2010 ANNUAL REPORT

Cotton-O’Neil Cancer Center
Division of Stormont-Vail HealthCare
1414 S.W. 8th Ave Topeka, KS 66606
About the Cotton-O’Neil Cancer Center            System that delivers high-dose radiation to
The Cotton-O’Neil Cancer Center, located in      even the smallest tumor. The equipment has
the Howard N. Ward, M.D. Medical                 the capability to target an area as small as a
Building, is a prevention, treatment and         pencil point, minimizing damage to healthy
research facility. As a division of Stormont-    tissue. This technology also allows for faster
Vail HealthCare, it offers one-stop outpatient   treatment delivery.
medical services for patients.
  The center houses state-of-the-art cancer
diagnostic, staging and treatment
technology, an infusion center for
chemotherapy, radiation therapy, in-house
phlebotomy and laboratory services and a
clinical research center. There are also
ancillary services offered for patients such
as genetic counseling, nutritional
counseling, social work and pastoral care.
  The Cotton-O’Neil Cancer Center was
designed with the patient and family in
mind. In addition to convenient parking, the
one-level center has a canopy area for pick-
up and drop-off directly outside the front
door. Inside treatment area options vary         Clinical Trials
from private rooms to family rooms, where        Clinical trials provide access to the most
visitors and family members can be with the      advanced oncology therapies available.
patients during treatment. There is also an      Currently, the Cotton-O’Neil Cancer Center
“open treatment” area where patients can be      offers access to over 60 clinical trials for
with other patients, if they choose.             more that 25 different cancer types. In
                                                 addition to fighting disease, clinical trials
In-Patient Services                              also contribute to the advancement of
If in-patient services are required, Stormont-   science.
Vail HealthCare has 32 available oncology         For questions regarding clinical trials,
beds, conveniently located just across the       contact the Clinical Trials department at
street from the Cotton-O’Neil Cancer             (785) 354-5300, or follow the link at
Center, at Stormont-Vail Regional Health
                                                 Ancillary Services
State-of-the-Art Radiation Technology            The Cotton-O’Neil Cancer Center offers
The Cotton-O’Neil Cancer Center installed        many ancillary services for additional
the first PET/CT in a 13-county region in        support to patients. Appointments can be
northeast Kansas. With PET/CT capabilities,      made with a genetic counselor, which
the equipment simultaneously images and          specializes in researching and studying
combines the results of two technologies         genetic risk of disease. There is also a social
into a single exam.                              worker and registered dietician available at
  The Cotton-O’Neil Cancer Center is also        the center, and appointments can be made
home to a linear accelerator known as the        for pastoral support. To contact one of these
Trilogy, an Image-Guided Radiotherapy            services call (785) 354-5300 or (800) 354-0091.
                                                   Multidisciplinary Tumor Conferences
Support Services                                   Each week, a multidisciplinary Tumor
Art therapy class is offered every                 Conference is held where physicians discuss
Wednesday morning at the Cotton-O’Neil             diagnostic work-up and treatment
Cancer Center, with all art supplies               possibilities for cancer patients. Tumor
provided. Pet therapists visit patients each       Conferences allow physicians to explore
Wednesday in the library of the Cancer             ideas from numerous disciplines, and act as
Center. Tai Chi classes are held in the lobby      an additional professional opinion for each
each week. A general Cancer Support Group          patient, without the patient having to visit
is held each Monday, and a Pediatric               each physician individually.
support group is also available.                     The Stormont-Vail HealthCare Tumor
                                                   Conferences include a specialized
                                                   conference discussing endocrinology tumors
Tumor Registry Operations                          once per month, with general cancer cases
The Tumor Registry is responsible for              being discussed each of the other weeks.
compiling, maintaining and analyzing data
on all patients diagnosed and/or treated for       Other Cotton-O’Neil Cancer Center Facts
cancer within the Stormont-Vail HealthCare          Stormont-Vail HealthCare and the Cotton-
organization. The registry added 1029 new          O’Neil Cancer Center are accredited by the
cancer cases in 2009. Of these, 947 were           American College of Surgeons Commission
analytic (diagnosed and/or treated for part        on Cancer.
or all of their first course of treatment within     The Cotton-O’Neil Cancer Center is a
our organization).                                 member of the Midwest Cancer Alliance.
  Follow up is done yearly on each patient           The Cotton-O’Neil Cancer Center now has
for his or her lifetime. Follow up is tracked      a pediatric oncologist/hematologist who
to help determine effectiveness of treatment       coordinates care with other Cotton-O’Neil
and morbidity of disease.                          pediatric specialists, including surgeons,
 Information collected by the registry is          endocrinologists, hospitalists, infectious
used not only within the Stormont-Vail             disease specialists and other specialists.
HealthCare organization, but also for state          Outreach clinics are currently available
and national research and statistics.              with a medical oncologist from the Cotton-
 The registry is operated by Certified             O’Neil Cancer Center in communities in
Tumor Registrars who are required to               northeast Kansas.
maintain knowledge of current cancer                 Stormont-Vail HealthCare facilities use an
trends and treatments.                             electronic medical record system for
                                                   seamless outpatient registration and
                                                   interfacing between facilities.
Specialized Nursing                                  Stormont-Vail HealthCare is the only
The Cotton-O’Neil Cancer Center has two            facility in Kansas performing Palladium 103
nurse navigators, who provide individual,          seed implants for prostate cancer.
comprehensive education and support to               Yearly skin and prostate screening
oncology patients. Nursing is provided by a        programs are offered on-site and free of
dedicated oncology trained nursing staff,          charge.
including 10 Oncology Certified Nurses.              Stormont-Vail HealthCare maintains
                                                   Magnet Status by the American Nurses
                                                   Credentialing Center.
                                                  Edwin Petrik, MD
                                                 Medical Degree – University of Kansas
                                                 School of Medicine in Kansas City.
                                                 Clinical interests include all forms of solid
                                                 tumors and general internal medicine.

                                                  Stanley Vogel, MD
                                                 Medical Degree – Washington University
                                                 School of Medicine in St. Louis. Board
                                                 certified in internal medicine and medical
                                                 oncology. Clinical interests include
                                                 clinical research.

                                                            Pediatric Specialist
                                                               Joins Staff
                                                 Cotton-O’Neil Cancer Center is proud to
                                                 introduce one of our newest physicians,
                                                 Jakica Tancabelic, MD, a pediatric
Medical Oncologists:                             oncologist/hematologist who is now
                                                 available for patient referrals. Dr.
 Karissa Boyd, DO                               Tancabelic comes to us from the University
Medical Degree – University of Health            of Kansas School of Medicine, where she
Sciences College of Osteopathic Medicine in      served as the Chief of Pediatric
Kansas City. Board certified in internal         Hematology/Oncology since 2007.
medicine. Clincal interests include blood         Dr. Tancabelic works with patients along
diseases, solid cell tumors and improved         with a multi-disciplinary team of specialists
health of her patients.                          who diagnose and determine appropriate
                                                 treatment for children and teens with cancer
 Adrian Caracioni, MD                           or blood disorders.
Medical Degree - Timisoara Medical School in
Romania. Board certified in internal medicine,
medical oncology and hematology.

 Jyothi Dodlapati, MD
Medical Degree – Osmania Medical College
in India. Board certified in internal medicine
and medical oncology. Clinical interests
include general oncology and breast cancer.

 David Einspahr, MD                              Jakica Tancabelic, MD
Medical Degree – University of Nebraska          Medical Degree – University of Rijeka
School of Medicine in Omaha. Board certified     Medical School in Croatia. Board certified
in internal medicine, medical oncology and       in pediatrics and pediatric
hematology. Clinical interests include anemia,   hematology/oncology. Clinical interests
blood clotting disorders and cancer heredity     include pediatric blood disorders and
syndromes.                                       pediatric oncology.
   Radiation Oncologists:

   Stephen Coon, MD
  Medical Degree – University of Kansas
  School of Medicine in Wichita. ACR
  board certified.

   Russell Greene, MD
  Medical Degree – University of
  California in Irvine. ACR board

   Judith Kooser, MD
  Medical Degree - Rush Medical College
  in Chicago. ACR board certified.

                Dr. Vogel Enrolls 1,000th Patient in Clinical Research Trial

Dr. Stanley Vogel, a medical oncologist at Cotton-      He has also served on SWOG committees and has
O’Neil Cancer Center and long-time clinical             served as an auditor of quality of life SWOG site
researcher, has enrolled his 1000th patient in a        visits.
clinical research trial. Dr. Vogel has been involved      Under Dr. Vogel’s guidance, the Cotton-O’Neil
in clinical research trials for more than 30 years      Cancer Center has developed a progressive clinical
and was one of the first physicians in the Topeka       research program for patients with a diagnosis of
area to participate in research trials.                 cancer. It typically has 60-70 open research trials
 “Dr. Vogel is known for his dedication and             available to patients and provides screening to see
commitment to his patients and those he has             if they match protocols and are interested in
treated in clinical research trials. To reach a         participating. The Cotton-O’Neil Cancer Center
milestone like this is phenomenal,” said Maynard        was nationally recognized by the American Society
Oliverius, president and chief executive officer of     of Clinical Oncology for its clinical research
Stormont-Vail. “Dr. Vogel has furthered the             contributions. The Cotton-O’Neil Cancer Center
quality of care for patients with cancer for many       also became affiliated as a major clinical research
years to come because of his participation and          partner of the Midwest Cancer Alliance, a network
oversight of clinical trials.”                          of cancer professionals dedicated to increasing
 Clinical research trials are health-related research   access to the latest advancements in cancer care
studies done with people that follow a specific         throughout the Heartland.
protocol to measure the outcome of a treatment or         “Dr. Vogel is recognized nationally for his work
intervention. Results of studies can become new         with clinical trials. His work has enhanced the care
treatment standards and lay the groundwork for          of patients in the region for decades,” said Dr.
the next study.                                         Gary Doolittle, medical director for the Midwest
 Dr. Vogel has participated in Southwest                Cancer Alliance.
Oncology Group (SWOG) trials since 1978 and has           For a current list of open clinical trials through
registered patients predominantly in treatment          the Cotton-O’Neil Cancer Center, go to:
trials. He is responsible for the treatment and
follow-up for the patients while they are on trial.                   from The Vital Connection, July 2, 2010
                                         2009 New Cases by Primary Site Total

                Misc Sites
         Multiple Myeloma
              Male Genital
            Female Genital
      Oral Cavity/Pharynx
             Other Urinary
          Urinary Bladder
           Other Digestive

                              0           25               50   75           100         125          150

Cotton-O’Neil Cancer Center to
  Participate in ONS Project                                              2010 Cases Presented at Tum or Conference

The Cotton-O’Neil Cancer Center has been                             45
selected to participate in a three-year project that
will develop, test and evaluate quality of care                      40

measures for patient– and survivor-centered                          35
experiences of diverse populations of women
with breast cancer. The national project is being
funded through a $1.54 million grant being                           25
distributed by the Oncology Nursing Society
Foundation for the Breast Cancer Fund of
National Philanthropic Trust.                                        15
 The goals of the multi-year initiative are to
develop a process for testing patient- and
survivor-centered quality measures and to                            5
develop and disseminate education about the
use of patient-centered breast cancer quality
                                                                                      ph l


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measures in ambulatory practices to improve


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safe and effective cancer care. Quality measures





focused on the care of patients undergoing

                                                                   n i er
                                                                 Be th

active treatment for early-stage breast cancer

will undergo reliability and validity testing in 30
to 50 pilot sites.
                from The Vital Connection, June 25, 2010
                              Breast Cancer Data & Survival 2005 & 2006
                                      Stormont-Vail HealthCare
                                                 David Einspahr, MD

  The Cancer Registry data was queried for all incident cases of breast cancer in each of 2005 and 2006. Salient
data regarding demographics, stage of disease, tumor markers, and surgery utilized, along with data for survival
and recurrence through 2009 was obtained. Data was tabulated for interpretation.
  Over the two years reviewed, data was consistent in year-to-year comparisons in each data set – demographics,
tumor markers, surgery utilized and recurrence/survival. In our sample, breast cancer is predominately a disease
of women over fifty (83%), is predominately estrogen receptor positive (71%), and predominately found early
(Stage I 33%, Stage II 29%).
  Initial treatment utilized in the majority of cases was limited surgery with radiation therapy (54%). Reconstructive
surgery was often combined with single mastectomy, while the operation of modified radical mastectomy, with or
without reconstruction, was utilized in 10% of women.
  Data for recurrence and survival is available out to four years of follow-up. The low recurrence rate for all stages
(11%) is reassuring of the adequacy of care provided. Recurrences for Stage I (2 of 88) and Stage II (7 of 78) are
well within national norms. Stage III disease remains a challenge with 6 of 20 patients having died with disease
recurrence. Although only a few patients present with Stage IV disease (n=8, 3%), the disease remains treatable,
with approximately half of the patients (5 of 8) surviving within the period of follow-up.

                                          Age and Tumor Markers
                                 <50            >50         ER +        HER2neu +         all Negative
                 2005             22            104          81            16                  16
                 2006            22             113          105            14                   17

               Combined          44             217          186            30                   33

                                      Surgery Utilized
                                         2005             2006              Combined
   Local Excision                         64               79                 143
   Simple Mastectomy with or
   without reconstruction                 24               24                    48
   Modified Radical
   Mastectomy with or without             19                7                    26

                                                       Stage Distribution at Diagnosis
                                                                 2005                 2006            Combined
                                           Stage I                 40                  48                 88
                                           Stage II                45                  33                 78
                                          Stage III                 9                  11                 20
                                          Stage IV                  5                   3                  8
                                              0                    13                   5                 18
                                        99 (unknown)               10                  27                 37

                                  Recurrence and Survival
                                  2005                      2006                      Combined
   Recurrence                      16                        15                       31 (11%)
   Deaths                          11                         9                        20 (7%)
                         Prostate Screening Clinic
The National Cancer Institute indicates that prostate cancer is the most common
cancer, excluding skin cancer, and the second leading cause of cancer-related death in
men in the United States. If prostate cancer is found and treated at an early stage, the
survival rate is near 100%. Cotton-O’Neil Cancer Center offers an annual free
screening, looking for prostate cancer before symptoms arise.

In 2009, 446 men participated in the free prostate screening. Seventy-seven men had
abnormal results, with either an abnormal DRE (digital rectal exam), an elevated PSA
(prostate-specific antigen), or a combination of both. Five of these men were found to
have prostate cancer.

The American Urological Association and the American Cancer Society recommend
annual screening for men aged 50 to 70. Stormont-Vail HealthCare and the Cotton-
O’Neil Cancer Center are dedicated in joining the fight against prostate cancer. By
providing our annual screening clinic, we strive to help protect the overall health of
our patients.
            Cancer Program Leadership Team
                    President/CEO – Maynard Oliverius
       Cancer Center Director – Vicky McGrath, MBA, BSN, OCN, RN
              Cancer Committee Chair – David Einspahr, MD
               Cancer Liaison Physician – Stanley Vogel, MD
                Diagnostic Radiologist – Timothy Allen, MD
                   General Surgeon – William Sachs, MD
                 Medical Oncologist – David Einspahr, MD
                     Pathologist – Sheila McMeekin, MD
                Radiation Oncologist – Russell Greene, MD
               Hospital Oncology Nurse - Salena Gillam, RN
                        Pain Control– Ian Kucera, MD
             Palliative Care – Connie Rundell, ARNP, ACHPN
              Performance Improvement – Martha Tucci, RN
                Cancer Conference – Kate Bure, RHIT, CTR
                     Quality Control – Karla Savoie, CTR
                   Clinical Research – Anita Leonard, RN
Social Work/Case Management – Beth Browder, MHSA, BSN, RN-BC, NE-BC
                   Clinic Social Work – Kim Olson, LMSW
                 American Cancer Society – Jennifer Taylor
                      Community Outreach – Anita Fry
                Rehabilitative Services – Gerald Appelhans
             Our Mission
     Working together to improve
     the health of our community

            by the American
Accredited INSERT PICTURE College
of Surgeons Commission on Cancer

  Find our link at

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