LIVESTRONG AT THE YMCA 2015 CanCer Program a rePort

Not 1 Forgotte

n Ar

t

L I V E S T R O N G A T T H E Y M C A2015 CanCer Program annual rePort

2014 S TAT I S T I C A L Y E A R

25th McD

aniels Golf Classic

Fost

er G

. McGaw Award 25th Walk for Life

1Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

Integrated Network Cancer Committee Membership

Required Physician Members M.A. Ackerman, MD, ChairAye Phyu Aung, MDDouglas Bull, MDCharles Butler, MDTerry Chapman, MDJeanette Fulton, MDPaul Guerry, MDMichael Hayes, MDAndres F. Leone, MD Hart Parker, MD, Cancer Liaison Physician Dalton Prickett, MDScott Sommers, MDBen Wright, MD

Required Non-Physician Members Mary Ann Betenbaugh, PT, LMTValencia Bostic, MPADawn Bowers, RNJulie Marie Brown, RN, BSN, MHA, CCRAMelisa Carter, RN, BSN, OCNHeather Fleck, RDGreg Gattman, Acute Care ExecutiveRoger Hancock, PharmDAlice S. Hughes, RN, BSN, MBAKel Jansen, OTR/L, CLT-LANACaroline White Kearns, LMSWDonna Keisler, CTRHolly Knight, RNRachel A. Lewis, LISW-CP Malinda McCray, LMSWSue Modugno, RN, BSN, OCN, CCRCPatti Patterson, MS, RDDebra D. Seale, RN, MNMark Twohey, PharmDSusan Whitlock, RN, BSN, OCNTiffany Winslow, RN

Table of Contents

Message from Charles D. Beaman, Jr., CEO ................................1

Celebrating Silver Anniversaries, Walk for Life ..........................2

Celebrating Silver Anniversaries, McDaniels Golf Classic .....4

Palmetto Health Foundation Fundingfor Cancer Programs and Equipment ..........................................6

Not 1 Forgotten ....................................................................................6

Ovarian Cancer Survivor Reflections ............................................7

NAPBC Accreditation .........................................................................8

Lung Cancer Screening .....................................................................9

Foster G. McGaw National Prize .................................................. 10

Cancer Prevention and Screening Programs .......................... 11

Statistical Summary of Cancer Data .......................................... 13

Acknowledgements

Cancer Data Management Data AnalysisMona Carter, CTRPatricia CatesJina HanRebecca Heaberlin, RHIT, CTRMichelle Ingham, CTRDonna Keisler, CTRDyonne Louden, CTRSigne Malcolm

Content CoordinationDonna KeislerDebra D. Seale

ContributorsValencia BosticField BrabhamAshley DusenburyVince FordTiffany JohnsonDonna KeislerDebra D. SealeKimberly SouthKelly Touchstone

Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

1

Charles D. Beaman, Jr. Chief Executive Officer

In May of this year, I was proud to represent Palmetto Health at the American Hospital Association annual meeting where our organization received the prestigious Foster G. McGaw Prize in recognition of our longstanding commitment to community service. I came away from this experience truly impressed with how much health care organizations throughout the country are doing for their communities. People really do care what happens to their neighbors, like we do here, and they are working hard every day to make communities healthier places to live and work. Palmetto Health community initiatives include cancer prevention and screening programs, maternal and child health, diabetes health, Richland Care and community partnerships.

In early October, our community experienced historic rainfall and catastrophic flooding. It was a natural disaster like no other in the history of our organization. While we always try to prepare for the unexpected, the flood of 2015 tested us in ways we could not have imagined. Our community leaders supported us by helping to secure a reliable water supply to keep our hospitals operating so we could continue to provide safe, quality care for every one of our patients.

Over the past year, Palmetto Health has had many memorable moments, and we’ve shared some of these activities, stories and milestones in this year’s Cancer Program annual report: re-accreditation by the National Accreditation Program for Breast Centers, establishment of a lung cancer screening program, presentation of an original painting by artist Joel Gresham, the silver anniversaries of the McDaniels Golf Classic and the Walk for Life.

We are thankful for the power of community, the response of our community, team members and physicians in times of need, and the opportunity to serve one another. Together, we are the community.

Sincerely,

Charles D. Beaman, Jr.CEO, Palmetto Health


32

1991200 participants at the former Baptist Medical Center The first walk, “First Ladies’ Walk for Life,” co-founded by former First Lady of Columbia, Beth Coble, in collaboration with Baptist Medical Center staff, was held Sat., Oct. 12, 1991.

201411,000+ registered walkers and runners8,305 registered online 451 team captains/teamsProceeds from the 2014 Walk for Life/Race for Life, more than $814,000 including in-kind donations, helped fund two 3D Tomosynthesis (DBT) units, a whole breast ultrasound system and 3D mammography software upgrades for the Breast Center.

First mobile mammography program in South CarolinaIn 25 years, the Breast Center has replaced five mobile mammography units. In the early years of mobile mammography, images were recorded on film. Film from an entire day was stored in a light-tight box on the mobile unit and then taken back to the Breast Center to develop at the end of the day. Now, results are immediate because of digital technology.


Celebrating Silver Anniversaries Walk for Life

1990First breast cancer

nurse navigator

1991All technologists became

registered mammographers

1994First stereotactic biopsy performed

1995First multidisciplinary breast

cancer conference

1997First film processor installed

on the mobile unit

1998First ultrasound unit installed

at the Breast Center

2006First technologist to become registered

in breast ultrasound (5 total now)

2008System-wide digital mammography,

including the mobile unitBreast Imaging Center of Excellence (BICOE)

Award by the American College of Radiology (ACR)

2009First breast center in SC to be accredited by

the National Accreditation Program for Breast Centers (NAPBC)

2015First 3D Tomosynthesis

mammogram performed

199140 biopsies performed;

4 technologists

2014752 biopsies performed;

11 technologists

1991

2015

25 years of innovation, enhancements and firsts for the breast program at Palmetto Health; More than $8 million raised

3Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 StatisticsPalmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

Celebrating Silver Anniversaries Walk for Life

http://www.WalkForLifeColumbia.org

4 Palmetto Health Cancer Centers | 2014 Cancer Program Annual Report | 2013 StatisticsPalmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

Celebrating Silver Anniversaries McDaniels Golf Classic

25 years of changing lives at Palmetto Health Cancer Centers; more than $4 million in proceeds

Bill McDaniels, 25-year signature sponsor of the McDaniels Golf Classic, has been instrumental in raising more than $4 million for Palmetto Health Cancer Centers. He personally has given more than $500,000 through his businesses and has cultivated relationships with hundreds of sponsors, many of whom have been supporting the event since day one.

Bucky Drake, longtime supporter of Palmetto Health, was instrumental to the event 24 years ago after helping to develop a number of golf courses in the area.

“I said to one of my business partners, ‘You know, we should get a philanthropic golf tournament started on one of these greens,’” recalls Drake. “After getting in touch with Palmetto Health Foundation, we were able to make it happen. Bill McDaniels sponsored a hole-in-one the first year. Someone actually made it and won a car! Bill has been involved ever since.”

Over the years, proceeds have helped enhance programs and services for patients and families as well as purchase vital equipment, including an endoscopic ultrasound (EUS) and da Vinci® robotic surgical system upgrade.

McDaniels Golf Classic sponsors (left to right) John Harris, III, Suzanne Pucci, Bucky Drake, and Bill McDaniels join together to benefit Palmetto Health Cancer Centers.


Celebrating Silver Anniversaries McDaniels Golf Classic

76 Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

Foundation Funding for Cancer Programs and Equipment

Not 1 Forgotten founder, artist Joel Gresham

Palmetto Health Cancer and Breast Centers are extremely fortunate to have passionate Cancer Centers Board members who work through the Palmetto Health Foundation to raise funds to provide patient support, comfort items and new technology to improve the Cancer and Breast Centers’ programs. We are thankful for the people in our community who donate their time, effort and financial support. Through the support of our community in fiscal year 2015, the people we serve benefited from the following:

n Cancer patient educational materials and comfort items, tote bags for patients to carry their information with them to medical visits, calendars to keep up with their appointments, breast bears and post-mastectomy camisoles provided by the cancer nurse navigators

n Patient support programs: Bosom Buddies, Colon Cancer Support group and one-on-one counseling

n Ultrasound unit for the Breast Center

n Sofa beds and recliner chairs for inpatient oncology unit

n Cancer education and screening program women’s health event

n 3D digital mammography unit with tomography (tomo) for the Breast Center

n Mammography tomo workstation for the Breast Center

n Patient assistance upon discharge from the hospital for cancer patients who cannot afford the medications and supplies necessary to continue their care at home

n Lymphedema compression garments for cancer patients who cannot afford them

n Cancer education and screening program: screening mammograms and screening colonoscopies for uninsured and underserved residents of Richland, Lexington and Fairfield counties

n Trumpeter Campaign and smoking cessation program

Cancer program team members gather with artist Joel Gresham for the painting presentation. (L-R) Malinda McCray, Nan Carter, Tiffany Winslow, Valencia Bostic, Janet Groves, Greg Gattman, Debbie Seale, Joel Gresham, and Joan Cobb.

http://www.not1forgotten.org

Tiffany Johnson thought her abdominal pain could be appendicitis, so she went to the emergency room. A CT scan showed a large abdominal tumor. Her gynecologist did an ultrasound and referred her to a gynecologic oncologist. They thought it would be unusual for a 21 year old to have cancer, but it was a possibility they had to evaluate. She had been having irregular menstrual periods, and the growing tumor was causing increasing abdominal pressure. They decided the best course of action would be to remove the tumor. Before surgery, she looked about four months pregnant and weighed 134 pounds. After surgery on Nov. 20, she weighed 119 pounds, her abdominal pressure was relieved, and she was able to enjoy Thanksgiving with her family. However, the surgery revealed that she had ovarian cancer. Her faith and support from family and friends were paramount in helping her through this experience. Tiffany shares her story…

“Dr. Will Merritt, my gynecologic oncologist, was very compassionate and explained everything to me starting with the surgery. I was scheduled to have my right ovary removed. After the procedure, he explained that I had an early stage ovarian cancer and I needed chemotherapy to get rid of any remaining cancer cells. This was a very new situation to me, and I was still very confused and scared. Ironically, my grandmother met another young lady who had been through the same thing. Her name is Natalie, and she helped me with many of the questions I had. This was a defining moment when I could talk with another young survivor.

I started chemotherapy in December. I would go into the hospital for a week while receiving the chemotherapy continuously, and then I would get a break for two weeks. I repeated this process twice in a nine-week period. The hospital stays were physically and emotionally draining. My body would be fatigued, and my appetite was different after treatment. I lost my hair after the second week of treatment. That was a different experience! I’ve always had long hair and that’s been a trademark for me. It was traumatic, but with the support of family and friends, I found ways to deal with it. I went wig shopping with my grandmother and found cool ways to tie scarves on YouTube. I eventually told Natalie that I was tired of wearing it, and she said ‘just wear the bald head,’ so I did. The response I got was not what I expected at all. People


“I reflect on how far I’ve come, and I am excited for the future.”By Tiffany Johnson, ovarian cancer survivor

actually complimented me more than asked me why I was bald. To me, my bald head was a tragic side effect, and to the world it was a bold fashion statement.

When it was over, I really wanted to act like all of this never happened, but I was dealing with changes in body image. I was bald; my fingernails and veins were black. Let’s be honest, it was hard. The way I look has always been important to me, and I was constantly reminded of what happened because of the side effects of treatment. I just kept praying and tried to go through it with a good attitude. I tried to enjoy the happy times I did have, and I stayed away from people who were anything other than positive.

Before all this happened, I had taken prerequisite courses for the nursing program and was on the admission waiting list. I had been working at the mall for the past three years and was let go from my job. That was God’s timing and probably the best thing that could have happened to me; it helped me cope with what was going on. I just kept pushing and my grandmother made me get out as much as possible. Dr. Merritt kept encouraging me too; he said, ‘Keep pushing through.’ I’m getting healthier now, have gained some of my weight back and am now at a normal weight. I feel normal again, and it’s easier to talk about it. I go for a checkup every three months from my wonderful health care team.

As I reflect back on this experience, my health care team was amazing, and I’ve learned some things too: n Faith is the center; my faith in God carried me through. n Attitude: I focused on having a good outlook,

accepting the situation and dealing with it. It’s okay to feel sorry for yourself, but give yourself a time frame. Pick yourself up and fight back.

n Family members and friends supported me. I am forever grateful for those who were there for me.

Thinking about my future as a nurse, I recognize that people have lives outside of the hospital. As a nurse, I want my patients to trust me. I want to use smart judgment and prioritize what’s important to my patients. I want to be compassionate, listen to my patients, be caring and show respect to my patients, because that’s what was given to me. I reflect on how far I’ve come, and I am excited for the future.”

Palmetto Health Breast Center Team Achieves Three-Year Full NAPBC Accreditation

The American College of Surgeons, National Accreditation Program for Breast Centers, congratulates the Palmetto Health Breast Center team on achieving Three-Year Full Accreditation. NAPBC Accreditation is the seal of approval for breast centers from the American College of Surgeons and formally acknowledges the center’s commitment to providing the highest quality evaluation and management of patients with breast disease. As a NAPBC accredited Program, the Palmetto Health Breast Center has demonstrated that they meet the needs of breast patients by providing multidisciplinary, high-quality, patient-centered care. Congratulations to the Breast Center team on this achievement!

In 2009, the Palmetto Health Breast Center was the first in South Carolina to achieve NAPBC accreditation. The Breast Center was re-accredited in 2012 and again in 2015. The most recent NAPBC Survey in June confirms that our Breast Center is compliant in all 28 standards, and the program is nationally recognized for the Best Practice of discussing nearly all newly diagnosed breast cancer cases at the multidisciplinary Breast Cancer Conference.

8 Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

Palmetto Health provides a comprehensive lung cancer screening program for individuals identified at high risk for developing lung cancer. High risk factors include 55 to 77 years of age, 30+ pack-years* of smoking and having smoked within the past 15 years. The intent of lung cancer screening is to discover lung cancer at an early stage, increasing the chances for successful treatment and a full

recovery. Low Dose CT (LDCT) lung cancer screening is a quick and easy test taking less than one minute to perform. No medications or needles are needed. A person can eat before and after the test. In most cases, there is no need to change clothes. The person must be able to hold their breath for at least six seconds while the chest scan is being taken.

LDCT-based screening, performed in a high quality setting, has been found to reduce the number of people who die from lung cancer. As with any screening test, further testing should be expected in 20 to 25 percent of the screening population.

Lung Cancer Screening Program

Palmetto Health has screened 87 patients since beginning the program approximately one year ago. The screenings revealed the following results:

n Negative results were found (no cancer) in 59 percent of the tests performed.

n Benign findings (nodules with a very low likelihood of becoming cancerous) were found in 22 percent of the tests performed.

n Probably benign findings (nodules requiring short-term follow-up) were found in 11 percent of the tests performed.

n Suspicious findings (additional testing needed) were found in 7 percent of the tests performed.

The Centers for Medicare & Medicaid Services (CMS) announced in February, 2015, the addition of annual LDCT Lung Screening as a preventative service benefit under the Medicare program for appropriate beneficiaries. Some commercial insurance carriers are providing benefits as well. The cost of screening is lower than traditional CT.

It is important to have a shared decision making session with a primary care physician prior to scheduling the screening examination. Benefits and potential risks of CT lung screening should be discussed, as well as follow-up diagnostic testing, potential diagnostic results and radiation exposure. Smoking cessation and/or maintaining smoking abstinence also are important components to the program.

To find out more about the program or smoking cessation classes, call CareCall at 803-296-CARE (2273) or visit www.palmettohealth.org/lung.

*Pack-years is a way to measure how much someone has smoked. It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. For example, one pack-year of smoking would mean that someone had smoked one pack of cigarettes (20 cigarettes) daily for one year, or two packs a day for half a year, or 10 cigarettes a day for two years.

Kelly Touchstone, MA, CPHQPerformance Improvement Project Manager, Palmetto Health Corporate Quality

Palmetto Health lung cancer screening program is designated as a Screening Center of Excellence by the Lung Cancer Alliance.

98 Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics

http://www.lungcanceralliance.org/am-i-at-risk/where-should-i-be-screened/lung-cancer-screening-centers/centers/south-carolina/

http://www.palmettohealth.org/lung

Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 StatisticsPalmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics10

Caring for our Community: Palmetto Health wins the 2014 Foster G. McGaw Prize for Excellence in Community Health Services

residents of South Carolina. Being a part of the health care community is a blessing. At Palmetto Health, we strive to live out our Mission every day—to be committed to improving the physical, emotional and spiritual health of all individuals and communities we serve.

For the past 17 years, Palmetto Health has held strong to a commitment to give 10 percent of our bottom line to cancer, diabetes, teen, maternal and child health services and education, case management, specialty health care and community partnerships. That has equaled more than 45 million dollars of the health system’s bottom line returned to the community to improve lives.

At Palmetto Health, we aim to live our Vision every day:To be remembered by each patient as providing the care and compassion we want for our families and ourselves. We demonstrate this in the work we do, not just in our hospital but in our communities, as well. To be named the winner of the American Hospital Association’s Foster G. McGaw Prize for Excellence in Community Health is truly an honor. We are humbled to be able to share our stories and what we have learned at Palmetto Health with others. On behalf of Palmetto Health, myself, and all who have help us reach this milestone, thank you for your continued support and for allowing a chance for those who would otherwise not have it.

Palmetto Health team and community members accept the Foster G. McGaw prize in Washington, D.C., in May 2015.

Hearing someone say “you may have saved my life,” is humbling and rewarding. Recently, I’ve been blessed to hear that after a Palmetto Health radio commercial aired encouraging prostate cancer screenings.

Earlier this year, Palmetto Health was announced as the 2014 Foster G. McGaw Prize winner, a tribute to our

health care team’s community service through programs that demonstrate a drive for making communities healthy through active involvement. The American Hospital Association, with funding from the Baxter Foundation and the Health Research and Educational Trust, gives the award.

Knowing that we’ve helped thousands of people in our community and hearing testimonies of people with a new outlook on life helps us understand that what we do every day is important. A man recently told me how having a prostate cancer screening may have saved his life, and he is now receiving appropriate care and sharing his story with others. That’s what it’s all about.

My role as Chief Community Health Services Officer provides me with many opportunities for myself and the organization to reach out to the community, allowing us take a proactive stance in bettering the lives of the

Vince Ford, Palmetto Health Chief Community Health Services Officer

http://www.aha.org/about/awards/foster/index.shtml

http://www.PalmettoHealth.org/CommunityHealth

Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 StatisticsPalmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics 1110

Cancer Prevention and Screening Programs

Cancer is the second leading cause of death in the United States and accounts for one of every four deaths. According to the American Cancer Society, in 2015, there will be an estimated 1,658,370 new cancer diagnoses and 589,430 cancer deaths in the US. Cancer is the second leading cause of death in South Carolina and the primary cause in the Midlands, according to the SC Department of Health and Environmental Control (SC DHEC, 2014).

The Palmetto Health Cancer Health Initiative offers cancer education, screenings, case management and follow up care for residents of Richland, Lexington and Fairfield counties. The Cancer Health Initiative addresses five of the most prevalent types of cancer in South Carolina: breast, cervical, colorectal, lung and prostate.

Cancer education, screenings and lung health services are available to participants at health events, schools, faith-based, civic organizations, businesses and clinics. Intensive follow-up care and case management for patients with abnormal screening results also is provided. The Cancer Health Initiative provides screenings and services to the medically underserved and general public due to our state having one of the highest reported rates of prostate and lung cancer mortality.

FY 2015 Summary of Cancer Health Services Patients screened 2,676Screenings 4,480Lung health patients served 8,940Lung health services 9,335

Health Education and Cancer ScreeningsFree cancer awareness events, screenings and prevention workshops are provided throughout the year in more than 125 community locations. These events help educate the community about the signs and symptoms of cancer, as well as prevention. Clinical screenings also are provided weekly at Palmetto Health.

In order to provide clinical-based services, the Cancer Health Initiative partners with a variety of Palmetto Health specialty health care offices, including Palmetto Health Women’s Center, Palmetto Health Breast Center at the Baptist and Richland locations, Palmetto Health Cancer Center, Palmetto Health Orthopedics and their surgery center and Richland Care. Numerous primary care providers also ensure patients have ongoing access to medical care regardless of health insurance coverage.

FY 2015 Cancer Screening and Intervention Outcomes

Screening and Intervention Participants *Services Outcomes

Breast exams 1 breast cancer Clinical breast exam, mammogram and, if needed, ultrasound 818 2,504 Cervical exams Pelvic exam, Pap Smear, and if indicated ultrasound and colposcopy 2 cervical dysplasias

Colorectal exams 28 28 14 patients had polyps removed Colonoscopy Prostate exams 1,830 1,948 3 prostate cancers Prostate speci�c antigen and digital rectal exam Lung health 8,940 9,335 N/A outcomes Smoking cessation and Trumpeter Campaign TOTALS 11,616 13,815 4 cancers found and referred for follow-up treatment

*Participants may receive multiple services.

13Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics12

Case ManagementHealth care can be complicated following a cancer diagnosis. Case management and psychosocial support groups are vital to the continued care and well-being of cancer patients and their families. Case management is provided to all patients who have abnormal breast, cervical, colorectal or prostate screenings requiring further evaluation or treatment. Case management coordinators assist patients with follow-up medical appointments and diagnostic results.

Cancer Support ProgramIn addition, the case management team facilitates the MARYS (Meeting and Reviving Your Spirit) support group for cancer survivors. This group is designed for the unique needs of African-American women diagnosed with cancer, and provides a safe environment in which they can share their experiences and receive psychosocial, educational and spiritual insight and support. Each monthly session averages 10 women, accounting for more than one hundred contacts during the fiscal year.

Smoking CessationThe Smoking Cessation program consists of six 90-minute group meetings for smokers eager to quit. The initial meeting is a medical consultation with the program physician. Participants receive a medical check-up and, if desired, a prescription for Wellbutrin, Zyban or the nicotine patch. Participants can discuss personal motivations and learn cognitive-behavioral skills to quit smoking. In fiscal year 2015, 86 people participated in the program.

Next StepsIn fiscal year 2016, the Cancer Health Initiative will increase our responsibilities for population health and expand services to include other health concerns such as diabetes. Our team will continue to provide education, screening, wellness sessions and case management for breast, cervical, colon, lung and prostate cancers.

Cancer Prevention and Screening Programs

Trumpeter ProgramThe Trumpeter program is an initiative to educate

and prevent tobacco use by middle and high school students. Participants receive one hour of tobacco education, then are challenged to create positive tobacco-free marketing and media tools. This year 8,854 students

participated in the campaign. This anti-tobacco media campaign encourages students to have smoke-free lifestyles and to understand facts and myths of tobacco-related advertising.

Palmetto Health Cancer Centers | 2015 Cancer Program Annual Report | 2014 Statistics 13

For the 2014 statistical year, Cancer Data Management staff collected data on 1,951 newly diagnosed cancers which were diagnosed and/or treated at Palmetto Health. Data also was collected on an additional 1,366 non-analytic cases including recurrent or persistent cancers previously diagnosed and treated elsewhere, cases reviewed by pathology exam only, and cases which were seen at Palmetto Health for diagnostic work-up, consultation, or in-transit care only, for a total caseload of 3,317. In 2014, 150 patients were enrolled in cancer-related clinical trials.

Site-specific cancer conferences are held for frequently diagnosed cancers providing a multidisciplinary forum for physicians to discuss and plan treatment. In addition, a teaching conference is held for gynecological cancers focusing on didactic lecture, retrospective case reviews and journal discussions for residents and medical school students. The American College of Surgeons Commission on Cancer requires that at least 15 percent of the annual analytic caseload is presented at cancer conference and 80 percent of those must be prospective case presentations. During 2014, 1,361 cases were presented in 148 CME approved treatment planning conferences, representing 70 percent of the annual analytic caseload of 1,951 cases. All cases were presented prospectively, at a point in time when the multidisciplinary discussion could influence treatment choices. Palmetto Health cancer conference activities are shown in the table below.

Cancer Data Management Activity Palmetto Health 2014 Statistical Year

Total Cases 3,317

Analytic Cases 1,951

Non-analytic Cases (excludes history only with no active disease) 1,366

Follow-up Rate – 5 Year (CoC Target Rate 90%) 91%

Follow-up Rate – Reference Year 1998 (CoC Target Rate 80%) 84%

Clinical Trials Accrual Rate 7.7%

Cancer Conference Activity Palmetto Health 2014 Statistical Year

Conference Format Conference Number of Number of Percent Number of Percent Average Frequency Meetings Case Analytic Prospective Prospective Attendance (Minimum) Presentations* Case Case Case Presentations Presentations Presentations

Breast 84/year 95 913 47% 913 100% 19

Medical Specialties Represented Surgery, Medical Oncology, Radiation Oncology, Diagnostic Radiology, Pathology

GI 8/year 10 40 2% 40 100% 13

Medical Specialties Represented Surgery, Medical Oncology, Diagnostic Radiology, Pathology, Gastroenterology

Thoracic 15/year 24 165 8% 165 100% 20

Medical Specialties Represented Surgery, Medical Oncology, Radiation Oncology, Diagnostic Radiology, Pathology, Pulmonology

Urology/Prostate 15/year 19 243 12% 243 100% 11

Medical Specialties Represented Urology (Surgeons), Medical Oncology, Radiation Oncology, Pathology

Total 122 148 1,361 70% 1,361 100% 16

Commission on Cancer Requirements – – – 15% – 80% –

*Cases may be presented and counted more than once per Commission on Cancer.

Statistical Summary of Cancer Data


Frequency of Cancer – 2014 Palmetto Health

1,600

1,400

1,200

1,000

800

600

400

200

0 Breast Bronchus Corpus Uteri Prostate Skin All Other and Lung Sites

516

612

239

455

100

365

133 15592

130

871

1,600

� Analytic (1,951 Cases)

� Total Caseload (3,317) Cases

Cases

Age at Diagnosis – 2014 Analytic Cases

700

600

500

400

300

200

100

00-29 30-39 40-49 50-59 60-69 70-79 80-89 90+

29

196

377

593

440

175

6378

Cases

Palmetto Health - 1,951 Cases

The top five cancer sites in 2014 were breast, lung and bronchus, corpus uteri, prostate, and skin. The majority of skin cancers were melanoma (91 percent). Cancers in the top five sites comprised 55 percent of new cancer cases diagnosed and/or treated at Palmetto Health in 2014.

The risk for developing cancer increases with age with the majority of Palmetto Health patients (84 percent) diagnosed at age 50 or older. The average age at diagnosis during 2014 was 61.


1514



Distribution by Race - 2014 Analytic Cases Distribution by Gender - 2014 Analytic Cases


The patient population distribution for analytic cases by race was 60 percent caucasian, 39 percent African-American, and 1 percent other ethnicity, with females constituting 63 percent of the annual caseload. Distribution by county shows that 52 percent of these patients resided in Richland County, 16 percent in Lexington, 8 percent in Kershaw, 4 percent in Fairfield, 4 percent in Orangeburg, 3 percent in Sumter, 2 percent in Newberry and 11 percent in other counties.

Distribution by County - 2014 Analytic Cases


Kershaw 158

Fair�eld 87Newberry

47

Sumter53

Richland 1,019

Orangeburg 72

All Other 203

Lexington 312

Female 1,217

Male 734

Other 18

African-American 753

Caucasian 1,180

15

16

Analytic Cases by AJCC Stage and Non-Analytic Totals Palmetto Health Statistical Year 2014 AJCC Stage Group Cases

Primary Site 0 I II III IV N/A UNK Analytic Non-Analytic TotalOral Cavity/Pharynx 0 11 3 0 10 2 2 28 42 70 Lip 0 1 0 0 0 0 0 1 0 1 Base of Tongue 0 0 0 0 0 0 0 0 7 7 Other Tongue 0 6 1 0 0 0 1 8 4 12 Gum 0 1 0 0 0 0 0 1 2 3 Floor of Mouth 0 0 0 0 1 0 0 1 2 3 Palate 0 1 2 0 0 0 0 3 2 5 Other Parts of Mouth 0 0 0 0 1 0 0 1 2 3 Parotid Gland 0 1 0 0 2 0 0 3 4 7 Other Major Salivary Glands 0 0 0 0 0 0 0 0 2 2 Tonsil 0 1 0 0 3 0 1 5 4 9 Oropharynx 0 0 0 0 1 0 0 1 3 4 Nasopharynx 0 0 0 0 0 0 0 0 2 2 Pyriform Sinus 0 0 0 0 0 0 0 0 2 2 Hypopharynx 0 0 0 0 2 0 0 2 3 5 Other Lip, Oral Cavity & Pharynx 0 0 0 0 0 2 0 2 3 5 Digestive System 3 68 52 50 67 9 2 251 215 466 Esophagus 0 2 2 1 5 0 1 11 10 21 Stomach 0 9 1 8 7 1 0 26 19 45 Small Intestine 0 1 3 2 0 0 0 6 4 10 Colon 1 16 24 15 27 0 0 83 70 153 Rectosigmoid Junction 0 3 3 0 1 0 0 7 5 12 Rectum 0 18 9 14 6 0 0 47 24 71 Anus & Anal Canal 2 5 0 1 1 0 0 9 11 20 Liver & Intrahepatic Bile Duct 0 10 4 4 7 2 1 28 20 48 Gallbladder 0 0 0 3 2 0 0 5 1 6 Other Parts Of Biliary Tract 0 1 1 0 0 0 0 2 3 5 Pancreas 0 3 5 2 11 0 0 21 46 67 Other Digestive Organs 0 0 0 0 0 6 0 6 2 8Respiratory System and Intrathoracic Organs 2 63 26 52 114 0 1 258 233 491 Nasal Cavity & Middle Ear 0 0 0 0 1 0 0 1 2 3 Larynx 2 5 2 1 3 0 0 13 12 25 Bronchus & Lung 0 56 23 51 108 0 1 239 216 455 Heart, Mediastinum & Pleura 0 2 1 0 2 0 0 5 3 8Bones & Cartilage of Limbs 0 0 1 0 0 1 0 2 1 3Bones & Cartilage of Other 0 0 0 0 1 4 0 5 2 7Hematopoietic & Reticuloendothelial Systems 0 1 0 0 0 69 0 70 134 204Skin 37 31 11 5 5 3 0 92 38 130Peripheral Nerves & Autonomic Nervous System 0 1 0 0 0 0 0 1 0 1Retroperitoneum & Peritoneum 0 0 1 4 1 0 0 6 6 12Connective & Other Soft Tissue 0 2 1 6 2 0 0 11 5 16Breast 75 217 141 59 22 0 2 516 96 612Female Genital Organs 9 127 9 55 13 3 2 218 73 291 Vulva 7 16 0 2 1 0 2 28 4 32 Vagina 1 0 0 0 0 0 0 1 0 1 Cervix Uteri 0 11 1 4 1 0 0 17 22 39 Corpus Uteri 1 90 6 23 11 2 0 133 22 155 Ovary 0 10 2 25 0 1 0 38 24 62 Other Female Genital Organs 0 0 0 1 0 0 0 1 1 2Male Genital Organs 1 8 64 23 8 0 2 106 269 375 Penis 1 0 0 0 0 0 0 1 0 1 Prostate Gland 0 5 63 22 8 0 2 100 265 365 Testis 0 3 1 1 0 0 0 5 3 8 Other Male Genital Organs 0 0 0 0 0 0 0 0 1 1Urinary Tract 52 55 17 22 13 1 0 160 60 220 Kidney 0 41 4 13 6 1 0 65 26 91 Renal Pelvis 2 1 0 3 3 0 0 9 3 12 Ureter 1 0 0 2 1 0 0 4 0 4 Bladder 49 13 13 4 3 0 0 82 31 113Brain and CNS 0 1 1 0 0 93 0 95 61 156 Eye & Adnexa 0 0 0 0 0 5 0 5 5 10 Meninges 0 0 0 0 0 51 0 51 19 70 Brain 0 1 1 0 0 32 0 34 25 59 Spinal Cord & Other CNS 0 0 0 0 0 5 0 5 12 17Thyroid & Endocrine Glands 0 24 3 9 2 24 4 66 39 105 Thyroid Gland 0 24 3 9 2 0 4 42 12 54 Adrenal Gland 0 0 0 0 0 4 0 4 0 4 Other Endocrine Glands 0 0 0 0 0 20 0 20 27 47Other & Ill-de�ned Sites 0 0 0 0 0 1 0 1 2 3Lymph Nodes 0 4 9 12 22 1 0 48 81 129Unknown Primary Site 0 0 0 0 0 17 0 17 9 26

Total 179 613 339 297 280 228 15 1,951 1,366 3,317


Palmetto Health Cancer Centers2015 Cancer Program Annual Report2014 Statistics

5 Richland Medical Park Dr.Columbia, SC 29203 andTaylor at Marion St.Columbia, SC 29220

Patients are admitted to this facility and are rendered services without distinction due to race, color, national origin, handicapping condition or age.

http://www.palmettohealth.org

LIVESTRONG AT THE YMCA 2015 CanCer Program a rePort

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