CANCER CENTER ANNUAL REPORT by mmcsx

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									    HARBOR HOSPITAL

    CANCER CENTER
    ANNUAL REPORT     2010




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                               Message from Our Director
                               On behalf of my colleagues         •	   We	met	rigorous	requirements	to	receive	The	
                               and the entire cancer care team         Joint	Commission	accreditation	this	year	and	The	
                               at Harbor Hospital and the              American	College	of	Surgeons	also	accredited	
                               HarborView Cancer Center,               our	cancer	center.	Both	of	these	accreditations	
                               I’m pleased to share highlights         demonstrate that our center maintains the highest
                               from 2010—a dynamic year                standards	of	quality.	The	hospital	also	learned	
                               for our cancer program:                 that	we	received	several	five-star	ratings	from	
                                                                       HealthGrades, a national health care ratings
    •	   Fouad	Abbas,	M.D.,	head	of	the	Division	of	                   organization;
         Gynecologic Oncology, expanded his schedule to
         provide	additional	expert	specialty	care	for	patients	   •	   Harbor	Hospital	earned	the	Excellence	Award	for	
         with	gynecological	malignancies,	vaginal	prolapses,	          Quality	again	this	year—an	unprecedented	five	
         vaginal	reconstructions,	advanced	laparoscopy	                times	(2001,	2006,	2007,	2008	and	2010),	more	
         and	robotic	laparoscopy.	Dr.	Abbas	recently	was	              than	any	other	hospital	in	the	Delmarva	area.	This	
         awarded with the distinction as of one of the Top             is	the	highest	award	bestowed	by	the	Delmarva	
         Doctors	in	Baltimore magazine’s	November	issue.	              Foundation,	an	independent,	not-for-profit	health	
         This	was	the	fourth	time	he	received	this	award	              care	quality	improvement	organization;	and
         for gynecologic oncology (2006, 2007, 2009 and
         2010.)	This	honor	is	bestowed	to	physicians	based	       •	   In	addition	to	the	several	high	profile	recognitions	
         on	a	peer	review	process	and	is	locally	recognized	           mentioned	above,	we	have	demonstrated	
         as a distinction of excellence;                               continued	growth	in	our	outreach.	We	have	
                                                                       enhanced	our	cancer	screening	services	provided	
    •	   We	welcomed	an	exceptional	new	expert	                        through	the	Breast	and	Cervical	Cancer	Program	
         physician,	Daniel	L.	Kim,	M.D.,	FACOG,	                       (BCCP)	by	adding	a	bilingual	translator	for	our	
         to	our	staff.	He	is	a	board–certified	                        Latina	population,	and	we	are	embarking	on	
         urogynecologist	and	pelvic	surgeon,	who	offers	               an exciting collaboration with the Cherry Hill
         the	latest	nonsurgical	and	minimally	invasive	                community.	Our	goal	is	to	further	educate	on	the	
         treatment options for those in need of complex                importance	of	early	detection	and	regular	exams.
         pelvic	reconstructive	procedures;
                                                                  These enhancements, distinctions and collaborations
    •	   We	hired	Cancer	Registry	Coordinator	Jessica	K.	         mentioned	above	demonstrate	our	ongoing	
         Dohler,	BS,	CTR,	to	help	facilitate	our	continued	       commitment to our patients, whom it is our mission to
         growth,	partnerships	and	distinctions.	Jessica’s	hard	   serve.	We	are	dedicated	to	providing	exceptional	care,	
         work, dedication and expertise already has been          memorable experiences and most importantly, the best
         proved	through	our	recent	Commission	award;              possible	clinical	outcomes	for	you	and	your	families.	

    •	   The	HarborView	Cancer	Center	received	the	               I hope you’ll join me in celebrating our successes
         Commission	on	Cancer	Accreditation	Award	                from this year, and looking forward to another year of
         three	Year	with	Commendation,	receiving	                 excellence.
         commendation on six out of the nine standards
         that are eligible;


                                                                  David	Van	Echo,	M.D.
                                                                  Director,	HarborView	Cancer	Center

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    Medical Oncology                                                     Director	of	the	Northern	Virginia	Thoracic	Oncology	
    The	Medical	Oncology	Center,	under	the	direction	                    Program	in	Reston	Virginia.		Marc	Margolis,	M.D.	
    of	David	Van	Echo,	M.D.,	is	committed	to	providing	                  serves	as	the	Associate	Chief	of	Thoracic	Surgery	
    our	patients	with	a	truly	comprehensive	cancer	care	                 at	Harbor	Hospital,	Associate	Clinical	Professor	
    experience.	With	an	emphasis	on	clinical	trials	in	                  of	Cardiothoracic	Surgery	at	George	Washington	
    breast, lung and colorectal cancers, our team offers                 University	Hospital	and	Professor	at	the	George	
    patients	state-of-the-art	options	for	treatment	in	one	              Washington	University	Medical	School	and	Associate	
    convenient,	relaxed	and	inviting	environment.	Our	                   Chief	of	Thoracic	Surgery	of	the	Washington	Institute	
    caring	experts	offer	all	the	benefits	of	world–class	                of	Thoracic	and	Cardiovascular	Surgery.
    treatment	in	a	community	hospital.
                                                                         The	Thoracic	Surgical	team	also	includes	a	specially	
    Thoracic Oncology                                                    trained team of dedicated members who support the
    The Thoracic Oncology Center, under the direction                    continuum of care to facilitate excellent outcomes
    of	Farid	Gharagozloo,	M.D.,	FACS,	utilizes	an	                       for	the	patient.	Prompt	consultations	and	response	
    all-inclusive,	multi-disciplinary	approach	for	early	                to referrals allows assessment and rapid surgical
    detection and diagnosis, as well as contemporary,                    intervention	when	appropriate,	while	delivering	a	
    innovative	treatment	of	lung	and	esophageal	cancer.                  continuity	of	care	with	quality	and	excellence	for	our	
                                                                         patients and their families

                                                                         Radiation Oncology
                                                                         The	HarborView	Radiation	Oncology	Center,	under	
                                                                         the	direction	of	Jack	J.	Hong,	M.D.,	provides	state-
                                                                         of-the-art	radiation	treatments,	including	Intensity	
                                                                         Modulated	Radiation	Therapy	(IMRT),	Image-
                                                                         Guided	Radiation	Therapy	(IGRT),	three-dimensional	
                                                                         CT	planning	with	PET/CT	fusion,	remote	
                                                                         afterloading	brachytherapy	with	CT-based	three-
                                                                         dimensional	reconstruction	and	MammoSite	Radiation	
                                                                         therapy	(partial	breast	irradiation).	The	prostate	cancer	
                                                                         brachytherapy program continues to offer options in
    Farid Gharagozloo, M.D., Jack Hong, M.D., and David Van Echo, M.D.   definitive	prostate	cancer	managements.

    Minimally	invasive	surgical	management	of	lung	cancer	               The center continues to update electronic health
    may	be	facilitated	by	the	VATS	(Video-Assisted	Thoracic	             records,	and	currently	is	a	total	filmless/paperless	
    Surgery)	if	indicated.	This	procedure	is	well-tolerated	and	         department.	Information	Technology	continues	to	
    is	performed	for	a	diagnostic	biopsy	and	resection.                  enhance	planning	and	operations	along	with	MedStar	
                                                                         Health	corporate	initiatives.
    Our	thoracic	surgical	team	is	composed	of	board-
    certified	physicians	in	general	and	thoracic	surgery.		              Clinical	research	continues	with	the	MedStar	
    Farid	Gharagozloo	is	currently	Harbor’s	Division	                    Research	Institute	and	affiliation	with	the	Georgetown	
    Chief	of	Thoracic	Surgery	and	Director	of	the	                       University/Lombardi	Cancer	Center.	In	addition,	active	
    Harbor	Lung	Cancer	Center	as	well	as	Cardiothoracic	                 cooperation	with	the	National	Institute	of	Health/
    Surgeon-in-Chief	of	the	Washington	Institute	of	                     National	Cancer	Institute	at	Harbor	Hospital	is	ongoing.	
    Thoracic	and	Cardiovascular	Surgery.	He	also	is	
    the	Clinical	Professor	of	Surgery	and	Chief	of	the	                  The center continues to be a preferential site for the
    Clinical	Cardiothoracic	Surgery	at	George	Washington	                Baltimore	region	Veterans	Administration	Radiation	
    University	Hospital	in	Washington,	D.C.,	and	the	                    Therapy,	lending	assistance	in	cancer	care	to	all	veterans.

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    Gynecologic Oncology                                      Oncology Nursing
    The Gynecologic Oncology Center, under the                The Oncology Nursing Unit, under the direction of
    direction	of	Fouad	Abbas,	M.D.,	treats	the	full	range	    Bette	O’Connor,	R.N.,	at	Harbor	Hospital	is	an	active	
    of	gynecological	cancers	and	offers	reconstructive	       member	of	the	cancer	program’s	multi-disciplinary	
    surgery	to	women	who	have	undergone	extensive	            health	care	team.	Each	nurse	is	certified	through	the	
    surgery,	including	removal	of	the	vagina,	bladder	        Oncology	Nursing	Society	as	providers	of	specialized	
    or	rectum.	Pelvic	reconstructive	procedures	also	         care.	They	administer	chemotherapy	and	manage	the	
    benefit	many	female	patients	with	non-malignant	          complications of patients admitted to the hospital’s
    conditions	like	vaginal	prolapse,	organ	prolapse,	or	     fourth-floor,	24-bed	oncology	unit.	As	educators,	
    urinary	stress	incontinence.	Our	teaching	efforts	have	   they instruct patients and their families on illness
    also expanded to include patients, physicians, and        prevention,	symptom	control	and	follow-up	care.	To	
    obstetric/gynecology	residents.	Monthly	gynecologic	      maximize the physical and psychological comfort of
    conferences keep all staff updated on the latest          patients,	a	“care	pair”	–	a	registered	nurse	and	a	care	
    technology	and	expertise.                                 associate	–	is	assigned	to	each	cancer	patient.	Care	
                                                              pairs	become	well–acquainted	with	their	patients	
    Pulmonary Oncology                                        and	oversee	most	of	their	ongoing	treatment.	The	
    The	Chest	Diagnostic	Center,	under	the	direction	         advantage	to	our	inpatients	is	especially	significant.	
    of	Ko-Pen	Wang,	M.D.,	FCCP,	specializes	in	the	           Therapies and pretesting procedures are routinely
    staging	and	treatment	of	lung	cancer.	Minimally	          provided	in	patient	rooms,	greatly	lessening	the	time	
    invasive	procedures	and	innovative	pain	control	          patients might otherwise spend waiting in, or in
    techniques	are	emphasized.	Specialized	diagnostic	        transport	through,	hospital	corridors.	This	approach	
    and	therapeutic	procedures	include:	Nd	YAG	laser	         to nursing has earned our cancer program national
    vaporization	coagulation	of	airway	tumors;	removal	       recognition	as	a	model	for	patient-centered	care.
    of foreign objects and stent placement in major
    airways;	Percutaneous	Needle	Aspiration	of	lung	
    masses	or	nodules;	Thoracentesis;	Pleural	biopsy;	
    Esophagoscopy	and	Stenting;	Transbronchial	Needle	
    Aspiration	Biopsy	(TBNA);	Brachytherapy	and	
    fluorescence	endoscopy.	These	services	assist	with	
    the	early	detection	and	treatment	of	lung	cancer.	
    Specialized	training	programs	including	a	pulmonary	
    fellowship	are	continuously	offered.

    Dr.	Wang’s	on-going	fellowship	program	for	fully	
    trained pulmonary fellows allows physicians from
    many	different	institutions	to	learn	from	his	world-
    renowned	expertise	in	bronchoscopy.	Pulmonary	            Mohsen Gharib, M.D.
    fellows come from highly regarded academic
    institutions,	such	as	Walter	Reed	Army	and	Navy	          Imaging
    Hospital,	and	The	Johns	Hopkins	Hospital,	and	            The	Department	of	Imaging,	under	the	direction	
    as well as from other countries — such as China           of	Mohsen	Gharib,	M.D.,	provides	comprehensive	
    and	Turkey.	Dr.	Wang’s	training	program	consists	         diagnostic	services	within	a	compassionate	
    of learning and mastering different methods and           community	hospital	setting.	Our	spiral	CT	
    techniques	in	bronchoscopy,	which	includes	various	       (computed	tomography)	scanners	provide	detailed	
    types	of	biopsies,	laser	and	stenting.                    images	of	any	anatomical	area	within	minutes.	
                                                              They	are	interfaced	with	the	treatment-planning	
                                                              computer	in	the	radiation	oncology	center.	This	

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    capability helps the radiation oncology team to             In	the	future,	the	team	hopes	to	use	PET/CT	scans	
    create	individualized	treatment	plans	for	patients.	        after only a round of chemotherapy to determine if
    For	diagnostic	purposes,	MRI	(magnetic	resonance	           the	treatment	is	affecting	the	cancer.
    imaging),	using	a	Phillips	1.5	Tesla	scanner,	is	
    available,	as	are	fluoroscopic	X-ray,	color	Doppler	        Our	expert	team	of	radiologists,	Mohsen	Gharib,	
    ultrasound,	low-dose	mammography,	and	stereotactic	         M.D.,	William	Higgins,	M.D.	and	Rafi	Raza,	M.D.,	
    biopsy.	Vaccum-assisted	ultrasound-guided	core	             routinely	provide	many	other	minimally	invasive	
    biopsies	of	breast	lesions	are	also	performed.	The	         diagnostic and therapeutic procedures, including
    most	advanced	SPECT	(single	photon	emission	                biopsies, aspirations, line placements, angioplasties,
    computed	tomography)	allows	the	Department	                 and	catheter-directed	infusions	of	medicines.
    of	Nuclear	Medicine	to	perform	accurate	bone	
    imaging.	Other	nuclear	medicine	studies,	such	as	           Interventional Radiology
    MUGA	(multi-gated)	scan	of	the	heart,	are	used	             Our	Oncologic	Interventional	Radiology	team,	
    as	a	pre-chemotherapy	evaluation.	We	continue	to	           under	the	direction	of	Andrew	Brown,	M.D.,	works	
    provide	sentinel	lymph	node	localization	procedures	        with	oncologists	to	diagnose	and	treat	cancer.	After	
    which helps localize lymph nodes most likely to be          biopsy, tumors often can be treated with minimally
    involved	by	malignancy,	and	provides	surgeons	with	         invasive	techniques,	including	chemoembolization,	
    information that may influence the surgical treatment       microwave	or	radiofrequency	ablation.
    of	oncology	patients.
                                                                Chemoembolization	is	a	technique	in	which	a	catheter	
                                                                is	placed	into	the	liver,	and	injected	directly	into	the	
                                                                liver	arteries.	This	technique	allows	chemotherapy	
                                                                to	be	delivered	at	much	higher	doses	than	traditional	
                                                                treatment,	and	delivers	treatment	in	a	way	that	spares	
                                                                the	rest	of	the	body	from	chemotherapy	side	effects.	
                                                                Microwave	and	radiofrequency	ablation	are	techniques	
                                                                in which a needle or needles are placed like a probe
                                                                into	a	tumor.	The	needle	heats	the	tumor	and	destroys	
                                                                it.	Lung,	liver	and	bone	tumors	may	be	treated	using	
                                                                this	technique.

                                                                Our	interventional	radiologists	also	perform	a	
    Rafi Raza, M.D., and Susan Morgan                           technique	called	kyphoplasty	to	treat	painful	spinal	
                                                                metastasis as well as osteoporotic compression
    We	also	offer	the	most	advanced	nuclear	medicine	           fractures.	Kyphoplasty	uses	small	needles,	which	are	
    imaging,	PET/CT	Scan	(Positron	Emission	                    inserted into the bony portion of the spine to create
    Tomography/	Computertized	Tomography).	This	                a	tiny	cavity.	The	cavity	is	then	filled	with	cement.		
    study is used in early detection of lung cancer, in         This	procedure	strengthens	the	tumor–weakened	
    tumor	staging,	as	well	as	to	assess	the	effectiveness	of	   bone	and	keeps	it	from	moving,	which	alleviates	
    treatments.	Once	a	patient	has	undergone	treatment,	        the	pain.	More	kyphoplasty	is	performed	at	Harbor	
    the	team	uses	the	PET/CT	scan	to	determine	if	the	          Hospital	than	at	any	other	center	in	the	region.
    treatment	has	been	successful.	The	traditional	method	
    of	determining	treatment	effectiveness	is	to	“watch	        Pathology and Clinical Laboratories
    and	see,”	which	can	waste	precious	time.	With	PET/          The	Department	of	Pathology,	under	the	direction	
    CT technology, the team is able to determine — in a         of	Thomas	Gipson,	M.D.,	provides	comprehensive	
    more	timely	fashion	—	if	further	treatment	is	needed.	      diagnosis of cancer and assists in the staging


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    and	management	of	Cancer	Center	protocols.	               Screenings/Community Outreach
    Traditional	microscopic	techniques	are	used	to	detect	    The Baltimore City Breast and Cervical Cancer
    malignancies—from	fine-needle	aspirations	and	            Program (BCCP) at Harbor Hospital has been
    exfoliative	cytology	to	surgical	and	endoscopic	biopsy	   going	strong	for	the	past	seven	years.	Under	the	
    specimens.	Immunohistochemical	testing,	as	well	as	       direction	of	Linda	Wieczynski,	R.N.,	BCCP	has	
    molecular biologic assays, enhance the department’s       provided	3,987	mammograms,	detected	33	breast	
    diagnostic	capabilities.	Cancer	patients	are	monitored	   cancers,	four	cervical	cancers	and	five	additional	
    during treatment by the clinical laboratory and           gynecological	cancers	since	its	inception	in	2002.
    its	component	divisions:	chemistry,	hematology,	
    microbiology,	immunology	and	blood	banking.               Colorectal Cancer Screenings –	Harbor	Hospital	
                                                              is	a	recipient	of	a	Maryland	Cancer	Fund	grant	
                                                              for colorectal cancer screening for low income,
                                                              uninsured	residents.	The	Maryland	Cancer	Fund	is	a	
                                                              resource	for	funding	for	cancer	prevention,	screening,	
                                                              treatment,	and	research	in	Maryland.	The	money	in	
                                                              the	Maryland	Cancer	Fund	comes	from	contributions	
                                                              by	Maryland	residents	in	an	income	tax	check	off	
                                                              system	on	the	Maryland	annual	tax	return	or	from	
                                                              other	donations	to	the	fund.	The	funding	will	cover	
                                                              approximately	25	free	colonoscopies	annually.

                                                              Prostate Screening –	23	men	took	advantage	of	
                                                              Harbor’s	free	prostate	screening	in	September.
    Thomas Gipson, M.D.
                                                              Skin Cancer Screening –	32	community	members	
    Rehabilitation                                            participated in Harbor’s free skin cancer screening in
    Our	Rehabilitation	Services	team	provides	treatment	      July.
    for patients with lung disease in our pulmonary
    rehabilitation	outpatient	program.	This	program	          Smoking Cessation –	Harbor	offered	two	
    enables	pre–and	post–lung	cancer	surgery/lung	            smoking cessation classes through a grant from
    transplant patients to regain their strength and          the	Anne	Arundel	County	Health	Department,	
    endurance	while	breathing	easier.	The	positive	           providing	smoking	cessation	support	for	a	total	of	32	
    outcomes are:                                             community	members.
      •	 reduced	number	of	hospitalizations
                                                              Support Groups
      •	 improved	quality	of	life                             Survivors Offering Support (SOS) is a breast
      •	 reduced	symptoms	of	shortness	of	breath              cancer	survivor’s	support	program	that	integrates	
         and fatigue                                          trained	survivor	volunteer	mentors	into	our	hospitals’	
      •	 increased	endurance	for	daily	activities             standard of care for newly diagnosed breast cancer
                                                              patients.	SOS	mentors	are	highly	trained	and	
    Rehabilitation	Services	also	has	services	to	address	     informed and they are linked to the hospital and not a
    the needs of lymphadema patients who may be seen          stand-alone	survivor	support	program.	
    following surgery (mastectomy, lumpectomy, or surgery
    in	the	lymph	node	region)	and/or	radiation	treatments.    Arm-in-Arm is a breast cancer support group which
                                                              offers	the	opportunity	to	discuss	issues	and	provides	
    Our	expert	physical	therapists	are	Klose-trained	and	     support,	education	and	resources.	Family	members	
    they specialize in lymphadema treatment using the         and	loved	ones	also	are	invited	to	attend.
    Vodder	method.
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    Man to Man	provides	support,	encouragement	and	                             Look Good...Feel Better	is	a	community-based,	
    solutions to common problems associated with prostate                       free,	national	service	for	women	undergoing	cancer	
    cancer.	Support	and	sharing	is	done	in	small	group	                         treatment that offers beauty tips to look and feel
    sessions	led	by	trained	facilitators.	Discussion	takes	place	               better	about	themselves	during	chemotherapy	and	
    around	the	common	questions,	concerns	and	feelings	                         radiation	treatments.
    of	the	group.	There	is	an	educational	presentation	by	a	
    health	care	professional	on	a	pre-selected	topic	followed	
    by	a	question	and	answer	session.




                                                                                Linda Wieczynski



    Patient, Debbie Allen (center) and her expert caregivers, Shirley Bottom,
    Sheila Mehring, Marc Margolis, M.D., David Van Echo, M.D., Vicki Cole and
    Steve Friedman.

    Red Devils	funds	services	to	improve	quality	of	
    life	for	breast	cancer	patients	and	their	families.	The	
    emotional and physical impact of this disease may
    make some of the things we take for granted almost
    impossible such as house cleaning, getting to doctor
    appointments	and	preparing	family	meals.




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    The Cancer Registry Report
    The	cancer	registry	is	a	vital	component	of	the	cancer	      treated	at	Harbor	Hospital	in	2009	were	lung	–	124	
    program	at	Harbor	Hospital.		It	is	a	database	comprised	     cases	(25.7	percent),	breast	–	77	cases	(15.9	percent),	
    of malignancies and select benign diseases of those          prostate	–	48	cases	(10.1	percent),	colorectal	–	31	cases	
    patients	that	have	been	treated	and/or	diagnosed	at	         (6.4	percent),	and	uterine	–	21	cases	(4.3	percent).			
    Harbor	Hospital.	The	cancer	registry	was	originally	
    established	in	1993	to	support	the	informational	needs	      The	cancer	registry	maintains	follow-up	information	
    of	the	hospital’s	cancer	care	team	and	local	community.		    on	all	analytic	patients	in	our	database.	This	process	
    Harbor Hospital’s cancer program is accredited by the        involves	periodic	contact	with	health	care	providers	
    American	College	of	Surgeons	Commission	on	Cancer	           and	patients.	The	goal	is	to	ascertain	information	
    (ACS	CoC).	The	cancer	registry	is	a	required	element	        annually throughout a patient’s lifetime as related
    of	the	cancer	program	and	essential	to	its	success.		        to	their	disease	recurrence	status	and	survival.	
                                                                 Currently, the registry contains more than 8,700
    Certified	tumor	registrars	(CTRs)	compile	an	abstract	       cases.	Our	5-year	follow-up	rate	is	at	91	percent	
    for	each	analytic	case	according	to	the	ACS	CoC	             while	our	reference	year	follow-up	rate	is	at	
    standards.	Analytic	cases	are	defined	as	those	cases	        approximately	89	percent.	
    that	are	newly	diagnosed	and/or	receive	first	course	
    treatment	at	Harbor	Hospital.	Data	related	to	patient	       Harbor Hospital’s cancer registry data contributes to
    demographics, diagnostics, primary site of cancer, stage     the	evaluation	of	state	and	national	cancer	incidence	
    of	cancer	at	diagnosis,	treatment,	vital	status,	provider	   that	assists	health	care	providers,	health	officials,	and	
    identification	and	follow-up	information	are	collected	      researchers	in	the	management	of	cancer.		Cancer	
    and	maintained	in	the	cancer	registry.	Limited	data	         registry	data	is	reported	to	the	Maryland	Cancer	
    is	collected	for	non-analytic	cases.		Those	are	cases	       Registry,	as	required	by	law,	and	to	the	National	Cancer	
    where patients that were initially diagnosed and treated     Database	(NCDB)	as	required	by	the	ACS	CoC	in	
    elsewhere, but are now seen at Harbor Hospital for           accordance	with	the	cancer	program	accreditation.	
    additional	metastatic	diagnosis	or	treatment.		

    In	2009	the	cancer	registry	accessioned	483	new	cases.		
    Of	these	440	were	analytic	and	43	were	non-analytic.		
    The	most	common	malignancies	diagnosed	and/or	




8
    County at Diagnosis




9
     Primary Site Table
                                                                                                Stage Distribution -
                                                    Sex              Analy     Status           Analytic Cases Only


     Primary Site                  Total (%)   M           F    Analy NA Alive Exp        Stg 0 Stg I Stg II Stg III Stg IV   88   Unk Blank/Inv

                                       5
 Oral Cavity & Pharynx                         4          1      5       0    5     0      0      1      1      1      1      0     1    0
                                    (1.0%)
                                      59
 Digestive System                              35         24     55      4    38    21     3      10     8     12      15     4     3    0
                                   (12.2%)
                                     133
 Respiratory System                            79         54    124      9    65    68     2      22     5     54      37     1     3    0
                                   (27.5%)
                                       2
 Soft Tissue                                   1          1      2       0    2     0      0      0      0      0      0      0     2    0
                                    (0.4%)
                                       3
 Skin Excluding Basal & Squamous               1          2      1       2    1     2      1      0      0      0      0      0     0    0
                                    (0.6%)
                                      77
 Breast                                        0          77     71      6    74    3      9      24     21     7      4      0     6    0
                                   (15.9%)
                                      68
 Female Genital System                         0          68     62      6    57    11     1      26     2     13      10     3     7    0
                                   (14.1%)
                                      50
 Male Genital System                           50         0      45      5    44    6      0      0      29     5      5      0     6    0
                                   (10.4%)
                                      27
 Urinary System                                12         15     25      2    20    7      7      7      7      1      2      0     1    0
                                    (5.6%)
                                       9
 Brain & Other Nervous System                  7          2      5       4    5     4      0      0      0      0      0      5     0    0
                                    (1.9%)
                                       7
 Endocrine System                              1          6      4       3    7     0      0      2      1      0      0      0     1    0
                                    (1.4%)
                                      12
 Lymphoma                                      7          5      11      1    8     4      0      4      3      1      3      0     0    0
                                    (2.5%)
                                       3
 Myeloma                                       1          2      3       0    2     1      0      0      0      0      0      3     0    0
                                    (0.6%)
                                       5
 Leukemia                                      4          1      5       0    3     2      0      0      0      0      0      5     0    0
                                    (1.0%)
                                       1
 Mesothelioma                                  1          0      1       0    1     0      0      0      0      0      0      0     1    0
                                    (0.2%)
                                      22
 Miscellaneous                                 13         9      21      1    12    10     0      0      0      0      0      21    0    0
                                    (4.6%)

 Total                               483       216        267   440      43   344   139    23     96     77    94      77     42   31    0

 Exclusions                          NA         0




10
     Patient Care Evaluation Study: Diagnosis of Lung Cancer
     Every	breath	you	take	depends	on	the	function	of	        for	the	next	endeavor.	The	key	to	improving	survival	
     your	lungs,	they	are	a	vital	organ.	One	depends	         and	outcomes	for	lung	cancer	is	earlier	detection.	
     totally on the breathing in the oxygen and out the       Because	there	are	no	early	warning	signs	for	lung	
     carbon	dioxide,	but	how	often	do	we	give	them	a	         cancer, too many patients are diagnosed in later stages
     thought? Usually not at all—not until something          and	the	options	for	treatment	are	limited.
     goes	wrong.	Therein	demonstrates	one	of	the	largest	
     problems	in	the	diagnosis	of	lung	cancer.

     Lung	cancer	is	the	leading	cause	of	cancer	death	in	
     the	United	States.	Over	three	times	as	many	men	
     die	from	lung	cancer	as	prostate	cancer.	Twice	as	
     many	women	die	from	lung	cancer	as	breast	cancer.	
     Approximately	437	deaths	occur	daily	from	lung	
     cancer.	In	2010	the	expected	estimated	cases	of	newly	
     diagnosed	lung	cancer	is	222,520.	Eighty	five	percent	
     of	those	newly	diagnosed	patients	will	have	an	active	
     of	remote	history	of	tobacco	smoking	and	15	percent	
     will	have	never	smoked	at	all.

     Lung	cancer	does	not	respect	gender,	age,	ethnic	
     background	or	even	age.	Although	there	are	
     significant	risk	factors	that	place	you	in	a	more	
     susceptible	group,	lung	cancer	is	not	exclusive.	
     Tobacco smoking does increase your risk for
     developing	lung	cancer.	Harbor	Hospital	has	made	
     concerted	efforts	to	promote	smoking	cessation.	
     Counseling,	tools,	education	and	support	services	
     provide	an	environment	to	encourage	smoking	
     cessation.	The	band	on	smoking	on	the	hospital	
     property demonstrates the sincerity and acknowledges
     the	importance	of	this	effort.

     Lung	cancer	is	divided	into	two	types:	Small	
     Cell	Lung	Cancer	(SCLC)	and	Non-Small	Cell	
     Lung	Cancer	(NSCLC).	Eighty	percent	of	cases	
     are	NSCLC	and	20	percent	are	SCLC.	For	either	
     type,	staging,	or	the	extent	of	the	disease,	is	vital	   In 2009, Harbor Hospital diagnosed 116 patients with
     in	determining	treatment	options.	Clear	evidence	        lung	cancer.	Of	those	17	(15	percent)	were	Small	
     is present to support the fact that early diagnosis      Cell	carcinomas	and	99	(85	percent)	were	Non-Small	
     improves	options	and	outcomes.	Although	Chest	           Cell	carcinomas.	Unfortunately	most	of	the	patients	
     CT	Screening	remains	under	investigation,	reports	       at Harbor Hospital were diagnosed in the late stages,
     are	promising	to	demonstrate	the	benefit	of	such	        limiting	their	options	for	treatment	and	cure.	Of	the	
     screening	programs.	Harbor	Hospital	has	had	three	       Small	Cell	carcinomas	diagnosed,	only	one	patient	
     CT	Screening	programs	in	the	past	and	is	planning	       was	stage	I,	with	the	rest	being	stage	III	and	IV.

11
     The	Non-Small	Cell	carcinoma	patients	presented	          extensive	and	all-inclusive	treatment	options.	The	team	
     in	a	more	diverse	nature,	but	the	majority	was	           approach from diagnosis, treatment, support systems, as
     diagnosed	at	a	late	stage.	One	patient	was	stage	0	       well	as	patient	and	family	centered-wellness	goals	makes	
     which	can	be	characterized	as	non-invasive	cancer.	       the HarborView Cancer Center at Harbor Hospital a
     Nineteen	patients	were	stage	I,	five	were	stage	II,	43	   center	of	excellence	and	a	harbor	of	hope.
     were	stage	III	and	28	were	stage	IV.	
                                                               Vicki	Cole,	P.A.
     Treatment	for	lung	cancer	is	multi-faceted	and	is	
     determined	by	the	type	and	stage	of	the	lung	cancer.		
     Harbor	Hospital	remains	committed	to	providing	




     Sources
     www.lungcanceralliance.org/facing/facts.html
     www.lungcanceralliance.org/facing/about.html
     www.cancer.org/Cancer/news/News/ct-scans-cut-lung-cancer-deaths-study-finds

     *Harbor	Hospital	Cancer	Registry	2009	Data




12
     Cancer Committee Members 2010
     Physician Members
     Oncology	–	Medical              David	Van	Echo,	M.D.

     Oncology	–	Radiation            Jack	Hong,	M.D.

     Pathology                       Thomas	Gipson,	M.D.

     Radiology                       Mohsen	Gharib,	M.D.

     Surgery	–	General               Anthony	Raneri,	M.D.




     Non-physician members
     Administration                  Jill	Donaldson

     Cancer	Screening	Programs       Linda	Weiczynski,	R.N.

                                     Jessica	Dohler,	BS,	CTR
     Cancer	Registry
                                     Kathy	Kneavel-Smith,	CTR

     Case	Management                 Brenda	Thomas

     Community	Relations             Meg	Miller

     Infection	Prevention            Julia	Gardner,	R.N.

     Nursing	Administration          Diana	Langhauser,	BSN,	R.N.	

     Nursing	–	Oncology              Bette	O’Connor,	R.N.

     Nutrition                       Amy	McHale

     Pharmacy                        Chris	Muskelly

     Project	Manager/Lung	Cancer     Sonya	Henson

     QM	Coordinator/Patient	Safety   Christine	Roberge,	R.N.

     Rehabilitation                  Jessica	Jordan

     Surgery	–	Thoracic              Vicki	Cole,	P.A.

     American	Cancer	Society         Tori	Lijewski




13
                              HARBOR HOSPITAL

                              CANCER CENTER
                              ANNUAL REPORT                                                2010
                                                         Kenneth A. Samet, FACHE
                                                                     President and CEO
                                                                        MedStar Health

                                                              Edward P. (Ned) Carey
                                                          Chairman, Board of Directors
                                                                      Harbor Hospital

                                                           Dennis W. Pullin, FACHE
                                                                              President
                                                                         Harbor Hospital


                                                                                 Editor:
                                                                            Nikki Laska




                                                                harborhospital.org




Harbor Hospital is part of MedStar Health, a not-for-profit, regional healthcare system
with nine hospitals and more than 20 other health-related services in the Maryland and
Washington, D.C., region. More than a half-million patients trust their care to MedStar
Health each year. medstarhealth.org

								
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