Christiana Care Cancer Update November 2013

Celebrating Ten Years of Transforming Cancer Care November 2013

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IN TH I S

Nurse Navigator Charlene Marinelli, BSN, OCN, speaks with a patient.

I S S U E

Innovations in patient care

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Research: Our name and mission

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Screening that makes a difference

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Care beyond diagnosis

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Triple negative breast 11 cancer study findings What’s next for cancer care?

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The Friends celebrate 13 10 years of giving

One of the original 14 cancer centers in the nation selected for the National Cancer Institute Community Cancer Centers Program.

On the cover: Helen F. Graham Cancer Center & Research Institute leadership team (from left) Patrick Grusenmeyer, Sc.D., FACHE, Nicholas J. Petrelli, M.D., and William Holden, MBA, RN, RT (T), (R)

Christiana Care is a private, not-for-profit regional health care system that relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. To learn more about our mission, please visit christianacare.org/donors.

Cancer Update is produced by Christiana Care Health System. Š Christiana Care Health System, 2013. All rights reserved.

HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE CELEBRATES 10 YEARS OF TRANSFORMING CANCER CARE A national leader in comprehensive, multidisciplinary cancer treatment, services and research Ten years ago, the Christiana Care Cancer Program took a giant leap toward transforming how we deliver quality, value-driven cancer care and services to our community.

The Helen F. Graham Cancer Center & Research Institute opened its doors and is now home to an entire continuum of cancer care resources – the very essence of our comprehensive, multidisciplinary approach.

“What we do inside and outside these walls isn’t just a job to us, it is our vocation,” said Bank of America endowed and founding Medical Director

Nicholas J. Petrelli, M.D. “We celebrate the lives and the experience of the many people who have come to us for care and treatment, but our focus is fixed forward on the greater challenge — to end the specter of cancer.”

Dr. Petrelli and his leadership team, including Senior Vice President of Cancer and Imaging Services and President of Health Initiatives Patrick Grusenmeyer, Sc.D., FACHE, and Graham Cancer Center Vice President William Holden, MBA, RN, RT (T), (R), are change leaders in an ongoing effort to systematically transform Delaware’s cancer profile.

“What we do inside and outside these walls isn’t just a job to us, it is our vocation.”

NI C H OLAS J. P ETRELLI, M.D. Bank of America endowed and founding medical director

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Cancer rates are declining, thanks in part to the cancer treatment and technological advances we have introduced to the region and to our collaborations on cancer screening and prevention with other Delaware hospitals, providers, state government and community outreach groups.

In 2002, Delaware had the highest cancer mortality in the nation. Today, we are number 14 on that list, and the state’s cancer mortality rates for both men and women are dropping twice as fast as the national average.

A landmark accomplishment in 2007 was being chosen by the National Cancer Institute (NCI) to serve as an NCI-selected Community Cancer Center Program (NCCCP). This means we are part of an elite national network collaborating to bring the latest cancer treatments to patients in their own communities.

Today, we rank among the country’s top five NCCCPs, and we have earned recognition as a model for cancer

treatment, research and supportive care. NCI funding to continue this work will reach $5.2 million by June 2014.

This year, we also earned three-year reaccreditation with commendation from the American College of Surgeon’s Commission on Cancer, signifying our cancer program meets or exceeds 34 Commission on Cancer quality standards.

Our patients speak the loudest about what we accomplish here. That is why 95 percent of them return to the Graham Cancer Center for treatment after second opinions in Philadelphia, New York or Baltimore. 

In the pages that follow are a few highlights, among many, of how the Helen F. Graham Cancer Center & Research Institute is transforming cancer care, not just in our local community and wider region, but across the nation…

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INNOVATIVE PATIENT CARE AND TREATMENT PROGRAMS Multidisciplinary cancer specialists meet regularly to plan patient care.

The Graham Cancer Center is recognized as a national model for our multidisciplinary cancer care.

We have established 13 multidisciplinary, disease-specific treatment centers (MDCs) for every type of cancer.

We also have developed specialized programs for cancer survivorship; mind, body, spirit, and wellness; pain and symptom management; smoking cessation and a follow-up clinic for young adults who have survived childhood cancer.

At our MDCs, patients meet with an entire team of specialist, all in one visit — a surgeon, medical oncologist, geneticist, radiation oncologist, health psychologist, nurse

navigator, subspecialists and support staff — to map out their personalized treatment plans. Studies show that patients do better in this type of multidisciplinary care setting.

“We continue to receive affirmation that our multidisciplinary approach to cancer care is producing positive outcomes in the lives of our patients and their families,” said Christiana Care Cancer Program Clinical Director Patricia Strusowski, MS, RN. “Not only are we helping patients here, but through leadership roles nationally, we are able to share our experience and knowledge gained with cancer programs around the country.”

“““Although the message was overwhelming, I left the meeting knowing I was getting the best, scientifically based treatment with access to all the support services I might need.”

BARBARA BRIGGS, a patient at the Graham Cancer Center

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Our nurse navigator program, one of the first in the nation, now serves as a model for similar programs around the country. Christiana Care nurse navigators have helped more than 70,000 patients with some 650,000 individual support services as they “navigate” their journeys through cancer treatment and survivorship. Graham Cancer Center staff host on-site educational programs and have developed webbased educational programming to train nurse navigators at other community cancer centers.

“I’m here to reinforce, listen, comfort, answer questions, coordinate appointments and help in any way I can.”

Latonya Mann, RN, OCN

“I’m here to reinforce, listen, comfort, answer questions, coordinate LATONYA MANN, RN, OCN appointments and help patients any way I can.” Nurse Navigator LaTonya Mann, RN, OCN. “I’m here until you tell me you don’t need me anymore.”

Leading edge technologies and advanced surgical techniques, supported by the latest minimally invasive cancer staging and treatment modalities, including Video Assisted Thoracic Surgery and robotic surgery, are more reasons our patients prefer not to travel far from home for their cancer treatment.

“It is amazing how thoracic surgery has advanced here in the last decade,” said Chief of Thoracic Surgery Thomas Bauer, M.D. “We have a successful multidisciplinary

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aerodigestive dilation and stenting program with both gastroenterology for esophageal stenting and pulmonary for airway stenting. We have transformed our pulmonary surgery capabilities, and are now using almost exclusively minimally invasive techniques.”

A state-of-the-science Radiation Oncology program serves patients at three locations in Maryland and Delaware and will soon open at the Concord Health

Sunjay Shah, M.D., and Karen Karchner, RN, OCN

Center in Pennsylvania. Our radiation oncologists are leaders in adapting the latest imaging and treatment advances into clinical practice: external beam radiation delivered by our newest-generation linear accelerators with precise 4D treatment planning; image-guided intensity modulated radiation therapy (IGT/IMRT) stereotactic radiosurgery, and high-dose-rate brachytherapy to treat gynecologic, skin and breast cancers.

We offer Delaware’s first and only CyberKnife robotic radio surgery system that targets hard-to-treat tumors, particularly in the brain, lung and spinal cord, with pinpoint accuracy.

“The Radiation Oncology Department is committed to delivering the highest quality treatment using state-ofthe-science technology and to fostering a culture of safety and responsibility,” said Christopher Koprowski, M.D., MBA, chair of Radiation Oncology. “The Department

seeks to provide the best possible patient experience while patients are under treatment. As part of the commitment to clinical excellence, the radiation oncologists are committed to participation in patient-focused research and were honored with an award by the American Society of Clinical Oncology in 2013 for having enrolled the largest number of patients on National Cancer Institute-sponsored trials. In addition, the department was recognized for being fifth in North America for overall quality.”

Frank Beardell, M.D., and Donna Kerr, RN, BSN, examine a patient on the Bone Marrow Transplant Unit.

Christiana Care’s Bone Marrow/Stem Cell Transplant Program celebrated its 17th anniversary in August and earned recognition from the National Marrow Donor Program as a performance leader and accreditation as an Apheresis Collection Center, Bone Marrow Collection Center and Bone Marrow Transplant Center. Since 1997, the program has earned continuous accreditation by the Foundation for the Accreditation of Cellular Therapy, demonstrating compliance with rigorous standards for stem cell transplantation, cellular therapy product collection and processing.

A 40-bed inpatient Hematology/Oncology Unit at Christiana Hospital offers 24-hour care and support for cancer patients and includes a specialized unit for inpatients in our Bone Marrow/Stem Cell Transplant Program. The oncology nurses on the inpatient unit helped Christiana Care to obtain Magnet status, recognition of outstanding patient care. 

The Helen F. Graham Cancer Center & Research Institute scored highest in patient experience for the quality of cancer care among six U.S. centers in a July 2013 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey report issued by the Mayo Clinic and the American Institutes for Research and sponsored by the Agency for Healthcare Research and Quality and the National Cancer Institute.

Training tomorrow’s cancer specialists is important to our mission. In August 2013, the Christiana Care residency program in Radiation Oncology Physics, one of only a few in country, in affiliation with the Thomas Jefferson University residency program for medical physicists, earned accreditation through December 2015. The recognition comes from the the Board of Directors of the Commission on Accreditation of Medical Physics Educational Programs, thanks to the efforts of Firas Mourtada, MSE, Ph.D., D.ABR, chief of Clinical Physics in the Department of Radiation Oncology.

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Bruce Boman, M.D., Ph.D.

Jennifer Sims-Mourtada, Ph.D., and Firas Mourtada, MSE, Ph.D.

Brenda Rabeno, MLS, MBA

RESEARCH IS NOW IN OUR NAME – AND A BIG PART OF OUR MISSION Our research program is one of the largest among community-based hospitals in the country, with some 120 active clinical trials in every kind of cancer.

Our leadership in pursuing the latest clinical trial opportunities for our patients earned a top spot (number 3 in the nation last year) for patient enrollment. Clinical trials are often a patient’s best opportunity for treatment, and studies show survival rates and outcomes are better when patients participate in clinical trials.

The NCI-funded Christiana Care Community Clinical Oncology Program (CCOP) is one of the top enrollers in cancer clinical trials in the newly formed Alliance of Clinical Trials in Oncology.

“We have experienced Our physicians and nothing less than a nurses have leadership roles on multiple seismic shift in our approach NCI Cooperative to cancer management.” Group and Alliance committees.

MICHAEL J. GUARINO, M.D.

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Participation in landmark clinical trials (such as STAR for breast cancer, I-ELCAP for lung cancer, CALGB-Zometa for metastatic cancer and many more) fuels our knowledge about cancer and drives innovation in cancer care.

A robust pharmaceutical trials program is conducting Phase I and Phase II drug trials in collaboration with private industry and university research centers across the country.

Many of these studies give our patients the opportunity for leading edge cancer treatments tailored to their particular cancers. Examples include trials for advanced breast cancer, the largest ever anti-cancer vaccine trial for non-small cell lung cancer and the very first gene therapy trial in Delaware that targets melanoma.

“We have experienced nothing less than a seismic shift in our approach to cancer management,” said Michael J. Guarino, M.D., director of Pharmaceutical Clinical Trials. “Our current roster shows all our trials are focused on targeted therapies, vaccines and immunotherapies.

Hopefully, this points the way to more specific treatments for individual tumors and individual patients, with less collateral damage from treatments.”

The Center for Translational Cancer Research (CTCR) houses 7,000 square-feet of scientific research expertise. In collaboration with the University of Delaware, The Wistar Institute in Philadelphia and Delaware State University, world-class scientists are solving research riddles in the lab that translate into better treatments for cancer patients.

Within these walls, distinguished scientist Bruce Boman, M.D., Ph.D., MSPH, FACP, director of Cancer Genetics and Stem Cell Biology at the CTCR, whose published research identified a new marker for colon cancer stem cells, continues to investigate potential new diagnostic and treatment targets for colorectal cancer.

Molecular biologist Jennifer Sims-Mourtada, Ph.D., CTCR’s senior research scientist, is tracking the sonic hedgehog protein linked to aggressive breast cancer. Her efforts to identify why some cancers are resistant to treatment could aid the development of more individualized therapies and less invasive preventive alternatives to mastectomies for the most aggressive hereditary breast cancers.

Medical Oncology and Radiation Oncology practices at the Graham Cancer Center have won several national awards for record-breaking National Cancer Institute clinical trial accruals, earning the prestigious American Society of Clinical Oncology (ASCO) award twice.

Robert Witt, M.D., director of the Multidisciplinary Head & Neck Cancer Center, and molecular biologist Swati Pradhan-Bhatt, Ph.D., Graham Cancer Center director of Tissue Engineering, are developing laboratory-engineered salivary gland tissues that could eventually lead to artificial implants for patients who suffer complications from radiation treatments. Dr. Witt’s $3 million RO-1 grant from the National Cancer Institute furthers this groundbreaking research.

Led by Eric Kmiec, Ph.D., chairman of the Department of Chemistry, Delaware State University, a Genome Customization Core within the CTCR will create customized cell lines for drug screening and analysis that better reflect genetic variances in our general population. This project is called TALENS – Transcription Activator Like Effector Nucleases.

As a partner in Delaware’s Cancer Prevention and Control Program, the Graham Cancer Center collaborates with multiple research centers in our region, including the University of Delaware, the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia, Delaware State University, The Wistar Institute and Nemours/A.I. duPont Research Institute.

Swati Pradhan-Bhatt, Ph.D., and Robert Witt, M.D.

At Christiana Care: 24 percent of patients are enrolled in clinical trials, well above the national average of 4 percent.

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The Tissue Procurement Center has provided researchquality biospecimens for the groundbreaking Cancer Genome Atlas Project since 2009, supporting the work of scientists to unlock the genetic secrets of cancer’s origins and vulnerability. Exciting results have already emerged, including the discovery of four genetically different subtypes of breast cancer in the largest most comprehensive breast cancer genomic study to date, published in the journal Nature.

The Center also processes biospecimens for The Wistar Institute for extensive melanoma, ovarian and head and neck cancer research and the development of a commercially viable blood test for non-small cell lung cancer, and to the CTCR, for breast, colon and head and neck cancer studies.

“Our goal is to continue to expand the types of tissues we collect, and our capabilities have grown to the point where we can further assist scientists to meet the stringent requirements of customized research protocols,” said Mary Iacocca, M.D., director of the Tissue Procurement Center. “In the future, we plan to target specimen collection to underserved individuals at high-risk for particular cancers.”

“As a biospecimen collection center for the Cancer Genome Atlas Project, the National Cancer Institute has selected the Graham Cancer Center to be a training facility for several university programs across the United States,” said Brenda Rabeno, MLS, MBA, technical specialist for the Tissue Procurement Center and CTCR. 

SCREENING INITIATIVES AND SERVICES MAKING A DIFFERENCE FOR OUR NEIGHBORS The Ruth Ann Minner High-Risk Cancer Registry constitutes an important tool for finding genetic links to cancer that could prevent the disease for present and future generations.

The statewide registry contains 4,978 individuals and more than 150,000 family members. The first licensed

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adult genetics counselors in Delaware were members of our Familial Cancer Genetic Risk Assessment Program who helped launch the licensing initiative. This is the state’s first and only genetic counseling and gene testing program for adults. The ultimate in prevention, the Familial Cancer Genetic Risk Assessment Program is one of several reasons for the dramatic drop in cancer mortality in Delaware in the last seven years.

Wide-reaching Cancer Outreach and Screening programs are effectively reducing racial disparities in the incidence of colorectal and other cancers. Community Outreach and Education under the direction of Nora Katurakes, RN, MSN, OCN, manager of Community Health Outreach and Education, offers screenings for early detection of skin, prostate, breast, cervical, and colorectal cancers, as well as combination screening for heart, diabetes and other cancer risks. At the same time, they provide education about cancer and prevention and healthy behaviors, including help to quit smoking. Partnerships through the Delaware Cancer Prevention and Control Program’s Screening for Life and others has broadened access to financial support for health screenings.

The Christiana Care Breast “Center of Excellence” is the only facility in the region to offer leading-edge breast cancer care from diagnosis to treatment all under one roof.

The Breast Center now offers 3D mammography, the latest breast cancer screening and diagnostic technology, and the only dedicated breast MRI unit in the region. Each year, the Breast Center performs more than 20,000 mammograms in its beautiful, state-of-the-science facility.

Designated a breast imaging “Center of Excellence” by the American College of Radiology, the Breast Center has earned the Gold Seal accreditation in digital mammography, stereotactic breast biopsy, breast ultrasound and ultrasound guided biopsy.

“It is truly a pleasure going to work each day as medical director of the Christiana Care Breast Center,” said Diana Dickson-Witmer, M.D. “It doesn’t get any better than working with a staff of more than 50 highly trained individuals, using the best equipment, in the continuous quest to provide our neighbors with the highest quality breast diagnostic and therapeutic services anywhere in the country.” 

In April 2013, the Journal of Clinical Oncology published results of Delaware’s successful colon cancer screening program, in an article entitled, “Eliminating Racial Disparities in Colorectal Cancer in the Real World: It Took a Village,” co-authored by Christiana Care’s Manager of Community Outreach and Education Nora Katurakes, RN, MSN, OCN, and Medical Oncologist Stephen Grubbs, M.D., a member of the Delaware Cancer Consortium. Overall colorectal cancer incidence from 2002 to 2009 declined and closed the gap between African-American and white patients. Authors estimated the screening program saved about $8.5 million in health care costs, due to earlier cancer detection and lower incidence.

Zohra Ali-Khan Catts, MS, LCGC

“Working ... in the continuous quest to provide our neighbors with the highest quality breast diagnostic and therapeutic services anywhere in the country.”

DIANA DICKSON-WITMER, M.D.

Jacqueline Napoletano, M.D. November 2013

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CARE MANAGEMENT AND SUPPORT BEYOND DIAGNOSIS “Patients who travel to another city for treatment, often return home to struggle alone with their symptoms, financial worries and distress,” said Theresa Gillis, M.D., director of Oncology Pain and Symptom Management.

“A voice over the phone from many miles away is just not the same as the comfort that comes from knowing that there is an entire care management team right here, who knows you by name, will meet you face-to-face and can get you the help you need from your community. This place has so much heart. It is unbelievably special.”

Among the nation’s first, our cancer survivorship program is now widely recognized for innovation in Our award winning Cancer Care Management team was one of only four employers in the country, and the only health care organization, to receive the American Psychological Association’s Psychologically Healthy Workplace Award for 2013. Christiana Care is only the fourth health care employer to receive this recognition in the history of the award. Social workers, nurse navigators, financial assistant, registered dieticians, genetic counselors, health psychologist, pain and rehabilitation specialists, and wellness coaches are all part of the Cancer Care Management team. They offer assistance, encouragement and support to patients along the entire cancer care continuum.

We were first in Delaware to offer specialized physical and occupational therapy for patients living with cancer.

Located in the West Pavilion of the Graham Cancer Center, the oncology rehabilitation center has an experienced group of professionals under the direction of Lisa Marshall, OTR-L, who continually work to improve quality of life for cancer patients.

Christiana Care won a 2012 Computerworld Laureate Award for creating an iPad-based, self-assessment tool that enables patients to document the severity of their symptoms and their effect on quality of life, and gives doctors a better insight into patients’ distress, level of function, and wellbeing. Patients are now using this tool, under the direction of Theresa Gillis, M.D.

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supporting patients through life beyond cancer. The program is part of a multi-faceted cancer psychosocial program that has supported more than 1,000 individuals through their cancer experiences and serves as a model for community cancer centers around the country.

“Most programs don’t have any psychologists on staff, let alone psychologists who have formal, specialized training in working with people affected by cancer. We are unique in this regard,” said Director of Cancer Psychology Scott Siegel, Ph.D. “We have also become an active site for training clinical psychology doctoral students.”

The Graham Cancer Center initiated a statewide video conferencing program, profiled in the 2008 Annals of Surgical Oncology journal, to provide consultations on difficult cases with oncology providers across Delaware. 

Scott Siegel, Ph.D.

“A voice over the phone from many miles away is just not the same as the comfort that comes from knowing that there is an entire care management team right here, who knows you by name, will meet you face-to-face and can get you the help you need from your community.

This place has so much heart. It is unbelievably special.”

T H ER ES A G I L L IS, M .D. Director of Oncology Pain and Symptom Management

GRAHAM CANCER CENTER APPLIES NATIONAL “BEST PRACTICES” TO TREAT AGGRESSIVE BREAST CANCER Compliant with Commission on Cancer Standard 4.6 Patients with triple negative breast cancer receive treatment at the Helen F. Graham Cancer Center & Research Institute that is in line with the most forward-looking national guidelines, a 2013 study shows.

Triple negative breast cancer is particularly aggressive and can be harder to treat than other types of breast cancer. Named because of the absence of three hormone receptors common to other breast cancers, the disease doesn’t respond to the same hormone therapies or cancer drugs used to treat other breast cancers.

However, certain kinds of chemotherapy can be effective against triple

negative cancer, particularly in the early stages. The National Comprehensive Cancer Network (NCCN) which issues national guidelines for cancer treatment, suggests that patients diagnosed with triple negative breast cancer receive chemotherapy or that their physicians at least consider chemotherapy, based on several variables such as tumor size, patient’s age and other health conditions.

In compliance with Commission on Cancer Standard 4.6, the Graham Cancer Center conducted a study in 2013 that examined the previous year’s data on 70 patients diagnosed with triple negative breast cancer. An

in-depth chart review that included assessing private physician records, concluded that 94 percent of patients received treatment in accordance with the NCCN guidelines, either being treated with chemotherapy or considered for chemotherapy by their physicians.

“The Helen F. Graham Cancer Center & Research Institute is committed to providing our patients with exceptional care that meets or exceeds best practice guidelines,” said Bank of America endowed Medical Director Nicholas J. Petrelli, M.D. “This study evaluating patients with negative hormone receptors confirms that commitment.” 

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AND FOR THE FUTURE, WHAT’S NEXT? CONTINUING TO TRANSFORM CANCER CARE

HERE IS JUST SOME OF WHAT WE CONTINUE TO WORK ON….

Ensuring the

Supporting the

Center for Translational Cancer

work of the CTCR

Research (CTCR) is a premier

and other research centers

site for the synthesis of ideas,

around the country with the

technologies and research

biospecimen resources

focused on preventing and

provided by the Tissue

curing cancer.

Procurement Center.

Expanding screening,

Strengthening

genetic counseling and

partnerships and forging

prevention programs to reach

new ones to speed cancer

all of our neighbors, especially

research, treatment

those at highest risk

and prevention through

for cancer.

clinical trials.

Fostering the development of a Delaware Center for Cancer Biology, where physicians and scientists can exchange ideas and work together on cancer’s challenges.

“The future of cancer medicine is closely linked to the ongoing transformation of our vision into the reality of delivering patient-centered, valued-based cancer care.”

NI C HOLAS J . PET R ELLI , M.D.

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THE FRIENDS OF THE HELEN F. GRAHAM CANCER CENTER & RESEARCH INSTITUTE CELEBRATE 10 YEARS OF GIVING

For 10 years, the Friends of the Helen F. Graham Cancer & Research Institute have lived The Christiana Care Way. The group has helped us care for our neighbors by working to raise funds and awareness for the treatment and prevention of cancer.

So far, the Friends have raised more than $2 million to support the Graham Cancer Center research, technologies, patient care services, and education and screening programs.

“The Friends have been invaluable to the cancer program,” said Nicholas J. Petrelli, M.D., Bank of America endowed medical director of the Graham Cancer Center. “Without their support many of our programs and technologies would not have been possible. Their generous philanthropic efforts help our patients to receive cutting-edge, high-quality care.”

The group of 60-plus volunteers grew from the vision of Carroll Carpenter, chair of Christiana Care Health System’s Trustees. A significant portion of their fundraising has supported the Center for Translational Cancer Research, where scientists and physicians work together to make the newest research available as treatment options. The group has helped to purchase the latest radiation therapies, such as the CyberKnife robotic

Co-chairs of the Friends of the Helen F. Graham Cancer Center & Research Institute (from left) Amanda Friz, Karen Kimmel Legum, Anne Martelli, Diane du Pont, Penny Saridakis, Elisa Morris and Maureen Rhodes. radiosurgery system that precisely targets hard to reach tumors, and to enrich the Cancer Special Needs Fund, which helps patients pay for medication, transportation to and from appointments, supplies, nutrition counseling and massage therapy.

At an inspirational “Celebration of Hope” gala event on Oct. 5 attended by nearly 400 loyal supporters, Gov. Jack Markell honored Dr. Petrelli with an Order of the First State. The recognition is the highest the governor can grant and recognizes Dr. Petrelli’s leadership to expand access to world-class cancer care to Delawareans. The governor also issued a proclamation designating the date of the event – Oct. 5, 2013 – as Carroll M. Carpenter Day to honor the founder of the Friends for her leadership in raising awareness and funds to treat cancer.

“It’s extraordinary what the people here are doing to transform the lives of others in this state and country,” Markell said.  Gov. Jack Markell, right, and First Lady Carla Markell present Nicholas Petrelli, M.D., Bank of America endowed medical director, with the Order of the First State for his role in world-class cancer care.

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PRSRT STD U.S. POSTAGE PAID WILMINGTON DE PERMIT NO. 357

P.O. Box 1668 Wilmington, DE 19899-1668 www.christianacare.org

The Multidisciplinary Cancer Centers at the Helen F. Graham Cancer Center & Research Institute offer comprehensive care and treatment.

Ten years of saving lives.

Bone Sarcoma Breast Cancer Genetic Risk Assessment Genitourinary Cancer Head & Neck Cancer/Thyroid Hepatobiliary/Pancreatic Cancers Lymphoma Neuro/CyberKnife

Melanoma/Soft Tissue Sarcoma Mind, Body & Spirit Wellness Ostomy Care Rectal/Anal Cancers Skin Screening Spinal Tumor & Metastatic Lesion Thoracic/Esophageal Cancers Young Adult Follow-up

“I would have driven anywhere to get the best medical care, but at the Graham Cancer Center, I didn’t have to go far. All of my providers worked well as a team all in one place, and to me that made all the difference.”

DON N A HARRIS, a patient at the Graham Cancer Center

Stay connected with Christiana Care!

Learn how we are transforming cancer care and treatment. christianacare.org/cancer 14CANC1