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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
