Mission StAtement - Akron General Medical Center

The Choice You Can Believe In.

2010/2011 AnnUAL RePoRtCAnCeR CommitteeMedical Staff membersH. Scott Awender, MD, SurgeryPaula S. Bauer, MD, Chair, PathologyBrian Canterbury, MD, UrologyAndrew H. Fenton, MD, SurgeryThomas E. Herbener, MD, RadiologyEric L. Jenison, MD, Gynecologic OncologyRenee L. Markovich, MD, Family PracticeFrederick Marquinez, MD, Hematology/OncologyScott McGee, MD, Hematology/OncologyRobert G. Netzley, MD, Thoracic SurgeryIfeoma R. Okeke, MD, Hematology/OncologyAshok Ramalingam, MD, Radiation OncologyEsther H. Rehmus, MD, Hematology/OncologyAdministrative membersAmanda Benedetti, RPhConnie T. Bollin, MBA, RNBarb Carter, RN, OCNColeen DeSalvo, CTRCindra DiBlasi, RNMichele Dudek, MPTCathy Farmer, RN, OCNBarb Greve, RNShirley Hayes, RN, CNSLisa Hirt, RD, LDSue Hobson, Director, Community HealthJulie Imani, MSN, RN, CNSLinda Izzo, RN, CNA, BC, CCM, CPHQMargaret Kimes, RN, OCN, BSN, MBAErin Lohr, ACS RepresentativeKathy Lukity, RN, CBCN, BSNNicole McMullen, PharmDTim Tyler, MSWClaire Wilson, RN, MSNmission stAtementThe mission of the Akron General McDowell Cancer Center isto offer the best opportunity for cure, quality of life and hopefor people with cancer.Vision stAtementTo have Centers of Excellence in Breast, Lung, Colon andGynecology.To provide true, multidisciplinary care that is integrated,timely, and close to where patients live.To have a coordinated scope of wellness, education, detection,treatment and survival services, encompassing patients, thecommunity and physicians.To be well known for exceptional outcomes and survival.To exceed six percent accrual rate for Commission on CancerCommendation Status and attain accreditation status forcenters of excellence as they become available.

2010/2011 AnnuA l r eporTgyneCoLogiC onCoLogyThe Gynecologic Oncology Group (GOG)and NCI-cooperative research trialscontinue to provide Akron General’spatients with the latest therapies.Patients with cervical, uterine and othergynecologic cancers are being treatedwith the latest technology available. High-Dose Rate (HDR) brachytherapy, IntensityModulated Radiation Therapy (IMRT) andImage-Guided Radiation Therapy (IGRT)are being incorporated into the treatmentplans for patients requiring radiationtherapy. Intraperitoneal, or “bellywashing,”chemotherapy protocols are among theseveral methods offered to provide ovariancancer patients with the best therapeuticoptions available.Research within the Obstetrics &Gynecology Department continues toattract interest at national conferences.Cancer-related research presented by EricJenison, MD, included “Skill Acquisition andMaintenance on the da Vinci® Robot” atthe May 2011 World Robotic GynecologyCongress III (WRGCIII). Karen Gil, PhD,Director of OB/GYN Research, serves onthe Quality of Life Committee for theGynecologic Oncology Group and hascontributed to research on a national level.Robotic surgical research through aDepartment of Defense grant has providedtraining for more than 50 surgeons. Roboticsurgery for gynecologic malignancies isnow used to treat patients who requireradical surgery with pelvic and para-aorticlymph node dissection and can result inless pain, earlier hospital discharge (oftenwithin 24 hours) and faster recovery.The GYN Oncology Subcommitteereviewed Stage I Ovarian Cancer casesas its annual quality project and thedepartment was found to be compliantwith NCCN/NCI treatment guidelines.In addition, the OB/GYN Departmentprovided several cervical cancer screeningsfor indigent patients through the AkronGeneral Women’s Health Clinic.The William A. Cook, MD, 14th AnnualMemorial Lecture in Obstetrics andGynecology was combined with theSecond Annual Ohio Breast OncologyFellowship Research Symposium and tookplace in conjunction with the Departmentof Surgery. The topics presented included“Questions & Controversies in NeoadjuvantChemotherapy for Breast Cancer” byEsther Rehmus, MD, and Ifeoma Okeke,MD, and “Breast Oncology Fellow ResearchPresentations” by Tiffany Berry, MD,Gelen Del Rosari, MD, and Jessica Partin,MD. The William A. Cook, MD, VisitingProfessor Dr. Summer James presented on“Fertility Preservation & Breast Cancer” and“Polycystic Ovary Syndrome.”inPAtient mCDoWeLLonCoLogy UnitNursing expertise and compassioncontinue to drive the progressive InpatientOncology Unit. Located on the fifth floor,5400 consists of 27 private rooms. Themultidisciplinary approach to optimalhealthcare for our patients consists ofboard-certified oncologists, physicians,certified chemotherapy nurses, advancedpractice nurses, dietitians, social workers,care managers, Rehabilitation Services,Pharmacy, Respiratory Care, Laboratory andSpiritual Care. All disciplines work togetherto provide highly competent, evidencebasedcare promoting well-being whileembracing quality of life through caring,listening and unconditional acceptance.5400 has open visiting hours for theconvenience of patients and their families.A beautifully appointed family room andkitchen are also available. For those familieswishing to spend the night, a privatebedroom or lounge chairs are provided fornighttime comfort.The milkshake program - founded by thelate “Milkshake Man” Berman Stills - stillremains intact in his honor and memory.The milkshakes, made by our volunteers,provide a soothing treat for patients.inteRVentionALRADioLogyfoR CAnCeR tReAtmentInterventional Radiologists at AkronGeneral play a key role in cancer treatmentand are performing minimally invasivecancer treatment procedures. AkronGeneral is the only hospital in the areaperforming these highly effective ablativetechniques.Through Interventional Radiology, imageguidance is used for aspiration or corebiopsy of suspected tumors and needlelocalization assists surgical resectionof suspected tumors. InterventionalRadiology serves as a key component torelieving obstructions caused by tumors aswell as pain management.Ablative techniques are minimallyinvasive and can be highly effective inthe treatment of certain types of cancer.Bland embolization, or embolizationwithout chemotherapy, can be extremelyeffective in treating primary liver cancersand has also shown promising resultswith some types of metastatic tumors,especially when combined with othertherapies. Chemoembolization deliverschemotherapy directly to the canceroustumor via the feeding blood vessel andcan be used as sole treatment or maybe combined with other treatmentoptions such as surgery, chemotherapy,radiation therapy or radiofrequencyablation. Radiofrequency (RF) ablation isa non-surgical procedure that heats andkills cancer cells via a CT- or ultrasoundguidedneedle and often requires only onetreatment session. Cryoablation kills cancercells by freezing them utilizing ultrasoundto guide cryoprobes through the skin.The Choice You Can Believe In.6

mcdowell cancer centerLung CenterThe Oncology Care Coordinator, aregistered nurse, receives referrals fromphysicians for patients with suspiciouslung nodules. The Care Coordinator assistsin scheduling referrals to specialists andnecessary tests in order to fast-track thepatient’s treatment plan, and is availableto offer patients support and educationthroughout their course of care.Medical Oncology andHematology2010 was a year of progress for the sectionof the Medical Oncology and HematologyDepartment. Currently eight specialists areactively involved in the program, treatinga multitude of patients and their oftenvery complicated diseases and relatedproblems. The many changes in thisfield are adapted to our practices rapidly,with a consistent effort in maintainingquality of care and early incorporation ofnew and more effective therapies. This isaccomplished only with the help of superbcolleagues and staff members. Recruitmentof a new Doctor of Pharmacology filleda much-felt gap in the program. TheDoctor of Pharmacology conductseducational classes for all new patientsrequiring chemotherapy, helping toease patient anxiety toward undergoingtreatment. A major change that tookplace within the department wasconversion to an electronic medicalrecord that is shared among the medicaloncologists, radiation oncologists and theCancer Treatment Center.Oncology NutritionNutrition continues to be central to acancer patient’s treatment and recovery.Akron General’s Oncology Dietitianutilizes evidence-based guidelines tominimize malnutrition and side effects ofcancer treatment. The Patient- GeneratedSubjective Global Assessment (PG-SGA)screening process assists with identifyingpatients at high risk for nutritionalcomplications. In 2010, approximately700 oncology patients were screened andapproximately 50 percent of them requiredadditional dietitian intervention.Outpatient McDowellCancer TreatmentCenterThe top priority of the Outpatient McDowellCancer Treatment Center is patient careand safety. All new registered nursesattend the Oncology Nursing Society(ONS) Chemotherapy and Biotherapyclass and pass a rigorous chemotherapycertification exam. Nurses maintain theircertification by completing an annualcompetency exam. Akron General isproud that 41 percent of nurses caring forcancer patients have received certificationas Oncology Certified Nurse (OCN), anadvanced certification which is in additionto the ONS Chemotherapy and Biotherapyclass. Nurses receive additional educationfrom “lunch and learns” organized by theCancer Research Department, whereby areaeducators speak on cancer-related topics.The Cancer Treatment Center had 12,788patient visits in 2010. The addition of aReimbursement Specialist to assist with theRevenue Cycle Team helped to increase thenumber of patients the Resource Counselorcould connect to various programs. Thewaiting room in the Physician OfficeBuilding was expanded to improve thecomfort of patients, friends and family,and integrated physician office visits in thecenter eliminate patient waiting in twolocations. The “Orientation Express” classeswere expanded to two days per week toaccommodate patients and physicians.A program was developed to increaseaccess to care for patients closer to wherethey live, so that patients receiving nonchemotherapymedications could receiveinfusion services at the Akron GeneralHealth & Wellness Centers in Stow andwest Akron at a time convenient to themand their families. Infusion services werealso expanded on the main campus toaccommodate those patients needingservice outside of the traditional 8 a.m.-5p.m. hours, including weekends andholidays. With the implementation ofRelationship-Based Care, Akron General’spractice model for professional nursing, theCancer Treatment Center increased patientsatisfaction scores to a mean of 95 for thepast three quarters.Akron General’sOncology Dietitianutilizes evidence-basedguidelines to minimizemalnutrition and sideeffects of cancertreatment. The Patient-Generated SubjectiveGlobal Assessment(PG-SGA) screeningprocess assists withidentifying patients athigh risk for nutritionalcomplications.7

2010/2011 AnnuA l r eporTPAin mAnAgementThe Pain Management Program providesrelief from pain related to cancer and itstreatment. The goal is to improve overallquality of life for patients and their families.This is achieved through pain managementcounseling, education and therapyoptions for patients, caregivers, nurses andphysicians. Treatment depends on the causeof the pain and the patient. Each plan oftreatment is highly personalized, dependingon patient needs and preferences. Thephysicians and pharmacists with the PainManagement Program also provide trainingfor medical and pharmacy students andresidents.The Pain Management Program continuesto grow every year, based on new inpatientconsultations. In 2010, new inpatientconsultations increased by roughly 11percent over 2009, with the programreceiving a total of 842 new inpatientconsultations. The greatest increase wasnew cancer pain consultations, increasingby approximately 26 percent in 2010. Mostof the new cancer consultations wererequested by a surgical service.PAthoLogyPathology works closely with MedicalOncology, Radiation Oncology and Surgeryto provide accurate diagnostic, prognosticand staging information. Pathologistsparticipate in weekly cancer conferences,contribute to site-specific cancercommittees and are involved in residenteducation.Akron General’s Fine Needle Aspiration(FNA) service provides point-of-careevaluation of patient samples obtainedby image guidance, and specially trainedcytopathologists perform the FNAprocedure on palpable lesions. This allowsfor rapid, non-surgical diagnosis.In the clinical laboratory, medicaltechnologists perform highly complextesting on blood and bone marrow,providing information that helps guidetherapy. Medical technologists work closelywith the Cancer Treatment Center staff toprovide rapid test results, decreasing time totreatment.PsyChiAtRy AnDBehAVioRAL sCienCesPatients and families have access to variousmental health services to help them copewith the many phases of cancer diagnosis,treatment and recovery. Consultations witha clinical psychologist and/or psychiatristwho is Board-certified in the subspecialtyof psychosomatic medicine are availableto patients during hospitalizationfor both counseling and medicationrecommendations. Both patients and familiescan be referred to various outpatient mentalhealth services for ongoing treatment needs,including an intensive outpatient programwith evening hours now available at theHealth & Wellness Center – West in additionto programming on main campus.RADiAtion onCoLogyMore than 13,000 radiation therapytreatments were administered at AkronGeneral and Robinson Radiation Oncology, asatellite facility joint venture with RobinsonMemorial Hospital, in 2010.A program of stereotactic radiotherapytreatment for small peripheral lungtumors and selected previously treatedmetastatic tumors was initiated. Stereotacticradiotherapy enables selected patients tobe managed with five or fewer high-doseradiation therapy treatments. This techniqueis made possible with methodologyto localize tumors more precisely andimmobilize patients more effectively.Because of this, the tumors may then betreated with a much smaller surroundingmargin of normal tissue within thetreatment volume. Specifically for the lung,local control is markedly improved whencompared to standard longer durationradiotherapy.Radiation therapy treatment of patients withcervical cancer has improved with the useof new tandem and ring applicators, whichare more durable and may deliver a moreeffective radiation therapy treatment doseto cancerous tissue surrounding the cervix.In addition, the prostate brachytherapytechnique has again been further refinedthrough the use of seed stranding at thetime of the procedure.Akron General is now using an ActiveBreathing Control (ABC) device to minimizerespiratory movement in selected patientsduring radiation therapy treatments. Thisis predominantly used in patients withlung cancer or left-sided breast cancers.The Department of Radiation Oncologycontinues to enter patients into NCIsponsoredinvestigational protocols as partof Akron General’s membership in multiplenational cooperative group studies.The Choice You Can Believe In. 8

Physician Office Building224 W. Exchange St., Akron, OH 44302330-344-HOPE (4673)www.akrongeneral.org