St. Luke's Cancer Center 2014 Annual Report by KSA&D Interactive

S T. L U K E â&#x20AC;&#x2122; S C A N C E R C E N T E R

2014 Annual Report and Outcomes

ACTIVITIES AND ACHIEVEMENTS St. Luke’s University Health Network is committed to being one of the best places to receive comprehensive cancer care. The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) granted three-year approval to St. Luke’s Integrated Network Cancer Program with commendation, through 2016. St. Luke’s Cancer Center continues to maintain its current level of excellence in clinical care while embracing new clinical advances and leading-edge technology that give patients and their families the best care possible. We are proud of the St. Luke’s Cancer Center team and its steadfast commitment to provide the highest quality, personalized cancer care to those we serve. 2014 Highlights and Accomplishments: ◆ St. Luke’s University Health Network was recognized for achieving the highest level of quality and patient safety in Radiation Oncology, earning a three-year accreditation by the American College of Radiology (ACR). To achieve ACR accreditation, a facility’s personnel qualifications, equipment requirements, quality assurance and quality control procedures go through a rigorous review process and meet specific qualifications  St. Luke’s implemented a Lynch Syndrome Surveillance Program. Lynch Syndrome is the most common inherited cause of both colorectal cancer and endometrial cancer. The program includes universal screening for malignant lesions in patients at potential risk for this group of heritable malignancies. A task force, including clinicians with special interest and expertise in Lynch Syndrome, performs systematic review of results and communicates with treating physicians in order to recommend appropriate counseling and surveillance for any patients found to be positive. The test, performed on endometrial and/or colonic tumors, will help direct the appropriate patients to genetic counseling and potential testing for the genetic mutations involved.

St. Luke’s Cancer Center

• The Clinical Trials Office at St. Luke’s provides support to our clinical investigators on all activities related to the successful conduct of clinical trials and research from protocol inception through closeout. This includes patient recruitment, clinical coordination, data and regulatory management, and financial and contract management. The staff consists of a mix of Administrators, Research Nurses, Research Coordinators, and Research Assistants trained in regulations and compliance, clinical trials financial operations, oncology and other clinical areas, clinical trials in general, and Good Clinical Practice (GCP). Our staff provides patients with the most up-to-date information on treatments that are available to them, as we believe in putting the patient first by ensuring that we present all available treatment options, including participation in a clinical trial. The St Luke’s Oncology Clinical Trials team offers studies that are sponsored by industry pharmaceutical companies, government-sponsored studies through NCI’s National Clinical Trials Network (NCTN), such as ECOG-ACRIN and NRG, as well as investigator-initiated trials (IITs) originating at St. Luke’s, some of which are multi-site trials with St. Luke’s serving as the lead coordinating center. With this centralized infrastructure, and implementation of streamlined processes, the St. Luke’s Clinical Trials Office has made significant achievements:  A robust clinical trial portfolio consists of numerous treatment trials and trials exclusive to St. Luke’s, bringing innovative therapies to the Lehigh Valley area.  St. Luke’s offers clinical trials which consist of newly FDA-approved drugs, as well as expanded access trials (awaiting FDA approval), providing the latest and most innovative therapies, including novel unapproved therapies, to our patients.  Within the last two years, we have increased the number of trials we open per year by over 50 percent, enabling us to offer our patients treatment options for various diseases that, previously, may not have been available.  In 2014, 6 percent of our patients were enrolled in clinical trials.  Reduction in the start-up time (e.g., time to activation) by over 40 percent has allowed us to offer innovative treatments to patients who are waiting for new treatment options and/or their next line of therapy without delay.  A robust staffing infrastructure, including a Director of Clinical Trials, regulatory staff, financial staff, oncology manager and oncology nurses and coordinators, ensures coverage of all aspects involved in the clinical trials workflow.  Disease Management Meetings identify any gaps in patient treatment options as well as future needs for clinical trials for specific patient populations.  Research coordinators attend disease-specific tumor boards to help identify patients for clinical trials.  A 100 percent secure Clinical Trials Management System (CTMS) was implemented for all regulatory tasks and patient management.  Operational excellence was achieved in patient recruitment and treatments, as well as coordination of care with other clinical services.  St Luke’s Oncology Clinical Trials offer patients a variety of clinical research trials quality service, education and support across the continuum of care of the patient.

2014 Annual Report and Outcomes

ACTIVITIES AND ACHIEVEMENTS cont. ◆ All St. Luke’s patients benefit from St. Luke’s Pathology Second Opinion Program; 100 percent of pathology specimens are reviewed by a minimum of two independent pathologists, improving the quality and integrity of pathology reports. ◆ St. Luke’s Lung Cancer Screening Program was developed under the leadership of thoracic surgeon Dr. William Burfeind. Radiology locations throughout St. Luke’s University Health Network offer a low-dose spiral CT scan to detect early-stage lung cancers. Designed to screen at-risk current and former heavy smokers, programs like this have been shown to reduce lung cancer mortality risk by 20 percent.  Over 1,000 patients have been screened to-date through St. Luke’s University Health Network, resulting in 250 positive scans. Eleven cases of cancer were identified and seven had curative resections.

St. Luke’s Cancer Center continues to maintain its current level of excellence in clinical care while embracing new clinical advances and leading-edge technology that give patients and their families the best care possible. ◆ Comprehensive cancer care services are now available throughout the St. Luke’s Outpatient Physical Therapy Network, from pre-surgical through post-surgical intervention, to help the patients with cancer return to their prior level of function. Physical Therapy has much to offer, including our new lymphedema index system called the L-Dex, which can measure extracellular fluid build-up before it is even seen in girth measurements, thereby alerting clinicians earlier to the possibility of onset of lymphedema. ◆ Intellidose, a computerized order entry system for chemotherapy, was implemented. This system contains a standardized chemotherapy order library per NCCN guidelines and automates the physician ordering process in order to expedite orders and improve patient safety. ◆ St. Luke’s Infusion Centers implemented a Distress Thermometer Screening for all new cancer patients undergoing treatment. This assures that every new patient starting chemotherapy has his/her psychosocial needs addressed and is referred to our Cancer Care Counselors if needed. ◆ Our Cancer Survivorship Program was implemented in 2014. Patients receive an individualized survivorship care plan outlining their cancer diagnosis, therapies received, and a follow-up plan. ◆ Radiation Oncology implemented new dose-check software that checks plan parameters against the Radiation Therapy Oncology Group (RTOG) standards.

St. Luke’s Cancer Center

St Luke’s Oncology Clinical Trials offer patients a variety of clinical research trials.

◆ St. Luke’s University Health Network facilities participate annually in the National Cancer Data Base (NCDB) through the Cancer Registry and utilize the Cancer Program Practice Profile Reports (CP3R) for breast, colon, rectum, lung, and gastric cancers as a mechanism to assess and monitor concordance with standards of care.  Accountability and Quality Improvements Measure rates for SLUHN facilities were above the Commission on Cancer expected performance rates, indicating our patients are consistently treated according to evidence-based national guidelines. ◆ A multidisciplinary team of surgeons, radiologists, pathologists, medical oncologists, and radiation oncologists meets regularly to discuss complex cases and devise the best individualized treatment plan. Patients benefit from the combined expertise of each member of the team. ◆ St. Luke’s HOPE Line (484-503-HOPE) continues to improve patient access into the programs and services of the Cancer Center. ◆ A nutrition risk-screening tool was implemented to identify radiation oncology patients at high nutrition risk prior to the start of radiation therapy to initiate earlier nutrition intervention. ◆ Philanthropic support allowed St. Luke’s to purchase Faxitron technology for our St. Luke’s Allentown Campus. The device allows clinicians to biopsy tissue right in the Operating Room; the sample never leaves the sterile field for transfer to a lab to be read. The main benefit is a decrease in the amount of time a patient must remain under anesthesia. ◆ St. Luke’s Cancer Social Work Fund continues to help underserved patients receiving care through St. Luke’s Cancer Centers. The fund supports patients who need financial assistance with medications, mortgage or rent payments, and paying utility bills.

2014 Annual Report and Outcomes

ACTIVITIES AND ACHIEVEMENTS cont. ◆ Monthly Oncology Grand Rounds held for St. Luke’s physicians and clinical staff on current oncology topics included: Pain Management: A Multidisciplinary Approach; Liver Cancer; Updates in GI Malignancies; Breast Cancer: From Genes to Genomics; and Cancer: Healing When There is No Cure. ◆ The 2nd Annual Oncology Symposium was held April 5, 2014. Topics included Cancer Patient Symptom Management for the Primary Care Physician; Managing the Oncology Patient with 1,000 Questions in 15 Minutes; Survivorship: The Primary Care Physician’s Role; and Intimacy and Relationships During and After Cancer Treatment. ◆ St. Luke’s Warren Campus improved the average turnaround time for patients receiving chemotherapy by 31 percent. ◆ Participation in the Commission on Cancer’s Rapid Quality Reporting System (RQRS) allowed St. Luke’s Cancer Program to assess compliance against national standards. St. Luke’s consistently performed above the statewide and U.S. norms. ◆ The Cancer Registry reports cancer incidence for St. Luke’s University Health Network to the Pennsylvania Cancer Registry. Occurrence of cancer (incidence); types of cancer; location within the body; extent of cancer at time of diagnosis (stage); and the types of treatment patients receive are reported to the central state registry to enable public health professionals to better understand and address the cancer burden.  Timeliness of reporting and follow-up rate is continually monitored and exceeds the required standard.  Reliable registry data are integral to our research efforts, including those aimed at evaluating effectiveness of treatment. ◆ Blanket warmers were distributed to all Infusion Centers within St. Luke’s University Health Network to improve patient comfort; they have been received favorably by our patients. Two St. Luke’s Infusion Centers — Bethlehem and Easton (Anderson Campus) — have become recipients of The Chemo Bag initiative. Chemo Bag Inc., supported by the generosity of our community, provides gift bags filled with items that provide comfort to the men and women in the Lehigh Valley undergoing chemotherapy treatments. ◆ The Infusion Center’s quality award submission entitled “Documentation for the Patient Receiving Chemotherapy via Continuous Drug Delivery Pump” received first place in the category of “Safety” in the Network’s Quality Award submissions.

St. Luke’s Cancer Social Work Fund continues to help underserved patients receiving care through St. Luke’s Cancer Centers. 6

St. Luke’s Cancer Center

2014 â&#x20AC;&#x201D; INCP CANCER COMMITTEE MEMBERS Lee B. Riley, MD, PhD INCP Committee Chair Surgical Oncology Darius Desai, MD Cancer Liaison Physician Surgical Oncology Sanjiv Agarwala, MD Medical Oncology David Anderson, MD Pathology Ric Baxter, MD Palliative Care Neil Belman, DO Medical Oncology William Burfeind, MD Thoracic Surgery Bonnie Coyle, MD Community Health Nimisha Deb, MD Radiation Oncology Edward Gilkey, MD VP, Medical Affairs Warren Campus Eric Mayer, MD Urology Hugh Moulding, MD Neurosurgery Subhash Proothi, MD Medical Oncology

Laurie Sebastiano, MD Radiology

John Flenner, M. Ed. Cancer Counselor

John Smith, MD Medical Oncology

Kathleen A. Hedges, CTR Cancer Registry Manager

Thomas J. Tachovsky, MD Oncology Quality Oversight

Kristen Maggipinto, RN Med-Surg Nursing Anderson Campus

Nicholas Taylor, MD Gynecologic Oncology Steve Tellschow, MD Pathology David Yen, MD Otolaryngology Cheryl Belman, RN, OCN Neuro-Oncology Nursing Debra Bubba, MSN, RN Administrative Director Oncology Allison Brewer, PT, DPT, CLT Rehabilitation Donna Bydlon, RN, OCN Oncology Nursing Rose Cabral, RN, OCN Clinical Trials Beth Ciliberti, RDN, LDN, CSO Oncology Nutrition Elizabeth Gregg, RN Oncology Nursing

Linda Moller, RNC Hospice Erin Moskel American Cancer Society Kathy Nunemacher, RN, CPN, CPHQ Quality Resources Joseph Pinto VP, Network Operations Robyn Plesniarski Manager Radiation Oncology Oncology Community Outreach Susan Ross Marketing and Public Relations Jen Sinclair Cancer Support Community Andrea Smith, CGC Genetic Counselor Brian Waldron, R.Ph Pharmacy Brenda West, RHIT, CTR Cancer Data Registrar

2014 Annual Report and Outcomes

ST. LUKE’S COMMUNITY OUTREACH EVENTS Month January

Event St. Luke’s Cancer Connection e-Newsletter

Participants 10,000

January through March

Breast and Cervical 56 Cancer Screening Program for Uninsured and Underinsured Women in Bethlehem

January through June

Breast and Cervical 101 Cancer Screening Program for Uninsured and Underinsured Women in Allentown

January through June

Live Your Life Campaign

263

January through December

St. Luke’s Healthy Living Initiative: Get Your Tail on the Trail

582

March

* Talk With Your Doctor 1 million TV Program: viewers Colorectal Conditions Appeared on WFMZ-TV Channel 69

April

Breakthrough Over Breakfast Community Program: Updates in GI Cancers Breakthrough Over Breakfast Community Program: Updates in GI Cancers

St. Luke’s Cancer Center

103

Outcome The January 2014 issue provided articles on St. Luke’s Integrated Network Cancer Program, malignant and benign blood disorders, patient testimonials, and the Hope & Healing series. Partnership with the Bethlehem Health Bureau — Breast and cervical cancer screening for uninsured, low income women living in the City of Bethlehem: 54 mammograms (27 screening and 27 diagnostic mammograms, including four biopsies) and 25 pap smears were completed. Partnership with the Allentown Health Bureau — Breast and cervical cancer screening for uninsured, low income women living in the City of Allentown: 61 pap smears and 100 mammograms (54 screening and 46 diagnostic mammograms) were completed. A community-based wellness initiative with the goal of promoting healthy eating habits and increasing physical activity in the community. The winter challenge resulted in 582 community residents logging 44,051 miles; the spring challenge resulted in 1,000 community residents logging 51,000 miles. Colorectal surgeons Drs. Terrence Reilly and Daniel Eyvazzadeh and gastroenterologist Berhanu Geme presented the latest information on colorectal conditions, specifically highlighting colon and rectal cancer, including risk factors and screening standards. Watch the episode here. Educational community program on GI malignancies presented by surgical oncologist Dr. Darius Desai. Educational community program on GI malignancies presented by surgical oncologist Dr. Roderick Quiros and medical oncologist Dr. Neil Belman.

Month April

Event Lung Cancer Presentation

Participants 25

April (ongoing)

Social Media: Facebook, Twitter and Linked In

varies

April

St. Luke’s Cancer Connection e-Newsletter

10,000

April

* Talk With Your Doctor 1 million TV Program: viewers Community Health Appeared on WFMZ-TV Channel 69

April May

Tobacco Control/ 10 families Cessation Program Skin Cancer Screenings 67 (Pennsylvania)

May

Skin Cancer Screenings 35 (New Jersey)

May

St. Luke’s Cancer Survivors Day Event 2014: St. Luke’s Strong (Pennsylvania)

610

Outcome Educational community presentation on lung cancer symptoms, screening criteria, diagnosis, treatment options, new advances, and survivorship by thoracic surgeon Dr. William Burfeind. Weekly cancer “blasts” are broadcast through St. Luke’s social media accounts every Thursday, highlighting cancer-related topics. E-blasts began in April 2014 and continued throughout the year. The April 2014 issue provided articles on a patient with head and neck cancer; nutrition and chemotherapy; genetic testing; advances in medical oncology; and the St. Luke’s Brain & Spine Tumor Center. St. Luke’s Director of Community Health Dr. Bonnie Coyle, cardiologist Dr. Tom Dale and Dr. Meagan Grega of the Kellyn Foundation discussed the importance of smoking cessation, how healthy living impacts cancer rates, and programs and services St. Luke’s provides to promote good health in the community. Watch the episode here. Smoking cessation program continued with education and awareness presentations. Screening locations in Allentown and Bethlehem. 67 screening participants: 42 normal exams, 21 referred for biopsies, and four referred for further physician follow-up. Screening location — St. Luke’s Warren Campus. 35 screening participants: 15 normal exams, eight referred for biopsies, and 12 referred for further physician follow-up. Survivorship event held at the Lehigh Valley Zoo in celebration of National Cancer Survivors Day. Educational presentations included: • Updates on GI Cancers • Life After Diagnosis • Updates on Breast Cancer • How well do you know Your Family Tree? • Updates on Lung Cancer • Healing Rhythms 2014 Annual Report and Outcomes

ST. LUKE’S COMMUNITY OUTREACH EVENTS cont. Month May

July

September

Event St. Luke’s Cancer Survivorship Day at St. Luke’s Warren Campus (New Jersey) St. Luke’s Cancer Connection e-Newsletter

Participants 160

Outcome Relay for Life “Survivors’ Dinner” sponsored by St. Luke’s.

10,000

Prostate Cancer Screening at the Roseberry Surgery Center (New Jersey) 2nd Annual St. Luke’s Blue Ribbon 5K & Family Fun Walk Wings of Hope Butterfly Release

The July 2014 issue provided articles on St. Luke’s Lynch Syndrome Surveillance Program, ovarian cancer prevention, treating GI cancers with targeted therapies and community support resources. Prostate cancer screening: 36 screening participants, four with suspicious findings. A summary of results and recommendations was sent to each participant. Educational materials were distributed on prostate screening.

100

400

* Talk With Your Doctor 1 million TV Program: Palliative viewers Care and Hospice Appeared on WFMZ-TV Channel 69

September

* Talk With Your Doctor 1 million TV Program: Prostate viewers Cancer Treatment and Long-Term Challenges Appeared on WFMZ-TV Channel 69

St. Luke’s Cancer Center

The Wings of Hope event, held in honor of National Cancer Survivors Day, celebrated cancer survivors; served as an inspiration for those just beginning their cancer journey; and offered support for all those affected by cancer. During the program, breast surgical oncologist Dr. Tricia Kelly led a yoga group of cancer survivors, educating them on the positive attributes of yoga. Dr. Ric Baxter, Chairman, Pain Medicine/ Palliative Care; Dr. Jenni Levy, Medical Director, St. Luke’s Hospice; and social worker Kim Giamportone, MSW, LSW, discussed the differences between palliative care and hospice and when patients and their families may want to consider these services. Watch the episode here. Urologists Dr. Eric Mayer and Dr. Jonathan Bingham and radiation oncologist Dr. Grace Fan presented information on prostate cancer, including screening, diagnosis, treatment and how to mitigate side effects of the treatment’s long-term health challenges. Watch the episode here.

Month September

Event Participants * Talk With Your Doctor 1 million TV Program: Brain viewers and Spine Tumors Appeared on WFMZ-TV Channel 69

October October

October

Women’s 5K Classic Health Expo Breast Cancer Screening

4,000 26

* Talk With Your Doctor 1 million TV Program: viewers Mammograms – One Size Does Not Fit All Appeared on WFMZ-TV Channel 69

October

Community Day Event at St. Luke’s Warren Campus (New Jersey) October to Hope & Healing December Programs – Infusion Centers

900

Outcome Neurosurgical oncologist Dr. Hugh Moulding, radiation oncologist Dr. David Andolino and medical oncologist Dr. Neil Belman educated the public on brain and spinal tumors, including symptoms, leadingedge treatments and the individualized targeted care provided through St. Luke’s Brain and Spine Tumor Program. The show addressed both malignant and benign tumors. Watch the episode here. Distributed cancer prevention information at the Women’s 5K Classic Health Expo. Breast cancer screening: 26 women participants — 22 had a negative exam and 4 had suspicious findings and were referred for further screening. The average age of participants was 56, with 81 percent being NJ residents. Dr. Joseph Russo, Section Chief of Women’s Imaging, breast surgical oncologist Dr. Tricia Kelly and genetic counselor Andrea Smith discussed individualized breast screening, including what screening tests are appropriate for women with dense breast and/or other risk factors. Watch the episode here. Distributed health information, including cancer prevention education, to the community.

In conjunction with the Cancer Support Community of Greater Lehigh Valley, St. Luke’s began offering meditation, art and yoga within the Infusion Centers while patients received their chemotherapy. Extremely positive feedback was received from patients. Program was launched October 29, 2014.

2014 Annual Report and Outcomes

ST. LUKE’S COMMUNITY OUTREACH EVENTS cont. Month November

November

Event Participants * Talk With Your Doctor 1 million TV Program: viewers Ovarian Cancer

Outcome Gynecologic oncologist Dr. Israel Zighelboim presented the symptoms and treatments of ovarian cancer.

Appeared on WFMZ-TV Channel 69 St. Luke’s Cancer 10,000 Connection e-Newsletter

Watch the episode here.

December

Memorial Service of Remembrance for Oncology Patients

December

PEAK TV Emmy award- --winning program – two segments: A Breast Cancer Survivor’s Story

Dr. Joseph Russo, Section Chief of Women’s Imaging, also discussed the new screening standards for breast cancer.

St. Luke’s Individualized Breast Screening Program

Monthly Monthly Monthly

Quarterly

Appeared on WFMZ-TV Channel 69 Prostate Support 32 Group Breast Cancer 73 Support Group Journey of 95 Hope Group Look Good, Feel Better Program

St. Luke’s Cancer Center

The November 2014 issue provided articles on reducing mealtime stress, understanding the radiation risk from CT scans, testimonials from breast and ovarian cancer patients, major advancements for patients with melanoma, and ways to reduce the risk of ovarian cancer. The 13th Annual Memorial Service, held to remember the oncology patients who passed away in 2014, included a spiritual and musical tribute. Family members and friends who attended the service were appreciative of the encouragement and support. In the December 2014 program, a patient shares her journey with breast cancer. Segment features surgical oncologist and Network Chairman, Department of Oncology, Dr. Lee Riley.

Watch the episode here. Monthly support group for men diagnosed with prostate and urologic cancers. Monthly support group for women diagnosed with breast cancer. Cancer support group for patients in the Quakertown area with any cancer diagnosis and their caregivers. Program, offered through the ACS, free of charge to patients in active cancer treatment, focuses on helping patients with appearancerelated side effects.

Month Ongoing

Event Hope & Healing Programs are held throughout the community.

Participants 3,086 throughout region 111 – Anderson Campus participants

Outcome St. Luke’s, in conjunction with the Cancer Support Community of Greater Lehigh Valley, offered programs including artful movement, yoga, meditation, and healing rhythms.

Special program also held at St. Luke’s Cancer Center – Anderson Campus * St. Luke’s award-winning, Nielsen-rated television program Talk with Your Doctor on WFMZ-TV Channel 69 is a 30-minute live, weekly call-in show featuring expert physician hosts from St. Luke’s University Health Network. TWYD is estimated to have 1 million viewers throughout the region, including Lehigh Valley and Berks, Philadelphia, Poconos and portions of New Jersey and Delaware.

All St. Luke’s patients benefit from St. Luke’s Pathology Second Opinion Program.

2014 Annual Report and Outcomes

COUNTY OF RESIDENCE AT DIAGNOSIS FOR CY2013 ANALYTIC CASES 8.68%

PA — Northampton 6.30%

PA — Lehigh 5.82%

NJ — Warren

4.00% 24.23%

3.68% 5.72%

PA — Monroe 4.15% 0.89% 0.68%

PA — Bucks PA — Carbon PA — Schuylkill Other

41.56%

Other PA Counties County at Diagnosis PA — Montgomery PA — Berks PA — Pike PA — Luzerne PA — Lackawanna PA — Cumberland PA — County unknown PA — Crawford PA — Delaware PA — Lebanon PA — Northumberland PA — Philadelphia PA — Wayne Total

St. Luke’s Cancer Center

Other PA Counties

Other NJ Counties

Out of State

Out of State Percent 1.70% 1.45% 0.24% 0.20% 0.16% 0.12% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 4.15%

Count 42 36 6 5 4 3 1 1 1 1 1 1 1 103

Percent 0.61% 0.08% 0.08% 0.04% 0.04% 0.04% 0.89%

Count 15 2 2 1 1 1 22

Other NJ Counties County at Diagnosis NJ — Hunterdon NJ — County unknown NJ — Morris NJ — Middlesex NJ — Somerset NJ — Union Total

County at Diagnosis TN — Knox TX — Polk NY — New York NY — Orange NY — Queens NY — Sullivan CA — San Diego DE — Sussex FL — Citrus FL — Lee FL — Palm Beach FL — St. Johns KY — Clark MA — Hampden MA — Norfolk MD — Montgomery Total

Percent 0.04% 0.04% 0.04% 0.04% 0.04% 0.08% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 0.04% 0.68%

Count 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 17

CANCER CASES BY YEAR Number of Cancer Cases by Calendar Year 3,000

3,000 2,500 2,000

2,741 2,335 242

2,383 348

377

2,093

2,035

2,364

2,383 348

2,825

377

371

Analytic Cases

2,093 1,000 2,454

2,035

2,364 2,454 Non-Analytic Cases

500

500 0

2,500 3712,335 242 2,000 1,500

1,500 1,000

2,741

2,825

0 2010

2011

2012

2010 2013

2011

2012

2013

Highest Volume of Cancer Cases by Site (Calendar Year) 600

Breast Volume

500

Digestive/GI Volume

400

Lung Volume

300

Prostate Volume Urinary Volume

200

Melanoma Volume

100 0

GynOnc Volume 2010

2011

2012

2013

Our staff provides patients with the most up-to-date information on treatments that are available to them.

2014 Annual Report and Outcomes

CANCER CASES SUMMARY 2013 Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report Class of Case

Sex

Status

Primary Site

Total (%)

Oral Cavity & Pharynx Lip Tongue Salivary Glands Floor of Mouth Gum & Other Mouth Nasopharynx Tonsil Oropharynx Hypopharynx Other Oral Cavity & Pharynx Digestive System Esophagus Stomach Small Intestine Colon Excluding Rectum Cecum Appendix Ascending Colon Hepatic Flexure Transverse Colon Splenic Flexure Descending Colon Sigmoid Colon Large Intestine, NOS Rectum & Rectosigmoid R ectosigmoid Junction Rectum Anus, Anal Canal & Anorectum

67 (2.3%) 4 (0.1%) 21 (0.7%) 10 (0.3%) 3 (0.1%) 7 (0.2%) 4 (0.1%) 12 (0.4%) 1 (0.0%) 4 (0.1%)

46 3 16 3 2 6 2 9 0 4

21 1 5 7 1 1 2 3 1 0

57 4 18 7 3 6 4 9 1 4

10 0 3 3 0 1 0 3 0 0

52 4 15 8 3 3 3 12 1 2

15 0 6 2 0 4 1 0 0 2

1 (0.0%)

380 21 20 10 148 40 3 22 5 12 8 5 41 12 54 12 42 14

434 (15.2%) 21 (0.7%) 24 (0.8%) 10 (0.3%) 169 (5.9%) 42 5 25 5 14 9 7 47 15 66 (2.3%) 16 50 20 (0.7%)

251 183 15 6 16 8 6 4 89 80 20 22 2 3 9 16 2 3 8 6 6 3 6 1 27 20 9 6 47 19 13 3 34 16 7

Stage Distribution*

Analy NA Alive Exp 0

III IV 88 Unk

2 0 0 0 1 0 0 1 0 0

11 3 3 1 0 1 3 0 0 0

7 0 3 1 0 3 0 0 0 0

7 0 3 0 1 0 1 1 0 1

25 0 8 4 1 2 0 6 1 3

2 0 0 1 0 0 0 0 0 0

3 1 1 0 0 0 0 1 0 0

54 0 4 0 21 2 2 3 0 2 1 2 6 3 12 4 8

282 152 34 65 75 80 93 12 9 0 6 4 6 5 13 11 3 3 1 4 8 7 3 0 2 3 3 2 134 35 23 27 25 36 28 34 8 7 7 5 11 9 5 0 1 0 2 0 0 18 7 1 4 5 5 5 4 1 2 1 1 0 1 12 2 2 1 1 6 0 7 2 2 1 1 2 1 7 0 1 0 1 3 0 40 7 7 12 8 7 6 7 8 0 1 1 2 6 52 14 7 8 4 16 13 12 4 1 1 2 3 3 40 10 6 7 2 13 10

5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

28 0 1 0 9 1 0 2 0 2 1 0 1 2 6 2 4

*Analytic Cases Only

St. Lukeâ&#x20AC;&#x2122;s Cancer Center

Class of Case

Sex Primary Site Liver & Intrahepatic Bile Duct Liver I ntrahepatic Bile Duct Gallbladder Other Biliary Pancreas Retroperitoneum Peritoneum, Omentum & Mesentery Other Digestive Organs Respiratory System Nose, Nasal Cavity & Middle Ear Larynx Lung & Bronchus Bones & Joints Bones & Joints Soft Tissue Soft Tissue (including Heart) Skin Excluding Basal & Squamous Melanoma â&#x20AC;&#x201D; Skin Other Non-Epithelial Skin Basal & Squamous Skin Basal/Squamous cell carcinomas of Skin Breast Breast Female Genital System

Status

Total (%)

39 (1.4%)

4 (0.1%) 8 (0.3%) 66 (2.3%) 2 (0.1%)

0 5 38 0

4 3 28 2

4 8 59 1

4 (0.1%)

Stage Distribution* I

III IV 88 Unk

0 0 7 1

1 5 24 2

3 3 42 0

0 0 1 0

0 0 7 0

1 4 21 0

3 0 2 0

0 1 24 0

0 1 0 1

0 2 4 0

1 351

0 30

0 6

0 0 0 0 1 72 39 68 158 1

0 7

15 335 3 3 19

3 26 0 0 1

14 4 156 205 1 2 1 2 14 6

3 3 0 0 0

2 3 1 6 0 70 36 67 151 1 0 0 0 1 0 0 0 0 1 0 6 3 5 3 0

0 7 2 2 2

205 (7.2%) 121

155

183

29 78 20 19

197 (6.9%) 118 8 (0.3%) 3 1 (0.0%) 0

79 5 1

150 5 0

47 3 1

180 3 1

17 5 0

29 77 20 16 0 1 0 3 0 0 0 0

7 0 0

0 0 0

1 1 0

25 103 221 89 28 19 25 103 221 89 28 19 25 3 92 12 18 18

0 0 2

19 19 7

1 (0.0%) 0 1 381 (13.3%) 200 181 2 (0.1%)

18 (0.6%) 14 4 361 (12.6%) 184 177 3 (0.1%) 3 0 3 (0.1%) 3 0 20 (0.7%) 8 12 20 (0.7%)

Analy NA Alive Exp 0

0 1 171 210 1

1 (0.0%)

497 (17.4%) 497 (17.4%) 196 (6.9%)

7 7 0

490 490 196

479 479 152

18 18 44

472 472 171

*Analytic Cases Only

2014 Annual Report and Outcomes

CANCER CASES SUMMARY cont. Class of Case

Sex Primary Site Cervix Uteri Corpus & Uterus, NOS Corpus Uteri Uterus, NOS Ovary Vagina Vulva Other Female Genital Organs Male Genital System Prostate Testis Penis Other Male Genital Organs Urinary System Urinary Bladder Kidney & Renal Pelvis Ureter Other Urinary Organs Eye & Orbit Eye & Orbit Brain & Other Nervous System Brain Cranial Nerves Other Nervous System Endocrine System Thyroid Other Endocrine including Thymus Lymphoma Hodgkin Lymphoma

Status

Total (%)

15 (0.5%) 104 (3.6%) 102 2 41 (1.4%) 4 (0.1%) 26 (0.9%)

0 0 0 0 0 0 0

15 104 102 2 41 4 26

13 94 92 2 26 0 15

2 10 10 0 15 4 11

13 95 95 0 31 4 22

2 9 7 2 10 0 4

6 (0.2%)

0 0 0 0

223 209 12 1

83 83 0 0

217 (7.6%) 157 137 (4.8%) 102 72 (2.5%) 49 7 (0.2%) 5 1 (0.0%) 1 1 (0.0%) 0 1 (0.0%) 0

60 35 23 2 0 1 1

88 (3.1%)

29 (1.0%)

Stage Distribution* I

III IV 88 Unk

0 0 0 0 0 0 2

5 73 73 0 5 0 9

3 2 2 0 5 0 2

3 7 6 1 6 0 2

2 9 8 1 6 0 0

0 0 0 0 0 0 0

0 3 3 0 4 0 0

283 271 11 0

23 21 1 1

0 0 0 0

64 119 20 18 54 117 19 18 9 2 1 0 1 0 0 0

0 0 0 0

2 1 0 0

200 122 70 7 1 0 0

17 15 2 0 0 1 1

180 117 55 7 1 0 0

37 20 17 0 0 1 1

50 73 26 19 15 46 28 19 10 4 1 43 6 9 10 2 2 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0

17 15 1 1 0 0 0

59 (2.1%)

141 (4.9%) 123 (4.3%)

34 29

107 94

134 117

7 6

140 123

1 0

0 0

88 11 88 11

9 9

3 3

17 0

6 6

18 (0.6%)

114 (4.0%) 9 (0.3%)

63 3

51 6

98 8

16 1

93 7

21 2

0 0

25 16 25 27 2 2 4 0

1 0

4 0

306 (10.7%) 306 292 (10.2%) 292 12 (0.4%) 12 1 (0.0%) 1 1 (0.0%)

Analy NA Alive Exp 0

*Analytic Cases Only

St. Lukeâ&#x20AC;&#x2122;s Cancer Center

Class of Case

Sex Primary Site

Total (%)

Status

Stage Distribution*

Analy NA Alive Exp 0

Non-Hodgkin Lymphoma 105 (3.7%) 60 45 90 NHL - Nodal 72 45 27 62 NHL - Extranodal 33 15 18 28 Myeloma 40 (1.4%) 24 16 29 Myeloma 40 (1.4%) 24 16 29 Leukemia 55 (1.9%) 33 22 40 Lymphocytic Leukemia 20 (0.7%) 11 9 10 Acute Lymphocytic 1 0 1 1 Leukemia C hronic Lymphocytic 16 9 7 7 Leukemia O ther Lymphocytic 3 2 1 2 Leukemia Myeloid & Monocytic 31 (1.1%) 20 11 26 Leukemia Acute Myeloid Leukemia 21 14 7 18 Acute Monocytic 1 1 0 1 Leukemia C hronic Myeloid 9 5 4 7 Leukemia Other Leukemia 4 (0.1%) 2 2 4 Mesothelioma 7 (0.2%) 4 3 7 Mesothelioma 7 (0.2%) 4 3 7 Kaposi Sarcoma 1 (0.0%) 1 0 0 Kaposi Sarcoma 1 (0.0%) 1 0 0 Miscellaneous 87 (3.0%) 49 38 68 Miscellaneous 87 (3.0%) 49 38 68 Total 2,861 1,339 1,522 2,476

III IV 88 Unk

15 10 5 11 11 15 10

86 58 28 28 28 30 17

19 14 5 12 12 25 3

0 0 0 0 0 0 0

23 14 21 27 1 13 5 20 21 0 10 9 1 6 1 0 0 0 0 29 0 0 0 0 29 0 0 0 0 40 0 0 0 0 10

4 3 1 0 0 0 0

0 2 2 0 0 0 0 797

0 0 0 0 0 0 0 417

0 0 0 0 0 0 0 298

0 2 2 0 0 0 0 389

0 2 0 3 0 3 1 1 1 1 19 48 19 48 385 2,221

2 0 4 0 4 0 0 0 0 0 39 0 39 0 640 227

4 0 0 3 0 3 0 0 0 0 68 0 68 0 246 102

*Analytic Cases Only

2014 Annual Report and Outcomes

CLINICAL PERFORMANCE DATA Performance measures give the health care community a way to assess quality of care provided against recognized standards. These accountability and quality measures, endorsed by the National Quality Forum (NQF), were developed along with input from the American Society for Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN), and the Commission on Cancer (CoC). Data were obtained from the National Cancer Database (NCDB), Cancer Program Practice Profile Reports (CP3R) along with comparative data from the Pennsylvania Health Care Quality Alliance (PHCQA). Data are updated annually. St. Luke’s consistently performed above the statewide and U.S. norms for breast and colon cancer for both the accountability and quality improvement measures.

St. Luke’s consistently performed above the statewide and U.S. norms for breast and colon cancer for both the accountability and quality improvement measures. 20

St. Luke’s Cancer Center

Breast Cancer Radiation therapy following breast-conserving surgery Radiation therapy is administered within one year of diagnosis for women under age 70 receiving breast-conserving surgery for breast cancer. SLUHN’s compliance with this standard was at 97 percent compared to the state norm of 95 percent and the national norm of 92 percent.

100

97%

95%

SLUHN

PA Rate

92%

90%

80 60 40 20 0

US Rate CoC Standard

Hormone modification therapy for breast cancer Hormone modification therapy is considered or administered within one year of diagnosis for women with AJCC T1c, or stage IB - III hormone receptor positive breast cancer. SLUHN’s compliance with this standard was at 100 percent compared to the state norm of 95 percent and the national norm of 91 percent.

100

100%

95%

91%

90%

80 60 40 20 0

SLUHN

PA Rate

US Rate CoC Standard

Combination chemotherapy for breast cancer Combination chemotherapy is considered or administered within four months of diagnosis for women under age 70 with AJCC T1c, or Stage IB - III hormone receptor negative breast cancer. SLUHN’s compliance with this standard was at 100 percent compared to the state norm of 94 percent and the national norm of 93 percent.

100

100%

94%

93%

90%

80 60 40 20 0

SLUHN

PA Rate

US Rate CoC Standard

2014 Annual Report and Outcomes

CLINICAL PERFORMANCE DATA cont. Colon Cancer Adjuvant chemotherapy within four months of surgery Adjuvant chemotherapy is considered or administered within four months of diagnosis for patients under the age of 80 with AJCC Stage III lymph node positive colon cancer. SLUHN’s compliance with this standard was at 100 percent compared to the state norm of 95 percent and the national norm of 91 percent.

100

100%

95%

91%

90%

80 60 40 20 0

SLUHN

PA Rate

90%

88%

US Rate CoC Standard

Number of lymph nodes excised during surgery At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer. SLUHN’s compliance with this standard was at 90 percent compared to the state norm of 88 percent and the national norm of 88 percent.

100 80

88%

80%

60 40 20 0

St. Luke’s Cancer Center

SLUHN

PA Rate

US Rate CoC Standard

We are proud of the St. Lukeâ&#x20AC;&#x2122;s Cancer Center team and its steadfast commitment to provide the highest quality cancer care to those we serve.

2014 Annual Report and Outcomes