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					      2007 ANNUAL REPORT
       Incorporating 2006 Statistics




S URVIVORSHIP
C OMMUNITY-B ASED S UPPORT
   •
OUTREACH
   •
P AT I E NT C A RE




                             The Holy Cross Hospital Cancer Institute cares

                             for more cancer inpatients annually than any

                             other hospital in Montgomery and Prince
   •




                             George’s counties. As a top provider of cancer
RESEARCH




                             services in the area, our focus is and always will

                             be the patient – more specifically successful

                             cancer survivorship.
   •
T R E ATME NT
   •
S TAFF
   •
E QUIPMENT




                                                            2007 ANNUAL REPORT 3
                     S URVIVORSHIP


                     A cancer diagnosis is a life-altering moment in an individual’s life. However,
                     more than ever, a diagnosis of cancer is not a death sentence. New treatment
                     options and innovative cancer therapies are helping cancer patients live healthy
                     lives long after their cancer diagnosis. Through our research programs and
                     treatment options, our primary goal is successful survivorship for every patient.
                           • We have state-of-the-art medical equipment, including our newly
                             purchased MRI (magnetic resonance imaging) scanner.
                           • We have added new health care staff while current staff members have
                             earned cancer-specific training and certification in order to keep their
                             skills up-to-date.
                           • We have effective treatments, delivered in a multidisciplinary setting.
                           • We offer a number of support services for cancer survivors.
                           • We provide community-based events where family members, friends or
                             any individual who wants to participate can do their part to support
                             cancer research or other services.
                     We do all of this because our goal is to provide the care, information and
                     resources cancer survivors need both while they are receiving therapy and after
                     they have completed treatment. We help our patients to be strong. We help give
                     them hope. We help them to fight. We help them to be survivors. That is our
                     purpose as health care providers here at Holy Cross Hospital.
                     In this report, we will tell you about the milestones and accomplishments we
                     have achieved in 2007. You will find out about the people, equipment, programs,
                     events and research that have helped us deliver the best possible cancer care
                     for our community.
                     Thank you for your continued support and partnership.
                     The Holy Cross Hospital Cancer Committee




2007 ANNUAL REPORT                                                                       2007 ANNUAL REPORT 1
                       2 0 0 7 H IGHLIGHTS




                       EQUIPMENT                                               self-care, which has been well received by patients.
                       In June 2007, Holy Cross Hospital completed the         One hundred lymphedema patients were treated
                       installation of the Siemens MAGNETOM Avanto –           in 2007 and our department consistently hits its
                       a revolutionary new magnetic resonance imaging          benchmarks for volume reduction in the
                       (MRI) scanner that enables radiologists to obtain       affected limbs.
                       the highest resolution full-body images faster,
                                                                               RESEARCH
                       helping physicians to diagnose and treat patients
                                                                               The National Surgical Adjuvant Breast and Bowel
                       more effectively.
                                                                               Project (NSABP), a clinical trials cooperative
                       As part of the XOFT, Inc. breast cancer study, the      research group supported by the National Cancer
                       Holy Cross Hospital Radiation Treatment Center          Institute, invited Holy Cross Hospital to participate
                       received the XOFT machine to provide a new              in its first national research study examining
                       targeted therapy for breast cancer.                     cancer survivorship. This research study is a
                       PEOPLE                                                  collaborative effort with the University of
                       Staff member Diane Bryson, PTA, took the course         California, Los Angeles, and is supported by a
                       to become a lymphedema therapist, allowing              grant from the American Cancer Society. The study
                       more patients to be seen in a more timely fashion.      addresses the need to examine important issues
                                                                               in long-term colon and rectal cancer survivors by
                       Five of our nursing staff became certified in hospice
                                                                               assessing quality of life, symptoms and health
                       and palliative care, which helps meet our goal of
                                                                               behaviors.
                       providing the highest standards of clinical
                       competence to patients.                                 In September 2007, the Legacy Lung Screening
                                                                               and Smoking Cessation Project opened at Holy
                       An oncology social worker was hired to provide
                                                                               Cross Hospital. We are one of only three sites
                       emotional support, offer referrals to community
                                                                               conducting this study nationally. The Legacy Lung
                       resources and assist cancer patients, particularly
                                                                               Screening and Smoking Cessation Project is part
                       in outpatient settings. Her services are available
                                                                               of the International Early Lung Cancer Action
                       for newly diagnosed cancer patients and patients
                                                                               Program (I-ELCAP) which is the largest, long-term
                       receiving radiation and chemotherapies in our
                                                                               study to determine the usefulness of annual
                       outpatient centers. She also is available for
                                                                               screening using low-dose spiral CT (computed
                       patients who are followed in the community by
                                                                               tomography) to detect lung cancer in smokers or
                       our oncologists.
                                                                               ex-smokers who are at least 50 years of age. Like
                       TREATMENT                                               I-ELCAP, the Legacy Project also is investigating
                       The Holy Cross Hospital Radiation Treatment             the effectiveness of brief smoking cessation
                       Center focused on developing targeted therapy           counseling on individuals who smoke. Both
                       programs for breast cancer and prostate cancer,         I-ELCAP and Legacy Studies are sponsored by the
                       and developing the stereotactic radio surgery           Weill Medical College of Cornell University.
                       program. Many women were treated with the high
                                                                               The Radiation Treatment Center entered into a
                       dose radiation unit for breast cancer – using
                                                                               research study with XOFT, Inc. – treating one
                       Mammosite® technology. The Radiation Treatment
                                                                               patient with this new targeted therapy for
                       Center has a robust prostate treatment program,
                                                                               breast cancer.
                       which includes prostate seed implantation.
                                                                               PATIENT CARE
                       The Holy Cross Hospital Physical Medicine
                                                                               The Holy Cross Hospital Palliative Care service
                       department developed a DVD that contains
                                                                               became a 24-hour, seven-day-a-week,
                       information for patients about home lymphedema


2007 ANNUAL REPORT 2
                                                                             2 0 0 7 H IGHLIGHTS




interdisciplinary team service, led by a board-certified   Assistance, a total of 270 women received breast
physician, Barbara Supanich, MD, RSM. Other                health education, free clinical breast examinations,
members added to the team were Bonnie Dank,                mammograms, breast ultrasounds and follow-up
CRNP; Ruth Ebiasah, PharmD; and chaplain Linda             diagnostic services. Twenty-one underserved             The Healing Process
Arnold, PhD, BCC. Care is facilitated in part by a         Montgomery County community members received
secure Intranet website that provides access and           free colonoscopy screenings, all of which had
education to clinicians as well as patients and            negative findings.                                      “Two years after being
family members. Clinician education is offered             The overall outreach efforts of Holy Cross Hospital’s   successfully treated for
through grand rounds, the End-of-Life Nursing              community health department resulted in over            Stage 1 breast cancer, I
Education Consortium and Hospice and Palliative            35,000 educational encounters on cancer.
Nurses Association certification education. In                                                                     was diagnosed with
2007, the palliative care service provided care to         COMMUNITY-BASED SUPPORT                                 lymphedema and referred
more than 800 patients at Holy Cross Hospital              On June 2, 2007, Holy Cross Hospital participated       to Holy Cross Hospital’s
including 62 oncology patients and their families.         in the 2007 Komen National Race for the Cure.           Physical Therapy Depart-
                                                           There were 435 participants registered and the
Holy Cross Home Care celebrated its 40th                                                                           ment. It has now been
                                                           team raised an additional $6,000 in donations
anniversary in 2007. In conjunction with Kaiser                                                                    almost three years since
                                                           and pledges. More than 35 employees who are
Permanente, Holy Cross Home Care provided care                                                                     I started treatment for
                                                           breast cancer survivors participated in the race.
to 245 cancer patients. The agency provides
                                                                                                                   lymphedema and I’m living
home-based palliative care to cancer patients              The Holy Cross Hospital Pink in the Park Women's
                                                           Cancer Awareness Day with the Bowie Baysox              a perfectly normal and for
who are in treatment or may not be quite ready for
hospice. The goal of this program is to provide            took place on Sunday, Aug. 12, 2007. The Bowie          the most part unrestricted
enough support to these patients and families in           Baysox wore one-of-a-kind pink jerseys that were        life. Having received proper
a home setting preventing unnecessary                      auctioned during the game, raising more than            treatment has resulted in
hospitalizations or visits to the emergency room.          $7,300 for the Holy Cross Hospital Breast Fund.         the lymphedema not
                                                           Thirty cancer survivors were recognized before the
In 2007, the Holy Cross Hospice program expanded                                                                   having any affect on my
                                                           game and also participated in “field of dreams”
its inpatient hospice care to the hospital’s sixth                                                                 quality of life. I am a
                                                           by running onto the field with the players as they
floor oncology unit, working in collaboration with                                                                 happy, healthy and very
                                                           took their positions.
the palliative care consult team and oncology                                                                      much blessed breast
staff. Our hospice program provided                        On Sept. 26, 2007, the annual Country Goes Pink
                                                           fundraiser was held with festivities that
                                                                                                                   cancer, lymphedema
compassionate care to 165 terminally ill cancer
                                                           included line dancing, a concert, refreshments          survivor – much of which
patients.
Cancer is the primary diagnosis of 80 percent of           and raffles in an intimate setting. Holy Cross          I owe to the excellent
patients admitted to the hospice program.                  Hospital proudly accepted a $25,000 donation            treatment and care received
                                                           from Country Goes Pink, and funds were allocated        at Holy Cross Hospital.”
OUTREACH                                                   to support female cancer patients at the Holy
Holy Cross Hospital coordinated multiple                   Cross Hospital Cancer Institute.                              Veronica C. Stubbs
community screening events for prostate, colorectal,                                                                     Breast Cancer Survivor
                                                           For the first time, on Oct. 20, 2007, Holy Cross
cervical and breast cancers. More than 350
                                                           Hospital participated in the Leukemia & Lymphoma
community members were screened.
                                                           Society annual Light the Night walk. The Holy
In addition, with the support of the Susan G.              Cross Hospital team raised more than $700 for
Komen for the Cure Foundation, Montgomery                  the Leukemia & Lymphoma Society. Funds were
County Cigarette Restitution Fund Program and              raised by selling one-of-a-kind bracelets and
the Office of Minority Outreach and Technical              donations were collected at an afternoon tea.



                                                                                                                    2007 ANNUAL REPORT 3
                       2 0 0 7 H IGHLIGHTS




                       PATIENT AND FAMILY SUPPORT SERVICES                    protect the health and safety of our patients, staff
                       The artist-in-residence program in partnership         and visitors.
                       with Smith Farm Center for the Healing Arts provides   In collaboration with the Cancer Institute, the
                       access to specially trained artists for inpatients     hospital’s Community Health department provided
                       and outpatients and their families. On a daily         the Mayo Clinic Tobacco Treatment Specialist
                       basis, the artists awaken healing resources            Program to the community. There were more than
                       through the mediums of music, storytelling,            30 participants. Three Holy Cross Hospital
                       creative writing, movement and other activities.       Community Health staff members were certified
                       Smith Farm Center also offers a variety of healing     as tobacco treatment specialists.
                       retreats, creativity workshops and nutrition
                                                                              When Holy Cross Hospital went tobacco-free on
                       programs that support adults living with serious
                                                                              Nov. 15, 2007, the Nicotine Dependence Center
                       illness and their caregivers.
                                                                              was created to ease the transition. The mission of
                       Friendly, four-legged ambassadors from the pet         the center is to serve as a reliable and respected
                       therapy program visit patients, visitors and staff     resource for evidence-based tobacco use and
                       at least once a week.                                  dependence treatment for tobacco users, the
                       Local stained-glass artist, Micki Fuller, began        health care community and for the community
                       making butterfly ornaments to give hope to             we serve.
                       breast cancer patients and raise money for the         For our patients
                       hospital’s Cancer Institute, all in memory of her      New patients who identify themselves as smokers
                       daughter, Karen, who died from the disease             during the admission process will be seen by a
                       several years ago.                                     tobacco treatment specialist. Counseling and
                       Survivors Offering Support (SOS) is a support          medications are available to all patients.
                       program that pairs breast cancer survivor              For our visitors
                       volunteers with newly diagnosed breast cancer          Nicotine replacement therapy (patch and gum) is
                       patients. SOS establishes highly trained mentors       available for sale in our gift shop and outpatient
                       who provide patients with unique communication         pharmacy. Group counseling also is available.
                       support for their hospital care.
                                                                              For the community
                       Using an integrated approach, an on-site cancer        Group counseling, also known as “Nixing Nicotine”
                       risk and genetics testing counselor helps identify     is available. The group is led by a tobacco
                       individuals who may be at risk for the most            treatment specialist and provides a unique and
                       common hereditary cancers — breast, ovarian            supportive opportunity for each participant to learn
                       and colorectal — and suggests appropriate clinical     to be and stay tobacco free. Individuals first meet
                       interventions to improve prevention, early             with the tobacco treatment specialist to develop an
                       detection and treatment. This service is not           individualized quit/treatment plan.
                       restricted to Holy Cross Hospital patients; the
                       program accepts referrals from other area medical      CELEBRATING SURVIVORSHIP
                       centers that lack the service.                         More than 100 cancer survivors celebrated spirit
                                                                              and courage with their loved ones and caregivers
                       TOBACCO-FREE PROGRAM                                   at the first annual Celebration of Cancer
                       Holy Cross Hospital became a tobacco-free campus       Survivorship on Sept. 9, 2007, at the Holy Cross
                       on Nov. 15, 2007, the day of the Great American        Hospital Professional and Community Education
                       Smoke Out. All Montgomery County hospitals and         Center. Rev. Timothy Brown, SJ, was the keynote
                       Frederick Memorial Hospital made this move to          speaker.


2007 ANNUAL REPORT 4
C ANCER R EGISTRY

Since 1995, it has been the goal of Holy Cross        In addition to analyzing and capturing
Hospital’s (HCH) Cancer Registry to be the most       complete and accurate cancer data, the
trusted source of cancer data information. The        department was one of the key players in the
data collected and analyzed by the Cancer             American College of Surgeon’s Commission on
Registry is essential for reviewing survival,         Cancer survey process. This accreditation
cancer staging, treatment, tumor makers and           encourages Holy Cross Hospital to improve our
other data items essential for outcomes               quality of patient care through various cancer-
analysis. We hope this information will assist        related programs. These programs are focused
in monitoring the quality of patient care and         on prevention, early diagnosis, pretreatment
treatment outcomes, and be an important               evaluation, staging, optimal treatment,
source of data for facility utilization assessments   rehabilitation, surveillance for recurrent
and the allocation of resources by HCH                disease, support services and end-of-life care.
administrators as they plan for future needs.         As part of the accreditation process, the Cancer
                                                      Registry participated in the National Cancer
In 2007, there were some new initiatives              Data Base (NCDB) call for data for 2006, 2001,
implemented to ensure compliance with                 1996, 1991 and 1986. Participation in
providing quality patient outcome, which is           submitting this data provides HCH with the
centered on the National Quality Forum’s              opportunity to analyze comparative data with
endorsement of measures for breast and                other hospitals of similar size and organization
colorectal cancer care and the Centers for            throughout the nation. The Cancer Registry also
Medicare and Medicaid Services precursors to          regularly reports data to the state of Maryland
pay-for-performance measures. While these             Central Cancer Registry for national reporting to
measures are tracked in other states for pay-         the Centers for Disease and Control, National
for-performance measures, the data collected          Program for Central Cancer Registries.
are submitted to the Commission on Cancer’s
National Cancer database and are used by the
HCH Cancer Committee.




                                                                                         2007 ANNUAL REPORT 5
     TABLE 1. HOLY CROSS HOSPITAL                     2006 SITE DISTRIBUTION FOR ALL ANALYTIC CASES***
     SITE                                          TOTAL            SEX         CLASS OF CASE     STATUS                 AJCC STAGE DISTRIBUTION - ANALYTIC CASES ONLY
                                               N       %       M           F      Analytic      Alive   Expired   Stage 0    Stage I   Stage II   Stage III   Stage IV   88 **B/B   Unknown
     All Sites                                1353    100     433         920      1353         1000     353       133        364       349         193         162        115        37
     ORAL CAVITY & PHARYNX                     19      1.40   13          6        19            16       3          0         5          3          2           7          1          1
         Tongue                                 5      0.37    5          0          5            4       1          0         0          2          1           2          0          0
         Salivary Glands                        3      0.22    0          3          3            3       0          0         2          1          0           0          0          0
         Floor of Mouth                         1      0.07    1          0          1            0       1          0         0          0          0           1          0          0
         Gum and Other Mouth                    2      0.15    2          0          2            2       0          0         1          0          0           1          0          0
         Nasopharynx                            3      0.22    2          1          3            3       0          0         1          0          1           0          0          1
         Tonsil                                 3      0.22    2          1          3            3       0          0         1          0          0           2          0          0
         Oropharynx                             1      0.07    1          0          1            1       0          0         0          0          0           1          0          0
         Other Oral Cavity &F Pharynx           1      0.07    0          1          1            0       1          0         0          0          0           0          1          0
     DIGESTIVE SYSTEM                         192     14.19   85     107          192           108      84          8       29          50         37          44         15          9
         Esophagus                              7      0.52    7       0            7             2       5          0        1           0          1           4          0         1
         Stomach                               13      0.96    6       7           13             5       8          1        2           5          0           4          1         0
         Small Intestine                        7      0.52    2       5            7             6       1          0        0           0          0           1          6         0
         Colon Excluding Rectum                98      7.24   41      57           98            69      29          6       15          36         25          14          1         1
            Cecum                              25      1.85    9      16           25            15      10          1        4           4         10           5          0         1
            Appendix                            4      0.30    0       4            4             4       0          0        1           2          0           0          1         0
            Ascending Colon                    20      1.48   11       9           20            19       1          0        3          13          3           1          0         0
            Hepatic Flexure                     6      0.44    4       2            6             3       3          0        0           3          3           0          0         0
            Transverse Colon                    6      0.44    4       2            6             4       2          1        2           1          1           1          0         0
            Splenic Flexure                     3      0.22    1       2            3             2       1          0        0           1          1           1          0         0
            Descending Colon                    5      0.37    2       3            5             3       2          1        1           2          1           0          0         0
            Signoid Colon                      24      1.77    8      16           24            18       6          3        4          10          4           3          0         0
            Large Instestine, NOS               5      0.37    2       3            5             1       4          0        0           0          2           3          0         0
         Rectum and Rectosigmoid               24      1.77   18       6           24            17       7          1        5           5          8           4          1         0
            Rectosigmoid Junction               3      0.22    2       1            3             2       1          0        0           0          2           1          0         0
            Rectum                             21      1.55   16       5           21            15       6          1        5           5          6           3          1         0
         Anus, Anal Cavity & Anorectum          2      0.15    1       1            2             2       0          0        0           1          0           1          0         0
         Liver & Intrahepatic Bile Duct         7      0.52    5       2            7             1       6          0        1           0          1           2          0         3
         Other Biliary                          2      0.15    0       2            2             0       2          0        0           1          0           0          0         1
         Pancreas                              24      1.77    5      19           24             3      21          0        5           2          2          12          0         3
         Retroperitoneum                        2      0.15    0       2            2             1       1          0        0           0          0           1          1         0
         Peritoneum, Omentum, & Mesentary       6      0.44    0       6            6             2       4          0        0           0          0           1          5         0
     RESPIRATORY SYSTEM                       127      9.3    60      67          127            47      80          0       31          10         27          50          3          6
         Larynx                                 7      0.52    4       3            7             4       3          0        1           2          0           4          0          0
         Lung & Bronchus                      120      8.87   56      64          120            43      77          0       30           8         27          46          3          6
     BONES & JOINTS                             1      0.07    0          1          1            1       0          0         0          0          0           0          0          1
     SOFT TISSUE (including Heart)              5      0.37    3          2          5            4       1          0         1          2          0           0          1          1
     SKIN EXCLUDING BASAL & SQUAMOUS           19      1.40   13          6        19            16       3          3         7          1          4           3          1          0
         Melanoma - Skin                       17      1.26   11          6        17            15       2          3         6          1          4           3          0          0
         Other Nonepithelial Skin               2      0.15    2          0         2             1       1          0         1          0          0           0          1          0
     BASAL & SQUAMOUS SKIN                      7      0.52    6          1          7            5       2          0         3          0          1           1          1          1
     BREAST                                   287     21.21    0     287          287           263      24         54       91          92         39           6          0          5
     FEMALE GENITAL SYSTEM                    332     24.54    0     332          332           257      75         46      149          33         58          32          9          5
         Cervix Uteri                          57      4.21    0      57           57            52       5         25       14           3         10           4          0          1
         Corpus & Uterus, NOS                 152     11.23    0     152          152           123      29          2      102          15         17           9          6          1
           Corpus Uteri                       150     11.09    0     150          150           123      27          2      102          15         17           9          4          1
           Uterus, NOS                          2      0.15    0       2            2             0       2          0        0           0          0           0          2          0
         Ovary                                 80      5.91    0      80           80            47      33          0       25          10         25          17          1          2
         Vagina                                 5      0.37    0       5            5             3       2          1        2           0          1           0          1          0
         Vulva                                 30      2.22    0      30           30            25       5         17        3           4          4           1          0          1
         Other Female Genital Organs            8      0.59    0       8            8             7       1          1        3           1          1           1          1          0
     MALE GENITAL SYSTEM                      161     11.90   161         0       161           155       6          0         4       139          13           3          1          1
         Prostate                             155     11.46   155         0       155           151       4          0         0       139          12           3          0          1
         Testis                                 6      0.44     6         0         6             4       2          0         4         0           1           0          1          0
     URINARY SYSTEM                            50      3.70    31     19           50            34      16         22         9          8          0           9          0          2
         Urinary Bladder                       36      2.66    25     11           36            26      10         22         6          7          0           1          0          0
         Kidney & Renal Pelvis                 14      1.03     6      8           14             8       6          0         3          1          0           8          0          2
     BRAIN & OTHER NERVOUS SYSTEM              30      2.22     8     22           30            12      18          0         0          0          0           0         30          0
         Brain                                 15      1.11     7      8           15             3      12          0         0          0          0           0         15          0
         Other Nervous System                  15      1.11     1     14           15             9       6          0         0          0          0           0         15          0
     ENDOCRINE SYSTEM                          38      2.81    12     26           38            36       2          0       26           4          5           2          1          0
         Thyroid Gland                         37      2.73    11     26           37            35       2          0       26           4          5           2          0          0
         Other Endocrine (including Thymus)     1      0.07     1      0            1             1       0          0        0           0          0           0          1          0
     LYMPHOMAS                                 32      2.37    14     18           32            21      11          0         9          7          7           4          0          5
         Hodgkin Disease                        6      0.44     3      3            6             3       3          0         0          5          1           0          0          0
         Non-Hodgkin Lymphoma                  26      1.92    11     15           26            18       8          0         9          2          6           4          0          5
           NHL - Nodal                         24      1.77    10     14           24            16       8          0         9          2          5           4          0          4
           NHL - Extranodal                     2      0.15     1      1            2             2       0          0         0          0          1           0          0          1
     MULTIPLE MYELOMA                           8      0.59     4         4          8            4       4          0         0          0          0           0          8          0
     LEUKEMIAS                                 16      1.18     9         7        16             7       9          0         0          0          0           0         16          0
         Lymphocytic Leukemia                   7      0.52     5         2          7            4       3          0         0          0          0           0          7          0
           Acute Lymphocytic Leukemia           4      0.30     4         0          4            1       3          0         0          0          0           0          4          0
           Chronic Lymphocytic Leukemia         3      0.22     1         2          3            3       0          0         0          0          0           0          3          0
         Myeloid & Monocytic Leukemia           9      0.67     4         5          9            3       6          0         0          0          0           0          9          0
           Acute Myeloid Leukemia               5      0.37     3         2          5            3       2          0         0          0          0           0          5          0
           Chronic Myeloid Leukemia             4      0.30     1         3          4            0       4          0         0          0          0           0          4          0
     MESOTHELIOMA                               1      0.07     1         0          1            0       1          0         0          0          0           1          0          0
     KAPOSI SARCOMA                             1      0.07     1         0          1            1       0          0         0          0          0           0          1          0
     MISCELLANEOUS                             27      2.00    12     15           27            13      14          0         0          0          0           0         27          0

2007 ANNUAL REPORT 6
                                                                                                                                              Figure 1
The 2006 Cancer Experience                                                                                                     2006 MALE VS FEMALE BY AGE DIAGNOSIS

In 2006, a total of 1,341 new cancer cases were seen at Holy                                                   35                                               34

Cross Hospital (HCH). The site table (page 6) shows the
                                                                                                               30
distribution for all cancers seen at HCH in 2006 and the most                                                                                              27


common sites.                                                                                                  25




                                                                                            PERCENT OF CASES
                                                                                                                                                                          22
                                                                                                                                                                     21
Over 24 percent (329) of the cases diagnosed and treated at                                                    20                                     19
                                                                                                                                                                               18

HCH were gynecologic malignancies, followed by breast cancer at
                                                                                                               15                                14
21 percent (287). Fifteen percent (211) were genitourinary with
                                                                                                                                                                                      11
155 (over 11 percent) of these cancers being prostate. The                                                     10
                                                                                                                                             8
                                                                                                                                                                                           10



number of gynecologic cancer cases has increased from 232                                                                                6

                                                                                                                5
cases in 2005 to 329 cases in 2006, which is a 41 percent                                                                        3
                                                                                                                                                                                                           Male
                                                                                                                           2                                                                          2

increase. The overall volume of gynecologic cancer cases places                                                 0
                                                                                                                    1                                                                           1
                                                                                                                                                                                                           Female
                                                                                                                    0-29         30-39       40-49    50-59     60-69     70-79       80-89     90+
HCH at the top of gynecologic cancer care in the state of
Maryland.                                                                                                      AGE DISTRIBUTION


Of the total, 68 percent of the cases were female and 32 percent
were male. The majority of the patients lived in Montgomery
County (57 percent), while 22 percent came from Prince George’s                                                                              Figure 2
County, 2 percent were from Anne Arundel County and 8 percent                                                                   2006 DISTRIBUTION BY STATE/COUNTY
from the District of Columbia. An additional 11 percent were
referred from other states and foreign countries. See figure 2.
                                                                                                                MD-PRINCE GEORGE’S
                                                                                                                       22%
For more information regarding the statistics collected in the
                                                                                                                                                                                     DC 8%
Cancer Registry, please call 301-754-7542.
                                                                                                                                                                                     ALL OTHER 11%

                                                                                                                                                                                     MD-Anne Arundel 2%




                                                                                                                                                                                     MD-MONTGOMERY 57%




* Data on basal and squamous cell of the skin (AJCC T0, T1 and T2) are not included in the total.
** Includes cases not eligible for staging, borderline and benign brain tumors.
*** Analytic Cases are patients diagnosed at Holy Cross Hospital and/or received all or part of the first course of treatment here at Holy Cross Hospital.


                                                                                                                                                                                    2007 ANNUAL REPORT 7
                                                                    The National Lung Cancer Experience
                                                                    According to the American Cancer Society, lung cancer affected 213,380
                                                                    individuals in the United States in 2007. The state of Maryland contributed
                                                                    4,130 of those patients. An estimated 160,390 people died from lung
                          Figure 3                                  cancer in 2007. This figure surpasses the total number of people who will
         HOLY CROSS HOSPITAL LUNG CANCER HISTOLOGY                  die from prostate cancer, breast cancer, colon cancer and HIV combined.
                                                                    Tobacco exposure is the overwhelming major cause of lung cancer.
                                                                    However, there is a growing body of literature highlighting the unique
 CANCER TYPE              SUBTYPE       NUMBER        PERCENTAGE    genetics and biology of those individuals who have no smoking history and
 Small Cell                               83             12.7%      are diagnosed with lung cancer. This class of cancer tends to fall into the
 Non-small Cell                          570             87.3%      adenocarcinoma subtype.
 Adenocarcinoma                          161             28.2%
 Squamous                                110             19.3%      In addition, there is growing data suggesting an increased responsiveness
 NOS                                     154             23.6%      to a certain class of drugs targeting the epidermal growth factor receptor in
 Bronchoalveolar                          30              5.2%      Asian women with no smoking history.
 Neuroendocrine                            5              0.9%

                                                                    The Holy Cross Hospital
                                                                    Lung Cancer Experience
                           Figure 4
                                                                    From 2002 to 2006, there were 653 individuals diagnosed with lung
      HOLY CROSS HOSPITAL AGE OF LUNG CANCER DIAGNOSIS
                                                                    cancer at Holy Cross Hospital of which 311 were males and 342 were
                                                                    females. The majority of patients were diagnosed between the ages of 70
50%
                                                                    to 79, which corresponds with the national average. See figure 4. In
45%                                                                 addition, 52 percent of the cases were diagnosed in women, as compared
40%                                                                 to 47 percent in men. This is contrary to the national average of 43 percent
35%                                                                 of cases being diagnosed in women and 57 percent in men. This may
30%                                                                 reflect our strong emphasis on women’s health and the fact that many
25%                                                                 women in the area consider Holy Cross Hospital as the primary hospital for
20%                                                                 all of their medical needs. The majority of our patients were diagnosed at
15%                                                                 either stage III or IV, consistent with the national averages.
10%
                                                                    Figure 3 demonstrates that just as in the rest of the country,
5%
                                                                    adenocarcinoma and squamous cell cancer account for the majority of
0%
      0-29   30-39   40-49    50-59   60-69   70-79   80-89   90+   cases. There are a large number of cases that are NOS (Not Otherwise
                                                                    Specified), which is an area of increasing importance, in light of the new
                                                                    therapies that are based on histology (specifically the distinction between
                                                                    adenocarcinoma and squamous cell carcinoma).




             2007 ANNUAL REPORT 8
Once the diagnosis of lung cancer was made, the treatment
provided at HCH reflected the stage at which the patient was
diagnosed. For patients diagnosed with non-small cell                                                                          Figure 5
carcinoma at HCH, 30 percent of the patients underwent                                                 FIVE YEAR SURVIVAL RATES—NON-SMALL CELL CANCER
surgery, compared to the National Cancer Data Base (NCDB)
                                                                                           100
where only 18 percent underwent surgery. There were fewer                                                                                                  NCDB Stage O
                                                                                                                                                           n=288
                                                                                           90
patients who received radiation and chemotherapy compared
                                                                                                                                                           HCH Stage I
to the NCDB data, 23 percent and 10 percent, respectively. At                              80                                                              n=28
                                                                                                                                                           NCDB Stage I
HCH, 12 percent of patients had surgery followed by                                        70                                                              n=14836

chemotherapy, compared to 7 percent reported by the NCDB.                                  60                                                              HCH Stage II
                                                                                                                                                           n=9
Both HCH and the NCDB reported high percentages of patients                                                                                                NCDB Stage II
                                                                                           50
                                                                                                                                                           n=5402
receiving no first course of treatment, 28 percent and 22
                                                                                           40
percent, respectively.                                                                                                                                     HCH Stage III
                                                                                                                                                           n=21
                                                                                           30                                                              NCDB Stage III
For patients diagnosed with small cell carcinoma, the number                                                                                               n=16784
                                                                     Percent Surviving     20
reported by HCH (14 cases) were fewer than those reported in                                                                                               HCH Stage IV
                                                                                                                                                           n=33
                                                                                            10
the NCDB-ACS Southeast division – 71 cases. In both HCH data                                                                                               NCDB Stage IV
                                                                                                                                                           n=22070
and NCDB, the data reflects similarity with patients treated                                0
                                                                                                 Dx             1       2       3         4    5
with radiation only, 7 percent. The data reported by the NCDB                              Years Surviving

showed that 31 percent of patients received radiation and
chemo compared to HCH – 14 percent. HCH reported a higher
percentage of patients receiving no first course of treatment,
36 percent and 13 percent, respectively.

As shown in figure 5, HCH’s non-small five-year survival rates                                                                 Figure 6
for AJCC Stages are as follows: Stage I (55 percent), Stage II (22                                            FIVE YEAR SURVIVAL RATES—SMALL CELL CANCER
percent), Stage III (19 percent), and Stage IV (3 percent). These
                                                                                           100
rates seem to be better that the NCDB survival rates: 42                                                                                                    NCDB Stage O
                                                                                                                                                            n=56
                                                                                            90
percent, 24 percent, 9 percent, 2 percent, respectively. During                                                                                             HCH Stage I
                                                                                            80                                                              n=2
the five-year analysis of the data reported by the cancer
                                                                                                                                                            NCDB Stage I
Registry, there were no patients diagnosed with stage 0                                     70                                                              n=972

                                                                                                                                                            NCDB Stage II
non-small cell lung cancer.                                                                 60                                                              n=549


As shown in figure 6, HCH’s five-year small cell survival rates                             50                                                              HCH Stage III
                                                                                                                                                            n=2
are depicted compared to the NCDB. Interestingly, the NCDB                                  40                                                              NCDB Stage III
                                                                                                                                                            n=4060
reports five-year survival data for AJCC Stage 0 small cell lung                            30
                                                                                                                                                            HCH Stage IV
cancer. During the five-year analysis of the data reported by                                                                                               n=12
                                                                       Percent Surviving




                                                                                            20
                                                                                                                                                            NCDB Stage IV
HCH Cancer Registry, there were no patients diagnosed with                                                                                                  n=7722
                                                                                            10
stage 0 or stage II small cell lung cancer.
                                                                                             0
                                                                                                  Dx             1      2       3         4    5
                                                                                            Years Surviving

Dr. Kashif Firozvi, MD, medical oncologist

NCDB Benchmark Reports, v9.0
American Cancer Society, Cancer Facts and Figures – 2007
American Cancer Society, Inc. 2007, page 6
Holy Cross Hospital Cancer Registry Database
1500 Forest Glen Road
Silver Spring, MD 20910
301.754.7000
www.holycrosshealth.org

				
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