Saint Francis Cancer Center Annual Report | 2021

Since 1975, the cancer program at Saint Francis Health System has provided state-of-the-art medical oncology and radiotherapy technology to residents in eastern Oklahoma and surrounding states. Committed to advancing oncology care, Saint Francis provides an array of oncology services to meet patient needs. The cancer center’s treatments include board-certified physicians who provide multidisciplinary care in a professional, patient- and family-focused setting. Additionally, the cancer program is accredited by the American College of Surgeons as a Comprehensive Community Cancer Program.

2021 Annual Cancer Program Update

2021 was a year of transition when we learned to experience living in a world of COVID-19 precautions in a routine manner. While we did experience a fairly significant decrease in cancer screenings in 2020, we saw a turnaround in 2021 with an increase in not only cancer screenings but, unfortunately, new cancer cases diagnosed. Because of delayed cancer screenings in 2020, industry experts expect there to be a negative impact on new cancer diagnoses in that patients will be diagnosed later and thus in more advanced stages, which is extremely unfortunate. We remain committed to providing excellent clinical, patient-centered care and services.

Highlights from 2021 include the following:

• Renovation of a portion of the second floor of Saint Francis Cancer Center was completed, which allowed for the opening of 20 new chemotherapy infusion bays on this floor.

• Over $38 million in outpatient drug assistance for oncology patients was obtained to help defray the costs of chemotherapy treatment through drug replacement and/or drug co-pay cards.

• One additional Warren Clinic medical oncologist joined the Saint Francis team.

• In 2021, Saint Francis provided 613 (87% more than 2020) breast health services to Oklahoma Project Woman patients (screening mammograms, diagnostic mammograms, ultrasounds, biopsies and MRI) who are female patients in Oklahoma who have no health insurance and/or limited financial resources.

• Saint Francis remains a nationally recognized Lung Cancer Screening Center of Excellence in the state of Oklahoma.

• The radiation oncology department at Saint Francis was recognized as a top radiation department in the country for patient satisfaction for the fifth year in a row.

• The Saint Francis Cancer Center infusion department was recognized as a “5 Star” performer for patient satisfaction/experience being at the 90th percentile or higher.

• Saint Francis Hospital’s cancer program was reaccredited for three more years by the American College of Surgeons’ Commission on Cancer (CoC).

• Completion of renovation and move of the inpatient oncology nursing unit to 3 South in Saint Francis Hospital with a total of 39 beds with 13 being able to be utilized for patients who have transitioned to comfort care and awaiting discharge on hospice.

Saint Francis Health System remains committed to being a leader in oncology care and services for northeastern Oklahoma focused on improving the health and outcomes of our patients as we carry out our mission to extend the presence and healing ministry of Christ in all that we do.

Nancy N. Thomas, M.A., RHIA, CPHQ

Senior

Director, Oncology Service Line

Saint Francis Health System

Commission on Cancer

Since 1978, the cancer program at Saint Francis Hospital has been continually accredited by the American College of Surgeons’ Commission on Cancer (CoC). The Commission on Cancer is the only multidisciplinary accreditation program for cancer programs in the U.S. and recognizes cancer care programs for their commitment to providing comprehensive, high-quality and multidisciplinary patient-centered care. Membership and accreditation is voluntary for healthcare organizations with cancer programs. Saint Francis Hospital has a dedicated multidisciplinary cancer committee that meets quarterly to ensure the highest quality of care is being provided to our patients. This dedicated committee sets annual programmatic and clinical goals and implements improvement projects that focus on quality of care and services.

Ancillary and Support Services

Ancillary Services include:

• Nurse Navigation—navigators serve as a coordinator of care and central point of contact for patients/families throughout the oncology journey.

• Oncology Social Worker—assistance and guidance in linking patients with appropriate resources in the community

• Oncology Financial Counselor—assists patients with accessing any patient financial assistance available to them, such as drug replacement, drug co-pay cards, patient foundation assistance funds, Medicaid, charity care, etc.

• Genetic Counselor—access to genetic counselor for understanding of genetic testing results and how they affect the patient individually as well as potential implications for family members

• Oncology Registered Dietitian—available to assist patients with addressing nutritional needs, concerns and issues to optimize patients’ nutritional status

• Oncology Rehabilitation—physical therapy, occupational therapy and speech therapy services, including lymphedema clinic provided by oncology-trained therapists to help patients achieve improved functional status, decreased pain, etc.

• Pharmacy—Registered pharmacists oversee technicians who prepare all the chemotherapy drugs to be administered intravenously to patients as well as oral drugs dispensed through our outpatient pharmacy

• Pastoral Care—members of the Department of Religion are available to all oncology inpatients as well as their family to provide support and minister to them as needed/requested, including providing Holy Communion to Catholics.

• Hospice—Saint Francis Hospice provides physical, psychological, social and spiritual support to terminally ill patients and their families. The hospice team also serves as consultants for end-of-life care.

• Laureate Psychiatric Clinic and Hospital—licensed clinical psychologists and psychiatrists provide counseling and therapy services on both inpatient and outpatient basis

• Outpatient palliative care (supportive care)—consult with oncology advanced care provider, oncology nurse and social worker as a team to understand the benefits of palliative care and ongoing visits and dialogue with these providers (without charge) to help cancer patients and their families with comfort and support

Diagnostic Services include:

• Tomosynthesis (3D) digital mammography

• Automated Whole Breast Ultrasound (ABUS)

• Handheld breast ultrasound

• CT (computerized axial tomography) scan

• MRI and Breast MRI (Magnetic Resonance Imaging)

• PET scan (Positron Emission Tomography)

• Nuclear Medicine

• Diagnostic Radiology

• Laboratory and Pathology Services

• Genetics Lab

About Saint Francis Cancer Center

The Saint Francis Cancer program was established in honor of Natalie Warren Bryant, second daughter of hospital founders Mr. and Mrs. William K. Warren, Sr. Natalie passed away from breast cancer at age 49. Originally, cancer services were only provided to patients at Saint Francis Hospital; however, in 2013, outpatient cancer services were expanded to the newly acquired Saint Francis Cancer Center located at 11212 E. 48th Street in Tulsa. Services provided through the cancer program are multidisciplinary in nature and are patient-centered and focused.

Quality Patient-Centered Cancer Care

Maintaining a state-of-the-art, quality cancer treatment center requires teamwork among many disciplines. Our multidisciplinary team approach is the key to providing excellent quality care for patients and their families. By combining the cancer center’s medical and other clinical teams’ expertise and specialized knowledge, a comprehensive care management plan is developed to meet the individual patient’s needs.

The cancer center provides patients with the convenience of receiving most ambulatory services in one location. Our cancer treatment center physicians and providers have access to the extensive resources of Saint Francis Hospital, including an acute inpatient oncology unit. Post-treatment care is available through Saint Francis Home Health as well as hospice and palliative care services.

Cancer Treatment Center With a Family Focus

As advanced as our treatments are, we understand one of the most powerful tools in our patients’ fight against cancer is the support of their family and friends. We have support groups for both patients and caregivers that are facilitated by our outpatient oncology social worker.

Prevention and Screening Programs Offered Through Saint Francis

Saint Francis Hospital offers a variety of annual prevention and screening programs to the community. The Saint Francis Cancer Committee is committed to developing programs that have a direct impact on health. These programs provide early detection and promote a healthy lifestyle.

2021 Prevention Programs and Outcomes

Dermatology and Skin Cancer Prevention Presentation

Virtual Town Hall Meeting for community • Jonathan Ledet, M.D. • May 18, 2021 • 81 Participants

• 79% of the participants who took the post-presentation survey indicated they would change their behavior with regard to skin cancer prevention in that they would use sunscreen more regularly and check themselves for moles and skin lesions

Skin Cancer Screening Event as part of the Saint Francis HealthZone Annual Wellness Expo

Jonathan Ledet, M.D. and two physician assistants • June 26, 2021 • 108 Participants

• 100% of participants had some finding—39.8% having seborrheic keratosis and 38.9% having actinic keratosis

• 43.5% of participants screened had at least two diagnostic findings

• 11.1% of participants had three diagnostic findings

• 55% of participants indicated they use sunscreen “sometimes” (most prevalent answer)

• 33% of participants responded either rarely or never wearing sun-protective clothing

• 36% of participants indicated use of indoor tanning

2021 Screening Programs and Outcomes

The Saint Francis Cancer Center is committed to offering screening programs to detect cancers at an early stage, improving rates of survival.

Lung Cancer Screening (Low-Dose CT scans)

• 1,454 screenings completed (calendar year 2021)—this represents a 38.5% increase from the previous year in spite of the pandemic.

• 15 positive diagnoses for lung cancer (1.03%)—all referred—only 8 (53.3% were early stage) which is indicative of delayed screenings due to the pandemic

• 8/15 (53.3%) were diagnosed during annual screenings, not initial, which is indicative of how important returning annually for this screening is

Saint Francis Breast Center

• 27,816 screening mammograms performed (calendar year 2021)—an increase of 12.2% from 2020

• 1,071 biopsies performed (52.1% increase from 2020)

• 420 biopsies positive for cancer (39.2%)—all referred

Oklahoma Project Woman

• 548 total mammograms performed (calendar year 2021)

• 613 total procedures performed for these patients, which included 30 biopsies

Other Notable Activities and Outcomes within the Cancer Program

Each month, our Saint Francis Oncology Nurse Navigators work with an average of 558 patients helping address barriers to care, facilitating care coordination, and providing education regarding disease and treatment.

In 2021, there were 10,520 oncology distress screening forms completed with 1,888 (18%) having a need for contact by an oncology social worker. One of the many ways social workers were able to assist patients was helping to arrange 374 one-way rides to/from Saint Francis Hospital or Saint Francis Cancer Center for care and services. We were able to help so many due to an American Cancer Society transportation grant as well as providing gas cards to some individuals.

Saint Francis Oncology Rehabilitation Services Outcomes

2021 Adult | Age 18–120 years *88’s & Unknowns is a combination of 88’s not applicable or not defined by AJCC and Unknown (the criteria for the stage classification has not been met or it is unknown if it has been met)

PRIMARY SITE M F TOTAL (%) STG 0 STG I STG II STG III STG IV 88’s & Unknown*

ORAL CAVITY & PHARYNX 42 22 64 (2.4%) 3 10 13 9 18 11

DIGESTIVE SYSTEM 242 179 421 (15.9%) 6 63 77 84 118 73

RESPIRATORY SYSTEM 178 156 334 (12.6%) 3 53 27 73 146 32

BONES & JOINTS 1 1 2 (0.1%) 0 1 0 0 0 1

SOFT TISSUE (including Heart) 3 4 7 (0.3%) 0 1 0 1 1 4

SKIN EXCLUDING BASAL & SQUAMOUS 76 39 115 (4.3%) 49 24 8 5 8 21

BREAST 2 539 541 (20.5%) 86 303 60 41 26 25

FEMALE GENITAL SYSTEM 0 96 96 (3.6%) 0 34 4 11 20 27 MALE GENITAL SYSTEM 306 0 306 (11.6%) 0 85 105 50 34 32

URINARY SYSTEM 146 56 202 (7.6%) 54 62 21 20 23 22

BRAIN & OTHER NERVOUS SYSTEM 48 77 125 (4.7%) 0 0 0 0 0 125

ENDOCRINE SYSTEM 29 99 128 (4.8%) 0 85 10 1 2 30 LYMPHOMA 51 48 99 (3.7%) 0 14 20 18 40 7 MYELOMA 31 20 51 (1.9%) 0 1 1 4 0 45

LEUKEMIA 39 24 63 (2.4%) 0 1 0 0 20 42 MESOTHELIOMA 1 0 1 (0.0%) 0 0 0 0 1 0

KAPOSI SARCOMA 0 1 1 (0.0%) 0 0 0 0 0 1

MISCELLANEOUS 37 49 86 (3.3%) 0 0 0 0 0 86

TOTAL: 1232 1410 2,642 201 737 346 317 457 584

2021 Pediatric Cases | Age at Diagnosis: 0–17 years *88’s—not applicable or not defined by AJCC

PRIMARY SITE TOTAL (%) M F STG 0 STG I STG II STG III STG IV 88*

DIGESTIVE SYSTEM 2 (3.0%) 2 0 0 1 0 0 0 1

BONES & JOINTS 4 (6.0%) 2 2 0 1 2 0 1 0

SOFT TISSUE 1 (1.5%) 1 0 0 0 0 0 0 1

MALE GENITAL SYSTEM 1 (1.5%) 1 0 0 0 0 0 0 1

URINARY SYSTEM 7 (10.4%) 3 4 0 0 0 0 0 7

BRAIN & OTHER NERVOUS SYSTEM 14 (20.9%) 10 4 0 0 0 0 0 14

ENDOCRINE SYSTEM 7 (10.4%) 3 4 0 0 1 0 0 6 LYMPHOMA 5 (7.5%) 3 2 0 2 1 0 0 2 LEUKEMIA 24 (35.8%) 14 10 0 0 0 0 0 24

MISCELLANEOUS 2 (3.0%) 2 0 0 0 0 0 0 2

TOTAL 67 41 26 0 4 4 0 1 58

MISSION

To extend the presence and healing ministry of Christ in all we do

VISION

Inspired to create a sustainable and just healthcare system, Saint Francis will be the technology-enabled health ministry that delivers integrated, market-leading, high-quality, affordable care through engaged caregivers to the people of eastern Oklahoma.

VALUES Excellence

Promoting high standards of service and performance

Dignity

Respecting each person as an inherently valuable member of the human community and as a unique expression of life

Justice

Advocating for systems and structures that are attuned to the needs of the vulnerable and disadvantaged and that promote a sense of community among all persons

Integrity

Encouraging honesty, consistency and predictability in all relationships

Stewardship

Ensuring prudent use of talents and resources in a collaborative manner