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					        Annual Report
        Cancer Care Centers
     at Blue Ridge HealthCare
Grace Hospital and Valdese Hospital
       With Statistical Data from 2008




                                         1
Table of Contents                                                                                                                   Acknowledgements
Message from the Cancer Committee Chair…..............................................3                                             We want to acknowledge and
                                                                                                                                    thank Cancer Committee
Cancer Committee Membership 2008………………………….………….. 3
                                                                                                                                    members, cancer program staff
Summary of Cancer Services                                                                                                          and others who supported our
      Case Management………………………………………………………………….. 4                                                                                  cancer center program this past
      Home Health……………………………………………………………………….. 4                                                                                    year.
      Financial Counselor………………………………………………………………… 4
      Medical Oncology………………………………………………………………….. 4                                                                                  ………….
      Patient Navigator........................................................................................................ 4
      Pathology ………………………………………………………………………….. 5                                                                                    This report was prepared
      Pharmacy…………………………………………………………………………… 5                                                                                       by BRHC staff from the
      Radiology and Imaging Services…………………………………………………... 5                                                                        Cancer Registry and
      Radiation Oncology ……………………………………………………………….. 5                                                                               Marketing and
      Rehabilitation Services…………………………………………………………….. 5                                                                            Communications, with
                                                                                                                                    guidance from the Cancer
Summary of Support Services                                                                                                         Committee. Requests for
      Food & Nutrition …………………………………………………………………..                                                                             6
                                                                                                                                    more information can be
      Hospice……………………………………………………………………………..                                                                                   6
                                                                                                                                    directed to the Cancer
      Pastoral Care………………………………………………………………………..                                                                               6
                                                                                                                                    Registry at 828-580-6875
      Phifer Wellness Center……………………………………………………………..                                                                          6
                                                                                                                                    or 828-879-7685.
      Tobacco Prevention…………………………………………………………………                                                                              6
Program Activities 2008
     Goals Accomplished……………………………………………………………….. 7
     Program Improvements…………………………………………………………….. 7
     Quality & Outcome Studies………………………………………………………… 7
     Community Outreach……………………………………………………………….. 8
     Cancer Education…………………………………………………………………… 9
Professional Education Programs 2008……………………………………10
Cancer Registry Report…………………………………………………....11
     Grace Hospital Statistics………………………………………………………….. 12
     Valdese Hospital Statistics………………………………………………………... 16
Breast Cancer – 2008 Site Review
     Grace Hospital……………………………………………………………………..20
     Valdese Hospital……………………………………………………………….…..23
Words from the Heart……………………………………………………..26
Program & Support Services Contact Information……………………… .27
                                                                                                                                                               2
Cancer Center Location & Map………………………………………….. 28
                                                                                             Cancer Committee
                                                                                             Membership Listing 2008
                     Christopher R. McDonald, MD
                            Medical Oncologist/Hematologist                                                             Kathy Bailey
                                                                                             Dr. Christopher McDonald
                               Cancer Committee Chair                                        Chair Cancer Committee     V.P., Administration
                                                                                             Medical Oncologist         Tina Brooks
                                                                                                                        Pharmacy
                                                                                             Dr. William Cloud
                                                                                             Physician Liaison          Camille Welch,
                                                                                             General Surgery            Tobacco Prevention Coordinator

The Cancer Center at Blue Ridge HealthCare continues its dedication to being the             Dr. Dorwyn Croom           Debbie Dale
region’s pre-eminent provider of cancer care services in Burke County and surrounding        Pathology
                                                                                                                        Oncology Service Line Director
areas. The cancer care team is committed to enhancing life by providing excellent
care. We have a devoted cancer care team that coordinates and delivers                                                  Amy Davis
                                                                                             Dr. Benjamin Garrou        Burke County Hospice
comprehensive, compassionate, multi-disciplinary patient care using the latest               Family Practice
advanced technologies and innovative techniques.                                                                        Lindsay Wall
                                                                                             Dr. Edwin Holler           Financial Counselor
In 2009, both Grace and Valdese Hospitals have been re-accredited by the American            General Surgery
                                                                                                                        Carol Ervin
College of Surgeons (ACoS), Commission on Cancer (CoC). Maintaining CoC                                                 Nursing Administration
accreditation ensures our patients will have access to a full range of services necessary    Dr. Alan Jacks
to diagnose, treat, rehabilitate and support patients with cancer and their families. With   Physician Liaison          Kim Ellingson
increasing technologies and early detection the Blue Ridge cancer program and                General Surgery            Radiation Oncology
services continue to grow.
                                                                                             Dr. Gregory Jones          Kathleen Foote
                                                                                                                        Cancer Registry
                                                                                             Radiation Oncology
Our cancer conference consists of physicians, nurses, and support services that meet
bi-weekly to discuss newly diagnosed cases in order to establish the best treatment          Dr. John Lafferty
                                                                                                                        Sue Hall, RN
available for that particular patient’s cancer.                                              Obstetrics/Gynecology
                                                                                                                        Medical Oncology

                                                                                                                        Karen Hicks, RN
The facility at Valdese Hospital is outstanding in our area – equipped to provide the        Dr. Timothy Robinson       Medical Oncology
highest level of care available in a community setting. In 2008, the cancer center           Family Practice
                                                                                                                        Rachel Hobbins
completed the addition of a new vault and linear accelerator. Radiation Oncology in                                     Food & Nutrition
2009 upgraded a linear accelerator to include On Board Imaging (OBI) and Rapid               Dr. Michael Skolochenko
Arc. A satellite medical oncology office is located at Grace Hospital in the Medical         Family Practice            Jan Hollar
Office Building. Two medical oncologists, Muhammed Janjua, M. D. and Doug                                               Cancer Services Coordinator
Thompson, M.D., have been recruited to join our team in 2010.                                Dr. John Spiggle
                                                                                             Urology                    William Minor
                                                                                                                        Quality Improvement
We at BRHC Cancer Center will continue to strive for that perfect mix of quality staff       Dr. W. Frank Steele
and intelligent, loving care that provides hope and support in the fight against cancer in   General Surgery
                                                                                                                        Barbara Rush
our community.                                                                                                          American Cancer Society

                                                                                             Dr. Scott Whiddon          Diana Spangler-Crawford
                                                                                             Radiology                  Chaplain

                                                                                             Dr. Jamie Young            Delores Wall, CTR
                                                                                                                        Cancer Registrar
                                                                                             Internal Medicine
                                                                                                                        Anne Coffey
                                                                                                                        Social Work               3
  CANCER SERVICES                                                Medical Oncology: BRHC’s Medical
                                                                 Oncology services are available to
                                                                 inpatients and outpatients, 18 years or
Case Management: The Case Management Department                  older, with a diagnosis of cancer/blood
consists of social workers and nurse case managers whose         dyscrasias. Care is delivered by skilled
goal is to improve the quality of life for patients and their    staff including a medical oncologist,
families through coordination of care with community             registered nurses, and registered nurses
resources, helping the patients adjust to and cope with the      with oncology certifications. Other
changes and circumstances brought on by prolonged or             patient care needs are coordinated with
terminal illness. The social worker serves as the liaison        home health, hospice, food and nutrition   BRHC Oncology
between the interdisciplinary team, physician and community      services, radiation oncology, physical     certified nurses
resources such as the American Cancer Society, Hospice,          therapy, laboratory, pharmacy,
Home Health, skilled nursing facilities and other community      radiology and patient/family services.     Certifications
support groups to ensure that the patients and their families
are linked with the appropriate resources.                                                                  Certifications in oncology
                                                                 Patient Navigator: The Patient             nursing makes a difference,
                                                                 Navigator for Breast Health is a           not only to the nurse who
Home Health Care: BRHC’s Home Care agency can                    professional counselor/coordinator who     works to elevate his or her
accept patients with a cancer diagnosis who are homebound        specifically provides patient support      knowledge, but to the
and under the care of a physician. They provide a single         upon diagnosis of breast cancer. She       patients whose care is
service or a combination of services in the patient's home all   may assist with issues as broad as         provided by a more skilled
under the care and direction of a physician. The care is         understanding physician prescribed         staff.
individualized to meet each patient’s special needs and to       treatment options, obtaining
ensure that services are designed to accomplish the goals and    medications, dealing with hair loss,
outcomes of each patient. Home Health provides continuity        arranging transportation and much
of care and a smooth transition from the hospital to home                                                   Karen Hicks, RN, OCN
                                                                 more.
while providing care and treatment in the home that can                                                     Mary Wise, RN, OCN
prevent re-hospitalization and urgent care visits.
                                                                                                            Wanda Mace, RN, OCN

Financial Liaison: The Patient Financial Liaison helps                                                      Sherry Rockett, RN, OCN
determine patient resources and assists with insurance and                                                  Peggy Hewitt, RN, OCN
other financial matters. These may include: medication
reimbursement, food assistance (Meals on Wheels), applying
for Medicaid, and more.



                                                                                                                           4
Pathology: The Clinical and Anatomic Pathology Laboratory at
BRHC supports the hospital’s Cancer Program through a number of
clinical and anatomic pathology services. The laboratories are
accredited by the College of American Pathologists Laboratory
Accreditation Program (CAP) and by the Centers for Medicare and
Medicaid Services (CLIA). Four pathologists, all board certified in
Anatomic and Clinical Pathology, direct the laboratory, ensuring
prompt and accurate results. One of the pathologists serves on the
Cancer Committee and attends the Cancer Conferences to present the
pathologic findings on each case.

Pharmacy: The Department of Pharmacy Services at BRHC provides
chemotherapeutic agents at both Valdese Hospital and Grace Hospital.
The Pharmacy prepares the medication doses for Oncology and assists
with drug dosing, standing orders for medications and literature           Rehabilitation Services: At BRHC’s Rehabilitation Services, our
searches. Pharmacists work closely with the nursing staff and              professional and highly skilled staff provides patients, families, and
physicians to provide the most appropriate therapy possible for the        caregivers with the resources, training and support needed to best
patients being treated in our Medical Oncology facilities.                 guide them through the recovery process. By giving our patients the
                                                                           level of care they need and closely monitoring their progress, we help
                                                                           them get their lives back on track as quickly as possible.
Radiation Oncology: The Radiation Oncology Department for                  Rehabilitation Services include: Physical Therapy, Occupational
BRHC is located at the Valdese campus. We offer our services to in-        Therapy, Speech Therapy, Hand Therapy, Lymphedema Therapy, and
patients and outpatients from 18 years of age and older that have been     Aquatic Therapy.
diagnosed with benign or malignant tumors for a prescribed series of
treatments. We perform teletherapy treatment (conformal and IMRT
external beam irradiation), brachytherapy treatment (seed implant for
gynecological and prostate irradiation), and superficial x-ray treatment
(skin lesions and pterygium cases). Our highly skilled team consists of
a Radiation Oncologist, Registered Nurse, Certified Medical
Dosimetrist, a Physicist and a team of Radiation Therapists that are all
supported by our dedicated front office personnel.

Radiology (Imaging) Services: The Department of Diagnostic
Imaging provides state of the art technologies to diagnose diseases at
BRHC. Some of the technologies offered are Multi-detector CT,
High-resolution 512K ultrasound, State-of-the-art Gamma cameras,
PET/CT Tomography, High strength 1.5 Tesla MRIs, Computerized
radiography, Mammography/Computer Aided Detection, Vacuum
Assisted Breast Biopsy, and Image Guided Interventions.




                                                                                                                                                5
SUPPORT SERVICES
Food and Nutrition: For the cancer patient, the registered
dietician may provide nutritional counseling or
recommend food supplements. They also provide
education and resources to help the patient understand
their unique nutritional needs as it relates to their treatment
regimen. The clinical nutrition staff participates in the
HOPE support group as requested and a clinical dietitian is
an active member of the Cancer Committee and Tumor
Board.
                                                                  Phifer Wellness Center: Phifer encompasses two areas
Hospice: Burke Hospice and Palliative Care, Inc. (BHPC)           related to the prevention, education and well being of
as an integral part of BRHC, leads in the planning and            persons with cancer through our Restorative yoga and
provision of services at the end of life. BHPC sponsors a         therapeutic massage programs. Cardiac Rehab nurse, Beth
Palliative Care program which provides support to people          Blanton, offers cancer survivors and patients a class twice
living with any type illness, such as cancer, who are             a week in Restorative Yoga. The licensed massage
undergoing aggressive treatment. Personnel actively               therapists at Phifer are experienced in therapeutic massage
participate in the Tumor Board and Cancer Committee               that can aid the cancer patient in relieving pain, improving
meetings.                                                         sleep, decreasing fatigue and removing toxins in the body.

Pastoral Care: When a patient has been given a diagnosis          Tobacco Prevention: The Tobacco Prevention project
of cancer, the chaplain often plays an important role in          provides prevention, education and resources to reduce the
counseling and listening – both to the patient and family         number of teens who use tobacco, increase the number of
members facing the uncertainty of life with cancer. In            teens who wish to quit using tobacco, and expand TRU
some cases they can help obtain financial support for the         (Tobacco Reality Unfiltered) Club youth advocacy
patient through the Chaplain’s Discretionary Funds. Our           membership. The project also works with the community
chaplains are also experts in advance directives and can          to decrease youth exposure to secondhand smoke by
assist with the completion of a living will or healthcare         increasing the number of smoke free youth venues,
power of attorney.                                                compliance with Tobacco-Free Schools policies, and
                                                                  partnering with the local American Cancer society to
                                                                  advocate for more Burke County restaurants to go smoke
                                                                  free.


                                                                                                                           6
  Program Activities 2008
                   Goals Accomplished 2008

• A colorectal study investigated the number of patients being
                                                                                          Quality & Outcomes Studies
  diagnosed at an earlier stage and compared 2008 data to 2004,
  2005, 2006 and 2007 data. At Valdese Hospital the majority of
  patients continue to be diagnosed at a later stage, Stage IV. At       • A 2008 colorectal study was done to evaluate the stage at
  Grace Hospital, the majority of patients were diagnosed at Stage 1       diagnosis. At Grace most colorectal cases are being diagnosed at
  and II. We will continue this study in 2009.                             Stage II. At Valdese, most cases are being diagnosed at Stage III.
• A study to ascertain if radiation therapy was administered within        More screenings are being done now helping to decrease the
  one year of diagnosis for women under age 70 who had also                higher stages.
  received breast conserving surgery for breast cancer. At both
  Grace and Valdese Hospitals, all patients received radiation therapy   • A study to evaluate if a needle biopsy was performed prior to breast
  or it was recommended.                                                   cancer surgery was conducted. At Valdese, 44% of breast cancer
• Determine the number of breast cancer patients contacted at              cases underwent needle biopsy prior to excision. At Grace, 25%
  diagnosis who remain at BRHC for care, goal 60%. Develop a               had needle biopsy prior to surgery. This study will be continued.
  patient survey regarding patient navigation services. Determine          The Cancer Committee recommended that physicians discuss with
  the percentage of patients with positive diagnosis being consulted       patients the benefit of needle biopsy.
  by the patient navigator, goal 75%. The percentage of patients
  remaining at BRHC for care is 85%. The survey was developed and
  implemented with 100% rating. A very high percentage, 98%, of
  patients with positive diagnosis are being consulted by the patient
  navigator. This service will continue in 2009.

                Program Improvements 2008

• Started a Lymphedema Support Group
• Added an additional linear accelerator at Valdese
  Radiation Oncology
• Added a patient education computer for Radiation
  Oncologist to discuss radiology studies with patients.



                                                                                                                                             7
  Program Activities 2008
                                               Community Outreach
During 2008, we increased participation in patient support programs by 10%. In 2008 we began offering art therapy to cancer
patients and established free wig styling with local cosmetologists for our patients. We continue to provide drug assistance for
patients, nutritional consults and cardiopulmonary therapy.

The BRHC Cancer Program participates in the American Cancer Society’s Relay for Life fundraiser each year. In 2008, BRHC
sponsored a team with approximately 30 people in attendance. In addition we implemented Road To Recovery Program of the
American Cancer Society for patient assistance with transportation.

In 2008, we hosted “Putting For The Pink” Golf Tournament raising over $7000.00 for Komen Breast Cancer Foundation and
assisted with “Cut For The Cure” which raised $10,000.00 for Komen Foundation.

In June 2008, we held National Cancer Survivor’s Day with over 500 in attendance. The Cancer Center staff sponsors and
participates in this event for our cancer patients and survivors.

Our Tobacco Prevention Program was successful in increasing the number of smoke-free policies in local businesses frequented by
youth and educating local merchants about the “Red Flag” campaign aimed at reducing underage tobacco sales. We provided
training for dental and medical professionals in Burke County regarding spit tobacco education and cessation.

In our community, we were able to participate in 24 health fairs/screenings and reached approximately 8000 individuals at these
events. We provided 453 free PSA screening tests, 2 free skin screenings to 150 individuals, 550 free colorectal screening kits and
one community program on colorectal cancer.



                                                                                                                                   8
 Program Activities 2008
                                            Cancer Education
Our Cancer Support Program goal is to help people with cancer be as comfortable as possible in a physical, emotional,
and/or spiritual sense, as they go through their illness. BRHC continues to offer several FREE programs throughout the
year.
                   Restorative Yoga Classes – every Tuesday at Phifer Wellness Center, 11:30am-12:30pm
  The Look Good Feel Better Program – third Monday each month at Valdese Cancer Center (pre-registration required)
                                  Financial Counseling – Cancer Center Financial Counselor
                    Information and Education – free brochures, videos, books, and audiotapes available
                                       in our resource center at Valdese Cancer Center
Our HOPE Cancer Support Group continues to meet the second Monday of each month at The Learning Center behind
Grace Hospital at 6:00pm.
              January 12 – Facing Life’s Challenges (Facilitator – Greg Brown, MDTV, MED, LDC)
              February 9 – Healing Power of Storytelling (Facilitator – Jan Hollar)
              March 9 – Discovering Your Body’s Wisdom (Facilitator – Kristine White)
              April 13 – Yoga for Cancer Care (Facilitator – Beth Blanton, RN)
              May 11 – Facing Life’s Challenges (Facilitator – Greg Brown)
              June 8 – The Price Is Right (Facilitator – Wanda Mace, ICN, Mary Wise, OCN and Peggy Hewitt, OCN)
              July 13 – Music Is Therapy (Facilitator – Helen Moore, PA-C)
              August 10 – Update on Cancer (Facilitator – Karen Hicks, RN)
              September 14 – Healing Power of Storytelling (Facilitator – Jan Hollar)
              October 12 – An Attitude of Gratitude (Facilitator – Kristine White)
              November 9 – Music Therapy
              December 14 – Christmas Party                                                                              9
Professional Education Programs 2008
As required by the Commission on Cancer, the physicians, nurses and other allied health professionals participate in cancer related
educational activities each year. In our continuing effort to provide relevant and new topics for our professional staff, the Cancer
Program at BRHC offered two educational programs in 2008.



         Karen Russell and Judy Ray presented a program on
                “Benefits of Healing Touch Therapy.”


   Walter Shephard, Director of North Carolina State Cancer
    Comprehensive Program presented a program on state
                          initiatives.




                                                                                                                              10
 CANCER REGISTRY REPORT
The Cancer Registry reports cancer information to the National Cancer Data Base and
North Carolina Central Cancer Registry on an annual basis. Most importantly this data is
used to analyze current trends to improve patient care by comparing diagnostic studies,
treatment, stage and survival data for national research. The Cancer Registry is also        Delores Wall, RHIT,
required to conduct a lifetime follow up of the patients.                                    CTR, BRHC System
                                                                                             Cancer Registrar, joined
The Grace Hospital Cancer Registry database consists of 4050 patients since our              the Cancer Registry in
reference year of 1995. The Valdese Hospital Cancer Registry database consists of 4765       1998 at Grace Hospital.
patients since our reference year of 1985.                                                   In 2003, Delores assumed
The Grace Registry collected data on 195 cases in 2008; 74 males and 121 females. The        responsibility for the
majority of Grace patients came from Burke, Caldwell and McDowell counties. Analytic         Valdese Hospital Cancer
cases totaled 183; 64 males and 119 females. The following graphs are based on the           Registry. Delores earned
analytic data.                                                                               her CTR in 2002.

The Valdese Registry collected data on 357 patients; 165 males and 192 females. The
majority of Valdese patients came from Burke, Caldwell and Catawba counties. Analytic
cases totaled 309; 139 males and 170 females. The graphs that follow are based on
analytic data.
The Cancer Committee oversees the registry activity by ensuring quality of data
collection through monitoring of abstracting. The registry is responsible for coordinating
Tumor Boards at each hospital where a majority of newly diagnosed cases are discussed.
This facilitates in providing the most comprehensive care for the cancer patient.            Kathleen Foote, CTR,
                                                                                             Cancer Registrar, BRHC
                                                                                             Cancer Registry, was
                                                                                             certified by the National
                                                                                             Cancer Registrars
                                                                                             Association in September
                                                                                             2008. Kathleen has
                                                                                             worked in several areas of
                                                                                             the cancer program since
                                                                                             2004.


                                                                                                          11
                                                                 GRACE HOSPITAL STATISTICS

                                                                                         In 2008 breast cancer was again the top cancer
                                                                                         site. Grace Hospital saw an increase in colorectal
                                                                                         cancer cases diagnosed and treated.

    55

                       Top 5 Cancer Sites - Analytic Cases


                                                                                                           Top 5 Sites by Stage - Analytic Cases



                           Males 40      Females 102

                 25



                                   17
           15
                                         13

                                                             8
                                                                         5
                                                                 4




Breast    Colorectal          Bronchus, Lung             Bladder     Ovary




  The Cancer Care Outreach program continues
                                                                                               Breast     Colorectal         Bronchus, Lung        Bladder        Ovary
  to promote early detection through                                         Stage 0            15                                                   4
  mammography and colorectal screenings. As a                                Stage I            17             7                    7                7
  result, the majority of the top 5 sites were                               Stage II           19            15                                     1
                                                                             Stage III           4            14                    8                              4
  diagnosed at an early stage, providing earlier
                                                                             Stage IV                          3                    13                             1
  treatment options and increased survival.                                  Unstageable                       1                    2




                                                                                                                                                             12
                                                                                               152


                                                                                                                  County at Diagnosis - Analytic Cases

Grace Hospital continues to treat patients from
surrounding counties offering the latest high-tech
tools, drugs and other treatment options
supporting the most excellent cancer care in the
region. The majority of our patients are diagnosed
in the seventh decade of their life.


                                                                                                         10         10
                                                                                                                                    7
                                                                                                                                                   2       1          1


                                                                                              Burke   McDowell   Caldwell      Catawba           Avery   Lincoln    South
                                                                                                                                                                   Carolina
           Age at Diagnosis by Sex - Analytic Cases
                                                                          39



                                   Males - 64

                                   Females - 119
                                                                21
                                                      18                           19
                                                           17        16
                                         15
                                                13

                                                                               8
                                     6
                             4
                                                                                        2 3
             1           1

            20-29       30-39       40-49       50-59      60-69     70-79     80-89    90+




                                                                                                                                                                          13
The Cancer Registry at Grace Hospital recorded a total of 195 cases this year. Analytic cases consisted of 183,
with 12 cases being non-analytic. Analytical cases were diagnosed and/or had part of their first course of treatment
at Grace Hospital whereas non-analytical cases were seen for recurrence of cancer.



   2008 CANCER INCIDENCE:                  2008 TOTAL         Male        Female         Analytic         Non-Analytic

   PRIMARY SITE (All Sites)                             195          74            121              183                  12

   ORAL CAVITY & PHARYNX

   Nasopharynx                                            1                         1                1

   Oropharynx                                             1          1                               1

   DIGESTIVE SYSTEM

   Esophagus                                              1          1                               1

   Stomach                                                3          3                               3

   Small Intestine                                        1          1                               1

   Colon, excluding rectum                               36          15            21               34                   2

   Rectum, Rectosigmoid                                   6          2              4                6

   Anus, Anal Canal                                       2          2                               2

   Liver, Intrahepatic Bile Duct                          3          1              2                3

   Pancreas                                               2          2                               1                   1

   RESPIRATORY SYSTEM

   Lung, Bronchus                                        30          17            13               30

   Pleura                                                 1                         1                1

   Soft Tissue                                            1          1                               1

   MELANOMA - SKIN                                        3          3                               2                   1


                                                                                                                              14
2008 CANCER INCIDENCE:               2008 TOTAL        Male        Female        Analytic        Non-Analytic

PRIMARY SITE (All Sites Continued)                47          25            22              41                  6

BREAST                                            57                        57              55                  2

FEMALE GENITAL SYSTEM

Cervix Uteri                                      1                         1               1

Corpus & Uterus, NOS                              4                         4               4

Ovary                                             5                         5               5

MALE GENITAL SYSTEM

Prostate                                          7           7                             1                   6

Testis                                            2           2                             2

URINARY SYSTEM

Urinary Bladder                                   12          8             4               12

Kidney & Renal Pelvis                             2           2                             2

NERVOUS SYSTEM                                    1                         1               1

ENDOCRINE SYSTEM

Thyroid                                           4           2             2               4

Other Endocrine                                   1                         1               1

NON-HODGKIN LYMPHOMA                              3           2             1               3

MULTIPLE MYELOMA                                  2           1             1               2

LEUKEMIA                                          1                         1               1

MISCELLANEOUS                                     2           1             1               2




                                                                                                                15
                                                               VALDESE HOSPITAL STATISTICS

                                                                                In 2008 the number of cancer cases diagnosed and /or
                                                                                treated at Valdese Hospital increased. Lung and breast
                                                                                cancer were the top cancer sites.
                 70             Top 5 Cancer Sites - Analytic Cases




                         Males 90
 38                      Females 134
      34
                                             27                                                                   Top 5 Sites by Stage - Analytic Cases

                              20
                        16
                                                                          10
                                                                      8
             1

  Lung       Breast     Colorectal           Prostate           Hematopoietic

                                                                                                     Bronchus,
                                                                                                                 Breast          Colorectal      Prostate Gland   H&R
                                                                                                       Lung

The Cancer Care Outreach program continues to                                          Stage 0                    10
                                                                                       Stage I          11        25                  1
promote early detection through mammography                                            Stage II          1        22                  8                   25
and colorectal screenings. As a result, breast                                         Stage III        27        12                 20
cancer cases are being diagnosed at an early stage,                                    Stage IV         33         2                  7                   2
                                                                                       Unstageable                                                                18
providing earlier treatment options and increased
survival.
                                                                                                                                                                   16
                                                                                              227

Valdese Hospital continues to treat patients from                                                                                   County at Diagnosis - Analytic Cases

Burke and surrounding counties offering the latest
high-tech tools, drugs and other treatment options
supporting the most excellent cancer care in the
region.
At Valdese, the majority of patients were
                                                                                                              49
diagnosed in their 7th decade. The age range was
from 22 to 93 with average age being 65.                                                                                  16            12
                                                                                                                                                            2             1             1            1




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                                                                                                                                            Ru
                          Age at Diagnosis by Sex
                                                                   48

             Males -139                                       43
                                                         38
             Females - 170                          36
                                       31 30

                                                                             24

                                 18
                                                                        16

                     9       8

     2 1         1                                                                2 2


     20-29       30-39      40-49      50-59        60-69     70-79     80-89     90+




                                                                                                                                                                                                         17
The Cancer Registry at Valdese Hospital recorded a total of 357 cases this year. Analytic cases consisted of 309,
with 48 cases being non-analytic. Analytical cases were diagnosed and/or had part of their first course of
treatment at Valdese Hospital whereas non-analytical cases were primarily diagnosed and treated elsewhere.

  2008 CANCER INCIDENCE                          Total         Male         Female         Analytic         Non-Analytic

  PRIMARY SITE (All Sites)                               357          165            192              309                  48

  ORAL CAVITY & PHARYNX

  Gum, other mouth                                        3            3                               3

  Nasopharynx                                             3            2              1                3

  Tonsil                                                  2            2                               2

  Oropharynx                                              2            1              1                2

  Hypopharynx                                             1                           1                1

  DIGESTIVE SYSTEM

  Esophagus                                               6            6                               6

  Stomach                                                 1                           1                1

  Small Intestine                                         1            1                                                   1

  Colon Excluding Rectum                                 36           20             16               30                   6

  Rectum, Rectosigmoid                                    7            2              5                6                   1

  Anus, Anal Canal                                        3            3                               3

  Liver, Intrahepatic Bile Duct                           2            2                               2

  Gallbladder                                             2                           2                2

  Pancreas                                                9            4              5                8                   1

  Retroperitoneum                                         1            1                               1

  RESPIRATORY SYSTEM

  Nasal Cavity                                            1                           1                                    1

  Larynx                                                  5            4              1                5

  Lung, Bronchus                                         80           41             39               72                   8

  Pleura                                                  1                           1                1

  SOFT TISSUE                                             1                           1                1

  MELANOMA - SKIN                                         3            1              2                3                        18
2008 CANCER INCIDENCE                Total         Male         Female         Analytic         Non-Analytic

PRIMARY SITE (All Sites Continued)           357          165            192              310                  47

BREAST                                       78            1             77               71                   7

FEMALE GENITAL SYSTEM

Cervix Uteri                                  2                           2                2

Corpus & Uterus, NOS                          4                           4                4

Ovary                                         4                           4                4

Vagina                                        1                           1                1

MALE GENITAL SYSTEM

Prostate                                     34           34                              27                   7

Testis                                        4            4                               4

URINARY SYSTEM

Urinary Bladder                               2            2                                                   2

Kidney & Renal Pelvis                         2            2                               1                   1

BRAIN & OTHER NERVOUS SYSTEM                  4            2              2                4

ENDOCRINE SYSTEM

Thyroid                                       3            2              1                3

Other Endocrine                               1                           1                                    1

LYMPHOMAS

Hodgkin Lymphoma                              1                           1                1

Non-Hodgkin Lymphoma                         15            6              9               11                   4

MULTIPLE MYELOMA                              9            6              3                7                   2

LEUKEMIAS

                                                                                                               5


Lymphocytic Leukemia                          9            4              5                4

Myeloid & Monocytic Leukemia                  2            1              1                2

MESOTHELIOMA                                  2            2                               2                        19
MISCELLANEOUS                                10            6              4                9                   1
Breast Cancer – 2008 Site Review at Grace Hospital
  Breast Cancer Overview
  Breast cancer is the most frequently diagnosed malignancy in women (excluding skin cancer). According to the American
  Cancer Society Cancer Facts and Figures, in the U.S. an estimated 184,450 new cases of breast cancer would be diagnosed
  in 2008, representing 26% of all cancers diagnosed in women. An estimated 5,000 of these cases were expected to be in
  North Carolina. Of that number, it was projected that 71 new cases would be Burke County residents. Though the death
  rates have decreased since 1990, breast cancer ranks second after lung cancer as the leading cause of cancer death in
  women. Early detection and improved treatment options are key in the fight against cancer.

  Grace Hospital Experience – 2008 Cases
  Since 1995 Grace Hospital has been collecting data on cancer and breast cancer has consistently been the most common
  cancer diagnosed and treated. In 2008, Grace Hospital saw 55 newly diagnosed cases of breast cancer. Of these, the
  majority of patients were diagnosed in their 7th decade of life and greater than 90% were diagnosed at an earlier stage.
  (refer to Figure 1,and Figure 2).

  Early detection can help detect breast cancer at an early stage. This saves lives and increases treatment options available
  for the patient. Grace Hospital patients are diagnosed by mammogram followed by biopsy for abnormal findings.
  Screening guidelines from the American Cancer Society recommend yearly mammograms starting at age 40, clinical breast
  exams about every 3 years and every year for women 40 and older, and screening MRI for women with approximately 20-
  25% or greater lifetime risk of breast cancer. This early detection and diagnosis is indicative of increased survival rates at
  five years. At Grace Hospital 80% of the cases diagnosed at early stage survive 5 years or more. Cases diagnosed at later
  stage have a 70% survival rate at 5 years.

  Treatment Options
  Patients at Grace Hospital received up-to-date advances in cancer therapy including the latest in surgical options, highly
  precise technology in radiation treatment, modern advances in chemotherapy and hormone modulation therapy as needed.
  The best news for cancer patients in Burke County is that they can feel confident about treatment options in their own
  community (refer to Figure 3). Grace Hospital is committed to continuing to upgrade our facilities and stay on the cutting
  edge of technology with standards of care here that match or exceed what patients would find at any other cancer facility in
  the U.S.




                                                                                                                             20
                                  Breast Cancer - 2008 - Age at Diagnosis
                                              Grace Hospital



                                                                     18
                                                                                                                Figure 1. Age at Diagnosis
      55 Cases
                                                                                                                In 2008, Grace Hospital saw 55 newly
      Average age - 64
      Age Range - 36 to 94                                                                                      diagnosed cases of breast cancer. Of
                                                                                                                these, the majority of patients were
                                                                                                                diagnosed in their 7th decade of life with
                             10                                                                                 the average age at diagnosis to be 64.
                                                    9
                                   8


                                                                             6




       3


                                                                                      1



      30-39              40-49    50-59           60-69             70-79   80-89     90+


                                                                                            Breast Cancer - 2008 - Stage at Diagnosis


                                                                                                                              19

                                                                                                                                        55 Cases
                                                                                               17


                                                                              15




Figure 2. Stage at Diagnosis
In 2008, Grace Hospital saw 55 newly
diagnosed cases of breast cancer. Of these,
greater than 90% were diagnosed at an                                                                                                                 4


earlier stage.

                                                                            Stage 0           Stage I                       Stage II               Stage III


                                                                                                                                                               21
                                                                 Figure 3. Treatment of Breast Cancer Diagnosed 2000-2006
                                                                 Compared to other community cancer centers in North Carolina,
                                                                 the majority of patients diagnosed with breast cancer at Grace
                                                                 Hospital were offered surgery, radiation and hormone therapy.




Figure 4. Stage of Breast Cancer Diagnosed 2000 to 2006.
Compared to other community cancer centers in North
Carolina, the majority of patients diagnosed at Grace Hospital
with breast cancer were early stage reported cases. 88% of the
cases were diagnosed at Stage II or better, as compared to 84%
at all other facilities.



                                                                                                                          22
Breast Cancer – 2008 Site Review at Valdese Hospital
  Breast Cancer Overview
  Breast cancer is the most frequently diagnosed malignancy in women (excluding skin cancer). According to the American
  Cancer Society Cancer Facts and Figures, in the U.S. an estimated 184,450 new cases of breast cancer would be diagnosed
  in 2008, representing 26% of all cancers diagnosed in women. An estimated 5,000 of these cases were expected to be in
  North Carolina. It is expected that 71 of these will be Burke County residents. Though the death rates have decreased
  since 1990, breast cancer ranks second after lung cancer as the leading cause of cancer death in women. Early detection
  and improved treatment options are key in the fight against cancer.

  Valdese Hospital Experience – 2008 Cases
  Valdese Hospital has been collecting and analyzing data on cancer cases since 1985. In 2008, Valdese Hospital diagnosed
  and/or treated a total of 71 new cases of breast cancer. The average age at diagnosis was 63 and a majority of patients were
  diagnosed at Stage I (refer to Figure 1,and Figure 2).

  Early detection saves lives and increases treatment options for the patient. Screening guidelines from the American Cancer
  Society recommend yearly mammograms starting at age 40, clinical breast exams about every 3 years and every year for
  women 40 and older, and screening MRI for women with approximately 20-25% or greater lifetime risk of breast cancer.
  This early detection and diagnosis can help detect breast cancer at an early stage which is indicative of increased survival
  rates at five years. At Valdese Hospital 85% of the cases diagnosed at early stage survive 5 years or more. Cases
  diagnosed at later stage have a much less survival rate.

  Treatment Options
   Patients at Valdese Hospital received up-to-date treatment options in cancer therapy including surgery, highly precise
  technology in radiation treatment, modern advances in chemotherapy and hormone modulation therapy as needed. The best
  news for cancer patients in Burke County is that they can feel confident about treatment options in their own community
  (refer to Figure 3). Valdese Hospital is committed to continuing to upgrade our facilities and stay on the cutting edge of
  technology with standards of care here that match or exceed what patients would find at any other cancer facility in the U.S.


                                                                                                                            23
                                 Breast Cancer - 2008 - Age at Diagnosis
                                            Valdese Hospital



      71 Cases                                                              22
                                                                                                                      Figure 1. Age at Diagnosis
      Average age - 63
                                                                                                                      In 2008, Valdese Hospital saw 71 newly
                                                             17                                                       diagnosed cases of breast cancer. Of these, the
                                                                                                                      majority of patients were diagnosed in their 7th
                                         14
                                                                                                                      decade of life with the average age at diagnosis
                                                                                                                      to be 63.
                          9


                                                                                              6


         3




       30-39             40-49         50-59               60-69           70-79             80-89



                                                                                                               Breast Cancer - 2008 - Stage at Diagnosis
                                                                                                                            Valdese Hospital




                                                                                                       25


                                                                                                                                  22




Figure 2. Stage at Diagnosis                                                                                                                                 12

                                                                                     10
In 2008, Valdese Hospital saw 71 newly
diagnosed cases of breast cancer. Of these,
the majority were diagnosed at Stage II or
better which represents greater than 80%                                                                                                                                  2


diagnosed at an earlier stage.
                                                                                   Stage 0           Stage I                    Stage II                   Stage III   Stage IV



                                                                                                                                                                                  24
                                                               Figure 3. Treatment of Breast Cancer Diagnosed 2000-2006

                                                               Compared to other community cancer centers in North Carolina,
                                                               the majority of patients diagnosed with breast cancer at Valdese
                                                               Hospital were offered surgery, radiation and hormone therapy.




Figure 4. Stage of Breast Cancer Diagnosed 2000 to 2006.

Compared to other community cancer centers in North
Carolina, the majority of patients diagnosed at Valdese
Hospital with breast cancer were early stage reported cases.
81% of the cases were diagnosed at Stage II or better, as
compared to 80% at all other facilities.



                                                                                                                    25
Words from the heart
“I honestly love the people who work in The Cancer Center. When you
walk through the doors, you know you’re in a place where people
understand what you are going through, and truly care about how you
feel.”
-Leigh Mazaleski, Morganton, NC

“When you have cancer you get depressed easily – you just get so tired
having to go back and forth to treatments. But when you walk into The
Cancer Center you definitely begin to have hope –”
-Vicki Dula, Lenoir, NC

-“When I first learned I had cancer I was scared to death. But as I went to
The Cancer Center every week, seeing the same wonderful people, the
fear passed…They know how to encourage you and keep you going.”
- Nancy Thomas, Glen Alpine, NC




                                                                          26
Program & Support Services Contact Information
  Breast Prosthesis and Bras
        Burke Pharmacy          828-437-5800        Complementary Care
        East Burke Pharmacy 828-397-3420            Look Good Feel Good
        Second To Nature        1-800-789-7306
                                                         Rhonda Crowe        828-438-4643
  Cancer Center                 828-879-7536
  Cancer Registry                                   Wigs
        Grace Hospital          828-580-6875             Rhonda Crowe        828-438-4643
        Valdese Hospital        828-879-7685
  Cancer Resource Center        828-879-7536        Resource Directory
  Cancer Services Coordinator
                                                    Diagnostic Imaging
        Jan Hollar              828-580-6703
  Chemotherapy                                            Grace Hospital      828-580-6901
        Grace Hospital          828-580-6700              Valdese Hospital    828-879-7611
        Valdese Hospital        828-879-7536        Cancer Foundation         828-580-5357
  Financial Counselor                               Health Information Management
        Lindsay Wall            828-879-7536
                                                          Grace Hospital      828-580-6887
  Hospice & Palliative Care     828-1601
  Outpatient Infusion Center 828-879-7536                 Valdese Hospital    828-874-2251 x381
  Pastoral & Spiritual Services                     Home Health Services      828-580-6455
        Dennis Stamper          828-580-5143        Nutritional Services
        Diana Spangler-Crawford 828-874-2251 x114         Rachel Hobbins      828-874-2251 x142
  Patient Navigator
                                                    Phifer Wellness Center    828-580-6615
        Dolly Wilson            828-228-4898
  Radiation Oncology            828-879-7536        Rehabilitation Services   828-879-7592
  Social Services                                   Wound Care                828-879-7563
        Tracy Copas             828-580-5405
        Anne Coffey             828-874-2251 x259
  Tobacco Prevention
        Camille Welch           828-580-6728
                                                                                                  27
 For more information or to make an
 appointment, call 828-879-7536, or visit
 www.wherehopegrows.org


The Cancer Center at Blue Ridge HealthCare
Main Campus - Valdese Hospital
I-40, Exit 113 • 1 mile North of Interstate
720 Malcolm Blvd.
Rutherford College, NC
 Phone: 828-879-7536




                                  28

				
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