86.3 Stage III 100 93.5 84.8 80.4 76 71.4 Overall 100 97.8 94.9 92.9 91 88.3 *WCM Stage IV case numbers were not sufficient for survival reports* National Cancer Database
Survival
Report:
Breast
Cancer 2003-2007
Na&onal Cancer Database Survival Report: Cumula&ve Survival Rate *SBJRCC Stage IV case numbers
not
sufficient for survival reports•
Breast Cwere
ancer 2003-­‐2007 105 100 95 90 85 80 75 70 65 60 Stage 0 Stage I Stage II Stage III Overall 0.0 yr 100 100 100 100 100 1.0 yr 99.4 99.1 98.1 94.7 97.2 2.0 yr 98.6 97.6 95.1 86.5 94.2 3.0 yr 97.6 95.8 91.7 78.9 91.1 4.0 yr 96.5 93.8 88.3 72.6 88.2 5.0 yr 95.2 91.7 85.2 67.3 85.2 *WCM Stage IV case numbers were not sufficient for survival reports* Breast Cancer
National
Breast Survival:
Cancer Survival: SBJRCC
SBJRCC vs. Nvs.
aOonal 2003-­‐2007 2003-2007
105 Cumula&ve Survival Rate 100 95 90 85 80 75 70 65 60 NCDB SBJRCC 0.0 yr 100 100 1.0 yr 97.2 97.8 2.0 yr 94.2 94.9 18 • Seby B. Jones Regional Cancer Center Annual Report
3.0 yr 91.1 92.9 4.0 yr 88.2 91 5.0 yr 85.2 88.3 Lung Cancer & Non-Hodgkin Lymphoma Survival Report
LungLung Cancer
Survival:
vs.
National
2003-2007
Cancer Survival: SSBJRCC
BJRCC vs. NaOonal 2003-­‐2007 Cumula&ve Survival Rate 120 100 80 60 40 20 0 NCDB SBJRCC 0.0 yr 100 100 1.0 yr 45.1 42.5 2.0 yr 29.4 23.1 3.0 yr 22.9 12.8 4.0 yr 19.1 10.6 5.0 yr 16.4 10.6 Non-­‐Hodgkin Lymphoma Survival: Non-Hodgkin Lymphoma
SBJRCC
vs. National 2003-2007
SBJRCC Survival:
vs. NaOonal 2003-­‐2007 Cumula&ve Survival Rate 110 100 90 80 70 60 50 NCDB SBJRCC 0.0 yr 100 100 1.0 yr 78.9 77.1 2.0 yr 71.7 72.8 3.0 yr 67.2 68.4 4.0 yr 63.4 64 5.0 yr 60 59.6 www.apprhs.org/cancercenter • 2014 • 19
Leukemia Cancer & Colorectal Cancer Survival Report
Leukemia Cancer Survival: SBJRCC vs. National 2003-2007
*For the SBJRCC, there is insufficient cases to display survival information
Leukemia ancer Survival: NaOonal 2003-­‐2007 (There are onlyC23
cases in
SBJRCC database
from 2003-2007)•
Cumula&ve Survival Rate 120 100 80 60 40 20 0 NCDB 0.0 yr 100 1.0 yr 63.7 2.0 yr 53.5 3.0 yr 48 4.0 yr 44.1 5.0 yr 41.1 • For the SBJRCC, there is insufficient cases to display survival informaOon (there are only 23 cases in the SBJRCC database from 2003 -­‐ 2007) Colorectal Cancer Survival: Colorectal Cancer
Survival:
SBJRCC
vs. National 2003-2007
SBJRCC vs. NaOonal 2003-­‐2007 Cumula&ve Survival Rate 110 100 90 80 70 60 50 40 NCDB SBJRCC 0.0 yr 100 100 1.0 yr 83.5 83.7 2.0 yr 74.5 72.1 20 • Seby B. Jones Regional Cancer Center Annual Report
3.0 yr 67.5 62.7 4.0 yr 61.9 56.3 5.0 yr 57.2 51.2 Annual Report of Cancer Registry Data
Seby B. Jones Regional Cancer Center at Watauga Medical Center
2013 Summary by Body System, Gender, Class, Status and AJCC Stage Report
Primary Site
Total (%)
Male
Female
Analytic Alive
Expired Stage 0
Stage I
Stage II
Stage III Stage IV
ORAL CAVITY & PHARYNX
Tongue
Gum & Other Mouth
Tonsil
Hypopharynx
DIGESTIVE SYSTEM
Esophagus
Stomach
Small Intestine
Colon Excluding Rectum
Rectum & Rectosigmoid
Liver & Intrahepatic Bile Duct
Other Biliary
Pancreas
Peritoneum, Omentum & Mesentery
RESPIRATORY SYSTEM
Nose, Nasal Cavity & Middle Ear
Larynx
Lung & Bronchus
SOFT TISSUE
Soft Tissue (including Heart)
SKIN EXCLUDING BASAL & SQUAMOUS
Melanoma -- Skin
Other Non-Epithelial Skin
BREAST
Breast
FEMALE GENITAL SYSTEM
Cervix Uteri
Corpus & Uterus, NOS
Ovary
Vagina
Vulva
MALE GENITAL SYSTEM
Prostate
Testis
Other Male Genital Organs
URINARY SYSTEM
Urinary Bladder
Kidney & Renal Pelvis
Other Urinary Organs
BRAIN & OTHER NERVOUS SYSTEM
Brain
Cranial Nerves Other Nervous System
ENDOCRINE SYSTEM
Thyroid
Other Endocrine including Thymus
LYMPHOMA
Hodgkin Lymphoma
Non-Hodgkin Lymphoma
MYELOMA
Myeloma
LEUKEMIA
Lymphocytic Leukemia
Myeloid & Monocytic Leukemia
Other Leukemia
MISCELLANEOUS
Miscellaneous
9 (2.4%)
2 (0.5%)
2 (0.5%)
3 (0.8%)
2 (0.5%)
43 (11.3%)
3 (0.8%)
2 (0.5%)
6 (1.6%)
17 (4.5%)
10 (2.6%)
1 (0.3%)
1 (0.3%)
2 (0.5%)
1 (0.3%)
64 (16.9%)
2 (0.5%)
4 (1.1%)
58 (15.3%)
4 (1.1%)
4 (1.1%)
17 (4.5%)
16 (4.2%)
1 (0.3%)
83 (21.9%)
83 (21.9%)
18 (4.7%)
3 (0.8%)
7 (1.8%)
4 (1.1%)
1 (0.3%)
3 (0.8%)
16 (4.2%)
14 (3.7%)
1 (0.3%)
1 (0.3%)
21 (5.5%)
14 (3.7%)
6 (1.6%)
1 (0.3%)
10 (2.6%)
3 (0.8%)
7 (1.8%)
11 (2.9%)
10 (2.6%)
1 (0.3%)
20 (5.3%)
3 (0.8%)
17 (4.5%)
15 (4.0%)
15 (4.0%)
22 (5.8%)
12 (3.2%)
9 (2.4%)
1 (0.3%)
26 (6.9%)
26 (6.9%)
5
1
1
2
1
25
2
1
2
9
7
1
1
2
0
32
1
3
28
3
3
10
9
1
0
0
0
0
0
0
0
0
16
14
1
1
17
13
3
1
4
3
1
3
3
0
10
0
10
8
8
11
6
5
0
10
10
4
1
1
1
1
18
1
1
4
8
3
0
0
0
1
32
1
1
30
1
1
7
7
0
83
83
18
3
7
4
1
3
0
0
0
0
4
1
3
0
6
0
6
8
7
1
10
3
7
7
7
11
6
4
1
16
16
9
2
2
3
2
43
3
2
6
17
10
1
1
2
1
64
2
4
58
4
4
17
16
1
83
83
18
3
7
4
1
3
16
14
1
1
21
14
6
1
10
3
7
11
10
1
20
3
17
15
15
22
12
9
1
26
26
7
2
1
3
1
32
1
2
4
13
10
1
0
1
0
36
1
4
31
4
4
15
15
0
81
81
16
2
6
4
1
3
13
11
1
1
17
12
4
1
10
3
7
11
10
1
15
3
12
10
10
15
11
4
0
14
14
2
0
1
0
1
11
2
0
2
4
0
0
1
1
1
28
1
0
27
0
0
2
1
1
2
2
2
1
1
0
0
0
3
3
0
0
4
2
2
0
0
0
0
0
0
0
5
0
5
5
5
7
1
5
1
12
12
1
0
1
0
0
3
0
0
0
3
0
0
0
0
0
1
0
0
1
0
0
6
6
0
16
16
1
0
0
0
0
1
0
0
0
0
7
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
5
0
0
1
2
2
0
0
0
0
13
0
1
12
0
0
6
6
0
34
34
3
0
1
1
0
1
1
0
1
0
5
4
1
0
0
0
0
8
8
0
3
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
2
0
0
1
0
0
5
0
2
3
3
3
2
2
0
21
21
1
0
1
0
0
0
6
6
0
0
4
3
1
0
0
0
0
0
0
0
6
2
4
0
0
0
0
0
0
0
0
1
0
0
0
1
12
1
0
1
5
5
0
0
0
0
16
1
1
14
0
0
0
0
0
8
8
5
1
1
2
0
1
1
1
0
0
2
0
2
0
0
0
0
2
2
0
3
1
2
0
0
0
0
0
0
0
0
5
1
1
2
1
16
1
1
4
5
1
1
0
2
1
29
1
0
28
1
1
0
0
0
4
4
3
1
1
1
0
0
7
7
0
0
1
0
1
0
0
0
0
0
0
0
5
0
5
0
0
0
0
0
0
0
0
Total
379
154
225
379
296
83
35
79
51
50
71
www.apprhs.org/cancercenter • 2014 • 21
Male
Female
Total
Total
Top Sites, Grouped by Gender
40.63%
59.37%
100.00%
Male Number of Cases
Percentage of Cases
379
Chart Title Male Chart Title Chart Title Male 2013 Newly Diagnosed Cancers by
Gender
Female
225
59.37%
154
225
379
100.00%
Female Female 41% Female Male
154
40.63% 59% 59% 41% Female
Male
41% 59% Top 7 Cancer Sites for Women
at SBJRCC 2008-2013
100 90 80 Number of Cases
70 60 50 40 30 20 10 0 2008 81 2009 68 2010 68 2011 94 2012 91 2013 83 Lung & Bronchus 27 Colon & Rectum 13 23 15 26 22 30 16 11 12 24 Non-­‐Hodgkin Lymphoma 15 11 13 10 9 9 Thyroid 10 Page 14 1
7 11 6 7 7 Uterine 4 Leukemia 6 7 5 7 7 7 6 8 4 7 11 2008 35 2009 15 2010 22 2011 28 2012 12 2013 14 Lung & Bronchus 33 38 26 31 31 28 Non-­‐Hodgkin Lymphoma 20 5 16 9 8 9 Colon & Rectum 17 17 11 15 13 16 Breast Page
1
Number of Cases
Top 7 Cancer Sites for Men
Page 1
at SBJRCC
2008-2013
40 35 30 25 20 15 10 5 0 Prostate Melanoma of the skin 15 6 8 6 8 9 Bladder 11 19 12 19 12 13 Oral Cavity & Pharynx 4 4 8 8 5 5 22 • Seby B. Jones Regional Cancer
Center Annual Report
Seby B. Jones Regional Cancer Center, Cancer Registry Data
Breast (116)
Lung
(47) Cancer Conference/Tumor
2013 Seby B. Jones Regional Cancer
Center,
Colon & Rectum (22)
Board Summary
Melanoma (8)
Number of conferences held: 48
Liver (2)
Number of cases presented: 235
Lymphnoma (6)
yroid (5)
2013 Cancer Cases Presented
by Site
Prostate (3)
2% 1% Breast (116)
Other (26)
Lung (47)
3% Colon & Rectum (22)
11% 4% 1% Melanoma (8)
Liver (2)
9% 6.86%
40 - 49
49% Lymphnoma (6)
6.86%
50 - 5940 - 49 13.98%
20% yroid (5)
13.98%
60 - 6950 - 59 26.39%
Prostate (3)
60 - 69
26.39%
2% 70 - 7970 - 79 27.70%
1% Other (26)
27.70%
80 - 8980 - 89 18.21%
3% 18.21%
Other Other 6.86%
6.86%
11% 1% 4% 9% 2013 Age of Diagnosis of all Cancer
Cases for Seby B. Jones
49% Regional
Cancer Center
20% 7% 18% 18% 7% 7% 7% 28% 28% 14% 40 - 49
40 - 49
14% 50 - 59
26% 26% 60 -50
69- 59
70 -60
79- 69
80 -70
89- 79
Other
80 - 89
Other
Age at Diagnosis
40 - 49
50 -59
60 - 69
70 - 79
80 - 89
Other
Number of Cases
26
53
100
105
69
26
Percentage
6.86 %
13.98 %
26.39 %
27.70 %
18.21 %
6.86 %
www.apprhs.org/cancercenter • 2014 • 23
Quality & Liaison Annual Report
This year we achieved official accreditation once again for our cancer program as a Community Cancer Center for three years through the American College of Surgeons Commission
on Cancer. This emphasizes our focus on quality cancer care for our community and upholding the highest standards for patients in our small community.
We have continued to focus on prevention of cancer, utilization of our resources, and networking with other cancer programs for providing coordination of services for our patients.
We continue our relationship with the American Cancer Society and appreciate the bene- Anne-Corinne Beaver, MD
fits that it provides to our community.
For tracking our data, we are using the Rapid Quality Reporting System to monitor timely and appropriate care
under research-based guidelines. This allows us to present data at our Cancer Committee Meetings with up-todate accuracy and ensure that we are meeting proper goals for cancer treatment. It has been a successful tool and
highlights the excellence of cancer care here.
We are always striving for improvement in our community and have been working on several goals for the next
year. We look forward to the opening of the Breast Center of Excellence in 2015, encouraging smoking cessation,
developing more screening programs, and striving for healthier lifestyles with diet and exercise plans. Most of all,
we want to continue to offer coordinated cancer care with medical expertise and compassion.
Dr. Anne-Corinne Beaver
Anne-Corinne Beaver, MD, FACS
Surgeon, Cancer Liaison Physician
Clinical Trials Annual Report
The Clinical Trial Department is extremely proud to be able to offer research opportunities
to our mountain community. We know that having studies available locally enables more
people to participate in research.
Dr. Anna Sobol serves as the Clinical Trial Program Director and is also the Principal Investigator for current open trials. Dr. Flint Gray and Dr. Yvonne Mack are the Co-Principal
Investigators. Marjorie Hrozencik RN, BSN, OCN is the Clinical Research Coordinator.
Marjorie Hrozencik,
RN, BSN, OCN
Seby B. Jones Regional Cancer Center (SBJRCC) is a research affiliate site for the University
of North Carolina at Chapel Hill (UNC-CH). Currently there are two trials that we are partnering with UNCCH to conduct. Carolina Senior is a registry study that recruits patients over the age of 65 that gathers information about functional age. Before the end of 2014 an interventional study S-PACT (Senior Physical Activity
after Chemotherapy) will be opening. This is a study of patients over the age of 65 that evaluates the impact of a
home-based self-directed walking program on fatigue after chemotherapy.
In November 2014 a contract was executed to conduct the first industry sponsored trial at SBJRCC. This is a
prospective, non-interventional study of disease progression and treatment of patients with polycythemia vera
being treated in United States academic or community clinical practices. We anticipate this trial will open early
in 2015.
Marjorie Hrozencik, RN, BSN, OCN
Marjorie Hrozencik, RN, BSN, OCN
24 • Seby B. Jones Regional Cancer Center Annual Report
Vital Stats
Nurse Navigation Data Summary
Dates of Service 10/1/13 - 9/30/14
New Patients Navigated: 268
Disease sites:
Breast
60 Gyn
19
2 Malignant Heme
31
Skin
Thoracic
58 GU
24
42 Brain 7
GI
Head and Neck
17 Unknown Primary
2
Payer Classes:
Medicare
139 Commercial
63
30 Uninsured
36
Medicaid
Total Interventions: 1,979
Top Barriers to Care:
Knowledge deficit regarding diagnosis and treatment,
Financial concerns, Transportation difficulties, Fatigue.
Total Referrals Made:
Social Worker
230 Pain Clinic
7
Dietician
65 Prescription Assistance 35
Financial Navigator 164 Clinical Trials
3
PT/OT/Sp.Therapy
49 Home Health/ Hospice 21
Behavioral Health
57 Second Opinion
21
Pastoral Care
3 Transfer Care
34
ACS programs
0 Genetic Counselor
5
Social Worker’s Data Summary
Dates of Service 10/1/13 - 9/30/14
Total Cancer Emergency Foundation Funds distributed
FYD: $59,799.12
Since 2007: $410,384.07
Dates of Service 1/2/14 - 10/31/14
Psychosocial Assessments
Chemotherapy
122
Radiation
102
_______________________________________
Both
63
TOTAL
287
Advanced Directives
Health Care Power of Attorney
21
Living Wills
15
Health Talk
Date of Service 4/10/14
“Colorectal Cancer” by Dr. Thomas Haizlip
Avery Y’s Hugh Chapman Center
people in attendance
9
THRIVE Oncology Data Summary
Dates of Service 10/1/13 - 9/30/14
participants have generated 658 total visits
(526 were CRA visits)
improvement in physical well-being
improvement in emotional well-being
improvement in functional well-being
improvement in fatigue scores
increase in meters walked during walk test
37
21.58%
4.63%
5.38%
26.78%
14%
Behavioral Health Colocation Summary
Dates of Service 10/1/13 - 9/30/14
Total Referrals Received
Total Clients Seen
Initial Sessions
Follow-up Sessions
Informal Sessions
Referrals to Psychiatry
Declined services after referral
Too sick for sessions
No-shows
Could not contact
65
39 (60%)
39
16
10
3
17
4
3
2
Health Fairs & Screenings Data Summary
Dates of Service 1/1/14 - 10/30/14
Offering 27 health events to 2,953 attendees.
Offering health screenings to 262 participants.
Melanoma Cancer Screening
Skin Surveys
170
No treatment needed
80
Continue to observe for changes
8
Recommended treatment or biopsy
82
Head & Neck Cancer Screening
Screened 14
Normal9
Abnormal, recommended follow up
5
Prostate Cancer Screening
Screened 78
Normal 75
Abnormal 3
Smoking Cessation Program
Smoking Cessation Education
925
EMR documented patients counseled to quit 790
Registered callers 76
Fax referrals
33
One-on-one counseling
26
www.apprhs.org/cancercenter • 2014 • 25
Three Year Strategic Plan
Open Breast Center of Excellence with Breast Navigation
What began in 2012 as a committee using Lean process
improvement tools to streamline breast health services
between the hospital imaging departments and ordering
physicians, turned into a larger vision to create a Breast
Center of Excellence.
equipment and staff in one central location. The
centralized location will allow surgeons and radiologists
to work with a breast navigator to quickly assess patients
and move them through the diagnostic testing process
more efficiently. The new process will reduce wait time
Many hours of brainstorming and planning have resulted and facilitate a more efficient diagnostic and treatment
in the development of plans for a comprehensive Breast environment for patients. Renovations are expected
to begin in early 2015 and take approximately seven
Center of Excellence that will provide enhanced breast
health services. The Center will be located at 1200 State months to complete.
Farm Road in Boone, the
current location of our
Outpatient Imaging and
Lab Center.
A major portion of
the Outpatient Center
will be renovated to
accommodate imaging
EMR Implementation
Seby B. Jones Regional Cancer will go live with their
electronic medical record (EMR) services in 2015.
Radiation Oncology has been using the Mosaiq EMR
for several years to document radiation treatment plans
and delivery, but the upgrade will allow usage of Mosaiq
to its full capacity. Medical Oncology plans to make the
transition from paper charts to EMR in November 2015.
Mosaiq EMR is a multidisciplinary, patient-centered
software that centralizes both medical and radiation
oncology patient data in a single location. This allows
the cancer center to have a single medical record system
for all patient documentation, streamline and improve
order accuracy, and have an integrated schedule for
patient appointments.
Lung Cancer Screening: Forging a New Pathway
Lung cancer is the third most common cancer in the United States and the most common cause of cancer-related
death in the United States, accounting for 28% and 26% of all cancer deaths among men and women respectively.
In fact, bronchogenic carcinoma accounts for more cancer deaths than the combined total of the next three causes
of cancer deaths in both men (prostate cancer, colorectal cancer, and pancreatic cancer) and women (breast cancer,
colorectal cancer, and pancreatic cancer). The global impact of lung cancer is devastating as there are 1.8 million
new lung cancer cases discovered each year and over 1.6 million lung cancer deaths each year world wide (more
deaths per disease than seen with tuberculosis, malaria, and HIV disease).
In 2011, the National Lung Screening Trial published information in the New England Journal of Medicine which
involved 53,474 high-risk individuals aged 55 to 74 years of age who were randomized to three years of annual
screening with either low-dose CT scanning or regular chest x-ray. After over six years of surveillance, patients
(continued on page 27)
26 • Seby B. Jones Regional Cancer Center Annual Report
Three Year Strategic Plan
Lung Cancer Screening: Forging a New Pathway (continued from page 26)
screened with low-dose CT showed a reduction in lung cancer mortality of 16% compared
to the chest x-ray group and a reduction in all-cause mortality of 6.7%. The NLST also
calculated that the number of high risk patients needed to screen to save one lung cancer
death was approximately 320. Having this information, the United States Preventative
Services Task Force commissioned a systematic evidence review to assess the efficacy
of low-dose CT, chest radiography, and sputum cytologic evaluation for lung cancer
Kevin Wolfe, MD
screening in asymptomatic persons who are at average or high risk for the development
of bronchogenic carcinoma (current or former smokers). In the December 31, 2013
issue of the Annals of Internal Medicine, the United States Preventative Services Task Force published their
recommendation that asymptomatic, high-risk individuals receive annual screening for lung cancer with low-dose
CT. High-risk individuals were defined as adults aged 55 to 80 years who have a 30 pack-year smoking history and
currently smoke or have quit smoking within the past 15 years. The USPFTF also recommended that screening
should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially
limits life expectancy or the ability or willingness to have curative corrective surgery.
As the recommendations from the USPFTF circulated throughout the medical community, all medical specialties
related to the care of patients who are high risk for the development of bronchogenic carcinoma were eager to
implement the lung cancer screening protocol. When the Centers for Medicare and Medicaid Services reviewed
the recommendations from the USPFTF, many questions were raised and, in April 2014, the Medicare Evidence
Development and Coverage Advisory Committee (MEDCAC) released a statement in opposition to the USPFTF
recommendations. In that statement, MEDCAC pointed out that 82% of the patients enrolled in the NLST were
enrolled in large academic centers (>400 beds) and that 76% of the patients were enrolled in National Cancer
Institute designated cancer centers, all of which had dedicated chest radiologists and thoracic surgeons who
participated in a multidisciplinary lung cancer team that made recommendations for intervention and follow up.
As such, the surgical mortality for the NLST was only 1% (representing both lobectomies and pneumonectomies),
a rate significantly superior to the national surgical mortality rate of 3-5% (for lobectomies alone). Radiographic
surveillance of solitary pulmonary nodules strictly adhered to the Fleischner Society Recommendations from
2005. As a consequence, the Medicare respondents concluded that the U. S. population eligible for lung cancer
screening was different from the NLST and that better outcomes were achieved in high volume centers and centers
that had dedicated thoracic surgeons to provide surgical intervention and dedicated chest radiologists to provide
appropriate radiographic surveillance.
Since the publication of the National Lung Screening Trial, further work regarding lung cancer screening has been
focused on helping to identify those patients who may gain the most from the screening, decreasing the number of
false positive screens, and personalizing the choice for lung cancer screening by providing an individual risk profile
for each patient. The physicians at Appalachian Regional Healthcare System and those physicians associated with
Watauga Medical Center stand ready to implement the best protocol to provide lung cancer screening for high
risk individuals. At the present time, it is anticipated that CMS/ MEDCAC will release their final decision and
recommendation in early 2015.
Kevin W. Wolfe, MD, FCCP
Appalachian Regional Pulmonology
www.apprhs.org/cancercenter • 2014 • 27
Seby B. Jones Regional Cancer Center
Medical Oncology
(828) 262-4332
Located on the Campus of Watauga Medical Center
336 Deerfield Road • Boone, NC 28607
Jefferson Specialty Clinic
257 Medical Park Drive • Jefferson, NC 28640
Grandfather Specialty Clinic
436 Hospital Drive, Suite 210 • Linville, NC 28646
Radiation Oncology
(828) 262-4342
Located on the Campus of Watauga Medical Center
336 Deerfield Road • Boone, NC 28607
Infusion Center (non-oncology)
(828) 262-4332
Located on the campus of Watauga Medical Center
336 Deerfield Road • Boone, NC 28607
www.apprhs.org/cancercenter
Seby B. Jones Regional Cancer Center is located
on the Watauga Medical Center campus.
Watauga Medical Center is a member of
Appalachian Regional Healthcare System.
Seby B. Jones Regional Cancer Center, consisting of
medical oncology and radiation oncology, opened
in 1993 on the Watauga Medical Center campus.
In 2002, an 8000 sq. ft. addition was opened to
accommodate the growing regional demand for
medical oncology services. The Cancer Center offers
a multidisciplinary approach to the prevention,
diagnosis and treatment of cancers. Through
advanced technology and a highly trained staff, the
Center offers exceptional diagnostic and treatment
procedures that include radiation, chemotherapy,
biotherapy, immunotherapy, prostate brachytherapy
and hormonal treatments.
The Cancer Center was among the first few North
Carolina facilities to offer a new treatment modality
called intensity modulated radiation therapy, or
IMRT. This unique form of treatment is the most
advanced method available to deliver high dose
radiation to destroy cancer cells while minimizing
risk to normal tissues. IGRT (image guided
radiation therapy) is the added component of a high
quality x-ray system, or “on-board” imager, that
allows quick and precise adjustments of a patient’s
target volume for greater accuracy. Examples of
sensitive tissues that can now be “sculpted” around
include the prostate, spinal cord, optic nerve and
salivary glands.
The American College of Surgeons awarded the
Commission on Cancer® Three Year Certification
of Accreditation to Seby B. Jones Regional
Cancer Center in October 2014 and is accredited
through 2016. The Cancer Center has been CoC
accredited since 1997.
Designation status:
Accredited Community
Cancer Program with three
commendations.